Thesis (M.S.)--University of Michigan, 1979.

Thesis (doctoral)--Rijksuniversiteit te Groningen.

A dissertation submitted to the Faculty of Science, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Master of Science. Johannesburg, 2013. / Recent studies of the dental remains from Malapa, a fossil-bearing karstic cave-site located in the Cradle of Humankind (Berger et al., 2010), have demonstrated the presence of dental calculus and associated plant material in the form of phytoliths, preserved on the teeth of Australopithecus sediba (MH1) (Henry et al., 2012). This discovery raised the probability that dental calculus and plant microremains may also be present on hominin material from other cave sites in southern Africa, where fossils are preserved under similar conditions. The aim of this study was to establish the presence of dental calculus and associated microfossils on the teeth of other southern African Plio-Pleistocene early hominins. The dental collection of the Plio-Pleistocene age hominin site of Sterkfontein was examined. Where fossils were observed with adherent material, several analyses were performed to determine whether this material was calculus or not. Where possible, comparisons with the texture of the sediment matrix surrounding the fossil were conducted. Small quantities of this material were removed and observed microscopically to determine if it included food particulates and microfossils. In these cases, we also looked for microfossils in the surrounding matrix as a control. Phytoliths were recovered from all tooth sample material tested. The establishment of phytoliths in the dental calculus is direct evidence that these two structures existed simultaneously, as the formation of calculus can only take place in the presence of saliva. A large number of phytolith morphotypes further indicated that A.africanus had an adaptable and diverse diet, and that monocotyledons and dicotyledons appear to have made up a considerable part of their diet. The results from this study will benefit future analyses, by not only providing new protocols for establishing the presence of dental calculus, but also for promoting better preservation of dental calculus in the future. Further, future studies may be able to obtain direct evidence of consumed food that can directly be associated with individual hominins’ feeding behaviours. This could result in significant clues to the diet and ecology of not only individual hominins, but populations, species and comparisons of diet and behaviour between species and genera.

The utility of dental calculus as a proxy for diet and mouth use is explored for the Middle Holocene Cis-Baikal region of Central Siberia based on two methods: a macroscopic analysis of severity and a microscopic analysis of particles within deposits. The study area was inhabited by two culturally and biologically distinct cultures, the Early Neolithic (EN) Kitoi culture (8,000 to 7,000/6,800 cal B.P.) and the Late Neolithic-Early Bronze Age (LN-EBA) Isakovo-Serovo-Glaskovo (ISG) cultural complex (6,000/5,800 to 4,000 cal B.P.), separated by a period of cultural transition marked by a cessation in formal cemetery use. Data were collected from four cemetery sites, two dating to the EN and two dating to the LN-EBA. Nonparametric testing of calculus severity revealed that, for adult males and juveniles, lakeshore populations displayed greater affinity to each other than to their contemporaneous cultural counterpart populations living along riverine systems in the Angara River Valley. Trends within the EN cemetery Shamanka II contrasted to the other cemetery populations, with noticeably larger deposits in anterior quadrants and significant sexual distinctions. The proportion of protein to carbohydrates consumed is known to influence calculus formation, but both cultural groups lived on a diet based predominately on meat sources so dietary ratios alone do not adequately explain the differences distinguished. A complex multifactorial model involving microregional differences in resources/environment, foraging patterns, individual variation, and dental wear patterns provides at least a partial explanation for the results observed. A wide range of particles were recovered during the microscopic analysis of calculus, albeit in low concentrations. The low starch grain counts were consistent with a diet based predominately on meats but still provide some of the first direct evidence for plant consumption in the Cis-Baikal, including possible plant processing by cooking or grinding based on damage evident on the grains. Other particles recovered may provide evidence of mouth use activities or palaeoenvironmental influences. Together, the two components of this analysis offer strong evidence that dental calculus is a useful tool for reconstructing hunter-gatherer lifeways but also highlight the limitations of conducting this type of research on previously excavated and potentially contaminated material.

