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Alhabshi SF, Nambiar P. The contribution of forensic odontology in the

Highland Towers Condominium disaster. Annals Dent Univ Malaya 1995; Vol
2; No 1: 25-28.

Article · January 1995

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Phrabhakaran Nambiar
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 The Contribution of Forensic Odontology in the Highland
Towers
Condominium Disaster-
Allubshi sF, Nambiar p rhc contribution of Fotercic odontorogy in tte Hightand
Toutas Condontinium Disster. Antuls Dent.llnio. Malaya lggs/".2s_2g.

ABSTRACT.
complex *--Uq*d-^ )ShaifahE Alhabshi
1..:ptp*t
inside. rhe dentar disaster lftaysia killing 4S people kapped taPhtabhakarunNambiar
victim iamun ation team comprising of officers
a
F-.ft"_Iyd" Lumpur General Hospital, armea Fortes and the Dental
lacrilty, university of Maraya played a very active role in
Senior Dental Consultant
the identification arul IIad of Dental Department
process. Most of the bodies were badly iecomposed taala Lunpur Gawal Hospital
and some slosslv
disfi€uled. prroble^s were encountereci aue to inaaequa[ ri"rruL-*i IQahl;umptir
equipmmts at the mortuary. Difficulties were also encoirnterea *kcluro,Dan's affce
procurement and- deciphering of information from
auringt;
dental ,""ola*
Faculty olDntistry
Duggestsons have been madg to improve facilities, Uniwrsity of Malaya
expdise and also
o1*e alTreryrs amongst dentists to ensur€ proper-recording of to IQalaLumpur
their
patients' dental status.

Key Worils: Fomsie Oilontology, tlirrlster, identification,

age iletamirution.

