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Prehistoric dentistry? P4 rotation, partial M3 impaction, toothpick grooves and other signs of manipulation in Krapina Dental Person 20

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Aims: We describe four associated mandibular teeth, left P4 – M3, which show a number of features consistent with a diagnosis that toothpick grooves and other dental manipulations were associated with treating multiple eruption abnormalities. Materials and Methods: The four isolated teeth making up Krapina Dental Person (KDP) 20 were analyzed by eye and with a light microscope to document occlusal wear, toothpick groove formation, ante mortem enamel, dentin scratches and lingual fractures. Results: Definitive, stage 4 toothpick grooves (1) occur on all four teeth, but are especially marked on both mesial and distal faces of the left P4 (tooth #32) and the mesial face of the left M1 (tooth #82). Less distinct interproximal grooves, defined as stage 2 striations, appear on the distal face of left M1, distal lingual edge of M2 (tooth #3) and the mesial face of M3 (tooth #8). The left P4 also shows signs of dental probing on the mesial buccal cusp and all four teeth have fractures on their lingual margins. These features are associated with malpositioned left P4 and a left M3 with lingual rotation and a crown that is partially impacted. The M3's buccal face occupies an occlusal position and shows considerable wear, indicating it was in approximation with the upper dentition. Conclusion: The anomalous dental eruption features of the P4 and M3 are associated with several kinds of dental manipulations, which seem to have been palliative measures to " treat " the dental problems. We consider this a kind of " prehistoric dentistry. "
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Prehistoric dentistry? P4 rotation, partial M3 impaction,
toothpick grooves and other signs of manipulation in
Krapina Dental Person 20.
• David W. Frayer (1), Joseph Gatti (2), Janet Monge (3), Davorka Radovčić (4) •
1 – Department of Anthropology, University of Kansas, Lawrence, KS, 66045, USA
2 – Gatti Dental Studio, Lawrence, KS 66049, USA
3 – Department of Anthropology, University of Pennsylvania Philadelphia, PA, 19104, USA
4 – Department of Geology and Paleontology, Croatian Natural History Museum, 10000 Zagreb,
Croatia
Address for correspondence:
David W. Frayer
Department of Anthropology, University of Kansas, Lawrence, KS, 66045, USA
E- mail: frayer@ku.edu
Bull Int Assoc Paleodont. 2017;11(1):1-10.
Abstract
Aims:
We describe four associated mandibular
teeth, left P4
M3, which show a number of features
consistent with a diagnosis that toothpick grooves and other dental manipulations were associated with
treating multiple eruption abnormalities. Materials and Methods: The four isolated teeth making up Krapina
Dental Person (KDP) 20 were analyzed by eye and with a light microscope to document occlusal wear,
toothpick groove formation, ante mortem enamel, dentin scratches and lingual fractures. Results: Definitive,
stage 4 toothpick grooves (1) occur on all four teeth, but are especially marked on both mesial and distal
faces of the left P4 (tooth #32) and the mesial face of the left M1 (tooth #82). Less distinct interproximal
grooves, defined as stage 2 striations, appear on the distal face of left M1, distal lingual edge of M2 (tooth
#3) and the mesial face of M3 (tooth #8). The left P4 also shows signs of dental probing on the mesial
buccal cusp and all four teeth have fractures on their lingual margins. These features are associated with
malpositioned left P4 and a left M3 with lingual rotation and a crown that is partially impacted. The M3’s
buccal face occupies an occlusal position and shows considerable wear, indicating it was in approximation
with the upper dentition. Conclusion: The anomalous dental eruption features of the P4 and M3 are
associated with several kinds of dental manipulations, which seem to have been palliative measures to
“treat” the dental problems. We consider this a kind of “prehistoric dentistry.”
Keywords:
interproximal groo
ves; ‘premolar problem’; rotated, impacted M3; palliative actions
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Introduction
Numerous studies have documented toothpick
grooves in recent and fossil dentitions. From
work on recent dentitions various authors have
documented the presence of these grooves,
imbedded into the interproximal surfaces of
mandibular and maxillary permanent teeth
from North America, Europe, Africa, Asia,
Australia and the Pacific (2-9). Premolars and
molars are the primary targets, but incisors and
canines are sometimes involved and attributed
to fiber processing when they are combined
with grooves in the occlusal surface (10). We
are unaware of any grooves in deciduous teeth
or in non-Homo taxa (11). This habit is
extended as far back as the earliest Homo in
Africa (12), but also to a wide variety of later
Homo from Europe and Asia (1,13-18) While
some have contended causes other than
palliative measures such as fiber processing
and saliva jetting (8,19,20),
they are most
commonly associated with periodontal disease
or caries in modern groups. Yet, they also
occur with no signs of oral pathology, so they
may be idiosyncratic, the product of a nervous
behavior or without a determinable etiology.
Multiple materials have been proposed to
account for the formation of the grooves, from
bone to grass stems (1,21)
and, again, given
their widespread geographic occurrence and
their appearance in hunter-gatherer and
agricultural groups, it is unlikely a single type of
instrument was the cause.
The tooth set KDP 20. Krapina Dental Person
(KDP) 20 is represented by four mandibular
teeth. Wolpoff (22) assembled many of the
Krapina isolated teeth into tooth sets, which he
called a Krapina Dental Person. He based
these associations on similar morphological
features, occlusal wear and, especially,
interlocking interproximal facets. Consisting of
P
4
-M
3
, he originally labeled this specimen as
mandible M (22), but later in the Krapina
Catalog (23), it was re-labeled as KDP 20. The
specimen is interesting because it shows
evidence of a buccally displaced P
4
, a partially
impacted, lingually rotated M
3
, a number of
toothpick grooves in the interproximal spaces
of all four teeth (16),
a series of scratches on
the superior labial surface of P
4
and what
appear to be ante mortem lingual chips on at
least M
1
-M
2
. Added together these features
suggest that the Krapina Neandertal (KDP 20)
was having dental irritation or pain associated
with the abnormal tooth eruption and was
attempting palliative maneuvers through
toothpicking, dental probing and, maybe, other
more drastic measures.
Dental state. The P
4
-M
3
set shows some
occlusal wear (Figure 1a). P
4
has polishing of
the labial and lingual cusps, but no dentin
exposure. M
1
is the most worn with flattening
of all the occlusal cusps and dentin exposure
on all cusps, but especially the entoconulid
(cusp 4) and the hypoconulid – cusp 5 (24) that
are highly polished. The M
2
has only flattening
and polishing of the occlusal cusps plus very
faint dots of dentine exposure on two mesial
cusps (protoconid, cusp 1, and metaconid,
cusp 2). M
3
is anomalous in that the crown
surface is rotated lingually, so that the top half
of the buccal face is in the occlusal plane.
Rotation of the tooth results in no wear on the
lingual aspect of the occlusal surface, which
was has been completely twisted, inferiorly out
of the occlusal plane. According to Wolpoff
(22) KDP 20 is 19, but the individual may have
been older at death based on the depth of the
toothpick grooves and the occlusal wear on
M
3
. In any event, age at death of KDP 20 does
not affect our diagnosis.
