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Facial soft tissue thicknesses for the Portuguese adult population
Forensic Science International 184 (2009) 80.e1–80.e7
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Forensic Anthropology Population Data
Facial soft tissue thicknesses for the Portuguese adult population So´nia Codinha * Departamento de Antropologia, Faculdade de Cieˆncias e Tecnologia da Universidade de Coimbra, Rua Arco da Traic¸a˜o, 3000-056 Coimbra, Portugal
A R T I C L E I N F O
A B S T R A C T
Article history: Received 8 October 2008 Received in revised form 17 November 2008 Accepted 18 November 2008 Available online 4 January 2009
In recent years there has been an important increment of studies on the determination of facial soft tissue thicknesses for craniofacial identification purposes. In spite of this, there is no information on the particularities of the facial soft tissue depths for the Portuguese adult population. In order to address this lack, the soft tissue thicknesses of a Portuguese cadaver sample of 151 individuals, 103 males and 48 females with ages between 20 and 99 years old, autopsied at the South Branch of the National Institute of Legal Medicine, were measured using published needle puncture methods at 20 anatomical points. The stature and weight of all cadavers were determined and their body mass index (BMI) calculated. In order to prevent post-mortem distortion, soft tissue depths were assessed prior to the individual’s autopsy in cadavers whose time of death did not exceed 24 h. From these data, descriptive statistics were calculated and the average soft tissue depths were reported considering the BMI and the sex of the cadavers. In general, males were found to have greater soft tissue depths than females but some landmarks showed the opposite while others presented the same values for both sexes. In spite of this, almost all the differences among the sexes were found to be not statistically significant. The Post Hoc Gabriel test performed between the different BMI categories for mixed sexes and for each sex suggested BMI-related differences on the soft tissue thicknesses, although these vary considerably within and between the sexes with no linear correspondence between the anatomical landmarks. These results, point not only to the necessity to present data in accordance with the sexual dimorphism, but also to consider the BMI as an important variable for better results in the achievement of the likeness of the deceased individuals in both two-dimensional and three-dimensional facial approximations or superimpositions. Additionally, evidence of interpopulation differences in the average soft tissue thicknesses were observed by the comparison of this data set with similar studies from Caucasian groups with different geographic origin. ß 2008 Elsevier Ireland Ltd. All rights reserved.
Keywords: Craniofacial identification Soft tissue thicknesses Body mass index Adult cadavers
1. Introduction Craniofacial identification methods rely mostly on the knowledge of soft tissue thicknesses on determined anatomical points of the skull both in situations where a facial approximation is conducted or using superimposition methods [1,2]. The first studies to establish average facial soft tissue depths go back to the end of the 19th century and were performed on cadaver samples using the needle puncture technique [3–5]. Only in the middle of the 20th century, as an outcome of the increasing importance of facial approximation techniques as an auxiliary tool in the identification of human skeletal remains in forensic contexts [1,2,6–8], the investigation on facial soft tissue depths was incremented. Consequently several researchers developed average facial soft tissue depths tables for adult individuals of both sexes and different ancestry [9–27].
* Tel.: +351 239 855 210; fax: +351 239 823 491. E-mail address: [email protected]. 0379-0738/$ – see front matter ß 2008 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.forsciint.2008.11.011
In recent times, the advent of non-invasive diagnostic techniques such as cephalometric radiographs, ultrasound probing, magnetic resonance imaging (MRI) and computerized tomography allowed the access to samples of living individuals, providing an important actualization on the average soft tissue values for adults [13–18,20,23,26,27]. MRI and CT scan methods of data collection have been pointed as the most accurate techniques for measuring soft tissue thicknesses [20,29], but these are expensive and CT implies high radiation outputs harmful to biological tissues. Furthermore, the realization of these studies is often associated with medical diagnostic procedures. All these constraints are reflected in the intermittent studies published using these non-invasive techniques [20,23,25–27]. As mentioned, the needle puncture technique was the first method used to collect soft tissue depths data. Although this methodology has been identified with many constraints, namely the distortion of the soft tissues as a consequence of the decomposition processes associated with the nature of the samples, the difficulty in identifying the measurements sites [28] and the false measurements that can be caused by the horizontal position of the cadavers
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due the action of gravity [2], this technique also has some advantages such as the immobility of the subjects, the inexpensiveness and simplicity of the equipment required and the possibility of measuring any point in the head [22]. Studies on soft tissue depths from both cadaver and living samples always group the individuals according to their sex and population’s affinity, but most only consider individuals of normal complexion [3,9,13–21,24,27]. Exceptions are the analysis performed by Rhine and Campbell [10], Rhine [11], Rhine and Moore [12], Villanueva et al. [21], De Greef et al. [23], Valencia [24] and Bellman et al. [25], which took into account the three main BMI categories in the presentation of the data. Although we cannot be absolutely sure of an individual’s complexion only by its skeleton, if we have complete and well preserved human skeletal remains or if any clothing is found associated with those remains, we may infer the robustness of the victims. Knowing that the facial soft tissues vary in accordance with the nutritional condition of the individuals [4,5,9–12,23,27,30], it is important to have data for the three main body builds (emaciated, normal and overweight), particularly in forensic contexts, since the facial variation resulting from the different body types has the potential to constrain the effectiveness of facial recognition [31,32]. Therefore, this paper attempts to contribute data on the average soft tissues thicknesses for the Portuguese adult population, for which there were no data, taking into account the body mass index (BMI) of the individuals. Considerations on the effect of the different BMI in the soft tissue depths within and between the sexes, and how it affects the different regions of facial anatomy, are also discussed. In order to evaluate the interpopulation variation, data will also be compared with published [12,21] and unpublished [24] data sets from Caucasian groups with distinct geographic origin, which used similar samples and methods.
the craniofacial skeleton. In this sense, cause of death was assumed to have no impact on the results. Furthermore, individuals with beards or moustaches were also not considered. The stature and weight of all cadavers were measured and their body mass index calculated. The soft tissue measurements were performed at a total of 20 facial anatomical points, most of which are standard anthropological landmarks (Table 1). Eight of these measurement sites were in the midline and 12 were bilateral. The measurements followed the needle puncture methods [3–5], with a slight alteration. Instead of a rubber mark, a forceps positioned perpendicularly to the needle and parallel to the soft tissue was used against the skin to determine the soft tissue limit. This procedure intended to prevent any artificial alteration on recording caused by the manipulation of rubber stoppers during the needle removal. In order to avoid the inevitable soft tissue compression induced by the introduction of the needle, the skin was pooled up along the needle and then capped at the level of the adjacent soft tissues with the help of a forceps. The soft tissue thickness at each point was measured reading the distance between the tip of the needle to the inner surface of the forceps against a stainless steel ruler (scale readable to 0.5 mm). All soft tissue depths were conducted by the author. Prior to the data collection, a careful analysis of the cadavers’ skull by palpation was performed to better identify the anatomical points in relation to the skull. A sample of 20 randomly selected cadavers was re-measured to evaluate the absolute and relative technical intraobserver error [33]. It must be noted that due to the fact that the data collection had to be done prior to the autopsy, as well as the need to avoid as much as possible the post-mortem soft tissues distortion due to decomposition, the re-measurements were done in a time period of 1–2 h after the first measurements. Data were analyzed using the Statistical Package for the Social Sciences (SPSS, version 15.0). General descriptive analyses were determined for each anatomical point and average soft tissue depths were calculated considering the BMI and the sex of the cadavers. The nature of the sample invalidated the consideration of age as a variable since the distribution of the individuals through the three main age groups (20–39, 40–59 and >60 years old), considering the sexes and BMI, resulted in very small samples sizes for certain age groups while others had no representatives at all. The differences between the sexes were compared using Independent samples T test and a multiple comparisons Post Hoc Gabriel test was performed between the different BMI categories for males, females and mixed sexes. The average soft tissue depths were compared with other studies that used similar methods and samples from Caucasian groups with different geographic origin. For all statistical analysis, a significance level of <0.05 was used.
2. Materials and methods This study was performed on a Portuguese cadaver sample of 151 individuals, 103 males and 48 females, autopsied at the South Branch of the National Institute of Legal Medicine (Lisbon). During the data collection all the ethical and legal requirements were followed. The age range of the sample was from 20 to 99 years old, with an average age of 62 years for males (ranging from 26 to 91 years) and 64 years for females (ranging from 20 to 99 years). In order to prevent post-mortem distortion as much as possible, soft tissue depths were assessed prior to the individual’s autopsy in cadavers whose time of death did not exceed 24 h. All cadavers were kept on refrigeration. None of the cadavers measured had signs of congenital deformity, trauma or diseases affecting the soft tissues of the face and
3. Results The results for the calculation of the absolute and relative technical intraobserver error were minimal for all anatomical points (Table 2). The absolute technical error was found to be less then 0.5 mm (Table 2) with the occlusal line and Supra M2 landmarks displaying the largest absolute technical error (0.3 mm). The measurement error exhibited by this study is less than those reported by other authors using needle puncture
Table 1 Description of the anatomical landmarks considered in this study. Anatomical landmarks
Description
1. Supraglabella 2. Glabella 3. Nasion 4. Rhinion 5. Mid-pilthrum 6. Supramental 7. Pogonion 8. Gnathion 9. Supra orbital 10. Infra orbital 11. Mid-zygomatic
The most anterior point of the forehead, above the glabella in the midsagital plane The most prominent point between the supra orbital ridges in the midsagital plane Located at the midpoint of maximum convexity between the nose and forehead in the midsagital plane The anterior tip of the nasal bones Centred between the midpoint of the columella base and the vermilion border of the upper lip in the midsagital plane Centred in the fold of chin The most prominent point in the midline of the mental protuberance Most inferior point of the mandible in the midsagital plane A point in the supra orbital ridge in vertical alignment with the pupil of the eye Located in the lower bony orbital margin in vertical alignment with the pupil of the eye Perpendicular point to the lateral orbital border, centred between the lower border of the orbit and the lower portion of the zygomatic process The most lateral point of the zygomatic arch Point in the extremity of the anterior portion of the mandibular ramus at the horizontal level of the cheilion Middle point in the extremity of the posterior portion of the mandibular ramus between the condilion and the gonion Point located in the alveolar process at the level of the middle of the upper canine Point located in the alveolar process at the level of the middle of the lower canine Point located in the alveolar process at the level of the middle of the second upper molar Point located in the alveolar process at the level of the middle of the second lower molar Point in the inferior border of the mandible centred between gnathion and gonion Point located in the jaw line at the level of the angle between the posterior with the inferior borders of the mandible
12. 13. 14. 15. 16. 17. 18. 19. 20.