!}.ITRODUCTION

In rccent years there were numerous disasters due to
natural causes such as eatthqujkes, cyclones, floods,
fires and o,thers due to vehicular accideng and
exploeives
a1limelent parts of the world. Many of these disasters
claimed numerous lives and have ca'used great damage
p-pro1:Iy and the enviroment On Diember l1fr,
1993 a difierentkind of disaster occumed at UIu Kelang,
Selang:t A 12 storey apartsnent complo< bufri
lvtalaysia.
-, " ry slope - Bloc\ A.9f Higlitana Towens collapsed
gntombingeveryone inside. Although the buildinjwas
believed to have been constmcted on; Btable fo;d;fio;;
auirc.{ties hlve ditrficulty in aeterminint ttrJ
-treat
actual cause for the ctash. Othert concede that iiwas
due to land slides occulilg in the ,r"ighbo.ir,g
causing water to seep and weaken ttre foinaauon. "r."
Within the first
lour of the collapse a Japanese
housewife, an Indonesian
maid and her iighteen month
old toddler were nescued. Ho-nwer, the
ftpanese lady
d_ied.subsequently at the Kuala f,.mp',,. General
noeprtar fiom massive internal iniuircs. The Malaysian
emgrgjlcy workers comprising of firemen, policemen
and deJence personnel were
i-oinea by r#ue teams
from Singapore, Japan and France. Ttrey arrived with
very sophisticated equipmmts and were assisted
with
hained sniffer - tracker dogs. They were cautious
not to
!. ,"-ry lggress.ive
fear of
white Jarryini out tfreir operations
endangering
fgr-the an"y suniving victims.
Unforfunately, no rescue.was made after onl week of
searching w$ch prompted the disaster managerrent
team to tear down the slabs of the buitding witlihe"ry
maddnery. Emertency workers started rerrioving bodies
on 18th December and this work stretctred for tlie next
days. Bodies were then brcught to the Kuala Lumpur
5 f"-ily members, relatives aid friends. Furthermore,
Hospital mortuary fol postsnortem. t\,r,o lirge
refrigerated fteight containers were borrowed from-a
agency to complement the,mortuary space.
lHp.pi"g
Bodies were recovered at different stiges of
decomposition - some badly mutilated and fragirented
while others werc actually skeletonised.
The disaster victim identification @VI) eam ttrat
was quiqkly assembled was headed by a senior
pathologist of the hospital. It comprised k forensic
ygtholgeisB dentists and also a geneticist to help in the
identification process. A foreisic pathologiit was
specifically assigned to record ani catatJgue the
identifying information of each victim. Tne aen=tat pVt
lam gmprised of ten officens. They were from.the
P"Fl Departnent of-$ala Lumpur General Hospital,
the- tvlalaysian Anned Forces
tt Dental faiutty,
U-dversity of lvlalaya. The aim "rriof "this article is to
lllueFate the importance of dental identificatibn done
for the first time in a mass disaster in lvlalavsia. It also
reinforces the need for the inclusion of aelitat
for. confirming or supporting any identification "*p""t,
of
unknown deceased persbns inttre future.
IMPORTANCE OF VICTIM IDENNFrcAilON
Ih" 9ot of a Malaysian
the issue of a
citizen is officially certified by
death certificate. A death'certificate is
necessary to solve many legal matters such as inheritance
and zuccession to property, the collection of insurance
policies and pensions, settlement of business mattens
3a {? tty remarriage of the remainingspouse. positive
identification of victims following ai unprecedented
accident is imperative to bring to an end thl distress
on
additional relief may be afforded to a family who learns
Tr T g$nown body is not the remains of a missing
relative (1).
26 Annals oJ Wntistry,llnioasity of Malaya Vol. 2
Visual recognition represF{rts the most frequent
method of idenfification. Generally the body must be
well preserved with intact facial features- Many victims
of this disaster could not be identified visually due to
the extensive trauma and advanced decomposition. In
these conditions, it was deemed advisable not to invite
relatives and friends to provide any visual identification.
Their iudgement in recognizing anybody would be
questionable because of the emotional stress that they
were experiencing.
Personal effects such as clothing, identity cards,
iewellery, prescription spiectacles and keys provided
some favourable leads in the identification process.
However, this is not scientilically reliable as they canbe
switched with criminal intent or could have been
borrowed. The use of fingerprints was limited because
of the decomposed nature of the bodies. The pathologists
on their part worked to assess age, determine race, sex,
