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Evidence of pulp disease in the inlayed teeth of the ancient Mayans: a micro-CT study


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Oral Presentation performed at the SkyScan User Meeting 2011 in Leuven, Belgium.

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Evidence of pulp disease in the inlayed teeth of the ancient Mayans: a micro-CT study

  1. 1. Thank you very much. It is an honor to be here with you today. I would like to thankSkyScan for this invitation and to the University of São Paulo in the person of Prof.Manoel for the oportunity to be here. 1
  2. 2. An old and fascinating human practice, body ornamentation can be achieved througha variety of means including clothing, piercings, tattooing, scarification, dentalmodification, among others. 2
  3. 3. Artificial dental modification is found in many areas of the world …. 3
  4. 4. ….but is best known in the ancient civilization of Mesoamerica. The Mayas were apeople with a highly developed culture who inhabited the Yucatan Peninsula. Thenations history began about 2500 B.C., but the culture flourished from about 300A.D. to about 900 A.D. 4
  5. 5. In their dental practiced, teeth were drilled with small holes to permit the insertion ofround pieces of stone. 5
  6. 6. The filing procedure was employed using a hard tube that was spun between thehands or in a rope drill, with a slurry of powdered quartz in water as an abrasive, tocut a hole through the enamel of the tooth. 6
  7. 7. Then, the inlay was cemented into place. 7
  8. 8. Although many studies involve description and classification of artificially modifiedteeth, few examine the consequences of this modification. 8
  9. 9. The aim of this study was to evaluate three-dimensionally the anatomical relationshipbetween the cavity prepared to hold the inlay stone and the pulp chamber in six well-preserved Mayas teeth found in an archaeological site in Guatemala, withapproximately 1600-year-old. 9
  10. 10. Each specimen was vertically positioned on a metal holder in the center of the stageand scanned in a desktop X-ray microfocus CT scanner SkyScan 1174v2 using thefollowing parameters: 10
  11. 11. Images of each specimen were reconstructed from apex to the coronal level withNRecon software which provided axial cross sections of the inner structure of thesamples in approximately 450 slices. 11
  12. 12. Ctan and CTVol software were used for the three-dimensional visualization andqualitative analysis of the external and internal anatomy of the teeth 12
  13. 13. A tooth is basically made up of two parts: the crown and the root. Different tissuesmake up each tooth: the enamel, the dentin, that supports the enamel, and the pulpthat is a soft tissue located within a tooth, in a place called pulp cavity that is dividedinto root canal and pulp chamber. 13
  14. 14. In a situation that a tooth is considered so threatened and infection of the root canalspace is considered inevitable, the removal of the pulp tissue is advisable to preventsuch infection that could lead to necrosis, calcification or internal resorption. 14
  15. 15. In ancient Mesoamerica civilizations, non-therapeutic dental modification was adistinguishing mark of high status, of belonging to a tribe or clan, or of beauty. InMayas culture, alteration of the crown contour was the most common form of dentalmodification, followed by inlays or incrustations. Dental modification was foundpredominantly in the anterior teeth. The types of stones used for inlay varygeographically and temporally but include pyrite, jade, turquoise, jadeite, hematite,and obsidian 15
  16. 16. Despite a complete classification of artificial modifications to human teeth has beenperformed by some authors, in the present study it was used the classification systemcreated by Romero Molina (1970) because it constitutes the Mesoamerican standardfor categorization.Romero defined seven basic types of dental modifications based on the study of acollection of 1,212 teeth. Each type was subdivided into at least five variants,resulting in a total of 59 different types. According to Romero’s classification, thedental modification of all specimens in the present study was classified as type E1(one stone on the buccal surface of the crown), except one lateral incisor that was E2(two stones on the buccal surface of the crown). 16
  17. 17. Now, I am going to present you the three-dimensional reconstruction of the Maya’steeth. In the canine teeth, the holes made to insert the inlay stone did not reach thepulp chamber. 17
  18. 18. It probably happened because of the thickness of enamel compared to the otherteeth. 18
  19. 19. In the premolar tooth only a small perforation of the pulp chamber under the buccalcusp, without morphological alteration of the intraradicular dentine, was observed. 19
  20. 20. Multiple levels of responses and interactions occur in reaction to mechanical injuriesof the dental pulp. Depending on the severity and duration of the insult and the hostresponse, two distinct hard tissue changes may be induced: resorption orcalcification. In the maxillary incisors, it was observed that the holes clearlyperforated the pulp chamber resulting in a massive internal inflammatory resorption. 20
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  22. 22. and partial calcification of the pulp cavity. 22
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  24. 24. The intentional modifications of human teeth hold anthropological and socialsignificance. Their study helps to understand past and present human behaviour froma geographic, cultural, religious, and aesthetic perspective. Micro-computedtomography analysis of ancient Mayas teeth showed that the holes made to insertthe inlay stone reach the pulp chamber in the maxillary incisors and premolar teeth.In the incisors, it was observed the development of internal resorption andcalcification. Intraradicular dentine and pulp cavity of canines and premolar teethshowed no morphological alteration. To our knowledge, this is the first study ofmodified Maya’s teeth using micro-computed tomography and opens a perspectivefor further research on the understanding of pulpal and/or periradicular pathosis inancient civilizations. 24
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