Dental defects of congenital syphilis

Hillson, Simon; Grigson, Caroline; Bond, S.

doi:10.1002/(sici)1096-8644(199809)107:1<25::aid-ajpa3>3.0.co;2-c

Cited by 92 publications

(92 citation statements)

References 29 publications

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“…A differential diagnosis was established that included congenital treponematosis, hypoplastic amelogenesis imperfecta and cuspal enamel hypoplasia. Dental characteristics of the molars in congenital venereal disease include an irregular surface with a honeycomb pattern, undefined cusps and dome-shaped teeth known as Moon's molar (Cruickshank, 1939;Hillson et al, 1998). Congenital treponemal disease seems to be a likely cause of condition, because treponematosis had been encountered in adults of the study sample.…”

Section: Resultsmentioning

confidence: 99%

“…Enamel hypoplasia serves as an indication that the presence of acute episodes of disease or malnutrition compromised the health of the individual, subsequently causing a disturbance in the process of enamel formation during childhood (Goodman & Rose, 1991;Hillson, 2000). Specific diseases such as treponematosis may affect the normal development of teeth, leading to a disruption in enamel formation (Hillson et al, 1998). It has also been suggested that vitamin D deficiency may cause poor mineralisation of enamel.…”

Section: Discussionmentioning

confidence: 99%

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A Palaeopathological Assessment of the Late 19th and Early 20th Century Khoesan

Botha

Steyn

2014

Intl J of Osteoarchaeology

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Since the arrival of Dutch colonists in the Cape of Good Hope, South Africa, Khoesan populations were subjected to severe political and economic marginalisation and often fell prey to racial conflict. These circumstances persisted until the early 20th century, during which an astonishing number of Khoesan skeletons were transported from South Africa to various locations in Europe, as at the time, different institutions competed to obtain these remains. The purpose of this study was to assess the health status of the late 19th and early 20th century Khoesan. Skeletal remains housed in two different European institutions were studied. The sample comprised 140 specimens from the Rudolf Pöch Skeletal Collection in Vienna, Austria, and 15 specimens from the Musée de l'Homme in Paris, France. These individuals represent both sexes and were aged between newborn and 75 years, with 54 being younger than 20 years of age. Results indicated high levels of typical disease conditions associated with groups under stress, such as periostitis, cribra orbitalia and porotic hyperostosis. Treponemal disease, rickets, osteoarthritis and trauma were also encountered amongst other more specific indicators of health and disease. This study provided additional knowledge on the health status and lives of the Khoesan people during this turbulent period and created new awareness regarding a group of severely mistreated individuals.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Palaeopathological Assessment of the Late 19th and Early 20th Century Khoesan

Botha

Steyn

2014

Intl J of Osteoarchaeology

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“…In fact, even within the clinical scenario, the disease is so diverse (la grande simulatrice) that no single criterion can be independently applied for a clinical diagnosis and the actual definite decision can only be provided via serological / molecular testing, which, however, is not available in archaeological / anthropological samples [6,7,10]. In addition, HS may also be significant for the definite establishment of the presence of congenital syphilis in the pre-Columbian ancient Greek world and the Old World in general, as well as for the differential diagnosis between syphilis and other variants of treponemal / spirochete infections [2,3,11,28]. A thorough osteoarcheological study of the specimens at the Museum of London is very likely to yield an answer to this hypothesis.…”

Section: Resultsmentioning

confidence: 91%

“…This observation is also supported by the inclusion of the criterion in several major reviews of disease clinical diagnosis [4,5,26]. The additional fact that dental stigmata of the disease, such as Hutchinson's incisors and mulberry molars, are only observed in about 30% of all patients [2,11,27], allow us to advocate evaluating the clavicle sign in osteoarcheological studies, especially when cranial data evaluation is missing or remains inconclusive. In fact, even within the clinical scenario, the disease is so diverse (la grande simulatrice) that no single criterion can be independently applied for a clinical diagnosis and the actual definite decision can only be provided via serological / molecular testing, which, however, is not available in archaeological / anthropological samples [6,7,10].…”

