Multi-headed (bifid and trifid) mandibular condyles in archaeological contexts: Two posttraumatic cases.

OBJECTIVE: Bifid and trifid mandibular condyles are infrequent morphological alterations of the mandibular condyle. With the aim of better identifying its possible causing factors in the past and provide clues on the potential types and severities of joint dysfunction that may occur if clinical intervention is not undertaken, two archaeological cases of multi-headed mandibular condyles are presented, and their possible aetiology and pathogenesis are discussed. DESIGN: In this study, 143 adult mandibles recovered in the northwest of Spain were examined: 91 exhumed from San Juan Bautista church (Guardo, Palencia; 16th-19th centuries), and 52 from San Salvador de Palat de Rey church (León, 13th-19th centuries). All mandibles were observed macroscopically for the presence of any morphological and/or pathological alterations. When justified, the mandibles were also scrutinized through computed tomography. RESULTS: Two isolated mandibles (n = 1, Palencia; n = 1, León) with multi-headed mandibular condyles (bifid and trifid) were identified. The computed tomography scan of the affected mandibles revealed alterations compatible with traumatic events, namely line fractures and deformations at the angle of the mandible. CONCLUSIONS: Both the bifid and trifid mandibular condyles here described probably result from traumatic events during childhood leading to a posttraumatic deformation. Although no severe impairment of mandibular use was identified, some asymmetries probably resulted in some sort of malfunction, with TMJ-OA and gonial angle eversion as supporting evidence. Nevertheless, the degree of bone remodelling observed indicates that both individuals lived long after the traumatic occurrence.

Mycobacterium leprae diversity and population dynamics in medieval Europe from novel ancient genomes.

BACKGROUND: Hansen's disease (leprosy), widespread in medieval Europe, is today mainly prevalent in tropical and subtropical regions with around 200,000 new cases reported annually. Despite its long history and appearance in historical records, its origins and past dissemination patterns are still widely unknown. Applying ancient DNA approaches to its major causative agent, Mycobacterium leprae, can significantly improve our understanding of the disease's complex history. Previous studies have identified a high genetic continuity of the pathogen over the last 1500 years and the existence of at least four M. leprae lineages in some parts of Europe since the Early Medieval period. RESULTS: Here, we reconstructed 19 ancient M. leprae genomes to further investigate M. leprae's genetic variation in Europe, with a dedicated focus on bacterial genomes from previously unstudied regions (Belarus, Iberia, Russia, Scotland), from multiple sites in a single region (Cambridgeshire, England), and from two Iberian leprosaria. Overall, our data confirm the existence of similar phylogeographic patterns across Europe, including high diversity in leprosaria. Further, we identified a new genotype in Belarus. By doubling the number of complete ancient M. leprae genomes, our results improve our knowledge of the past phylogeography of M. leprae and reveal a particularly high M. leprae diversity in European medieval leprosaria. CONCLUSIONS: Our findings allow us to detect similar patterns of strain diversity across Europe with branch 3 as the most common branch and the leprosaria as centers for high diversity. The higher resolution of our phylogeny tree also refined our understanding of the interspecies transfer between red squirrels and humans pointing to a late antique/early medieval transmission. Furthermore, with our new estimates on the past population diversity of M. leprae, we gained first insights into the disease's global history in relation to major historic events such as the Roman expansion or the beginning of the regular transatlantic long distance trade. In summary, our findings highlight how studying ancient M. leprae genomes worldwide improves our understanding of leprosy's global history and can contribute to current models of M. leprae's worldwide dissemination, including interspecies transmissions.

A possible case of ameloblastoma in an adult male from the early 20th century Coimbra, Portugal.

OBJECTIVE: This article discusses the differential diagnosis of an unusual lesion found in the mandible of an adult male individual (late 19th to early 20th century). MATERIALS: A cranium from the Identified Skulls Collection Escolas Médicas of the University of Coimbra, Portugal. METHODS: Macroscopic analysis, conventional radiography. RESULTS: Macroscopically, a conspicuous osteolytic lesion was identified in the middle vestibular area of the mandible. The conventional radiography examination revealed a multilocular and non-expansive lesion, with undefined contours and irregular walls. CONCLUSIONS: These characteristics are compatible with a benign lesion, possibly an ameloblastoma or an odontogenic keratocyst. SIGNIFICANCE: The present work contributes substantially to the knowledge of the development of cystic and tumour lesions in the past and generates a broader body of knowledge about these lesions. LIMITATIONS: Destructive methods were not authorized. SUGGESTIONS FOR FURTHER RESEARCH: In the future, computed tomography scans and 3D reconstruction analysis, not performed in the current study, may add new and valuable information.

