Human Evolution

Macroevolutionary effects on primate trophic evolution and their implications for reconstructing primate origins Publication date: August 2019 Source: Journal of Human Evolution, Volume 133 Author(s): Jeremiah E. Scott Abstract The visual-predation hypothesis proposes that certain derived features shared by crown primates reflect an insectivorous ancestry. Critics of this idea have argued that because insectivory is uncommon among extant primates it is unlikely to have been a major influence on early primate evolution. According to this perspective, the low frequency of insectivory indicates that it is an apomorphic deviation from the mostly conserved primate ecological pattern of herbivory. The present study tests two alternative hypotheses that are compatible with an insectivorous ancestor: (1) that trophic evolution was biased, such that herbivory evolved repeatedly with few shifts back to insectivory, and (2) that insectivorous lineages have diversified at a lower rate than herbivorous lineages owing to differential trophic effects on speciation and extinction probabilities. Model-based analysis conducted using trait data for 307 extant primate species indicates that rates of transition into and out of insectivory are similar, rejecting the hypothesis of biased trophic evolution. On the other hand, the hypothesis of asymmetric diversification is supported, with insectivorous lineages having a lower rate of diversification than herbivorous lineages. This correlation is mediated by activity pattern: insectivory occurs mostly in nocturnal lineages, which have a lower diversification rate than diurnal lineages. The frequency of insectivory also appears to have been shaped by repeated transitions into ecological contexts in which insectivory is absent (large body size) or rare (diurnality). These findings suggest that the current distribution of trophic strategies among extant primates is the result of macroevolutionary processes that have favored the proliferation and persistence of herbivory relative to insectivory. This conclusion implies that the low frequency of insectivory is not necessarily evidence against the visual-predation hypothesis.

New hominoid fossils from Moroto II, Uganda and their bearing on the taxonomic and adaptive status of Morotopithecus bishopi Publication date: July 2019 Source: Journal of Human Evolution, Volume 132 Author(s): Laura MacLatchy, James Rossie, Alexandra Houssaye, Anthony J. Olejniczak, Tanya M. Smith Abstract The early Miocene site of Moroto II, Uganda has yielded some of the oldest known hominoid fossils. A new partial mandible (UMP MORII 03'551) is notable for its long tooth row and large, narrow M2 with well-developed cristids - a morphological combination previously unknown for large bodied catarrhines of the Early Miocene and suggesting folivory. The tooth proportions are compatible with belonging to the same taxon as the maxilla UMP 62-11, the holotype of Morotopithecus bishopi; likewise, the long tooth row and vertical planum of UMP MORII 03'551 suggest that it may represent the same taxon as mandible(s) UMP 66-01 and UMP 62-10. Canine size strongly suggests UMP MORII 03'551 is a female. Comparisons of the tooth crown morphology and tooth row proportions, relative enamel thickness, enamel-dentine junction morphology, long-period line periodicity, and dental wear patterns support significant morphological, developmental, and inferred dietary differentiation, and therefore generic-level distinctiveness, among Afropithecus, Morotopithecus and the Proconsul clade. An isolated M1 (UMP MORII 03'559) is morphologically dissimilar, and much smaller than the actual or inferred size of molars in UMP MORII 03'551, UMP 66-01 and UMP 62-10, supporting the presence of two hominoid taxa at Moroto II, M. bishopi and a smaller bodied proconsulid. Given the high level of body mass dimorphism inferred for Morotopithecus and other early Miocene catarrhines, the known postcrania from Moroto II could be attributable to either taxon. However, UMP MORII 03'551 and the femora UMP MORII 94'80 derive from the same stratigraphic interval, while the isolated M1 was deposited later, increasing the likelihood that the mandible and femora are from the same individual. These new fossils expand our understanding of the taxonomic and adaptive diversity of early Miocene catarrhines.

Earliest axial fossils from the genus Australopithecus Publication date: July 2019 Source: Journal of Human Evolution, Volume 132 Author(s): Marc R. Meyer, Scott A. Williams Abstract Australopitheus anamensis fossils demonstrate that craniodentally and postcranially the taxon was more primitive than its evolutionary successor Australopithecus afarensis. Postcranial evidence suggests habitual bipedality combined with primitive upper limbs and an inferred significant arboreal adaptation. Here we report on A. anamensis fossils from the Assa Issie locality in Ethiopia's Middle Awash area dated to ∼4.2 Ma, constituting the oldest known Australopithecus axial remains. Because the spine is the interface between major body segments, these fossils can be informative on the adaptation, behavior and our evolutionary understanding of A. anamensis. The atlas, or first cervical vertebra (C1), is similar in size to Homo sapiens, with synapomorphies in the articular facets and transverse processes. Absence of a retroglenoid tubercle suggests that, like humans, A. anamensis lacked the atlantoclavicularis muscle, resulting in reduced capacity for climbing relative to the great apes. The retroflexed C2 odontoid process and long C6 spinous process are reciprocates of facial prognathism, a long clivus and retroflexed foramen magnum, rather than indications of locomotor or postural behaviors. The T1 is derived in shape and size as in Homo with an enlarged vertebral body epiphyseal surfaces for mitigating the high-magnitude compressive loads of full-time bipedality. The full costal facet is unlike the extant great ape demifacet pattern and represents the oldest evidence for the derived univertebral pattern in hominins. These fossils augment other lines of evidence in A. anamensis indicating habitual bipedality despite some plesiomorphic vertebral traits related to craniofacial morphology independent of locomotor or postural behaviors (i.e., a long clivus and a retroflexed foramen magnum). Yet in contrast to craniodental lines of evidence, some aspects of vertebral morphology in A. anamensis appear more derived than its descendant A. afarensis.

