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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 17  |  Issue : 4  |  Page : 920-924

Evaluating the efficacy of innovative coding system for ceramic restorations


1 Department of Prosthodontics and Crown and Bridge, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed University), Wardha, Maharashtra, India
2 Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed University), Wardha, Maharashtra, India
3 Department of Prosthodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed University), Wardha, Maharashtra, India

Date of Submission17-May-2022
Date of Decision01-Nov-2022
Date of Acceptance03-Nov-2022
Date of Web Publication10-Feb-2023

Correspondence Address:
Dr. Seema Sathe Kambala
Department of Prosthodontics and Crown and Bridge, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed University), Wardha, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdmimsu.jdmimsu_211_22

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  Abstract 


Background: Forensic odontology has evolved with the evolution of mankind. Since ages it has been of our interest to identify the dead. Because of events beyond our control many human beings may not die a natural death or in familiar surroundings. The task of identifying these individuals is of paramount importance in forensic odontology. Method: A Quick response code of minimum dimension was customized and incorporated into e max lithium disilicate restorations. Restorations are fabricated in such a way that it can scanned using mobile software and displays aadhar number of patient, which ultimately helps in forensic identification. Result: This coded prosthesis helps in the identification of individuals. Conclusion: Code used in present study was readable in most of the ceramic restorations and maintains its sustainability in all the conditions under which it was tested.

Keywords: Ceramics, coding, forensic identification, forensic odontology, quick response code


How to cite this article:
Kambala SS, Godbole S, Borle AB, Dhamande MM, Kambala R, Jaiswal T. Evaluating the efficacy of innovative coding system for ceramic restorations. J Datta Meghe Inst Med Sci Univ 2022;17:920-4

How to cite this URL:
Kambala SS, Godbole S, Borle AB, Dhamande MM, Kambala R, Jaiswal T. Evaluating the efficacy of innovative coding system for ceramic restorations. J Datta Meghe Inst Med Sci Univ [serial online] 2022 [cited 2023 Apr 1];17:920-4. Available from: http://www.journaldmims.com/text.asp?2022/17/4/920/369485




  Introduction Top


Forensic odontology has evolved with the evolution of mankind. Its history dates back to the Eden garden of Adam and Eve. It is said that the history of bite marks is attributed to the consumption of forbidden fruit in the Garden of Eden. Earlier attempts for coding the prosthesis have focused on removable dentures, but the marking methods have either spoiled the denture esthetics or have led to increasing the weight of the denture. The fragile nature and flammable character of dentures have rendered them unsuitable for the marking system.[1]

The British Council on Prosthetic Services and Dental Laboratory Relations have provided some standards for denture marking.[2]

With the limitations of coding system for fixed partial dentures due to cost or unesthetic appearance or compromise in strength of the restoration, there is a significant need for generating a more feasible coding system.

The aim of this study was to develop and evaluate the efficacy of coding system for ceramic restorations for the identification of individual in forensic dentistry. This is an experimental observational study. The sample size calculations were carried out on the basis of purposive sampling.


  Materials and Methods Top


This study focused on developing of the code to be used for ceramic restoration:

The present study was carried out after obtaining IEC approval letter with ref no.DMIMS (DU)/IEC/2017-18/6564, study comprised of 100 samples of e-max press lithium di silicate restorations. A quick response (QR) code (data matrix) of 3.75 mm dimension was generated 12 digits Aadhaar number was selected to be incorporated in the code. After the entry of the QR code in the software, it was then printed using specialized heat resistant paper. The QR (data matrix) code was incorporated just before the application of glaze the code after the glaze cycle of all ceramic e-max crowns could be read easily with scanner [Figure 1]. These codes can also be scanned using mobile phone camera and endotube scanner [Figure 2]. These softwares are available for free on the internet. On scanning the code, the screen displays the Aadhaar number. The site for Aadhaar is to be accessed through the Internet via uidai.goverment.in.
Figure 1: Scanning by mobile phone

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Figure 2: Scanning by endotube scanner

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Testing sustainability and retrievability of the quick response (data matrix) code