Interproximal grooving. As described by
Frayer and Russell (16) the four teeth making
up KDP 20 have a total of six toothpick
grooves: two each on the mesial and distal
faces of P
4
(#32) and M
1
(#82), one on the
distal of M
2
(#3) and one on the mesial of M
3
(#5). Grooves on the distal M
1
and M
2
and
mesial M
3
are very faint compared to the deep
grooves on the P
4
and mesial M
1
(Figure 2).
We scored them as stage 4 (1).
These grooves
have been described in detail for KDP 20, so
we limit our description of them. The most
impressive is the long, deep groove running
along nearly the entire cervical, mesial border
of M
1
(#82). (Figure 2a). This groove is highest
on the buccal edge and tapers lingually,
suggesting the toothpick was inserted buccally
and used repeatedly given the depth of the
groove. Areas with cementum build-up occur
below the groove and striations within the
groove suggest the tool was inserted in a back
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Figure 1
.
Three views of the four articulated teeth making up KDP 20. a. occlusal view showing lingually placed
mesial interproximal wear facet on P4 (arrow) and buccal wear on M3; b. lingual view showing a mesially
placed interproximal wear facet on P4 (arrow), chips from lingual faces of all teeth and rotated, partially
impacted M3; c. buccal view showing rotated buccal face of M3 (arrow) and hypercementosis on its root.
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and forth, horizontal action. A much less
distinct groove occurs on the distal face of #82.
Consisting mainly of polishing below the
cemento-enamel junction, we classify this as a
stage 2 groove. (Figure 2b) Mesial and distal
grooves on the left P
4
(#32) are stage 4 and
impressive in their extent and depth (Figure 3a,
b). The distal groove does not run across the
entire distal face, but is confined to the lingual-
most edge. Unlike the matching groove on the
M
1
, this groove is considerably shorter and
confined to the lingual half of the P
4
’s cervical
border. The groove is more angled than the
one on the mesial M
1
and widest lingually. The
wide gap between the P
4
’s distal face and the
mesial face of M
1
allowed for a large
interproximal opening, which may account for
the different orientation of the toothpick
grooves in the P
4
and M
1
. It may be that this
groove was produced by a different action than
the mesial interproximal groove on M
1
. In tooth
#32 the mesial interproximal facet is the
smallest of the three. Like the mesial M
1
groove, it runs horizontally across the mesial
face, but extends over only the lingual third of
the root and is oval in shape. Signs of
interproximal grooving are much less
pronounced on the M
2
and M
3
. For the M
2
(tooth #3) there is a small facet on the lingual
edge of the distal root face, which is a faint
toothpick groove. This corresponds to a
polished area on the enamel of the mesial face
of M
3
(tooth #8). Both of these are little more
than polishing of the surface and represent a
stage 2 expression (1).
Rotated P
4
.
As described by Rougier et al. (25)
four Krapina mandibles show rotated P
3
s, all
from the left side, based on teeth or angled
root sockets. When teeth are preserved, there
are no associated toothpick grooves in any of
these specimens. They briefly described KDP
20 (25) and argued that the mesial
interproximal facet on the P
4
“can only be
explained by a clockwise rotated P
3
whose
lingual face was in contact with the fourth
premolar” (p. 276). We disagree with this
interpretation. In our view the P
4
mesial
interproximal facet occupies a very lingual
position, well off the center of the mesial face
(Figure 3a, b). In the rotated P
3
’s of other
Krapina specimens (especially, KDP 4, 10, and
28) the mesial interproximal facet is buccally
oriented. In KDP 20 when the distal facet is
articulated with the M
1
, the P
4
protrudes
buccally from the lateral plane defined by the
M
1
and M
2
, as shown in Figure 1a. The
combined positions of the mesial and distal
interproximal facets suggest this is an example
of P
4
malposition. This occurs on the left side
as in all of the other rotated mandibular
premolars at Krapina. The buccal positioning of
the P
4
is consistent with the shape and
orientation of the deep interproximal grooves
on it.
Figure 2. Toothpick grooves on the left M1. a.
mesial view of a deep toothpick groove running
across the entire cervical margin; b. distal surface
showing polished surface (arrow) representing a
shallow toothpick groove.
Partially
impacted and rotated left M
3
.
This
tooth is clearly rotated from its normal position
so that most of the normal occlusal plane faces
lingually. The occlusal lingual cusps are
unworn, while the buccal surface of the tooth
shows considerable wear (Figure 1a). Dentin is
not exposed on this buccal face, but there are
two large wear facets on the mesial buccal and
distal buccal cusps. These are ‘cratered’ and
the buccal face enamel is definitely polished
and thinned, so that it is translucent (Fig. 1a/c).
Other evidence for this rotation consists of the
abnormal condition of the interproximal facets
on the distal M
2
and mesial M
3
.
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Figure 3. Toothpick grooves, irregular interproximal
facets and other anomalies on the left P4. a. mesial face
with a small toothpick groove on the mesial-lingual edge. Above it is a very lingually positioned interproximal
wear facet (arrow); b. distal surface with a deep toothpick groove and an interproximal wear facet that has an
abnormal lingual location (arrow); c. chips from the occlusal/lingual margin; d. probing striations on the
mesial/buccal facet.
On the M
2
the distal facet is lingually oriented
and deeply etched into the enamel so that the
dentin is almost exposed. The matching mesial
interproximal facet on the M
3
is superiorly
positioned so that it is contiguous with the
occlusal face. When articulated with the M
2
interproximal facet, the normal occlusal face is
oblique, tilted lingual to the occlusal plane
(~45º) and the buccal edge is the new occlusal
face. From the depth of the interproximal
facets on M
2
and M
3
it is clear that these teeth
rocked against each for some time producing
the deep gouges in both surfaces. While the
sample is small, KDP 20 is the only specimen
from the site with a mal-aligned P
4
and a
rotated, partially impacted M
3
.
P4 scratches. In addition to the toothpick
grooves in the interproximal space, this tooth
shows a series of scratches on the face of the
mesial buccal cusp. (Figure 3c) At least ten
striations run up the buccal face, from below
the occlusal surface to its face. These run from
the mesial face to the occlusal surface and are
wider and deeper than scratches produced by
dietary items. They are roughly parallel,
oblique to the occlusal plane and resemble
striations found on the Krapina Neandertal
incisors and canines (26). These scratches
were produced by some hard probe, which
was inserted into the mouth and rubbed
against the mesial face of the P
4
crown.
Lingual chipping. All four teeth show chips
removed from the enamel on the lingual edge.
The smallest are two small chips missing from
the distal lingual edge of P
4
(Figure 3b).