Dental macrowear and cortical bone distribution of the Neanderthal mandible from Regourdou (Dordogne, Southwestern France) Publication date: July 2019 Source: Journal of Human Evolution, Volume 132 Author(s): Luca Fiorenza, Stefano Benazzi, Ottmar Kullmer, Giulia Zampirolo, Arnaud Mazurier, Clément Zanolli, Roberto Macchiarelli Abstract Tooth wear is an important feature for reconstructing diet, food processing and cultural habits of past human populations. In particular, occlusal wear facets can be extremely useful for detecting information about diet and non-masticatory behaviors. The aim of this study is to reconstruct the diet and cultural behavior of the Neanderthal specimen Regourdou 1 (Dordogne, Southern France) from the analysis of the macrowear pattern, using the occlusal fingerprint analysis method. In addition, we have also examined whether there is any association between the observed dental macrowear and mandibular bone distribution and root dentine thickness. The posterior dentition of Regourdou 1 is characterized by an asymmetric wear pattern, with the right side significantly more worn than the left. In contrast, the left lower P3 shows a more advanced wear than the right premolar, with unusual semicircular enamel wear facets. The results from occlusal fingerprint analysis of this unique pattern suggest tooth-tool uses for daily task activities. Moreover, the left buccal aspect of the mandibular cortical bone is thicker than its right counterpart, and the left P3 has a thicker radicular dentine layer than its antimere. These results show a certain degree of asymmetry in cortical bone topography and dentine tissue that could be associated with the observed dental macrowear pattern. The molar macrowear pattern also suggests that Regourdou 1 had a mixed diet typical of those populations living in temperate deciduous woodlands and Mediterranean habitats, including animal and plant foods. Although this study is limited to one Neanderthal individual, future analyses based on a larger sample may further assist us to better understand the existing relationship between mandibular architecture, occlusal wear and the masticatory apparatus in humans.

Internal nasal morphology of the Eocene primate Rooneyia viejaensis and extant Euarchonta: Using μCT scan data to understand and infer patterns of nasal fossa evolution in primates Publication date: July 2019 Source: Journal of Human Evolution, Volume 132 Author(s): Ingrid K. Lundeen, E. Christopher Kirk Abstract Primates have historically been viewed as having a diminished sense of smell compared to other mammals. In haplorhines, olfactory reduction has been inferred partly based on the complexity of the bony turbinals within the nasal cavity. Some turbinals are covered in olfactory epithelium, which contains olfactory receptor neurons that detect odorants. Accordingly, turbinal number and complexity has been used as a rough anatomical proxy for the relative importance of olfactory cues for an animal's behavioral ecology. Unfortunately, turbinals are delicate and rarely preserved in fossil specimens, limiting opportunities to make direct observations of the olfactory periphery in extinct primates. Here we describe the turbinal morphology of Rooneyia viejaensis, a late middle Eocene primate of uncertain phylogenetic affinities from the Tornillo Basin of West Texas. This species is currently the oldest fossil primate for which turbinals are preserved with minimal damage or distortion. Microcomputed tomography (μCT) reveals that Rooneyia possessed 1 nasoturbinal, 4 bullar ethmoturbinals, 1 frontoturbinal, 1 interturbinal, and an olfactory recess. This pattern is broadly similar to the condition seen in some extant strepsirrhine primates but differs substantially from the condition seen in extant haplorhines. Crown haplorhines possess only two ethmoturbinals and lack frontoturbinals, interturbinals, and an olfactory recess. Additionally, crown anthropoids have ethmoturbinals that are non-bullar. These observations reinforce the conclusion that Rooneyia is not a stem tarsiiform or stem anthropoid. However, estimated olfactory turbinal surface area in Rooneyia is greater than that of similar-sized haplorhines but smaller than that of similar-sized lemuriforms and lorisiforms. This finding suggests that although Rooneyia was broadly plesiomorphic in retaining a large complement of olfactory turbinals as in living strepsirrhines, Rooneyia may have evolved somewhat diminished olfactory abilities as in living haplorhines.

Three-dimensional geometric morphometric analysis of the first metacarpal distal articular surface in humans, great apes and fossil hominins Publication date: July 2019 Source: Journal of Human Evolution, Volume 132 Author(s): Lorenzo Galletta, Nicholas B. Stephens, Ameline Bardo, Tracy L. Kivell, Damiano Marchi Abstract Understanding the manual abilities of fossil hominins has been a focus of palaeoanthropological research for decades. Of interest are the morphological characteristics of the thumb due to its fundamental role in manipulation, particularly that of the trapeziometacarpal joint. Considerably less attention has been given to the thumb metacarpophalangeal (MCP) joint, which plays a role in stabilizing the thumb during forceful grasps and precision pinching. In this study we use a three-dimensional geometric morphometric approach to quantify the shape of the first metacarpal head in extant hominids (Homo, Pan, Gorilla and Pongo) and six fossil hominin species (Homo neanderthalensis Tabun C1 and La Chappelle-aux-Saints, Homo naledi U.W. 101-1282, Australopithecus sediba MH2, Paranthropus robustus/early Homo SK84, Australopithecus africanus StW 418, Australopithecus afarensis A.L. 333w-39), with the aims of identifying shapes that may be correlated with human-like forceful opposition and determining if similar morphologies are present in fossil hominins. Results show that humans differ from extant great apes by having a distally flatter articular surface, larger epicondyle surface area, and a larger radial palmar condyle. We suggest that this suite of features is correlated with a lower range of motion at the MCP joint, which would enhance the thumbs ability to resist the elevated loads associated with the forceful precision grips typical of humans. Great ape genera are each differentiated by distinctive morphological features, each of which is consistently correlated with the predicted biomechanical demands of their particular locomotor and/or manipulatory habits. Neanderthals and U.W. 101-1282 fall within the modern human range of variation, StW 418, SK 84 and U.W. 88-119 fall in between humans and great apes, and A.L. 333w-39 falls within Pan variation. These results agree with those of traditional linear analyses while providing a more comprehensive quantitative basis from which to interpret the hand functional morphology of extinct hominins.