Embora os indivíduos construtores dos sambaquis constituam o grupo pré-histórico brasileiro melhor estudado, várias questões continuam em aberto. Algumas delas estão ligadas a estratégias de subsistência. Sabe-se que a economia desses indivíduos era baseada na pesca e que a coleta de moluscos teria papel complementar na alimentação. Mas, atualmente, estudos antracológicos e de cálculo dentário vêm demonstrando a grande importância da utilização de plantas pelos sambaquieiros. Entretanto, pouco se conhece sobre as espécies consumidas e o modo de preparo dos alimentos. O sambaqui Jabuticabeira II, localizado na região sul de Santa Catarina, apresenta indícios da utilização de plantas que incluem: artefatos líticos que se acredita que tenham sido usados para raspar, moer e quebrar vegetais; sementes de famílias de plantas que produzem frutos comestíveis; coquinhos; e restos carbonizados de lenho de uma grande diversidade de espécies. Além disso, notou-se grande número e variedade de grãos de amido no cálculo dentário dos indivíduos sepultados nesse sambaqui, sugerindo que o consumo de vegetais ricos em amido teria sido grande. O presente estudo trata, portanto, da análise de 119 microvestígios vegetais de cálculo dentário de 19 adultos de Jabuticabeira II, objetivando avaliar se ocorria, de fato, um consumo de grande variedade de vegetais amiláceos, bem como identificar quais plantas foram consumidas. Para possibilitar tal identificação, foi iniciada a elaboração de uma coleção de referência de grãos de amido de plantas nativas da região. A partir dos resultados obtidos sugere-se que os sambaquieiros de Jabuticabeira II consumiam uma grande variedade de plantas ricas em amido. Embora o número de microrrestos vegetais variasse bastante entre os indivíduos, aparentemente, não ocorria diferença quanto a dieta vegetal de acordo com sexo, classe etária ou lócus de enterramento. A presença de diatomáceas de ambientes de água salobra indicam que os recursos faunísticos consumidos eram obtidos a partir da paleolaguna. Eram consumidos órgãos de reserva subterrâneos de aráceas (inhames), Dioscorea sp. (carás), Calathea SP. (ariá) e Ipomoea batatas (batata-doce) e, possivelmente, frutos das famílias Myrtaceae (incluindo Eugenia uniflora - pitanga) e Arecaceae (palmeiras). Acredita-se que o milho (Zea mays) também fazia parte da dieta, embora não tenha sido possível discernir se era cultivado nesse sitio, ou se foi obtido através de troca com grupos cultivadores de outras regiões. Ainda que fitólitos de gramíneas possam ter sido acidentalmente incorporados ao cálculo dentário dos indivíduos de Jabuticabeira II, sugere-se que algumas gramíneas poderiam ter sido utilizadas, não somente como alimento, mas também com fins medicinais ou de higiene oral. O alimento de origem vegetal parece ter sido processado através de moagem ou maceração, assado em brasas ou cinzas ou, ainda, preparado em fornos escavados. As evidências obtidas neste trabalho não apontam para o cultivo intensivo das plantas que eram utilizadas na dieta desse grupo, mas não corroboram, nem descartam a hipótese de que o manejo ou horticultura de alguns taxa florísticos importantes tenha ocorrido / The sambaqui (shellmound) builders are the best studied ancient human group from Brazil. However, much has still to be discovered about them. It is very well known that their subsistence was based on fishing and that molluscs\' gathering was a complement to their diet. Recently, anthracology and dental calculus studies have shown the importance of plants, but very little is known about the species eaten and the processes that were used for food preparation. The Jabuticabeira II sambaqui, located in southern Santa Catarina, shows evidences of plant use that include: lithic artifacts related to food processing; seeds from plant families that produce edible fruits; palm nuts; and remains from carbonized wood from a variety of species. Besides that, a high number and variety of starch grains were recovered from the dental calculus of some skeletons, suggesting that the consumption