Pathology of the Mandibles and Maxillae from Archaeological Context: Discrepancy between Diagnoses Obtained by External Inspection and Radiological Analysis

The goal of this research was to investigate the type and frequency of mandibular and maxillary lesions that could not be diagnosed relying solely on external macroscopic observation. The sample comprised of 189 maxillae and 182 mandibles from a late-medieval graveyard. The material was examined both macroscopically and radiologically, using traditional X-ray facilities, orthopantomographs, and a dental X-ray unit. The total number of lesions detected by radiography was 103, with the majority of them (90.3%) showing no external macroscopic features. The most frequently detected diseases were periodontal inflammatory lesions (64.1%), followed by developmental anomalies of the teeth (22.3%). The results of this study revealed that radiography allowed the detection of many underlying pathological lesions of the jaws that otherwise were not detected through external macroscopic examination

Paranasal sinus osteoma: is there any association with anatomical variations?

Background: Developmental disturbances of the paranasal sinuses are proposed as the cause of osteoma. We examined whether such disturbances may result in the frequent presence of anatomical variations of the paranasal sinuses in patients with osteoma. Methodology/Principal: The study was performed retrospectively on 2,820 patients subjected to CT examination during 2005 - 2011. Demographic and CT characteristics of osteoma, and associated pathological findings were evaluated for 104 patients with diagnosed osteoma. The presence of anatomical variations was assessed for 51 osteoma patients with a complete medical history, and for 1,233 patients from a control group. Results: The prevalence of osteomas was found to be 3.69%, with male to female ratio 1.08:1. The frontal sinus was most commonly affected, The presence of anatomical variations was more frequent in patients with osteoma than in controls, with significant differences confirmed for the sphenomaxillary plate, infraorbital cell, and crista galli pneumatization. Conclusions: The paranasal sinus osteoma is associated with higher prevalence of anatomical variations, This can be explained either by the stronger influence of genetic and/or environmental factors on the development of the paranasal sinuses in patients with osteoma, or by their higher susceptibility to abovementioned factors

