Personal ornaments from Hayonim and Manot caves (Israel) hint at symbolic ties between the Levantine and the European Aurignacian.

Situated at the crossroads of Africa and Eurasia, the Levant is a crucial region for understanding the origins and spread of Upper Paleolithic (UP) traditions associated with the spread of modern humans. Of the two local Early Upper Paleolithic technocomplexes, the Ahmarian and the Levantine Aurignacian, the latter appears to be unique in the endemic UP sequence, exhibiting greater similarity to the West European 'classic' Aurignacian than to the local preceding and proceeding UP entities. Previous publications have mostly focused on the similarities between the two lithic industries and less on studies conducted on Levantine Aurignacian bone tools and ornaments. Here, we present an archaeozoological, technological and use-wear study of ornaments on animal teeth from the Levantine Aurignacian layers at Manot and Hayonim caves (the Galilee, Israel). The selection of taxa, the choice of teeth, the mode of modification, and the use-wear analysis exhibit clear similarities with the European Aurignacian. This, with the technology of the osseous raw material exploitation, the presence of antler simple-base points, and some lithic typotechnological features, suggest a link between the symbolic spheres of the Levantine and the European Aurignacian cultural entities. Such similarity also supports some contribution of European Aurignacians groups to the local cultural entities, intermingling with the local material culture features.

Are chin and symphysis morphology facial type-dependent? A computed tomography-based study.

INTRODUCTION: The chin is a major determinant of the facial profile; hence, it plays a major role in orthodontics and orthognathic surgery. It is thus essential to follow and better understand its expression in different facial types. The major objectives of the current study were to characterize morphometrically the chin and symphysis and reveal their association with different facial types. METHODS: Computed tomography scans of the head and neck of 311 adults (163 males, 148 females; age range, 18-95 years) were classified into 3 facial types: short, average, and long. Height, width, projection, inclination, thickness, and area were measured on the chin and symphysis. RESULTS: The majority of the population (70%) manifested an average facial type; the other 30% were almost equally distributed between short and long facial types. The long facial type was more common among females and the short facial type among males. Chin projection, area, and size were significantly greater in short-faced patients. Chin width in males was similar for all facial types, whereas, in females, chin width was the widest in the short facial type and the narrowest in the long facial type. Symphysis height was significantly greater in long-faced patients in both sexes. The mandibular incisors' inclination relative to the mandibular plane was not significantly associated with the chin or symphysis morphology. CONCLUSIONS: Chin and symphysis morphology is facial type-dependent. Orthodontists and maxillofacial surgeons should be aware of the complex relationship between facial types and chin/symphysis size and shape when planning treatment.

Rate and pattern of interproximal dental attrition.

Although occlusal and interproximal attrition occur because of diverse etiology and present dissimilar features, both progress with age. The objectives of this study were to reveal the rate and pattern of development of interproximal attrition facets (PAF) with age and to compare those with occlusal attrition (OA) changes. Five-hundred and ninety-four teeth were collected from 198 skulls (of adults, 20-71 yr of age). Three mandibular teeth [first premolar (P1), second premolar (P2), and first molar (M1)] were examined for PAF size and OA rate. Interproximal attrition and OA followed similar patterns of development until subjects reached 40-45 yr of age, after which they took different paths: PAF did not increase in size and were not as large as in younger groups, regardless of facet location, whereas OA continued to progress. The PAF changes with age differed between premolars and molars, unlike OA, which presented a similar rate for all teeth studied. Although OA scores presented significantly moderate correlations with age, PAF area size demonstrated low correlations with age. Low, but significant, correlations were found between the rate of OA and that of PAF. However, PAF and OA exhibited different patterns of development with age. Premolars and molars presented dissimilar development of PAF, which is probably caused by a unique attrition pattern in the molar teeth, different morphology, and force vectors.

Pattern of maxillary and mandibular proximal enamel thickness at the contact area of the permanent dentition from first molar to first molar.