of starchy plants was important. For the present study, plant microfossils (n=119) recovered from the dental calculus from 19 adults exhumed from Jabuticabeira II shellmound were analysed, in order to identify the species consumed and to test if, in fact, their diet consisted of a high variety of starchy plants. To allow identification, the construction of a starch reference collection from plants from the studied region was initiated. The results suggest that the individuals buried at Jabuticabeira II indeed ate a high variety of starchy plants. Despite the inter- individual variation in the number of microfossils, there seems to be no difference in the plant intake according to sex, age class and burial site. The diatoms from brackish water that were also found indicate that the faunal resources consumed were obtained from the paleolagoon nearby. Underground storage organs from the Araceae family (arum family), Dioscorea sp. (yams), Calathea sp. (llerén), Ipomoea batatas (sweet potato), and possibly fruits from the Myrtaceae family, including Eugenia uniflora (pitanga), and Arecaceae family (palm trees) were eaten. Although corn starch (Zea mays) grains were also identified, it is not yet clear if it was cultivated in Jabuticabeira II, or if it was obtained through exchange with cultivators from other sites. The grass leaf phytoliths that were also recovered suggest that plants from the Poaceae family could have been used as medicine or for oral hygiene. Plant food seems to have been processed through grinding, toasting in ashes, and maybe in underground ovens. Finally, there is no evidence that suggests that plants were cultivated in Jabuticabeira II, but the management of some botanical taxa cannot be excluded

As part of a multinational project and with the help of other professionals, I gathered and analyzed 110 samples of dental calculus (fossilized plaque) from human remains discovered at Paquimé and the Convento site in the Casas Grandes River valley to identify various microfossils still present in the silica matrix. Once identified, I used the results to reconstruct human/plant relationships present during the Viejo (700-1250 CE) and Medio (1250-1450 CE) periods in and around Paquimé. My data suggest that maize was used throughout both time periods, supplemented by wild plants, and possible marine resources. Further, evidence for cultural food modification methods such as fermentation, roasting, grinding, and nixtamalization (an alkaline treatment of the grain) was present. The data suggest prehistoric plant use went beyond simple subsistence, being modified for use as part of non-subsistence activities.

Esse estudo transversal avaliou a saúde bucal de 36 pacientes com fibrose cística (FC). Um questionário foi aplicado para obter informações sobre autocuidados e outros aspectos que pudessem influenciar os resultados. Os exames, realizados por examinadora treinada e calibrada, foram placa visível (IPV), sangramento gengival (ISG), profundidade de sondagem (PS), perda de inserção (PI), exsudato à sondagem (SS), presença de sítios com cálculo dental, experiência de cárie (ceo/CPO-D + MBA) e número de dentes com sinais de anomalias no esmalte. Os resultados das variáveis clínicas foram comparados (P<0,05), segundo dois extratos de idade e segundo a experiência de cárie positiva (EC+) ou não (EC-), por meio dos testes t de Student ou U de Mann-Whitney. O teste de Spearman foi usado para identificar possíveis correlações entre os achados. Para as idades 12 anos e > 12 anos os resultados foram: IPV (65,40±35,13% e 58,90±34,51%), ISG (14,00±21,61% e 26,51±27,09%) e presença de cálculo dental (21,59±28,96% e 11,97±9,29%), sem diferenças significativas entre os grupos. As médias de PS foram 1,30±0,32mm e 1,70±0,30mm (P=0,00) e de SS foram 3,89±9,92% e 7,72±20,04% (P=0,09). A média de PI, somente presente no grupo >12 anos, foi 0,15±0,35mm. Os valores do índice ceo/CPO-D+MBA foram 1,74±3,33/1,20±1,74 e 5,14±4,26, respectivamente. A presença de anomalias de esmalte variou de nenhum até todos os dentes com