The earliest dental prosthesis in Celtic Gaul? The case of an Iron Age burial at Le Chene, France

Abstract

The discovery of an iron pin in place of an
upper incisor tooth from a La T`ene burial at
Le Chˆene in northern France may represent
one of the earliest examples of a dental implant
in Western Europe. The body was that of
a young woman who had been buried in a
richly furnished timber chamber. The iron
pin may have been inserted during life to
replace a lost tooth, or before burial to restore
the visual integrity of the corpse. The concept
of the dental prosthesis may have been
taken from the Etruscans by returning Celtic
mercenaries, although dental implants of this
specific kind have not been found in Etruscan
contexts.

Full text

The earliest dental prosthesis in Celtic
Gaul? The case of an Iron Age burial at
Le Chˆ
ene, France
Guillaume Seguin1,∗, Emmanuel d’Incau2,3, Pascal Murail2&Bruno
Maureille2
The discovery of an iron pin in place of an
upper incisor tooth from a La T`
ene burial at
Le Chˆ
ene in northern France may represent
one of the earliest examples of a dental implant
in Western Europe. The body was that of
a young woman who had been buried in a
richly furnished timber chamber. The iron
pin may have been inserted during life to
replace a lost tooth, or before burial to restore
the visual integrity of the corpse. The concept
of the dental prosthesis may have been
taken from the Etruscans by returning Celtic
mercenaries, although dental implants of this
specific kind have not been found in Etruscan
contexts.
Keywords: Celtic Gaul, La T`
ene, Etruscans, dental prosthesis, prehistoric dentistry
Introduction
Le Chˆ
ene is situated in the Aube Valley in the western part of Champagne-Ardenne,
France. Discovered during housing development by the local council, which prompted a
rescue excavation, the initial surface stripping revealed a quadrangular funerary enclosure
of approximately 100m2associated with four adult female burials, two of them within the
enclosure itself (Figure 1). Sections across the enclosure ditch suggest that a wooden palisade
had once surrounded it. Examination of the infill of the graves clearly demonstrates the
1Preventive funerary archaeology unit, Arch´
eosph`
ere, 20 rue Suffren, 33300 Bordeaux, France (Email:
g.seguin@archeosphere.com)
*Author for correspondence
2UMR 5199 PACEA-A3P, Anthropologie des populations pass´
ees et pr´
esentes, Universit´
eBordeaux1,B
ˆ
atiment
B8, Avenue des Facult´
es, 33405 Talence Cedex, France (Email: p.murail@pacea.u-bordeaux1.fr;
b.maureille@pacea.u-bordeaux1.fr)
3UFR des Sciences Odontologiques, Universit´
e Bordeaux 2, 16–20 cours de la Marne, 33802 Bordeaux Cedex,
France (Email: emmanuel.dincau@u-bordeaux.fr)
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Guillaume Seguin, Emmanuel d’Incau, Pascal Murail & Bruno Maureille
Figure 1. Organisation of the funerary complex of Le Chˆ
ene.
former existence of a wooden lining, roof and floor, showing that they had timber burial
chambers. The volumes of these graves (between 1.8 and 2.5m3) are much greater than
those presently known from the Late Iron Age in northern France. The time and careful
attention paid to the digging and preparation of these graves constitutes an initial indication
of the privileged status of the deceased.
Numerous metal objects, including bronze torcs, anklets and bracelets, fibulae and belt
rings, and coral and amber bead necklaces, recovered from these burials place them in the
Late Iron Age (La T`
ene B2, 300–250 BC) (Kaurin & Seguin 2013). The richness and
diversity of funerary objects confers upon this group the image of a refined and ostentatious
elite. Additionally, an iron currency bar unearthed in one of these graves may be linked
to the activities of the deceased individual or group whose prosperity may have been based
on the working and trading of iron.
