14 +ok+ (10) +Fahriza+Oktaviana+89-98+doi
14 +ok+ (10) +Fahriza+Oktaviana+89-98+doi
14 +ok+ (10) +Fahriza+Oktaviana+89-98+doi
DOI: https://doi.org/10.35790/eg.v13i1.54461
URL Homepage: https://ejournal.unsrat.ac.id/index.php/egigi
Abstract: Various methods for estimating post-mortem (PMI) have been investigated such as rigor
mortis, livor mortis, molecular, chemical, and forensic entomology (insect) methods. However, these
methods have weaknesses, therefore researchers are looking for more accurate methods in
determining the time of death of a person. Molecular methods are unreliable due to the degradation
of DNA, RNA, and proteins in corpses over time. In different parts of the body, the amount of
diversity of microbes will be different. The oral cavity is the most abundant microbial area among
other parts of the body due to its continuous exposure to the respiratory and digestive systems. This
area has great potential in estimating time intervals of death because of its ease of access and the
types of microbiomes that predominate at any given time. Therefore, this narrative review was
conducted to describe studies that used oral microbiota communities to estimate post-mortem
intervals. Proteobacteria, Firmicutes, Actinobacteria, and Bacteroidetes are the dominant microbial
types found in corpses. Firmicutes became one of the dominant bacterial phyla in the early stages of
decomposition. Actinobacteria were found to decrease as PMI increased. Studies have shown that
the oral microbiome has excellent potential as a parameter to determine the post-mortem interval.
However, further research is needed with more complex environmental conditions such as different
humidity and temperature. In addition, further research requires more samples of human remains to
obtain more valid results.
Keywords: oral microbiome; post-mortem interval; human identification; forensic odontology
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Introduction
Death is the end of a physiological process in which cells are no longer able to maintain their
function and integrity, followed by changes both chemically and physically.1 In forensics,
determining the length of time between death and the time when the corpse is found (post-mortem
interval) will assist in making death certificates, writing wills, and death schemes for a corpse.
Estimation of PMI by observing biological changes that occur in corpses such as insect activity
(forensic entomology), rigor mortis, livor mortis, molecular, and chemical are methods that are
often applied to determine the death of a human being in days, weeks, or months. Molecular
methods are unreliable due to the degradation of DNA, RNA, and proteins in corpses over time.
Another method is by looking at the last communication made before he died, one of which is via
a cell phone. However, these methods are too subjective, limited in time accuracy, and sensitive
because they depend on the environmental conditions around the corpse, and the estimated time
of death is too broad.2–5
Forensic microbiologists seek to develop methods of determining death by observing the
changes in the microbiota that occur when a person dies. The microbiota community in the
decomposition process will experience changes as cell autolysis and chemical degradation occur so
that it can be used to estimate PMI. Two kinds of post-mortem microbiota communities can be
observed in corpses when differentiated from their location, namely the thanatomicrobome and
epinecrotic communities. The thanatomicrobiome studies changes in the community of
microorganisms in internal organs (heart, liver, intestines, brain, spleen, and others) after death,
while the epinecrotic microbial community studies prokaryotes, fungi, protists and microeukaryotes
that grow on the surface of corpses (superficial epithelial tissue, oral mucous membranes, and the
distal orifice of the digestive tract).5,6 Numerous studies have investigated microbes for the
estimation of time to death with a wide variety of samples, ranging from dead animals to human
cadavers. 5,7
The oral cavity consists of teeth, keratinized (hard palate and gingiva) and nonkeratinized
tissues (lips, soft palate, cheeks), tongue, tonsils, and gingival sulcus which act as a link to the
digestive and respiratory tracts. These parts become a place for various microorganisms such as
bacteria, fungi, and viruses to colonize which are then called the oral microbiome.8 This
community is very important for humans because it functions as a normal flora in the oral cavity
and if there is an imbalance it will cause dental caries disease, inflammation of the gingival and
periodontal, as well as oral and systemic (gastrointestinal and nervous) mucosal diseases.9 The
oral microbial community is the second most microbial area after the colon, with about 100
bacterial species identified. Some of them are from the phyla Proteobacteria, Actinomycetes,
Spirochetes, Firmicutes, Bacteroidetes, and Aponeurophytes. Both oral and gastrointestinal
community bacteria have significant roles in decomposition. 1 However, the oral microbiome has
received less attention than the gut microbiome because there has been little research related to
this community.10 Based on this, this narrative review was undertaken to describe the use of the
oral microbiota community to estimate post-mortem intervals.
