Brief communication: prehistoric dentistry in the American southwest: a drilled canine from Sky Aerie, Colorado

Interventive dental therapy in Ancient Egypt (ca. 2686 BCE - AD 323): A critical review

OBJECTIVE

This paper critically reviews the history of research concerning ancient Egyptian interventive dental therapy between the Old Kingdom - Graeco-Roman Period (c. 2686 BCE-AD 323), concentrating on the published osteological evidence.

MATERIALS

Eight osteological examples reportedly exhibiting markers of interventive dental therapy, including a mandible presenting purported evidence for a drilling procedure for the relief of an abscess; four dental bridges; a maxilla with multiple teeth extracted; and two carious lesion fillings.

METHODS

Previous claims are critically reviewed using a qualitative research method involving collecting and critiquing published data, both primary evidence and relevant secondary literature.

CONCLUSIONS

Without further scientific analysis, only four specimens can currently be plausibly attributed to ancient Egyptian interventive dental therapy including the Tura el-Asmant Bridge, the enucleation described for a Graeco-Roman child, and two carious lesion fillings identified in the mummified individuals known as the 'Redpath Mummy' (RM2718) and 'Sekhem' (AIG3343).

SIGNIFICANCE

Several enduring historiographical and museological problems within the discourse are identified, revising our understanding of the nature and scope of ancient Egyptian interventive dental therapy based on currently known osteological evidence.

LIMITATIONS

This review relies on the published documentation for each osteological example, namely images, which in several cases are poor quality.

SUGGESTIONS FOR FURTHER RESEARCH

There is significant opportunity for further scientific analysis of the osteological evidence discussed. In each case, specific potential methods to improve our understanding and interpretation have been identified.

The physiological linkage between molar inclination and dental macrowear pattern

OBJECTIVES

Exact symmetry and perfect balance between opposite jaw halves, as well as between antagonistic teeth, is not frequently observed in natural masticatory systems. Research results show that asymmetry in our body, skull, and jaws is often related to genetic, epigenetic, environmental and individual ontogenetic factors. Our study aims to provide evidence for a significant link between masticatory asymmetry and occlusal contact between antagonist teeth by testing the hypothesis that tooth inclination is one of the mechanisms driving distribution of wear in masticatory phases in addition to dietary and cultural habits.

MATERIALS AND METHODS

The present work investigates the relationship between dental macrowear patterns and tooth inclinations on a sample of complete maxillary and mandibular 3D models of dental arches from 19 young and adult Yuendumu Aboriginal individuals. The analysis was carried out on first molars (M1) from all quadrants. Occlusal Fingerprint Analysis was used for the quantification of macrowear patterns, and 2D cross-sectional geometric analysis was carried out to investigate asymmetry in dental arches.

RESULTS

The asymmetry is highly variable on both arches, and it is associated with differences in the inclination of upper M1 crowns. Each molar has variable inclination (buccal/lingual) which influence tooth to tooth contact, producing greater or lesser variation in wear pattern. Interindividual variability of morphological variation of the occlusal relationship has to be considered in macrowear analysis.

DISCUSSION

Our results suggest that overall asymmetry in the masticatory apparatus in modern humans affects occlusal contact areas between antagonist teeth influencing macrowear and chewing efficiency during ontogeny.

The dawn of dentistry in the late upper Paleolithic: An early case of pathological intervention at Riparo Fredian

OBJECTIVES

Early evidence for the treatment of dental pathology is found primarily among food-producing societies associated with high levels of oral pathology. However, some Late Pleistocene hunter-gatherers show extensive oral pathology, suggesting that experimentation with therapeutic dental interventions may have greater antiquity. Here, we report the second earliest probable evidence for dentistry in a Late Upper Paleolithic hunter-gatherer recovered from Riparo Fredian (Tuscany, Italy).

MATERIALS AND METHODS

The Fredian 5 human consists of an associated maxillary anterior dentition with antemortem exposure of both upper first incisor (I¹ ) pulp chambers. The pulp chambers present probable antemortem modifications that warrant in-depth analyses and direct dating. Scanning electron microscopy, microCT and residue analyses were used to investigate the purported modifications of external and internal surfaces of each I¹ .

RESULTS

The direct date places Fredian 5 between 13,000 and 12,740 calendar years ago. Both pulp chambers were circumferentially enlarged prior to the death of this individual. Occlusal dentine flaking on the margin of the cavities and striations on their internal aspects suggest anthropic manipulation. Residue analyses revealed a conglomerate of bitumen, vegetal fibers, and probable hairs adherent to the internal walls of the cavities.

