# Assessment of evidence from teeth and the alveolar bone of skulls

## TL;DR

This study examines changes in alveolar bone and tooth substance in skulls to improve forensic dentistry practices.

## Contribution

The study provides a detailed assessment of alveolar bone and tooth changes in a standardized skull collection.

## Key findings

- Most missing teeth were lost before death, with enamel-dentine trauma being the most common dental injury.
- Dehiscence was the most prevalent pathology in trabecular bone, followed by fenestration.
- Blunt force trauma affected tooth insertion in two cases, highlighting challenges in determining perimortem events.

## Abstract

A notable lack of agreement on a standardised criterion for representing changes in alveolar bone persists, which limits its application in forensic dentistry. This study aimed to describe the data on loss of tooth substance and alveolar bone in skulls. Dental and trabecular bone information from 28 skulls from the German Helmer skull collection was collected through dental charting, intraoral photographs taken with a DSLR camera (Nikon D5600, Nikon Corporation, Japan), and small radiographs obtained using a handheld dental X-ray device (Nomad Pro 2, Kavo Kerr, Biberach, Germany). Adobe Photoshop 26.4.1 was used to create diagrammatic representations of alveolar socket changes following tooth loss. Blunt force skull trauma affected tooth insertion in two cases. Most of the dental trauma involved enamel-dentine (n = 48; 74%), and untreated decay was relatively low (n = 14). Most missing teeth were lost antemortem (n = 283; 87%). Dehiscence was the most prevalent pathology seen in the trabecular bone (n = 26), followed by fenestration (n = 14). While fracture propagation patterns and tissue changes provide preliminary diagnostic criteria for assessing the timing of tooth or bone fracture, the assessment of events perimortem continues to challenge. The summary of alveolar socket changes could be of assistance in legal reports and teaching.