Inverted and horizontal impacted third molars in an Early Modern skull from Wroclaw, Poland: a case report
Abstract
Background: An impacted tooth is one of the most commonly occurring dental anomalies, although some types of impaction (i.e. inverted angulation) may be considered rare finding. There are many hypotheses regarding impaction aetiology. One of the most popular hypotheses suggested that this condition may result from insufficient space in retromolar space, other: improper angulation of tooth bud, malposition of the tooth germ or hereditary factors, insufficient interproximal attrition, ectopy or dysfunction of genes necessary for proper tooth eruption. This study aims to present the odontological and paleopathological assessment of the impacted molars observed within the skull excavated from an early modern cemetery in Wroclaw.
Materials and methods: The skull used in the study was complete and in a good state of preservation. It belonged to an adult individual whose body was buried at the former Salvator Cemetery (currently Czysty Square). The individual’s dentition was almost completely lost antemortem. Only second molars preserved within the maxillae (bilaterally) and the mandible was almost edentulous as well. The morphometric traits have been taken according to standards established by R. Martin. Macroscopic observations were supported by X-rays and computed tomography imaging.
Results: The age at death was estimated at 20–35 years. Comparison of the metric characteristics of skull with the reference material reveals that it is much smaller than the average female skull from this series. Morphometric indices calculated for both splanchocranium and neurocranium allow defining the skull and jaw as short, which could be an important factor involved in the teeth impaction.
Conclusions: Atypical impaction of the third molars could result from small size of skull and could have significantly deteriorated the quality of life of the individual.
Keywords: tooth impactiontooth abnormalitiespaleopathology
References
- Ayranci F, Omezli M, Sivrikaya E, et al. Prevalence of Impacted Wisdom Teeth in Middle Black Sea Population. J Clin Exp Investig. 2017; 8(2): 58–61.
- Bilge NH, Yeşiltepe S, Törenek Ağırman K, et al. Investigation of prevalence of dental anomalies by using digital panoramic radiographs. Folia Morphol. 2018; 77(2): 323–328.
- Brickley M, Ives R. The bioarchaeology of metabolic bone disease. 2008: 351.
- Brothwell DR. Digging up bones: the excavation, treatment, and study of human skeletal remains. 3rd ed. British Museum, London 1981.
- Buikstra J, Ubelaker D. Standards for data collection from human skeletal remains [Internet]. Vol. 44, Fayetteville Arkansas Archaeological Survey. 1994. http://core.tdar.org/document/323332 (cited 2016 Dec 15).
- Chu FCS, Li TKL, Lui VKB, et al. Prevalence of impacted teeth and associated pathologies — a radiographic study of the Hong Kong Chinese population. 2003: 158–63.
- Dąbrowski P, Gronkiewicz S, Soliński D, et al. A case of elongated styloid process in a modern-age skull from Puerto Cabello, Venezuela. Folia Morphol. 2015; 74(4): 475–478.
- Guszpit P, Mruczek R, Wojcieszak J, Wojcieszak M, Wójcik M. Pierwszy wrocławski cmentarz protestancki przy kościele imienia Salwatora – wstępne wyniki badań. In: Czechowicz B, editor. Śródmiejska Katedra Kościół św Marii Magdaleny w dziejach i kulturze Wrocławia 2010.
- Hatem M, Bugaighis I, Taher E. Pattern of third molar impaction in Libyan population: A retrospective radiographic study. Saudi J Dental Res. 2016; 7(1): 7–12.
- Javali R, Meti M. Prevalence of developmental anomalies of teeth in a group of North Karnataka population, India. Int J Dental Res. 2015; 3(1): 5.
- Juodzbalys G, Daugela P. Mandibular third molar impaction: review of literature and a proposal of a classification. J Oral Maxillofac Res. 2013; 4(2): e1.
- Kim TW, Artun J, Behbehani F, et al. Prevalence of third molar impaction in orthodontic patients treated nonextraction and with extraction of 4 premolars. Am J Orthod Dentofacial Orthop. 2003; 123(2): 138–145.
- Kling JM, Clarke BL, Sandhu NP. Osteoporosis prevention, screening, and treatment: a review. J Womens Health (Larchmt). 2014; 23(7): 563–572.
