The rachitic tooth: The use of radiographs as a screening technique

This study investigates morphological changes in pulp chambers of living and archaeological individuals with past vitamin D deficiency. Living individuals (n = 29), four with detailed medical and dental records and three groups of archaeological individuals (n = 25) were radiographed; selected individuals were further evaluated histologically for the presence of incremental interglobular dentin (IIGD), indicative of deficiency (28 living; 17 archaeological). Measurements of pulp horns/chambers from radiographs were conducted to quantify morphological observations. One group had clear skeletal evidence of rickets from St. Matthew, Quebec (n = 1) and St. Jacques, France (n = 4); a second group had slight skeletal indicators from Bastion des Ursulines, Quebec (n = 6); and a third group lacked both skeletal and radiological evidence of deficiency from St. Antoine (n = 6) and Pointe-aux-Trembles (n = 4). Results showed archaeological individuals with clear and slight skeletal evidence of past deficiency displayed constricted or chair shaped pulp horns. Living individuals with deficiency exhibited similar pulp chamber morphology. Radiographic pulp horn/chamber measurements corroborated morphological findings and significant differences were found in pulp horn/chamber measurements between those with and without deficiency. Results suggest that radiograph assessment of teeth can be used as a screening technique to elucidate patterns of deficiency and select individuals for microCT or histological assessment.