Original article. Dental and Jaws Status in Pre-historic Human Population of the Gomolava Site

Summary Introduction Knowledge of biological and cultural heritage represents a significant basis for the advance of human civilization. The aim of this study was to determine and define dental health status of pre-historic people of the Vinca culture. Material and method Study included twenty skeleton remnants of different gender and age from anthropological series of Gomolava. Skeletons originated from one necropolis and two individual graves dating from mid and early Neolithic periods of the Vinca culture. Based on radiocarbon analysis absolute skeletal age was determined to date within the periods from 5848±38 to 5739±35 BC. Preservation of skeletons varied from completely preserved skulls and jaws to fragmented parts of jaws. Data analysis was performed with methodology used in the research of human population teeth and jaws from the Lepenski Vir culture. Results Results showed high level of teeth abrasion (98,1%), medium level of dental calculus deposits (44,9%), low level of tooth decay, significant number of retained roots, as well as the occurrence of periapical lesions and periodontal disease within the neolith population of Gomolava site. Conclusion Taking into account absolute age of examined skeletons, collected data are very significant, from the perspective of its wide content. From a pathological perspective, teeth abrasion stands out as a dominant feature, while tooth decay fits within standard values for human population of the neolith period.


INTRODUCTION
Archaeological site Gomolava is located on the left bank of the river Sava in a wider region of Ruma municipality, the Republic of Serbia (Picture 1). First individual, amateur exploration of this site dates back as far as to the beginning of the 20 th century, while first systematic ones were done on two occasions half a century later when larger sites were found and explored (over 3600m 2 ) [1][2][3][4][5]. First phase took place between 1954 and 1957. These explorations found that the site holds a significant cultural layer, which indicates continuity and length of colonisation to this area [3,4,6]. Through the second phase which went on for two decades  archaeologists like Brukner, Jovanovic and Tasic defined the stratigraphic site location and determined that the rich cultural layer, which thickness ranges from 5.5 to 6.5 m, contains remains of settlements from seven different cultural periods [1]. Based on material, cultural traces and remains of human skeleton found between the first cultural layer, Gomolava I, originating from late Neolith regarded as the period of Vinca culture, and the last one, Gomolava VII, belonging to the Roman period, there is possibility to explore human activity in a timeframe of over 6000 years [4,5,[7][8][9][10][11].
Several necropolis and individual graves were found during excavation [2,5,8,9,12,13]. Twenty human skeletons found at Gomolava I date back to late Neolith, e.g. the Vinca culture. These are significant and numerous findings with respect to soil characteristics these skeletons were excavated from. It is known that the soil, where skeletons were buried is very aggressive, leading to fast disintegration of biological remains. From this group, physical anthropologist Z. Zoffmann extracted and anthropologically processed fourteen adult skeletons, assorting them to a "very gracile type of atlanto-mediterranean taxons within the Carpathian basin", except two (2/75 & 16) which she assorted to the Cro-Magnon group. Anthropological analysis determined that the average height of pre-historic habitants of Gomolava ranged from 1576 to 1767 mm. Also, finding of pathological changes on skeletons is very deficient (occasional blow or arthrosis). Regarding dental parameters from that period, a relatively high rate of tooth decay was identified (3.7%) [12].
The aim of this study was to review and define dental health status of pre-historic people dating from the Vinca culture period, based on the analysis of teeth and jaws of preserved remains of human skeleton skulls from the anthropological group of Gomolava.