- Krimmel M, Reinert S. Mandibular fracture after third molar removal. J Oral Maxillofac Surg. 2000; 58(10): 1110–1112.
- Krzyżaniak M, Miszkiewicz B. Crania Polonica: Cmentarzyska Warszawskie z XVII-XIX w. [Warsaw Cemeteries from the XVII th to the XIXth century]. Mater i Pr Antropol. 1955: 10.
- Leandro I, Rodrigues C, Gómez-Martínez S, et al. Ectopic eruption of a lower permanent molar from the mediaeval necropolis of Alcáçova do Castelo, Mértola, Portugal. Int J Paleopathol. 2017; 16: 1–4.
- Lim AA, Wong CW, Allen JC. Maxillary third molar: patterns of impaction and their relation to oroantral perforation. J Oral Maxillofac Surg. 2012; 70(5): 1035–1039.
- Loescher AR, Smith KG, Robinson PP. Nerve damage and third molar removal. Dent Update. 2003; 30(7): 375–80, 382.
- López-Frías FJ, Castellanos-Cosano L, Martín-González J, et al. Clinical measurement of tooth wear: Tooth wear indices. J Clin Exp Dent. 2012; 4(1): e48–e53.
- Malinowski A, Bożiłow W. Podstawy Antropometrii. Metody, techniki, normy. PWN, Warszawa-Łódź 1997.
- Martin R, Saller K. Lehrbuch der Anthropologie. , Stuttgart 1957.
- Muhamad AH, Nezar W. Prevalence of Impacted Mandibular Third Molars in Population of Arab Israeli: A Retrospective Study. IOSR J Dent Med Sc. 2016; 15(1): 2279–2861.
- Padhye MN, Dabir AV, Girotra CS, et al. Pattern of mandibular third molar impaction in the Indian population: a retrospective clinico-radiographic survey. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013; 116(3): e161–e166.
- Pihlstrom B, Michalowicz B, Johnson N. Periodontal diseases. Lancet. 2005; 366(9499): 1809–1820.
- Pillai AK, Thomas S, Paul G, et al. Incidence of impacted third molars: A radiographic study in People's Hospital, Bhopal, India. J Oral Biol Craniofac Res. 2014; 4(2): 76–81.
- Quek SL, Tay CK, Tay KH, et al. Pattern of third molar impaction in a Singapore Chinese population: a retrospective radiographic survey. Int J Oral Maxillof Surg. 2003; 32(5): 548–552.
- Sękowska A, Chałas R, Dunin-Wilczyńska I. Width of dental arches in patients with maxillary midline diastema. Folia Morphol. 2018; 77(2): 340–344.
- Şener S. Presence, Distribution, and Association of Dental Anomalies: a Clinical and Radiographical Study. Clin Dent Res. 2011; 35(3): 43–52.
- Stanley J. Nelson. Wheeler’s dental anatomy, physiology, and occlusion. 3rd ed. Elsevier, St Louis 2015.
- Thangavelu A, Yoganandha R, Vaidhyanathan A. Impact of impacted mandibular third molars in mandibular angle and condylar fractures. Int J Oral Maxillofac Surg. 2010; 39(2): 136–139.
- Tomaszewska IM, Zwinczewska H, Gładysz T, et al. Anatomy and clinical significance of the maxillary nerve: a literature review. Folia Morphol. 2015; 74(2): 150–156.
- Wachowski K, Klápště J, Krabath S, et al. I. Wratislavia Antiqua, t. 21. Cmentarz Salwatora. Pierwsza nekropolia wrocławskich protestantów. Uniwersytet Wrocławski, Instytut Archeologii. 2015.
- White TD, Black M, Folkens P. Human osteology. Berkeley, California 2012.
- Wise GE. Cellular and molecular basis of tooth eruption. Orthod Craniofac Res. 2009; 12(2): 67–73.
- Yilmaz S, Adisen MZ, Misirlioglu M, et al. Assessment of third molar impaction pattern and associated clinical symptoms in a central anatolian Turkish population. Med Princ Pract. 2016; 25(2): 169–175.