Technical note: Micro-computed tomography calibration using dental tissue for bone mineral research.

Computed tomography (CT) and microcomputed tomography (µCT) require calibration against density phantoms scanned with specimens or during routine internal calibration for assessment of mineral concentration (MC) and density. In clinical studies involving bone, alternative calibration methods using bodily tissues and fluids ("phantomless" calibration) have been suggested. However, such tissues are seldom available in archeological and osteological research. This study investigates the potential of dental tissue as internal reference for calibration of µCT scans, facilitating the analysis of bone MC. We analyzed 70 molars from 24 extant primate species, including eight human teeth, each scanned with density phantoms for calibration. Our findings indicate that sampling specific regions of molars (lateral aspects of the mesial cusps) yields low variation in enamel and dentine MC values, averaging 1.27 g/cm3 (±0.03) for dentine and 2.25 g/cm3 (±0.03) for enamel. No significant differences were observed across molar types or among scanning procedures, including scanner model, resolution, and filters. An ad hoc test on 12 mandibles revealed low variance in MC between the conventional phantom and dental tissue calibration methods; all 36 measurements (low, medium, and high MC for each mandible) were within 0.05 g/cm3 of each other -81% were within 0.03 g/cm3 and 94% within 0.04 g/cm3. Based on these results, we propose a new "phantomless" calibration technique using these mean enamel and dentine MC values. The presented phantomless calibration method could aid in the assessment of bone pathology and enhance the scope of studies investigating bone structure and physical property variations in archeological, osteological, and laboratory-based research.

Artificial neural networks reconstruct missing perikymata in worn teeth.

Dental evolutionary studies in hominins are key to understanding how our ancestors and close fossil relatives grew from the early stages of embryogenesis into adults. In a sense, teeth are like an airplane's 'black box' as they record important variables for assessing developmental timing, enabling comparisons within and between populations, species, and genera. The ability to discern this type of nuanced information is embedded in the nature of how tooth enamel and dentin form: incrementally and over years. This incremental growth leaves chronological indicators in the histological structure of enamel, visible on the crown surface as perikymata. These structures are used in the process of reconstructing the rate and timing of tooth formation. Unfortunately, the developmentally earliest growth lines in lateral enamel are quickly lost to wear once the tooth crown erupts. We developed a method to reconstruct these earliest, missing perilymata from worn teeth through knowledge of the later-developed, visible perikymata for all tooth types (incisors, canines, premolars, and molars) using a modern human dataset. Building on our previous research using polynomial regressions, here we describe an artificial neural networks (ANN) method. This new ANN method mostly predicts within 2 counts the number of perikymata present in each of the first three deciles of the crown height for all tooth types. Our ANN method for estimating perikymata lost through wear has two immediate benefits: more accurate values can be produced and worn teeth can be included in dental research. This tool is available on the open-source platform R within the package teethR released under GPL v3.0 license, enabling other researchers the opportunity to expand their datasets for studies of periodicity in histological growth, dental development, and evolution.

Variation in enamel prism size in primate molars.

OBJECTIVE: This study examines whether larger enamel prism diameters accommodate a greater enamel volume from the enamel-dentine junction (EDJ) to the outer-enamel surface (OES) in primate molars, and how prism size relates to enamel thickness and crown location. DESIGN: We assessed variation in enamel prism diameter in relation to crown location and enamel thickness in catarrhine lower molars (n = 14 species) and one platyrrhine. Prism diameter and enamel thickness were recorded in four locations (lingual lateral; lingual cuspal; buccal cuspal; buccal lateral), using a buccal-lingual section through the centre of the mesial cusps. Ten prism diameter readings were collected at inner (near the EDJ), outer (near the OES) and middle (between the two locations) enamel for each location. RESULTS: Mean prism diameter values for each species were similar (range: 4.06 µm to 5.81 µm). Prism diameter enlarged from inner to outer enamel, suggesting larger prisms help accommodate the increase in enamel volume from the EDJ to the OES. Average prism diameter does not associate with enamel thickness. Instead, cuspal positions had significantly smaller prism diameter at the EDJ than lateral positions, and larger prism sizes at the OES, leading to an overall similar prism diameter mean for all positions (Lingual lateral: 5.11 µm; Lingual cuspal: 5.04 µm; Buccal cuspal: 4.78 µm; Buccal lateral: 4.99 µm). CONCLUSIONS: Our study revealed consistent average enamel prism diameters in various crown locations of lower primate molars, potentially contributing to the mechanical integrity and functional optimization of enamel in primates.