Upper Paleolithic cultural diversity in the Iranian Zagros Mountains and the expansion of modern humans into Eurasia Publication date: July 2019 Source: Journal of Human Evolution, Volume 132 Author(s): Elham Ghasidian, Saman Heydari-Guran, Marta Mirazón Lahr Abstract This paper aims to understand the cultural diversity among the first modern human populations in the Iranian Zagros and the implications of this diversity for evolutionary and ecological models of human dispersal through Eurasia. We use quantitative data and technotypological attributes combined with physiogeographic information to assess if the Zagros Upper Paleolithic (UP) developed locally from the Middle Paleolithic (MP), as well as to contextualize the variation in lithics from four UP sites of Warwasi, Yafteh, Pasangar, and Ghār-e Boof. Our results demonstrate (1) that the Zagros UP industries are intrusive to the region, and (2) that there is significant cultural diversity in the early UP across different Zagros habitat areas, and that this diversity clusters in at least three groups. We interpret this variation as parallel developments after the initial occupation of the region shaped by the relative geotopographical isolation of different areas of the Zagros, which would have favored different ecological adaptations. The greater similarity of lithic traditions and modes of production observed in the later phases of the UP across all sites indicates a marked increase in inter-group contact throughout the West-Central Zagros mountain chain. Based on the chronological and geographical patterns of Zagros UP variability, we propose a model of an initial colonization phase leading to the emergence of distinct local traditions, followed by a long phase of limited contact among these first UP groups. This has important implications for the origins of biological and cultural diversity in the early phases of modern human colonization of Eurasia. We suggest that the mountainous arc that extends from Anatolia to the Southern Zagros preserves the archaeological record of different population trajectories. Among them, by 40 ka, some would have been transient, whereas others would have left no living descendants. However, some would have led to longer term local traditions, including groups who share ancestry with modern Europeans and modern East/Southeast Asians.

Dental microwear texture analysis of Pliocene Suidae from Hadar and Kanapoi in the context of early hominin dietary breadth expansion Publication date: July 2019 Source: Journal of Human Evolution, Volume 132 Author(s): Ignacio A. Lazagabaster Abstract Stable carbon isotope studies suggest that early hominins may have diversified their diet as early as 3.76 Ma. Early Pliocene hominins, including Australopithecus anamensis, had diets that were dominated by C3 resources while Late Pliocene hominins, including Australopithecus afarensis—a putative descendant of A. anamensis—had diets that included both C3 and C4 resources. It has been hypothesized that the expansion of C4 grasslands in eastern Africa during the Pliocene could have prompted hominins to incorporate C4 resources in their diets. However, dental microwear analyses suggest that diet diversification did not involve changes in the mechanical properties of the foods consumed. To provide contextual and comparative information on this issue, the diet of suids from the A. anamensis site of Kanapoi and the A. afarensis site of Hadar is investigated. Using dental microwear texture analyses, it is shown that despite significant dietary overlap, there is evidence for dietary niche partitioning among suids. Based on comparisons with the diet of extant African suids, it is inferred that Nyanzachoerus pattersoni (n = 21) was a mixed feeder, Nyanzachoerus jaegeri (n = 4) and Notochoerus euilus (n = 61) were habitual grazers, and Kolpochoerus afarensis (n = 34) had a broad diet that included hard brittle foods and underground resources. The dental microwear of Ny. pattersoni and Ny. jaegeri/No. euilus do not differ significantly between Kanapoi and Hadar. Most differences are driven by K. afarensis, a suid absent at Kanapoi but present at Hadar. Food availability probably differed between Hadar and Kanapoi, and it is likely that A. afarensis did not exploit some of the foods (e.g., underground resources) consumed by suids. It is hypothesized that despite the incorporation of C4 resources in the diet, a significant dietary change towards flexible diets in the hominin lineage had yet to come.

A window into the early evolutionary history of Cercopithecidae: Late Miocene evidence from Chad, Central Africa Publication date: July 2019 Source: Journal of Human Evolution, Volume 132 Author(s): Laurent Pallas, Guillaume Daver, Hassane T. Mackaye, Andossa Likius, Patrick Vignaud, Franck Guy Abstract Central Africa is known as a major center of diversification for extant Old World Monkeys (OWM) and yet has a poorly documented fossil record of monkeys. Here we report a new colobine monkey (Cercopithecoides bruneti sp. nov.) from the Central African hominin-bearing fossiliferous area of Toros-Menalla, Chad at ca. 7 Ma. In addition to filling a gap in the spatial and temporal record of early OWM evolutionary history, we assess the ecomorphological diversity of early OWM by providing evidence on the onset of a folivorous diet and a partial reacquisition of terrestrial locomotor habits among Miocene colobines. We also support the phylogenetic affinities of the genus Cercopithecoides among the stem group of the extant African colobine monkeys.

