The need for a complete dental autopsy of unidentified edentulous human remains

In December 2017, a decomposed unidentified body was found near the river Tronto in Teramo, Italy. The corpse was found without any identifying documents or specific personal belongings, except for a packet of cigarettes. The medical examiner determined a gastric perforation from the intake of hydrochloric acid to be the cause of death. A jar of muriatic acid found near the body led to suicide being considered the manner of death. The Penal Court in Teramo appointed two forensic odontologists to complete the postmortem assessment and collect dental data for personal identification. The corpse was found wearing a complete set of upper and lower dentures. The dental autopsy and 42 periapical X-ray images helped generate a biological profile of a man totally edentulous with upper and lower dentures, as well as an osteosynthesis with two plates and screws in the left ascending ramus of the mandible. In March 2018, the sister of a missing person reported the disappearance of her brother, and a presumptive identification was performed through visual recognition of the decomposed body. The sister confirmed the presence of two dentures and the location of the maxillo-facial surgery for the treatment of the fractured mandible. A complete dental autopsy was able to establish his identity without any DNA comparison needed. This case highlights the importance of performing a complete dental autopsy inclusive of dental radiographs, and its value in the identification of all unknown human remains even when totally edentulous. A complete dental autopsy should be performed in all cases of human identification. KEYPOINTS: Despite a corpse being edentulous, a complete dental autopsy can still be useful. Dental radiographs, such as bitewings, periapical images, panoramic radiographs, and CT scans, are recommended in all identification autopsies.