Chipping of the M
1
and M
2
is much more
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extensive and completely limited to the lingual
side. For the M
1
the whole lingual face is
missing from the occlusal surface to the
cervical border. The break barely extends to
the root surface on its most mesial aspect
(Figure 1b). The lingual break on the M
2
is
smaller than on the M
1
with the broken surface
starting from the midpoint of mesial lingual
cusp (Figure 1b). The break continues to the
distal interproximal facet and extends down the
root some 5mm below the cervical border. This
lingual break has a wide U-shape, similar to
the break on M
1
. For M
3
there is a chip missing
from the distal lingual edge. This chip is
different from the ones on the M
1
and M
2
in
that it is confined to the crown and more
obliquely angled (Figure 1b). In every
specimen, the impacts causing the missing
sections were delivered to the occlusal face
and spalled off the lingual edge. There are
clear impact fractures with spalling of the more
inferior portions, whether on the enamel or
root. The exposed surfaces on all the molars
show smooth dentin surfaces and are without
surface scratches. The surfaces have a
creamy appearance as if the dentin was
stained, but this could be due to discoloration
from cave sediments. There are secondary
chips from the fractured edges, especially on
the M
1
and M
2
. On the M
1
the occlusal-most
edge of the lingual fracture shows microchips
with smoothing and other signs of wear along
its border (Figure 4a). On the M
2
secondary
microchipping occurs within the primary
fracture and the edges are smoothed and
polished. (Figure 4b) Another aspect of the
lingual chipping is the different angulations of
the chips removed from the surface. On the P
4
the chips are small and angled at ~45º to the
occlusal plane. The large chip removed from
the M
1
shows a completely vertical orientation
with spall fractures at the lingual, cervical
border. On M
2
the chip is also vertically placed,
but is more distally oriented and on the M
3
the
chip is confined to the crown on the
distal/lingual surface and slightly angled to the
occlusal plane. (Figures 1a & b) The M
3
chip
shows no polishing. These chips were
removed in separate actions and, especially on
the M
1
and M
2
, appear to be ante mortem.
While it is unclear what caused the lingual
chipping, it happened before the death of the
KDP individual.
Roots. All teeth show some root damage. The
most extensive is the P
4
with at least half of its
root missing. There is a sharp break across the
root from the lingual to the buccal side. The
exposed surface appears lighter than the
breaks on the molar surfaces and there are a
few patches of hypercementosis, especially on
the mesial aspect. M
1
shows some slight
damage to the mesial root tip and the inferior
ends of the mesial and distal roots show
hypercementosis. M
2
has the base of the root
broken away, exposing the inferior pulp canal.
The root surfaces are smooth and free of
hypercementosis. The M
3
shows some
damage to the inferior-most root, but this area
is covered with hypercementosis, which is
mostly confined to the root tip (Figure 1c).
Adhering cave sediment obscures the root tip.
None of the roots bear evidence of surface
erosion or pitting associated with periodontal
disease.
Discussion.
The oldest toothpick grooves
discovered so far occur in the isolated left and
right P
3
s of a Homo habilis
specimen from Omo
(L894-1a/c) dated at 1.84 mya (12). These are
nearly matched in age by the isolated right M
3
(OH 60) from Olduvai Gorge dated between
1.7-2.1 mya (11)
. In this specimen, a single
interproximal groove occurs on its mesial face.
As in the Omo teeth, there are no signs of
pathology. Later Homo specimens from Dmanisi
(15), Sima del Elefante (14)
and Konso (27)
are
dated between 1.77-1.42 mya. Of these latte
r
cases the involved teeth are still located in jaws
and each mandible shows signs of periodontal
disease. Dmanisi mandible D2735
has a right
M
1
with a distal toothpick groove and “local
marginal periodontitis” (15) (p. 17280).
Sima del
Elefante ATE 9-1
has signs of alveolar pitting
and it has a deep toothpick groove on the P
4
.
Konso 10-1
has multiple toothpick grooves on
its P
4
-M
3
with associated periodontal disease
(27).
A few other cases of toothpick grooves
occur among Neandertals, such as
Cova
Forada 28 and Banyoles 17,
which also show
signs of periodontitis.
None of these specimens involve impacted
teeth and, indeed, impacted teeth are rarely
found in the human fossil record. There are
two cases in Neandertals, both involving
anterior teeth, but neither have an occlusal
eruption.
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Figure 4. Ante mortem wear on broken edges of teeth #82 and # 3. a. view from the occlusal
perspective of
the M1 with arrows indicating segments of polishing and smoothing after the main chip was removed.
Brownish circular patches on the occlusal surface are dentin exposures from wear. b. lingual view of the M2
with arrows showing polished and smoothed surfaces on the secondarily flaked edge.
The Moustier 1 mandible is estimated to date
to about 40 kyrs ago and is thought to be a
15.5 year old male (29).
As described by
Bilsborough and Thompson (30) the left
permanent canine is impacted below the
alveolar border and is associated with a
retained, heavily worn left deciduous canine. In
Le Moustier 1 there are no toothpick grooves
or other signs of dental manipulation, but the
deciduous canine experienced heavy,
anomalous occlusal wear. The second case of
a Neandertal impacted tooth comes from El
Sidròn 2, where an adult, left mandible shows
a horizontally placed permanent canine crown
and root well below the root apices of the left
M
3
(31). Like in Le Moustier 1 the left
deciduous canine is retained in its occlusal
position. Given its anomalous position in the
mandibular corpus, this permanent canine
would never have erupted. Toothpick grooves
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occur on the right I
1
and on the associated
right I
2
, but these are unrelated to the impacted
canine (1).
In KDP 20 we do not have the mandibular
bone to check for other dental problems and
periodontal disease, but these four isolated
teeth exhibit evidence that a Neandertal made
attempts to ‘treat’ the rotated P
4
and partially
impacted M
3
. Even without the bone, we can
propose that the six toothpick grooves, the
scratches on the P
4
and, possibly, the lingual
chips on all four teeth are the result of attempts
to get at the pain and irritation of the dental
eruption problems involving the misplaced P
4
and, especially, the partially impacted M
3
.
The cause of the lingual chipping is the most
difficult to explain. One could argue that the
broken surfaces are due to post mortem
causes, --- the result of trampling, cave
sediment damage or carnivore activity. But, we
rule these out since the broken lingual edges
are at different angles to each other and
appear to have occurred at different times. We
expect carnivore damage would be more
organized, occurring in single incident and
leaving a more consistent pattern of damage.
The same is expected for trampling or
sediment damage. There are also secondary
fractures within the primary fractured surfaces
on the M
1
and M
2
and smoothing and polishing
occur on the occlusal-most portions of the
fractured areas. These are signals that the
breaks are ante mortem. The most likely factor
accounting for the main lingual fractures is
normal mastication. In modern dentistry
mandibular posterior teeth commonly show
chipped lingual margins, mainly the result of
chewing forces. For example, Bader, Martin
and Shugars (32) found in a large clinical
sample that lingual cusps of mandibular teeth
showed incidence rates for noncarious
fractures (fractures/1000 teeth/year) of .4 for
P
3
, 3.1 for P
4
, 15.1 for M
1
, 7.7 for M
2
and 4.0
for M
3
. On a per/tooth basis these represent
1.8 % for P
3
, 14.1% for P
4
, 48.5% for M
1
,
30.7% for M
2
and 4.9% for M
3
. Clearly the
molars are more likely to show lingual fractures
than the premolars. They also found that the
fracture “almost always exposed dentin” and
that occasionally the fracture extended below
the cemento-enamel junction, as in tooth #82
and #3. Surveying Inuit and two Medieval
samples from Norway and Spain, Scott and
Winn (33) came to similar results, in that the
posterior teeth, especially M
1
and M
2
, were
more likely to have ante mortem fractures in
the Inuit hunter-gatherers. In a review of 15
skeletal samples Milner and Larsen (34)
reported more involvement of the posterior
teeth and common lingual surface chipping in
the mandibular molars.