Tooth chipping patterns and dental caries suggest a soft fruit diet in early anthropoids.

OBJECTIVES: Fossils from the Fayum Depression, Egypt, are crucial for understanding anthropoid evolution due to the abundance of taxa and the time interval they represent (late Eocene to early Oligocene). Dietary and foraging behavioral interpretations suggest fruits were their dominant food source, although hard foods (e.g., seeds and nuts) and leaves could have been important dietary components for particular groups. In this study, we compare dental chipping patterns in five Fayum primate genera with chipping data for extant primates, to assess potential hard object feeding in early anthropoids. MATERIALS AND METHODS: Original specimens were studied (Aegyptopithecus: n = 100 teeth; Parapithecus: n = 72, Propliopithecus: n = 99, Apidium: n = 82; Catopithecus: n = 68); with the number, severity, and position of chips recorded. Dental caries was also recorded, due to its association with soft fruit consumption in extant primates. RESULTS: Tooth chipping was low across all five genera studied, with a pooled chipping prevalence of 5% (21/421). When split into the three anthropoid families represented, chipping prevalence ranged from 2.6% (4/154) in Parapithecidae, 6% (12/199) in Propliopithecidae, and 7.4% (5/68) in Oligopithecidae. Three carious lesions were identified in Propliopithecidae. DISCUSSION: The chipping prevalence is low when compared to extant anthropoids (range from 4% to 40%) and is consistent with a predominantly soft fruit diet, but not with habitual hard food mastication. The presence of caries supports consumption of soft, sugary fruits, at least in Propliopithecidae. Our results add support for low dietary diversity in early anthropoids, with soft fruits as likely dominant food sources.

High frequency of dental caries and calculus in dentitions from a British medieval town.

OBJECTIVE: Dental pathology and tooth wear data can offer valuable insights into the diet and behaviour of past populations. This study aimed to investigate the presence of dietary continuity by examining different types of dental pathology and tooth wear in a medieval sample from the United Kingdom, comparing them to earlier and later samples from the same location. DESIGN: A comprehensive examination was conducted on 41 individuals (comprising 914 permanent teeth) retrieved from the medieval cemetery of St. Owens Church in Southgate Street, Gloucester, UK. The research focused on documenting and analysing various types of dental pathology and tooth wear, such as dental caries, calculus, and tooth chipping. The frequency of these specific pathologies and wear patterns was then compared to existing literature. Additionally, non-masticatory tooth wear was also evaluated as part of the study. RESULTS: The sample exhibits high levels of carious lesions and calculus (24 % and 74 % of teeth respectively). Anterior teeth also show an elevated chipping frequency, and along with occlusal notches on the maxillary central incisors suggest teeth were regularly used for non-masticatory purposes. CONCLUSIONS: Caries frequency is similar to sites from later periods and may relate to the early adoption of consuming refined carbohydrates. However, remains from the same area, but the earlier Roman period, also shows high rates of caries and calculus, suggesting a continuation of consuming certain cariogenic foods, or certain behavioural/environmental factors, may instead be responsible for these pathology and wear patterns.

Variation in enamel mechanical properties throughout the crown in catarrhine primates.

Enamel mechanical properties vary across molar crowns, but the relationship among mechanical properties, tooth function, and phylogeny are not well understood. Fifteen primate lower molars representing fourteen taxa (catarrhine, n = 13; platyrrhine, n = 1) were sectioned in the lingual-buccal plane through the mesial cusps. Gradients of enamel mechanical properties, specifically hardness and elastic modulus, were quantified using nanoindentation from inner (near the enamel-dentine junction), through middle, to outer enamel (near the outer enamel surface) at five positions (buccal lateral, buccal cuspal, occlusal middle, lingual cuspal, lingual lateral). Cuspal positions had higher mechanical property values than lateral positions. Middle enamel had higher mean hardness and elastic modulus values than inner and outer locations in all five crown positions. Functionally, the thicker-enameled buccal cusps of lower molars did not show evidence of increased resistance to failure; instead, lingual cusps-which show higher rates of fracture-had higher average mechanical property values, with no significant differences observed between sides. Preliminary phylogenetic results suggest there is relatively little phylogenetic signal in gradients of mechanical properties through the enamel or across the crown. There appears to be common mechanical property patterns across molar crowns in Catarrhini and potentially among primates more broadly. These results may allow more precise interpretations of dental biomechanics and processes resulting in mechanical failure of enamel in primates, such as wear and fracture.

Variation in enamel and dentine mineral concentration and density in primate molars.