  • Out of 100 samples, 20 each were subjected to testing the sustainability and retrievability of the QR code
  • The various forensic simulation tests that were carried out to evaluate the sustainability of coding system included:[3]


  1. Immersion in conc. NaOH for 24 h 50% (alkali testing) [Figure 3]
  2. Immersion in conc. H2SO4 for 24 h 99% (acid testing) [Figure 4]
  3. Burial in soil for 3 months [Figure 5]
  4. Exposure to fire for 5 min [Figure 6]
  5. Immersion in cold water for 24 h [Figure 7].
Figure 3: Immersion in sodium hydroxide

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Figure 4: Immersion in sulfuric acid

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Figure 5: Burial in soil

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Figure 6: Exposure to fire

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Figure 7: Immersion in cold water

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Immersion in sodium hydroxide for 24 h

After checking the readability of the samples, they were immersed in a sodium hydroxide (50%). The alkali was poured in a beaker and care was taken to immerse the samples completely in the alkali.

After 24 h: The samples were removed from the alkali and washed in running water for a period of 10 min. The samples were then checked for retrievability of the exposed QR (data matrix) code.

Immersion in sulfuric acid for 24 h

A similar procedure for immersion was followed for acid testing. The concentration of sulfuric acid used was 99% after cleaning of the samples in running water for period of 10 min. They were checked for readability.

Burial in soil for 3 months

The coded samples were buried in soil in a pit of 1½ feet depth for a period of 3 months. The samples were retrieved after a period of 3 months. After thorough cleaning under water for a period of 10min, the samples were subjected to readability of QR (data matrix code).

Exposure to fire for 5 min

The coded samples were exposed to direct fire for a period of 5 min. The samples were held on fire with forceps for the indicated time. After the exposure, the samples were allowed to cool down and then cleaned with running water for a period of 10 min and tested for readability of exposed QR (data matrix) code.

Immersion in cold water for 24 h

The samples were immersed in cold water at 8° and kept in the refrigerator to maintain the temperature. After a period of 24 h, the retrieved samples were cleansed and checked for readability of exposed QR code.

After the exposure of the samples to various conditions, all samples were evaluated to analyze the sustainability and retrievability of coding system.

Results and Observation

The collected data were entered in Excel chart and rendered for statistical analysis. Descriptive statistics were carried out. The data are represented in number and percentages [Graph 1] and [Table 1].

Table 1: Analysis of sample immersed in NaOH for 24 h, H2SO4 for 24 h, buried in soil for 3 months, exposed to fire for 5 min and immersed in cold water

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Statistical Analysis

SPSS (Statistical Package for the Social Sciences) software version 24.0 (IBM Corporation, Chicago, IL, USA) was used.

The samples were immersed in NaOH for 24 h, H2SO4 for 24 h, buried in soil for 3 months, exposed to fire for 5 min and immersed in cold water for 24 h. Each sample was later checked for readability.

When the samples were immersed in NaOH for 24 h, it was found that 19 (95%) of the samples were readable while only 1 (5%) sample was not readable.

When the samples were immersed in H2SO4 for 24 h and checked for readability. The analysis showed that 18 (90%) of the sample were readable while only 2 (10%) sample was not readable.

The samples were buried in soil for 3 months and checked for readability. It was found that all 20 (100%) samples were readable.

After the samples were exposed to fire for 5 min, 16 (80%) of the sample were readable while 4 (20%) samples was not readable.

The samples were immersed in cold water for 24 h and checked for readability. It was found that all 20 (100%) samples were readable after immersion in cold water for 24 h.


  Discussion Top


Various techniques of labeling including inclusion and surface techniques were described in the literature over the years. Each technique has its own merits and demerits. Surface markings are considered as inexpensive ways of coding, but they wear off easily. Inclusion methods are relatively more permanent and provide a positive result, but the amount of data that can be written on them is limited and requires a well-trained laboratory personnel.[3]

Selection of the site for coding

In the all ceramic or porcelain crowns or bridges, engraving method for coding is not possible due to brittleness of porcelain. It would either compromise the strength or esthetics. Therefore, the coding for all ceramic e-max crowns with digital coding system was preferred.