INTRODUCTION: Proximal enamel thickness (PET) at the mesial and distal contact areas of the complete permanent dentition has not been previously reported. Anatomic investigation of PET is essential for interproximal reduction treatment. Our objectives were to measure the PETs of the complete maxillary and mandibular dentitions at the contact areas, to compare the PETs of adjacent teeth, and to evaluate the vertical position of each contact area. METHODS: We evaluated 720 extracted teeth; of these, 109 intact teeth were selected. The mesial and distal contact areas were demarcated, and each tooth was embedded in transparent epoxy resin. Blocks were prepared so that the 2 demarcated contact areas were exposed, and 6 measurements were taken and statistically analyzed. RESULTS: Both jaws showed the same PET pattern characterized by 5 features: PET increased progressively from incisor (0.63 mm) to first molar (1.48 mm). Per tooth, mesial and distal PET did not differ. Total maxillary (26.86 mm) and mandibular (24.52 mm) PETs were similar. Paired PETs at the interproximal interface were similar, with the exception of the lateral incisor-canine interfaces. From incisor to first molar, the contact area becomes located farther gingivally. CONCLUSIONS: The existing guideline of maximal 0.5-mm interproximal reduction per 2 adjacent teeth should be kept in the anterior region and could be increased to 1 mm in the posterior region, when an equal amount is removed.

Proximal attrition facets: morphometric, demographic, and aging characteristics.

Although interproximal attrition is considered to be limited in modern populations, it has important clinical implications. However, in contrast to occlusal attrition, proximal attrition receives limited scientific attention. The main purpose of the current study was to fill this void. Seven-hundred and sixty-five teeth were collected from 255 skulls of subjects 18-75 yr of age. For each individual, three mandibular teeth (the first and second premolars and the first molar) were examined for proximal attrition facets (PAFs). The results provide detailed information on the size, shape, and location of the facets according to age cohort, gender, and ethnicity. The validity of the method used to measure the facets was also examined. The major findings were as follows: PAFs are usually located on the upper half of the crown proximal aspect; in each tooth, the mesial facet is more lingually positioned and the distal facet is more buccally positioned; the majority of the facets are subrectangular in shape; the size of the facets tends to increase in an anteroposterior direction (from premolars to molars); and facet size and location are age- and sex-dependent and ethnicity-independent. It is our recommendation that dentists bear in mind that interproximal attrition is a dynamic, long-term process and needs to be considered in many clinical scenarios.

The arrangement of the interproximal interfaces in the human permanent dentition.

OBJECTIVES: The interproximal interface (IPI) is the interface between two adjacent teeth, i.e., the site where forces are transmitted along the dental arch. We investigated the IPI arrangement of the human permanent dentition. Specifically, the IPI morphometrical characteristics were studied and interpreted within a biomechanical framework. SUBJECTS AND METHODS: A novel in vivo IPI measurement was developed based on diversity in transillumination of Polyvinyl siloxane impression of the interproximal region. The study group included 30 subjects, aged 27, ±4.0 years. Eleven parameters were examined in each of the 26 IPIs of the permanent dentition. RESULTS: The IPI showed intra-arch similarity and interarch diversity between the tooth groups. The IPI shape was predominantly oval (60-100%), yet kidney-shaped in some molars (22-40%). From incisors to molars: the IPI increased significantly (p < 0.001) in size (1.72 to 6.05 mm(2)), occupied more of the proximal wall (7.8-12%), changed its orientation from vertical to horizontal (88.66-14.80°), and was mainly located in the buccal-occlusal quadrant of the proximal wall, chiefly in the molar teeth. CONCLUSIONS: The IPI is a product of proximal wall attrition and is dictated by the mastication forces, number of cusps, and crown inclination. IPI arrangement counteracts the adverse crowding effect of the anterior component of the mastication forces. CLINICAL RELEVANCE: The IPI characteristics found in the present study provide guidelines for crown and proximal filling restorations to meet dental physiology requirements. Further, IPI determines correct tooth alignment and proximal wall stripping applied to resolve arch length deficiency.

The Associations between the Maxillary Sinus Volume, Infraorbital Ethmoid Cells, and the Infraorbital Canal: A CT-Based Study.

This CT-based study aimed to characterize and explain the existence of two anatomical structures positioned near the maxillary sinuses, which are of clinical relevance in rhinology and maxillofacial surgery. A total of 182 head scans (92 males and 90 females) were inspected for infraorbital ethmoid cells (IECs) and for the type (route) of infraorbital canal (IOC). The maxillary sinuses were segmented, and their volumes were measured. Statistical analysis was conducted to reveal the associations between the two anatomical variations, namely, sex and the maxillary sinus volume. Infraorbital ethmoid cells were noted in 43.9% of the individuals studied; they were more frequent in males (53.3%) than in females (34.4%). The descending infraorbital nerve (type 3 IOC) was found in 13.2% of individuals and was independent of sex. Infraorbital ethmoid cells were associated with the IOC types. The maxillary sinus volume was found to be sex-dependent. A large sinus volume is significantly associated with IOC Type 3 (the descending canal) and the presence of IEC. Dentists, radiologists, and surgeons should be aware that individuals with extensive pneumatization of the maxillary sinuses are more likely to display a descending IOC and IEC. These findings should be studied, along with CT scans, before treatment and surgery.

