Positive identification through comparative dental analysis in mass disaster: a systematic review and meta-analysis

Purpose: The study aimed to assess the probability of achieving positive identification through comparative dental analysis (CDA) and to determine the factors that influence its success rate in mass disaster scenarios. Methods: An electronic literature search was conducted across six databases for observational studies that reported both the total number of mass disaster victims and the count of victims identified through CDA alone. A random-effect meta-analysis, using the proportion of victims identified with CDA as the effect size, was conducted alongside subgroup analyses based on the type of disaster (natural or non-natural), the disaster classification (open or closed), and the geographical region (i.e., Europe, Asia). Results: The search yielded 3133 entries, out of which 32 studies were deemed eligible. Most of the studies (96.8%) presented a low risk of bias. The meta-analysis revealed a mean weighted-proportion probability of 0.32, indicating that forensic odontology could identify about one-third of the victims in a mass disaster. The probability of comparative dental identification was three times higher in closed mass disasters compared to open disasters (p < 0.05) and was higher in mass disasters occurring in North America and Europe compared to other regions (p < 0.05). Conclusion: The current result suggested that CDA can identify approximately 32% of a victim in a hypothetical scenario, emphasizing the integral role of teeth and forensic odontology in victim identification framework.