Marking of Aadhar number on surgical plate for forensic identification

Dental identification is the most reliable and frequently applied method of human identification, primarily by comparing ante-mortem and post-mortem records. Therefore, all types of dental care should be recorded and kept properly. Aadhaar is a 12-digit individual identification number issued by the Unique Identification Authority of India on behalf of the Government of India to all residents of India. Marking an Aadhar number on a surgical plate can play an important role in forensic identification when other methods fail. In the case presented here, given the importance of the medico-legal records, the patient’s surgical plates were labeled with the Aadhar number using a laser. A small effort on the part of all dental practitioners to obtain surgical plates marked with patient details can aid in quick identification should the need arise in the future.

Introduction

The identification of an individual is not only important for legal and administrative purposes, but also for humanitarian reasons. [1]. Correct identification is based on comparing known characteristics of a person with characteristics retrieved from an unknown body. Identification of the deceased by the family member or close acquittal is the usual method, but this may not be possible in the event of a traumatic and destructive disaster. Fingerprints are commonly used for identification in such cases, but in cases where they cannot be used, dental records could be helpful. During the process of reconstructive identification, all medical and dental records collected from an unknown victim are more reliable than circumstantial evidence. Records of routine dental treatment such as restorations, orthodontic treatments, implants, surgical plate models and x-rays, if properly kept, provide a very good record [2]. Identification code having patient details inserted into dentures, implants, removable and fixed orthodontic appliances as well as surgical plates helps in quick identification and brings the case to closure [3-5]. Denture labeling is recommended by most dental associations and forensic odontologists worldwide [6,7].

Although several previous studies have explored the labeling of removable prostheses, none have focused on the labeling of surgical plates. Surgical plates and screws are used in the treatment of mandibular and maxillary fractures to provide rigid internal fixation and a functionally stable fracture site. Labeling surgical plates with identification codes using lasers will help in quick identification of the deceased person. Aadhaar is a 12-digit individual identification number in India, issued by the Unique Identification Authority of India on behalf of the Government of India. This article describes a case report of a patient with a fracture of the mandible symphysis, treated by open reduction and rigid internal fixation with surgical plates labeled with his Aadhar number.

Presentation of the case

A 21-year-old patient presented to the oral and maxillofacial surgery department with a fracture of the mandibular symphysis caused by an accident. The orthopantomogram confirmed the presence of the symphysis fracture (Figure 1).

The surgical plates were laser marked with the patient’s Aadhar number (Figure 2).

The treatment consisted of maxillomandibular fixation by open reduction. Under local anesthesia, eyelet wire fixation and bridal wire fixation were performed to obtain teeth in good occlusion. An intraoral vestibular incision was made from canine to canine and a mucoperiosteal flap was retracted to expose the fracture site (Figure 3).

After that, a rigid internal fixation under stable occlusion with a 2.5 mm four-hole stainless steel plate in the lower edge of the mandible was performed. After that, a 2.5 mm two-hole stainless steel plate with screws was placed on top of the four-hole plate (Figure 4).

The flaps were repositioned and sutured to achieve closure. The patient was prescribed medication and was followed up after three days and after one week.

Discussion

Deceased persons who are severely decomposed, skeletonized, or cremated present a challenge for identification. Dental remains have played an important role in forensic identification when other diagnostic findings such as visual impressions or fingerprints have been destroyed beyond recognition. [8,9]. Dental remains as dense inorganic dental structures can withstand high temperatures during fire, explosion and collision with other body tissues and organs [10-13]. Dental surgical plates used in the treatment of fractures can play an important role in forensic identification.

The physical properties of stainless steel such as high melting point and corrosion resistance provide a good track record in forensic cases. Extreme temperatures can cause the pulp tissue to evaporate, causing the tooth to crack and break. Although restorative materials like amalgam and composite deteriorate at high temperatures, stainless steel can withstand temperatures up to 1100°C, thus withstanding high thermal stress. [14].

The digital revolution of laser printing allows fine marking of a few microns on the surface of surgical plates. Lasers were used to label cobalt-chrome prostheses as well as full prostheses [15,16]. Shreya et al. describes a technique where a rapid response code was marked with lasers on a stainless steel plate and then inserted into the prosthesis [16]. Not all surgical plates bear the manufacturer’s code and name. Considering the importance of identification for forensic reasons, the surgical plate in the present case was labeled with the patient’s Aadhar number by a laser sintering machine.

An Aadhaar number is a unique, easily verifiable 12-digit identification number that contains all patient information such as iris scan, fingerprints, age and address. It is issued by the Unique Identification Authority of India to all residents of India. Priya et al. describes a technique for using the Aadhar barcode as an identification mark to be inserted into the prosthesis [17].

The Aadhaar card number is easily scannable by a smartphone and will give full authenticated information about the individual in a very concise form. Most countries have a unique identification number for their citizens, which has been used for marking dentures. In India, marking of surgical plate with Aadhaar card number will serve the purpose. In this case, the patient’s Aadhar number will help in quick identification if all other methods fail.

conclusion

Forensic dental identification has played a very important role in both natural and man-made disasters. Good quality dental records are an essential part of a medical-legal requirement and are important for dental identification. The patient reported a mandibular symphysis fracture. Considering the importance of medico-legal records, the patient’s surgical plate was labeled with his Aadhar number. Aadhar number is a unique identification number provided to all citizens of India. This simple marking will help in quick identification should the need arise in the future.

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