Species-specific effects of climate change on the distribution of suitable baboon habitats – Ecological niche modeling of current and Last Glacial Maximum conditions Publication date: July 2019 Source: Journal of Human Evolution, Volume 132 Author(s): Desalegn Chala, Christian Roos, Jens-Christian Svenning, Dietmar Zinner Abstract Baboons (genus Papio) have been proposed as a possible analogous phylogeographic model for intra-African dispersal of hominins during the Pleistocene. Previous studies of the genus reveal complex evolutionary dynamics including introgressive hybridization and, as for hominins, it has been hypothesized that past climate change has been a major driver in their evolutionary history. However, how historical climate changes affected the distribution and extent of baboon habitats is not clear. We therefore employed three ecological niche modeling algorithms (maximum entropy model: MaxEnt; general additive model: GAM; gradient boosting model: GBM) to map suitable habitat of baboons at both genus and species levels under two extreme late-Quaternary climates: current (warm period) and Last Glacial Maximum (LGM, cold period). The three model algorithms predicted habitat suitabilities for the baboon species with high accuracy, as indicated by AUC values of 0.83–0.85 at genus level and ≥0.90 for species. The results suggest that climate change from LGM to current affected the distribution and extent of suitable habitats for the genus Papio only slightly (>80% of the habitat remained suitable). However, and in contrast to our expectation for ecological generalists, individual species have been differentially affected. While P. ursinus and P. anubis lost some of their suitable habitats (net loss 25.5% and 13.3% respectively), P. kindae and P. papio gained large portions (net gain >62%), and P. cynocephalus and P. hamadryas smaller portions (net gain >20%). Overlap among the specific realized climate niches remained small, suggesting only slight overlap of suitable habitat among species. Results of our study further suggest that shifts of suitable habitats could have led to isolation and reconnection of populations which most likely affected gene flow among them. The impact of historic climate changes on baboon habitats might have been similar for other savanna living species, such as hominins.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Photodiagnosis and Photodynamic Therapy

Clinical and microbiological effects of multiple applications of antibacterial photodynamic therapy in periodontal maintenance patients. A randomized controlled clinical study Publication date: September 2019 Source: Photodiagnosis and Photodynamic Therapy, Volume 27 Author(s): K. Grzech-Leśniak, B. Gaspirc, A. Sculean Abstract Background At present, very limited data are available on the clinical and microbiological outcomes obtained following repeated application of aPDT following one single mechanical debridement. Objective To evaluate clinically and microbiologically the outcomes following one single session of subgingival mechanical debridement (scaling and root planing; e.g. SRP) followed by 1x immediate application of aPDT and 2 x subsequent use of aPDT without SRP. Materials and methods Forty patients diagnosed with generalized chronic periodontitis that were enrolled in periodontal maintenance (supportive periodontal therapy) program, were randomly assigned to one of the two treatments: 1. SRP by means of ultrasonic and hand instruments followed by one single session of SRP followed by 1x immediate application of aPDT and 2 x subsequent applications of aPDT without SRP (test) or 2. SRP alone (control). The following clinical parameters were recorded at baseline, at 3 and 6 months: Full-Mouth Plaque Scores (FMPS), Full-Mouth Bleeding Scores (BOP), Probing Pocket Depth (PPD), Clinical Attachment Level (CAL) and Gingival Recession (RC). Additionally, microbiological samples were evaluated at baseline and six months after treatment. The primary outcome variable was BOP. Results Both treatments improved statistically significantly (p < 0.05) the FMPS, PPD and CAL values, while no statistically significant changes occurred in terms of RC. In the test group, BOP decreased statistically significantly (p < 0.05) after 3 and 6 months, while in the control group the respective values decreased statistically significantly only at 3 months. Both treatments reduced statistically significantly the total bacteria counts (TBC) after 6 months (p < 0.05). At 6 months, the use of SRP and aPDT resulted in a statistically significant decrease in the number of all tested bacteria except A. actinomycetemcomitans while the use of SRP alone resulted only in a statistically significant decrease in the numbers of P. gingivalis, T. denticola and T. forsythia. Conclusions In periodontal patients enrolled in a maintenance program one single session of SRP followed by 3x application of aPDT, enhanced the clinical and microbiological outcomes compared to SRP alone.

ALA-PDT combined with holmium laser therapy of postoperative recurrent extramammary Paget's disease Publication date: September 2019 Source: Photodiagnosis and Photodynamic Therapy, Volume 27 Author(s): Chunxiao Li, Lehang Guo, Peiru Wang, Lei Shi, Xiaofei Sun, Chan Hu, Guolong Zhang, Linglin Zhang, Yunfeng Zhang, Xiuli Wang Abstract Extramammary Paget's disease (EMPD) is a rare intraepithelial neoplasm arising in apocrine rich area of the skin. Surgery is the standard treatment but relapse is common. The postoperative skin defects, penile reconstruction, functional effects and old age are also challenges for curing disease. Herein, a case of postoperative recurrent EMPD, which was treated by combination therapy of non-invasive repeatable ALA-PDT and deep penetrated holmium laser is reported. Ultrasonography monitor of lesions showed light vascularity and the formerly hypoechoic lesion disappeared after treatment.

