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Establishing identity using cheiloscopy and palatoscopy Inês Morais Caldas, Teresa Magalhães & Américo Afonso Abel Salazar Biomedical Institute of Oporto University, Portugal With kind permission, ©2006 Abstract Establishing a person's identity can be a very difficult process. Dental, fingerprint and DNA comparisons are probably the most common techniques used in this context, allowing fast and secure identification processes. However, since they cannot always be used, sometimes it is necessary to apply different and less known techniques. In this paper, the authors describe two unusual techniques: cheiloscopy and palatoscopy. It is known that due to their special features, both lip grooves and palatal rugae can be used successfully in human identification. This paper reviews the techniques of cheiloscopy and palatoscopy, and describes the different classifications and their advantages and limitations. 1. Introduction In forensic identification, the mouth allows for a myriad of possibilities. Due to the distinctive features of teeth, dental identification is one of the most popular ways to positively identify somebody. In fact, teeth are known to have singular features and possess extraordinary resistance to extreme conditions [1], [2], [3], [4], [5], [6], [7], [8], [9], [10] and [11]. These properties enable fast and secure identification processes [2], [6], [7], [8], [9], [10], [11], [12], [13] and [14]. Nevertheless, in some particular circumstances, often related to a criminal investigation, there can be other data, which are important to the process of human identification. Some of those data result from soft oral and perioral tissues prints [2], [15] and [16]. In fact, lips, as well as the hard palate, are known to have features that can lead to a person's identification. The study of lip prints is known as cheiloscopy; the study of hard palate anatomy to establish someone's identity is called palatoscopy. 2. Cheiloscopy Cheiloscopy, (from the Greek words cheilos, lips, e skopein, see [15]) is the name given to the lip print studies [14], [17], [18] and [19]. The importance of cheiloscopy is linked to the fact that lip prints are unique to one person, except in monozygotic twins [10], [14], [17], [20], [21] and [22]. Like fingerprints and palatal rugae, lip grooves are permanent and unchangeable [14], [15], [17] and [20]. It is possible to identify lip patterns as early as the sixth week of in uterine life [15]. From that moment on, lip groove patterns rarely change, resisting many afflictions, such as herpetic lesions. In fact, only those pathologies that damage the lip subtract like burns, seem to rule out cheiloscopic study [15]. 2.1. Historical review This biological feature was first described by Fisher in 1902 [17], however, it was only in 1930, that Diou de Lille developed some studies which led to lip print use in criminology [23]. In 1932, Edmond Locard, one of France's greatest criminologists, acknowledged the importance of cheiloscopy [23]. In 1950, Le Moyer Snyder, in his book "Homicide Investigation", mentioned the possibility of using lip prints in the matter of human identification [24]. Some time later, Santos, in 1960, suggested that the fissures and the criss-cross lines in the lips could be divided into different groups (simple and compound), and each group could be further divided into eight subtypes [25]. Renaud, in 1972, studied 4000 lip prints and confirmed the singularity of each one, supporting the idea of lip print singularity [26]. Two years later, Suzuki and Tsuchihashi developed another study which resulted in a new classification for lip prints. This study, made over a long period of time, enabled the authors to confirm not only lip print singularity, but also lip response to trauma; in fact, these authors observed that after healing, the lip pattern was equal to that before the injury occurred [21] and [27]. 2.2. Anatomical aspects Lips are two, highly sensitive mobile folds, composed of skin, muscle, glands and mucous membrane. They surround the oral orifice and form the anterior boundary of the oral cavity. Anatomically, whether covered with skin or mucosa, the surface that forms the oral sphincter is the lip area. There is an upper lip (from under the nose and extending laterally toward the cheek from the nasolabial sulcus) and a lower lip (bound inferiorly by a prominent groove, the labiomental sulcus); the two lips are joined at the corners of the mouth - the comissures - and separated by the buccal fend [23], [28] and [29]. There are two different kinds of lip covering-skin or mucosa. When the two meet, a white wavy line is formed - the