Following Milner and Larsen’s suggestions for
separating ante mortem from post mortem, the
broken lingual faces show ante mortem
changes, especially near the occlusal border.
On the M
1
and M
2
secondary fractures,
blunting and smoothing occurs on the broken
occlusal edges. We think this damage
occurred before death, but given its limited
extent there was little time between the breaks
and the death of the KDP 20 Neandertal.
From the toothpick grooves and scratches on
the mesio-buccal edge of the P
4
, it is possible
there was some kind of intervention in an
attempt to ‘treat’ the dental problems by
removing the lingual edges, but we think it is
more likely the fractures occurred due to
chewing stress. However, such interventions
should not be unexpected given other
evidence that Neandertals used plants for self-
medication (35). In a recent study of plants
consumed by the El Sidrón Neandertals
Weyrick et al. (36) found small percentages of
genetic sequences of a natural painkiller
(poplar) and penicillin (fungal components) in
the calculus of El Sidrón 2. El Sidrón 2 also
has two large, draining abscesses on the right
mandible --- one under the I
2
root and the other
below the roots of P
4
and M
1
. While many
different animals self-medicate (37), most of
these relate to treatment for parasites and
none have been documented for a dental
infection. It seems likely that as more
Neandertal calculus is analyzed, especially in
specimens with dental pathologies, other
examples will be found where Neandertals are
using natural products to alleviate dental pain
and infection. We have no similar paleogenetic
data for KDP 20; some remnants of calculus
are present, but these have not been analyzed.
Conclusion.
The individual represented by KDP 20 appears
to have been making a direct, mechanical
approach to her (his) problems of the mis-
alignment in the P
4
and the partial impaction of
the M
3
. The toothpick grooves and enamel
scratching on the P4 seem to be aimed at
these problems, with very distinct tooth pick
grooves on the mesial and distal surfaces of
the P
4
and the mesial face of M
1
. Lingual
breaks on all four teeth are more difficult to
interpret, but some are clearly ante mortem
and are likely related to altered masticatory
F r a y e r e t a l . O R I G I N A L S C I E N T I F I C P A P E R
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forces related to the two mis-aligned teeth.
However, given the other interventions, it is
impossible to rule out that these fractures were
intentionally done to ‘treat’ the irritation caused
by partially impacted M
3
.
Acknowledgements
We want to especially acknowledge Milford
Wolpoff’s contribution to our work with KDP 20.
Nearly 40 years ago, the isolated teeth were
uncataloged and in separate boxes in the
Croatian Museum of Natural History. Wolpoff
convinced the director, Ivan Crnolatac, to
consecutively number the almost 200 isolated
teeth and combine them into one collection for
easier analysis. W olpoff was able to assemble
some of the isolated teeth into associated units
or tooth sets, a kind of scientific lego
reconstruction. Without his contribution, our
work would have not been possible. We thank
Luka Mjeda (Zagreb) for Figure 1.
References
1. Estalrrich A, Alarcón JA, Rosas A. Evidence of
toothpick groove formation in Neandertal
anterior and posterior teeth. Amer J Phys
Anthropol. 2017;162:747-756.
2. Ubelaker DH, Phenice TW, Bass WM. Artificial
interproximal grooving of the teeth in American
Indians. Amer J Phys Anthropol. 1969;30:145-
150.
3. Frayer DW. On the etiology of interproximal
grooves. Amer J Phys Anthropol. 1991;85:299-
304.
4. Bermudez de Castro JM, Arsuaga JL. L'usure
anormale de collet de la dent chez les
populations prehispaniques de Canaries. L'Anth.
1983;87:521-533.
5. Lebel S, Trinkaus E, Faure M, Fernandez P,
Guérin C, Richter D, Mercier N, Valladas H,
Wagner GA. Comparative morphology and
paleobiology of Middle Pleistocene human
remains from the Bau de l’Aubesier, Vaucluse,
France. PNAS. 2001;98:11097-11102.
6. Formicola V. Interproximal grooving of teeth:
additional evidence and interpretation. Curr
Anthropol. 1988; 29:663-671.
7. Lukacs JR, Pastor RF. Activity-induced patterns
of dental abrasion in prehistoric Pakistan:
evidence from Mehrgarh and Harappa. Amer J
Phys Anthropol. 1988;76:377-398.
8. Brown T, Molnar S. Interproximal grooving and
task activity in Australia. Amer J Phys Anthropol.
1990;81:545-554.
9. Turner CG II, Cacciatore E. Interproximal tooth
grooves in Pacific basin, East Asian, and New
World populations. Anthropol Sci. 1998;106
(Suppl):85-98.
10. Schulz PD. Task activity and anterior tooth
grooving in prehistoric California Indians. Amer J
Phys Anthropol. 1977;46:87-92.
11. Ungar PS, Grine FE, Teaford MF, Pérez-Pérez A.
A review of interproximal wear grooves on fossil
hominin teeth with new evidence from Olduvai
Gorge. Arch Oral Biol. 2001;46:285–292.
12. Boaz NT, Howell FC. A gracile hominid cranium
from Upper Member G of the Shungura
Formation, Ethiopia. Amer J Phys Anthropol.
1977;46:93–107.
13. Puech P-F. The diet of early man: Evidence from
abrasion of teeth and tools. Curr Anthropol.
1979;20:590-592.
14. Martinón-Torres M, Martín-Francés L, Gracia A,
Olejniczak A, Prado-Simón L, Gómez-Robles A,
Lapresa M, Carbonell E, Arsuaga JL, Bermúdez
de Castro JM. Early Pleistocene human mandible
from Sima del Elefante (TE) cave site in Sierra de
Atapuerca (Spain): a palaeopathological study. J
Hum Evol. 2011;61:1-11.
15. Margvelashvili A, Zollikofer CPE, Lordkipanidze
D, Peltomäki T, Ponce de León M. Tooth wear
and dentoalveolar remodeling are key factors of
morphological variation in the Dmanisi
mandibles. PNAS. 2013;110:17278-17283.
16. Frayer DW, Russell MD. Artificial grooves on the
Krapina Neandertal teeth. Amer J Phys
Anthropol. 1987;74:393–406.
F r a y e r e t a l . O R I G I N A L S C I E N T I F I C P A P E R
Bull Int Assoc Paleodont. Volume 11, Number 1, 2017
www.paleodontology.com
10
Bulletin of the International Association for Paleodontology
NO
NONO
NO-
--
-FEE OPEN ACCESS JOURNAL
FEE OPEN ACCESS JOURNALFEE OPEN ACCESS JOURNAL
FEE OPEN ACCESS JOURNAL
17. Lalueza C, Turbon D, Pérez-Pérez A. Microscopic
study of the Banyoles mandible (Girona, Spain):
Diet, cultural activity. J Hum Evol. 1993;24:281
300.
