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 Table of Contents  
CASE REPORT
Year : 2018  |  Volume : 1  |  Issue : 2  |  Page : 41-43

A bitemark on ear


Department of Oral Medicine and Radiology, H.P. Govt. Dental College Shimla, Himachal Pradesh, India

Date of Web Publication19-Feb-2019

Correspondence Address:
Prof. Neeta Sharma
Department of Oral Medicine and Radiology, H.P. Govt. Dental College Shimla, Himachal Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sjfms.sjfms_15_18

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  Abstract 


Bitemarks are the tool marks left by the action of teeth and other oral structure during biting of the objects and people. Bitemarks can occur on both victims and the assailants. It has an important role in the identification of suspect, especially in cases of interpersonal fights, sexual assault, and child abuse. The key for successful bitemark analysis is the proper and timely collection of bitemark evidence following the standardized guidelines as bitemarks heal and fade with time. The consequence of improper forensic dental evidence collection leads to miscarriage of justice. Here, we present and discuss a case where medical intervention before collection of the bitemark evidence on the ear resulted in the failure of delivery of appropriate bitemark analysis and justice to the victim.

Keywords: Bitemark, ear, forensic dental evidence, forensic odontology


How to cite this article:
Sharma N. A bitemark on ear. Saudi J Forensic Med Sci 2018;1:41-3

How to cite this URL:
Sharma N. A bitemark on ear. Saudi J Forensic Med Sci [serial online] 2018 [cited 2019 Mar 23];1:41-3. Available from: http://www.sjfms.org/text.asp?2018/1/2/41/252535


  Introduction Top


A bitemark has been defined by MacDonald as “a mark made by teeth, either alone or in combination with other mouth parts.”[1] The first bitemark investigation to be reported in the literature was in 1874.[2] The uniqueness of human dentition is the base for the forensic bitemark analysis.[3] Bitemarks may be found on almost any part of the body. In females, the most common areas are the breast and inner part of thighs, usually the result of sexual assault; males are often bitten on the arms and shoulders which are usually the result of violent fights. Sometimes, the victim may bite the assailant in defense. The bitemark can be self-inflicted either deliberately or involuntarily by the assailant to stifle the cry.[4] Most commonly, bitemarks appear as bruise or contusion due to the rupture of subcutaneous vessels under pressure. Bitemark analysis is the detection, recognition, description, and comparison of bitemarks that occur on living and inanimate objects caused by humans and nonhumans. The bitemark comparison is made up of two broad categories – (1) Metric analysis and (2) Pattern association. Bitemark analysis presupposes that there is a biting event that causes the injury and that the effects can be carefully recorded for comparison to the teeth causing disruption. A human bitemark may be identified by its gross characteristics, class characteristics, and individual characteristics.[5] Here, we present a case of bite injury on the ear, in which proper evidence collection was not done, which led to incompetence of methods of comparing exemplars of bitemarks.


  Case Report Top


In this case, a bitemark injury on the ear was reported in an adult male. There was an alleged history of assault, and the victim was bit on the ear by the assailant. The victim along with police personnel was referred from Casualty department to our dental OPD for bitemark injury on the ear. However, before referring us, the victim was sent to otorhinolaryngology department for the first aid. There was bleeding present from the injury, and the wound was stitched there [Figure 1]. The proper procedure for the bitemark evidence collection was not followed. The orientation and close-up photographs with and without the ABFO no. 2 scale, impression, and the saliva swab of the bitemark were not taken before the first aid. The bitemark analysis was not possible after the medical intervention.
Figure 1: The ear was bitten by the assailant during interpersonal fight. Medical intervention (first aid and suturing) has destroyed any potential of forensic dental evidence

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Whenever a bitemark case is reported, the primary concern is patient care. However, timely collection of bitemark evidence is very much important to provide justice to the victim.


  Discussion Top


The uniqueness of the human dentition is the basic concept on which forensic bitemark analysis is based. In bitemark analysis, bitemarks collected from the victim's body or crime scene are matched with the incisal edges of the suspect's teeth.[6] However, if the proper and timely bitemark evidence is not collected, then it leads to failure of application of bitemark analysis. This case illustrates that lack of evidence is detrimental in providing justice to the victim. In the literature, various cases are reported where the lack of use of standardized protocol, appropriate training, and carefully considered opinions and conclusion resulted in loss of forensic dental evidence.[3],[7] Early recognition and action is necessary for collection of bitemark evidence, as bitemarks may quickly fade, both in living and in dead or healing may occur. It should be collected as the bite injury is first reported and before any medical intervention.

