Self-inflicted Intraoral Shotgun Wound

[Meatpie]

This young man has a self-inflicted intraoral shotgun wound with birdshot ammunition.

Notice the blow-out injury to the left side of his face and the plethora of pellets scattered throughout his head on radiography.

Also note the presence of three radiopaque objects resembling teeth visible on the mandibular and maxillary dental arcades.

These correspond to yellow-colored, metallic caps on his incisors . It is important to verify that the radiopaque objects are in fact dental hardware, and not bullets or other projectiles.

In cases where larger ammunition such as buckshot has been used, it is important to retrieve all of the pellets to make sure that a handgun with bullets wasn’t also used in the assault, as buckshot pellets and bullets may have a similar appearance on an x-ray. In cases with birdshot ammunition, only a representative sample of the tiny pellets need to be recovered.