Zygion Occlusal line Mid-masseter Supra canine Infra canine Supra M2 Infra M2 Middle mandibular Gonion
S. Codinha / Forensic Science International 184 (2009) 80.e1–80.e7 Table 2 Relative and absolute technical error of measurement. Landmarks
Relative TEM (%)
Absolute TEM (mm)
1. Supraglabella 2. Glabella 3. Nasion 4. Rhinion 5. Mid-pilthrum 6. Supramental 7. Pogonion 8. Gnathion 9. Supra orbital 10. Infra orbital 11. Mid-zygomatic 12. Zygion 13. Occlusal line 14. Mid-masseter 15. Supra canine 16. Infra canine 17. Supra M2 18. Infra M2 19. Middle mandibular 20. Gonion
1.4 1.4 1.6 2.1 2.1 1 1.7 2.5 1.8 1.6 1.4 1.4 1.6 1 1.6 1.3 1.1 1.8 2.2 1.6
0.1 0.1 0.1 0.1 0.2 0.1 0.2 0.2 0.2 0.2 0.2 0.1 0.3 0.2 0.2 0.1 0.3 0.2 0.2 0.2
methods [19,22]. This may be related to the fact that remeasurements were taken relatively soon after the first measurements. Moreover, in some cadavers the piercing mark of the first measurement on the skin could be seen, enabling the author to reinsert the needles precisely at the previous point of insertion. The estimated average soft tissue thicknesses considering the sex and the BMI of the cadavers are presented in Tables 3 and 4. In general, males were found to have greater soft tissue depths then females, but some landmarks showed the opposite while others presented the same average value for both sexes. The largest soft tissue difference observed between the sexes was at the occlusal line landmark, namely 3.3 mm for the emaciated category and 2.4 mm for the normal category (Tables 3 and 4). The mid-pilthrum (2.4 mm) for the emaciated category and the gonion (2.3 mm) for the normal category were the other two landmarks, which displayed the largest differences between the sexes (Tables 3 and 4). On the other hand, for all BMI categories, the mid-zygomatic landmark was thicker in females (0.3 mm for the emaciated and normal categories and 0.7 mm for the overweight category). In the remainder landmarks where females showed thicker soft tissues, specifically the supramental
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and supra orbital landmarks for the emaciated category; the glabella, pogonion and zygion landmarks for the normal category; and the supraglabella, infra orbital and infra canine landmarks for the overweight complexion, the differences varied between 0.1 and 1 mm (Tables 3 and 4). Equal average soft tissue thicknesses for both sexes were found at the infra canine landmark for the normal category and at the glabella and zygion landmarks for the overweight category (Tables 3 and 4). It must be noted that most of the differences observed between the sexes were found to be not statistically significant (Table 5). The significant differences were observed mainly around the mouth and chin regions, with males showing the greater average values. That is, the supraglabella, mid-pilthrum, gnathion and occlusal line for emaciated category; rhinion, supra canine and infra M2 landmarks for the normal category; and nasion, midpilthrum and pogonion for the overweight category (Table 5). Nevertheless, we must always consider the considerable overlapping between the sexes demonstrated by the range values of each soft tissue landmark (Tables 3 and 4). In Table 5 are reported the results of the multiple comparisons Post Hoc Gabriel test performed between the different BMI categories for the mixed sexes and for each sex. Males showed statistically significant differences between the emaciated and overweight categories at all landmarks. Significant differences were also found at the supra orbital, infra orbital, mid-zygomatic, mid-masseter, infra M2, middle mandibular and gonion landmarks for all BMI comparisons. But at the supraglabella and supramental landmarks, these differences were only observed between the emaciated and normal categories. Moreover, at the glabella, nasion, rhinion, pogonion, gnathion, zygion and occlusal line landmarks, the significant differences were between the normal and overweight categories (Table 5). Females showed a completely different scenario. The supraglabella, glabella, pogonion and gnathion landmarks showed statistically significant differences between the emaciated and normal categories and between the emaciated and overweight categories. At the infra orbital, occlusal line, infra M2 and gonion landmarks these differences were between the normal and overweight categories as well as between the emaciated and overweight categories. The supra orbital, mid-zygomatic, zygion, mid-masseter, infra canine, supra M2 and middle mandibular landmarks were significantly different between the emaciated and overweight categories, while the nasion, rhinion, mid-pilthrum,
Table 3 Average soft tissue thicknesses (mm) for Portuguese adult males. Landmarks
1. Supraglabella 2. Glabella 3. Nasion 4. Rhinion 5. Mid-pilthrum 6. Supramental 7. Pogonion 8. Gnathion 9. Supra orbital 10. Infra orbital 11. Mid-zygomatic 12. Zygion 13. Occlusal line 14. Mid-masseter 15. Supra canine 16. Infra canine 17. Supra M2 18. Infra M2 19. Middle manbibular 20. Gonion
Emaciated (BMI<20) n = 19
Normal (BMI 20–25) n = 27
Overweight (BMI > 25) n = 57
Mean
S.D.
Range
Mean
S.D.
Range
Mean
S.D.
Range
3.2 4.9 5.3 2.5 10.2 9.2 9.8 6.5 6 6 8.7 5.7 18 15.2 9.2 8.8 22 9.7 6.2 10.8
0.8 1.0 1.5 1.1 2.5 1.7 2.0 1.7 1.4 2.5 2.3 1.8 3.7 4.7 3.4 1.9 4.8 2.8 1.9 3.6
2–4.5 3–6 3.5–8.5 1–4 6–14.5 6–13 8–14.5 4–10 3–8.5 3–11 4–12 2.5–9 13–24.5 7–24.5 2.5–15 6–12.5 11–31.5 6–17 3–8 5–17
4.4 5.8 5.8 3 11.1 10.8 10.9 7.5 7.4 8.1 11 7.9 20.4 20.6 10.3 9.7 23.4 12.6 9 14.2
1.4 1.3 1.3 0.8 2.3 2.5 2.1 1.7 1.3 2.5 2.4 2.4 3.3 4.2 1.8 1.8 3.5 2.4 1.9 3.8
2.5–9 3.5–8 3.5–10 2–5 8–17.5 8–15 5–14 5–12 5–10 4–15.5 7–16.5 4.5–13 14–26.5 14–30 7–13.5 4.5–12.5 17.5–30 8.5–17 7–12.5 8–22.5
4.8 6.9 6.6 3.7 12.2 11 12.8 9.4 8.5 10 12.3 11.2 24.6 26 11.2 10.8 27 16.6 12.2 19.3
1.0 1.6 1.5 1.3 2.7 1.9 2.4 2.3 1.6 2.8 2.1 4.0 3.5 4.9 2.5 1.7 5.4 4.0 3.5 5.2
2.5–7 5–11.5 4–9.5 1–8 8–16.5 8–17 9–20 6–14 4.5–12.5 4–17 8–17 5–26.5 5–26.5 16–37 8–17 7–15 8.5–26 8.5–26 6.5–22 7–38
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Table 4 Average soft tissue thicknesses (mm) for Portuguese adult females. Landmarks
Emaciated (BMI < 20) n = 9
1. Supraglabella 2. Glabella 3. Nasion 4. Rhinion 5. Mid-pilthrum 6. Supramental 7. Pogonion 8. Gnathion 9. Supra orbital 10. Infra orbital 11. Mid-zygomatic 12. Zygion 13. Occlusal line 14. Mid-masseter 15. Supra canine 16. Infra canine 17. Supra M2 18. Infra M2 19. Middle manbibular 20. Gonion
Normal (BMI 20–25) n = 11
Overweight (BMI > 25) n = 28
Mean
S.D.
Range
Mean
S.D.
Range
Mean
S.D.
Range
2.4 4.6 4.9 2.2 7.8 9.7 8.1 4.8 6.5 5.3 9.1 5.2 14.7 13.0 8.4 8.1 18.3 8.4 5.4 9.4
0.8 1.5 1.1 1.4 1.5 0.8 2.5 1.6 1.0 2.1 1.6 1.6 2.5 4.1 1.8 1.2 4.1 4.1 1.7 3.3
1–3 2–7 3–6.5 1–5.5 5–9 8–11 5–13 3–7.5 5–8 1–8.5 6.5–12 3–8 11.5–19 9.5–21 5–11 6–10 11–25 5–15 3–7.5 6.5–16
3.9 6.3 5.6 2.2 10.5 9.9 11.4 7.2 7.3 7.8 11.4 8.9 18.2 18.9 8.7 9.7 22.2 10.7 8.6 11.9
1.2 1.1 1.3 1.2 1.6 1.4 1.3 1.9 1.2 2.1 1.8 1.5 2.1 1.8 1.6 1.3 3.7 2.2 1.3 2.2
2–6.5 4.5–8 3.5–8 1–5 8–14 8–12 9–13.5 4–10 5.5–9 5–11.5 8.5–14.5 6.5–11.5 16–21 16–22 7–11 8–12.5 16–28 9–16 6–10 8.5–15
4.9 6.9 5.9 3 10.4 10.4 11.6 8 8.3 10.2 13 11.2 22.8 23.6 10.4 10.9 26.9 15.7 11.7 18.1
1.4 1.5 1.5 1.2 3.6 2.3 2.7 2.0 2.1 3.1 3.5 4.2 5.6 6.8 4.0 2.9 7.5 5.1 5.2 7.3
2–7 4–9.5 3–8 1–5.5 5.5–23 6–14.5 5–17 4–12 5–14 6–18 7–26 3–22 13.5–45 10.5–45 7–28 7–18 14.5–55 9–31 3.5–30 8–44
supramental and supra canine landmarks displayed no statistically significant differences between any of the BMI categories (Table 5). The comparison of the average soft tissue thicknesses for the Portuguese adult population with other studies that used similar methods and samples from Caucasian groups with different geographic origin, revealed some variations between the averages (Tables 6 and 7). Although these differences were not very large and the unavailability of the raw data from the other studies invalidated the estimation of the statistical significance of the results, it must be noted that in comparison to the other groups, the Portuguese males showed the thickest average values for all BMI categories at the supra M2, occlusal line and mid-pilthrum landmarks. Thicker values were also found at the infra orbital and gonion landmarks for the normal and overweight categories and at the mid-zygomatic for the emaciated and normal categories. In the opposite direction, the Portuguese males showed the smallest soft tissue depths at the infra M2 landmark for the
emaciated and normal body mass categories; at the supramental for the emaciated category; and at the supraglabella for the overweight complexion (Table 6). Portuguese females also showed the thickest average values at the supra M2 landmark for all body mass categories. Thickest average values were also observed at the supra orbital and midzygomatic for the emaciated and normal categories; at the pogonion, gnathion and zygion for the normal category; and at the infra orbital and occlusal line for the overweight category. In comparison to the other groups, the Portuguese females showed the smallest average values at the infra M2 and rhinion landmarks for the emaciated and normal categories, at the supraglabella for the emaciated, and at the supramental for the overweight complexion (Table 7). It must be noted that in spite of the geographical proximity of the Portuguese and Spanish, these two groups were the ones which exhibited the greater absolute differences between average values,
Table 5 Statistical analysis of the facial soft tissue thicknesses for the Portuguese adult population. Landmarks
Multiple comparisons (Post Hoc Gabriel) Mixed sexes between BMI
Independent samples T-test
Males between BMI
Females between BMI
Between sexes
<20/20–25 20–25/>25 <20/>25 <20/20–25 20–25/>25 <20/>25 <20/20–25 20–25/>25 <20/>25 BMI < 20 BMI 20–25 BMI > 25 1. Supraglabella 2. Glabella 3. Nasion 4. Rhinion 5. Mid-pilthrum 6. Supramental 7. Pogonion 8. Gnathion 9. Supra orbital 10. Infra orbital 11. Mid-zygomatic 12. Zygion 13. Occlusal line 14. Mid-masseter 15. Supra canine 16. Infra canine 17. Supra M2 18. Infra M2 19. Middle manbibular 20. Gonion *
0.000* 0.004* 0.323 0.514 0.092 0.051 0.007* 0.015* 0.007* 0.003* 0.001* 0.004* 0.011* 0.000* 0.475 0.080 0.263 0.011* 0.001* 0.039*
Significant at P 0.05.