Impact of tooth-related factors on photodynamic therapy effectiveness during active periodontal therapy: A 6-months split-mouth randomized clinical trial Publication date: September 2019 Source: Photodiagnosis and Photodynamic Therapy, Volume 27 Author(s): Laetitia Harmouche, Aymeric Courval, Anne Mathieu, Catherine Petit, Olivier Huck, Francois Severac, Jean-Luc Davideau Abstract Background The persistence of periodontal pockets > 5 mm after periodontal treatments increases the risk of periodontitis recurrence and the need of periodontal surgery. This study evaluated the impact of tooth-related factors on the effectiveness of adjunctive photodynamic treatment (PDT) in the reduction of pockets > 5 mm during active periodontal treatment. Methods Thirty-six patients suffering from severe chronic periodontitis were evaluated in a 6-months split-mouth randomized clinical trial. Each quadrant was assigned to test (scaling and root planing (SRP) + PDT) or control (SRP alone) group. PDT was conducted using the toluidine blue O and a light-emitting diode (LED) with a red spectrum. PDT applications were performed immediately after SRP, 7 days later and at 3 months. Plaque index (PI), bleeding on probing (BOP), periodontal pocket depth (PPD), and clinical attachment level (CAL) were recorded at baseline, 3 and 6 months. Results Multilevel analysis showed a significant reduction of pockets > 5 mm in test group in comparison with control group at 3 (OR = 0.69) and 6 months (OR = 0.77). This effect was mainly observed at 6 months in initially deep sites (PPD > 6 mm) with BOP (OR = 0.57). At sites exhibiting PI > 1 no PDT effect was observed. A more moderate PDT effect was observed on mean PPD and BOP reductions at 3 months only. Conclusions Repeated applications of PDT significantly improved SRP outcomes, reducing by more than 40% residual pockets > 5 mm in initially deep and bleeding on probing periodontal sites. PDT effect was negatively influenced by dental plaque accumulation.

Optical coherence tomography angiography to assess vascular remodeling of the choriocapillaris after low-fluence photodynamic therapy for chronic central serous chorioretinopathy Publication date: September 2019 Source: Photodiagnosis and Photodynamic Therapy, Volume 27 Author(s): Gilda Cennamo, Michela Cennamo, Giuseppe Caputo, Federica Mirra, Pia Clara Pafundi, Giuseppe de Crecchio, Giovanni Cennamo Abstract Background To evaluate the efficacy of optical coherence tomography angiography (OCTA) in identifying changes in the choriocapillaris layer after low-fluence verteporfin photodynamic therapy (vPDT) in patients affected by chronic central serous chorioretinopathy (CSCR). Methods Low-fluence vPDT was performed on 28 eyes of 27 patients with CSCR. All patients underwent the following tests at baseline and 6 months after treatment: best corrected visual acuity (BCVA), fluorescein angiography, indocyanine green angiography, enhanced depth imaging OCT and OCTA. Results Subretinal fluid was completely absorbed in 18 of the 28 affected eyes (64.3%) after low-fluence vPDT ("responders"), and incompletely absorbed in 10 eyes (35.7%) ("non responders"). BCVA was significantly improved (p = 0.006) whereas central foveal thickness and choroidal foveal thickness were significantly decreased (p = 0.001 and p = 0.00 respectively) 6 months after treatment in responders. Conclusions OCTA revealed a different pattern of vascular remodeling of the choriocapillaris between CSC patients who responded and those who did not respond to low-fluence vPDT.

Diagnosis of cervical squamous cell carcinoma and cervical adenocarcinoma based on Raman spectroscopy and support vector machine Publication date: September 2019 Source: Photodiagnosis and Photodynamic Therapy, Volume 27 Author(s): Chengxia Zheng, Song Qing, Jing Wang, Guodong Lü, Hongyi Li, Xiaoyi Lü, Cailing Ma, Jun Tang, Xiaxia Yue Abstract In this report, we collected the Raman spectrum of cervical adenocarcinoma and cervical squamous cell carcinoma tissues by a micro-Raman spectroscopy system. We analysed, compared and summarized the characteristics and differences of the normalized mean Raman spectra of the two tissues and pointed out the major differences in the biochemical composition between the two tissues. The PCA-SVM model that was used to distinguish the two types of cervical cancer tissues was established. The accuracy of the model in differentiating cervical adenocarcinoma from cervical squamous cell carcinoma was 93.125%. The results of this study indicate that Raman spectroscopy of cervical adenocarcinoma and cervical squamous cell carcinoma tissue in combination with SVM (support vector analysis) and PCA (principal component analysis) can be useful for the classification of cervical adenocarcinoma and cervical squamous cell carcinoma tissues and for the exploration of the differences in biochemical compositions between the two types of cervical tissue. This study lays a foundation to further study Raman spectroscopy as a clinical diagnostic method for cervical cancer.

Facile spectroscopy and atomic force microscopy for the discrimination of α and β thalassemia traits and diseases: A photodiagnosis approach Publication date: September 2019 Source: Photodiagnosis and Photodynamic Therapy, Volume 27 Author(s): Khalid E. AlZahrani, Sandhanasamy Devanesan, Vadivel Masilamani, Fatima Al Qahtani, Mohamad S. AlSalhi, Duran Canatan, Karim Farhat Abstract Thalassemia (Thal) is an inherited blood disorder endemic to the Mediterranean and Middle East (e.g., KSA and UAE). This disease is caused by defects in the synthesis of one or more hemoglobin chains in red blood cells (RBCs). Alpha (α) Thal is caused by a reduced or absent alpha globin segment. Similarly, beta (β) Thal is caused by a defect in the beta globin segment. We divided the diseases into four groups: α Thal trait, α Thal disease, β Thal trait, and β Thal disease. The α or β Thal traits are milder variants of these diseases and do not require treatment; but β Thal disease (and to a lesser extent, α Thal) causes hemolytic anemia, splenomegaly, and bone deformities and requires repeated lifelong blood transfusions. This paper presents results regarding the identification of Thal variants using fluorescence spectroscopy of blood biomolecules and atomic force microscopy analysis of the morphologic features of red blood cells. The combined results provide new insights into the characteristics of these diseases. Furthermore, this study shows why β Thal disease subjects are often transfusion-dependent, and α Thal disease subjects are only occasionally transfusion dependent.