The Champagne region is reputed for its Iron Age sites, which provide evidence for the
substantial settlement of a powerful Celtic group (Rozoy 1987; Charpy & Roualet 1991;
Demoule 1999; Stead & Rigby 1999; Kruta 2000). Although the Celts are renowned for
their skilled handiwork, especially their wood and iron crafts, their medical knowledge is
largely undocumented until the Roman conquest (52 BC), and relatively little is known
about medicine in La T`
ene times (de Navarro 1955). No case of medicinal dental prosthesis
or aesthetic dental ornament had ever been described, either from the Champagne region or
in the wider Celtic world. The discovery of an iron pin in place of an incisor in the mouth
of a woman from the Le Chˆ
ene graveyard was totally unexpected. Here we discuss several
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possibilities concerning the object and compare it with other proven or suspected dental
prostheses from late prehistory and antiquity.
Burial LCH1
The suspected prosthesis discussed here was found in the first grave, LCH1 (Figure 2). The
greater part of the skeleton is no longer present, with only the denser portions
of the femoral diaphyses and several cranial elements having been preserved, precluding
the establishment of the individual’s sex (Murail et al. 2005). The measurements which
could be made on the femora reveal a particularly gracile individual who falls within the
metrical range of variability of female individuals in archaeological populations (Murail
et al. 1999). Iron Age populations in the Champagne region express a strong sexual
dichotomy in terms of both funerary attire and the nature of associated grave goods (Charpy
1998; Demoule 1999). In terms of the latter, the deceased was buried with a belt composed
of eight bronze rings and with four fibulae which presumably closed the burial attire.
The individual also wore a knobbed bronze bracelet on the left wrist, and a small bronze
alloy ornament, linked to a headdress, was recovered near the forehead. A small pair of iron
shears, no doubt designed to trim hair, lay along the right arm. This combination of personal
ornaments and tools in conjunction with what little anthropological data is available leans
towards the reasonable conclusion that this individual was female. The cranio-facial area is
represented by just a few fragments of the cranial vault, part of the union of horizontal and
vertical branches of the lower left jaw (gonion) and two heavily degraded portions of the
temporal bone (petrous bone). The roots (parts of the teeth embedded in dental sockets)
are also heavily deteriorated, and in some cases completely absent. Dental crowns (parts of
the teeth visible in the mouth) are, on the other hand, completely preserved, although the
enamel appears damaged by erosion (demineralisation potentially caused by soil acidity)
(Figure 3). If we consider the limited dental wear (Molnar 1971), coupled with the absence
of ante mortem tooth loss, this individual appears to have died prematurely (perhaps at
20–30 years of age).
Location and description of the iron fixture
Careful excavation of the burial allowed us to observe that maxillary and mandibular teeth
retained significant anatomical coherence, despite the face having caved in upon itself
medially, crushed by the collapse of the funerary chamber roof. Incisors, canines, premolars
and molars remain in anatomical order; both posterior maxillary and mandibular teeth are
still in contact (occlusion) (Figure 4). It is therefore probable that the mouth remained
closed with the head tilted to the right. The iron pin was recovered in the place normally
occupied by the left central maxillary incisor (21, LI1), which was the only tooth that was
absent. It is certain that this object would never have caught our attention had its precise
location not been observed and recorded during excavation.
The pin is made entirely of iron which is now heavily corroded. It is 24mm long with a
maximum diameter of 4.4mm and weighs 0.56g. These measurements include significant
residues of peripheral corrosion. X-rays were taken with a Kodak 2200 generator (65kv
and 4mA) using a high-resolution Kodak 5100 digital radiography system (1600dpi) to
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Figure 2. Plan of burial LCH1.
distinguish the interface between the metal body and the gangue (oxide envelope) formed
by the corrosion. This limit was further defined by adjusting the greyscale. From these images
we were able to determine the object’s original dimensions (23.1mm long and 1.85mm at
its point of maximum width). The layer of corrosion drastically modified its appearance,
which was initially much more tapered (Figure 5).