Oral Microbiome
The human oral cavity is one of the habitats of a complex microbial community in which the
second most abundant microbiome contains microorganisms after the gut microbiome (intestine).
This is because the oral cavity is continuously exposed to microbes from the respiratory and
digestive systems. The oral microbiome maintains the balance and health of the oral cavity. If this
balance is disturbed, periodontal disease, endodontics caused by caries, tonsillitis, and osteitis will
appear. In addition, systemic diseases such as cardiovascular disease, diabetes, pneumonia,
premature birth, obesity, colon carcinoma, and psychological disorders are also correlated with
changes in the balance of the oral microbiome.11
In the oral cavity, there are about 1000 species of microorganisms such as bacteria, viruses,
fungi, protozoa, and archaea.11 Several viruses are associated with diseases, namely mumps,
Oktaviana et al: Estimation of PMI using oral microbiota changes 91
rabies, hepatitis, HIV, and HPV where each has clinical manifestations and different locations, in
the oral cavity. Protozoa species such as Entamoeba gingivalis and Trichomonas tenax are normal
amoeba found in the oral cavity. Poor oral health and the presence of gingival disease can increase
the number of these microorganisms. Fungus is also a normal flora, but it can cause both acute
and chronic infections. The most dominant fungal genera in the oral cavity are Candida,
Aspergillus, Saccharomycetales, Aureobasidium, Fusarium, Cladosporium, and Cryptococcus.
Minor components such as archaea can be detected by a small number of species in the oral
microbiome such as Methanosarcina mazeii and Methanobacterium curvum/congolense,
Methanibrevibacter oralis and other unidentified Methanobrevibacter phylotypes. Their number
and prevalence increase in subjects with periodontitis.12
The most dominant bacterial communities in the oral microbiome are the phyla
Bacteroidetes, Firmicutes, Actinobacteria, Spirochaetes, Fusobacteria, and Proteobacteria
where these bacteria are included in 96% of the detected species.12 The order of the most abundant
bacteria in the oral cavity is, as follows:13,14 Firmicutes (36.7%), Bacteroidetes (17.1%),
Proteobacteria (17.1%), Actinobacteria (11.6%), Spirochaetes (7.9%); and Fusobacteria (5.2%).
Phylum such as Chlamydia, Chloroflexi, Tenericutes, Euryarchaeota, Synergistetes, SR1,
TM7 are small, namely around 4% of the total bacteria in the oral cavity. Firmicutes dominate the
oral cavity of healthy people, while the Bacilli from Firmicutes that are mostly found are in the
Streptococci genus (19.2%) followed by Veilonella (8.6%). Prevotella are most numerous on the
lateral and dorsal surfaces of the tongue. Porphyromonas gingivalis and Captocytophaga are
examples of Bacteroidetes that live in healthy oral microbiota. α-Proteobacteria, β-Proteobacteria,
γ-Proteobacteria, δ-Proteobacteria, ε-Proteobacteria are five classes of Proteobacteria detected in
the mouth. However, only γ-Proteobacteria are contained in saliva based on NGS analysis. This
phylum is more numerous if a person has a disease of the oral cavity. Examples of genera of
Actinobacteria that live in healthy people are Actinomyces, Atopobium, Corynebacterium and
Rothia. Spirochaetes belong to a phylum of the oral microbiome that are rarely cultured. As many
as 70% of the species have not been cultured. Spirillaceae and Leptospiraceae are the most common
Spirochaetes found in healthy human oral cavity. Fusobacteria such as Fusobacteriaceae and
Leptotrichiaceae are included in late colonizers in the mouths of healthy people.14
and the epinecrotic microbiome. The microorganisms studied in the thanatomicrobiome are
internal organs such as the brain, spleen, heart, intestines, liver, and others.5,6 Among these organs,
the highest microbial diversity lies in the liver according to Can et al.17 Another community
included in the post-mortem microbiome of humans is the epinecrotic microbial community.