labial cord - which is quite prominent in negroes. Where identification is concerned, the mucosal area holds the most interest. This area, also called Klein's zone [20], is covered with wrinkles and grooves that form a characteristic pattern-the lip print [17]. However, this is not the only area that deserves careful study. In fact, in cheiloscopy, one should also analyse lip anatomy, considering their thickness and the position. The lips can be horizontal, elevated or depressed [15] and [20] and, according to their thickness, it is possible to identify the following four groups: (1) thin lips (common in the European Caucasian); (2) medium lips (from 8 to 10 mm, are the most common type); (3) thick or very thick lips (usually having an inversion of the lip cord and are usually seen in negroes); (4) mix lips (usually seen in Orientals) [15], [20] and [30]. 2.3. Lip print classification 2.3.1. Martín Santos classification [25] This author divides the lip grooves into two groups: (1) simple, when they are formed only by one element; this element can be a straight line (R-1), a curve (C-2), an angular form (A-3) or sinusoidal (S-4); (2) compound, when they are formed by several elements; in this case, they can be bifurcated (B-5), trifurcated (T-6) or anomalous (An-7). 2.3.2. Suzuki and Tsuchihashi classification [27] These authors considered six different types of grooves, as seen in Table 1. Table 1. Suzuki and Tsuchihashi lip prints classification Classification Groove type Type I Complete vertical Type I' Incomplete vertical Type II Branched Type III Intersected Type IV Reticular pattern Type V Irregular 2.3.3. Renaud classification [26] This is, probably, the most complete classification. The lips are studied in halves (left and right), and every groove, according to its form, has a number (Table 2). A formula is then elaborated using capital letters to describe the upper lip left (L) and right (R) sides, and small letters to classify each groove; in the lower lip, it is done the other way around, using capital letters to classify the grooves, and small letters to separate left from right sides. Table 2. Renaud lip prints classification Classification Groove type A Complete vertical B Incomplete vertical C Complete bifurcated D Incomplete bifurcated E Compete branched F Incomplete branched G Reticular pattern H X or coma form I Horizontal J Others forms (ellipse, triangle) 2.3.4. Afchar-Bayat classification [31] This classification, dated from 1979, is based on a six-type groove organization, as seen in Table 3. Table 3. Afchar-Bayat lip prints classification Classification Groove type A1 Vertical and straight grooves, covering the whole lip A2 Like the former, but not covering the whole lip B1 Straight branched grooves B2 Angulated branched grooves C Converging grooves D Reticular pattern grooves E Other grooves 2.3.5. José Maria Dominguez classification [32] This is a classification based on the one made by Suzuki and Tsuchihashi. In the grooves classified as Type II of Suzuki and Tsuchihashi, the author and his co-workers observed, with some frequency, a slight variation: they observed that branched grooves often divided upwards in the upper lip, and downwards in the lower, as reported by Suzuki and Tsuchihashi; but they also realise that some grooves, the so called II' type branched the other way around. 2.4. Analysing and recording lip prints Searching for prints in a crime scene investigation can be very important in establishing the true nature of the facts [18], [33], [34], [35] and [36]. Lip prints can link a subject to a specific location if found on clothes or other objects, such as glasses, cups or even cigarettes' buts [34], [35] and [37]. Sometimes lip prints will be seen as lipstick smears [38]. Lipsticks are complex substances, which have in their constitution, several compounds, oils or waxes [34] and [38]. The colour of the lipsticks is due to organic inks and inorganic pigments [38]. However, all lip prints are important, even the ones that are not visible [34] and [39]. In fact, this complex process is not restricted to studying visible prints, but also the latent ones [34]. The vermillion border of the lips has minor salivary and sebaceous glands which, together with the moisturising done by the tongue, leads to the possibility of the existence of latent lip prints [33]. When searching for lip prints, one must always consider that not all lipstick smears are coloured; in fact, in recent years the cosmetic industry has been developing new lipsticks which do not leave a visible smear or mark when they come in contact with different items-these are called persistent lipsticks [40]. The identification of latent