The patient opting for the e-max crowns is esthetic conscious. Hence, coding in such cases is desired to be carried out in areas which are not easily visible. Hence, the site selected for coding in our study was on the palatal or lingual aspects of the restorations. Similar site was selected by Akbaba in 2018 in which they labeled the lingual aspect of metal restoration using laser.[4]

Criteria for the selection of coding system

Currently, there are multiple coding systems available of which bar codes and QR codes are the types of codes using the recent technology.

Barcode is a graphic depiction in the forms of bar and spaces of data on a surface. These bars and spaces have different widths and contains numbers, characters, and symbols in the form of dot, colon, and others. Barcodes are in the form of rectangles which consist of thin or thick lines parallel to each other. Scanners or cameras are usually required to read the barcodes.[5] Numerous studies have reported of using the barcode in their complete denture cases.[6],[7] The QR code can help track and store information about individuals and form a useful aid in medico-legal aspects and forensic odontology. One of the most important advantage is of accuracy of the information that this digital system offers in comparison to the entry done manually. Human errors can occur while carrying out the manual tracking, but the QR codes are considered to be very accurate. The speed of the system allows tracking to be done quickly. They are cost effective and a reliable method of entering and storing data.[8]

QR code have also been used in a case report Varmudy et al.[8] and also in a study carried out by Poovannan et al.[7] in an article by Sheriff et al. Multiple advantages have been quoted for using the two-dimensional matrix code.[9]

Criteria for development of code

Data matrix code used in the study has the additional benefit of being readable even after distortion up to 30% and does not require the contrast as critically as in bar code scanning.[10]

In a study reported by Dineshshankar et al., it was quoted that to be readable the size of the bar code should be at least 12 mm.[11] However, the code developed in the study has the advantage of being small as well as readable. The smallest code that was used for the identification of complete denture prosthesis was by Mahoorkar and Jain of size 6 mm.[12]

Criteria for selection of Aadhaar card number for identification

In the present study, as content for incorporation in QR (data matrix) code, we proceeded with the use of 12 digit Aadhaar card number issued by Unique Identification Authority of India as an identification code. This Aadhaar number is unique for every citizen and can be used to identify the residents anywhere in the country. Similar use of Aadhaar card was done in a study carried out by Pathak et al. The main characteristics of Aadhaar card which are quoted in the study includes: Permanency, uniqueness, and global. It provides a national platform for Id authentication.[13] Similarly, the use of Aadhaar card number was done in a study by Sikka et al., in which they labeled the complete denture using Aadhaar number by incorporating it in QR code.[14]

In criminal cases, the offender may deliberately use methods to prevent the identification of victim using corrosive agents to destroy the body. Destroying the body by immersing it in acid or some caustic substances is receiving considerable interest from forensic scientists. Human teeth could be exposed to various corrosive chemicals in many scenarios such as forensic cases, industrial chemical spills at work, and for engraving.[15]

Hence, by reviewing the aspects of previous literature, this study was planned to perform an experiment on coded ceramic prosthesis by immersing it in alkali solution like NaOH and acidic solution like H2SO4, after which it was checked for its readability to recognize its utility for forensic purposes. A total of 40 samples were selected, out of which 20 were immersed in NaOH for 24 h and 20 were immersed in H2SO4 acid for 24 h. Similar time period exposure was done in a study carried out by Phulari et al. for the immersion of samples of acrylics with labels.[16]

Similar assault on various denture labels was carried out by Richmond and Pretty.[17] They used sulfuric acid and sodium hydroxide to expose the various denture labels to simulate the assault. Comparable results were obtained in a study carried out by Poovannan et al. in which all the samples with the QR code embedded in acrylic block were readable after being exposed to sulfuric acid and sodium hydroxide.[7]


  Conclusion Top


The QR (data matrix) code used in the present study can be used for coding of ceramic prosthesis. This is the smallest QR code of size 3.75 mm.

The code was reliable since almost all the samples were readable when scanned with scanner.

