Planimetric correlation between the submandibular glands and the pancreas: a postmortem ductographic study.

The salivary glands and pancreas have comparable anatomic and antigenic properties and can share common pathogenetic mechanisms involving toxic or autoimmune processes. The aim of this study is to assess the correlation in size between the normal submandibular glands and the pancreas. The study was based on human autopsy specimens of the pancreas, neck and oral base from 22 adults, both sexes (mean age, 57.9 years). The pancreatic and submandibular ducts were injected with a contrast medium, and the area of the salivary and pancreatic glandular ductograms was measured with the aid of software for quantification of visual information. Samples of tissue from the salivary glands and the pancreas were studied by means of light microscopy. A high correlation was found between the planimetric size of the pancreas and the submandibular glands (correlation coefficient 0.497 and 0.699 for the right and the left gland, respectively). This ratio was close to 5:1. There were no significant differences in size for the left vs. right submandibular gland (p = 0.39). The ductograms were significantly larger in size in males than in females (p < 0.001). This study has proven a positive correlation in planimetric size between the normal submandibular glands and pancreas, a result that is expected to have possible clinical implications in the long-term follow-up of patients with chronic pancreatitis.

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.

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.

Association between regional heterogeneity in the mid-facial bone micro-architecture and increased fragility along Le Fort lines.

BACKGROUND/AIM: Le Fort lines have traditionally been considered as zones of weakness in the mid-facial skeleton although the structural basis of increased bone fragility at these sites has not yet been investigated. Considering recent findings of occlusal loading-related regional heterogeneity in the mid-facial bone micro-architecture, the aim of this study was to explore whether such heterogeneity in cortical and cancellous bone micro-architecture may contribute to increased fragility at Le Fort fracture sites. MATERIALS AND METHODS: Twenty-five cortical and thirteen cancellous bone specimens were harvested from a dry skull and analyzed by micro-CT. Specimens were classified into Le Fort or Non-Le Fort groups based on their location in the mid-facial skeleton. RESULTS: Cortical bone along Le Fort lines showed tendencies toward lower thickness (1.5±0.63 vs 1.75±0.79; P=.39) and greater porosity (11.48±5.67 vs 10.28±5.28; P=.59). A significant difference was detected in the trabecular degree of anisotropy which was higher in cancellous bone from Le Fort fracture sites (2.14±0.69 vs 1.58±0.34; P=.02). CONCLUSIONS: Regional heterogeneity in cortical bone micro-architecture could not fully explain increased fragility of the mid-facial skeleton at the Le Fort lines. However, regional differences in trabecular bone anisotropy may contribute to increased bone fragility.

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 ± 11.1 years) and 14 women without HFI (age: 74.1 ± 9.7 years). 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 100 µm. 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.

Hyperostosis frontalis interna in postmenopausal women-Possible relation to osteoporosis.

To improve our understanding of hyperostosis frontalis interna (HFI), we investigated whether HFI was accompanied by changes in the postcranial skeleton. Based on head CT scan analyses, 103 postmenopausal women were divided into controls without HFI and those with HFI, in whom we measured the thickness of frontal, occipital, and parietal bones. Women in the study underwent dual energy x-ray absorptiometry to analyze the bone density of the hip and vertebral region and external geometry of the proximal femora. Additionally, all of the women completed a questionnaire about symptoms and conditions that could be related to HFI. Women with HFI had a significantly higher prevalence of headaches, neurological and psychiatric disorders, and a significantly lower prevalence of having given birth. Increased bone thickness and altered bone structure in women with HFI was localized only on the skull, particularly on the frontal bone, probably due to specific properties of its underlying dura. Bone loss in the postcranial skeleton showed the same pattern in postmenopausal women with HFI as in those without HFI. Recording of HFI in medical records can be helpful in distinguishing whether reported disorders occur as a consequence of HFI or are related to other diseases, but does not appear helpful in identifying women at risk of bone loss.

Impact of the lower third molar presence and position on the fragility of mandibular angle and condyle: A Three-dimensional finite element study.