0.028* 0.002* 0.051 0.008* 0.485 0.792 0.008* 0.001* 0.002* 0.000* 0.010* 0.000* 0.000* 0.000* 0.113 0.008* 0.001* 0.000* 0.000* 0.000*
0.000* 0.000* 0.000* 0.000* 0.001* 0.001* 0.000* 0.000* 0.000* 0.000* 0.000* 0.000* 0.000* 0.000* 0.002* 0.000* 0.000* 0.000* 0.000* 0.000*
0.001* 0.092 0.618 0.418 0.569 0.025* 0.260 0.256 0.006* 0.026* 0.002* 0.064 0.054 0.001* 0.354 0.278 0.720 0.016* 0.004* 0.048*
0.249 0.004* 0.043* 0.044* 0.179 0.471 0.001* 0.001* 0.006* 0.007* 0.046* 0.000* 0.000* 0.000* 0.314 0.024* 0.005* 0.000* 0.000* 0.000*
0.000* 0.000* 0.002* 0.001* 0.009* 0.001* 0.000* 0.000* 0.000* 0.000* 0.000* 0.000* 0.000* 0.000* 0.006* 0.000* 0.000* 0.000* 0.000* 0.000*
0.038* 0.038* 0.589 0.999 0.134 0.994 0.012* 0.023* 0.700 0.145 0.274 0.051 0.256 0.071 0.996 0.390 0.431 0.574 0.252 0.730
0.102 0.539 0.837 0.129 1.000 0.769 0.989 0.492 0.293 0.041* 0.295 0.169 0.020* 0.053 0.361 0.355 0.103 0.007* 0.082 0.012*
0.000* 0.000* 0.120 0.126 0.058 0.623 0.001* 0.000* 0.028* 0.000* 0.003* 0.000* 0.000* 0.000* 0.287 0.008* 0.002* 0.000* 0.000* 0.001*
0.019* 0.600 0.419 0.464 0.012* 0.412 0.060 0.021* 0.380 0.523 0.594 0.460 0.029* 0.229 0.552 0.330 0.058 0.349 0.303 0.328
0.318 0.298 0.631 0.020* 0.436 0.255 0.479 0.587 0.710 0.729 0.667 0.181 0.052 0.095 0.016* 0.980 0.376 0.033* 0.451 0.067
0.866 0.985 0.048* 0.056 0.014* 0.225 0.046* 0.011* 0.517 0.768 0.220 0.987 0.073 0.074 0.272 0.785 0.960 0.397 0.663 0.394
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Table 6 Comparison of facial soft tissue thicknesses measured using needle puncture methods on male cadavers from groups with different geographic origin. Landmarks
Supraglabella Glabella Nasion Rhinion Mid-pilthrum Supramental Pogonion Gnathion Supra orbital Infra orbital Mid-zygomatic Zygion Occlusal line Supra M2 Infra M2 Gonion
Emaciated
Normal
Overweight
Codinha [this paper]
Valencia [16]
Villanueva et al. [14]
Rhine and More [12]
Codinha [this paper]
Valencia [16]
Villanueva et al. [14]
Rhine and More [12]
Codinha [this paper]
Valencia [16]
Villanueva et al. [14]
Rhine and More [12]
Portuguese n = 19
Spanish n=8
Mexican n=8
American Caucasians n=3
Portuguese n = 27
Spanish n=8
Mexican n = 18
American Caucasians n = 37
Portuguese n = 57
Spanish n=4
Mexican n = 18
American Caucasians n=8
3.2 4.9 5.3 2.5 10.2 9.2 9.8 6.5 6.0 6.0 8.7 5.7 18.0 22.0 9.7 10.8
4.3 6.1 3.0 10.2 7.6 9.3 6.1 5.3 6.0 8.5 6.3 9.2 14.5 13.1 12.1 12.1
4.2 5.1 6.2 2.8 10.1 10.8 9.8 7.5 6.2 6.0 7.7 7.6 15.4 14.1 11.7 12.5
2.3 2.5 4.3 2.5 6.3 8.8 7.0 4.5 6.3 2.8 5.0 3.0 12.0 12.0 10.0 4.5
4.4 5.8 5.8 3.0 11.1 10.8 10.9 7.5 7.4 8.1 11.0 7.9 20.4 23.4 12.6 14.2
4.4 5.7 2.6 9.9 7.7 9.1 7.4 4.5 6.7 7.5 8.8 8.8 16.6 15.7 15.2 12.7
4.8 5.8 6.7 3.1 10.7 11.5 10.5 8.5 6.8 7.2 9.5 8.5 16.7 15.5 13.0 14.1
4.3 5.3 6.5 3.0 10.0 10.8 11.3 7.3 8.3 5.8 10.0 7.3 18.3 19.5 16.0 11.5
4.8 6.9 6.6 3.7 12.2 11 12.8 9.4 8.5 10.0 12.3 11.2 24.6 27 16.6 19.3
5.8 5.8 2.2 9.9 7.5 8.5 5.8 4.5 6.7 6.9 8.6 8.3 15.5 13.9 14.8 14.2
5.4 6.6 7.1 3.5 11.4 12.8 12.4 10.2 8.1 8.7 10.4 10.7 20.0 18.1 15.4 17.5
5.5 7.5 7.5 3.5 11.0 12.3 14.0 10.8 10.3 8.3 13.8 11.8 23.5 25.0 19.8 17.5
the average soft tissue thicknesses for the Portuguese adult population, for which, until the present study, were no records. Furthermore, this analysis also brings into discussion the need to consider the different BMI categories of the individuals while performing average soft tissue tables since it was observed that soft tissue depths vary considerably and not in a linear manner when the BMI is introduced as a variable. Given that the physiognomy of individuals changes in accordance with their nutritional status [4,5,9–12,23,27,30], it is significant to have access to this type of data. In fact, on a study performed on the effect of tissue depth variation on craniofacial reconstruction, Starbuck and Ward [36] observed that ‘‘variation in weight may be an important contributor to the ability to achieve correct recognition of a reconstructed face’’ since apparently the size of the face plays a stronger role than facial configuration in the identification of individuals. As expected from the natural sexual dimorphism displayed by the skull and facial musculature and as recorded by similar studies [9–12,21,22,24], the present analysis showed that in general
with some anatomical points displaying differences up to 5 mm for both sexes (Tables 6 and 7). The greatest differences were observed at the supra M2 landmark for both males and females (6.5 mm for overweight females and 13.1 mm for emaciated males). 4. Discussion One of the main problems concerning the forensic craniofacial identification methods is the reliance on the use of average soft tissue depths values as control in tri-dimensional and bidimensional facial approximations and/or superimposition techniques. Taking into account that each face has its own particularities, this situation contributes with a great deal of error and compromises the success of the achievement of the likeness of unidentified deceased individuals. Considering the phenotypic variation observed in Europeans and bearing in mind that the effectiveness of the probability of achieving the resemblance of a person is related to the access of data gathered from genetically related individuals [15], this paper attempts to contribute data on
Table 7 Comparison of facial soft tissue thicknesses measured using needle puncture methods on female cadavers from groups with different geographic origin. Landmarks
Supraglabella Glabella Nasion Rhinion Mid-pilthrum Supramental Pogonion Gnathion Supra orbital Infra orbital Mid-zygomatic Zygion Occlusal line Supra M2 Infra M2 Gonion
Emaciated
Normal
Overweight
Codinha [this paper]
Valencia [16]
Villanueva et al. [14]
Rhine and More [12]
Codinha [this paper]
Valencia [16]
Villanueva et al. [14]
Rhine and More [12]
Codinha [this paper]
Valencia [16]
Villanueva et al. [14]
Rhine and More [12]
Portuguese n=9
Spanish n=6
Mexican n = 41
American Caucasians n=3
Portuguese n = 11
Spanish n=8
Mexican n = 87
American Caucasians n = 19
Portuguese n = 28
Spanish n=8
Mexican n = 40
American Caucasians n=3
2.4 4.6 4.9 2.2 7.8 9.7 8.1 4.8 6.5 5.3 9.1 5.2 14.7 18.3 8.4 9.4
3.8 5.5 2.8 10.6 9.3 9.8 6.1 4.0 6.2 7.2 6.3 6.8 14.5 14.6 14.0 11.1
4.2 4.7 5.6 2.8 10.4 9.2 9.5 6.8 6.2 6.0 8.0 7.1 14.8 12.5 11.0 10.8
2.5 4.0 5.3 2.3 5.0 9.3 8.5 3.8 5.3 4.0 6.0 3.5 11.0 12.0 9.5 5.0
3.9 6.3 5.6 2.2 10.5 9.9 11.4 7.2 7.3 7.8 11.4 8.9 18.2 22.2 10.7 11.9
4.6 5.6 3.4 9.8 9.4 10.4 6.9 5.0 7.1 7.8 8.7 8.8 19.1 17.8 15.6 17.0
4.2 5.2 5.4 2.4 9.5 10.3 9.3 6.7 6.2 7.0 8.5 8.8 16.4 14.3 11.5 13.2
3.5 4.8 5.5 2.8 8.5 9.5 10.0 5.8 7.0 6.0 10.8 7.5 17.0 19.3 15.5 12.0
4.9 6.9 5.9 3.0 10.4 10.4 11.6 8 8.3 10.2 13.0 11.2 22.8 26.9 15.7 18.1
6.0 7.0 3.4 11.7 11.6 12.7 9.1 5.6 8.0 9.7 11.2 10.5 21.6 20.4 17.8 19.5
4.8 6.0 6.0 2.8 9.5 11.2 11.2 9.2 7.2 8.2 10.5 10.3 16.5 16.1 12.8 13.8
4.3 7.5 7.0 4.3 9.0 13.8 14.3 9.0 10.0 8.5 14.8 11.3 20.3 23.8 18.8 17.5
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Portuguese males have thicker soft tissues than females. These differences are statistically significant at most of the midline landmarks and around the mouth and chin regions of the face. In spite of this, some anatomical points revealed identical average values for both sexes, while the anatomical landmarks at the cheek region for all BMI categories were found to be thicker for females. Although only half of the anatomical landmarks considered in this study showed statistically significant differences between the sexes, when we compare the average soft tissue depths between the BMI categories for males, females and mixed sexes, it is clear that the results for the mixed sexes and for each sex are different. For example, while for males and for the mixed sexes all landmarks show statistically significant differences between the emaciated and overweight categories, the same does not happen in the correspondent anatomical points and BMI categories for females (Table 5). Males showed statistically significant differences between all the BMI categories at the cheek, jaw and around the eye regions, while between the normal and overweight categories these differences were observed mainly at the nasal and chin areas and around the mouth portions of the face. Between the emaciated and normal categories the significant differences were found at the supraglabella and supramental landmarks. The analysis of the female results showed a distinct pattern of variation. The forehead and lower chin areas of the face showed statistically