Evidence for the cooking of fish 780,000 years ago at Gesher Benot Ya'aqov, Israel.

Although cooking is regarded as a key element in the evolutionary success of the genus Homo, impacting various biological and social aspects, when intentional cooking first began remains unknown. The early Middle Pleistocene site of Gesher Benot Ya'aqov, Israel (marine isotope stages 18-20; ~0.78 million years ago), has preserved evidence of hearth-related hominin activities and large numbers of freshwater fish remains (>40,000). A taphonomic study and isotopic analyses revealed significant differences between the characteristics of the fish bone assemblages recovered in eight sequential archaeological horizons of Area B (Layer II-6 levels 1-7) and natural fish bone assemblages (identified in Area A). Gesher Benot Ya'aqov archaeological horizons II-6 L1-7 exhibited low fish species richness, with a clear preference for two species of large Cyprinidae (Luciobarbus longiceps and Carasobarbus canis) and the almost total absence of fish bones in contrast to the richness of pharyngeal teeth (>95%). Most of the pharyngeal teeth recovered in archaeological horizons II-6 L1-7 were spatially associated with 'phantom' hearths (clusters of burnt flint microartifacts). Size-strain analysis using X-ray powder diffraction provided evidence that these teeth had been exposed to low temperature (<500 °C), suggesting, together with the archaeological and taphonomic data, that the fish from the archaeological horizons of Area B had been cooked and consumed on site. This is the earliest evidence of cooking by hominins.

Middle Pleistocene dental remains from Qesem Cave (Israel).

This study presents a description and comparative analysis of Middle Pleistocene permanent and deciduous teeth from the site of Qesem Cave (Israel). All of the human fossils are assigned to the Acheulo-Yabrudian Cultural Complex (AYCC) of the late Lower Paleolithic. The Middle Pleistocene age of the Qesem teeth (400-200 ka) places them chronologically earlier than the bulk of fossil hominin specimens previously known from southwest Asia. Three permanent mandibular teeth (C(1) -P(4) ) were found in close proximity in the lower part of the stratigraphic sequence. The small metric dimensions of the crowns indicate a considerable degree of dental reduction although the roots are long and robust. In contrast, three isolated permanent maxillary teeth (I(2) , C(1) , and M(3) ) and two isolated deciduous teeth that were found within the upper part of the sequence are much larger and show some plesiomorphous traits similar to those of the Skhul/Qafzeh specimens. Although none of the Qesem teeth shows a suite of Neanderthal characters, a few traits may suggest some affinities with members of the Neanderthal evolutionary lineage. However, the balance of the evidence suggests a closer similarity with the Skhul/Qafzeh dental material, although many of these resemblances likely represent plesiomorphous features.

Dental Anomalies' Characteristics.

The aim of this study was to characterize dental anomalies. The pretreatment records (photographs and radiographs) of 2897 patients (41.4% males and 58.6% females) were utilized to detect dental anomalies. The dental anomalies studied were related to number, size and shape, position, and eruption. A Chi-square test was carried out to detect associations between dental anomalies, jaw, and sex. A total of 1041 (36%) of the subjects manifested at least one dental anomaly. The prevalence of all dental anomalies was jaw-dependent and greater in the maxilla, except for submerged and transmigrated teeth. The most frequently missing teeth were the maxillary lateral incisor (62.3%) and the mandibular second premolars (60.6%). The most frequent supernumerary teeth were the incisors in the maxilla (97%) and the first premolars in the mandible (43%). Dental anomalies are more frequent in the maxilla and mainly involve the anterior teeth; in the mandible, however, it is the posterior teeth. These differences can be attributed to the evolutionary history of the jaws and their diverse development patterns.

Response to Comment on "A Middle Pleistocene Homo from Nesher Ramla, Israel".

Marom and Rak claim, on the basis of a few mandibular features, that the Nesher Ramla (NR) Homo is a Neanderthal. Their comments lack substance and contribute little to the debate surrounding the evolution of Middle Pleistocene Homo. Limitations and preconceptions in their study prevented them from achieving resolution beyond a dichotomous interpretation of the NR as either a Neanderthal or a modern human.