sinais, em ambos os grupos. A comparação dos grupos EC+ e EC- revelou que os valores do IPV (70,52±30,92% e 52±37,50%) e ISG (25,13±29,40% e 10,09±10,04%), não diferiram significativamente, ao contrário dos percentuais de cálculo, com valores de 9,97±10,06% e 28,86±32,05% nos grupos, respectivamente. Placa bacteriana (r=0,50; P=0,02), e preferência por alimentos doces (r=0,48; P=0,02) relacionaram-se positivamente com experiência cárie na dentição decídua, assim como o histórico de dor (r=0,48; P=0,03), que também teve relação positiva com a dentição permanente (r=0,52; P=0,02). Correlação positiva foi observada entre a perda de inserção e a percepção da gengiva já ter sangrado anteriormente (r=0,51; P=0,00). Os níveis de escolaridade da mãe e do pai relacionaram-se negativamente com a EC nas crianças FC (r=-0,57; r=-0,71). Conclusões: Nessa amostra, manifestações de cárie foram observadas a partir de sinais incipientes de perda mineral, sendo que a experiência de cárie foi semelhante àquela observada na população do sul do Brasil. A remoção de cálculo dental para tratamento da gengivite não deve ser priorizado no atendimento de pacientes císticos com atividade de cárie. Atenção odontológica deve ser direcionada à prevenção e ao tratamento da doença cárie. / This cross-sectional study assessed the dental health of 36 cystic fibrosis (CF) patients. Questionnaire was applied to obtain information about self-care and other aspects that could influence the results. One trained and calibrated examiner evaluated the presence of visible plaque (VIP), gingival bleeding (GB), bleeding on probing (BOP), pocket depth (PD), clinical attachment loss (CAL), presence of supragingival calculus, dmf/DMF-T index modified by the presence of active white spots, and the presence of enamel defects. The results of the clinical variables were compared (P<0.05), according to two age groups, and according to caries experience (CE), positive (+) or not (-), by Student t test or U Mann-Whitney test. The non-parametric test of Spearman was used to identify possible correlations between findings. The results seen for age’s 12 years old and > 12 years old were: VIP (65.40±35.13% and 58.90 ± 34.51%), GB (14.00±21.61% and 26.51% ± 27.09%) and presence of calculus (21.59±28.96% and 11.97±9.29%), without statistic differences between the groups. The mean value of PS was 1.30±0.32 mm and 1.70±0.30mm (P= 0.00) and BOP were 3.89± 9.92% and 20.04±7.72% (P= 0.09). The CAL mean value present in the group > 12 years old, was 0.15±0.35 mm. The values of the dmf/DMF-T modified index were 1.74 ±3.33 / 1.20 ± 1.74 and 5.14 ± 4.26, respectively. The presence of teeth with enamel defect, per individual, ranged from none to all teeth with signs in both groups. The analysis of the groups CE+ and CE- revealed that VIP (70.52±30.92% - 52.00±37.50%) and of GB (25.13±29.40% -10.09±10.04%), did not differ significantly. Differences were observed between the percentages of dental calculus (9.97±10.06% - 28.86±32.05%). Few significant correlations were observed between the findings. The presence of visible plaque (r= 0.50, P=0.02), and preference for sweet foods (r= 0.48, P=0.02) correlated positively with caries experience in primary dentition, as well as the history of pain (r= 0.48, P=0.03), and that also had positive correlation with the permanent dentition (r= 0.52, P=0.02). Positive correlation was also found between attachment loss and the perception of gingival bleeding by the patient (r= 0.51, P=0.00). Mother’s and father’s education were negatively correlated with CE+ in primary dentition (r= - 0.57, r= - 0.71). Conclusions: In the study, symptoms of decay were observed from the incipient signs of mineral loss, and the caries experience in the cystic patients sample were similar to those observed in the population from south of Brazil. In cystic patients with caries activity, the removal of dental calculus for the treatment of gingivitis should not take priority in the planning of dental care. Dental care should be directed to prevention and treatment of caries.