significant differences between the emaciated and normal categories and also between the emaciated and overweight categories. The comparison between the normal and overweight categories showed differences at the infra orbital landmark and jaw region, while between the emaciated and overweight categories these were recorded at the supra orbital landmark, cheek and jaw portions of the face. Landmarks from the nasal area and around the mouth regions showed no statistical differences for any of the female BMI comparisons. Although it is empirically observable that in general the facial tissues increase with an augment of weight, these results reveal that the distribution and accumulation of the adipose tissue along the different portions of the face is quite variable, not only between the sexes but also within the sexes. In this sense, and even though some authors argue that the sexual dimorphism displayed on facial soft tissue depths is not marked and is of little practical meaning for craniofacial identification, such that these data should be combined to increase sample sizes [34,35], in conformity with the results achieved, when the BMI is considered as a variable, the sexes must not be computed, and data should be presented in accordance with sexual dimorphism. This study also showed the presence of interpopulation variations in the facial soft tissue thicknesses when comparing the Portuguese data set with similar data from Caucasian groups of different geographic origin gathered with similar measuring methods. Although these variations were not very large and the unavailability of the raw data from the other studies invalidated the estimation of the statistical significance of the results, it is worth noting that Portuguese males displayed the thickest average soft tissue depths for all BMI categories at the occlusal line and mid-pilthrum landmarks. Furthermore, both Portuguese males and females showed the thickest average values for all BMI categories at the supra M2 landmark. These observations suggest a particularity of the Portuguese faces, namely a thicker buccal pad of fat. But the greater absolute differences were found between the Portuguese and Spanish data set, with some anatomical points displaying differences up to 5 mm for both sexes (Tables 6 and 7), supporting that geographic proximity between population groups does not necessarily mean similar soft tissue depths. Craniofacial morphology is a complex interaction between inheritance and environmental factors [37], and there-
fore it is important to collect data from geographically distinct populations. 5. Conclusion This paper attempts to bring a valuable contribution to the knowledge of the particularities of the Europeans faces since there were no previous data on the average soft tissue depths for the Portuguese adult population. Furthermore, given that the physiognomy of individuals changes in accordance with their nutritional status and taking into consideration the results attained, it is recommended that further studies on the estimation of the soft tissues thickness consider presenting data for the three main BMI and for both sexes. In fact, in the absence of evidences of an individual’s body structure from its skeletal remains, a range of possible faces, taking into account data from the three main BMI categories, should be generated for better results in the achievement of the likeness of unidentified persons. Acknowledgements I would like to thank Professor Euge´nia Cunha from the Department of Anthropology, University of Coimbra, Professor Jorge Costa Santos, Director of the South Branch of the Portuguese National Institute of Legal Medicine (INML), Dr. Francisco Costa Santos (INML), Dr. Luisa Eiras (INML), Dr. Filipa Gallo (INML) and the autopsy room technicians for their disposition. I would also like to thank the Fundac¸a˜o para a Cieˆncia e Tecnologia (FCT) for the financial support for this research (grant reference SFRH/BD/ 21604/2005). References [1] K.T. Taylor, Forensic Art and Illustration, CRC Press, Boca Raton, FL, 2001. [2] C. Wilkinson, Forensic Facial Reconstruction, Cambridge University Press, Cambridge, 2004. [3] H. Welcker, Schiller’s Scha¨del und Todenmaske, nebst Mittheilungen u¨ber Scha¨del und Todenmaske Kants, Vieweg und Sohn, Braunschweig, 1883. [4] W. His, Anatomische Forschungen u¨ber Johann Sebastian Bach Gebeine und Antlitz. nebst Bemerkungen u¨ber dessen Bilder, Abhandlungen der mathematisch-physikalischen Klase der Ko¨niglichen Sachsischen Gesellschaft der Wissenchaften 22 (1895) 379–420. [5] J. Kollmann, W. Bu¨chly, Die Persistenz der Rassen und die Reconstruction der Physiognomie pra¨historischer Scha¨del, Arch. Anthropol. 25 (1898) 329–359. [6] W.M. Krogman, The reconstruction of the living head from the skull, FBI Law Enforcement Bull. 15 (1946) 1–8. [7] M.M. Gerasimov, The Face Finder, Hutchinson & Co., London, 1968. [8] C.C. Snow, B. Gatliff, K.R. McWilliams, Reconstruction of facial features from the skull, an evaluation of its usefulness in forensic anthropology, Am. J. Phys. Anthropol. 33 (1970) 221–228. [9] K. Suzuki, On the thickness of the soft parts of the Japanese face, J. Anthropol. Soc. Nippon 60 (1948) 7–11. [10] J.S. Rhine, H.R. Campbell H.R., Thickness of facial tissue in American Blacks, J. Forensic Sci. 25 (1980) 847–858. [11] J.S. Rhine, Tissue Thickness for the Southwestern Indians [Dissertation], Physical Anthropology Laboratories, Maxwell Museum, University of New Mexico, 1983. [12] J.S. Rhine, C.E. Moore, Tables of Facial Tissue Thickness of American Caucasoids in Forensic Anthropology. Maxwell Museum Technical Series, vol. 1, University of New Mexico, 1984. [13] R.M. George, The lateral craniographic method of facial reconstruction, J. Forensic Sci. 32 (5) (1987) 1305–1330. [14] C.V. Lebedinskaya, T.S. Balueva, E.V. Veselovskaya, Principles of facial reconstruction, in: M.Y. Iscan, R.P. Helmer (Eds.), Forensic Analysis of the Skull, Willey–Liss, New York, 1993, pp. 183–198. [15] W.A. Aulsebrook, P.J. Becker, Y.M. Iscan, Facial soft-tissue thicknesses in the adult male Zulu, Forensic Sci. Int. 79 (1996) 83–102. [16] V.M. Phillips, N.A. Smuts, Facial reconstruction: utilization of computerized tomography to measure facial tissue thickness in a mixed racial population, Forensic Sci. Int. 83 (1996) 51–59. [17] M.H. Manheim, G.A. Listi, R.E. Barsly, R. Musselman, E. Barrow, D. Ubelaker, In vivo facial tissue depth measurements for children and adults, J. Forensic Sci. 45 (1) (2000) 48–60. [18] I.H. El-Mehallawi, E.M. Soliman, Ultrasonic assessment of facial soft tissue thicknesses in adult Egyptians, Forensic Sci. Int. 117 (2001) 99–107.
S. Codinha / Forensic Science International 184 (2009) 80.e1–80.e7 [19] E. Simpson, M. Henneberg, Variation in soft-tissue thicknesses on the human face and their relation to craniometric dimensions, Am. J. Phys. Anthropol. 118 (2002) 121–133. [20] D. Sahni, I. Jit, M. Gupta, P. Singh, S. Suri, Preliminary study on facial soft tissue thickness by magnetic resonance imaging in Northwest Indians, Forensic Sci. Commun. 4 (1) (2002), http://www.fbi.gov/hq/lab/fsc/backissu/jan2002/ sahni.htm. [21] M. Villanueva, C. Serrano, L. Escorcia, L. Valencia, Grosor de tejido blando en una serie Mexicana, Antropol. Fis. Latinoam. 4 (2006) 231–245. [22] M. Domaracki, C. Stephan, Facial soft tissue thicknesses in Australian adult cadavers, J. Forensic Sci. 47 (4) (2006) 730–735. [23] S. De Greef, P. Claes, D. Vandermeulen, W. Mollemans, P. Suetens, G. Willems, Large-scale in-vivo Caucasian facial soft tissue thicknesses database for craniofacial reconstruction, Forensic Sci. Int. 159 (2006) 126–146. [24] L. Valencia, Metodologia para elaborar reconstrucciones faciales empleando gra´ficos computorizados tridimensionales [dissertation], Laboratorio de Antropologı´a, Universidad de Granada, 2007. [25] D. Bellman, T. Fuchs, A. Weidenbusch, J. Haber, K.M. Stein, T. Georg, J. Wilske, Computer-aided measurement of the tissue thickness of deceased persons with computer tomography scans of the head, in: T.M. Buzug, K.-M. Sigl, J. Bongartz, K. Pru¨fer (Eds.), Facial Reconstruction/Gesichtsrekonstruktion, BKA Series: Police and Research, vol. 35, Luchterhand/WoltersKluwer, Mu¨nchen, 2007, pp. 21–39. [26] S. Niinima¨, A. Karttunen, Study on the facial tissue thickness of the Finns, in: T.M. Buzug, K. Sigl, J. Bongartz, K. Pru¨fer (Eds.), Facial Reconstruction/Gesichtsrekonstruktion, BKA Series: Police and Research, vol. 35, Luchterhand/WoltersKluwer, Mu¨nchen, 2007, pp. 95–120.