Pulsed xenon ultraviolet and non-thermal atmospheric plasma treatments are effective for the disinfection of air in hospital blood sampling rooms Publication date: September 2019 Source: Photodiagnosis and Photodynamic Therapy, Volume 27 Author(s): Shan-Ni Wang, Jing-Jing Li, Ying-Xin Liu, Zhi Lin, Jiao-Jiao Qiao, Li-Hua Chen, Yu Li, Yong Wu, Mei-Mei Wang, Yun-Bo Liu, Chen Yan, Zhi-Heng Chen, Chang-Qing Gao Abstract Background and objectives Non-thermal atmospheric plasma treatment and pulsed xenon ultraviolet (PX-UV) treatment are widely used in disinfection of hospital environments. However, their effectiveness has not been evaluated against a comparator. The objective of this study is to evaluate their effectiveness in the disinfection of pathogens in the air in hospital blood sampling rooms. Methods Samples were taken from the air before and after disinfection with PX-UV and non-thermal atmospheric plasma. We counted bacterial colonies and identified the types of bacteria. Results Non-thermal plasma treatment significantly reduced bacterial counts in the air, the median reduced from 1 before treatment to zero afterwards (p = 0.03). PX-UV treatment also significantly reduced bacterial counts in the air (p = 0.01), the median reduced from 1.5 before treatment to zero afterwards. Pathogens identified in the current study include nosocomial bacteria, such as Staphylococcus aureus, Staphylococcus epidermidis, and yeast. Conclusion Disinfection of blood sampling sites is essential in a health service department. The efficiency of PX-UV and non-thermal atmospheric plasma treatment are comparable in air disinfection.

Parameters for antimicrobial photodynamic therapy on periodontal pocket—Randomized clinical trial Publication date: September 2019 Source: Photodiagnosis and Photodynamic Therapy, Volume 27 Author(s): Letícia H. Alvarenga, Ana Carolina Gomes, Pamela Carribeiro, Bianca Godoy-Miranda, Giovane Noschese, Martha Simões Ribeiro, Ilka Tiemy Kato, Sandra Kalil Bussadori, Christiane Pavani, Yhago Gazote Eloy Geraldo, Daniela de Fátima Teixeira da Silva, Anna Carolina Ratto Tempestini Horliana, Mark Wainwright, Renato Araujo Prates Abstract Background Antimicrobial photodynamic therapy (aPDT) has been investigated as an adjunctive to periodontal treatment but the dosimetry parameters adopted have discrepancies and represent a challenge to measure efficacy. There is a need to understand the clinical parameters required to obtain antimicrobial effects by using aPDT in periodontal pockets. The aim of this study was to investigate parameters relating to the antimicrobial effects of photodynamic therapy in periodontal pockets. Material and methods This randomized controlled clinical trial included 30 patients with chronic periodontitis. Three incisors from each patient were selected and randomized for the experimental procedures. Microbiological evaluations were performed to quantify microorganisms before and after treatments and spectroscopy was used to identify methylene blue in the pocket. A laser source with emission of radiation at wavelength of ʎ = 660 nm and output radiant power of 100 mW was used for 1, 3 and 5 min. One hundred μM methylene blue was used in aqueous solution and on surfactant vehicle. Results The results demonstrated the absence of any antimicrobial effect with aqueous methylene blue-mediated PDT. On the other hand, methylene blue in the surfactant vehicle produced microbial reduction in the group irradiated for 5 min (p < 0.05). Spectroscopy showed that surfactant vehicle decreased the dimer peak signal at 610 nm. Conclusion Within the parameters used in this study, PDT mediated by methylene blue in a surfactant vehicle reached significant microbial reduction levels with 5 min of irradiation. The clinical use of PDT may be limited by factors that reduce the antimicrobial effect. Forms of irradiation and stability of the photosensitizers play an important role in clinical aPDT.

