Methods: The sample consisted of the skeletal remains of 60 individuals. Only mandibles in a good state of preservation were studied. All teeth were radiographed and observed macroscopically. Caries were diagnosed, and location and lesion level were noted. Wear was graded according to the Brabant index with two parameters, quantity and direction of wear. Apical lesions were classified into three groups: abscess (assumed if diameter <3mm), and cysts (assumed if diameter >3 mm), with or without fistulae. Two practitioners noted all data. The statistical significance of recorded values was tested. A P value of less than 0.05 was considered as statistically significant.
Results: Apical lesions affected 21 individuals and 36 lesions were diagnosed on the 788 teeth examined. 12 lesions were assumed to be periapical granulomas: 58.33% of teeth were not carious and attrition was more than level 3 in 58.33%. 14 lesions were cysts without fistulae: 64.28% were located on retained teeth and the quantity of wear was more than level 3 in the other cases. 10 lesions were cysts with fistulae: 70% with gross caries reaching the pulp but attrition was generally less than level 2.
Conclusion: To our knowledge no study has compared the association of coronal wear and dental caries in the development of apical lesions. These findings show that there could have been different ways of developing such a disease. Attrition has an important impact on small lesions. For cyst lesions, retained teeth and gross dental caries are the principal factors of disease. Presence or absence of fistulae is connected with coronal lesions.