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[27] D. Sahni, P. Claes, G.S. Singh, I. Jit, P. Singh, Facial soft tissue thickness in northwest Indian adults, Forensic Sci. Int. 176 (2008) 137–146. [28] V. Suk, Fallacies of Anthropological Identifications and Reconstructions. A Critique Based on Anatomical Dissections, vol. 22, Publications of the Faculty of Science, University of Masaryk, 1935, pp. 337–372. [29] S.S. Rocha, D.L.P. Ramos, M.G.P. Cavalcanti, Applicability of 3D-CT facial reconstruction for forensic identification, Pesqui. Odontol. Bras. 17 (1) (2003) 24–28. [30] P.R.N. Sutton, Zygomatic diameter: the thickness of the soft tissues over the zygions, Am. J. Phys. Anthropol. 30 (1969) 303–310. [31] A.J. Tyrrell, M.P. Evison, A.T. Chamberlain, M.A. Green, Forensic three-dimensional facial reconstruction: historical review and contemporary developments, J. Forensic Sci. 42 (4) (1997) 653–661. [32] G. Quatrehomme, S. Cotin, G. Subsol, H. Delingette, Y. Garidel, G. Gre´vin, M. Fidrich, P. Bailet, A. Ollier, A fully three-dimensional method for facial reconstruction based on deformable models, J. Forensic Sci. 42 (4) (1997) 649–652. [33] T. Perini, G. Oliveira, J. Ornellas, F. Oliveira, Ca´lculo do erro te´cnico de medic¸a˜o em antropometria, Rev. Bras. Med. Esporte. 11 (1) (2005) 81–86. [34] G.J.R. Maat, Facial reconstruction: a review and comment, TALANTA 30–31 (1998–1999) 247–253. [35] C.N. Stephan, R.M. Norris, M. Henneberg, Does sexual dimorphism in facial soft tissue depths justify sex distinction in craniofacial identification? J. Forensic Sci. 50 (3) (2005) 513–518. [36] J.M. Starbuck, R.E. Ward, The effect of tissue depth variation on craniofacial reconstructions, Forensic Sci. Int. 172 (2–3) (2007) 130–136. [37] B. Baydas, A. Erdem, I. Yavuz, I. Ceylan, Hereditability of facial proportions and soft-tissue profile characteristics in Turkish Anatolian siblings, Am. J. Othod. Dentofacial. Orthop. 131 (4) (2007) 504–509.
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Forensic Science International journal homepage: www.elsevier.com/locate/forsciint
Forensic Anthropology Population Data
Facial soft tissue thicknesses for the Portuguese adult population So´nia Codinha * Departamento de Antropologia, Faculdade de Cieˆncias e Tecnologia da Universidade de Coimbra, Rua Arco da Traic¸a˜o, 3000-056 Coimbra, Portugal
A R T I C L E I N F O
A B S T R A C T
Article history: Received 8 October 2008 Received in revised form 17 November 2008 Accepted 18 November 2008 Available online 4 January 2009
In recent years there has been an important increment of studies on the determination of facial soft tissue thicknesses for craniofacial identification purposes. In spite of this, there is no information on the particularities of the facial soft tissue depths for the Portuguese adult population. In order to address this lack, the soft tissue thicknesses of a Portuguese cadaver sample of 151 individuals, 103 males and 48 females with ages between 20 and 99 years old, autopsied at the South Branch of the National Institute of Legal Medicine, were measured using published needle puncture methods at 20 anatomical points. The stature and weight of all cadavers were determined and their body mass index (BMI) calculated. In order to prevent post-mortem distortion, soft tissue depths were assessed prior to the individual’s autopsy in cadavers whose time of death did not exceed 24 h. From these data, descriptive statistics were calculated and the average soft tissue depths were reported considering the BMI and the sex of the cadavers. In general, males were found to have greater soft tissue depths than females but some landmarks showed the opposite while others presented the same values for both sexes. In spite of this, almost all the differences among the sexes were found to be not statistically significant. The Post Hoc Gabriel test performed between the different BMI categories for mixed sexes and for each sex suggested BMI-related differences on the soft tissue thicknesses, although these vary considerably within and between the sexes with no linear correspondence between the anatomical landmarks. These results, point not only to the necessity to present data in accordance with the sexual dimorphism, but also to consider the BMI as an important variable for better results in the achievement of the likeness of the deceased individuals in both two-dimensional and three-dimensional facial approximations or superimpositions. Additionally, evidence of interpopulation differences in the average soft tissue thicknesses were observed by the comparison of this data set with similar studies from Caucasian groups with different geographic origin. ß 2008 Elsevier Ireland Ltd. All rights reserved.
Keywords: Craniofacial identification Soft tissue thicknesses Body mass index Adult cadavers
1. Introduction Craniofacial identification methods rely mostly on the knowledge of soft tissue thicknesses on determined anatomical points of the skull both in situations where a facial approximation is conducted or using superimposition methods [1,2]. The first studies to establish average facial soft tissue depths go back to the end of the 19th century and were performed on cadaver samples using the needle puncture technique [3–5]. Only in the middle of the 20th century, as an outcome of the increasing importance of facial approximation techniques as an auxiliary tool in the identification of human skeletal remains in forensic contexts [1,2,6–8], the investigation on facial soft tissue depths was incremented. Consequently several researchers developed average facial soft tissue depths tables for adult individuals of both sexes and different ancestry [9–27].
* Tel.: +351 239 855 210; fax: +351 239 823 491. E-mail address: [email protected]. 0379-0738/$ – see front matter ß 2008 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.forsciint.2008.11.011
In recent times, the advent of non-invasive diagnostic techniques such as cephalometric radiographs, ultrasound probing, magnetic resonance imaging (MRI) and computerized tomography allowed the access to samples of living individuals, providing an important actualization on the average soft tissue values for adults [13–18,20,23,26,27]. MRI and CT scan methods of data collection have been pointed as the most accurate techniques for measuring soft tissue thicknesses [20,29], but these are expensive and CT implies high radiation outputs harmful to biological tissues. Furthermore, the realization of these studies is often associated with medical diagnostic procedures. All these constraints are reflected in the intermittent studies published using these non-invasive techniques [20,23,25–27]. As mentioned, the needle puncture technique was the first method used to collect soft tissue depths data. Although this methodology has been identified with many constraints, namely the distortion of the soft tissues as a consequence of the decomposition processes associated with the nature of the samples, the difficulty in identifying the measurements sites [28] and the false measurements that can be caused by the horizontal position of the cadavers
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due the action of gravity [2], this technique also has some advantages such as the immobility of the subjects, the inexpensiveness and simplicity of the equipment required and the possibility of measuring any point in the head [22]. Studies on soft tissue depths from both cadaver and living samples always group the individuals according to their sex and population’s affinity, but most only consider individuals of normal complexion [3,9,13–21,24,27]. Exceptions are the analysis performed by Rhine and Campbell [10], Rhine [11], Rhine and Moore [12], Villanueva et al. [21], De Greef et al. [23], Valencia [24] and Bellman et al. [25], which took into account the three main BMI categories in the presentation of the data. Although we cannot be absolutely sure of an individual’s complexion only by its skeleton, if we have complete and well preserved human skeletal remains or if any clothing is found associated with those remains, we may infer the robustness of the victims. Knowing that the facial soft tissues vary in accordance with the nutritional condition of the individuals [4,5,9–12,23,27,30], it is important to have data for the three main body builds (emaciated, normal and overweight), particularly in forensic contexts, since the facial variation resulting from the different body types has the potential to constrain the effectiveness of facial recognition [31,32]. Therefore, this paper attempts to contribute data on the average soft tissues thicknesses for the Portuguese adult population, for which there were no data, taking into account the body mass index (BMI) of the individuals. Considerations on the effect of the different BMI in the soft tissue depths within and between the sexes, and how it affects the different regions of facial anatomy, are also discussed. In order to evaluate the interpopulation variation, data will also be compared with published [12,21] and unpublished [24] data sets from Caucasian groups with distinct geographic origin, which used similar samples and methods.
the craniofacial skeleton. In this sense, cause of death was assumed to have no impact on the results. Furthermore, individuals with beards or moustaches were also not considered. The stature and weight of all cadavers were measured and their body mass index calculated. The soft tissue measurements were performed at a total of 20 facial anatomical points, most of which are standard anthropological landmarks (Table 1). Eight of these measurement sites were in the midline and 12 were bilateral. The measurements followed the needle puncture methods [3–5], with a slight alteration. Instead of a rubber mark, a forceps positioned perpendicularly to the needle and parallel to the soft tissue was used against the skin to determine the soft tissue limit. This procedure intended to prevent any artificial alteration on recording caused by the manipulation of rubber stoppers during the needle removal. In order to avoid the inevitable soft tissue compression induced by the introduction of the needle, the skin was pooled up along the needle and then capped at the level of the adjacent soft tissues with the help of a forceps. The soft tissue thickness at each point was measured reading the distance between the tip of the needle to the inner surface of the forceps against a stainless steel ruler (scale readable to 0.5 mm). All soft tissue depths were conducted by the author. Prior to the data collection, a careful analysis of the cadavers’ skull by palpation was performed to better identify the anatomical points in relation to the skull. A sample of 20 randomly selected cadavers was re-measured to evaluate the absolute and relative technical intraobserver error [33]. It must be noted that due to the fact that the data collection had to be done prior to the autopsy, as well as the need to avoid as much as possible the post-mortem soft tissues distortion due to decomposition, the re-measurements were done in a time period of 1–2 h after the first measurements. Data were analyzed using the Statistical Package for the Social Sciences (SPSS, version 15.0). General descriptive analyses were determined for each anatomical point and average soft tissue depths were calculated considering the BMI and the sex of the cadavers. The nature of the sample invalidated the consideration of age as a variable since the distribution of the individuals through the three main age groups (20–39, 40–59 and >60 years old), considering the sexes and BMI, resulted in very small samples sizes for certain age groups while others had no representatives at all. The differences between the sexes were compared using Independent samples T test and a multiple comparisons Post Hoc Gabriel test was performed between the different BMI categories for males, females and mixed sexes. The average soft tissue depths were compared with other studies that used similar methods and samples from Caucasian groups with different geographic origin. For all statistical analysis, a significance level of <0.05 was used.