Variation in Chin and Mandibular Symphysis Size and Shape in Males and Females: A CT-Based Study.

The chin is a unique anatomical landmark of modern humans. Its size and shape play an important role from the esthetic perspective. However, disagreement exists in the dental and anthropological literature regarding the sex differences in chin and symphysis morphometrics. The "sexual selection" theory is presented as a possible reason for chin formation in our species; however, many other contradictory theories also exist. This study's aims were therefore to determine how chin and symphysis size and shape vary with sex, and to discuss "sexual selection" theory as a reason for its formation. Head and neck computed tomography (CT) scans of 419 adults were utilized to measure chin and symphysis sizes and shapes. The chin and symphysis measures were compared between the sexes using an independent-samples t-test, a Mann-Whitney test, and the F-statistic. The chin width was significantly greater in males than in females (p < 0.001), whereas the chin height, area, and size index were significantly greater in females (p < 0.001). Symphysis measures did not differ significantly between the sexes. Size accounted for 2-14% of the chin variance and between 24-33% of the symphysis variance. Overall, the chin was found to be a more heterogeneous anatomical structure than the symphysis, as well as more sexually dimorphic.

The earliest modern humans outside Africa.

To date, the earliest modern human fossils found outside of Africa are dated to around 90,000 to 120,000 years ago at the Levantine sites of Skhul and Qafzeh. A maxilla and associated dentition recently discovered at Misliya Cave, Israel, was dated to 177,000 to 194,000 years ago, suggesting that members of the Homo sapiens clade left Africa earlier than previously thought. This finding changes our view on modern human dispersal and is consistent with recent genetic studies, which have posited the possibility of an earlier dispersal of Homo sapiens around 220,000 years ago. The Misliya maxilla is associated with full-fledged Levallois technology in the Levant, suggesting that the emergence of this technology is linked to the appearance of Homo sapiens in the region, as has been documented in Africa.

A possible case of cherubism in a 17th-century Korean mummy.

Cherubism is a benign fibro-osseous disease of childhood limited specifically to the maxilla and mandible. The progressive replacement of the jaw bones with expansile multilocular cystic lesions causes eventual prominence of the lower face, and hence the classic "cherubic" phenotype reflecting variable extents of jaw hypertrophy. Histologically, this condition has been characterized as replacement of the normal bone matrix with multicystic pockets of fibrous stroma and osteoclastic giant cells. Because of radiographic features common to both, primarily the presence of multiloculated lucencies with heterogeneous "ground-glass" sclerosis on CT imaging, cherubism was long mistaken for a craniofacial subtype of fibrous dysplasia. In 1999, however, the distinct genetic basis for cherubism was mapped to chromosome 4p16.3 and the SH-3 binding protein SH3BP2. But while there are already three suspected cases of fibrous dysplasia amongst archaeological populations, no definitive cases of cherubism have yet been reported in historical populations. In the current study we describe micro- and macro-structural changes in the face of a 17th century Joseon Dynasty Korean mummy which may coincide with the clinic-pathologic and radiologic features of cherubism.

Malocclusion in early anatomically modern human: a reflection on the etiology of modern dental misalignment.

Malocclusions are common in modern populations. Yet, as the study of occlusion requires an almost intact dentition in both the maxilla and mandible, searching for the ultimate cause of malocclusion is a challenge: relatively little ancient material is available for research on occlusal states. The Qafzeh 9 skull is unique, as its preserved dentition allowed us to investigate the presence and manifestations of malocclusion. The aim of this study was thus to examine the occlusal condition in the Qafzeh 9 specimen in light of modern knowledge regarding the etiology of malocclusion. We revealed a pathologic occlusion in the Qafzeh 9 skull that probably originated in the early developmental stage of the dentition, and was aggravated by forces applied by mastication. When arch continuity is interrupted due to misalignment of teeth as in this case, force transmission is not equal on both sides, causing intra-arch outcomes such as mesialization of the teeth, midline deviation, rotations and the aggravation of crowding. All are evident in the Qafzeh 9 skull: the midline deviates to the left; the incisors rotate mesio-buccally; the left segment is constricted; the left first molar is buccally positioned and the left premolars palatally tilted. The inter-arch evaluation revealed anterior cross bite with functional shift that might affect force transmission and bite force. In conclusion, the findings of the current study suggest that malocclusion of developmental origin was already present in early anatomically modern humans (AMH) (the present case being the oldest known case, dated to ca. 100,000 years); that there is no basis to the notion that early AMH had a better adjustment between teeth and jaw size; and that jaw-teeth size discrepancy could be found in prehistoric populations and is not a recent phenomenon.