Esse estudo transversal avaliou a saúde bucal de 36 pacientes com fibrose cística (FC). Um questionário foi aplicado para obter informações sobre autocuidados e outros aspectos que pudessem influenciar os resultados. Os exames, realizados por examinadora treinada e calibrada, foram placa visível (IPV), sangramento gengival (ISG), profundidade de sondagem (PS), perda de inserção (PI), exsudato à sondagem (SS), presença de sítios com cálculo dental, experiência de cárie (ceo/CPO-D + MBA) e número de dentes com sinais de anomalias no esmalte. Os resultados das variáveis clínicas foram comparados (P<0,05), segundo dois extratos de idade e segundo a experiência de cárie positiva (EC+) ou não (EC-), por meio dos testes t de Student ou U de Mann-Whitney. O teste de Spearman foi usado para identificar possíveis correlações entre os achados. Para as idades 12 anos e > 12 anos os resultados foram: IPV (65,40±35,13% e 58,90±34,51%), ISG (14,00±21,61% e 26,51±27,09%) e presença de cálculo dental (21,59±28,96% e 11,97±9,29%), sem diferenças significativas entre os grupos. As médias de PS foram 1,30±0,32mm e 1,70±0,30mm (P=0,00) e de SS foram 3,89±9,92% e 7,72±20,04% (P=0,09). A média de PI, somente presente no grupo >12 anos, foi 0,15±0,35mm. Os valores do índice ceo/CPO-D+MBA foram 1,74±3,33/1,20±1,74 e 5,14±4,26, respectivamente. A presença de anomalias de esmalte variou de nenhum até todos os dentes com sinais, em ambos os grupos. A comparação dos grupos EC+ e EC- revelou que os valores do IPV (70,52±30,92% e 52±37,50%) e ISG (25,13±29,40% e 10,09±10,04%), não diferiram significativamente, ao contrário dos percentuais de cálculo, com valores de 9,97±10,06% e 28,86±32,05% nos grupos, respectivamente. Placa bacteriana (r=0,50; P=0,02), e preferência por alimentos doces (r=0,48; P=0,02) relacionaram-se positivamente com experiência cárie na dentição decídua, assim como o histórico de dor (r=0,48; P=0,03), que também teve relação positiva com a dentição permanente (r=0,52; P=0,02). Correlação positiva foi observada entre a perda de inserção e a percepção da gengiva já ter sangrado anteriormente (r=0,51; P=0,00). Os níveis de escolaridade da mãe e do pai relacionaram-se negativamente com a EC nas crianças FC (r=-0,57; r=-0,71). Conclusões: Nessa amostra, manifestações de cárie foram observadas a partir de sinais incipientes de perda mineral, sendo que a experiência de cárie foi semelhante àquela observada na população do sul do Brasil. A remoção de cálculo dental para tratamento da gengivite não deve ser priorizado no atendimento de pacientes císticos com atividade de cárie. Atenção odontológica deve ser direcionada à prevenção e ao tratamento da doença cárie. / This cross-sectional study assessed the dental health of 36 cystic fibrosis (CF) patients. Questionnaire was applied to obtain information about self-care and other aspects that could influence the results. One trained and calibrated examiner evaluated the presence of visible plaque (VIP), gingival bleeding (GB), bleeding on probing (BOP), pocket depth (PD), clinical attachment loss (CAL), presence of supragingival calculus, dmf/DMF-T index modified by the presence of active white spots, and the presence of enamel defects. The results of the clinical variables were compared (P<0.05), according to two age groups, and according to caries experience (CE), positive (+) or not (-), by Student t test or U Mann-Whitney test. The non-parametric test of Spearman was used to identify possible correlations between findings. The results seen for age’s 12 years old and > 12 years old were: VIP (65.40±35.13% and 58.90 ± 34.51%), GB (14.00±21.61% and 26.51% ± 27.09%) and presence of calculus (21.59±28.96% and 11.97±9.29%), without statistic differences between the groups. The mean value of PS was 1.30±0.32 mm and 1.70±0.30mm (P= 0.00) and BOP were 3.89± 9.92% and 20.04±7.72% (P= 0.09). The CAL mean value present in the group > 12 years old, was 0.15±0.35 mm. The values of the dmf/DMF-T modified index were 1.74 ±3.33 / 1.20 ± 1.74 and 5.14 ± 4.26, respectively. The presence of teeth with enamel defect, per individual, ranged from