18. Weidenreich F. The dentition of Sinanthropus
pekinensis. Paleo Sin. 1937;101:1-180.
19. Eckhardt RB. The solution for teething troubles.
Nature. 1990;345: 578.
20. Wallace JA. Approximal grooving of teeth. Amer
J Phys Anthropol. 1974;40:385-390.
21. Hlusko LJ. The oldest hominid habit?
Experimental evidence for toothpicking with
grass stalks. Curr Anthropol. 2003;44:738-741.
22. Wolpoff MH. The Krapina dental remains. Amer
J Phys Anthropol. 1979;50:67–114.
23. Radovčić J, Smith FH, Trinkaus E, Wolpoff MH.
The Krapina Hominids. An Illustrated Catalog of
the Skeletal Collection. Zagreb: Mladost
Publishing House, Croatian Natural History
Museum, 1988.
24. Hillson S. Dental Anthropology. Cambridge:
Cambridge University Press, 1996.
25. Rougier H, Crevecoeur E, Wolpoff MH. Third
premolar rotation in the Krapina dental sample.
Period biol. 2006;108:269-278.
26. Fiore I, Radovčić J, Bondioli L, Frayer DW.
Oblique scratches on the teeth of the Krapina
Neandertals. PaleoAnthropol. 2015;19-36.
27. Suwa G, Asfaw B, Haile-Selassie Y, White, T,
Katoh S, Woldegabriel G, Hart WK, Nakaya H,
Beyene Y. Early Pleistocene Homo erectus
fossils from Konso, southern Ethiopia. Anthropol
Sci. 2007;115:133-151.
28. Lozano M, Subira ME, Aparicio J, Lorenzo C,
Gomez-Merino G. Toothpicking and periodontal
disease in a Neanderthal specimen from Cova
Forada site (Valencia, Spain). PloS ONE.
2013;8:e76852.
29. Thompson JL, Nelson AJ. Estimated age at
death and sex of Le Moustier 1. In: Ullrich H,
editor. The Neandertal Adolescent Le Moustier
1. Vol. 2. Berliner Beiträge zur vor- und
Frühgeschichte Neue Folge. Berlin: Staatliche
Museen zu Berlin, 2005, p. 208-224.
30. Bilsborough A, Thompson JL. The dentition of
the Le Moustier 1 Neandertal. In: Ullrich H,
editor. The Neandertal Adolescent Le Moustier
1. Vol. 2. Berliner Beiträge zur vor- un
Frühgeschichte Neue Folge. Berlin: Staatliche
Museen zu Berlin, 2005, p. 157-186.
31. Dean MC, Rosas A, Estalrrich A, García-
Tabernero A, Haguet R, Lalueza-Fox C, Mastir M,
de la Rasilla M. Longstanding dental pathology
in Neandertals from El Sidròn (Asturias, Spain)
with a probable familial basis. J Hum Evol.
2013;64:678–686.
32. Bader JD, Martin JA, Shugars DA. Incidence
rates for complete cusp fracture. Comm Dent
Oral Epidemiol. 2001;29:346–53.
33. Scott GR, Winn JR. Dental chipping: contrasting
patterns of microtrauma in Inuit and European
populations. Int J Osteoarch. 2011;21:723-731.
34. Milner GR, Larsen CS. Teeth as artefacts of
human behaviour: intentional mutilation and
accidental modification. In: Kelley MA, Larsen
CS, editors. Advances in Dental Anthropology.
New York: Wiley-Liss, 1991, p. 357-378.
35. Hardy K, Buckley S, Huffman M. Neanderthal
self-medication in context. Antiq. 2013;87:873-
878.
36. Weyrich LS, Duchene S, Soubrier J, Arriola L,
Llamas B, Breen J, Morris AG, Alt KW, Caramelli
D, Dresely V, Farrell M, Farrer AG, Francken M,
Gully N, Haak W, Hardy K, Harvati K, Held P,
Holmes EC, Kaidonis J, Lalueza-Fox C, de la
Rasilla M, Rosas A, Semal P, Soltysiak A,
Townsend G, Usai D, Wahl J, Huson DH, Dobney
K, Cooper A. Neanderthal behaviour, diet, and
disease inferred from ancient DNA in dental
calculus. Nature 2017;544:357-361.
37.
Huffman MA. Primate self-medication, passive
prevention and active treatment – a brief review.
Int J Multidiscipl Studies. 2016;3(2):1-10.
... For example, the 'stuff-and-cut' behavior, in which stone tools scrape the labial tooth surface during food preparation, is now interpreted as responsible for macroscopic striations on anterior teeth (e.g., Koby, 1956;Krueger et al., 2019;Lozano-Ruiz et al., 2004;Patte, 1960;Xing et al., 2017). Similarly, non-carious cervical lesions (NCCL's; Wood et al., 2008) are interpreted as evidence of interproximal probing in fossil hominins (e.g., to remove food debris or to alleviate pain) and have been described as 'toothpick' grooves (Frayer et al., 2017;Hlusko, 2003;Lozano et al., 2013;Turner & Cacciatore, 1998). Striations that are orientated in a common direction within the groove are often used to support this hypothesis. ...
... The striations on the labial surface of the upper incisor studied are within the 20-100 μm range of striation width that is often used to support a tool-use related origin for scratches in fossil hominins (Estalrrich & Marín-Arroyo, 2021;Hillson et al., 2010;Lalueza-Fox & Frayer, 1997;Lozano et al., 2009) The Koshima Japanese macaque population analyzed here has a few similarities with fossil hominis in terms of the presence of NCCL's on posterior teeth and macroscopic striations on anterior teeth. In addition, high rates of chipping, extensive interproximal wear and interdental spaces between molars, unusual wear on the buccal/labial surface of teeth (including rounded/beveled tooth wear on anterior teeth) and general extensive occlusal wear (e.g., Bonfiglioli et al., 2004;Clement, 2008;Frayer et al., 2017) were also observed. This study shed light on the etiology of NCCL's and macroscopic striations, suggesting that tool use does not necessarily explain atypical and localized tooth wear as observed in fossil hominins, and may suggest an alternative etiology (i.e., accidental grit consumption or specific types of food processing). ...
... Extreme tooth wear is well documented in Neanderthals, with interproximal wear and interdental space between teeth linked to high masticatory force levels, abrasive diets, and non-masticatory behaviors (Molnar et al., 1972;Smith, 1976). In a recent study on Krapina individual 20 (Frayer et al., 2017), the posterior teeth showed chipping, directional macroscopic scratches on an occlusal surface and interproximal and lingual grooves on root surfaces. Other Neanderthal specimens show NCCL's, as well as striations on the labial surface of incisors, and extensive wear (including lingual/labial wear; i.e., beveling) on anterior teeth (e.g., Frayer & Russell, 1987;Krueger et al., 2019;Lalueza-Fox & Frayer, 1997;Puech, 1981;Ungar et al., 1997). ...
