Validity of a dichotomous expert response in bitemark analysis using 3-D technology

Despite efforts to quantify bitemark evidence, comparison procedures remain subjective and yield different degrees of certainty. Our aim was to study the effectiveness of a comparison procedure requiring a dichotomous response by the expert. We compared overlays from 3-D images of dental casts and bite impressions, obtained using DentalPrint© software. Receiver operating characteristic (ROC) analysis was performed on the results of 104 comparisons, finding an area under the ROC curve of 0.955 (standard error = 0.029; 95% CI, 0.896–0.986), sensitivity of 92.3% (95% CI, 74.8–98.8) and specificity of 98.7% (95% CI, 93.0–99.8). According to these findings, this bitemark analysis procedure is highly accurate, although study limitations are discussed, placing these results in context. The main advantage of the dichotomous decision model is that it can be more easily understood, facilitating course of justice. Further research is warranted to explore the potential of this approach as an alternative to diagnostic decisions based on certainty levels.