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Methods in population study of orofacial injuries in Victorian family violence homicides


This study standardized the methods used in the determination of orofacial injuries in Victorian family violence homicides and informed potential control selection for an analytic study. Dental service contacts with family violence victims may be intervention avenues due to the presence of abusive injuries in the orofacial region. All Victorian family homicides from January 2000-September 2018 were identified by determining the kinship/relationship and grouped by age. A 20% random sample of adult cases, aged 18–64 years was selected. The median number of orofacial injuries in categories of injury mechanisms/age/gender and the nature of abusive orofacial injuries was reported for the sample. Of 357 closed cases of family homicide, 261 were adults aged 18–64 years. Offender information and injury mechanism data was available for all closed cases, enabling case selection. Of a random sample of 50 adults, 8 cases were excluded. After 2006, CT scans and photos were present in 20 (91%) and 19 (86.4%) of 22 cases, respectively. The nature and median number of orofacial injuries showed correlation to the reported injury mechanism. Strengths and limitations of the used methods were assessed. Not all cases were compatible for assessment of orofacial injuries, thus serving as an additional criterion for exclusion in our methodology. Further detailed study of the whole population of adults should be limited to the period 2006–2018 where the data is more complete. The mechanism of injury may influence control selection for analytic studies. We present preliminary evidence of the frequent occurrence of orofacial injuries in family violence homicides.

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We acknowledge the statistical expertise provided by Dr. Baki Billah from the School of Public Health and Preventive Medicine, Monash University.

Authorship contribution

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Reena Sarkar. The first draft of the manuscript was written by Reena Sarkar and all authors critically appraised and reviewed the manuscript. All authors read and approved the final manuscript.


All phases of this study were supported by Monash University, Australia. No external funding was secured for the manuscript. Reena Sarkar is supported by a Monash Graduate Scholarship (MGS) and a Monash International Postgraduate Research Scholarship (MIPRS) for the duration of her full-time PhD.

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Correspondence to Reena Sarkar.

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Appendix 1 Methods study

PMCT: The CT scanner was a 128-slice SOMATOM Definition Flash (Siemens Healthcare, Erlangen, Germany) with an in-plane (axial) and out-of-plane resolution of 1.5 and 0.98 mm respectively and a slice gap of 1 mm to ensure overlap.

Photography: Digital imaging procedures were consistently followed as per standard guidance for forensic and police laboratories by the Australian and New Zealand Policing Advisory Agency (; accessed 11/04/2019).

ICD-10 Coding: The ICD-10 codes are externally added to each NCIS case by the Australian Bureau of Statistics. In violent deaths, the ICD-10 underlying cause reflected the mechanism of fatal injury while nature of injury was depicted by the ICD-10 Level 1-6 codes.[ 12,017?OpenDocument, accessed 6/03/2019] Data was interpreted using the ICD-10 tabular list. [International statistical classification of diseases and related health problems. - 10th revision, Fifth edition, 2016. 3 volume.]

Appendix 2

Table 3 Completeness of data in random sample (N = 42; period = 2000–2018)

Appendix 3

Table 4 Victim offender relationship data

Appendix 4

Table 5 Injuries in gender categories

Appendix 5

Table 6 STROBE statement—checklist of items that should be included in reports of cross-sectional studies

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Sarkar, R., Ozanne-Smith, J. & Bassed, R. Methods in population study of orofacial injuries in Victorian family violence homicides. Forensic Sci Med Pathol 16, 78–90 (2020).

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  • Family violence
  • Homicides
  • Orofacial
  • Injury
  • Methods
  • Injury mechanism
  • Population