Archaeology, Ethnology & Anthropology of Eurasia 48 (2) 2020   DOI: 10.17746/1563-0110.2020.48.2.149-156

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A Case of Surgical Extraction of the Lower Third Molars
in a Cranial Series from the Pucara de Tilcara Fortress
(Jujuy Province, Argentina)

A.V. Zubova¹, O.L. Pikhur^{2, 3}, A.V. Obodovskiy⁴, A.A. Malyutina⁵, L.M. Dmitrenko¹, K.S. Chugunova⁶, D.V. Pozdnyakov⁷, and V.B. Bessonov⁴

¹Peter the Great Museum of Anthropology and Ethnography (Kunstkamera), Russian Academy of Sciences, Universitetskaya nab. 3, St. Petersburg, 199034, Russia

²St. Petersburg Institute of Bioregulation and Gerontology, Pr. Dinamo 3, St. Petersburg, 197110, Russia

³Kursk State Medical University, K. Marksa 3, Kursk, 305041, Russia

⁴St. Petersburg Electrotechnical University “LETI”, Professora Popova 5, St. Petersburg, 197022, Russia

⁵Institute for the History of Material Culture, Russian Academy of Sciences, Dvortsovaya nab. 18, St. Petersburg, 191186, Russia

⁶State Hermitage Museum, Dvortsovaya nab. 34, St. Petersburg, 191181, Russia

⁷Institute of Archaeology and Ethnography, Siberian Branch, Russian Academy of Sciences, Pr. Akademika Lavrentieva 17, Novosibirsk, 630090, Russia

This study analyzes the earliest known case of surgical extraction of the lower third molars, observed in a cranial series from Pucara de Tilcara fortress (15th-16th centuries AD), northwestern Argentina, excavated in 1908-1910. Crania were transported to the Kunstkamera in 1910 under an exchange project. Traces of dental surgery were registered in the mandible of a male aged ~40. Both third molars had been extracted after the removal of soft tissues and parts of the alveoli. Teeth were extracted by scraping alveolar walls with semicircular movements. The results of scanning electron microscopy, X-ray fluorescence, and X-ray microanalysis suggest that a stone tool was used. The results of macroscopic and CT analysis suggest that the surgery was motivated by the exacerbation of chronic periodontal disease and probably by caries. The left third molar was extracted without complications 2-3 months before the individual’s death. On the right side, the pathological process continued, culminating in osteomyelitis and its complications. The surgeon’s skill notwithstanding, the extraction of the right third molar did not cure the patient, who died, apparently following the destructive stage of acute osteomyelitis complicated by orofacial phlegmon. Our findings suggest that the level of dental surgery practiced in the Inca Empire was ahead of the diagnostic expertise.

Keywords: Paleopathology, computed tomography, ancient surgery, lower third molars, periodontitis, osteomyelitis