Discussion
With the exception of the upper left central incisor, no other tooth was missing from the
deceased, nor were any cavities observed. The teeth were not very worn (Molnar’s (1971)
stage 1 for the incisors), suggesting that this adult female was not very old at the time of
death (Lovejoy 1985). The fact that the replaced incisor was the only missing tooth argues
in favour of a loss brought about by trauma rather than pathology. Intentional avulsion of
the tooth does however remain possible, as has been suggested for females of the Etruscan
elite (Becker 1995, 1999b).
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Figure 3. Photograph of the iron object and its association with the maxillary incisors.
While the loss of a central incisor does not carry any major consequences for mastication,
it may have had important attendant aesthetic or phonetic repercussions. The replacement
of a missing tooth may be in keeping with the maintenance of appearances in a civilised
society. The richness and refinement of the ornamental elements recovered from the burials
at Le Chˆ
ene indicate a taste for the grandiose and ostentatious. That the object is made of
iron, however, does not substantiate the hypothesis of a tooth replaced for strictly aesthetic
purposes, as gold or silver would be more appropriate in such a context. The choice of iron
as the material of manufacture was without doubt conditioned by the availability of this
material to a group that had mastered both its transformation and its supply via trade, a fact
further supported by the presence of a large iron currency bar in the neighbouring burial
(grave LCH2).
If we accept that the main function of the implant was to compensate for an aesthetic
disadvantage, we may hypothesise that this object had initially been of a composite nature
and that the crown section was missing. The iron support, the only surviving element, could
have served as a radicular anchor for a crown made of another material (bone, ivory, wood)
which has not been preserved. This hypothesis of a composite dental prosthesis composed of
a metal support and a crown fashioned from a different material has already been suggested
and discussed in relation to two Iron Age sites in Israel, at Lachish (Powers 1989) and in the
Negev (Zias & Numeroff 1987).
Unfortunately, the absence of the maxilla precludes determination of how this piece
could have been held in place. Three possibilities can nevertheless be advanced in order
of probability: an intra-radicular ante mortem insertion; an attempt at an intra-socket ante
mortem insertion; or a post mortem ornament (Figure 6).
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Figure 4. Plan and photograph of the in situ dental remains from LCH1.
Hypothesis 1: an intra-radicular ante mortem insertion (Figure 6)
A dental fracture, involving the crown and/or the root, may occur as the result of facial
trauma. Among traumas suffered by permanent teeth, the frequency of crown fractures
varies between 26 and 76% (Andreasen et al. 1971), while root fractures are less common,
representing only between 0.5–7% (Welbury et al. 2002). However, when they do occur,
the central maxillary incisor is the most commonly affected (68%), followed by the lateral
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maxillary incisor (27%), with the mandibular incisors being the least affected (5%) (Caliskan
& Pehlivan 1996).
Figure 5. Close-up of the object and X-rays: original (centre)
and greyscale retouched (right).
These data enables us to hypothesise
that the left central incisor from individual
LCH1 suffered a total fracture at the
junction between the crown and the root,
corresponding to Type I, Division 1, C
or Type I, Division 2, B (Loomba et al.
2010). A sufficiently long intra-socket root
fragment could have remained and served
as an anchor for the metal object recovered.
In order to validate this possibility, it is
necessary to compare the dimensions of the
object at different levels with the variability
in the root canal dimensions of a central
maxillary incisor.
Kaya et al. (2010) have studied the
variability of the pulp canal (the space
occupied by the nerves, blood vessels and
lymphatic vessels in the root of the tooth),
based on length and width measurements
taken at the apical, middle and cervical
thirds. They have demonstrated that the diameter of this space decreases significantly with
age from the neck (constricted part of a tooth, between the crown and the root), towards the
apex (tip of the root). The individual from LCH1 is a young adult who can be compared
with Kaya et al.’s Group A (15–24 years old) or B (25–34 years old) (Table 1).
