Pulp pathosis associated with ancient Maya dental inlays.

OBJECTIVE: The ancient Maya used to practice dental inlays as part of the cultural traditions. Most of those inlays remain in place after more than one thousand years. The purpose of this paper is to investigate the incidence of pulp pathosis associated with ancient Maya dental inlays to assess the impact that such common practice had on the population's oral health.

DESIGN: We scored 193 anterior inlaid teeth from 107 pre-Hispanic Maya dentitions studied at three archaeological storage facilities (Universidad Autonoma de Yucatan, Harvard University, Atlas of Guatemala Project). Two hundred eleven untreated frontal teeth of pre-Hispanic Mayan collections were used as controls. We performed macroscopic, radiographic and microscopic analyses to assess the frequency of caries, pulp calcifications, internal root resorption (IRR), and periapical lesions (PALs).

RESULTS: In the inlaid teeth, the frequencies of pulp calcifications, IRR, caries and PALs were 59.8%, 2.2%, 18.5% and 19.2%, respectively. Compared with untreated teeth, inlaid specimens exhibited greater susceptibility to caries, pulp calcifications, IRR and PALs than untreated teeth (pulp calcifications: 44.5%, IRR: 0%, caries: 1.4%, and PAL: 1.9%). Age-at-death did not have any significant influence on susceptibility to pulp calcifications, IRR, caries or PALs.

CONCLUSIONS: We noted relatively low pulp irritation and a low frequency of carious infections, IRR and PALs in Mayan inlaid teeth. However, these levels exceeded the frequencies of untreated teeth from the same area and time period. We follow that the cements used by the pre-Hispanic Maya to fix the inlays into their sockets provided excellent sealing characteristics on average.