Mandibular Fracture and Dislocation in a Case Study from the Jewish Cemetery of Lucena (CÓRDOBA), in South Iberian Peninsula (8th–12th ad)

Abstract

The skeletal remains of an adult female have been exhumed in an 11th century tomb in the mediaeval Jewish cemetery of Ronda Sur, in the city of Lucena (Córdoba, Spain). Examination of the skull and mandible revealed evidences of bilateral condylar fracture and dislocation. Lesions were observed macroscopically and radiology was used as a complementary method of scrutiny, especially in cases of unclear observation. Irregular morphology of the condyles and coronoid processes, shallow glenoid fossa, altered and abnormal joint surfaces anterior to the glenoid fossa, and reduced height of both ascending rami were observed. Antemortem tooth loss, slight wear of occlusal surface and asymmetrical occlusal deposit of dental calculus were found. Radiologically, degenerative changes in the condyles and reparative bone in both coronoid processes have been identified. Dislocation of the condyles and lack of adequate treatment probably led to disruption of masticatory patterns and related structures, such as muscle attachments, articular disc and ligaments. Bilateral remodelled fracture and the altered appearance of the joint structures could probably mean that the individual survived the injury by several years. This type of fracture could be the consequence of direct blow to the mental or submental region that was transmitted in a direction that raised the mandible, causing the condylar head to collide directly with the mandibular fossa. Very few mandibular fractures in ancient skulls have been described in Spain, and this case is the first example found in a Spanish archaeological skeletal assemblage.

An anthropological and paleopathological analysis of a peculiar skeleton from the Necropolis of Zancle (1st century BCE – 1st century CE): a case report

“…Both arthritis and tumors were excluded as possible causes because the mandible does not show signs of erosion or lipping and inflammatory signs of the periosteal tissue. Among the factors that could cause the formation of a second condylar joint are postpartum (Dennison et al, 2008) or adolescent trauma (De Luca et al, 2013). An antenatal obstruction or injury suffered during adolescence can cause a dislocation of the jaw, which, leads to the formation of a second condylar articulation if not treated.…”

Timing of maxillofacial–oral injuries in an individual of the ancient city of Herculaneum (79 AD, Naples, Italy): a case report

“…Finally, De Luca et al. described in great detail a bilateral condylar fracture and dislocation of an adult female who was exhumed from the medieval Jewish cemetery of Ronda Sur, on the South Iberian Peninsula.…”

“…Keenleyside (59) reported an unreduced condylar dislocation in an Alaskan Eskimo who was dated to between 1400 and 1850. Finally, De Luca et al (60) described in great detail a bilateral condylar fracture and dislocation of an adult female who was exhumed from the medieval Jewish cemetery of Ronda Sur, on the South Iberian Peninsula.…”

“…In modern clinical findings, the most common complications and symptoms of mandibular fractures and temporomandibular joint disorders include (i) difficulty in opening the mouth, (ii) inability to masticate, (iii) limitation of mandibular movement, particularly for lateral excursion, (iv) difficulty with speech, (v) malocclusion of the teeth, (vi) facial asymmetry, (vii) haemotympanum, (viii) pain and tenderness over the affected temporomandibular joint, (ix) swelling locally, usually just below the zygomatic arch and in front of the lobule of the external auricle and (x) masseteric spasm on the affected side, caused by irritation of the nerve endings due to an inflammatory response (59,60,97,98).…”

Dientes Fósiles de Carcharocles megalodon : La Colección del Museo Universitario de Chieti (Italia). Parte II: Análisis Paleopatológico

“…ej. : D 'Anastasio et al, 2009'Anastasio et al, , 2013de Buffrénil et al, 2010;De Luca et al, 2013;Bedosti et al, 2015;Viciano et al, 2015a,c;Cilli & D'Anastasio, 2017). Respecto al estudio de las enfermedades en la Prehistoria, los huesos y los dientes fósiles constituyen las únicas fuentes directas con las que poder extrapolar información sobre la naturaleza y la epidemiología de las enfermedades antiguas.…”