Article
Full-text available
Atypical tooth wear, including macroscopically visible striations on anterior teeth and within root grooves on posterior teeth, are often regarded as evidence of non‐masticatory, tool use behavior in fossil hominins. Both these types of dental tissue loss are often considered unique to the genus Homo and suggested to be the earliest evidence of human cultural habits. The aim of this study was to describe similar tooth wear found in a wild primate population and to conduct a differential diagnosis of this atypical tissue loss. The focus of this study was a sample of wild Japanese macaques from Koshima Island, Japan. Individuals were provisioned regularly on the beach as part of one of the longest running primate field sites. Tooth wear and fractures in this group were compared to two other non‐provisioned populations. Information on diet and behavior were obtained from extensive literature and on‐going field observations. All Koshima Island individuals analyzed showed atypical tooth wear. Large macroscopic striations were visible on many teeth, with sub‐vertical striations prominent on the labial surfaces of incisors. Root grooves on posterior teeth were observed in half of the individuals, some showing clear directional striations similar to those reported in “toothpick” grooves in fossil hominins. Tool use and the habitual insertion of non‐masticatory items in the mouth has not been observed in this population. Accidental ingestion of sand and oral processing of marine mollusks likely creates these atypical wear patterns. Implications for similar wear that has been associated with tool‐use in fossil hominin samples were discussed. Japanese macaques using their teeth to dislodge and eat marine mollusks
... Only six cases of dental impaction have been reported in the literature, two in the genus Australopithecus (Gibson & Calcagno, 1993) and four in Neanderthals (Bilsborough & Thompson, 2005;Dean et al., 2013;Frayer, Gatti, Monge, & Radovči c, 2017;Weinberger, 1948). ...
... Previous studies in the hominin fossils have described pathological lesions related to impacted teeth in two Australopithecus specimens and four Neanderthals (Bilsborough & Thompson, 2005;Dean et al., 2013;Frayer et al., 2017;Weinberger, 1948); although in the one Neanderthal specimen from Grotte du Renne this remains speculative (Bailey & Hublin, 2006). All individuals exhibit mandibular involvement (two M 3 and three canines), except for the specimen KNM-WT17400, where the condition involves the M 3 . ...
... All individuals exhibit mandibular involvement (two M 3 and three canines), except for the specimen KNM-WT17400, where the condition involves the M 3 . The factors accounting for these impactions included dental crowding (Gibson & Calcagno, 1993), rotation (Frayer et al., 2017) as well as the retention of deciduous canines (Bilsborough & Thompson, 2005;Dean et al., 2013). ...
Article
Objectives: Here we describe the case of an ectopic maxillary third molar (M3 ), preventing the eruption of the M2 , in the individual H3 of the hominin hypodigm of level TD6.2 of the Early Pleistocene site of Gran Dolina (Sierra de Atapuerca, Spain). Materials and methods: The fossil remains from the TD6.2 level of the Gran Dolina site (about 170 specimens) are assigned to Homo antecessor. Different geochronological methods place these hominins in the oxygen isotopic stage 21, between 0.8 and 0.85 million years ago (Ma). The immature individual H3 is represented by an almost complete midface (ATD6-69), preserving various teeth in situ. We used high-resolution microtomograhy (mCT) to investigate the abnormal position of the left M3 , virtually reconstruct M2 , and M3 as well as assessing the development stage of these. Finally, we compare this case with extinct and extant populations. Results: Based on the identified signs, we suggest that individual H3 suffered from a unilateral impaction of the M2 as a result of the ectopic position of the developing M3 . Discussion: We conclude that the most likely etiology for the ectopic position of the M3 is the lack of space in the maxilla. We discuss possible contributing factors, such as morphometric aspects of the maxilla and the early mineralization of the M3 , to support the M2 impaction. Finally, due to the early age at death of this individual we did not identify any secondary lesion associated with the M2 impaction.
... Among the many studies that have examined dental features of the Neandertals to infer alimentary and non-alimentary behaviors of these hominins (Kallay, 1951;Wallace, 1975;Smith, 1976aSmith, , 1976cTrinkaus, 1978;Puech, 1981;Frayer and Russell, 1987; Bermúdez de Castro et al., 1988;Lalueza-Fox and P erez-P erez, 1993;Villa and Giacobini, 1995;Lalueza-Fox et al., 1996;Lalueza-Fox and Frayer, 1997;P erez-P erez et al., 2003;Lozano et al., 2008Lozano et al., , 2013El Zaatari et al., 2011;Topi c and Vu ci cevi c-Boras, 2003;Clement et al., 2012;Hardy et al., 2012;Krueger and Ungar, 2012;Topic et al., 2012;Hlusko et al., 2013;Guatelli-Steinberg et al., 2014;Fiore et al., 2015;Karriger et al., 2016;Frayer et al., 2017;Weyrich et al., 2017), none has specifically dealt with chipping. Other studies more focused on the description of dental characters have mentioned the presence of chipping (de Lumley, 1973;Lalueza-Fox and Frayer, 1997;Bailey and Hublin, 2006;Estalrrich and Rosas, 2015), but there have been few systematic investigations of this feature in Neandertals. ...
... Some specific alterations, artificial grooves in the interproximal spaces of the posterior teeth (Frayer and Russell, 1987), dental scratches, mostly right-hand made on the labial surface of anterior teeth (Lalueza-Fox and Frayer, 1997;Fiore et al., 2015), microwear texture on anterior teeth related to moderate abrasive loads (Krueger and Ungar, 2012) and on posterior teeth connected to high meat consumption (Karriger et al., 2016), have been published. Recently the four teeth making up Krapina Dental Person (KDP) 20 have been used to argue for manipulative procedures on a rotated P 4 and a partially impacted M 3 (Frayer et al., 2017). As regards the dental fractures, besides the first study of Kallay (1951), until now no systematic studies have been provided on the Krapina teeth. ...
... In many cases, the presence of interproximal grooves is associated with the biggest fractures (KDP 20: teeth 5 and 82; KDP 24: the adjacent teeth 176 and 179; tooth 40; KDP 19: tooth 167). The four teeth (3,5,32,82) of KDP 20 that have been recently studied by Frayer et al. (2017) show multiple toothpick grooves, crown breakage and signs of other manipulation. This may be a way of relieving the discomfort or pain associated with the chipped teeth. ...
Article
Dental fractures can be produced during life or post-mortem. Ante-mortem chipping may be indicative of different uses of the dentition in masticatory and non-masticatory activities related to variable diets and behaviors. The Krapina collection (Croatia, 130,000 years BP), thanks to the large number of teeth (293 teeth and tooth fragments) within it, offers an excellent sample to investigate dental fractures systematically. Recorded were the distribution, position and severity of the ante-mortem fractures according to standardized methods. High frequencies of teeth with chipping in both Krapina adults and subadults suggest that the permanent and deciduous dentition were heavily subjected to mechanical stress. This is particularly evident when the frequencies of chipping are compared with those in modern humans (Upper Paleolithic and historic samples) that we analysed using the same methods. The distribution of chipping in the Krapina sample (anterior teeth are more affected) and its position (labial) suggest a systematic use of the anterior teeth for non-masticatory tasks.