print evidence is often considered the key in solving a crime [41]. A group of Spanish investigators has studied these latent lip prints and concluded that they could be studied in a similar way to fingerprints, using similar techniques [19], [35], [37], [38], [39] and [40]. In fact, even when located on "difficult" surfaces (such as porous or multicoloured ones), latent prints can be easily seen using fluorescent dyes [34] and [39]. When dealing with lip prints from persistent lipsticks, one must always remember that persistent lipsticks have minimal oil content and therefore, their development using conventional powders might not be effective. Lysochromes should then be used since they have the ability to dye fatty acids and are very effective when used on long-lasting lipstick prints, even on porous surfaces [36]. In this manner, latent lip prints should always be considered when processing a crime scene, even if there are no traces of lipstick. Processing lip prints depends on the anatomical, morphological and histological tissue features of lips [20]. Observation should be the first step when processing lip prints [8], using white and ultraviolet light sources [15] and [42]. Photographs should be made prior to any processing in order to protect the evidence [42]. Photographing latent prints is a complex process that obeys a strict methodology. According to FBI guidelines [42], latent prints should be photographed individually with an identification label and a scale; each step in the processing sequence must be photographed. If lipstick is present, the lipstick itself should be analysed in order to determine its constitution. About 65% of lipsticks share the same ingredients, however some are different and this difference can provide the identification of the lipstick manufacturer [37]. Lip prints can be recorded in a number of ways. If located on a non-porous surface, lip prints can be photographed and enlarged [33]. Using transparent overlays, it is possible to make an overlay tracing [20] and [33]. In some circumstances, lip prints can be covered with substances allowing direct observation and photography [15] and [20]. As previously referred to, the development of lip prints can be made using several substances, such as aluminium powder, silver metallic powder, silver nitrate powder, plumb carbonate powder, fat black aniline dyer or cobalt oxide [14], [37] and [40]. All lip prints contain lipids which make their development possible by using lysochromes dyes (Sudan III, Oil Red O, Sudan Black) [34]. Sometimes, the use of fluorescent reagents is necessary [35], [37] and [39], especially when the colour of the developer and the colour of the surface on which the lip print lies are the same, or when the lip print is an old brand [34], [39] and [43]. Plumb carbonate is a white powder which can be used as a developer with a brush, over smooth, polished, metallic or plastic surfaces. Its only limitation is its use over white surfaces [34]. In such circumstances, marphil black powder or fat black aniline dyer are better choices since they both have a dark colour [34]. Silver nitrate can lead to positive results on non-ideal surfaces, such as untreated wood or cardboard [41] and [44]. DFO (1,8-Diazafluoren-9-one) and ninhydrin are chemical developers also used on porous surfaces [41] and [44]. On plastic or waxed surfaces, or on vinyl gloves, using cyanoacrylate dye is a good choice [41] and [44]. In photographs, latent prints can be developed using cyanoacrilate dye or an iodine spray reagent [41]. Lips may also be studied and recorded in order to allow a proper comparative analysis. Although lips can be photographed directly, covering them with lipstick allows better groove visualisation [20] and [33]. The lip prints should be recorded, making several recordings until all transfer mediums are exhausted. Then, prints are covered with transparent overlays and, when using a magnifying lens, a trace can be successfully done [33]. 2.5. Problems with cheiloscopy The lip print is produced by a substantially mobile portion of the lip. This fact alone explains the reason why the same person can produce different lip prints, according to the pressure, direction and method used in taking the print [33]. If lipstick is used, the amount can also affect the print. This problem however, can be solved if recordings are made until all of the substance is used [20] and [33]. Manual register of the overlay is another problem, due to the possibility of some subjectivity [33]. Another factor to be considered is the existence of some pathological conditions (lymphangiomas, congenital lip fistula, lip sclerodermia, Merkelson-Rosenthal syndrome, syphilis, lip