Periapical inflammation in individuals of the medieval necropolis of São João de Almedina (Coimbra, Portugal) (12th−16th centuries)

Abstract

Periapical inflammation results from tooth pulp invasion by bacteria (result of trauma, severe wear or dental caries). Different periapical lesions (granuloma, cyst, abscess, and osteomyelitis) have different repercussions, from slight pain when biting to severe systemic effects. The objective of this study is to evaluate the frequency of the various types of periapical lesions in a sample of skeletons from the medieval necropolis (12^th-16^th centuries) of São João de Almedina (Coimbra, Portugal), in order to infer their impact in quality of life of the individuals. In all, 1040 alveoli belonging to 54 adult individuals (26 males, 16 females, and 12 individuals of unknown sex) were macroscopically examined. The differential diagnosis of the lesions was performed following Dias and Tayles (1997) and Hillson (2001). Periapical lesions were observed in 31.5% of the individuals, and 3.2% of the alveoli. Of the 33 lesions, 29 were granulomas or cysts and four were residual. Periapical inflammation was more frequently observed in men (38.46%, 10/26) than women (31.3%, 5/16). The main identified cause was dental caries. Only benign and asymptomatic lesions were identified. It is concluded that periapical inflammation did not have a very negative impact in the quality of life of these individuals.