... The paleobiological assessment of the Ciemna 1 incisor is most interesting with respect to the well-developed interproximal groove on the cervical margin. Interproximal grooves are not exceptional among Neandertals (e.g., Siffre 1911;Martin 1923;de Lumley 1973;Frayer and Russell 1987;Bermúdez de Castro et al. 1997;Bouchneb and Maureille 2004;Lozano et al. 2013;Smith et al. 2006;Lalueza-Fox et al. 1993;Ungar et al. 2001;Schmitz et al. 2002;Estalrrich et al. 2017;Frayer et al. 2017), but it does confirm that the incisor belongs to a Middle Paleolithic human. Furthermore, an interproximal groove is also noted on a second maxillary molar (S5000) from Stajnia Cave (Urbanowski et al. 2010), making the Ciemna 1 tooth the second Neandertal from Poland with this wear feature, but the first to exhibit an interproximal groove on an anterior tooth. ...
... While no oral paleopathology was documented, the Ciemna 1 incisor is too fragmentary to decisively conclude that oral pathology was absent. Thus, it is unclear if the toothpick groove was related to palliative/therapeutic behaviors (Lozano et al. 2013;Willman 2016Willman , 2017bFrayer et al. 2017), or hygienic ones (Ungar et al. 2001;Estalrrich et al. 2017). ...
... The paleobiological assessment of the Ciemna 1 incisor is most interesting with respect to the well-developed interproximal groove on the cervical margin. Interproximal grooves are not exceptional among Neandertals (e.g., Siffre 1911;Martin 1923;de Lumley 1973;Frayer and Russell 1987;Bermúdez de Castro et al. 1997;Bouchneb and Maureille 2004;Lozano et al. 2013;Smith et al. 2006;Lalueza-Fox et al. 1993;Ungar et al. 2001;Schmitz et al. 2002;Estalrrich et al. 2017;Frayer et al. 2017), but it does confirm that the incisor belongs to a Middle Paleolithic human. Furthermore, an interproximal groove is also noted on a second maxillary molar (S5000) from Stajnia Cave (Urbanowski et al. 2010), making the Ciemna 1 tooth the second Neandertal from Poland with this wear feature, but the first to exhibit an interproximal groove on an anterior tooth. ...
... While no oral paleopathology was documented, the Ciemna 1 incisor is too fragmentary to decisively conclude that oral pathology was absent. Thus, it is unclear if the toothpick groove was related to palliative/therapeutic behaviors (Lozano et al. 2013;Willman 2016Willman , 2017bFrayer et al. 2017), or hygienic ones (Ungar et al. 2001;Estalrrich et al. 2017). ...
... Most broad studies on AIDMs and atypical wear focus on extinct species of the human lineage (e.g., Ungar et al., 2001) and prehistoric and protohistoric populations (Bonfiglioli et al., 2004;Silva et al., 2016). Cultural dental wear has been linked with occupational tasks, being the most ancient evidence on Homo habilis teeth (Estalrrich & Rosas, 2015;Frayer et al., 2017;Lozano et al., 2008). ...
Article
Non‐masticatory dental lesions (e.g., notching, interproximal grooving, polished surfaces, lingual tilting, and dental trauma) may help evaluate the impact that dietary, individual, or social‐cultural habits had on ancient populations. Thus, this study aims to describe and discuss possible causes for dental wear and trauma recorded in 1206 commingled teeth recovered from a medieval‐modern ossuary in Miranda do Corvo (Coimbra, Portugal). All teeth were observed macroscopically under good light conditions. Dental wear and traumatic injuries were recorded according to their location. Atypical wear was divided into five categories – notches and grooves, polished surfaces, oblique wear plane, interproximal grooves, and lingual tilting. Higher mean values of occlusal dental wear were found in the anterior dentition (3.03±1.457; n=396), being the central incisors the more worn out (3.19±1.28; n=102). In all, 11.0% of the observed teeth presented atypical wear (130/1185), being anterior teeth (26.7%; 112/419) more affected than posterior (17.0%; 128/765). The most common alterations were notches/grooves (50.0% of the teeth with atypical wear; 65/130) and dental microtrauma (20.3% of the observed teeth; 240/1184). Furthermore, teeth presenting microtrauma were more affected by atypical wear, affecting 38.9% (48/130) of the worn teeth. An association between chipping and notches and/or grooves (62.5%; 30/48) was also noted. The obtained results, namely the morphology and distribution of the "incisor‐dominant" dental wear and dental trauma patterns, suggest that many individuals of this population may have used their teeth as a 'third hand' in routine practices. However, some types of atypical wear, namely polished lingual surfaces of anterior teeth, may have had other causes, such as malocclusion. This study provides new insights into how ancient populations used their dentitions, even when the osteological remains are recovered from a commingled context.
... It is considered to be the first-ever evidence of deliberate dental intervention. Research carried out in 2017 allows for adopting the concept [3] that Neanderthals used dental tools known to them even 130,000 years ago [4]. ...
Article
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A very extensive literature review presents the possibilities and needs of using, in endodontics, the alloys commonly known as nitinol. Nitinol, as the most modern group of engineering materials used to develop root canals, is equilibrium nickel and titanium alloys in terms of the elements’ atomic concentration, or very similar. The main audience of this paper is engineers, tool designers and manufacturers, PhD students, and students of materials and manufacturing engineering but this article can also certainly be used by dentists. The paper aims to present a full material science characterization of the structure and properties of nitinol alloys and to discuss all structural phenomena that determine the performance properties of these alloys, including those applied to manufacture the endodontic tools. The paper presents the selection of these alloys’ chemical composition and processing conditions and their importance in the endodontic treatment of teeth. The results of laboratory studies on the analysis of changes during the sterilization of endodontic instruments made of nitinol alloys are also included. The summary of all the literature analyses is an SWOT analysis of strengths, weaknesses, opportunities, and threats, and is a forecast of the development strategy of this material in a specific application such as endodontics.
... 25-years-old man, from the rocky shelter Ripari Villabruna in the Italian Dolomites of Veneto near Belluno [109]. This is the first-ever evidence of intentional dental intervention, although it is suggested [110] that research carried out in 2017 indicates that, as early as 130,000 years ago, Neanderthals used dental tools known to them [111]. The earliest beeswax tooth fillings dating back 6500 years were found in Slovenia [112]; however, a mixture of beeswax mixed with powdered minerals was previously used in ancient Egypt to repair loose teeth, as reported in the 16th century BC Ebers Papyrus [113]. ...
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... A Neanderthal individual from the site of Krapina in Croatia, and dated to around 130,000 years ago, has evidence for interproximal grooves as well as dental probing on several teeth. These are thought to be linked to the evident dental problems including rotation and fractures, seen in the teeth of this individual (Frayer et al. 2017). Further evidence for dental treatment can be found in the Late Upper Paleolithic where scraping inside a dental carious lesion, suggesting invasive treatment, was identified in a skeleton dating to around 14,000 years ago (Oxilia et al. 2015). ...