Sistemska nemaligna osteoporoza skeleta i resorpcija bezubih grebenova vilica

Introduction. Systemic osteoporosis damages skeletal bones to different degrees. The aim of this study was to determine the intensity and correlation of the osteoporotic changes in the bone density of the skeleton and body mass index (BMI) with a reduction in edentulous mandibles, and to assess possibility of reparation of layers of mandibles with increase of mineral content in jaws of patients affected by osteoporosis. Material and Methods. In this study, 99 edentulous patients with decreased bone density comprised the experimental group, and 48 edentulous patients with normal bone densities formed the control. The age of the examined patients was 69.02 ± 7,9, range 53-74 of females and 69.11 ± 7.1, range 59-76 years. Radiographs of the hands and panoramic radiographs were done for all the patients. The values of BMI, metacarpal index, density of lumbar spine (L2-L4), in the phalanx and in segments of the mandibles as well as the edentulous alveolar ridges heights were measured, assessed and calculated. Results. The lowest value of the total skeletal density was established in the osteoporotic patients on the basis of the average T-score of- 2.5 in men, and - 2.6 in women. Minimum values of the edentulous ridges heights (right/left, in mm) were measured in both osteoporotic females (21.84/22.39) and males 24.90/24.96) patients. By comparison of the densities of the metacarpal bones, proximal phalanx, segments of the edentulous mandibles and based on the numerical values of the edentulous ridges heights, x2 = 3.81 was found in men and x2 = 4.03 was found in women with normal bone densities; x2 = 5.92 was found in men and x2 = 6.25 was found in women with osteopenia; x2 = 2.63 was found in men and x2 = 3.85 was found in women with osteoporosis, on the level of probability of 0.05. After application of calcium and calcitonin in solutions, moderate increment of density (p lt 0.05; p lt 0.01) was verified, compensating up to 4% of total loss of mass, minerals and solidity of denture bearing areas of osteoporotic mandibles. Conclusion. Systemic osteoporosis leads to decrease of densities of bones of mandibles and causes reduction of edentulous ridges.Uvod. Sistemska osteoporoza oštećuje kosti humanih skeleta u različitoj meri. Cilj ove studije je bio da se utvrde intenzitet i povezanost promena u gustini skeleta usled osteoporoze i indeks telesne mase (BMI) sa redukcijom bezube mandibule, i da se proceni mogućnost reparacije slojeva u mandibuli praćena porastom mineralnog sadržaja u vilicama pacijenata obolelih usled osteoporoze. Materijal i metode. U ovoj studiji, 99 bezubih pacijenata sa smanjenom gustinom kosti su sačinjavali eksperimentalnu grupu, a 48 bezubih pacijenata sa normalnom gustinom kosti su bili kontrolna grupa. Godine starosti ispitanih pacijenata i pacijentkinja su iznosile 69,02 ± 7,9, u granicama od 53 do74 godine kod žena, i 69,11 ±7,1, u granicama od 59 do76 godina kod muškaraca. Radiografije šaka i ortopantomogrami sunačinjeni kod svih ispitanih pacijenata. Vrednosti BMI, metakarpalnih indeksa, gustine tela lumbalnih pršljenova (L2-L4), u falangama i u segmentima donjih vilica, a takođe i visine bezubih alveolarnih grebenova su bile ispitane, izmerene i izračunate. Rezultati. Najmanja vrednost ukupne gustine skeleta je utvrđena kod pacijenata obolelih od osteoporoze na osnovu T veličine od -2,5 kod muškaraca, i -2,6 kod žena. Minimalne vrednosti visina bezubih grebenova (desno/levo, u mm) su bile izmerene i kod žena (21,84/22,39) i kod muškaraca (24,90/24,96) obolelih od osteoporoze. Upoređivanjima gustina metakarpalnih kostiju, proksimalnih falangi, segmenata (prostora) bezubih mandibula, i na osnovu numeričkih vrednosti izmerenih visina bezubih grebenova, x2 = 3,81 je izračunato kod muškaraca, a x2 = 4,03 kod žena sa normalnom koštanom gustinom; x2 = 5.92 je izračunato kod muškaraca, a x2 = 6,25 kod žena sa osteopenijom; x2 = 2,63 je izračunato kod muškaraca, a x2 = 3,85 je izračunato kod žena sa osteoporozom, na osnovu nivoa verovatnoće od 0,05. Posle aplikovanja kalcijuma i kalcitonina u rastvoru, umeren porast gustine (p lt 0,05; p lt 0,01) je zabeležen, nadoknađujući, na taj način ukupno do 4% gubitka koštane mase i mineralnog sadržaja u nosećim i potpornim tkivima osteoporoznih donjih vilica. Zaključak. Sistemska osteoporoza dovodi do smanjenja gustine kosti donje vilice i uzrokuje resorpciju bezubih grebenova

Hyoid Bone and Thyroid Cartilage Metastases from Sigmoid Colon Adenocarcinoma: A Case Report

Background: Secondary tumours of the hyoid bone and thyroid cartilage are extremely rare. In this paper, we present a case of the hyoid bone and thyroid cartilage metastases in a patient treated for sigmoid colon adenocarcinoma. Case Report: Four years after sigmoid colon adenocarcinoma was diagnosed and treated with surgery and chemotherapy, the patient developed bone metastases in the left sacroiliac joint and right proximal humerus. Although the patient did not complain of any related symptoms, in a bone scintigraphy the accumulation of Technetium-99m was incidentally detected in the two sites of the anterior neck. On ultrasound examination there were two hyperechoic and heterogeneous masses with calcifications placed in front of the hyoid bone and thyroid cartilage. Computerized tomography demonstrated massive hyoid bone and thyroid cartilage destruction. Conclusion: In patients with progressive sigmoid colon adenocarcinoma, destruction of the hyoid bone and thyroid cartilage could be suspected for metastases

