Virdentopsy | Third Eye in Covid-19 Pandemic

BY SIFS India | March 15, 2023

Virdentopsy | Third Eye in Covid-19 Pandemic

Forensic is a challenging and outstanding branch in the medical field. It is a deadly combination of science and technology which plays a substantial role in personal identification and solving medico-legal cases.

It encompasses the identification of deceased individuals by evaluating the ante‑ and postmortem records for which the presence of forensic experts is of paramount importance.

Dental autopsy requires the collection, documentation and evaluation of all the dental and radiological evidence of teeth and jaws and facial reconstruction by forensic odontologists which is required for victim identification.

The data collection and its interpretation necessitate the involvement of skilled and knowledgeable forensic odontologists with expertise in disaster victim identification (DVI).

The COVID-19 era has been the toughest time worldwide for every individual.2

It was challenging for medical health workers. Furthermore, owing to its higher transmission rate, it was declared a pandemic by WHO.

However, dealing of human remains of unknown medical history during this troublesome condition was alarming.

But, the probable solution to this life-threatening condition was the introduction of teledentistry in forensic odontology for remote consultations of dental autopsies.

The project termed ‘virdentopsy’ was inculcated in 2020, during the COVID-19 pandemic, which included the complete data collection from teeth and jaws of human remains and then transfers it to forensic odontologists remotely for a professional opinion to accomplish a defined profile of the unidentified human remains.

This article gives an insightful overview of this launched the innovative project.


Review of Litrature

Forensic odontology has enrolled many sharp innovations for personal identification which comprises virtopsy as a recent technology.

Virtopsy is an alternative to conventional autopsy which is a transdisciplinary, noninvasive diagnostic technology utilizing the whole-body volume documentation using CT, MRI, and radiology in combination with a 3D body documentation using photogrammetry and optical scanning.

The main advantage of it is that the collected data can be stored digitally for decades and can be used in telemedicine whenever required.

The post-mortem dental biography is paramount to narrow the search for compatible missing persons but requires knowledge and experience of forensic odontologists.

In case, if forensic odontologists are not accessible at the site, then the post-mortem dental data should be compiled by the available dentists and forwarded it to the forensic odontologists via tele-communication.

Henceforth, in 2020, owing to massive risk of infection throughout the duration of COVID-19 pandemic, a research project ‘virdentopsy’ was commenced by the Human Identification Laboratory and the medico-legal section of the University of Turin.

The term VIRDENTOPSY has been derived from two main terminologies as “virtual”+ “dental autopsy”= virdentopsy.

It is certified with an authentic webpage for telecommunication regarding the evaluation of post-mortem dental data specialty for slaughtered cases.

The current spectacular project was based on the fact that a comprehensive dental autopsy should be performed even when forensic odontologists are not available for the challenging cases.

Furthermore, the telecommunication has solved this mystery as meanwhile forensic pathologists can execute the autopsy exclusively without the consultation of forensic odontologists.

The current project consolidate the branches of pathology, odontology, anthropology, and archeology under one canopy.

Virdentopsy is a methodical compilation of post-mortem dental data accomplished by various specialists as forensic pathologists, non forensic odontologist, dental hygienists with a forensic background, or other forensic operators authorized in the mortuary.

These available specialists on behalf of forensic odontologists firstly execute the collection of postmortem dental data subsequently followed by its transmission to human identification laboratory, where experienced forensic odontologists assess the collected data and give their expert comments for the same.


Situations in Which Virdentopsy is Required

- Non availability of Forensic odontologists physically at the onsite area.

- Forensic odontologists are not affordable

- Second expertize opinion could amplify more precisely on the concerned case with a more confirmatory analysis by reducing unfairness.

- Necessity of less number of experts in an autopsy room for the post-mortem

- Data collection henceforth diminishes the infectious hazards such as those challenged throughout the COVID-19 pandemic.

- Source of Educational tool by utilizing the advanced technology of virtual reality and augmented reality.