DNase increases the efficacy of antimicrobial photodynamic therapy on Candida albicans biofilms Publication date: September 2019 Source: Photodiagnosis and Photodynamic Therapy, Volume 27 Author(s): Beatriz H.D. Panariello, Marlise I. Klein, Fernanda Alves, Ana Cláudia Pavarina Abstract Antimicrobial Photodynamic Therapy (aPDT) has been proposed as a means to treat Candida infections. However, microorganisms in biofilms are less susceptible to aPDT than planktonic cultures, possibly because the matrix limits the penetration of the photosensitizer. Therefore, the goals here were: (1) to target biofilm matrix components of a fluconazole-susceptible (S) and a fluconazole-resistant (R) C. albicans (Ca) strains using the hydrolytic enzymes β-glucanase and DNase individually or in combination; (2) to apply the best enzyme protocol in association with aPDT mediated by Photodithazine® (PDZ); (3) to verify under confocal microscope the penetration of PDZ in biofilms pre-treated or not with DNase at different periods of incubation. CaS and CaR 48h-old biofilms were incubated with the hydrolytic enzymes (5 min) and evaluated by cell viability, biomass, and matrix components. DNase showed the best outcomes by significantly reducing extracellular DNA (eDNA) and soluble proteins from the matrix of both strains; and water-soluble polysaccharides from CaR matrix. Subsequently, 48h-old biofilms were incubated with DNase for 5 min, followed by incubation with PDZ for 20 min and exposure to LED light (660 nm, 50 J/cm²). Controls were biofilms treated only with aPDT without DNase, PDZ only, PDZ + DNase, light only, light + DNase, and biofilm without treatment. Pre-treatment with DNase allowed PDZ penetration into deeper biofilm layers, and the aPDT effect was enhanced, showing a significant reduction of the cell viability (p = 0.000) and eDNA amounts (p ≤ 0.047). DNase affected the matrix composition improving the penetration of the photosensitizer, thereby, improving the effectiveness of subsequent aPDT.

Adjunctive application of antimicrobial photodynamic therapy in the prevention of medication-related osteonecrosis of the jaw following dentoalveolar surgery: A case series Publication date: September 2019 Source: Photodiagnosis and Photodynamic Therapy, Volume 27 Author(s): Pier Paolo Poli, Francisley Ávila Souza, Susanna Ferrario, Carlo Maiorana Abstract Background Medication-related osteonecrosis of the jaw (MRONJ) is a debilitating complication strongly associated to antiresorptive agents. The present study aimed to describe the use of antimicrobial photodynamic therapy (aPDT) in the prevention of MRONJ. Methods The sample consisted of 11 non-oncologic osteoporotic subjects in therapy with non-intravenous antiresorptive agents, requiring tooth extractions and/or implant removal. After minimally invasive surgical extractions, each alveolar socket was debrided and bony edges were smoothened. At this point, aPDT was performed using methylene blue-based phenothiazine chloride dye irradiated with a hand-held 100 mW diode laser with a wavelength of 660 ± 10 nm. Flaps were sutured to achieve first intention closure. Soft tissue healing was promoted with weekly applications of low-level laser therapy for 6 weeks. Recall visits were scheduled weekly for the first two months and monthly thereafter up to 6 months. At the 6-month appointment, healing was assessed clinically and radiographically. Results A total of 62 surgical extractions were performed in both jaws, including 51 natural elements and 11 dental implants. No intraoperative complications were observed. Immediate post-operative period was generally uneventful except for mild pain and ecchymosis that occurred rarely and resolved spontaneously. Healing proceeded uneventfully, with no clinical or radiological prodromal manifestations of MRONJ up to the latest follow-up visit. Conclusions aPDT might constitute a promising preventive treatment to reduce the risk of MRONJ in non-oncologic osteoporotic patients treated with non-intravenous antiresorptive agents that underwent dentoalveolar surgery.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Anatomy - Anatomischer Anzeiger

Advantages and disadvantages of implant navigation surgery. A systematic review Publication date: September 2019 Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 225 Author(s): Jordi Gargallo-Albiol, Shayan Barootchi, Oscar Salomó-Coll, Hom-lay Wang Abstract This review elucidates the advantages and disadvantages of the different implant navigation methods to assist the precise surgical placement of dental implants. Implant navigation surgery can be classified into: dynamic and static navigation, and static navigation can further be divided into full (FG)- and half-guided (HG) implant surgery. The HG implant placement includes the drilling-guided, pilot-drill guided, and the non-computed guided approaches. In dynamic navigation, the bone drilling and the implant placement are completely tracked with a specific software; while the static navigation refers to the use of static surgical templates. The FG associated with flapless surgery and teeth/crown supported guides has demonstrated the highest accuracy, followed by the drilling and pilot HG surgery that may provide comparable results, while the non-computer HG and FH implant placement provide the least accuracy in transmitting the implant positioning from the pre-surgical planning to the patient. Additionally, flapless implant surgery is related to reduced pain, less analgesic consumption, less swelling, shorter chair-time, and reduced risk of hemorrhage while achieving greater patient satisfaction. Nevertheless, other methods such as non-computer HG and FH implant surgery procedures require more surgical experience to overcome their limitations. There is still limited evidence to support dynamic surgery, and further investigations are needed.

The dentomaxillary apparatus from molecular biology to variational anatomy—Underpinning interdisciplinary research Publication date: September 2019 Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 225 Author(s): Andreea Cristiana Didilescu, Elena Martinez-Sanz Abstract Over the past decades, the research environment in anatomy has dramatically changed. Studies have become more interdisciplinary and complex, with many components required, from basic to clinical research. Within this framework, this special issue was designed to create a link between fundamental fields such as developmental and molecular biology, dental materials, anatomy, histology, and their applications in the clinical research of the dentomaxillary apparatus.

Holding donated human bodies in conservation: A novel interactive safe-keeping system meeting high ethical and safety standards Publication date: September 2019 Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 225 Author(s): Hans Schnittler, Uwe Ortmann, Stefan Washausen, Wolfgang Knabe, Frank Wesemann, Stefan Triphaus, Bettina Schöne-Seifert Abstract "Mortui vivos docent". Learning from donated bodies is widely considered a corner stone in pre-clinical education, advanced clinical training, and scientific progress in medicine. Making such use of dead human bodies must, of course, accord with high ethical standards and legal constraints. Piety and respect towards donors require using their remains (i) for valuable purposes, (ii) with what we call 'practical decency', (iii) in an efficient way, and (iv) with the utmost safety for all parties involved. With regard to these goals, practical aspects of preservation, safekeeping procedures (for up to several years), and complete documentation become of great importance, but have so far only been realized unsatisfactorily. Here, we describe the new Safe-Keeping System-Münster (SKS-Münster) that has been developed and implemented in the Anatomy Department of the University of Münster. Integrated components of the system include a paternoster transport system, a removal station with ventilation and an air barrier, RFID transponder technology, and an easy to use software package allowing the system together to provide all required functions in an unprecedented way.