Section: Resultsmentioning

confidence: 99%

“…The diagnosis of congenital syphilis on bones is based on osseous evidence, making osseous signs of congenital syphilis very important for the differential diagnosis of the disease [2,8,9], especially when ancient treponemal DNA is considered impossible to detect in archaeological specimens [10]. Dental stigmata, such as Hutchinson's incisor and mulberry molar, are very important for the diagnosis of congenital syphilis in archaeological populations but are not always sensitive / specific enough for a definite diagnosis [2,11]. On the other hand, if other signs are present on the bones of the remaining skeleton, this is very helpful in making the differential diagnosis in favour of congenital syphilis.…”

Section: Diagnosis Of Congenital Syphilis In Anthropologymentioning

confidence: 99%

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Higoumenakis’ sign in the diagnosis of congenital syphilis in anthropological specimens

2011

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Higoumenakis' sign (HS) is a diagnostic criterion referring to the enlargement of the sternal end of the (right) clavicle, frequently observed in patients with late congenital syphilis. Although indexed for several years in clinical medicine textbooks, it has not been extensively applied for the diagnosis of congenital syphilis among anthropological specimens. This is highly significant, since the other major palaeopathology findings refer almost exclusively to the skull and diagnosis thus becomes difficult if only peripheral skeletal remains are available for evaluation. The potential effectiveness of the proposed use of HS as a marker of syphilis in anthropology appears adequate, since descriptions very similar to that of HS have been reported for certain findings, although no attempt has been made to correlate them with the presence of the disease. Higoumenakis himself originally observed this sign in 86% of his patients with congenital syphilis, and this report was subsequently verified by other independent researchers. His attempt to explain the pathophysiology of the sign and its localization, on the basis of anatomical, biological, and mechanical reasons, however, has been questioned. On the other hand, the application of the remaining markers of congenital syphilis is also problematic, due to sensitivity and/or specificity limitations, and other signs may not be detected due to inability to retain soft tissue samples in anthropological populations and a lack of reliable techniques for treponematous DNA amplification in such old samples. Thus, the fact that the onset of any of the signs of syphilis is not a constant finding justifies the authors' suggestion that HS should be checked for in any available anthropological specimen, because it is highly indicative of possible infection by Treponema pallidum.

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Patterns of dental enamel defects at ancient Mendes, Egypt

Lovell

Whyte

1999

Am. J. Phys. Anthropol.

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The dental remains of 88 individuals from Old Kingdom, First Intermediate, and Greco-Roman periods at the ancient Egyptian site of Mendes (Tell er-Rub(c)a) were examined for dental enamel hypoplasia, and the results reported here provide some of the first comparative data on enamel defects in ancient Egypt. Overall, 48% of the individuals in the sample have one or more teeth with hypoplasia, with 17% of permanent teeth and 8% of deciduous teeth affected. The permanent teeth account for 87% of the total number of affected teeth, a prevalence over deciduous teeth that is significant at alpha = 0.05. Permanent and deciduous teeth display different patterns of hypoplasia, with the former exhibiting both discrete pitting and linear furrowing, and the latter exhibiting only pits. Teeth with linear defects significantly outnumber those with pits by a factor of more than three to one. Only permanent canines display more than one lesion on a tooth, with a mean of 1.4 defects per affected tooth. Although calculation of the age of insult from lesion position is imprecise, it appears that stress episodes occurred most commonly between approximately 3-5 years of age. The presence of pits in the deciduous dentition, however, suggests that physiological stresses began in utero. There is no statistically significant difference in the frequency of enamel defects between males and females. An observed decrease in the frequency of defects from the Old Kingdom period to the subsequent First Intermediate and Greco-Roman periods is not significant at alpha = 0.05, although such a decrease is expected given epigraphic and other data that refer to prolonged drought and malnutrition in the late Old Kingdom. The calculated chi(2) value of 3.83 is significant at the 0.10 level, however, and since our sample is rather small and the magnitude of the chi-square statistic is a function of sample size, we recommend that future research investigate further the relationship between the frequency of enamel defects and the time period in which they occur.

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Dental defects of congenital syphilis

Cited by 92 publications

References 29 publications

A Palaeopathological Assessment of the Late 19th and Early 20th Century Khoesan

A Palaeopathological Assessment of the Late 19th and Early 20th Century Khoesan

Higoumenakis’ sign in the diagnosis of congenital syphilis in anthropological specimens

Patterns of dental enamel defects at ancient Mendes, Egypt

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