Evaluation of five methods to identify composite restorations in human teeth on a forensic purpose-an ex vivo comparative study.

The use of tooth-colored composite resin materials in dentistry is increasing. As composite restorations appear similar to the natural tooth structure, their detection is becoming more challenging. The aim of this study was to compare five diagnostic methods for detection of dental restorations and to create reliable postmortem dental records for forensic purposes. A conventional examination method without a direct light source (CONV), with a dental loupe light (DL), Galilean loupes with a direct light source (GDL), a fluorescence-inducing device (FIT), and intraoral radiographs (RX) were compared. Dentists specializing in conservative dentistry or oral surgery and dentistry students participated. Regarding sensitivity, specificity, positive predictive value, and negative predictive value, FIT and RX showed significantly higher results than CONV, DL, and GDL. RX and FIT showed comparable results in identifying composite restorations but depending on their location. The combination of both methods may lead to even better results. In conclusion fluorescence-inducing devices show good results in identifying composite restorations and therefore should be considered as a standard tool in forensic examinations. Another advantage is their small size, low cost, and mobility. Good illumination and magnification devices are recommended to enhance performance during conventional examinations. Involving dentists specialized in conservative dentistry could contribute to dental identification.