DISCUSSION

The results are consistent with tool-assisted manipulation to remove necrotic or infected pulp in vivo and the subsequent use of a composite, organic filling. Fredian 5 confirms the practice of dentistry-specifically, a pathology-induced intervention-among Late Pleistocene hunter-gatherers. As such, it appears that fundamental perceptions of biomedical knowledge and practice were in place long before the socioeconomic changes associated with the transition to food production in the Neolithic.

Evaluation of different Diagnostic Modalities for Diagnosis of Dental Caries: An in vivo Study

AIM

The aim of this study was to compare and evaluate the efficacy of different diagnostic aids for diagnosis of dental caries and to compare the validity in terms of sensitivity and specificity of all four diagnostic modalities for diagnosis of caries.

MATERIALS AND METHODS

Occlusal surfaces of 100 primary and permanent molars were examined using the four diagnostic systems (visual, intraoral camera, DIAGNOdent, and DIAGNOdent with dye). These results were compared with operative intervention gold standard. Sensitivity and specificity were calculated for each diagnostic system for both enamel and dentin caries. Interrater agreement was calculated for each diagnostic system using kappa statistics.

RESULTS

For both enamel and dentin caries, the highest sensitivity values were provided by DIAGNOdent (0.91 and 0.72) and lowest for visual examination on wet surface (0.60 and 0.50). For both enamel and dentin caries, the specificity was found to be highest for intraoral camera on dry surface and lowest for visual examination. The DIAGNOdent gave the highest value of interrater agreement (kappa), i.e., 0.816 as compared with 0.03 for visual examination.

CONCLUSION

The study clearly demonstrated that DIAGNO-dent was the most accurate and valid system tested for the detection of occlusal caries. It has the advantage of quantifying the mineral content, helping to improve the diagnostic efficacy and treatment and accurate assessment of fissures where the visual examination alone is not adequate, thus complementing the traditional dental examination.

HOW TO CITE THIS ARTICLE

Zaidi I, Somani R, Jaidka S, Nishad M, Singh S, Tomar D. Evaluation of different Diagnostic Modalities for Diagnosis of Dental Caries: An in vivo Study. Int J Clin Pediatr Dent 2016;9(4):320-325.

Palaeontology: early Neolithic tradition of dentistry

Prehistoric evidence for the drilling of human teeth in vivo has so far been limited to isolated cases from less than six millennia ago. Here we describe eleven drilled molar crowns from nine adults discovered in a Neolithic graveyard in Pakistan that dates from 7,500-9,000 years ago. These findings provide evidence for a long tradition of a type of proto-dentistry in an early farming culture.

Iatrogenic molar borings in 18th and early 19th century Native American dentitions

Six iatrogenic dental borings were identified in four individuals of a Native American skeletal collection from an 18th and early 19th century Middle Columbia River burial site. The borings, all in maxillary first molars with severe dental attrition and secondary dentin, demonstrate striated walls and associated periapical alveolar lesions. An ethnographic review of the subsistence pattern during the burial period indicates a diet that is consistent in dental attrition with other riverine fisher-hunter-gathers. Histological changes of dental pulp tissue during the process of attrition may result in dental necrosis. Access into the pulp chamber is a technique used to drain necrotic fluid. A common Euro-American therapeutic dental practice of the 18th and 19th centuries for diseases of the pulp was dental extraction. Multiple dental borings indicate that the practice of molar drilling into the pulp chamber was an effective and independent technique used by the Wishram and Wasco people.

Digital imaging of bone and tooth modification

Digital cameras are capable of producing images of cut marks and other three dimensional subjects comparable to those obtained from the scanning electron microscope (SEM). Until now, the SEM has offered unparalleled depth of field and surface rendition. SEM units are, however, expensive to acquire and maintain, and SEM image production is time-intensive. Furthermore, SEM images lack color and are often incapable of imaging bone modifications because of magnification and chamber size limitations. A digital imaging method for producing extremely high depth of field enlargements of three dimensional, sub-millimeter scale objects circumvents these problems. In our presentation we employ four case studies of hard tissue modification related to: (1) the origins of meat-eating in the human lineage; (2) evidence for cannibalistic behavior among Neanderthals; (3) pre-Columbian evidence of North American dentistry; and (4) the earliest evidence of cranial surgery in North America. Procedures for replica production, image-capture, and image enhancement are provided. The digital images produced are compared to those obtained with the SEM. Image processing software, a crucial component of this method, allows complete control of graphic data, making graphic fraud a larger threat than ever before. Issues in ethics stemming from the application of this technology to scientific analysis are considered.