none to all teeth with signs in both groups. The analysis of the groups CE+ and CE- revealed that VIP (70.52±30.92% - 52.00±37.50%) and of GB (25.13±29.40% -10.09±10.04%), did not differ significantly. Differences were observed between the percentages of dental calculus (9.97±10.06% - 28.86±32.05%). Few significant correlations were observed between the findings. The presence of visible plaque (r= 0.50, P=0.02), and preference for sweet foods (r= 0.48, P=0.02) correlated positively with caries experience in primary dentition, as well as the history of pain (r= 0.48, P=0.03), and that also had positive correlation with the permanent dentition (r= 0.52, P=0.02). Positive correlation was also found between attachment loss and the perception of gingival bleeding by the patient (r= 0.51, P=0.00). Mother’s and father’s education were negatively correlated with CE+ in primary dentition (r= - 0.57, r= - 0.71). Conclusions: In the study, symptoms of decay were observed from the incipient signs of mineral loss, and the caries experience in the cystic patients sample were similar to those observed in the population from south of Brazil. In cystic patients with caries activity, the removal of dental calculus for the treatment of gingivitis should not take priority in the planning of dental care. Dental care should be directed to prevention and treatment of caries.

Esse estudo transversal avaliou a saúde bucal de 36 pacientes com fibrose cística (FC). Um questionário foi aplicado para obter informações sobre autocuidados e outros aspectos que pudessem influenciar os resultados. Os exames, realizados por examinadora treinada e calibrada, foram placa visível (IPV), sangramento gengival (ISG), profundidade de sondagem (PS), perda de inserção (PI), exsudato à sondagem (SS), presença de sítios com cálculo dental, experiência de cárie (ceo/CPO-D + MBA) e número de dentes com sinais de anomalias no esmalte. Os resultados das variáveis clínicas foram comparados (P<0,05), segundo dois extratos de idade e segundo a experiência de cárie positiva (EC+) ou não (EC-), por meio dos testes t de Student ou U de Mann-Whitney. O teste de Spearman foi usado para identificar possíveis correlações entre os achados. Para as idades 12 anos e > 12 anos os resultados foram: IPV (65,40±35,13% e 58,90±34,51%), ISG (14,00±21,61% e 26,51±27,09%) e presença de cálculo dental (21,59±28,96% e 11,97±9,29%), sem diferenças significativas entre os grupos. As médias de PS foram 1,30±0,32mm e 1,70±0,30mm (P=0,00) e de SS foram 3,89±9,92% e 7,72±20,04% (P=0,09). A média de PI, somente presente no grupo >12 anos, foi 0,15±0,35mm. Os valores do índice ceo/CPO-D+MBA foram 1,74±3,33/1,20±1,74 e 5,14±4,26, respectivamente. A presença de anomalias de esmalte variou de nenhum até todos os dentes com sinais, em ambos os grupos. A comparação dos grupos EC+ e EC- revelou que os valores do IPV (70,52±30,92% e 52±37,50%) e ISG (25,13±29,40% e 10,09±10,04%), não diferiram significativamente, ao contrário dos percentuais de cálculo, com valores de 9,97±10,06% e 28,86±32,05% nos grupos, respectivamente. Placa bacteriana (r=0,50; P=0,02), e preferência por alimentos doces (r=0,48; P=0,02) relacionaram-se positivamente com experiência cárie na dentição decídua, assim como o histórico de dor (r=0,48; P=0,03), que também teve relação positiva com a dentição permanente (r=0,52; P=0,02). Correlação positiva foi observada entre a perda de inserção e a percepção da gengiva já ter sangrado anteriormente (r=0,51; P=0,00). Os níveis de escolaridade da mãe e do pai relacionaram-se negativamente com a EC nas crianças FC (r=-0,57; r=-0,71). Conclusões: Nessa amostra, manifestações de cárie foram observadas a partir de sinais incipientes de perda mineral, sendo que a experiência de cárie foi semelhante àquela observada na população do sul do Brasil. A remoção de cálculo dental para tratamento da gengivite não deve ser priorizado no atendimento de pacientes císticos com atividade de cárie. Atenção odontológica deve ser direcionada à prevenção e ao tratamento da doença cárie. / This cross-sectional study assessed the dental health of 36 