Michael Pharoah

Non-invasive computed tomography and three-dimensional reconstruction of the dentition of a 2,800-year-old Egyptian mummy exhibiting extensive dental disease

A second CT scan of the mummy Djedmaatesankh, which is housed in the Royal Ontario Museum, Toronto, Ontario, has been undertaken after an interval of some 15 years. The image data set of her dentition and the associated tissues acquired from 3 mm thick x 3 mm spacing slices was transferred to an ISG Allegro work station where two-dimensional reformats and three-dimensional reconstructions were produced. This non-invasive examination provided information on dental disease that is, in a number of respects, an advance on that which previously could be obtained from mummies by the traditional methods of visual inspection after unwrapping and by two-dimensional radiography. The two- and three-dimensional images reveal that: three molars are missing and the right maxillary canine is impacted; the rest of the dentition is afflicted by severe attrition, caries and periodontal disease; and, of the 28 teeth present in the mouth, 24 exhibit exposure of their dental pulps and 18 are afflicted by periapical lesions including five that could have contributed to a large secondarily infected radicular cyst. The cyst have displaced the maxillary antrum and enlarged the maxilla on its lateral aspect and the vault of the palate on its medial aspect. Pus from the cyst may have drained through five different sinuses. In life, Djedmaatesankhs widespread dental infection probably caused her considerable pain, personal distress and malaise, and possibly resulted in her death.

Osteoblastoma of the Mandibular Condyle: Review of the Literature and Report of a Case

The first case of osteoblastoma of the mandibular condyle is reported. The clinical, radiographic and histologic features of this benign neoplasm are described and the differential diagnosis is discussed.

Ewing's sarcoma: Metastatic tumor to the jaw

Metastatic tumors to the jaw are a rare occurrence. The incidence of metastatic Ewings sarcoma to the jaw has been reported to be less than 2% of all cases of Ewings sarcoma. Early detection of such lesions is difficult because the signs and symptoms do not appear until the lesion has progressed considerably. The treatment options are therefore limited to palliative care of the patient rather than cure. This article reports a case of Ewings sarcoma that had metastasized to the mandible and reviews the literature.

Performance of titanium alloy sintered porous-surfaced (SPS) implants supporting mandibular overdentures during a 20-year prospective study.

OBJECTIVE This study was undertaken to assess short, sintered porous-surfaced (SPS), press-fit implants with mandibular overdentures to restore edentulous patients with severe mandibular resorption. MATERIALS AND METHODS Implant lengths of 7, 8, 9, and 10 mm were used, all with 2-mm polished collars, making the designed intrabony lengths 5, 6, 7, and 8 mm. Each patient received three non-splinted implants placed using a two-stage protocol. RESULTS Only 22 (with 53 implants) of the original 52 patients were available after 20 years. All but one of these patients was functioning with their implant-retained overdentures. Life table analysis accounted for all patients and implants, and showed a 20-year survival of 73.4%. Analysis of carefully standardized radiographs revealed mean cumulative bone loss after 20 years of 0.67 mm relative to the polished collar-SPS junction. CONCLUSIONS Short SPS implants with mandibular overdentures can provide an acceptable treatment over a 20-year period for fully edentulous patients with severe alveolar resorption.