stafure, disease status as well as the cause and time of
death of the deceased. Comparison with the known
medical history or prior surgical procedures of a
suspected victim may serve to corrobortte or exclude
an individual. Selected bone tissues were collected by
the pathologists and despatched to the geneticist for
DNA fingerprinting.
DENTAL IDENTIFICATTON
The procedures of dental identlfication are credible
because ihe human dentition has very good postmortem
preservation - although it undergoes destruction during
a penson's life. Dental restorations and prootheses are
extremely resistant to physical and chemical
deterioration and also to ttre changes to the enyironment.
The unique morphological characteristics of human
teeth and dental restorations have great individrrality.
The availability of .routine dental records, especially
radiographs provide exacting evidence for comparison.
Sometimes the recovery of only a single tooth or jaw
fragment maybe unique enough to make a posifive
identificatiory provided the antemortem recording has
been made. lvlarking of dentures with names or numbers
arc rccent introduction in the fabrication of dentures.
This is followed stringently in 7 states of United States
of America (2). Furthermore, it is also important to have
a dentist at the site of disaster during body removal and
eviilence retrieval. This is importait as-many trained
investigators at accident sitstend to overlook dental
evidence, which may be crucial for the positive
identification of .an indiviual.
VICTIMS OF THE DISASTER
Unlike in an airline crashwhere a passenger manifest is
quickty made available, the Highland Towers disaster
management teamwas unsure of the number of people
inside thebuilding. Beinga Saturdaya afternoory many
had notretumed home thus escaping the fatal accident.
The police recorded that 48 individuals lost their lives
in this mishap.
laa. 7995
Table I The nationality and ethnicity ol the victims of the
condominiumdisaster. ... -,'
Natlonallty No Ethnlclty
Malaysians 38 (Chinese - 22, Malays - 10, lndians - 6)
lndonesians 3
Koreans 2
Britisher 1
lndians 2
Filipino 1
Japanese 1 (died at the hospital)
The above list sufficiently shows the diversity of
ethnic, racial, cultural, national and religious affiliation
of those who perished (3). This posed a special problem
asallbodies had tobe identified positivelyand retumed
to their respective relatives for burial or cremation rites
in accordance to their own customary traditions.
DENTAL INVESTIGATION AND
INTERPRETATION PROCEDURES IN THIS
DISASTER
A total of forty six bodies were examined by the dental
identification team. This did not include the victim who
was hospitalized before dyrng. Another did not have
any skull bones for examination. Forty bodies had
relatively intact maxilla and mandibular bones while
six others had fragmented pieces for examination. Dental
status of all these bodies were charted on postnortem
odontograms. Gaining access for dental examination
was relatively easy because moet of the bodies were
decomposed or skeletonized. Radiological recording of
developing teeth of pre+chool, school going drildren
and juveniles wer€ taken for estimation of age. As we
had access only to intra-oral dental radi,ographs, both
upper and lower jaws of either side were radiographed
for age assessment. In cases when all the teeth had
completely erupted, radiographs of the third molar was
tdken to see if the root formation was complete. This
was to ensure that the bodies did not belong to any one
in the iate teens. Age assessment of adults lias based on
the attritional wear of the teeth. In addition, the level of
periodontal attachment and the amount of alveolar
resorption were other cumulative factors selected f6r
the sdme assessment. Difficulties weri: atso faced due to
improper lighting and inadequaE facilities at the hospital
mortuary for serious odontological work.
Numerous problems were also encountered when
attempts were made to obtain dental records. A few
dental surgeorrs were reluctant to release the records
but provided written statement of the treatment
rendered. Several others had tobe coaxed and reassured
that they would not be implicated for not having
adequate recording of their patients. In most cases dental
trcatment provided by the attending dentist were the
only information written on the records. There were
also problem3 in deciphering information due to
unfamiliar terminologies and illegible writing. Dental
 Tlu contibution of Forensic odontology in the Hightand rotoers condominium Dbaster