The aim of the present study was to investigate the influences of the presence and position of a lower third molar (M3) on the fragility of mandibular angle and condyle, using finite element analysis. From computed tomographic scans of a human mandible with normally erupted M3, two additional virtual models were generated: a mandibular model with partially impacted M3 and a model without M3. Two cases of impact were considered: a frontal and a lateral blow. The results are based on the chromatic analysis of the distributed von Mises and principal stresses, and calculation of their failure indices. In the frontal blow, the angle region showed the highest stress in the case with partially impacted M3, and the condylar region in the case without M3. Compressive stresses were dominant but caused no failure. Tensile stresses were recorded in the retromolar areas, but caused failure only in the case with partially impacted M3. In the lateral blow, the stress concentrated at the point of impact, in the ipsilateral and contralateral angle and condylar regions. The highest stresses were recorded in the case with partially impacted M3. Tensile stresses caused the failure on the ipsilateral side, whereas compressive stresses on the contralateral side.

Occlusal load distribution through the cortical and trabecular bone of the human mid-facial skeleton in natural dentition: a three-dimensional finite element study.

Understanding of the occlusal load distribution through the mid-facial skeleton in natural dentition is essential because alterations in magnitude and/or direction of occlusal forces may cause remarkable changes in cortical and trabecular bone structure. Previous analyses by strain gauge technique, photoelastic and, more recently, finite element (FE) methods provided no direct evidence for occlusal load distribution through the cortical and trabecular bone compartments individually. Therefore, we developed an improved three-dimensional FE model of the human skull in order to clarify the distribution of occlusal forces through the cortical and trabecular bone during habitual masticatory activities. Particular focus was placed on the load transfer through the anterior and posterior maxilla. The results were presented in von Mises stress (VMS) and the maximum principal stress, and compared to the reported FE and strain gauge data. Our qualitative stress analysis indicates that occlusal forces distribute through the mid-facial skeleton along five vertical and two horizontal buttresses. We demonstrated that cortical bone has a priority in the transfer of occlusal load in the anterior maxilla, whereas both cortical and trabecular bone in the posterior maxilla are equally involved in performing this task. Observed site dependence of the occlusal load distribution may help clinicians in creating strategies for implantology and orthodontic treatments. Additionally, the magnitude of VMS in our model was significantly lower in comparison to previous FE models composed only of cortical bone. This finding suggests that both cortical and trabecular bone should be modeled whenever stress will be quantitatively analyzed.

Evaluation of conventional and digital radiography capacities for distinguishing dental materials on radiograms depending on the present radiopacifying agent.

BACKGROUND/AIM: The radiopacity of an endodontic material can considerably vary as measured on film and a digital sensor. Digital radiography offers numerous advantages over conventional 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 mate- rial. 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 Endometh- asone, 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: Two-way ANOVA detected no significant differences with respect to the imaging system (p > 0.05), but the differences were significant with respect to radiopacifier (p < 0.001) and the interaction of the two factors (p < 0.05). Paired t-test 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% additions of YbF3 (p < 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 assessment obtained by digital according to conventional radiography.

Microstructural properties of the mid-facial bones in relation to the distribution of occlusal loading.

Although the concept of the occlusal load transfer through the facial skeleton along the buttresses has been extensively studied, there has been no study to link microarchitecture of the mid-facial bones to the occlusal load distribution. The aim of this study was to analyze micro-structural properties of the mid-facial bones in relation to occlusal stress. The study was performed by combining the three-dimensional finite element analysis (3D FEA) and micro-computed tomography analysis (micro-CT). Clenching was simulated on the computer model of the adult male human skull which was also used as a source of bone specimens. After the FEA was run, stress was measured at the specific sites in cortical shell and trabecular bone of the model along and between the buttresses. From the corresponding sites on the skull, twenty-five cortical and thirteen cancellous bone specimens were harvested. The specimens were classified into high stress or low stress group based on the stress levels measured via the FEA. Micro-architecture of each specimen was assessed by micro-CT. In the high stress group, cortical bone showed a tendency toward greater thickness and density, lower porosity, and greater pore separation. Stress-related differences in microstructure between the groups were more pronounced in trabecular bone, which showed significantly greater bone volume fraction (BV/TV) and trabecular thickness (Tb.Th) in the high stress group. Our results suggest that the mid-facial bones in the adult dentate male skull exhibit regional variations in cortical and trabecular bone micro-architecture that could be a consequence of different occlusal stress.