In terms of neck and mid-root dimensions, the measurements of the object from Le
Chˆ
ene falls within the variability documented by Kaya et al. (2010), making it possible for
such a piece to have been directly inserted into the pulp canal of an upper central incisor.
On the other hand, the dimensions of the pulp canal at the level of the last apical third are
too narrow to permit the passage of this metal object (Figure 7). Furthermore, it appears
unlikely that such a piece could have been inserted all the way to the apex. The insertion
Figure 6. The three hypotheses for insertion of the suspected prosthesis.
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Table 1. Metrical data for the dental canal of the central maxillary incisor of individual
LCH1 compared with the width measurements provided by Kaya et al. 2010.
Group A Group B
(15–24 years of age) (25–34 years of age) LCH 1
Pulp width at cervical 2.23 mm 1.44 mm 1.85 mm
Pulp width in apical 1/2 1.54 mm 0.83 mm 1.35 mm
Pulp width in apex 0.75 mm 0.38 mm 0.85 mm
Figure 7. The position of the object in the pulp canal according to the data provided by Kaya et al. 2010.
would however be sufficiently deep to assure minimal friction between the walls of the canal
and the metal object while ensuring that it did not surpass the crown height of the right
central incisor.
The fact that the root of incisor 21 was not recovered during excavations does not
contradict this hypothesis since taphonomic agents were particularly detrimental to the
survival of osseous material at this site. The roots of the maxillary incisors were significantly
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The earliest dental prosthesis in Celtic Gaul?
altered and for the large part missing. It is therefore conceivable for a weakened and
fragmented root to have entirely disappeared.
Hypothesis 2: an attempt at intra-socket ante mortem insertion (Figure 6)
According to this hypothesis, the metal pin may have been inserted after the loss of the
left central incisor and may immediately have been accepted as the healing process took
effect (Amler 1969). In fact, during the first week after tooth loss a clot forms which is
followed by granulation tissue (new connective tissue and tiny blood vessels that form
on the surface of a wound during the healing process) that fills the apical third of the
socket. The gum then starts to proliferate with osteoblasts and the first osteoid layers begin
to appear at the bottom of the socket. During the second week the granulation tissue
at the edges of the socket transform into fresh connective tissue while the reabsorption
of the socket continues. The marginal gingival zones begin to evert and totally close the
socket within four to five weeks (Amler 1969). This implicitly painful process implies
the existence of a device to hold the object in place during the healing process that was
not recovered during excavation. Finally, the fact that iron is not biocompatible and the
absence of sterile conditions would have provoked an unfavourable host response and would
have inevitably hindered the likelihood of osseointegration (the direct contact between bone
and the implanted pin). Only sterile titanium implanted according to a rigorous protocol
fulfils these two requirements (Br˚
anemark et al. 1985). Mastery of this type of implant is
a modern development which was achieved only towards the end of the twentieth century
(Ring 1995; Sullivan 2001). While successfully implanting an iron pin seems unlikely, it
remains possible that earlier societies deemed such an operation feasible based on their scant
understanding of dental medicine.
Hypothesis 3: a post mortem ornament (Figure 6)
The absence of the upper left incisor argues for the partial or total loss of the tooth ante
mortem, but the aesthetic disadvantage incurred by such a loss may have been compensated
post mortem. At death, a metallic ornament of the same form and dimensions as the missing
tooth could have been created and inserted in order to restore the corporeal integrity of the
deceased. The principal goal may have been to improve the appearance of the corpse for
the funeral ceremony. This possibility is independent of all technical constraints
developed in the two other hypotheses. In this regard, this object is more appropriately
considered as a funerary ornament or votive offering, rather than an element of dental
prosthetics.
Irrespective of which of these three possibilities is preferred, particular ante or post mortem
attention was paid to the young woman in order to replace her missing upper left incisor. The
complete disappearance of the maxillary bone makes it impossible to determine whether
the object was inserted with success or if the deceased suffered an infectious reaction.