Suitability of leached soils of Western Serbia for potato growing

Potato can be grown on a large number of soil types. In order to determine the suitability of leached soils for potato growing in Western Serbia, a trial was set up with the aim of observing agrophysical and agrochemical properties of this type of soil in the region of the Radočelo mountain massif in 2020. Three soil profiles were opened. Results pointed out that leached soils of Western Serbia are suitable for potato growing according to their agrophysical properties, but unfavourable as regards some agrochemical parameters (a low content of available phosphorus, high values of active, exchangeable, and hydrolytic acidity). Nevertheless, it is possible to achieve high yields that approach the biological potential of potato using appropriate soil amendment practices (timely application of proper amounts of the complex NPK fertiliser with increased phosphorus and potassium levels, basal liming of the soil along with manuring, and use of physiologically neutral nitrogen fertilisers)

Ispitivanje kapaciteta konvencionalne i digitalne radiografije za utvrđivanje razlika kod materijala na radiogramu zavisno od prisutnog kontrastnog sredstva

Bacground/Aim. The radiopacity of an endodontic material can considerably vary as measured on film and a digital sensor. Digital radiography offers numerous advantages over convential film-based radiography in dental clinical practice regarding both diagnostic capabilities and postintervention procedures. The aim of this study was to investigate the capacity of conventional and charge-conpled device (CCD) based digital radiography to detect material on radiograph depending on the radio-pacifying agent present in the material. Methods. Experimental cements were formulated by mixing Portland cement with the following radiopacifying agents: zinc oxide (ZnO), zirconium oxide (ZrO2), titanium dioxide (TiO2), barium sulphate (BaSO4), iodoform (CHI3), bismuth oxide (Bi2O3) and ytterbium trifluoride (YbF3). In addition, 5 endodontic materials comprising Endomethasone®, Diaket®, N2®, Roth 801® and Acroseal® were investigated to serve as control. Per three specimens of each material were radiographed alongside an aluminum step wedge on film (Eastman Kodak Company®, Rochester, NY) and a CCD-based digital sensor (Trophy Radiologie®, Cedex, France). Radiopacity values were calculated by converting the radiographic densities of the specimens expressed as a mean optical densities or mean grey scale values into equivalent thickness of aluminum. Results. Twoway ANOVA detected no significant differences with respect to the imaging system (p > 0.05), but the differences were significant with respect to radiopacifier (p lt 0.001) and the interaction of the two factors (p lt 0.05). Paired ttest revealed significant differences between the methods used for pure Portland cement, all concentrations of BaSO4 and CHI3, 10% and 20% additions of ZrO2 and Bi2O3 and 10% and 30% addition of YbF3 (p lt 0.05). Conclusion. The materials which incorporate CHI3 or BaSO4 as radiopacifying agents are expected to be significantly more radiopaque on a digital sensor than on film. During clinical practice one should concern to the quality of contrast assessement obtained by digital according to conventional radiography.Uvod/Cilj. Radiokontrastnost jednog endodontskog materijala može znatno varirati u zavisnosti od toga da li je određivano na filmu ili digitalnim senzorom. Digitalna radiografija pruža mnogobrojne prednosti u odnosu na konvencionalnu radiografiju u svakodnevnoj stomatološkoj kliničkoj praksi, kako u pogledu dijagnostičkih mogućnosti, tako i u praćenju rezultata lečenja. Cilj ove studije bio je da se ispitaju mogućnost i konvencionalne i charge-conpled device (CCD) digitalne radiografije za vizualizaciju materijala na radiogramu u zavisnosti od kontrastnog sredstva prisutnog u materijalu. Metode. Eksperimentalni cementi su pripremljeni dodavanjem sledećih kontrastnih sredstava u Portland cement: cink-oksid (ZnO), cirkonijum-oksid (ZrO2), titanijum-dioksid (TiO2), barijum-sulfat (BaSO4), jodoform (CHI3), bizmut-oksid (Bi2O3) i iterbijum-trifluorid (YbF3). Takođe, ispitivano je pet kontrolnih endodontskih cementa: Endomethasone®, Diaket®, N2®, Roth 801® i Acroseal®. Po tri uzorka svakog materijala su radiografisana pored aluminijumskog stepeničastog etalona na filmu (Eastman Kodak Company, Rochester, NY) i CCD digitalnom senzoru (Trophy Radiologie, Cedex, France). Vrednosti rendgenkontrastnosti izračunavane su konverzijom radiografskih gustina uzoraka izraženih optičkim gustinama ili stepenom tona sivo-bele skale u odgovarajuću debljinu aluminijuma. Rezultati. Dvostrukom analizom varijanse nije ustanovljena statistički značajna razlika između primenjenih metoda radiografisanja (p > 0.05), ali su vrsta kontrastnog sredstva (p lt 0.001) i interakcija ova dva faktora (p lt 0.05) bili značajno različiti. Upareni t-test pokazao je statistički značajnu razliku između korišćenih metoda za čisti Portland cement, sve koncentracije BaSO4 i CHI3, 10% i 20% dodatka ZrO2 i Bi2O3 i 10% i 30% dodatka YbF3 (p lt 0.05). Zaključak. Očekuje se da materijali koji sadrže CHI3 ili BaSO4 kao kontrastna sredstva budu lakše uočljivi na digitalnom senzoru nego na konvencionalnom dentalnom filmu. U kliničkom radu mora se imati u vidu kvalitet procene kontrasta koju pokazuje digitalna slika u odnosu na sliku dobijenu konvencionalnom radiografijom

