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Dental abscesses on the maxilla of a two million-year-old early Homo specimen

Abscesses and other periapical lesions are found in abundance in recent archeological samples, yet are scarce in the fossil hominin record. Periapical voids commonly develop after exposure of a tooth’s pulp chamber and are commonly associated with heavy crown wear, trauma or caries. In this study, all available maxilla and mandible fragments from the South African fossil hominin collections were studied, including specimens assigned to Homo naledi, Paranthropus robustus, Australopithicus africanus, A. sediba and early Homo. Only one specimen displayed voids consistent with periapical lesions, and a differential diagnosis of these voids was undertaken. The specimen, SK 847, is described as early Homo and has been dated to 2.3-1.65MA. There is one definite abscess, and likely at least two more with postmortem damage, all on the anterior aspect of the maxilla and associated with the incisors. The abscesses originate from the apices of the incisor roots and are therefore unlikely to represent a systemic disease such as multiple myeloma. They best fit the description of an abscess rather than a cyst or granuloma, with one showing a rounded thickened rim around the lesion. The abscesses highlight that this individual used their anterior dentition extensively, to the point that the pulp chambers were exposed on multiple teeth. This is one of the earliest hominin examples of a dental abscess and shows that this individual was able to cope with several concurrent abscesses, clearly surviving for an extended period. Therefore, this finding adds additional information to the history of dental pathology in our genus.