Protocol for collection of bitemark evidence

From victim

  1. Visual examination: It is the first step to examine the site when the victim gives a history of biting by the assailant. If the death has occurred, visual examination is done before autopsy
  2. Documentation: The appearance, color, shape, size, orientation, and location of the bitemark and type of injury; and contour and elasticity of the bitten site
  3. Photography: Two types of views are desirable – (1) orientation photography and (2) close-up photography with and without ABFO no. 2 scale placed in the same plane of the bitemark and devoid of perspective distortion. Both color and black-and-white prints are desirable. If upper and lower arch bitemark are in different planes, then separate photos should be taken
  4. Saliva swab for DNA and blood group matching: Double-swab technique: A cotton swab moistened with distilled water is used to collect saliva. About 0.3 ml saliva is deposited in the bitemark usually. A second dry swab is used to collect remaining moisture. Both swabs are air-dried at room temperature for at least 40 min and placed in a sterile container or paper envelope. A third control swab can be taken from the surrounding region of the bitemark. If the bite has occurred through clothing, the clothes must be sent for saliva swab test. DNA is not present in the liquid saliva, but it contains sloughed epithelial cells and glandular cells from the inner lining of the mouth
  5. Impression: Impression of the bitemark may be taken if a tooth indentation exists with light body elastomeric impression material. The impression can be stabilized with dowel, orthopedic mesh, dental compound, or dental plaster.


From suspect

  1. Clinical examination: Extraoral examinations include TMJ, facial symmetry, muscle tone, or any significant soft or hard tissue finding that influence the patient's mouth opening and closing or movement of the mandible. Maximum mouth opening, deviations, and occlusal disharmony should be recorded.


  2. Intraoral examination includes complete soft and hard tissue examination such as periodontal status; tongue size and function; injury in the oral region; tooth mobility; missing, prosthesis, attrition, and fracture of the teeth; supra- or infra-erupted teeth if any present should be recorded

  3. Photography: Full facial and profile intraoral photographs of the upper and lower arch and frontal and lateral view of the teeth in occlusion and in open bite should be recorded
  4. Impression: Elastomeric impression material is used to record the impression; alginate impression material can also be used in uncooperative individuals. Two sets of dental casts should be made, one for the record and the other one for the analysis. Photographs of the cast and impression should also be taken for future court reference
  5. Saliva swab: Saliva sample should be collected from the suspect with the help of sterile cotton swab rolled into the vestibule. If to be transported within few hours, transportation at room temperature is recommended; if submitted after 1 day, frozen storage (−20°C) and cold transportation is recommended
  6. DNA sample: The blood sample for DNA evaluation should be taken[8],[9],[10]

    The date, time, place, case number, and witnesses records should be properly maintained for the chain of custody.


All the case of suspected bitemarks should be referred to forensic odontologist expert for proper collection of evidences and analysis prior any medical intervention. This case illustrates that lack of evidence is detrimental in providing justice to the victim and thus violates his/her human rights.[11]


  Conclusion Top


The interpretation and analysis of a bitemark is a highly specialized skill belonging to forensic odontology expert. The training and making awareness among the paramedical and medical emergency staff and police personnel can result in efficient collection of forensic dental evidences. The analysis of bitemark evidence can assist the justice system to provide justice to the victims and can be invaluable in the resolution of heinous interpersonal crimes.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
MacDonald DG. Bite mark recognition and interpretation. J Forensic Sci Soc 1974;14:229-33.  Back to cited text no. 1
    
2.
Rothwell BR. Bite marks in forensic dentistry: A review of legal, scientific issues. J Am Dent Assoc 1995;126:223-32.  Back to cited text no. 2
    
3.
Franco A, Willems G, Souza P, Coucke W, Thevissen P. Uniqueness of the anterior dentition three-dimensionally assessed for forensic bitemark analysis. J Forensic Leg Med 2017;46:58-65.  Back to cited text no. 3
    
4.
Sweet D, Pretty IA. A look at forensic dentistry – Part 2: Teeth as weapons of violence – Identification of bitemark perpetrators. Br Dent J 2001;190:415-8.  Back to cited text no. 4
    
5.
Pretty IA, Sweet D. A paradigm shift in the analysis of bitemarks. Forensic Sci Int 2010;201:38-44.  Back to cited text no. 5
    
6.
Hinchliffe J. Forensic odontology, part 4. Human bite marks. Br Dent J 2011;210:363-8.  Back to cited text no. 6
    
7.
Stavrianos C, Vasilidias L, Papadopoulos C, Kokkas A, Tatsis D, Samara E. Loss of the ear cartilage from a human bite. Res J Med Sci 2011;5:20-4.  Back to cited text no. 7
    
8.
American Board of Forensic Odontology. Bitemark Methodology Standards and Guidelines. Colorado Springs: American Board of Forensic Odontology; 2016.  Back to cited text no. 8
    
9.
Sweet D, Lorente M, Lorente JA, Valenzuela A, Villanueva E. An improved method to recover saliva from human skin: The double swab technique. J Forensic Sci 1997;42:320-2.  Back to cited text no. 9
    
10.
Kenna J, Smyth M, McKenna L, Dockery C, McDermott SD. The recovery and persistence of salivary DNA on human skin. J Forensic Sci 2011;56:170-5.  Back to cited text no. 10
    
11.
Forrest A, Soon A. Bite marks. In: Taylor J, Keiser JA, editors. Forensic Odontology: Principles and Practice. UK: Willey Blackwell; 2016. p. 228-85.  Back to cited text no. 11
    


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