Internal stabilization of a flexion-distraction injury of the upper cervical spine of a toddler: a new technique and literature review.

STUDY DESIGN: A case report and literature review. OBJECTIVE: To present a new and simple technique of fixation without fusion of a rare unstable Salter-Harris type I injury in the upper cervical spine of a 23-month-old toddler. SUMMARY OF BACKGROUND DATA: Surgical treatment of unstable pediatric cervical spine injuries most commonly involves posterior fusion with internal fixation, usually posterior wiring. METHODS: Detailed description of the surgical procedure carried out for fixating an unstable flexion-distraction injury in a 23-month-old toddler, with severe head injury and pneumothorax, is presented. RESULTS: A rare unstable flexion-distraction injury in the upper cervical spine of a toddler was successfully treated with a posterior Number 2 Vicryl (polyglactin 910; ETHICON Division of Johnson & Johnson) suture fixation, with good healing of the ligaments and end plates, without fusion. Preservation of motion was achieved without obvious instability at 28 months postsurgery. CONCLUSION: In selected cases of cervical spine injuries in the young pediatric population, simple stabilization of the spine using degradable Number 2 Vicryl (polyglactin 910) sutures with minimal exposure can provide sufficient stability until healing occurs. Advantages are that fusion is avoided and motion preserved.

Man the fat hunter: the demise of Homo erectus and the emergence of a new hominin lineage in the Middle Pleistocene (ca. 400 kyr) Levant.

The worldwide association of H. erectus with elephants is well documented and so is the preference of humans for fat as a source of energy. We show that rather than a matter of preference, H. erectus in the Levant was dependent on both elephants and fat for his survival. The disappearance of elephants from the Levant some 400 kyr ago coincides with the appearance of a new and innovative local cultural complex--the Levantine Acheulo-Yabrudian and, as is evident from teeth recently found in the Acheulo-Yabrudian 400-200 kyr site of Qesem Cave, the replacement of H. erectus by a new hominin. We employ a bio-energetic model to present a hypothesis that the disappearance of the elephants, which created a need to hunt an increased number of smaller and faster animals while maintaining an adequate fat content in the diet, was the evolutionary drive behind the emergence of the lighter, more agile, and cognitively capable hominins. Qesem Cave thus provides a rare opportunity to study the mechanisms that underlie the emergence of our post-erectus ancestors, the fat hunters.

Tooth wear and dental pathology at the advent of agriculture: new evidence from the Levant.

Differences in patterns of diet and subsistence through the analysis of dental pathology and tooth wear were studied in skeletal populations of Natufian hunter-gatherers (10,500-8300 BC) and Neolithic populations (8300-5500 BC, noncalibrated) from the southern Levant. 1,160 Natufians and 804 Neolithic teeth were examined for rate of attrition, caries, antemortem tooth loss, calculus, periapical lesions, and periodontal processes. While the Natufian people manifest a higher rate of dental attrition and periodontal disease (36.4% vs. 19%), Neolithic people show a higher rate of calculus. Both populations manifested low and similar rates of caries (6.4% in the Natufian vs. 6.7% in the Neolithic), periapical lesions (not over 1.5%), and antemortem tooth loss (3.7% vs. 4.5%, respectively). Molar wear pattern in the Neolithic is different than in the Natufian. The current study shows that the dental picture obtained from the two populations is multifactorial in nature, and not exclusively of dietary origin, i.e., the higher rate and unique pattern of attrition seen in the Natufian could result from a greater consumption of fibrous plants, the use of pestles and mortars (which introduce large quantities of stone-dust to the food), and/or the use of teeth as a "third hand." The two major conclusions of this study are: 1) The transition from hunting and gathering to a food-producing economy in the Levant did not promote changes in dental health, as previously believed. This generally indicates that the Natufians and Neolithic people of the Levant may have differed in their ecosystem management (i.e., gathering vs. growing grains), but not in the type of food consumed. 2) Changes in food-preparation techniques and nondietary usage of the teeth explain much of the variation in tooth condition in populations before and after the agricultural revolution.