Application of portable digital radiography for dental investigations of ancient Egyptian mummies during archaeological excavations: Evaluation and discussion of the advantages and limitations of different approaches and projections

Purpose: In the age of X-ray computed tomography (CT) and digital volume tomography (DVT), with their outstanding post-processing capabilities, indications for planar radiography for the study of the dentition of ancient Egyptian mummies may easily be overlooked. In this article, the advantages and limitations of different approaches and projections are discussed for planar oral and maxillofacial radiography using portable digital X-ray equipment during archaeological excavations. Furthermore, recommendations are provided regarding projections and sample positioning in this context. Materials and Methods: A total of 55 specimens, including 19 skeletonized mandibles, 14 skeletonized skulls, 18 separate mummified heads, and 4 partially preserved mummies were imaged using portable digital X-ray equipment in the course of archaeological excavations led by the University of Basel in the Valley of the Kings between 2009 and 2012. Images were evaluated by 2 authors with regard to the visibility of diagnostically relevant dental structures using a 4-point grading system(Likert scale). Results: Overall, the visibility of diagnostically relevant dental structures was rated highest by both authors on X-ray images acquired using a dental detector. The tube-shift technique in the lateral projections of mandibular dentition achieved the second-best rating, and lateral projections achieved the third-best rating. Conclusion: Conventional planar digital X-ray imaging, due to its ubiquity, remains an excellent method-and often the only practicable one-for examining the skulls and teeth of ancient Egyptian mummies under field conditions. Radiographic images of excellent diagnostic quality can be obtained, if an appropriate methodology regarding the selected projections and sample placement is followed.