cheilitis, among others), which can invalidate the cheiloscopic study [23]. One must also consider the possibility of post-mortem changes of lip prints from cadavers with various causes of death. Utsuno et al. [28] have studied these changes and concluded that a satisfactory identification rate was achieved. However, this study was carried out under a laboratory environment and what happens to lip prints obtained from cadavers exposed to the natural environment is still not known. It should also be pointed out that only in very limited circumstances, is there antemortem data referring to lip prints, which obviously impairs a comparative study where necroidentification is concerned. The main feature for dental identification is the existence of antemortem data [6], [12], [13], [45] and [46], which cannot be expected in cheiloscopy. Therefore, the only use of cheiloscopy will be to relate lip prints to the lips that produced them. 3. Palatoscopy Palatoscopy, or palatal rugoscopy, is the name given to the study of palatal rugae in order to establish a person's identity [2], [11], [22] and [47]. 3.1. Historical review It seems that Kuppler, in 1897, was the first person to study palatal anatomy to identify racial anatomic features [2]. Palatal rugoscopy was first proposed in 1932, by a Spanish investigator called Trobo Hermosa [20] and [47]. In 1937, Carrea developed a detailed study and established a way to classify palatal rugae [20] and [47]. One year later, Da Silva proposed another classification and, in 1946, Martins dos Santos presented a practical classification based on rugae location [47] and [48]. In 1983, Briñon, following the studies of Carrea, divided palatal rugae into two groups (fundamental and specific) in a similar way to that done with fingerprints [47]. In this manner, dactiloscopy and palatoscopy were united as similar methods based on the same scientific principles [48] and are sometimes complementary: for instance, palatoscopy can be of special interest in those cases where there are no fingers to be studied (burned bodies or bodies in severe decomposition) [48]. 3.2. Anatomical aspects The surface of the oral mucosa is mostly flat and smooth without grooves or crests. This happens in order to achieve the best performance in oral functions. Nevertheless, there are some exceptions [29]: The back of the tongue, which is covered with papillae; The anterior portion of the palatal mucosa is another exception, having a dense system of rugae, firmly attached to the underling bone. Palatal rugae are irregular, asymmetric ridges of mucous membrane extending lateral from the incisive papilla and the anterior part of the median palatal raphe [49], [50] and [51]. Their purpose is to facilitate food transportation through the oral cavity, prevent loss of food from the mouth and participate in the chewing process. Due to the presence of gustatory and tactile receptors, they contribute to the perception of taste, the texture of food qualities and tongue position [52]. Generally, there is no bilateral symmetry in the number of primary rugae or in their distribution from the midline. It has been found that there are slightly more rugae in males and on the left side in both genders [49]. Palatal rugae are formed in the 3rd month in utero from the hard connective tissue covering the bone [47] and [53]. Their role in human oral function seems to be increasingly less important, which might explain why their development time is retarded [51] and [54]. Once formed, they do not undergo any changes except in length, due to normal growth [55], remaining in the same position through out an entire person's life [11], [20], [23] and [47]. Not even diseases, chemical aggression or trauma seem to be able to change palatal rugae form [20]. Investigations have been carried out to study the thermal effects and the decomposition changes on the palatal rugae of burn victims with panfacial third degree burns, and have concluded that most victims did not sustain any palatal rugae pattern changes, and when changes were noted, they were less pronounced than in the generalized body state. Furthermore, the ability of palatal rugae to resist decomposition changes for up to seven days after death was also noted [56]. However, some events can contribute to changes in rugae pattern, including extreme finger sucking in infancy and persistent pressure due to orthodontic treatment [51]. Nevertheless, in most cases, one must account for palatal rugae persistency. Camargo et al. [57] have referred that, in gingival graft surgery, the selection of the palatal donor site should avoid the rugae areas because they may persist in the grafted