Microorganisms in this community are protists, prokaryotes, fungi, and other microeukaryotes
that live on the surface of the corpse. Superficial epithelial tissue, oral mucous membranes, and
the distal orifices of the digestive tract are the surfaces with which the microbial community lives.
Several studies took samples with swabs on these surfaces and the results showed that there was
high microbial biodiversity and it differed between individuals. Research on post-mortem
microorganisms typically uses animal models such as pigs and rats or human cadavers that are
donated or have been autopsied in criminal cases. However, cadaveric use is difficult to replicate
when compared to animal studies.5,6
Several studies have examined microbes for the estimation of time to death with a wide
variety of samples, from dead animals to human cadavers. Metcalf et al7 examined
thanatomicrobiomes and epinecrotic community in the abdominal cavity and skin of rats that had
died and decayed, and soil used for burial for 3-48 days. At the bloat stage, anaerobic bacteria
such as Lactobacillaceae and Bacteroidaceae increased, followed by the dominance of aerobic
and facultative anaerobic bacteria such as Enterobacteriaceae after rupture. An epinecrotic study
on pig skin conducted by Pechal et al., 2014 found that at the beginning of the decomposition
stage bacteria were the most dominant. phylum Proteobacteria. Meanwhile, in the final stage, the
most numerous phyla are Firmicutes.18
Class I can represent this subregion as a phylogenetic bacteria study from the new phyla because
it has the highest sensitivity compared to Class II (V3 and V7) and Class III (V2 and V8). In
addition, Class I is the main functional part of the 16S rRNA because it includes the “690 hairpin”
and the coding center. “690 hairpins” are found in three phylogenetic domains whose loops are
very well preserved, namely in the V4 16S rRNA region. The procedure includes amplification
and cloning sequencing with PCR to view DNA segments. The purpose of DNA sequencing in
this method is to identify species. 16S rRNA sequencing is considered fast, accurate and can
detect viral DNA, however, PCR is very sensitive to contamination and prone to bias.22
The Home Oral Microbiome Database (HOMD) is the first database to describe and provide
insight into the oral microbiome and its importance in human health. HOMD is a 16S rRNA gene-
based data that provides scientific information about 700 species of prokaryotes that have been in
the human oral cavity for the last two decades. This database contains more than 35,000 clone
sequences and 600 gene libraries of 16S rRNA. HOMD links sequence data with phenotypic,
clinical, phylogenetic, and bibliographic information. Of the 700 species identified by HOMD, only
51% have been named, 13% have not been named but have been cultured and 28% have not been
named and cultured. In addition, HOMD contains 150 genera, genomes for 400 oral taxa, and about
1300 strains of microorganisms. HOMD also contains genomes for 202 strains and 30 Streptococcus
taxa. The weakness of HOMD is that the data in it show that 20-60% of microorganisms cannot be
cultured even though this database is based on microorganism culture.9
The metagenomics bioinformatics method can characterize the entire microbial community
both from the composition at the strain level and functional profiling of identified and unidentified
species.20 Extraction of the total DNA samples obtained by this method is then performed by
shotgun sequencing without carrying out the PCR amplification step. The shotgun sequencing
procedure is by fragmenting and sequencing long DNA randomly several times to read overlap
from the target DNA using a computer program. 22 This method is rarely used because it is more
expensive than the amplicon-sequencing survey method and more difficult to do, especially when
the environment being studied contains many DNA of the host as in the mucosa-associated
microbiome. This method is very complex because it requires knowledge in terms of programming
and bioinformatics as well as high computer technology to analyse data.20 The advantage of shotgun
sequencing is that it can see metabolic activity and also does not require much human intervention.
