背景:死后毒理学不断研究在尸体高度受损的情况下应用的可靠替代基质(例如我们碳化,骷髅,人类遗骸,等。).牙齿代表了一种有前途的替代矩阵,因为牙齿组织具有不同的特征,死后的抵抗力和稳定性。
方法:由于很少有文献报道外源性物质掺入牙齿组织的药代动力学和机理,这项试点研究旨在调查是否可以在纸浆中检测到与毒品有关的死亡病例中血液中发现的相同物质。其次,该研究旨在揭示药物在牙齿硬组织(牙本质和/或牙釉质)中的可能沉积,从而有助于重建药物滥用史(时机,例如)。
方法:这项研究尝试了一种新的方法来分别分析牙釉质,牙本质,和纸浆,适用于与毒品有关的死亡尸检期间收集的10颗牙齿,以及血液和头发样本,用于经典的毒理学分析。每颗牙齿通过“粉碎技术”制备,然后通过气相色谱与质谱联用(GC-MS)和超高效液相色谱与高分辨率质谱联用(UHPLC/HR-MS)进行分析,以寻找可卡因,阿片类药物,和代谢物。然后将结果与从血液和头发样品中获得的结果进行比较。
结果:初步结果表明,牙齿与任何其他经典基质(血液和毛发)不同,因为牙髓和血液以及牙齿硬组织和毛发之间检测到的物质的定性对应关系表明,它们可用于验尸评估,作为药物急性和慢性假设的独特基质。矿化物质在牙体组织中的积聚机制涌现了最显著的成绩,受分子类型和假设方法的影响。这项研究的主要局限性是样本的可用性有限,并且缺乏时间的记忆信息,生命中的药物假设率和方法。需要进一步的研究来系统地研究牙齿不同组织中不同物质的分布。
BACKGROUND: Post-mortem toxicology constantly deals with the research of reliable alternative matrices to be applied in case of highly damaged corpses (such us carbonized, skeletonized, human remains, etc.). Teeth represent a promising alternative matrix since dental tissues are endowed by different features, resistance and stability after death.
METHODS: Since scant literature reported on the pharmacokinetics and mechanism of incorporation of xenobiotics into dental tissues, this pilot research aims to investigate whether in the pulp can be detected the same substances found in blood in drug related death cases. Secondly, the study is addressed to disclose the possible deposit of drugs in dental hard tissues (dentine and/or enamel), thus contributing to reconstruct the drug abuse history (timing, e.g.).
METHODS: The study experimented with a novel method to separately analyse dental enamel, dentin, and pulp, applied to 10 teeth collected during autopsies of drug-related deaths along with blood and hair samples for classic toxicological analyses. Each tooth was prepared by \"pulverization technique\" and then analysed by gas chromatography paired with mass spectrometry (GC-MS) and ultra high performance liquid chromatography coupled to high resolution mass spectrometry (UHPLC/HR-MS) for searching cocaine, opiates, and metabolites. The results were then compared with those obtained from blood and hair samples.
RESULTS: Preliminary results demonstrated that teeth differ from any other classic matrix (blood and hairs) since the qualitative correspondence of the detected substances between pulp and blood as well as dental hard tissues and hair suggests that they can be useful in post-mortem evaluation as a unique matrix for both acute and chronic assumptions of drugs. The mechanism of accumulation of substances in mineralized dental tissues emerged the most significant result, being influenced by the type of molecule and the method of assumption. The main limitation of this study is the limited availability of the sample and the absence of anamnestic information of the time, rates and method of drug assumption during life. Further research is necessary to systematically investigate the distribution of different substances within the different tissues of the tooth.