OBJECTIVE: Variation in enamel and dentine mineral concentration and total effective density can be reliably collected using Micro-CT scans. Both variables are suggested to reflect mechanical properties such as hardness and elastic modulus in dental tissues, meaning Micro-CT methods allow relative composition and mechanical properties to be collected non-destructively. DESIGN: 16 lower molars from 16 Catarrhine primates were Micro-CT scanned alongside hydroxyapatite phantoms using standardized settings and methods to calculate mineral concentration and total effective density. Mineral concentration, total effective density and thickness of dentine and enamel were calculated for four cusps, representing each 'corner' of the tooth and four lateral crown positions (i.e., mesial, buccal, lingual and distal). RESULTS: The results show mean mineral concentration and total effective density values were higher in areas of thicker enamel, while the opposite was observed for dentine. Buccal positions had significantly higher mineral concentration and total effective density values than lingual areas. Cuspal positions had higher mean values than lateral enamel, for both dentine (mineral concentration cuspal: 1.26 g/cm3; lateral: 1.20 g/cm3) and enamel (mineral concentration cuspal: 2.31 g/cm3; lateral: 2.25 g/cm3). Mesial enamel had significantly lower values than other locations. CONCLUSIONS: These common patterns across Catarrhine taxa may be linked to functional adaptations related to optimization of mastication and tooth protection. Variation in mineral concentration and total effective density may also be associated with wear and fracture patterns, and can be used as baseline information to investigate the effect of diet, pathological changes and aging on teeth through time.

Tooth chipping patterns in Archaeolemur provide insight into diet and behavior.

OBJECTIVES: Archaeolemur is a recently extinct genus of lemur that is often compared to some Cercopithecidae, especially baboons. This is due in part to their derived dentition, with large anterior teeth and reduced bilophodont molars. Research involving comparative morphology, analysis of coprolites, isotopes, and enamel structure, have suggested Archaeolemur had an omnivorous diet involving mechanically challenging items. Yet, microwear analysis of posterior teeth does not necessarily support this conclusion. MATERIALS AND METHODS: In this macroscopic study, dental chipping was recorded on permanent teeth of Archaeolemur from different localities (53 individuals; 447 permanent teeth; including both A. edwardsi and A. majori specimens). This study aimed to compare chipping patterns across the dentition of Archaeolemur with chipping in other primates. RESULTS: The results show enamel chipping was prevalent on the anterior teeth of Archaeolemur (38.9% of anterior teeth showed at least one fracture) yet rare in posterior teeth (9%). There was a decrease in chipping frequency across the dentition, moving distally from incisors (50%; 20/40), through caniniform teeth (30%; 15/50), premolars (9.5%; 16/169), and molars (8.5%; 16/188). DISCUSSION: The results support previous research suggesting Archaeolemur had a varied omnivorous diet in which the anterior dentition was used for extensive food processing. This likely included mechanically challenging items such as tough/hard large fruits, small vertebrates, and crustaceans. Such a high rate of chipping in the anterior dentition is uncommon in other primates, with exception of hominins.

Dental caries in wild primates: Interproximal cavities on anterior teeth.

Dental caries has been reported in a variety of primates, although it is still considered rare in wild populations. In this study, 11 catarrhine primate taxa (n = 339 individuals; 7946 teeth) were studied for the presence of caries. A differential diagnosis of lesions in interproximal regions of anterior teeth was undertaken, since they had been previously described as both carious and non-carious in origin. Each permanent tooth was examined macroscopically, with severity and position of lesions recorded. Two specimens were examined further, using micro-CT scans to assess demineralization. Differential diagnosis confirmed the cariogenic nature of interproximal cavities on anterior teeth (ICATs). Overall results show 3.3% of all teeth (i.e., anterior and posterior teeth combined) were carious (n = 262), with prevalence varying among species from 0% to >7% of teeth affected. Those with the highest prevalence of ICATs include Pan troglodytes verus (9.8% of anterior teeth), Gorilla gorilla gorilla (2.6%), Cercopithecus denti (22.4%), Presbytis femoralis (19.5%), and Cercopithecus mitis (18.3%). ICATs make up 87.9% of carious lesions on anterior teeth. These results likely reflect dietary and food processing differences among species, but also between the sexes (e.g., 9.3% of all female P. troglodytes verus teeth were carious vs. 1.8% in males). Processing cariogenic fruits and seeds with the anterior dentition (e.g., wadging) likely contributes to ICAT formation. Further research is needed in living primate populations to ascertain behavioral/dietary influences on caries occurrence. Given the presence of ICATs in frugivorous primates, their diagnosis in archaeological and paleontological specimens may shed light on diet and food processing behaviors in fossil primates.