Pyrosequencing is very good at determining biodiversity, produces many sequences and is unbiased
because it doesn't need cloning. However, this method is the most expensive among the other
options and does not produce the full 16S rRNA sequence required for taxonomic studies.22
Research methods: Double swabbing of palate, tongue, buccal mucosa, teeth surfaces (buccal,
lingual, and occlusal surfaces)
Bioinformatic analysis: 16S rRNA sequencing
Results:
1. Fresh stage: Firmicutes and Actinobacteria dominant but decreasing over time (Day 1–5–6),
dominated by Lactobacillaceae, Staphylococcaceae, Gemellaceae, Carno-bacteriaceae,
Aerococcaceae, Veillonellaceae, Streptococcaceae, Campylobactera-ceae, Micrococcaceae,
Bifidobacteriaceae, Actinomycetaceae and Coryne-bacteriaceae
2. Bloat stage: Tenericutes (Day 5-7); Peptostreptococcaceae, Bacteroidaceae, Enterococcaceae;
Clostridiales (mulai muncul di beberapa hari terakhir)
3. Advanced decay: Firmicutes (Clostridiales and Bacillaceae) (Day 6-12); Ignatzschineria
(Gammaproteobacteria), Pseudomonadaceae, Alcaligenaceae, Planococcaceae increased.
4. Putrid dry remains: Bacilli and Clostridia (Day-12)
Conclusion: this research is a preliminary study regarding the use microorganism to estimate
time of death.
Dong et al, Research samples: 24 mice
20191 Research methods: Cotton swabs that have been sterilized at high temperature and moistened
with aseptic water are then rubbed into the oral cavity of the rats that have been sacrificed with
carbon dioxide gas.
Bioinformatic analysis: 16S rRNA sequencing
Results:
• 0 hours: dominated by phyla Proteobacteria, Firmicutes, Actinobacteria and Bacteroidetes
• 24 h (early PMI): Firmicutes increases first 24 hours then decreases, predominated by Bacilli,
Lactobacillales, Streptococcaceae and Streptococcus
• More than 24 h (late PMI): Enterobactericeae (Serratia, Escherichia, Klebsiella and Proteus)
• Predominates the post-mortem interval: Gamma-proteobacteria
Conclusion: Gamma-proteobacteria and Proteus have a great potential in the oral microbial
community for PMI estimation
Ashe et al, Research samples: three donors
20212 Donor 1: male, wearing dentures.
Donor 2: female, wearing complete denture with metal components
Donor 3: female, edentulous
Research methods: All donors were situated on the ground in a supine position and each donor
swabbed the entire surface of the hard palate. Swabs were carried out 5-7 times according to the
decomposition process.
Bioinformatic analysis: 16S rRNA sequencing, whole metagenomic (MetaG) and
metatranscriptomic (MetaT) sequencing, culture
Results:
• Dominant: Proteobacteria, Firmicutes, Actinobacteria, and Bacteroidetes but the distribution is
not good enough to distinguish stages or times
• Key genera observed at the genus level: Rothia; Firmicutes (Lysinibacillus, Lactobacillus,
Staphylococcus); fungi (Candida and Yarrowia)
• Bacteria found in all methods: Acinetobacter gerneri, Proteus vulgaris, Morganella morganii,
Pseudomonas koreensis, Pseudomonas moraviensis, Comamonas terrigena, Raoutella
terrigena, Stenotrophomonas maltophilia, Bacillus cereus, Lactobacillus paracasei, and
Kurthia zopfii
Conclusion: there is no relationship between PMI length and bacterial community at a given time
possibly due to influencing factors such as humidity, temperature, sample size, decay insect
activity, sex, body weight and cause of death.
Zhao et al, Research samples: 96 rats were divided into groups of 0 hours, 1st day, 3rd, 5th, 10th, 15th, 20th,
202215 24th, 30th, 40th, 52nd, 59th. Each group consisted of eight rats.
Research methods: Swab on palate, tongue, buccal mucosa, and tooth surfaces
Bioinformatic analysis: 16S rRNA sequencing
Results:
• Bacteria found: Lactobacilles, Enterobacteriaceae, Bacteroidetes, P. mirabilis,
Gammaproteobacteria, I. indica, Vagococcus lutrea, Rhodanobacter Lindaniclasticus,
Bacillales, and Cerabacillus
96 e-GiGi, Volume 13 Nomor 1, 2025, hlm. 89-98
Firmicutes is one of the bacterial phyla that predominate in the early stages of decay. In the
advanced decomposition stage, this phylum is separated from its cluster with Actinobacteria. This
is because Firmicutes are opportunistic bacteria that degrade organic matter from the availability of
oxygen. After oxygen is used up and decay enters the bloat stage, there is a change in composition
from aerobic bacteria to anaerobic bacteria.1,2,15,23 Examples of the Firmicutes phylum are
Streptococcus, Staphylococcus, Lysinibacillus, Lactobacillus, and Vagococcus.2 However, in a
study conducted by Dong et al,1 it was stated that the Firmicutes phylum did not have a significant
linear relationship with the post-mortem interval.