2. Materials and methods This study was performed on a Portuguese cadaver sample of 151 individuals, 103 males and 48 females, autopsied at the South Branch of the National Institute of Legal Medicine (Lisbon). During the data collection all the ethical and legal requirements were followed. The age range of the sample was from 20 to 99 years old, with an average age of 62 years for males (ranging from 26 to 91 years) and 64 years for females (ranging from 20 to 99 years). In order to prevent post-mortem distortion as much as possible, soft tissue depths were assessed prior to the individual’s autopsy in cadavers whose time of death did not exceed 24 h. All cadavers were kept on refrigeration. None of the cadavers measured had signs of congenital deformity, trauma or diseases affecting the soft tissues of the face and
3. Results The results for the calculation of the absolute and relative technical intraobserver error were minimal for all anatomical points (Table 2). The absolute technical error was found to be less then 0.5 mm (Table 2) with the occlusal line and Supra M2 landmarks displaying the largest absolute technical error (0.3 mm). The measurement error exhibited by this study is less than those reported by other authors using needle puncture
Table 1 Description of the anatomical landmarks considered in this study. Anatomical landmarks
Description
1. Supraglabella 2. Glabella 3. Nasion 4. Rhinion 5. Mid-pilthrum 6. Supramental 7. Pogonion 8. Gnathion 9. Supra orbital 10. Infra orbital 11. Mid-zygomatic
The most anterior point of the forehead, above the glabella in the midsagital plane The most prominent point between the supra orbital ridges in the midsagital plane Located at the midpoint of maximum convexity between the nose and forehead in the midsagital plane The anterior tip of the nasal bones Centred between the midpoint of the columella base and the vermilion border of the upper lip in the midsagital plane Centred in the fold of chin The most prominent point in the midline of the mental protuberance Most inferior point of the mandible in the midsagital plane A point in the supra orbital ridge in vertical alignment with the pupil of the eye Located in the lower bony orbital margin in vertical alignment with the pupil of the eye Perpendicular point to the lateral orbital border, centred between the lower border of the orbit and the lower portion of the zygomatic process The most lateral point of the zygomatic arch Point in the extremity of the anterior portion of the mandibular ramus at the horizontal level of the cheilion Middle point in the extremity of the posterior portion of the mandibular ramus between the condilion and the gonion Point located in the alveolar process at the level of the middle of the upper canine Point located in the alveolar process at the level of the middle of the lower canine Point located in the alveolar process at the level of the middle of the second upper molar Point located in the alveolar process at the level of the middle of the second lower molar Point in the inferior border of the mandible centred between gnathion and gonion Point located in the jaw line at the level of the angle between the posterior with the inferior borders of the mandible
12. 13. 14. 15. 16. 17. 18. 19. 20.
Zygion Occlusal line Mid-masseter Supra canine Infra canine Supra M2 Infra M2 Middle mandibular Gonion
S. Codinha / Forensic Science International 184 (2009) 80.e1–80.e7 Table 2 Relative and absolute technical error of measurement. Landmarks
Relative TEM (%)
Absolute TEM (mm)
1. Supraglabella 2. Glabella 3. Nasion 4. Rhinion 5. Mid-pilthrum 6. Supramental 7. Pogonion 8. Gnathion 9. Supra orbital 10. Infra orbital 11. Mid-zygomatic 12. Zygion 13. Occlusal line 14. Mid-masseter 15. Supra canine 16. Infra canine 17. Supra M2 18. Infra M2 19. Middle mandibular 20. Gonion
1.4 1.4 1.6 2.1 2.1 1 1.7 2.5 1.8 1.6 1.4 1.4 1.6 1 1.6 1.3 1.1 1.8 2.2 1.6
0.1 0.1 0.1 0.1 0.2 0.1 0.2 0.2 0.2 0.2 0.2 0.1 0.3 0.2 0.2 0.1 0.3 0.2 0.2 0.2
methods [19,22]. This may be related to the fact that remeasurements were taken relatively soon after the first measurements. Moreover, in some cadavers the piercing mark of the first measurement on the skin could be seen, enabling the author to reinsert the needles precisely at the previous point of insertion. The estimated average soft tissue thicknesses considering the sex and the BMI of the cadavers are presented in Tables 3 and 4. In general, males were found to have greater soft tissue depths then females, but some landmarks showed the opposite while others presented the same average value for both sexes. The largest soft tissue difference observed between the sexes was at the occlusal line landmark, namely 3.3 mm for the emaciated category and 2.4 mm for the normal category (Tables 3 and 4). The mid-pilthrum (2.4 mm) for the emaciated category and the gonion (2.3 mm) for the normal category were the other two landmarks, which displayed the largest differences between the sexes (Tables 3 and 4). On the other hand, for all BMI categories, the mid-zygomatic landmark was thicker in females (0.3 mm for the emaciated and normal categories and 0.7 mm for the overweight category). In the remainder landmarks where females showed thicker soft tissues, specifically the supramental
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and supra orbital landmarks for the emaciated category; the glabella, pogonion and zygion landmarks for the normal category; and the supraglabella, infra orbital and infra canine landmarks for the overweight complexion, the differences varied between 0.1 and 1 mm (Tables 3 and 4). Equal average soft tissue thicknesses for both sexes were found at the infra canine landmark for the normal category and at the glabella and zygion landmarks for the overweight category (Tables 3 and 4). It must be noted that most of the differences observed between the sexes were found to be not statistically significant (Table 5). The significant differences were observed mainly around the mouth and chin regions, with males showing the greater average values. That is, the supraglabella, mid-pilthrum, gnathion and occlusal line for emaciated category; rhinion, supra canine and infra M2 landmarks for the normal category; and nasion, midpilthrum and pogonion for the overweight category (Table 5). Nevertheless, we must always consider the considerable overlapping between the sexes demonstrated by the range values of each soft tissue landmark (Tables 3 and 4). In Table 5 are reported the results of the multiple comparisons Post Hoc Gabriel test performed between the different BMI categories for the mixed sexes and for each sex. Males showed statistically significant differences between the emaciated and overweight categories at all landmarks. Significant differences were also found at the supra orbital, infra orbital, mid-zygomatic, mid-masseter, infra M2, middle mandibular and gonion landmarks for all BMI comparisons. But at the supraglabella and supramental landmarks, these differences were only observed between the emaciated and normal categories. Moreover, at the glabella, nasion, rhinion, pogonion, gnathion, zygion and occlusal line landmarks, the significant differences were between the normal and overweight categories (Table 5). Females showed a completely different scenario. The supraglabella, glabella, pogonion and gnathion landmarks showed statistically significant differences between the emaciated and normal categories and between the emaciated and overweight categories. At the infra orbital, occlusal line, infra M2 and gonion landmarks these differences were between the normal and overweight categories as well as between the emaciated and overweight categories. The supra orbital, mid-zygomatic, zygion, mid-masseter, infra canine, supra M2 and middle mandibular landmarks were significantly different between the emaciated and overweight categories, while the nasion, rhinion, mid-pilthrum,
Table 3 Average soft tissue thicknesses (mm) for Portuguese adult males. Landmarks
1. Supraglabella 2. Glabella 3. Nasion 4. Rhinion 5. Mid-pilthrum 6. Supramental 7. Pogonion 8. Gnathion 9. Supra orbital 10. Infra orbital 11. Mid-zygomatic 12. Zygion 13. Occlusal line 14. Mid-masseter 15. Supra canine 16. Infra canine 17. Supra M2 18. Infra M2 19. Middle manbibular 20. Gonion
Emaciated (BMI<20) n = 19
Normal (BMI 20–25) n = 27
Overweight (BMI > 25) n = 57
Mean
S.D.
Range
Mean
S.D.
Range
Mean
S.D.
Range
3.2 4.9 5.3 2.5 10.2 9.2 9.8 6.5 6 6 8.7 5.7 18 15.2 9.2 8.8 22 9.7 6.2 10.8
0.8 1.0 1.5 1.1 2.5 1.7 2.0 1.7 1.4 2.5 2.3 1.8 3.7 4.7 3.4 1.9 4.8 2.8 1.9 3.6
2–4.5 3–6 3.5–8.5 1–4 6–14.5 6–13 8–14.5 4–10 3–8.5 3–11 4–12 2.5–9 13–24.5 7–24.5 2.5–15 6–12.5 11–31.5 6–17 3–8 5–17
4.4 5.8 5.8 3 11.1 10.8 10.9 7.5 7.4 8.1 11 7.9 20.4 20.6 10.3 9.7 23.4 12.6 9 14.2
1.4 1.3 1.3 0.8 2.3 2.5 2.1 1.7 1.3 2.5 2.4 2.4 3.3 4.2 1.8 1.8 3.5 2.4 1.9 3.8
2.5–9 3.5–8 3.5–10 2–5 8–17.5 8–15 5–14 5–12 5–10 4–15.5 7–16.5 4.5–13 14–26.5 14–30 7–13.5 4.5–12.5 17.5–30 8.5–17 7–12.5 8–22.5
4.8 6.9 6.6 3.7 12.2 11 12.8 9.4 8.5 10 12.3 11.2 24.6 26 11.2 10.8 27 16.6 12.2 19.3
1.0 1.6 1.5 1.3 2.7 1.9 2.4 2.3 1.6 2.8 2.1 4.0 3.5 4.9 2.5 1.7 5.4 4.0 3.5 5.2
2.5–7 5–11.5 4–9.5 1–8 8–16.5 8–17 9–20 6–14 4.5–12.5 4–17 8–17 5–26.5 5–26.5 16–37 8–17 7–15 8.5–26 8.5–26 6.5–22 7–38
S. Codinha / Forensic Science International 184 (2009) 80.e1–80.e7
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Table 4 Average soft tissue thicknesses (mm) for Portuguese adult females. Landmarks
Emaciated (BMI < 20) n = 9
1. Supraglabella 2. Glabella 3. Nasion 4. Rhinion 5. Mid-pilthrum 6. Supramental 7. Pogonion 8. Gnathion 9. Supra orbital 10. Infra orbital 11. Mid-zygomatic 12. Zygion 13. Occlusal line 14. Mid-masseter 15. Supra canine 16. Infra canine 17. Supra M2 18. Infra M2 19. Middle manbibular 20. Gonion
Normal (BMI 20–25) n = 11
Overweight (BMI > 25) n = 28
Mean
S.D.
Range
Mean
S.D.
Range
Mean
S.D.