Virtual Dental Autopsy Procedure




Virtopsy versus Virdentopsy 

Virtopsy: It is a compilation of dental data and then comparing the ante-mortem and post-mortem by utilizing the radiographing imaging such as orthopantomogram, multisliced computed tomography, magnetic resonance imaging.

Virdentopsy: It not only involves the application of virtopsy, but also on 2D and 3D video, photos, and photogrammetry documentation.

 


Virdentopsy Advantages

- It reduces the consultancy expenses as it does not necessitates the presence of forensic odontologists.

- It reduces the time for the process of identification technically.

- It gives esteem and respect throughout the whole assemblage and assessment of all dental evidence of forensic human identification procedures.

- It enhances the routine evaluation of human identification.

- Owing to the availability of this innovative tool in smartphones nowadays it is immediately applicable.


Virdentopsy Disadvantages

- Unable to determine internal tissue changes.

- As it is digitized, the determination by senses such as touch, smell, and seeing natural color cannot be done.


Conclusion

Virdentopsy is a newer approach towards dead and humanitarian forensic odontology specially in COVID-19 era worldwide.

The current project not only optimizes the identification process in the field of forensic by utilizing the digital means on an unavailability of forensic odontologists at the working place and can take expert opinions by experienced odontologists remotely but also may be the source of education for the young generations.


References

1. Nuzzolese, E.; Di Vella, G. Future project concerning mass disaster management: forensic odontology prospectus. Int. Dent. J.2007, 57, 261–266.

2. Nuzzolese, E.; Pandey, H.; Lupariello, F. Dental autopsy recommendations in SARS- CoV-2 infected cases. Forensic Sci. Int. Synerg.2020, 2, 154–156.

3. Jampani, N.D.; Nutalapati, R.; Dontula, B.; Boyaoati, R. Applications of teledentistry: A Literature review and update. J. Int. Soc.Prev. Communit. Dent. 2011, 1, 37–44.

4. Thali, M.J.; Yen, K.; Schweitzer, W.; Vock, P.; Boesch, C.; Ozdoba, C.; Schroth, G.; Ith, M.; Sonnenschein, M.; Doernhoefer, T.; et al.Virtopsy, a new imaging horizon in forensic pathology: Virtual autopsy by postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI)—A feasibility study. J. Forensic Sci. 2003, 48, 386– 403.

5. Thali, M.J.; Jackowski, C.; Oesterhelweg, L.; Ross, S.G.; Dirnhofer, R. VIRTOPSY—The Swiss virtual autopsy approach. Leg. Med.2007, 9, 100–104.

6. Perju-Dumbravã, D.; Aniþan, S.; Siserman, C.; Fulga, I.; Opincaru, I. Virtopsy—An alternative to the conventional autopsy. Rom.J. Leg. Med. 2010, 1, 75–78.

7. Song, X.; Liu, X.; Wang, C. The role of telemedicine during the COVID-19 epidemic in China-experience from Shandong province.Crit. Care 2020, 24, 178.

8. Franco, A.; Thevissen, P.; Coudyzer, W.; Develter, W.; Van de Voorde, W.; Oyen, R.; Vandermeulen, D.; Jacobs, R.; Willems, G.Feasibility and validation of virtual autopsy for dental identification using the Interpol dental codes. J. Forensic Leg. Med. 2013, 20,248– 254.

9. Emilio Nuzzolese, VIRDENTOPSY: Virtual Dental Autopsy and Remote Forensic Odontology Evaluation, Dent. J. 2021,9, 102.

10. Rutty, G.N.; Biggs, M.J.P.; Brough, A.; Morgan, B.; Webster, P.; Heathcote, A.; Dolan, J.; Robinson, C. Remote post-mortem radiology reporting in disaster victim identification: Experience gained in the 2017 Grenfell Tower disaster. Int. J. Leg. Med. 2020,134, 637– 643.

11.  Nuzzolese, E.; Lupariello, F.; Ricci, P. Human identification and human rights through humanitarian forensic odontology. Int. J. Forensic Odontol. 2020, 5, 38–42.

12. Yogish, P.; Yogish, A. Virtopsy: New phase in forensic odontology. Int. J. Dent. Health Sci. 2015, 2, 1548–1555.