3D dental images in forensic odontology: A scoping review of superimposition approaches utilizing 3D imaging

Background: Forensic odontology is crucial for human identification, especially in disaster scenarios, using comparisons between antemortem and postmortem dental data. Advances in 3D imaging have shifted practices from traditional 2D methods to 3D superimposition techniques, necessitating a comprehensive review. This scoping review maps current 3D superimposition methodologies in forensic odontology, focusing on key processes, sources of error, and research gaps. Methods: We used Arksey and O'Malley's framework, searching PubMed, Embase, Scopus, and DOSS for studies from January 2017. Search strategies incorporated MeSH and Emtree terms, Boolean operators, and truncations. Inclusion criteria required studies to utilize 3D superimposition techniques for comparing dental imaging, with exclusions for 2D imaging, non-forensic focus, and inaccessible texts. Data were extracted on anatomical features, imaging techniques, methods, and outcomes. Results: From 545 records, 20 studies met inclusion criteria. Most employed surface-based superimposition. Methodologies varied widely, with inconsistent software use and a lack of standardization. Root Mean Square (RMS) values were commonly used to assess alignment, but thresholds differed significantly across studies. Key challenges include operator variability and limited access to affordable software. Conclusions: The rapid advancement of 3D imaging in forensic odontology highlights the need for standardized methods. While surface-based techniques are promising, establishing uniform benchmarks and developing opensource tools are crucial for improving reliability and global adoption.