Tooth chipping prevalence and patterns in extant primates.

OBJECTIVES: A tooth chip occurs when a hard object forcefully contacts the surface of the tooth, typically removing enamel from the occlusal edge. In this study, chipping patterns in extant primates were compared, and hard-object-feeding assessed alongside other factors (e.g., grit mastication and dental properties), to elucidate dietary and behavioral inferences in archeological and paleontological samples. MATERIALS AND METHODS: Thirteen species of extant primates were studied, including eight species within the Cercopithecidae, two within the Ceboidea, and three within the Hominoidea. Four additional species were also incorporated from the literature for some of the analyses. The severity (Grade 1-3), position (buccal, lingual, mesial, and distal) and number of tooth fractures were recorded for each specimen. RESULTS: Species considered hard-object-feeding specialists presented higher rates of chipping, with sakis, mandrills, sooty mangabeys and Raffles' banded langurs having high chipping rates (28.3%, 36.7%, 48.4%, and 34.7% of teeth, respectively). Species that seasonally eat harder foods had intermediate chipping frequencies (e.g., brown woolly monkeys: 18.5%), and those that less commonly consume hard food items had the lowest chipping frequencies (e.g., Kloss gibbon: 7.3%; chimpanzees: 4.4%). DISCUSSION: The results suggest hard food mastication influences differences in chipping prevalence among the species studied. Although Homo fossil samples show high rates of chipping comparable to hard-object-feeding extant primates, they display a different pattern of chipping, supporting the hypothesis that these fractures are mostly non-food related (e.g., grit mastication in Homo naledi; non-masticatory tooth use in Neanderthals).

Root caries on a Paranthropus robustus third molar from Drimolen.

OBJECTIVES: Dental caries is often perceived as a modern human disease. However, their presence is documented in many early human groups, various nonhuman primates and, increasingly, our hominin ancestors and relatives. In this study, we describe an antemortem lesion on the root of a Paranthropus robustus third molar from Drimolen, South Africa, which likely represents another example of caries in fossil hominins. MATERIALS AND METHODS: The molar, DNH 40, is dated to 2.0-1.5 Ma and displays a lesion on the mesial root surface, extending from the cementoenamel junction 3 mm down toward the apex. The position and severity of the lesion was macroscopically recorded and micro-CT scanned to determine the extent of dentine involvement. RESULTS: A differential diagnosis indicates root caries, as the lesion is indistinguishable from clinical examples. Although necrotic in appearance, external tertiary dentine is evident on a micro CT scan. Gingival recession and/or continuous eruption of the tooth as a result of extensive occlusal wear would have occurred to facilitate caries formation. Therefore, the lesion is likely linked to relative old age of this individual. DISCUSSION: This new example increases the total number of carious lesions described in P. robustus teeth to 10, on occlusal, interproximal, and now, root surfaces. Beyond the consumption of caries-causing food, caries formation would have also required the presence of requisite intraoral cariogenic bacteria in this individual and the species. Of interest, the presence of tertiary dentine on the outward surface suggests the DNH 40 lesion may have been arrested, that is, no longer active, perhaps relating to a change in diet or oral microbiome just prior to the individual's death.

A descriptive study of a novel pharmacist led health outreach service for those experiencing homelessness.

OBJECTIVES: To illustrate and review this new service and to describe the demographics of the patient group and the typology of interventions made by the pharmacist prescribers. METHODS: Pharmacists provided pop-up, drop-in (no appointment needed) health clinics to various homeless support venues in Glasgow City Centre. Data from pharmacists' interventions (n = 52) and patient demographics were gathered from clinical records. Data were then extracted, transcribed and analysed. KEY FINDINGS: The demographics of the homeless patient group consisted mainly of white middle-aged males (mean age 39.8 years), of Scottish ethnicity and living in homeless hostels. Medications were prescribed by pharmacists in 62% of all patients. New medications were initiated in 69% of these patients; repeat/re-issues of lapsed medications were issued in 66% of these patients; changes were made to existing medication in 16%. The most commonly prescribed items were as follows: wound dressings; antihypertensives; antidiabetics; analgesics; inhalers; antidepressants; and nutritional supplements. Pharmacists diagnosed a new clinical issue in 69% of patients, most commonly with infections (skin or respiratory) in 36% of patients. Sixty-two per cent of patients had their presenting symptoms managed by the pharmacist alone. Patient engagement was good with 85% subsequently attending either a follow-up with the pharmacist or onward referral (to specialist services, secondary care, general practitioner appointment etc). CONCLUSIONS: Assertive outreach by pharmacist independent prescribers for people who are homeless is feasible and leads to increased access to medicines for acute and chronic health problems. Further work is needed to evaluate the impact of this new service on key clinical outcomes.