An infectious complication in an age when notions of asepsis or antisepsis had not been
mastered would have been fatal, with chronic inflammatory lesion around the apex of the
root (apical periodontitis) and osseous reabsorption rapidly degenerating into an abscess,
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followed by a dental infection leading to either bacterial endocarditis (heart infection) or a
cranial thrombophlebitis (cerebrovascular stroke) (Somma et al. 2001).
Comparison with other known cases of dental ‘implants’ from late prehistory and antiquity
The idea of replicating a tooth to replace a lost one is not a new concept. The trophy skull
(over 7000 years old) from Fa¨
ıd Souar in Algeria has a replica tooth sculpted from a fragment
of bone in place of its second maxillary premolar (Vallois 1971). This type of operation,
designed to embellish the trophy, was certainly post mortem as are the other modifications
of the skull (sawing, perforation) and should not be considered as a genuine attempt at an
implant.
Transplanted incisors have also been observed in two female skulls from the Neolithic
site of Nabta Playa in Egypt (Irish et al. 2003). It would seem that in this case the treatment
was also post mortem and linked to funerary practices designed to perpetuate the physical
integrity of the corpse. The recovery of a replica maxillary incisor fashioned in shell from
the 5500-year-old Neolithic necropolis of Gebel Ramlah could also be interpreted as a
possible dental prosthesis (Irish 2004). The maintenance of the body’s integrity after death
was a major preoccupation in the beliefs of the ancient Egyptians and it is possible that this
piece was also inserted after death in order that the deceased might enjoy a complete set of
teeth in the afterlife. The ‘Anatolian implant’ discovered in a sixth-century-BC sarcophagus
from the necropolis of Kalabak in Turkey is a replica of a maxillary canine made from
a fragment of calcite (Atilla 1993). These two objects were not, however, recovered in
anatomical position, which limits the likelihood of their being dental prostheses. It remains
possible that these objects were mere votive amulets (Becker 1999a). The care taken in
making these items as realistic as possible in terms of form, dimensions, texture and colour
nonetheless indicates a desire to create an object as similar as possible to an actual tooth.
While successfully implanting a stone or shell object seems unlikely, it remains possible
that ancient populations deemed such an operation feasible based on their rather limited
understanding of dental medicine.
TheimplantfromLeCh
ˆ
ene is not the first discovery of an iron dental pin from an
archaeological context in France. An object very similar in form and appearance to that
from Le Chˆ
ene was described at the Roman necropolis of Chantambre in the Essonne, only
130km from Le Chˆ
ene (Crub´
ezy et al. 1998). It replaced a second right maxillary premolar.
In this case, the buried individual was a male of 30 or more years of age. The fact that the
tooth replaced was a second premolar located towards the back of the mouth suggests that
it was more functional than aesthetic. This individual had lost all of his left molars, and
that may have motivated the insertion of an appliance permitting mastication on the right
side of his mouth. The maxilla is well preserved and seems to present no evidence of an
inflammatory reaction, suggesting that the insertion of this prosthesis did not provoke an
infectious abscess despite significant technical and hygienic constraints (Becker 1999a). The
burial containing the ‘Chantambre implant’ has been dated to the end of the first century
or beginning of the second century AD. The iron pin recovered from Le Chˆ
ene is therefore
nearly four centuries older than the example from Chantambre and would thus be the oldest
yet known in Gaul.
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An Etruscan inspiration?
Several cases of dental prostheses or appliances are known from late prehistory and antiquity
in the Mediterranean civilisations of the Egyptians, Etruscans, Greeks and Romans. The great
majority of these come from very early excavations or poorly documented archaeological
contexts (Schneider 2000). The Etruscan examples are the most numerous and best
documented and are most often in the form of a bridge connecting several teeth by means
of a small gold strip or wire (Becker 1999b; Baggieri & di Giacomo 2005; Monier et al.