In vitro radiographic detection of cement overhangs on cement-retained implant restorations.

PURPOSE: The aim of this in vitro study was to investigate the potential of digital and conventional radiography to detect small amounts of residual dental luting cements around implant abutments. MATERIALS AND METHODS: Artificial cement and aluminum overhangs in varying thicknesses, heights, and depths were radiographed adjacent to implant restorations with a radiovisiography sensor. Five trained evaluators were asked to identify the smallest depth of overhang that could be detected on radiographs. RESULTS: For detection of cement overhangs adjacent to implant abutments, a luting agent must have greater radiopacity than what is recommended by relevant International Organization for Standardization directives. To detect a 0.1-mm-thick portion of excess cement adjacent to an implant abutment, the cement should have a radiopacity of at least 1.7 mm of aluminum for high-resolution digital radiographs and 2.2 mm of aluminum for film-based radiographs. Two-way analysis of variance revealed that the thickness of the specimens, type of imaging detector, and type of cement all affected the radiopacity threshold for artificial cement excess (P < .05). The height of the specimens and the surrounding structures were not statistically significant factors in cement detection. CONCLUSIONS: Digital radiography offers better possibilities for visualization of cement excess than conventional radiography.

Madelung disease: a rare case associated with gynaecomastia and scrotal involvement.

Madelung disease is rare, and characterised by accumulation of fatty non-encapsulated tissue in the head, neck, shoulders, and upper extremities. The aetiology is not completely known, but the association with alcohol intake is clear. We present a neglected case that was associated with bilateral asymmetrical gynaecomastia. To the best of our knowledge, this is a pattern of involvement not previously reported. The treatment of choice is lipectomy for severe cases and liposuction for less extensive accumulations of fat.

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

OBJECTIVES: 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. DESIGN: A retrospective review of 18 consecutive patients in one centre. PATIENTS AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

A human mandible (BH-1) from the Pleistocene deposits of Mala Balanica cave (Sicevo Gorge, Nis, Serbia).

Neandertals and their immediate predecessors are commonly considered to be the only humans inhabiting Europe in the Middle and early Late Pleistocene. Most Middle Pleistocene western European specimens show evidence of a developing Neandertal morphology, supporting the notion that these traits evolved at the extreme West of the continent due, at least partially, to the isolation produced by glacial events. The recent discovery of a mandible, BH-1, from Mala Balanica (Serbia), with primitive character states comparable with Early Pleistocene mandibular specimens, is associated with a minimum radiometric date of 113 + 72 - 43 ka. Given the fragmented nature of the hemi-mandible and the fact that primitive character states preclude assignment to a species, the taxonomic status of the specimen is best described as an archaic Homo sp. The combination of primitive traits and a possible Late Pleistocene date suggests that a more primitive morphology, one that does not show Neandertal traits, could have persisted in the region. Different hominin morphologies could have survived and coexisted in the Balkans, the "hotspot of biodiversity." This first hominin specimen to come from a secure stratigraphic context in the Central Balkans indicates a potentially important role for the region in understanding human evolution in Europe that will only be resolved with more concentrated research efforts in the area.

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 influence of continuous magnetic field on periodontal tissues under overdentures]. / Uticaj stalnog magnetnog polja na parodontalna tkiva ispod mobiinih supradentalnih proteza.

INTRODUCTION: Last remained teeth with reduced alveolar support do not have long-term prognosis, which is the reason for prolonging the life and thus providing a stable support of overdenture. The data from literature point out that static magnetic field has certain possibilities in resolving such problems. OBJECTIVE: Having in mind the pathogenetic factors which cause the reduction of the alveolar ridge and periodontal problems in our population, as well as osteoblastic and antiinflamatory activity, the aim of this investigation was to assess the effect of static magnetic field on periodontal tissue under the overdenture. METHODS: The investigation involved 38 partially edentulous patients, of both sexes and similar oral status who were bearers of a lower complete overdenture and upper classic complete denture as antagonist restoration. In the base of the lower overdenture the micromagnets were installed in the region of the remained teeth, which had static concentrated field of 60-80 mT power. The evaluation was done after 3, 6 and 12 months using the method of light densitometry. Periodontologic analysis was performed by standard and modified periodontologic tests. RESULTS: In patients with overdentures, after exposure to a magnetic field, the density of bone was not significantly changed, but the use of ANOVA disclosed changes in the observed interval. The tendency of increased density of the alveolar part of the observed region was noted. The region of the corresponding tooth of the contralateral side without magnetic influence showed decreased density of this region in the observed intervals. Plaque index and gingival index were improved underthe influence of the magnetic field, while after 6 and 12 months following the magnet insertion statistically significant changes were confirmed. The magnetic devices did not show any influence on the level of the gingival margin and junction epithelium. CONCLUSION: Static magnetic field is to be considered as a noninvasive procedure which is recommended to patients with reduced number of teeth and alveolar support.