An aggressive chondroblastoma of the knee treated with resection arthrodesis and limb lengthening using the Ilizarov technique

This case report describes the management of a 15 year old male with a biologically aggressive chondroblastoma of the knee. Following CT, bone scan, angiography and an open biopsy, the diagnosis was confirmed histologically and immunohistochemically. The patient underwent a 13 cm en-bloc excision of the knee, and knee arthrodesis with simultaneous bone transport using an Ilizarov ring fixator. Following 136 days of bone transport, the patient achieved radiological and clinical bony union after a total frame time of 372 days. He then commenced 50% partial weight-bear in a protective knee brace and gradually worked up to full weight-bearing by 4 months. The patient developed superficial pin tract infections around the k-wires on 2 occasions; these settled with a cephalosporin antibiotic spray and local dressings. At 13 years follow-up there are no signs of disease recurrence or failure at the fusion site. The patient is able to fully weight bear and stand independently on the operated leg. Knee arthrodesis with simultaneous limb-lengthening is an effective treatment modality following en-bloc resection of an aggressive chondroblastoma. The case is discussed with reference to the literature

The treatment of scaphoid nonunion using the Ilizarov fixator without bone graft, a study of 18 cases

<p>Abstract</p> <p>Objectives</p> <p>Evaluating the safety and efficacy of the Ilizarov fine-wire compression/distraction technique in the treatment of scaphoid nonunion (SNU), without the use of bone graft.</p> <p>Design</p> <p>A retrospective review of 18 consecutive patients in one centre.</p> <p>Patients and Methods</p> <p>18 patients; 17 males; 1 female, with a mean SNU duration of 13.9 months. Patients with carpal instability, humpback deformity, carpal collapse, avascular necrosis or marked degenerative change, were excluded. Following frame application the treatment consisted of three stages: the frame was distracted 1 mm per day until radiographs showed a 2-3 mm opening at the SNU site (mean 10 days); the SNU site was then compressed for 5 days, at a rate of 1 mm per day, with the wrist in 15 degrees of flexion and 15 degrees of radial deviation; the third stage involved immobilization with the Ilizarov fixator for 6 weeks. The technique is detailed herein.</p> <p>Results</p> <p>Radiographic (CT) and clinical bony union was achieved in all 18 patients after a mean of 89 days (70-130 days). Mean modified Mayo wrist scores improved from 21 to 86 at a mean follow-up of 37 months (24-72 months), with good/excellent results in 14 patients. All patients returned to their pre-injury occupations and levels of activity at a mean of 117 days. Three patients suffered superficial K-wire infections, which resolved with oral antibiotics.</p> <p>Conclusions</p> <p>In these selected patients this technique safely achieved bony union without the need to open the SNU site and without the use of bone graft.</p

