Multifocal eosinophilic granuloma with a possible trepanation in a fourteenth century Greek young skeleton

Multiple lytic lesions in the cranial remains of a young adolescent from medieval Corinth in Greece, display characteristics best associated with multifocal eosinophilic granuloma. Some of the lesions have marginal sclerosis indicative of healing. The lesions vary in size from less than one centimeter in diameter to over two centimeters. The larger lesions, in particular, appear to be the result of confluence between two or more lytic foci. These lesions, rarely described in archaeological skeletal material, result from a pathological disturbance within the reticuloendothelial system. One of the cranial lesions has a different appearance from the other lesions and may have been produced by a therapeutic trepanation. © 1997 John Wiley & Sons, Ltd.     

Legg–Calvé–Perthes Disease and unifocal eosinophilic granuloma in a visigoth from the Duratón necropolis (Segovia,Spain)

Individual number 12, exhumed at the Duratón Visigoth necropolis (Segovia, Spain), was found in a supine position inside a simple fossa without adornments. He was a very robust adult (∼50/60 years) male presenting two pathologies, independently originated and both occurring in a particular anatomical area: the right hip. The first one has been diagnosed as Legg–Calvé–Perthes Disease, and it affects the right femur and the coxal. The femoral head has a diameter that is much greater than usual, with a porous articular surface, no fovea capitis and a marked arthritic secondary growth which is inserted in the femoral neck; the coxal shows a pathological acetabulum larger than the left one, and having osseous borders. The second disease, considered a unifocal eosinophilic granuloma, is in the inner face of the right ilium, and practically occupies the whole iliac fossa. The development of the two pathologies and their probable repercussions on the individual's mobility, on the basis of the study of both the pathological and normal pieces recovered, are discussed. Copyright © 2010 John Wiley & Sons, Ltd.     

Pathogenesis of apical periodontal cysts: guidelines for diagnosis in palaeopathology

Apical periodontal cysts are benign lesions developing in relation to the apices of non‐vital teeth due to inflammatory response from the infective pulp. These are epithelium‐lined bony cavities containing fluid. Despite being widely reported in medical/dental literature, this common condition is poorly diagnosed and documented in the archaeological literature. We aim to clarify the correct terminology, demonstrate bony manifestations at different stages of pathogenesis of chronic periapical dental lesions into granuloma and apical periodontal cysts, and to describe diagnostic criteria which would provide practical guidelines for the diagnosis of these conditions. Three identified skulls from the International Exchange Collection, housed in the Anthropological Museum at the University of Coimbra, are used to identify the progression of this condition from a small periapical granuloma to a large apical periodontal cyst with expansion of alveolar and facial bones. The pathogenesis of this condition is described, together with its surgical management in the early 20^th century in Portugal, which is the period in which these individuals lived. Confusion resulting from the different terminologies can be avoided if the term periapical granuloma is used to define apical bony lesions smaller than 3 mm at their maximum intra‐bony diameter, and the term apical periodontal cysts for the larger lesions. We recommend that these terminologies and parameters be used as a standard in future studies. This will make inter‐observer and inter‐population comparisons more accurate. Copyright © 2007 John Wiley & Sons, Ltd.     

Periapical Lesions in Intentionally Modified Teeth in a Skeletal Sample of Enslaved Africans (Lagos,Portugal)

Intentional dental modifications are alterations of teeth usually performed as a ritual for aesthetic or identity purposes. However, the execution of the technique is not exempt from risk and can be related to a higher prevalence of dental pathology, more specifically through the exposure of the dental pulp and consequent periapical inflammation. With the aim of analysing the relationship between intentional dental modifications and periapical inflammation, the current study evaluated 81 skeletons (49 women, 19 men, and 13 individuals of unknown sex) of enslaved Africans from Lagos, Portugal (15th–17th centuries), of which 50 (61.7%) had intentionally modified teeth. In all, 2285 sockets and 2063 teeth were observed. Two hundred and three intentionally modified anterior teeth (27.2%) were identified. Twenty five individuals (30.9%) and 54 teeth (25 anterior and 29 posterior) showed macroscopic evidences of periapical lesions. In the anterior dentition, intentional modification was identified as the probable aetiology of 17 (68.0%) periapical lesions, mostly granulomata or cysts, but also abscesses. The association between intentional modifications of the dentition and the presence of periapical lesions was found in both the maxilla and mandible. These results suggest that this cultural practice can predispose teeth to periapical inflammation, which may cause pain and sensitivity to cold, heat, and pressure, and probably had a negative impact on the quality of life of these individuals. Copyright © 2016 John Wiley & Sons, Ltd.