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.

Symmetry of the submandibular glands in humans--a postmortem study assessing the linear morphometric parameters.

BACKGROUND: The analysis of morphometric right-left symmetry of the salivary glands is important for assessing unilateral changes discovered in these organs during diagnostic imaging. STUDY DESIGN: A study was carried out on 18 adult human autopsy neck and maxillofacial specimens from both sexes (14 males, 4 females), with age range of 17 to 73 years (mean age 49.9 years). The submandibular duct was injected with contrast medium and images were made in two projection planes. RESULTS: Morphometry performed using the obtained radiographs included: (a) caliber (mean proximal, middle, and distal = 1.73 mm, 1.82 mm, and 1.77 mm), (b) length (mean = 37.2 mm); (c) genu of the submandibular duct (mean = 114 degrees ); and (d) longitudinal and transverse diameters of the gland (mean = 44.1 mm and 25.9 mm). Comparison of these morphometric parameters between the right and the left glands revealed no statistically significant differences. CONCLUSION: There is a high level of right-left symmetry in linear morphometric parameters of the submandibular gland.

Fractures in late medieval skeletal populations from Serbia.

Bone fractures were analyzed from skeletal remains of 861 adult individuals from six cemeteries dating to the Late Medieval period in Serbia. Results of the study were compared to other cemetery populations (635 individual skeletons) of the same date and region in an attempt to understand fracture patterns. The association of types of fractures and their prevalence with sex, age at death, cemetery site, and information deriving from historical sources are discussed. Results showed that the long bone fracture frequency was 0.7%, and the majority of the fractures were the result of direct force. This rate is similar to some studies of contemporary British skeletal samples. However, it is much lower than for some other Old World sites. Cranial vault fractures had a rate of 6.7%, and of the facial skeleton, 1.3%; the frontal bone was the most affected of bones of the cranial vault. Injuries were more common on the upper extremities (0.8%) compared to the lower (0.6%). However, the fibula was the most fractured bone (2.8%), followed by the ulna (2.4%). This pattern is similar to three of six Late Medieval urban sites in Britain. These findings suggest that this rural community was exposed to a low risk of trauma, probably related mostly to accidents sustained during farming, and rarely to interpersonal violence.

Interpersonal violence at Lepenski Vir Mesolithic/Neolithic complex of the Iron Gates Gorge (Serbia-Romania).

The Mesolithic populations of the Danube River's Iron Gates Gorge (Serbia/Romania) spanned over 1,500 years (from before 7000 bc to around 5500 bc) in one of the most favorable foraging environments of Europe. Over most of these 1,500 years, the dominant economy was foraging, but farming was practiced by communities in the region from around 6500 bc. This research examines individuals from four sites on the Danube (Lepenski Vir, Vlasac, Padina, and Hajducka Vodenica) whose traumatic lesions can be most plausibly interpreted as resulting from violent interactions. Given over four hundred individuals buried at these sites (MNI = 418), the episodes of violent interactions were few and without evidence of a specific temporal pattern. They probably represent sporadic episodes of interpersonal conflict that do not support the notion of endemic warfare deemed typical of the Mesolithic, or elevated levels of interpersonal/intertribal conflict at the time of contact with farming communities. The difference in patterns of violence between the Mesolithic sites on the right bank of the Danube and a coeval site of Schela Cladovei on the left bank is explained in terms of differences in archaeological context, geographic location, and possibly specific local histories.