tissue. However, extractions may produce a local effect on the direction of the rugae [58]. In fact, palatal rugae stability is considered an important factor when teeth are extracted as has been demonstrated in several studies, which point out the stability of the rugae medial points over the lateral points [55], [57], [58], [59], [60] and [61]. These features where first noticed in 1967, by Peavy and Kendrick [58], [59], [60] and [61], who said "the closer the rugae are to the teeth, the more prone they are to stretch in the direction that their associated teeth move". In addition to these findings of the importance of using medial points, it has been said that the more posterior rugae are less susceptible to changes with tooth movement, being the third palatal rugae pair in particular the most stable reference [50], [58] and [60]. Other studies however, point out that the first rugae is the most stable [61]. We believe further studies are needed in order to define which rugae is the most stable. The occurrence, number and arrangement of palatal rugae in mammals are species-specific [52]. In humans they are asymmetrical, which is an exclusive feature of human beings [46] and [49]. According to English's studies [45], palatal rugae patterns are sufficiently characteristic to discriminate between individuals. In fact, these authors found it legitimate to base identification upon their comparison [45], allowing for human identification even in extreme circumstances [62]. As with lips, interracial differences in palatoscopy can also be established [51], [63], [64], [65] and [66]. However, to reach definitive conclusions, more studies should be carried out. Differences between genders have also been studied [49], [51] and [66], without any conclusions. The relationship between hard palate measurements and dental arches has also been used to determine group ethnicity [5], [10] and [66]. Anatomically, in hard mucosal palate, one can identify an anteroposterior thin central groove, bordered, on each side, by a crest: the palatal raphae [20], [29] and [47]. From this crest, latterly, three to seven smaller crests emerge. These crests are called palatal rugae [29]. 3.3. Palatal rugae classifications The supposed uniqueness and overall stability of palatal rugae suggest their use for forensic identification. Palatal rugae are used in human identification not only due to their singularity and unchangeable nature, but also due to other advantages, namely their low utilization costs [47]. Researchers have found the task of classification a difficult aspect of rugae studies. The subjective nature of observation and interpretation within and between observers poses a problem [51]. Nowadays, there are several known palatal rugae classifications. However, according to several authors [50], [51] and [58], Lysell, in 1955, developed the first classification system for palatal rugae pairs. In this review, we have chosen to describe the most used, as we have previously done with lip prints. 3.3.1. Carrea classification [47] This author divides palatal rugae into four different types, as shown in Table 4. Palatal rugae are classified only according to their form and no formula (rugogram) is developed. Table 4. Carrea palatal rugae classification Classification Rugae type Type I Posterior-anterior directed rugae Type II Rugae perpendicular to the raphae Type III Anterior-posterior directed rugae Type IV Rugae directed in several directions 3.3.2. Martins dos Santos classification [47] and [48] Based on the form and position of each palatal rugae, this classification indicates and characterizes the following: One initial rugae; the most anterior one on the right side is represented by a capital letter; Several complementary rugae; the other right rugae are represented by numbers; One subinitial rugae; the most anterior one on the left side is represented by a capital letter; Several subcomplementary rugae; the other left rugae are represented by numbers. The numbers and letters given to each rugae, relate to its form and can be seen in Table 5. Table 5. Matins dos Santos palatal rugae classification Rugae type Anterior position Other positions Point P 0 Line L 1 Curve C 2 Angle A 3 Circle C 4 Sinuous S 5 Bifurcated B 6 Trifurcated T 7 Interrupt I 8 Anomaly An 9 3.3.3. López de Léon classification [20] Dating from 1924, this classification has only historic relevance. The author proposed the existence of a link between a person's personality and palatal rugae morphology. In this manner, there were four known types of palatal rugae: B-bilious personality rugae; N-nervous personality rugae; S-sanguinary personality rugae; L-lymphatic personality rugae. The letters B, N, L, and S, stand for the different personalities. The letters l and r stand for the left and right side of the palate, and are followed by a number, which specifies the palatal rugae number on each side. For instances, a possible rugogram would be Br6; Bl8. 