The importance of CBCT imaging to determine the characteristics of a bone sequestrum in a case of chronic osteomyelitis

Chronic osteomyelitis may show a suppurative course with abscess or fistula formation and sequestration at some stages, and persist for a variable period up to many years with intermittent exacerbation. The importance of imaging in osteomyelitis is threefold: to localize the condition, to find out its extent, and to assess the response after treatment. Conventional multislice computed tomography is a useful method of preoperative assessment, but it is not considered as the initial choice for imaging in osteomyelitis because of its reported lack of sensitivity in bone marrow disease. The Cone Beam Computed Tomography (CBCT) is used in dentistry to image high-contrast objects such as teeth and bone and it is particularly important for several applications including treatment planning for dental implants and evaluating dental and osseous diseases in the jaws and temporomandibular joints. However, CBCT provides a lower dose, lower cost alternative to conventional CT that promises to improve the practice of oral and maxillofacial radiology. In this case report the management of a patient with persistent suppurative osteomyelitis and its treatment assisted by Cone Beam Computed Tomography (CBCT) are presented

Imported Amphora forms found around the North Fortification walls of Parion in 2017 season

Parion, Antik Troas Bölgesi’nin önemli liman kentlerinden biridir. Antik kent bugünkü Çanakkale İli, Biga İlçesi, Kemer Köyü sınırları içerisinde yer almaktadır. Kuzey Surları, Parion kentinin Propontis’e (Çanakkale Boğazı) bakan jeopolitik yönden önemli bir konumunda yerleştirilmiştir. Kente ait Kuzey Surları çevresinde 2017 kazı sezonu içerisinde yüzey araştırmaları gerçekleştirilmiştir. Surların çevresinde farklı üretim merkezlerine ait amphora parçaları tespit edilmiştir. Yüzey araştırmasında farklı tipteki ticari amphoralara rastlanılması bölgedeki ticaret trafiğini göstermesi açısından önemlidir. Bu çalışmanın amacı, yüzey gezileri sırasında bulunan amphora gruplarını tanımlamak, sınıflandırmak, tarihlendirmektir. Bu amphoralar, depozit ya da kontekst buluntuları olmadıkları için, benzer örneklerden yola çıkılarak tarihlenmiştir. Kuzey Surları çevresinde saptanan amphoraların ilk kez çalışılması, bu yapının kullanımına dair öneriler getirecek olması açısından önemlidir. Parion Kuzey Surları çevresinde bulunan amphoralar tipolojik olarak sınıflandırıldığında 10 farklı grup tespit edilmiştir. Bu amphoraların Milethos, Samos, Chios, Mende, Lesbos, Knidos, Thasos, Akanthos, Kilikya Bölgesi ve Ganos (Gaziköy) gibi merkezlerlerden ithal edilen üretimlerden olduğu tespit edilmiştir. Surların çevresinde ele geçen bu gruplar; MÖ 6. yüzyıldan MS 11. yüzyıla kadar kentte ticaretin yapıldığına işaret etmektedir. Ayrıca, Ege ve Doğu Akdeniz Bölgesi kökenli amphoraların buluntular arasında yoğunlukta olduğu görülmektedir. Bu yoğunluktan hareketle Parion’un bu bölgelerdeki merkezler ile daha aktif ticari faaliyetler yürütmüş olabileceğine ihtimal verilmektedir.Parion is one of the important port cities of the Ancient Troad Region. The ancient city is located within the boundaries of today's Çanakkale Province, Biga District, Kemer Village. The Northern Fortification Walls are located in a geopolitically important position of the city of Parion, facing the Propontis (Çanakkale Strait). Surveys were carried out around the Northern Fortification Walls of the city during the 2017 excavation season. Amphora fragments belonging to different production centers were found around the fortification walls. The discovery of different types of commercial amphorae during the survey is important in terms of showing the trade traffic in the region. The aim of this study is to identify, classify and date the amphora groups found during the surface expeditions. Since these amphorae are not deposits or context finds, they were dated based on similar examples. Studying the amphorae found around the Northern Walls for the first time is important in terms of making suggestions for the use of this structure. When the amphorae found around the Parion Northern Fortification Walls were classified typologically, 10 different groups were identified. It was determined that these amphorae were imported from centers such as Milethos, Samos, Chios, Mende, Lesbos, Knidos, Thasos, Akanthos, Cilicia Region and Ganos (Gaziköy). These groups unearthed around the fortification walls; It indicates that trade was carried out in the city from the 6th century BC to the 11th century AD. In addition, it is seen that amphorae originating from the Aegean and Eastern Mediterranean Regions are among the finds. Based on this density, it is possible that Parion may have carried out more active commercial activities with the centers located in the two regions. Based on this density, it is possible that Parion may have carried out more active commercial activities with the centers in these regions