cystic fibrosis (CF) patients. Questionnaire was applied to obtain information about self-care and other aspects that could influence the results. One trained and calibrated examiner evaluated the presence of visible plaque (VIP), gingival bleeding (GB), bleeding on probing (BOP), pocket depth (PD), clinical attachment loss (CAL), presence of supragingival calculus, dmf/DMF-T index modified by the presence of active white spots, and the presence of enamel defects. The results of the clinical variables were compared (P<0.05), according to two age groups, and according to caries experience (CE), positive (+) or not (-), by Student t test or U Mann-Whitney test. The non-parametric test of Spearman was used to identify possible correlations between findings. The results seen for age’s 12 years old and > 12 years old were: VIP (65.40±35.13% and 58.90 ± 34.51%), GB (14.00±21.61% and 26.51% ± 27.09%) and presence of calculus (21.59±28.96% and 11.97±9.29%), without statistic differences between the groups. The mean value of PS was 1.30±0.32 mm and 1.70±0.30mm (P= 0.00) and BOP were 3.89± 9.92% and 20.04±7.72% (P= 0.09). The CAL mean value present in the group > 12 years old, was 0.15±0.35 mm. The values of the dmf/DMF-T modified index were 1.74 ±3.33 / 1.20 ± 1.74 and 5.14 ± 4.26, respectively. The presence of teeth with enamel defect, per individual, ranged from none to all teeth with signs in both groups. The analysis of the groups CE+ and CE- revealed that VIP (70.52±30.92% - 52.00±37.50%) and of GB (25.13±29.40% -10.09±10.04%), did not differ significantly. Differences were observed between the percentages of dental calculus (9.97±10.06% - 28.86±32.05%). Few significant correlations were observed between the findings. The presence of visible plaque (r= 0.50, P=0.02), and preference for sweet foods (r= 0.48, P=0.02) correlated positively with caries experience in primary dentition, as well as the history of pain (r= 0.48, P=0.03), and that also had positive correlation with the permanent dentition (r= 0.52, P=0.02). Positive correlation was also found between attachment loss and the perception of gingival bleeding by the patient (r= 0.51, P=0.00). Mother’s and father’s education were negatively correlated with CE+ in primary dentition (r= - 0.57, r= - 0.71). Conclusions: In the study, symptoms of decay were observed from the incipient signs of mineral loss, and the caries experience in the cystic patients sample were similar to those observed in the population from south of Brazil. In cystic patients with caries activity, the removal of dental calculus for the treatment of gingivitis should not take priority in the planning of dental care. Dental care should be directed to prevention and treatment of caries.

The mass grave in Västergarn, Gotland, Sweden is located between two medieval churches and thought to be a bone depot from when one of the churches expanded their wall in more recent time. The bone depot is problematic in a way because it could contain individuals from a wide time frame, making it hard to ask certain questions regarding how the individuals lived and died. Also conducting individual studies of the skeletons is hard since the osteological material is highly fragmented and the individual graves has been disturbed post burial. Therefore this osteological study will not focus on studying the health of the people individual by individual, but rather examine the permanent teeth of this material and then apply statistics to study the overall oral health of Västergarns mass grave. Enquiries regarding tooth health and how people experienced their life because of it, are questions that I will be trying to answer in this study. A deeper and thorough investigation regarding certain teeth conditions such as dental calculus, caries, enamel hypoplasia as well as mechanical damage will be conducted. There will also be comparisons between other historic locations in Sweden such as Uppsala, Skara and the older cemetery and its ruin in Västergarn. Last but not least a discussion regarding the difficulty of examining a diverse material with different timeframes.