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Modern human need for medicines is so extensive that it is thought to be a deep evolutionary behavior. There is abundant evidence from our Paleolithic and later prehistoric past, of survival after periodontal disease, traumas, and invasive medical treatments including trepanations and amputations, suggesting a detailed, applied knowledge of medicinal plant secondary compounds. Direct archeological evidence for use of plants in the Paleolithic is rare, but evidence is growing. An evolutionary context for early human use of medicinal plants is provided by the broad evidence for animal self-medication, in particular, of non-human primates. During the later Paleolithic, there is evidence for the use of poisonous and psychotropic plants, suggesting that Paleolithic humans built on and expanded their knowledge and use of plant secondary compounds. Graphical abstract:
... Only M20 LM 2 presents an elliptical and concave mark at the distal cervical margin (SOM-S20). It could be attributed to a toothpick groove (stage 4 in Estalrrich et al., 2017), given its similarity to others published for numerous fossils (e.g., Frayer and Russell, 1987;Lalueza et al., 1993;Bermúdez de Castro et al., 1997;Lozano et al., 2013;Estalrrich et al., 2017;Frayer et al., 2017). Yet, because this tooth was partially digested, this depression does not show visible scratches running parallel to its long axis such as those identified in other toothpick grooves (Bouchneb and Maureille, 2004). ...
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Few European sites have yielded human dental remains safely dated to the end of MIS 4/beginning of MIS 3. One of those sites is Marillac (Southwestern France), a collapsed karstic cave where archeological excavations (1967-1980) conducted by B. Vandermeersch unearthed numerous faunal and human remains, as well as a few Mousterian Quina tools. The Marillac sinkhole was occasionally used by humans to process the carcasses of different prey, but there is no evidence for a residential use of the site, nor have any hearths been found. Rare carnivore bones were also discovered, demonstrating that the sinkhole was seasonally used, not only by Neanderthals, but also by predators across several millennia. The lithostratigraphic units containing the human remains were dated to ∼60 kyr. The fossils consisted of numerous fragments of skulls and jaws, isolated teeth and several post-cranial bones, many of them with traces of perimortem manipulations. For those already published, their morphological characteristics and chronostratigraphic context allowed their attribution to Neanderthals. This paper analyzes sixteen unpublished human teeth (fourteen permanent and two deciduous) by investigating the external morphology and metrical variation with respect to other Neanderthal remains and a sample from modern populations. We also investigate their enamel thickness distribution in 2D and 3D, the enamel-dentine junction morphology (using geometric morphometrics) of one molar and two premolars, the roots and the possible expression of taurodontism, as well as pathologies and developmental defects. The anterior tooth use and paramasticatory activities are also discussed. Morphological and structural alterations were found on several teeth, and interpreted in light of human behavior (tooth-pick) and carnivores' actions (partial digestion). The data are interpreted in the context of the available information for the Eurasian Neanderthals.
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This paper presents some new observations on the Krapina Neandertal dental sample. A number of lower third premolars from this site are rotated in comparison to their expected position relative to the other teeth. We developed a method for accurately describing the rotation for teeth, whether they are in mandibles, included in dental sets or isolated. We compare the frequencies of rotated P3s in the Krapina sample with those observed in a modern human population and in the available Neandertal population specimens. It appears that the two latter have comparable frequencies of P3 rotation whereas rotations found in theKrapina sample have a much higher frequency, whether in relation to the total number of teeth or the number of individuals. Bootstrapping in the comparative samples shows that the probabilities of finding the frequencies of rotated P3s observed at Krapina within the modern and Neandertal lineage groups are very low, below the significance threshold. The Krapina sample thus appears to be unique in its proportion of rotated P3s. After rejecting a mechanical hypothesis (i. e. lack of space) for explaining this condition, we propose a genetic origin for this condition. We discuss the implications of related individuals utilizing the cave over a long period of time.
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We present a Neanderthal maxilla (CF-1) from Cova Foradà site (Oliva, Valencia, Spain) with periodontal disease and evidence of attempts to alleviate pain with the use of a toothpick. Two interproximal grooves have been found on the distal surfaces of the upper left Pm(3) and M(1) of CF-1 maxilla. The location, morphology and size of the grooves coincide with other interproximal grooves found on the teeth of other fossil specimens. Heavy dental wear and periodontal disease would have caused the Cova Foradà Neanderthal specimen pain and discomfort, which the individual attempted to mitigate using some kind of dental probe.
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Objectives: During the microscopic examination of the Neandertal dentitions from El Sidrón (Spain) and Hortus (France), we found unusual fine parallel microstriations on the mesial and distal sides of all tooth types, near the cervix. As its appearance was similar to toothpick grooves described in other Homo species, it could correspond to early stages on its formation. To test this hypothesis we developed an experimental replication of a groove using grass stalks. Materials and methods: Comparisons between 204 isolated Neandertal teeth and the two experimental dental specimens corroborate that the marks correspond to initial stages of toothpick groove formation, and we propose a five-grade recording scale that summarized the groove formation process. Results: Using this new recording procedure, we found that Hortus individuals have higher incidence of this trait (eight individuals out of nine) than the El Sidrón individuals (nine out of 11). Toothpick grooves from El Sidrón show the earliest stages of development, whereas the grooves found on Hortus Neandertals were well-developed. Toothpick grooves were also found in 21 incisors and canines. Conclusions: These differences could be due to the more advanced occlusal dental wear in Hortus individuals, maybe age-related and with a more meat-based diet maybe favoring the inclusion of food debris and thus probing as the cleaning methodology. Our results allow the identification and characterization of incipient toothpick grooves on the human fossil record and contribute to increase our knowledge on Neandertals behavioral and oral care habits.
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Cylindrically-shaped grooves that occur on the interproximal surface at or near the crown root (dentine-enamel) junction in human teeth are characterized by their shape, sharp margins, horizontal parallel striations, and shiny polishing. Ancient examples reported in the literature provide the oldest direct evidence of hominid tool use. Like other workers, we found these grooves in many populations of the Pacific Basin and adjoining continents. Of the various explanations for interproximal grooves, the most reasonable one is they represent the habitual use of toothpicks. In our pooled sample the frequency per tooth for interproximal grooves is 0.78% (1,199/154,167 teeth). The frequency of individuals with one or more interproximal grooves is 3.5%. Oceania has the greatest number of individuals with interproximal grooves (8.9%). Most of these crania originated in Australia. The American Arctic sample has no individuals with interproximal grooves, and prehistoric Arctic teeth lack crown caries. Elsewhere, frequencies of interproximal grooving vary markedly within and between regions suggesting multiple causes. Interproximal grooves are the result of habitual back-and-forth rubbing with a toothpick or some other artifact. In some cases rubbing may have started in an effort to deaden or desensitize a carious or inflammed site. Whatever the original stimulus, groove depth varies with individual age, indicating many years of habitual rubbing.