Informed consent

Informed consent was obtained for incorporation of the AADHAR number of the volunteer for the study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Alexander PM, Taylor JA, Szuster FS, Brown KA. An assessment of attitudes to, and extent of, the practice of denture marking in South Australia. Aust Dent J 1998;43:337-41.  Back to cited text no. 1
    
2.
Stavrianos CH, Petalotis N, Metska M, Stavrianou I, Papadopoulos CH. The value of identification marking on dentures. Balk J Stomatol 2007;11:212-6.  Back to cited text no. 2
    
3.
Bhathal MK, Garg S. Role of Denture Marking in Human identification-A Clinical Review. IP Annals of Prosthodontics and Restorative Dentistry. 2016;1:26-31.  Back to cited text no. 3
    
4.
Akbaba H, Zortuk M, Albayrak H. Implementation of a prosthetic labelling process in implant-supported fixed prosthesis and comparison of two different methods: An in vitro study. Egypt J Forensic Sci 2018;8:71.  Back to cited text no. 4
    
5.
Sathe S, Godbole S, Shrivastav S, Rajanikanth K, Bhoyar A, Dhamande M. A novel code for coding of ceramic prosthesis. Journal of Datta Meghe Institute of Medical Sciences University. 2021;16:363.  Back to cited text no. 5
    
6.
Acharya AB, Anehosur GV, Kanchi PP, Naik MG, Nadiger RK. Perceptions and preferences on denture marking in an Indian sample. Gerodontology 2012;29:117-24.  Back to cited text no. 6
    
7.
Poovannan S, Jain AR, Krishnan CJ, Chandran CR. An in vitro evaluation of the reliability of QR code denture labeling technique. J Forensic Dent Sci 2016;8:179.  Back to cited text no. 7
[PUBMED]  [Full text]  
8.
VVarmudy N, Regish KM, Rupesh PL. Personal identification using QR Code incorporated in dentures. Archives of Oral Research. 2013;9.  Back to cited text no. 8
    
9.
Sheriff AH, Dhanraj D, Nittla DP. Denture marking systems – A systematic review. Int J Curr Res 2017;9:5.  Back to cited text no. 9
    
10.
Vashisht D. Role of lasers in forensic prosthodontics – A review. J Res Med Dent Sci 2020;8:3.  Back to cited text no. 10
    
11.
Dineshshankar J, Venkateshwaran R, Vidhya J, Anuradha R, Mary GP, Pradeep R, et al. Denture bar-coding: An innovative technique in forensic dentistry. J Pharm Bioallied Sci 2015;7:S350-3.  Back to cited text no. 11
    
12.
Mahoorkar S, Jain A. Denture identification using unique identification authority of India barcode. J Forensic Dent Sci 2013;5:60-3.  Back to cited text no. 12
[PUBMED]  [Full text]  
13.
Pathak C, Pawah S, Sikri A, Rao I. Unique denture identification system for all Indian nationals. Contemp Clin Dent 2018;9:S185-8.  Back to cited text no. 13
    
14.
Sikka N, Saxena S, Priya K, Suthar V. Momentousness of denture labeling using Aadhaar number in Indian population. J Family Med Prim Care 2019;8:2760-2.  Back to cited text no. 14
[PUBMED]  [Full text]  
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Al-Owaidi MR, Al-Terehi MN, Al-Saadi AH, Zibara K. Forensic STR Identification of Human Teeth Samples Exposed to Various Acidic and Alkaline Chemical Conditions in the Iraqi Population. Systematic Reviews in Pharmacy. 2020;11:352-9.  Back to cited text no. 15
    
16.
Phulari RG, Rathore R, Jariwala P. Importance of denture marking for human identification in forensic odontology. J Clin Diagn Res 2014;8:IL01.  Back to cited text no. 16
    
17.
Richmond R, Pretty IA. A range of postmortem assault experiments conducted on a variety of denture labels used for the purpose of identification of edentulous individuals. J Forensic Sci 2009;54:411-4.  Back to cited text no. 17
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7]
 
 
    Tables

  [Table 1]



 

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