FORENSIC MEDICAL ASSESSMENT OF TOOTH INJURIES IN FALLS FROM A STANDING POSITION ONTO A HARD SURFACE: A RETROSPECTIVE ANALYSIS OF ARCHIVAL MATERIALS

Background: In forensic medical practice, assessment of dental injuries requires a valid distinction between trauma caused by a fall from a standing position onto a hard surface and trauma caused by a direct blow with a blunt object. An isolated description of a tooth defect without considering localization, associated soft tissue injuries, and case circumstances is insufficient for reliable interpretation of the injury mechanism. Aim: To identify the combination of clinical and radiographic features of tooth and periodontal injuries that is most informative for forensic medical assessment of the probable injury mechanism in falls from a standing position onto a hard surface. Methods: A retrospective descriptive analysis of 23 anonymized archival records of forensic medical examinations in cases of tooth trauma from 2020 to 2024 was performed. Only cases containing information on fall circumstances, dental status descriptions, photographic documentation, and, when available, radiographic or microscopic data obtained during the primary examination were included. No repeated examinations, new measurements, or additional interventions were performed for the present study. Results: Falls from a standing position onto a hard surface were most commonly associated with a combination of injuries to the anterior teeth and trauma to the lips, perioral tissues, and, in some cases, the chin. The leading dental findings were crown cracks and fractures, subluxation or luxation of individual teeth, radiographic signs of periodontal reaction, and local injury to the alveolar bone. An isolated crown defect alone was not sufficiently specific; diagnostic value emerged from the whole pattern of findings and its correspondence to the circumstances of the fall. Conclusion: Forensic medical assessment of tooth injuries in falls should be based on an integrated analysis of the clinical and radiographic features of dental injuries, periodontal condition, associated soft tissue damage, and the reported kinematics of the event. This approach improves the validity of conclusions regarding the probable mechanism of injury and reduces the risk of overinterpreting isolated features.