Osseous mass in a maxillary sinus of an adult male from the 16th-17th-century Spain: Differential diagnosis.

OBJECTIVE: To undertake a differential diagnosis of a large mass found in the left maxillary sinus of a cranium dated to the 16th-17th-century, and to expand knowledge of the diagnosis of osseous tissue formation in osteoarchaeological studies. MATERIAL: A cranium recovered from the cemetery of San Salvador de Palat de Rey church, León (Spain). METHODS: Macroscopic analysis, CT scanning. RESULTS: Macroscopic analysis indicated that the individual was probably a male over 30 years old with an ossified mass in the left maxillary sinus, measuring 24 × 19 × 24 mm, occupying approximately 27 % of the maxillary antrum. Computed tomography revealed a well-demarcated radiolucent unilocular mass with some radiopaque areas, with no communication with the alveoli of the premolars or molars. No erosive lesions or signs of inflammation were found. CONCLUSIONS: Neither the macroscopic, nor the radiological characteristics are compatible with inflammatory or malignant pathology, favoring a diagnosis of ossifying fibroma. SIGNIFICANCE: This case adds to the few reported cases in the osteoarchaeological literature, especially since there is limited relevant reference data to assist diagnosis. The CT scans and 3D reconstruction presented here facilitate differential diagnosis in future paleopathological studies. LIMITATIONS: Destructive methods were not authorized. SUGGESTIONS FOR FURTHER RESEARCH: In the future, micro-CT analysis, which was not performed in the current study, may add new and valuable information.

Stafne's bone defects from Spain: report of four cases and brief archaeological literature review.

OBJECTIVE: To present for the first time in the north-western Spanish osteological record prevalence data on Stafne's bone defect, to compare the results with those reported by other studies, and to increase the dataset for future inter-population comparisons. MATERIAL: In all, 143 complete adult mandibles recovered from two necropolises were analyzed (n = 118, San Juan Bautista of Guardo, Palencia province, 16th-19th centuries; n = 25, Plaza del Grano, city of León, 12th-15th centuries). METHODS: Differential diagnosis of the lesions was made through macroscopic and Computed Tomography (CT) analyses. RESULTS: Four mandibles (n = 3, Guardo, Palencia; n = 1, León) presented bone cavities on the lingual aspect of the mandible below the mylohyoid channel, between the first molar and the angle of the mandible. CT scan showed unilateral well-defined unilocular oval/round concavities in the lingual mandibular cortex below the inferior alveolar canal. Neither the macroscopic nor the radiological characteristics are compatible with inflammatory or malignant pathology, favoring instead a diagnosis of Stafne's bone defect. CONCLUSIONS: Four cases of Stafne's defects are added to the bioarchaeological inventory. The calculated prevalence is 2.54% for San Juan Bautista and 4% for Plaza del Grano, values in close agreement to those presented in other osteoarchaeological studies. SIGNIFICANCE: The identification of all examples of Stafne's bone defects in past populations will contribute to elucidate which factors may be responsible for this trait's cultural, ecological, temporal, and geographical patterning. LIMITATIONS: The skeletal samples are relatively small. SUGGESTIONS FOR FURTHER RESEARCH: In future investigations of Stafne's bone defects, CT analysis of dry bone specimens is recommended, whenever possible.

Congenital syphilis or mercury treatment: dental alterations in a twelfth- or thirteenth-century child from Medinaceli, Soria, Spain.

Syphilis, together with its variant congenital syphilis, is a disease caused by Treponema pallidum subsp. pallidum. This paper documents possible new skeletal evidence for congenital syphilis from the Medieval Era (twelfth and thirteenth centuries CE) burial site of Medinaceli in the Province of Soria in North-Central Spain. What is involved is dental alteration due to congenital syphilis, mercury treatment, or a combination of both. This study focuses on the hypoplastic dental changes observed in a child approximately eight years of age. Only a fragmented skull with left maxilla and the left side of the mandible were preserved. Macroscopic analysis, X-rays, computerized tomography (CT) and mercury detection analysis by inductively coupled plasma mass spectrometry (ICP-MS) techniques were used to observe dental abnormalities. In addition to extensive caries in the upper second deciduous molar, pulpo-alveolar lesions and facial alterations were observed. The absence of the rest of the skeleton tends to make a diagnosis of congenital syphilis difficult. However, the dental stigmata observed do permit a reasonable diagnosis.