Proteobacteria in the bacterial kingdom is the broadest phylum of the Gram-negative type. In
all studies regarding oral microbiomes as a post-mortem interval, the Proteobacteria phylum is the
most dominant, but it should be noted that the relationship between microbes and PMI is not the
same between families and orders of the Proteobacteria phylum. The bacteria Proteus,
Proteobacteria, Gamma-proteobacteria, Enterobacteriaceae, Enterobacteriales, and Oblitimonas
are examples of bacteria in this phylum.1,2,15,23 Proteus is a facultative anaerobe because it is related
to the closed mouth condition of rats when they die. After the dead body ruptures,
Enterobacteriaceae bacteria (Klebsiella, Proteus, Serratia, Escherichia) become more abundant.
According to Dong et al,1 Enterobacteriaceae is one of the bacteria in the digestive system that
also dominates the oral microbiome at the late PMI stage. Oblitimonas in Ashe et al 2021's2 study
appears at the advanced decomposition stage. Aerobic metabolism plays an important role in
diversity and bacterial colonization at the fresh stage of decomposition. The process of consuming
oxygen by aerobic metabolism is carried out by fermentative bacteria such as Proteobacteria and
Tenericutes.23 Proteus mirabilis is one of the bacteria whose number increases on the fifth day of
decay by producing urease which hydrolyzes urea and increases the pH. Therefore, the smell of
urea is wafted at that stage. Gamma-proteobacteria (Ignatzschineria) is a type of proteobacteria
that predominates on days 5, 10 and 15 where time has the potential to be an indicator of specific
post-mortem time.15 Dong et al1 stated in their research that Proteus and Gamma-proteobacteria
had great potential as bacteria to predict the PMI of the oral microbial community especially when
combined with Enterobactericeae in the digestive system.
In a study by Ashe et al,2 Actinobacteria was one of the most common bacteria found when
tested with three methods (16S rRNA, MetaT and MetaG sequencing). In the 16S rRNA
sequencing method, this bacterium has the highest score.2 However, the Actinobacteria phylum
was found to decrease with increasing PMI. In the early stages of decomposition, Actinobacteria
predominated, then began to form separate clusters in the advanced decomposition stage.23
Actinobacteria live in aquatic and terrestrial ecosystems, especially soil, and play a role in
recycling heat-resistant materials through the formation of humus and decomposition.1 According
to Adserias-Garaga et al,23 bacteria of the Tenericutes phylum appeared at the bloat stage, which
was on the fifth to seventh day due to changes in nutritional and physico-chemical conditions to
match the environment. Tenericutes are parasitic/commensal bacteria in their hosts (eukaryotic)
without cell walls that live in the gastro-intestinal tract and can be in the oral cavity during the
bloat stage. At this stage these bacteria always appear because when the host lacks the
tricarboxylic acid cycle, these bacteria use anaerobic fermentation of simple sugars for substrate-
Oktaviana et al: Estimation of PMI using oral microbiota changes 97
level phosphorylation. Research from Ashe et al2 mentioned the genera that grew with increasing
time of death, namely Ignatzschineria, Lysinibacillus, Vagococcus, and Yarrowia.
Conclusion
Along with the advancement of technology, microgenomics has been more accurate in
detecting microbes, resulting in this method being more desirable to researchers than other
methods. Most of the studies used the double swab technique to obtain the microbes from the
samples. Various studies related to the determination of the post-mortem interval of the oral
microbiome have shown different results. However, differences can be obtained from a
comparison between the early and late stages of decomposition. Research with cadavers is better
than experimental animals, but limitations in obtaining corpses according to the criteria and time
of study are still a weakness in research related to post-mortem intervals. In addition, studies are
needed in various conditions such as differences in temperature, humidity, and conditions of
corpses for further research.
Conflict of Interest
The authors declare no competing interests.
Acknowledgement
The authors would like to thank Universitas Indonesia for facilitating the literature search
used in this paper.
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