Mandibular üçüncü molarların angulus kırığı oluşumu üzerine etkisi

<p>The purpose of this study was to estimate the relative risk of mandibular angle fractures among people with a lower third molar compared with those without a lower third molar. For this purpose, database research was performed on a whole PUBMED/MEDLINE by using key words “mandibular third molars” and “angle fractures”. The data obtained from 9 articles that had a similar statistical analysis; and that included mandibular angle fractures and other mandibular fractures as a control group were evaluated statistically. In these 9 retrospective cohort studies, the sum of cases was 6466 and the sum of mandibular angle fractures was 1769. The analysis of articles shows a relative risk for a mandibula to fracture, comparing patients with and without third molars, ranging from 1,2 to 3.6. The estimated relative risk across the 9 studies was 2.14 (95% CI 1.92–2.39). The results obtained in this study suggest that the presence of lower third molar may double risk of an angle fracture of the mandible.</p> <p><strong>Keywords: </strong>Mandibular angle fractures, mandibular third molars, relative risk.</p><p> </p><p><strong>ÖZET</strong></p> <p>Bu makalenin amacı, mandibular 3. molar dişe sahip olan ve olmayan bireylerde mandibula angulus kırığı oluşma riskinin belirlenmesidir. Bu amaçla, “mandibular third molars” ve “angle fractures” anahtar kelimeleri kullanılarak PUBMED/MEDLINE veri tabanında literatür taraması gerçekleştirildi. Birbirine benzer istatiksel analiz yapmış ve mandibula angulus kırıkları ile beraber kontrol grubu olarak kabul edilebilecek şekilde diğer mandibula kırıklarını çalışmalarına dâhil etmiş 9 adet makaleden elde edilen veriler istatiksel olarak değerlendirildi. Bu makalelerdeki retrospektif kohort çalışmadaki vaka sayısı 6466 ve mandibula angulus kırığı sayısı 1769’idi. Çalışmalardaki rölatif risk değerleri, 1,2 ile 3,6 arasında hesaplandı. Ayrıca rölatif risk ortalamasının 2,14 olduğu belirlendi  (%95 güven aralığı 1,92–2,39). Sonuç olarak mandibular 3. molar dişe sahip olan bireylerin olmayanlara göre ortalama 2 kat daha fazla mandibula angulus kırığı oluşma riskine sahip oldukları bulundu.</p&gt

Effects of orthodontic treatment and premolar extractions on the mandibular third molars

Background: The space available for an unerupted mandibular third may depend on the choice of premolar extracted.Aims: To investigate the effects of orthodontic treatment and premolar extractions on the inclinations of the mandibular third molars and the space available for their eruption, and to compare these changes with a nonextraction group.Methods: The pre- and post-treatment panoramic radiographs of 54 subjects (20 males, 34 females) were used. Eighteen of these subjects had the four first premolars extracted, 16 subjects had four second premolars extracted and 20 subjects were treated nonextraction. Changes in the inclinations and spaces available for the unerupted third molars were compared.Results: In the nonextraction group the third molars uprighted approximately 1 degree and in the second premolar extraction group the third molars uprighted 10 degrees. The spaces available for the third molars increased significantly in the first and second premolar extraction groups as compared with the space available in the nonextraction group.Conclusions: Orthodontic treatment and extraction of the second premolars improved the inclinations of unerupted third molars and the space available for their eruption into the arch. The changes in inclination and eruption space were less marked following first premolar extractions. (Aust Orthod 2010; 26: 160-164

A Case of Mortal Klatskin Tumor with Bacteriemia after ERCP

KARA, ISMAIL HAMDI/0000-0003-2022-1882; KARA, ISMAIL HAMDI/0000-0003-2022-1882WOS: 000363103100009Due to the late onset of symptoms, Klatskin tumors or hilar cholangiocarcinoma are usually diagnosed late and long-term life expectancy is very low. In this case, an 83-year-old female patient with diagnosis of obesity and depression was admitted to Family Medicine Outpatient Clinic in Duzce University Medical Faculty because of abdominal pain and nausea ongoing for two days. In hepatobiliary ultrasound examination made in Family Medicine Clinic, gallbladder diameter was 50 mm and bile duct was seen distended to 14 mm. With these findings the patient was assessed by Infectious Diseases and Gastroenterology Clinic. She was directed outside the province for an endoscopic retrograde cholangiopancreatography (ERCP). After ERCP clinical situation is further aggravated by developed bacteremia. Due to the late onset of symptoms of the disease, as in our case, and developing bacteremic infections, the disease has resulted in a rapid mortality. In this case, it has been evaluated that table of bacteremic infection superimposed invasive medical procedures resulted to severe prognosis and increases the mortality in elderly patient with Klatskin tumor