2008). This technique presents a stark contrast to the insertion of an iron implant such as
that recovered from Le Chˆ
ene. Some Etruscan dental appliances involved fake teeth sculpted
from bone or animal teeth. This type of appliance is known from the seventh century BC
onwards, although the majority of well-documented cases are dated to the fifth to third
centuries BC. Etruscan dentistry appears as a technologically advanced knowledge that was
transmitted and perfected over more than six centuries, although Etruscan dental prostheses
are still rare and were undoubtedly reserved for the social elite. Dental appliances were
worn only by Etruscan women, suggesting that cosmetic concerns were paramount in their
creation. Moreover, the teeth commonly replaced by these bridges are upper central incisors
(Becker 1999b). This data presents interesting parallels with the example from Le Chˆ
ene.
Historical sources indicate that Celtic populations from the north of Gaul were in
contact with the Etruscans (Polybius, Histories II: 17–18; Shuckburgh 1889). From 400 BC,
numerous Celtic groups travelled south to serve in the flourishing mercenary business and
upon returning brought with them new technologies and artistic styles, particularly in
the realm of metallic containers (Verger 1997), ornaments and weaponry (Kruta 2000).
Contacts between Celtic groups settled in the Aube Valley and the Etruscan populations of
northern Italy are thus quite well established. It is certain that the Celts who arrived in Etruria
during the fourth and third centuries BC were in contact with individuals who had dental
prostheses. Etruscan elite individuals bearing dental appliances fashioned in gold would
certainly have made a profound impression on these new arrivals. Even if the Celts did not
necessarily learn dentistry from the Etruscans, it is without doubt conceivable that they may
have been inspired to employ new techniques modified to their own requirements. While
the design of the object from Le Chˆ
ene differs significantly from Etruscan models, the desire
to maintain appearance remained the same. The refinement and technical advancement of
Etruscan dentistry was transformed through a sort of Celtic DIY. Although the concept
of the dental prosthesis may have been transported by certain individuals, Etruscan
techniques themselves were not carried northwards.
Conclusion
The third century BC funerary site of Le Chˆ
ene has yielded four female burials atypical
in the richness and diversity of their associated grave goods. The iron pin occupying
the place of the central maxillary incisor recovered from burial LCH1 is remarkable and
its interpretation must be considered carefully. While an intra-alveolar or intra-radicular
insertion is conceivable, we cannot rule out the possibility that the object represents a post
mortem ornament. The richness and refinement of the ornamental elements belonging to this
group of women conveys the image of a social elite concerned about their appearance. The
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discovery of an iron currency bar in burial LCH2 suggests that the prosperity of this group
was built upon the trade and transformation of iron. It could therefore be conjectured that
the Celts of Le Chˆ
ene possessed not only the raw materials, but the know-how necessary
to fashion such a device. The chronological position of the cemetery coincides with the
period in which the Celts were in contact with the Etruscans of northern Italy; a society
particularly renowned for its mastery of dentistry. These convergent elements allow the iron
object from Le Chˆ
ene to be considered part of a dental prosthesis despite the fact that the
mediocre bone preservation precludes determination of the insertion process.
Acknowledgements
The authors would like to thank Solange Gaudy (Mayor of Le Chˆ
ene), Y. Desfoss´
es and J. Vanmoerkerke (Service
R´
egional de l’Arch´
eologie de Champagne-Ardenne), J. Kaurin (Centre National de la Recherche Scientifique,
UMR 5594, Artehis), K. Zipper (Centre Arch´
eologique du Mont Beuvray), Z. Hugon (Institut National de
la Recherche Arch´
eologique Pr´
eventive) and the Arch´
eosph`
ere team—F. Lacrampe-Cuyaub`
ere, C. Beauval, S.
Pasty, M.-C. Dawson, A.-S. Martineau, X. Rolland, J. Baltz and B. Gravina.
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Received: 28 May 2013; Accepted: 15 October 2013; Revised: 2 January 2014
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