MATERIAL AND METHOD
Study included twenty skeleton remains of different gender and age. Skeletons originated from one necropolis and two individual graves dating from mid and early Neolithic periods of the Vinca culture (Picture 2). Based on radiocarbon analysis absolute skeletal age was determined to date within the periods from 5848±38 to 5739±35 BC [10,11,14]. Preservation of skeletons varied from completely preserved skulls and jaws to fragmented parts of jaws. Data analysis was performed with the methodology used in the research of human population teeth and jaws from the Lepenski Vir culture [15,16,17]. Table for basic information data included: skeleton number, individuals' age and gender (data taken from previously published anthropological analysis). In the Table for jaws preservation assessment number 1 stands for complete preservation, 0.5 for partial and 0 for the absence of examined jaw segment. Tables for lower and upper jaw generate a wide range of data (7 columns and 16 rows). First column shows data on dentition type. Second column generates information on teeth status and consists of 6 types of data: 1 -present tooth, 2 -tooth lost during lifetime, 3 -tooth lost after death, 4 -present tooth root, 5 -tooth root lost after death, 6 -tooth germ. Third column shows data on tooth surfaces affected with tooth decay numerically defined on a 1-5 scale, (1 -occlusal and incisal, 2 -mesial, 3 -distal, 4 -vestibular, 5 -oral). Fourth column consists of data assessing tooth decay depth and it is numerated 1-4, (1 -superficial, 2 -medium and deep, 3 -dental cavity trepanation, 4 -radix). Data on teeth abrasion were summerized up in the fifth table and expressed on a 0-4 scale (0 -tooth without abrasion, 1 -enamel abrasion, 2 -dentin abrasion, 3 -abrasion with dental cavity trepanation, 4 -radix). Sixth column shows data on existing levels of tooth tartar on a 0-3 scale, (0 -without tartar, 1 -1/3 of tooth covered by tartar, 2 -2/3 of tooth covered by tartar, 3 -tooth completely covered by tartar). Seventh column generates data on existing macroscopically visible periapical lesions (0 -not present, 1 -≤5mm in diameter, 2 ->5mm in diameter).
Ordinary number of teeth [17,18,19] defined the number of rows in each of the two tables. All eventual findings on exceeded number of teeth were stated as anomalies in the space for additional comments.