3D-Microarchitectural patterns of Hyperostosis frontalis interna: a micro-computed tomography study in aged women

Although seen frequently during dissections and autopsies, Hyperostosis frontalis interna (HFI) - a morphological pattern of the frontal bone thickening - is often ignored and its nature and development are not yet understood sufficiently. Current macroscopic classification defines four grades/stages of HFI based on the morphological appearance and size of the affected area; however, it is unclear if these stages also depict the successive phases in the HFI development. Here we assessed 3D-microarchitecture of the frontal bone in women with various degrees of HFI expression and in an age- and sex-matched control group, hypothesizing that the bone microarchitecture bears imprints of the pathogenesis of HFI and may clarify the phases of its development. Frontal bone samples were collected during routine autopsies from 20 women with HFI (age: 69.9 +/- 11.1years) and 14 women without HFI (age: 74.1 +/- 9.7years). We classified the HFI samples into four groups, each group demonstrating different macroscopic type or stage of HFI. All samples were scanned by micro-computed tomography to evaluate 3D bone microarchitecture in the following regions of interest: total sample, outer table, diploe and inner table. Our results revealed that, compared to the control group, the women with HFI showed a significantly increased bone volume fraction in the region of diploe, along with significantly thicker and more plate-like shaped trabeculae and reduced trabecular separation and connectivity density. Moreover, the inner table of the frontal bone in women with HFI displayed significantly increased total porosity and mean pore diameter compared to controls. Microstructural reorganization of the frontal bone in women with HFI was also reflected in significantly higher porosity and lower bone volume fraction in the inner vs. outer table due to an increased number of pores larger than 100m. The individual comparisons between the control group and different macroscopic stages of HFI revealed significant differences only between the control group and the morphologically most pronounced type of HFI. Our microarchitectural findings demonstrated clear differences between the HFI and the control group in the region of diploe and the inner table. Macroscopic grades of HFI could not be distinguished at the level of bone microarchitecture and their consecutive nature cannot be supported. Rather, our study suggests that only two different types of HFI (moderate and severe HFI) have microstructural justification and should be considered further. It is essential to record HFI systematically in human postmortem subjects to provide more data on the mechanisms of its development

Study toward resolving the controversy over the definition of allergic fungal rhinosinusitis

Dysbiosis of the microbiome on the airway mucosa leads to the development of chronic inflammatory and allergic disorders. The aim of this study was to consider the potential diagnostic criteria for allergic fungal rhinosinusitis (AFRS) and nonallergic fungal rhinosinusitis (FRS), and the role of fungal presence in an environment for the development of AFRS. In this study, 136 patients were divided into two groups: patients with positive specific immunoglobulin E (sIgE) and fungal finding (AFRS group), and patients with negative sIgE and positive fungal finding (FRS group). The study design included: anamnesis data, sIgE, eosinophil count and skin-prick test, rhinology and computerized tomography (CT) observation and mycological finding. Our results showed: (i) the prevalence in Serbia is: AFRS 1.3%, FRS 2.8%; (ii) 30.4% patients with sIgE+ had more often severe and recurrent chronic rhinosinusitis (CRS) (P = .005) and the presence of polyps (P = .025); (iii) 46.4% patients with sIgE+ had positive fungi on the sinonasal mucosa and were considered as AFRS; (iv) patients with AFRS had more frequent asthma (P = .024) and chronicity of CRS > 10 years (P = .000). The persistent fungal presence and prolonged duration of CRS could be a silent threat for the progression of inflammation and development of FRS. Lavage with hypertonic-NaCl should be included in the everyday hygiene routine in an effort to decrease fungal load and antigenic exposure. The presence of allergological parameters and better response to corticosteroid therapy in AFRS patients should be considered as crucial diagnostic criteria for AFRS