Range
2.4 4.6 4.9 2.2 7.8 9.7 8.1 4.8 6.5 5.3 9.1 5.2 14.7 13.0 8.4 8.1 18.3 8.4 5.4 9.4
0.8 1.5 1.1 1.4 1.5 0.8 2.5 1.6 1.0 2.1 1.6 1.6 2.5 4.1 1.8 1.2 4.1 4.1 1.7 3.3
1–3 2–7 3–6.5 1–5.5 5–9 8–11 5–13 3–7.5 5–8 1–8.5 6.5–12 3–8 11.5–19 9.5–21 5–11 6–10 11–25 5–15 3–7.5 6.5–16
3.9 6.3 5.6 2.2 10.5 9.9 11.4 7.2 7.3 7.8 11.4 8.9 18.2 18.9 8.7 9.7 22.2 10.7 8.6 11.9
1.2 1.1 1.3 1.2 1.6 1.4 1.3 1.9 1.2 2.1 1.8 1.5 2.1 1.8 1.6 1.3 3.7 2.2 1.3 2.2
2–6.5 4.5–8 3.5–8 1–5 8–14 8–12 9–13.5 4–10 5.5–9 5–11.5 8.5–14.5 6.5–11.5 16–21 16–22 7–11 8–12.5 16–28 9–16 6–10 8.5–15
4.9 6.9 5.9 3 10.4 10.4 11.6 8 8.3 10.2 13 11.2 22.8 23.6 10.4 10.9 26.9 15.7 11.7 18.1
1.4 1.5 1.5 1.2 3.6 2.3 2.7 2.0 2.1 3.1 3.5 4.2 5.6 6.8 4.0 2.9 7.5 5.1 5.2 7.3
2–7 4–9.5 3–8 1–5.5 5.5–23 6–14.5 5–17 4–12 5–14 6–18 7–26 3–22 13.5–45 10.5–45 7–28 7–18 14.5–55 9–31 3.5–30 8–44
supramental and supra canine landmarks displayed no statistically significant differences between any of the BMI categories (Table 5). The comparison of the average soft tissue thicknesses for the Portuguese adult population with other studies that used similar methods and samples from Caucasian groups with different geographic origin, revealed some variations between the averages (Tables 6 and 7). Although these differences were not very large and the unavailability of the raw data from the other studies invalidated the estimation of the statistical significance of the results, it must be noted that in comparison to the other groups, the Portuguese males showed the thickest average values for all BMI categories at the supra M2, occlusal line and mid-pilthrum landmarks. Thicker values were also found at the infra orbital and gonion landmarks for the normal and overweight categories and at the mid-zygomatic for the emaciated and normal categories. In the opposite direction, the Portuguese males showed the smallest soft tissue depths at the infra M2 landmark for the
emaciated and normal body mass categories; at the supramental for the emaciated category; and at the supraglabella for the overweight complexion (Table 6). Portuguese females also showed the thickest average values at the supra M2 landmark for all body mass categories. Thickest average values were also observed at the supra orbital and midzygomatic for the emaciated and normal categories; at the pogonion, gnathion and zygion for the normal category; and at the infra orbital and occlusal line for the overweight category. In comparison to the other groups, the Portuguese females showed the smallest average values at the infra M2 and rhinion landmarks for the emaciated and normal categories, at the supraglabella for the emaciated, and at the supramental for the overweight complexion (Table 7). It must be noted that in spite of the geographical proximity of the Portuguese and Spanish, these two groups were the ones which exhibited the greater absolute differences between average values,
Table 5 Statistical analysis of the facial soft tissue thicknesses for the Portuguese adult population. Landmarks
Multiple comparisons (Post Hoc Gabriel) Mixed sexes between BMI
Independent samples T-test
Males between BMI
Females between BMI
Between sexes
<20/20–25 20–25/>25 <20/>25 <20/20–25 20–25/>25 <20/>25 <20/20–25 20–25/>25 <20/>25 BMI < 20 BMI 20–25 BMI > 25 1. Supraglabella 2. Glabella 3. Nasion 4. Rhinion 5. Mid-pilthrum 6. Supramental 7. Pogonion 8. Gnathion 9. Supra orbital 10. Infra orbital 11. Mid-zygomatic 12. Zygion 13. Occlusal line 14. Mid-masseter 15. Supra canine 16. Infra canine 17. Supra M2 18. Infra M2 19. Middle manbibular 20. Gonion *
0.000* 0.004* 0.323 0.514 0.092 0.051 0.007* 0.015* 0.007* 0.003* 0.001* 0.004* 0.011* 0.000* 0.475 0.080 0.263 0.011* 0.001* 0.039*
Significant at P 0.05.
0.028* 0.002* 0.051 0.008* 0.485 0.792 0.008* 0.001* 0.002* 0.000* 0.010* 0.000* 0.000* 0.000* 0.113 0.008* 0.001* 0.000* 0.000* 0.000*
0.000* 0.000* 0.000* 0.000* 0.001* 0.001* 0.000* 0.000* 0.000* 0.000* 0.000* 0.000* 0.000* 0.000* 0.002* 0.000* 0.000* 0.000* 0.000* 0.000*
0.001* 0.092 0.618 0.418 0.569 0.025* 0.260 0.256 0.006* 0.026* 0.002* 0.064 0.054 0.001* 0.354 0.278 0.720 0.016* 0.004* 0.048*
0.249 0.004* 0.043* 0.044* 0.179 0.471 0.001* 0.001* 0.006* 0.007* 0.046* 0.000* 0.000* 0.000* 0.314 0.024* 0.005* 0.000* 0.000* 0.000*
0.000* 0.000* 0.002* 0.001* 0.009* 0.001* 0.000* 0.000* 0.000* 0.000* 0.000* 0.000* 0.000* 0.000* 0.006* 0.000* 0.000* 0.000* 0.000* 0.000*
0.038* 0.038* 0.589 0.999 0.134 0.994 0.012* 0.023* 0.700 0.145 0.274 0.051 0.256 0.071 0.996 0.390 0.431 0.574 0.252 0.730
0.102 0.539 0.837 0.129 1.000 0.769 0.989 0.492 0.293 0.041* 0.295 0.169 0.020* 0.053 0.361 0.355 0.103 0.007* 0.082 0.012*
0.000* 0.000* 0.120 0.126 0.058 0.623 0.001* 0.000* 0.028* 0.000* 0.003* 0.000* 0.000* 0.000* 0.287 0.008* 0.002* 0.000* 0.000* 0.001*
0.019* 0.600 0.419 0.464 0.012* 0.412 0.060 0.021* 0.380 0.523 0.594 0.460 0.029* 0.229 0.552 0.330 0.058 0.349 0.303 0.328
0.318 0.298 0.631 0.020* 0.436 0.255 0.479 0.587 0.710 0.729 0.667 0.181 0.052 0.095 0.016* 0.980 0.376 0.033* 0.451 0.067
0.866 0.985 0.048* 0.056 0.014* 0.225 0.046* 0.011* 0.517 0.768 0.220 0.987 0.073 0.074 0.272 0.785 0.960 0.397 0.663 0.394
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Table 6 Comparison of facial soft tissue thicknesses measured using needle puncture methods on male cadavers from groups with different geographic origin. Landmarks
Supraglabella Glabella Nasion Rhinion Mid-pilthrum Supramental Pogonion Gnathion Supra orbital Infra orbital Mid-zygomatic Zygion Occlusal line Supra M2 Infra M2 Gonion
Emaciated
Normal
Overweight
Codinha [this paper]
Valencia [16]
Villanueva et al. [14]
Rhine and More [12]
Codinha [this paper]
Valencia [16]
Villanueva et al. [14]
Rhine and More [12]
Codinha [this paper]
Valencia [16]
Villanueva et al. [14]
Rhine and More [12]
Portuguese n = 19
Spanish n=8
Mexican n=8
American Caucasians n=3
Portuguese n = 27
Spanish n=8
Mexican n = 18
American Caucasians n = 37
Portuguese n = 57
Spanish n=4
Mexican n = 18
American Caucasians n=8
3.2 4.9 5.3 2.5 10.2 9.2 9.8 6.5 6.0 6.0 8.7 5.7 18.0 22.0 9.7 10.8
4.3 6.1 3.0 10.2 7.6 9.3 6.1 5.3 6.0 8.5 6.3 9.2 14.5 13.1 12.1 12.1
4.2 5.1 6.2 2.8 10.1 10.8 9.8 7.5 6.2 6.0 7.7 7.6 15.4 14.1 11.7 12.5
2.3 2.5 4.3 2.5 6.3 8.8 7.0 4.5 6.3 2.8 5.0 3.0 12.0 12.0 10.0 4.5
4.4 5.8 5.8 3.0 11.1 10.8 10.9 7.5 7.4 8.1 11.0 7.9 20.4 23.4 12.6 14.2
4.4 5.7 2.6 9.9 7.7 9.1 7.4 4.5 6.7 7.5 8.8 8.8 16.6 15.7 15.2 12.7
4.8 5.8 6.7 3.1 10.7 11.5 10.5 8.5 6.8 7.2 9.5 8.5 16.7 15.5 13.0 14.1
4.3 5.3 6.5 3.0 10.0 10.8 11.3 7.3 8.3 5.8 10.0 7.3 18.3 19.5 16.0 11.5
4.8 6.9 6.6 3.7 12.2 11 12.8 9.4 8.5 10.0 12.3 11.2 24.6 27 16.6 19.3
5.8 5.8 2.2 9.9 7.5 8.5 5.8 4.5 6.7 6.9 8.6 8.3 15.5 13.9 14.8 14.2
5.4 6.6 7.1 3.5 11.4 12.8 12.4 10.2 8.1 8.7 10.4 10.7 20.0 18.1 15.4 17.5
5.5 7.5 7.5 3.5 11.0 12.3 14.0 10.8 10.3 8.3 13.8 11.8 23.5 25.0 19.8 17.5
the average soft tissue thicknesses for the Portuguese adult population, for which, until the present study, were no records. Furthermore, this analysis also brings into discussion the need to consider the different BMI categories of the individuals while performing average soft tissue tables since it was observed that soft tissue depths vary considerably and not in a linear manner when the BMI is introduced as a variable. Given that the physiognomy of individuals changes in accordance with their nutritional status [4,5,9–12,23,27,30], it is significant to have access to this type of data. In fact, on a study performed on the effect of tissue depth variation on craniofacial reconstruction, Starbuck and Ward [36] observed that ‘‘variation in weight may be an important contributor to the ability to achieve correct recognition of a reconstructed face’’ since apparently the size of the face plays a stronger role than facial configuration in the identification of individuals. As expected from the natural sexual dimorphism displayed by the skull and facial musculature and as recorded by similar studies [9–12,21,22,24], the present analysis showed that in general
with some anatomical points displaying differences up to 5 mm for both sexes (Tables 6 and 7). The greatest differences were observed at the supra M2 landmark for both males and females (6.5 mm for overweight females and 13.1 mm for emaciated males). 4. Discussion One of the main problems concerning the forensic craniofacial identification methods is the reliance on the use of average soft tissue depths values as control in tri-dimensional and bidimensional facial approximations and/or superimposition techniques. Taking into account that each face has its own particularities, this situation contributes with a great deal of error and compromises the success of the achievement of the likeness of unidentified deceased individuals. Considering the phenotypic variation observed in Europeans and bearing in mind that the effectiveness of the probability of achieving the resemblance of a person is related to the access of data gathered from genetically related individuals [15], this paper attempts to contribute data on
Table 7 Comparison of facial soft tissue thicknesses measured using needle puncture methods on female cadavers from groups with different geographic origin. Landmarks
Supraglabella Glabella Nasion Rhinion Mid-pilthrum Supramental Pogonion Gnathion Supra orbital Infra orbital Mid-zygomatic Zygion Occlusal line Supra M2 Infra M2 Gonion
Emaciated
Normal
Overweight
Codinha [this paper]
Valencia [16]
Villanueva et al. [14]
Rhine and More [12]