3.3.4. da Silva classification [20] and [23] In this classification, palatal rugae are divided into two groups: simple, from 1 to 6 (see Table 6) and composed, resulting from two or more simple rugae. They are named according to each rugae number. Table 6. da Silva simple palatal rugae classification Classification Rugae type 1 Line 2 Curve 3 Angle 4 Circle 5 Wavy 6 Point It is possible to classify each ruga individually (describing its form), but also to describe all the palatal rugae system (describing each ruga type number), making this a difficult classification to use. 3.3.5. Trobo classification [20] This classification also divides rugae into two groups: Simple ruga, classified from A to F (see Table 7) and composed rugae, classified with the letter X. Composed rugae result from two or more simple rugae unions. The rugogram is made from right to left, beginning with the principal ruga (the one closest to the raphae), which is classified with a capital letter (see Table 5). The following rugae are classified with small letters. Finally, the left side of the palate is described using the same criteria. Table 7. Trobo palatal rugae classification Classification Rugae type Type A Point Type B Line Type C Curve Type D Angle Type E Sinuous Type F Circle 3.3.6. Basauri classification [20] and [23] Like the Trobo classification, this is a very easy classification to use. It distinguishes between the principal rugae, which is the more anterior one (labelled with letters) and the accessory rugae, which concerns all the remaining rugae (labelled with numbers), as seen in Table 8. Table 8. Basauri palatal rugae classification Principal rugae classification Accessory rugae classification Rugae anatomy A 1 Point B 2 Line C 3 Angle D 4 Sinuous E 5 Curve F 6 Circle X 7 Polymorphic The rugogram is elaborated beginning from the right side of the palate. 3.3.7. Cormoy System [20] and [23] This system classifies palatal rugae according to their size, in: (1) principal rugae (over 5 mm); (2) accessory rugae (ranging from 3 to 4 mm); (3) fragmental rugae (with less than 3 mm length). The form (line, curve, and angle), origin (medial extremity) and direction of each ruga are also described. Possible ramifications are also pointed out. Rugae that share the same origin, interrupted rugae and the incisive papilla are described as well. It is a very complete system. However, its use does not lead to rugogram elaboration, which makes the managing and processing of data difficult. 3.3.8. Correia classification [23] Rugae are labelled with numbers or letters, according their form (see Table 4). The rugogram is formed like a fractional equation. The right side is the numerator and the left side is the denominator. The first right and the first left palatal rugae (initial and subinitial rugae) are classified by a letter and the other right and left (complementar and subcomplementar rugae) are assigned numbers. 3.4. Analysing and recording palatal rugae There are several ways to analyse palatal rugae. Intraoral inspection is probably the most used and also the easiest and the cheapest. However, it can create difficulties if a future comparative exam is required [20] and [23]. A more detailed and exact study, as well as the need to preserve evidence may justify oral photography or oral impressions [20] and [28]. Calcorrugoscopy, or the overlay print of palatal rugae in a maxillary cast, can be used in order to perform comparative analysis [20]. Other more complex techniques are also available. By using stereoscopy, for example, one can obtain a three dimensional image of palatal rugae anatomy. It is based on the analysis of two pictures taken with the same camera, from two different points, using special equipment. Another technique is the sterophotogrammetry which, by using a special device called Traster Marker, allows for an accurate determination of the length and position of every single palatal ruga [20] and [23]. However, due to its simplicity, price and reliability, the study of maxillary dental casts is the most used technique [20]. 