Sometime in the middle of a weekday morning next month, two furniture vans believed operated by terrorists enter opposite ends of New York’s Lincoln tunnel simultaneously. within seconds, both vehicles explode violently, partially collapsing the portals. Devastating fires spread the length of the tunnel from vehicle to vehicle, blocking the escape of those trapped between the blasts.

Emergency crews fight desperately to suppress the inferno, but over 250 people perish, either in the flames, the fumes, or trampled as surviving motorists stampede to avoid suffocation. When located, most of the victims are unrecognizable. A forensic odontology team is summoned, whose job is to identify human remains as quickly as possible. The team arrives with a recently adopted dental identification technology called digital dental radiography.

Digital radiography, used for a decade or more by radiologists in most large hospitals, has become the solution of choice in mass casualty situations where the number of victims overwhelms the ability of forensic medical examiners to quickly and accurately identify decedents.

“Digital radiography dramatically increases the quality and timeliness associated with the use of dental x-rays in forensic dental victim identifications, particularly when combined with computer-based dental chart matching software,” said Richard A. Weems, DMD, director of Oral and Maxillofacial Radiology at the University of Alabama, Birmingham, School of Dentistry. Weems was a member of the odontology team working the aftermath of the 2001 World Trade Center disaster.

Mass disasters such as the World Trade Center and the 1995 Oklahoma City bombing demonstrate that when the victims number in the hundreds or thousands the traditional plain film method of exposing radiographs and manually comparing dental records to determine identities is complicated, time-consuming, and sometimes even careless.

Weems said the biggest advantages of digital radiography are immediate image availability and the time saved by eliminating film developing and the nuisance of establishing a film processing lab at the scene of a disaster or maintaining one at the medical examiner's office.

New digital X-ray systems and portable X-ray tube heads allow odontology teams to work directly at the site of mass fatalities.