Codinha [this paper]
Valencia [16]
Villanueva et al. [14]
Rhine and More [12]
Codinha [this paper]
Valencia [16]
Villanueva et al. [14]
Rhine and More [12]
Portuguese n=9
Spanish n=6
Mexican n = 41
American Caucasians n=3
Portuguese n = 11
Spanish n=8
Mexican n = 87
American Caucasians n = 19
Portuguese n = 28
Spanish n=8
Mexican n = 40
American Caucasians n=3
2.4 4.6 4.9 2.2 7.8 9.7 8.1 4.8 6.5 5.3 9.1 5.2 14.7 18.3 8.4 9.4
3.8 5.5 2.8 10.6 9.3 9.8 6.1 4.0 6.2 7.2 6.3 6.8 14.5 14.6 14.0 11.1
4.2 4.7 5.6 2.8 10.4 9.2 9.5 6.8 6.2 6.0 8.0 7.1 14.8 12.5 11.0 10.8
2.5 4.0 5.3 2.3 5.0 9.3 8.5 3.8 5.3 4.0 6.0 3.5 11.0 12.0 9.5 5.0
3.9 6.3 5.6 2.2 10.5 9.9 11.4 7.2 7.3 7.8 11.4 8.9 18.2 22.2 10.7 11.9
4.6 5.6 3.4 9.8 9.4 10.4 6.9 5.0 7.1 7.8 8.7 8.8 19.1 17.8 15.6 17.0
4.2 5.2 5.4 2.4 9.5 10.3 9.3 6.7 6.2 7.0 8.5 8.8 16.4 14.3 11.5 13.2
3.5 4.8 5.5 2.8 8.5 9.5 10.0 5.8 7.0 6.0 10.8 7.5 17.0 19.3 15.5 12.0
4.9 6.9 5.9 3.0 10.4 10.4 11.6 8 8.3 10.2 13.0 11.2 22.8 26.9 15.7 18.1
6.0 7.0 3.4 11.7 11.6 12.7 9.1 5.6 8.0 9.7 11.2 10.5 21.6 20.4 17.8 19.5
4.8 6.0 6.0 2.8 9.5 11.2 11.2 9.2 7.2 8.2 10.5 10.3 16.5 16.1 12.8 13.8
4.3 7.5 7.0 4.3 9.0 13.8 14.3 9.0 10.0 8.5 14.8 11.3 20.3 23.8 18.8 17.5
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Portuguese males have thicker soft tissues than females. These differences are statistically significant at most of the midline landmarks and around the mouth and chin regions of the face. In spite of this, some anatomical points revealed identical average values for both sexes, while the anatomical landmarks at the cheek region for all BMI categories were found to be thicker for females. Although only half of the anatomical landmarks considered in this study showed statistically significant differences between the sexes, when we compare the average soft tissue depths between the BMI categories for males, females and mixed sexes, it is clear that the results for the mixed sexes and for each sex are different. For example, while for males and for the mixed sexes all landmarks show statistically significant differences between the emaciated and overweight categories, the same does not happen in the correspondent anatomical points and BMI categories for females (Table 5). Males showed statistically significant differences between all the BMI categories at the cheek, jaw and around the eye regions, while between the normal and overweight categories these differences were observed mainly at the nasal and chin areas and around the mouth portions of the face. Between the emaciated and normal categories the significant differences were found at the supraglabella and supramental landmarks. The analysis of the female results showed a distinct pattern of variation. The forehead and lower chin areas of the face showed statistically significant differences between the emaciated and normal categories and also between the emaciated and overweight categories. The comparison between the normal and overweight categories showed differences at the infra orbital landmark and jaw region, while between the emaciated and overweight categories these were recorded at the supra orbital landmark, cheek and jaw portions of the face. Landmarks from the nasal area and around the mouth regions showed no statistical differences for any of the female BMI comparisons. Although it is empirically observable that in general the facial tissues increase with an augment of weight, these results reveal that the distribution and accumulation of the adipose tissue along the different portions of the face is quite variable, not only between the sexes but also within the sexes. In this sense, and even though some authors argue that the sexual dimorphism displayed on facial soft tissue depths is not marked and is of little practical meaning for craniofacial identification, such that these data should be combined to increase sample sizes [34,35], in conformity with the results achieved, when the BMI is considered as a variable, the sexes must not be computed, and data should be presented in accordance with sexual dimorphism. This study also showed the presence of interpopulation variations in the facial soft tissue thicknesses when comparing the Portuguese data set with similar data from Caucasian groups of different geographic origin gathered with similar measuring methods. Although these variations were not very large and the unavailability of the raw data from the other studies invalidated the estimation of the statistical significance of the results, it is worth noting that Portuguese males displayed the thickest average soft tissue depths for all BMI categories at the occlusal line and mid-pilthrum landmarks. Furthermore, both Portuguese males and females showed the thickest average values for all BMI categories at the supra M2 landmark. These observations suggest a particularity of the Portuguese faces, namely a thicker buccal pad of fat. But the greater absolute differences were found between the Portuguese and Spanish data set, with some anatomical points displaying differences up to 5 mm for both sexes (Tables 6 and 7), supporting that geographic proximity between population groups does not necessarily mean similar soft tissue depths. Craniofacial morphology is a complex interaction between inheritance and environmental factors [37], and there-
fore it is important to collect data from geographically distinct populations. 5. Conclusion This paper attempts to bring a valuable contribution to the knowledge of the particularities of the Europeans faces since there were no previous data on the average soft tissue depths for the Portuguese adult population. Furthermore, given that the physiognomy of individuals changes in accordance with their nutritional status and taking into consideration the results attained, it is recommended that further studies on the estimation of the soft tissues thickness consider presenting data for the three main BMI and for both sexes. In fact, in the absence of evidences of an individual’s body structure from its skeletal remains, a range of possible faces, taking into account data from the three main BMI categories, should be generated for better results in the achievement of the likeness of unidentified persons. Acknowledgements I would like to thank Professor Euge´nia Cunha from the Department of Anthropology, University of Coimbra, Professor Jorge Costa Santos, Director of the South Branch of the Portuguese National Institute of Legal Medicine (INML), Dr. Francisco Costa Santos (INML), Dr. Luisa Eiras (INML), Dr. Filipa Gallo (INML) and the autopsy room technicians for their disposition. I would also like to thank the Fundac¸a˜o para a Cieˆncia e Tecnologia (FCT) for the financial support for this research (grant reference SFRH/BD/ 21604/2005). References [1] K.T. Taylor, Forensic Art and Illustration, CRC Press, Boca Raton, FL, 2001. [2] C. Wilkinson, Forensic Facial Reconstruction, Cambridge University Press, Cambridge, 2004. [3] H. Welcker, Schiller’s Scha¨del und Todenmaske, nebst Mittheilungen u¨ber Scha¨del und Todenmaske Kants, Vieweg und Sohn, Braunschweig, 1883. [4] W. His, Anatomische Forschungen u¨ber Johann Sebastian Bach Gebeine und Antlitz. nebst Bemerkungen u¨ber dessen Bilder, Abhandlungen der mathematisch-physikalischen Klase der Ko¨niglichen Sachsischen Gesellschaft der Wissenchaften 22 (1895) 379–420. [5] J. Kollmann, W. Bu¨chly, Die Persistenz der Rassen und die Reconstruction der Physiognomie pra¨historischer Scha¨del, Arch. Anthropol. 25 (1898) 329–359. [6] W.M. Krogman, The reconstruction of the living head from the skull, FBI Law Enforcement Bull. 15 (1946) 1–8. [7] M.M. Gerasimov, The Face Finder, Hutchinson & Co., London, 1968. [8] C.C. Snow, B. Gatliff, K.R. McWilliams, Reconstruction of facial features from the skull, an evaluation of its usefulness in forensic anthropology, Am. J. Phys. Anthropol. 33 (1970) 221–228. [9] K. Suzuki, On the thickness of the soft parts of the Japanese face, J. Anthropol. Soc. Nippon 60 (1948) 7–11. [10] J.S. Rhine, H.R. Campbell H.R., Thickness of facial tissue in American Blacks, J. Forensic Sci. 25 (1980) 847–858. [11] J.S. Rhine, Tissue Thickness for the Southwestern Indians [Dissertation], Physical Anthropology Laboratories, Maxwell Museum, University of New Mexico, 1983. [12] J.S. Rhine, C.E. Moore, Tables of Facial Tissue Thickness of American Caucasoids in Forensic Anthropology. Maxwell Museum Technical Series, vol. 1, University of New Mexico, 1984. [13] R.M. George, The lateral craniographic method of facial reconstruction, J. Forensic Sci. 32 (5) (1987) 1305–1330. [14] C.V. Lebedinskaya, T.S. Balueva, E.V. Veselovskaya, Principles of facial reconstruction, in: M.Y. Iscan, R.P. Helmer (Eds.), Forensic Analysis of the Skull, Willey–Liss, New York, 1993, pp. 183–198. [15] W.A. Aulsebrook, P.J. Becker, Y.M. Iscan, Facial soft-tissue thicknesses in the adult male Zulu, Forensic Sci. Int. 79 (1996) 83–102. [16] V.M. Phillips, N.A. Smuts, Facial reconstruction: utilization of computerized tomography to measure facial tissue thickness in a mixed racial population, Forensic Sci. Int. 83 (1996) 51–59. [17] M.H. Manheim, G.A. Listi, R.E. Barsly, R. Musselman, E. Barrow, D. Ubelaker, In vivo facial tissue depth measurements for children and adults, J. Forensic Sci. 45 (1) (2000) 48–60. [18] I.H. El-Mehallawi, E.M. Soliman, Ultrasonic assessment of facial soft tissue thicknesses in adult Egyptians, Forensic Sci. Int. 117 (2001) 99–107.
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