Periapical inflammation in individuals of the medieval necropolis of Saõ Joaõ de Almedina (Coimbra, Portugal) (12thâ'16th centuries)

Abstract

Periapical inflammation results from tooth pulp invasion by bacteria following trauma, severe wear, or dental caries. Considering the different repercussions that the various periapical lesions present, the objective of this study is to evaluate their frequency in a skeletal sample from the medieval necropolis (12thâ'16th centuries) of Sao Joao de Almedina (Coimbra, Portugal). In all, 1007 alveoli, belonging to 54 adult individuals (26 males, 16 females, and 12 individuals of unknown sex), were macroscopically examined. The differential diagnosis of the lesions was performed following Dias and Tayles (1997) and Hillson (2001). Periapical lesions were observed in 31.5% of the individuals, and 3.2% of the alveoli. Of the 33 lesions, 29 (87.9%) were granulomas/cysts and four (12.1%) wereWasterundergoing remodelling. No abscesses or osteomyelitis were observed. No differences in the lesions' distribution by sex, age group or laterality were found. Both anterior and upper alveoli revealed more lesions, probably due to lower bone density or greater postmortem tooth loss. Granulomas/cysts were mainly found without any opening. The main aetiological factor identified was caries. Considering that only relatively benign and asymptomatic lesions were identified, periapical inflammation would not have had a very negative impact on the individuals studied.