records of a few were not trapjable because the whole

DISCUSSION
family perished in the disastei. A limited number of
them were treated by unqualified dentists who never
The collapse of the aparhnent building reinforced the
mantain any form of records. Some foreigners had
important role of forensic odontology in mass disaster
treatnent done in their home countries, while a few
victim identification in lvlalaysia. For the first time there
I-Valaysians had their treahnent ovelseas. Iastly, a few
were requests on television and the newspapers for the
families had problems providing information regarding
dental records of the victims. There wasiGo a greater
dental treatment received by their dead relatives because
recognition of the role of dental experts by the
they never had aregular dentist.
pathologists, police officers and other government
Positve identification was possible for sixteen
(34.8ol.) bodies because the.e was idequate antemortem fgencies. Suggestions have been made to improve
facilities such as proper lighting, availability of
dental records of the missing victim. Radiographs
radiological dental machines and provision of adequate
provided excellent confirmatory evidence. Identification
dental equipments at the hospital mortuary. Ttreie is
of eight other bodies (tZ.+V"'1 were only dentally also a need to have more dental surgeons trained in
supported because there were insufficient dental history
forensic odontological work by attending post-graduate
or only jaw fiagmenb were retrieved from the site of
courses. This is imperative as those trained will become
discovery. These included five edentulous ladies.
more confident when interpreting dental records and
However none of them had their dentures marked.
deducing evidence from oral and dental structures.
Accurate age estimation was possible for nine children
The dental identification team had a reasonably
(19.60l"), some of whomhad mixed dentition. The dental
favourable cooperation from the dental community,
investigators employed the chart prepared by Schour
and ldassler (4) which demonstrated Stages of tooth llthough some were hesitant to part with their patien/s
dental records. In light of this acciden! it is hoped that
developmentand sequence of eruption atyearly interval.
there is a greater awareness amongst practising dentists
In thirteen adult cases (28.5y") age estimation from for the need to mantain adequate dental recording of
attrition of teeth, periodontal recession and alveolar
their patients. They should also become aware ttrat
rcsolption was made for possible association or exclusion
whatever treatnent perfonned can become a potential
with other fi.di.gs to help in the identification. This legal issue later.
particular method is not considered very reliable, but it
The authors also wish to record sincere thanks to
is sometimes the only method possible under the given
conditionS. lt3jor Qr.) TanPeng Hui (Singapore) and Dr. Carl Ieung
(Hong Kong ) for expressing their readiness to provide
Various other information were also gathered from
their expert assistance. This form of international
the teeth. Theseinclude racial traits, oral hygeinestatus,
collaboration is very healthy, especially in the
smokinghabits, socio-economic status and iso aetalea
rrumagement of mass disasters involving a larger nunrber
morphology of the anterior dentition. In selected cases,
of victims from several countries. As the number of the
pJ{oeran\ of supected missing persons expressing deceased were only 48 in this disaster, these numbers
his/her teeth were compared with those of the victims.
were manageable by the dental disaster victim
The alignment, shape, size and any malfOrma$on or
identification team of Malaysia.
ryacing in the anterior.teeth were useful for positive
identification. Even a video tape recording showing the
smiling face of a suspected victim ias uged for ACKNOWLEDGEMENTS
identification. In another case, cornparison of a sibling
teeth morpholog5rwas made. The deceased had a featuri
called "double'shovel" shaped incisor teeth which Y" y_b].tg put to record that the following were part of
correeponded with her sister,s dentition. Both the $" OVlt Dental ) team during the collapse; Dr. Noraini
Nun Nahar, Dr. Criistopher Vincent, Dr.-Strarifafr Sfrium
mesial and distal margins of the palatal and labial Alhabshi Dr. Norinah Mustapha, Dr. Anita Rohini
surfaces of her upper anterior tieth were raised Nesadurai, Dr. Azida Abdul Aziz,lvt$t (Dr.) Didar
suggesting a familial trait. In extremely difficult Singh, Mejar (Dr.) Heng Swee Heong.
situationg when antemortem dental records wet€ not We also exprless our sincere thanlcs to Dr. Zaini A
available, relatives and family members were sometimes Rahman ( Senior Pathologist, Kuala Lurnpur General
questioned to determine if their deceased relatives had
any restorations on their teeth or prosthesis inserted to flgpital),_fne Forensic Pathology Team, The Royal
Malaysia Police Force and the moi-tuary attendenbior
replace them artificially. Selected tieth were sometimes harirg been very helpful in providing the necessary
removed for closer scnrtiny and detailed examination assistance to the dental team.
under magnifying glass to detect any tooth coloured
restorations. Even the dye of an indelible pencil was
used to disclose them.
 28 Amuls ofDaibtry,Unioersity of ltuWoVol. 2Jan. 7995

REFERENCES,
". -.L1,
L Cottone IA Dental idenffication In Cottone J A, Standish S M, ds. Outline of forensic dentistry. lst'edn Yearilff{&ita
Pnblishers, 1982,73.{i7.
2- McGivney|.lvlarkingof rernorral dmtures. tnAverill D I ed. Manual of forensic odontology.2nd edrullmeriqrSocbty<if Forenric
Science,199l;62-A.
3. Renrerrbering the imocentvictims of the condo collapse. The Star (daily)3/6/1994:5.
4. Ciapparelli L. Ttre ctrrcnology of dental develop,.ment and age assessment In Clark D H, ed. Pradical Forcnric-Odortalogy. lst edrr
Buttenrrorth - Heinmann Ltd,, 19/4, 29fi

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