RESULTS AND DISCUSSION
It was established after dental examination that there is not enough dental status data for the three individuals from graves 8, 14 and 15, and that the skeleton number 13 was on the display "in sittu" as a permanent museum exponent and not available for analysis. Therefore, the total number of samples included in this study was 16 skeletons, two children and 14 aduls. Adult group consisted of 13 male and 1 female individual.
Oral status of 14 adult individuals is shown in Table  1. There were 256 present teeth, 28 have been lost during lifetime and 79 lost after death during excavation or storing in the museum collection. There were 28 tooth roots found due to pathological processes that occurred during life. It was found with high certainty, that for 6 teeth, roots existed in the moment of death that indicated their loss after death. Through macroscopic analysis data was gathered on 406 teeth in total.
Knowing that both aforementioned taxons that examined skeletons belong to have number of teeth and teeth formula similar to present-day humans (32 teeth: 8 incisors, 4 canines, 8 premolars and 12 molars), it can be said that the status of 90% of teeth was defined within this study, with respect to the initial assumption that ideally (completely preserved dentition) there would be a sample of 448 teeth present (14x32).
Beside aforementioned, it is also possible to add results on data from another 11 molars (5 upper and 6 lower), representing 2.9% of all teeth. It was determined with high certainty these teeth did not erupt before the mo-  of death of an individual. It's valid to assume that in one sample (skeleton number 17) all four third molars were missing, due to the fact that the individual was less than 17 years old at the moment of death. Other seven third molars were probably left impacted because of their belonging to already mature individuals with formed dentition at the moment of death.
For the 29 teeth left (6.5%) it was not possible to collect data due to partial or complete devastation of jaws. In one case (skeleton number 13) maxillofacial segment was not complete, lacking the lower jaw with all 16 teeth (3.6%).
Optimal number of 448 teeth, which theoretically could have been present in all adult individuals at the moment of death, lacks another 13 teeth (2.9%) as it was not possible to determine their status due to skeletal devastation and loss of alveolar bone.
Teeth abrasion was dominant pathological finding in this neolith group. From 265 present teeth, this pathological process was found on 260 of them (98.1%). Different levels of tooth wearing were present. Most common was level 2 abrasion present on 137 (51.7%) of the total number of present teeth (Picture 3). There was similar number of teeth found with level 3 -43 teeth (16.2%) and level 1 abrasion -42 teeth (15.9%). The most severe case of abrasion (level 4) with certain dental cavity trepanation and total crown loss was identified on 38 teeth (14.3%). Similar findings for the neolith culture of Lepenski Vir were significantly lower, indicating that slightly more than half of total number of teeth was exposed to some level of abrasion (55%) [16]. Apart from that, abrasion was an eminent occurrence for all human populations of mesolith and neolith. Explanation to such tooth wear in the neolith population of Gomolava, can be found in the fact that 13 of 14 examined skeletons (93%) belong to mature and senile life chapters, meaning these individuals were in their fifth, sixth or seventh life decade at the moment of death.
Three male individuals belonging to mature age category were identified to have tooth decay. Tooth decay was found on 5 (1.9 %) of the total number of present teeth. Two lower incisors of the same skeleton were affected by tooth decay level 2 on their facing proximal surfaces. On the upper jaw of the same skeleton, level 1 tooth decay was identified on the occlusal surface of second molar. Other two teeth with decay were found on different skeletons. Both developed on molars. One affected two surfaces reaching as far as dentin (Picture 4) and the other one developed over three surfaces, causing dental cavity trepanation (level 3).
Dental calculus deposits were identified on 119 present teeth (44.9%). Most of them were level 1 deposit on 106 teeth (89%). One tooth was completely covered by calculus (level 3).
Due to resorption and perforation of alveolar bone during life, or devastation of porous bone under grave soil, it was sometimes possible to macroscopically detect periapical changes on teeth. This study examined and identified such lesions in 12 cases. In 10 cases the extent of the lesion was level 1, and in other two level 2 lesions were found (Picture 5).
Changes to the alveolar bone were also found on some of the skeletal remains of human populations of Gomolava site, which indicated the presence of periodontal disease. Eight persons had alveolar bone resorption and roots exposed in the level of their furcation. These resorptions ranged from 3 to 7 mm.
This study also showed two significant findings on tooth roots status. The first one was the number of roots present (28), which was relatively high and equal to the number of teeth lost during life, especially when there are 6 samples of shallow and non-healed alveolus indicating roots came out just before, or more probably after death. Second one shows tooth crowns were completely devastated under some pathological process or trauma during life. It was not rare to detect periapical processes around tooth roots. Analysis of this osteological material showed the presence of 28 tooth roots within jaws of 8 individuals, as well as another 6 cases where root was lost after death. In the apical area of identified roots 5 periapical lesions were registered (four level 1 and one level 2). Etiological factor for this pathological occurrence on 31 teeth was most probably abrasion. Tooth decay was not present on other teeth, while surrounding ones had level 3 and level 4 abrasions. In three cases loss of tooth crown could be assigned to tooth decay, because other teeth are preserved, with low-level abrasion. In that case, percentage of tooth decay for the Gomolava human population would rise from 1.95 to 3%, which is still lower than the values determined by Zofmann [12]. In her studies tooth decay was found in 3.7% of cases that is significantly higher than average values for that period. Regarding tooth decay, it's incidence during neolith on the territory of modern Eu-rope varied from 1.4% to 3.2% and that is in accordance with findings of the current study for the Gomolava site. Analysis of teeth from skeletons in the Iron Gate series from the territory of Iron Gate (modern day Serbia) found that tooth decay affected 1.28% teeth of 3.76% individuals from the neolith culture of Lepenski Vir [15,17,[19][20][21][22].
Child skeletons belonged to the infants II age group, being at the time of death between 6-8 years of age, with presence of mixed dentition. It was concluded that the data in this study showed information on primary dentition and positions of first and second permanent molars and incisors. Permanent dentition of both individuals consisted of four first molars and two second molar germs in the upper jaw of one individual. Permanent dentition also included 8 incisors (5 upper and 3 lower). It was found that at the moment of death, additional seven permanent teeth were present, probably lost during excavation or storing. All permanent teeth were healthy, without any present tooth decay, abrasion, deposits, anomalies or periodontal changes ( Table 2).
Primary dentition had 19 teeth present (47%) mostly molars (16) and canines (3). Remaining three canines were lost after death; one primary incisor was lost during life confirmed by the presence of agnate alveolus. One person was identified with class II tooth decay, which developed over occlusal and proximal surfaces of all four upper molars. Nine primary teeth were affected with abrasion (five level 1, four level 2). Deposits on teeth, tooth and jaw anomalies as well as changes on the periodontal tissues were not detected (Table 3).
This study showed with high certainty that after eight millenniums two children from the period of the Vinca culture, had completely preserved dentition that suits their age at the time of their death. Their skeletal remains showed they had all primary molars and canines, four permanent molars both, one primary and 15 permanent  incisors with one primary incisor being lost during life. Level 1 and level 2 abrasions were present on primary teeth, and in one case four teeth of class II level 2 tooth decay (caries media).

CONCLUSION
Taking into account the absolute age of examined skeletons, collected data are very significant, from the perspective of its wide content. Almost 8 millenniums ago human population had two dentitions. Tooth abrasion was dominant feature detected on most permanent teeth. In childhood it appeared in mixed dentition on primary teeth. Tooth decay affected both permanent and primary teeth, in low percentage, as typical for that period. Dental calculus was identified on almost half of teeth present. Signs of periodontal disease and periapical lesions were found.

ACKNOWLEDGEMENT
Courtesy of academics Bogdan Brukner and Borislav Jovanovic enabled us insight into the structure and documentation for this work, for which we express our deepest respect and gratitude.