To analyze the etiological factors behind the malocclusion of a Late Pleistocene woman (named Naia), who is the best-preserved of the earliest individuals of the American continent. The examination of Naia's malocclusion was performed through cephalometric and occlusal analyses, and by measuring her mandible. Her data were then compared to published data for modern, medieval, and postmedieval samples and seven Late Pleistocene individuals. Naia presented her permanent dentition fully erupted, except for the impacted mandibular third molars. She presented a class II molar malocclusion with crowding. The dental widths and mandible measurements were similar to or smaller than modern standards. The degree of dental wear was light. The cephalometric analysis confirmed a skeletal class II relationship, with a retrusive mandible and protruded upper incisors. Naia's mild level of dental wear is consistent with a low masticatory force, in a time when the norm was a high amount of grinding. The low masticatory forces help explain Naia's small jaws and crowding. However, it does not clarify Angle's class II relationship. Naia is an example that environmental factors are insufficient to explain the onset of malocclusions and emphasizes the importance of understanding hereditary factors' role.
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