3.5. Problems with palatoscopy Palatoscopy is a technique that can be of great interest in human identification. In fact, contrary to lip prints, it is possible to have antemortem data established such as records found in dental practice in different forms (dental casts, old prosthetic maxillary devices and intraoral photographs). However, palatoscopy might not be so useful in crime scene investigations in the linking of suspects to crime scenes. In fact, this kind of evidence is not expected to be found in such circumstances. Another aspect of palatoscopy that one must consider is the possibility of rugae pattern forgery. In a case report, Gitto et al. [67] described a method where palatal rugae were added to a complete denture in order to improve speech patterns in some patients. This process can lead to false identity exclusion due to misleading antemortem data. 4. Conclusions Identifying live or dead people is often a difficult and time-consuming process. Identifying living people is sometimes difficult because people do not normally wish to be identified. Therefore, in order to achieve this goal, people disguise their presence in various ways. Identifying the dead raises a whole different set of problems, which relate to: The natural process of decomposition; Scavenger animal actions; The circumstances in which death occurred. Cheiloscopy is interesting mostly in identifying the living, since it can be the only way to link somebody to someone or to a specific location. However, although lip prints have previously been used in a court of law, its use is not consensual and some authors believe further evidence is needed to confirm their uniqueness [33]. In fact, lip print use is controversial and rare. The FBI has used this kind of evidence only in a single case in order to obtain a positive identification. Nowadays, new research allows for cheiloscopy use in a court of law in the USA [28]. Recent studies [39] and [43] also point out other possibilities namely, DNA detection in latent lip prints where some researchers are trying to relate characteristic lip patterns with a person's gender [22]. Another aspect that might be interesting to study is the possibility of using identifiable lip prints obtained from the skin of assault and murder victims, in a similar way to what has already been done with latent finger prints [68]. Due to anatomical position, it is unlikely that the study of palatal rugae could be used in the process of linking a suspect to a crime scene. On the other hand, palatoscopy may be used as a necroidentification technique. In fact, the Brazilian Aeronautic Minister demands palatal rugoscopy of all its pilots, in order to ensure their identification in case of accident [47]. As previously mentioned, it will be in these particular circumstances that palatoscopy is most valuable. The possibility of finding antemortem data supports this idea. Nowadays, palatal rugae patterns are considered a viable alternative for identification purposes. Some investigators aim to assess its feasibility with the aid of a computer and a software program. The results so far are good, but expected to be better [69]. As with cheiloscopy, other aspects of palatoscopy have been studied. For instances, Thomas et al. [70] have worked on the possible use of palatal ruga patterns in paternity determination. This possibility was first suggested by Lysell [60]. However, there were no findings to link the two aspects. Kratzsch and Opitz [71] developed a study in cleft patients whose results suggest that palatal rugae, in combination with measuring points of the cleft palate, can serve to depict changes occurring in the anterior palate during various stages of therapy and growth. These findings suggest that some facial changes can be expected when studying specific rugae patterns. Few studies using palatal rugae as a means of forensic identification are found in literature. However, the idea of rugae being unique to an individual is promising and deserves further investigation. References [1] A.B. Acharya and J.A. Taylor, Are a minimum number of concordant matches needed to establish identity in forensic odontology?, J. Forensic Odontostomatol. 21 (2003), pp. 6-13. [2] I. Carrera Carbajo, Identificación de cadáveres y aspectos forenses de los desastres, Publicaciones de la Unidad de Investigación en Emergencia y Desastres, http://www.desastres.org. [3] R.B. Brannon and H.P. Kessler, Problems in mass-disaster dental identification: a retrospective review, J. Forensic Sci. 44 (1999) (1), pp. 123-127. [4] H. Brkic, D. Strinovic, M. Slaus, J. Skavic, D. Zecevic and M. Milicevic, Dental identification of war victims from Petrinja in Croatia, Int. J. Legal Med. 110 (1997), pp. 47-51. [5] P.G. Stimson and C.A. Mertz, Forensic Dentistry (1st ed.), CRC Press, Florida (1997) pp. 1-36. [6] B.J. Adams, The diversity of adult dental patterns in the United States and the implications for personal identification, J. Forensic Sci. 48 (2003) (3), pp. 497-503. [7] P.E. 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