title: Determination of medicinal and illicit drugs in post mortem dental hard tissues and comparison with analytical results for body fluids and hair samples.
abstract: In burnt or skeletonized bodies dental hard tissue sometimes is the only remaining specimen available. Therefore, it could be used as an alternative matrix in post mortem toxicology. Additionally, analysis of dental tissues could provide a unique retrospective window of detection. For forensic interpretation, routes and rates of incorporation of different drugs as well as physicochemical differences between tooth root, tooth crown and carious material have to be taken into account. In a pilot study, one post mortem tooth each from three drug users was analyzed for medicinal and illicit drugs. The pulp was removed in two cases; in one case the tooth was root canal treated. The teeth were separated into root, crown and carious material and drugs were extracted from the powdered material with methanol under ultrasonication. The extracts were screened for drugs by LC-MS(n) (ToxTyper™) and quantitatively analyzed with LC-ESI-MS/MS in MRM mode. The findings were compared to the analytical results for cardiac blood, femoral blood, urine, stomach content and hair. In dental hard tissues, 11 drugs (amphetamine, MDMA, morphine, codeine, norcodeine, methadone, EDDP, fentanyl, tramadol, diazepam, nordazepam, and promethazine) could be detected and concentrations ranged from approximately 0.13pg/mg to 2,400pg/mg. The concentrations declined in the following order: carious material>root>crown. Only the root canal treated tooth showed higher concentrations in the crown than in the root. In post mortem toxicology, dental hard tissue could be a useful alternative matrix facilitating a more differentiated consideration of drug consumption patterns, as the window of detection seems to overlap those for body fluids and hair.
authors.affiliation: Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Albertstraße 9, 79104 Freiburg, Germany; Hermann Staudinger Graduate School, University of Freiburg, Hebelstraße 27, 79104 Freiburg, Germany.
authors.forename: Miriam
authors.initials: M
authors.lastname: Klima
authors.affiliation: Center for Dental Medicine, Department of Operative Dentistry and Periodontology, Medical Center - University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany.
authors.forename: Markus J
authors.initials: MJ
authors.lastname: Altenburger
authors.affiliation: Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Albertstraße 9, 79104 Freiburg, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Kempf
authors.affiliation: Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Albertstraße 9, 79104 Freiburg, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Auwärter
authors.affiliation: Institute of Forensic Medicine, Forensic Toxicology, Medical Center - University of Freiburg, Albertstraße 9, 79104 Freiburg, Germany. Electronic address: merja.neukamm@uniklinik-freiburg.de.
authors.forename: Merja A
authors.initials: MA
authors.lastname: Neukamm
mesh_terms: D005260:Female; D049429:Forensic Pathology; D008401:Gas Chromatography-Mass Spectrometry; D006197:Hair / Q000737:chemistry*; D006801:Humans; D013287:Illicit Drugs / Q000032:analysis* / Q000097:blood; D008297:Male; D008875:Middle Aged; D011180:Postmortem Changes; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000175:diagnosis*; D014070:Tooth / Q000737:chemistry*; D055815:Young Adult
chemical_list: D013287:Illicit Drugs
keywords: Alternative matrices; Drugs of abuse; Forensic toxicology; Post mortem toxicology; Teeth