A probable genetic origin for pitting enamel hypoplasia on the molars of Paranthropus robustus.

We report the frequencies of linear enamel hypoplasia (LEH) and, specifically, pitting enamel hypoplasia (PEH) defects in the teeth of Paranthropus robustus, for comparison with four other South African hominin species and three extant nonhuman primate species. Unlike LEH, the lesser known PEH is characterized by multiple circular depression defects across a tooth crown and is often difficult to interpret in terms of developmental timing and etiology. Teeth in all samples were examined macroscopically with type, position and number of defects recorded. Frequencies of teeth with LEH vary among hominin species, but the differences in PEH are considerable. That is, P. robustus has much higher rates of pitting defects, with 47% of deciduous teeth and 14% of permanent teeth affected, relative to 6.7% and 4.3%, respectively, for all other hominin teeth combined; none of the extant primate samples evidences comparable rates. The defects on P. robustus molars are unlike those in other species, with entire crowns often covered in small circular depressions. The PEH is most consistent with modern human examples of amelogenesis imperfecta. Additionally, the defects are: 1) not found on anterior teeth, 2) uniform in shape and size, and 3) similar in appearance/severity on all molars. Therefore, this form of PEH may have been a side effect of selection on another trait that shares the same coding gene(s), i.e., these defects have a genetic origin. We discuss a possible scenario that may explain how this form of PEH evolved to become so common in the Paranthropus genus.

Root grooves on two adjacent anterior teeth of Australopithecus africanus.

Tooth root grooves and other ante-mortem dental tissue loss, not associated with caries found on or near the cementoenamel junction (CEJ), are commonly termed non-carious cervical lesions. Three main processes are implicated in forming these lesions: abrasion, dental erosion, and abfraction. As yet, these lesions have not been described in non-Homo hominins. In this study, South African fossil hominin collections were examined for evidence of any type of non-carious cervical lesion. Only one individual shows ante-mortem root grooves consistent with non-carious cervical lesions. Two teeth, a mandibular right permanent lateral incisor (STW 270) and canine (STW 213), belonging to the same Australopithecus africanus individual, show clear ante-mortem grooves on the labial root surface. These lesions start below the CEJ, extend over a third of the way toward the apex, and taper to a point towards the lingual side. The characteristics of these grooves suggest the predominant aetiology was erosive wear. In addition, they are extremely similar to clinical examples of dental erosion. These are the oldest hominin examples of non-carious cervical lesions and the first described in a genus other than Homo. Further, the lesions suggest that this individual regularly processed and consumed acidic food items.

Amelogenesis imperfecta in the dentition of a wild chimpanzee.

This report describes a case of amelogenesis imperfecta in the dentition of a female chimpanzee. Amelogenesis imperfecta is a group of rare genetic conditions that create severe enamel defects, which, although well researched in humans, has not yet been investigated in wild non-human primates.

Behavioral inferences from the high levels of dental chipping in Homo naledi.

OBJECTIVES: A variety of mechanical processes can result in antemortem dental chipping. In this study, chipping data in the teeth of Homo naledi are compared with those of other pertinent dental samples to give insight into their etiology. MATERIALS AND METHODS: Permanent teeth with complete crowns evidencing occlusal wear were examined macroscopically. The location, number, and severity of fractures were recorded and compared to those found in samples of two other South African fossil hominin species and in samples of nonhuman primates (n = 3) and recent humans (n = 7). RESULTS: With 44% of teeth affected, H. naledi exhibits far higher rates of chipping than the other fossil hominin samples. Specifically, 50% of posterior teeth and 31% of anterior teeth display at least one chip. The maxillary teeth are more affected than the mandibular teeth (45% vs 43%, respectively), 73% of molar chipping occurs on interproximal surfaces, and right teeth are more often affected than left teeth (50% vs 38%). DISCUSSION: Results indicate that the teeth of H. naledi were exposed to acute trauma on a regular basis. Because interproximal areas are more affected than buccal and posterior teeth more than anterior, it is unlikely that nonmasticatory cultural behavior was the cause. A diet containing hard and resistant food, or contaminants such as grit, is more likely. The small chip size, and steep occlusal wear and cupped dentine on some molars are supportive of the latter possibility. This pattern of chipping suggests that H. naledi differed considerably-in terms of diet, environment, and/or specialized masticatory processing-relative to other African fossil hominins.