The ultrastructural anatomy of the nuclear envelope in the masseter muscle indicates its role in the metabolism of the intracellular Ca++ Publication date: July 2019 Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 224 Author(s): M.C. Rusu, M.I. Nicolescu, A.M. Jianu, V.S. Mănoiu, A.C. Ilie, D. Dincă Abstract Specific ultrastructural anatomy of masticatory muscles is commonly referred to a general pattern assigned to striated muscles. Junctional feet consisting of calcium channels of the sarcoplasmic reticulum (i.e. the ryanodine receptors, RyRs) physically connected to the calcium channels of the t-tubules build triads within striated muscles. Functional RyRs were demonstrated in the nuclear envelopes of pancreas and of a skeletal muscle derived cell line, but not in muscle in situ. It was hypothesized that ryanodine receptors (RyRs) could also exist in the nuclear envelope in the masseter muscle, thus aiming at studying this by transmission electron microscopy. There were identified paired and consistent subsarcolemmal clusters of mitochondria, appearing as outpockets of the muscle fibers, usually flanking an endomysial microvessel. It was observed on grazing longitudinal cuts that the I-band-limited mitochondria were not strictly located in a single intermyofibrillar space but continued transversally over the I-band to the next intermyofibrillar space. It appeared that the I-band-limited transverse mitochondria participate with the column-forming mitochondria in building a rather incomplete mitochondrial reticulum of the masseter muscle. Subsarcolemmal nuclei presented nuclear envelope-associated RyRs. Moreover, t-tubules were contacting the nuclear envelope and they were seemingly filled from the perinuclear space. This could suggest that nucleoplasmic calcium could contribute to balance the cytosolic concentration via pre-built anatomical routes: (i) indirectly, via the RyRs of the nuclear envelope and (ii) directly via the communication of t-tubules and sarcoplasmic reticulum through the perinuclear space.

Punctal agenesis: Embryology, presentation, management modalities and outcomes Publication date: July 2019 Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 224 Author(s): Jenny C. Dohlman, Larissa A. Habib, Suzanne K. Freitag Abstract Punctal agenesis is defined as the absence of the punctum occurring secondary to a failure of embryogenesis. This review synthesizes existing data on the embryology, anatomy, clinical presentation, symptomatology, management options and treatment outcomes of punctal agenesis. A foundational knowledge of the underlying embryologic and anatomical abnormalities is fundamental to understanding its clinical presentation and assists in choosing an appropriate management strategy. Existing outcomes data is generally favorable and suggests management with a step-wise approach can alleviate symptoms in patients across a spectrum of disease.

A major review on disorders of the animal lacrimal drainage systems: Evolutionary perspectives and comparisons with humans Publication date: July 2019 Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 224 Author(s): Mohammad Javed Ali, Susan J. Rehorek, Friedrich Paulsen Abstract Purpose To provide a systematic review of the literature on the disorders and management of the lacrimal drainage system (LDS) in few of the species of the animal kingdom. Methods The authors performed a PubMed search of all articles that were published in English with specific reference to lacrimal drainage disorders in animals. Data captured include demographics, presentations, investigation, diagnoses and management modalities. Emphasis was also on anatomical differences, evolutionary perspectives and addressing the lacunae and potential directions for future research. Results The lacrimal drainage system is a terrestrial adaptation in vertebrates. Evolutionary development of the LDS is closely linked to the Harderian gland and the vomeronasal organ. Variable differences in the clinical presentations and management of lacrimal drainage disorders (LDD) are noted in comparison to humans. These are secondary to unique structural and pathophysiological differences. Uniformity in usage and reporting of disease terminologies is required. Diagnostic challenges in clinical examination can be met with the development of customized lacrimal instruments. Contrast dacryocystorhinography is a very useful investigation in the diagnosis of LDD. Multiple bypass procedures like conjunctivorhinostomy, conjunctivobuccostomy and conjunctivomaxillosinosotomy have been described for nasolacrimal duct obstruction (NLDO). Advances of endoscopy and radiological techniques are paralleled by minimally invasive lacrimal interventions. The search for an ideal animal model for human LDS is far from over and the choice of the animal needs to be customized based on the research objectives. Conclusion The lacrimal drainage system is an ancestral feature in tetrapod vertebrates and it is present, in some form or another, in most descendant species. The lacrimal drainage system has evolved considerably, adapting to the needs of the species. It is essential to understand the lacrimal drainage disorders of domestic animals so that the animal and human lacrimal sciences contribute more meaningfully to each other.

Focused practice of lacrimal drainage disorders Publication date: July 2019 Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 224 Author(s): Mohammad Javed Ali, Friedrich Paulsen

Dacryocystography: From theory to current practice Publication date: July 2019 Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 224 Author(s): Swati Singh, Mohammad Javed Ali, Friedrich Paulsen Abstract Purpose To provide a review and an update on dacryocystography (DCG) and its relevance in the current era. Methods The authors performed a PubMed search of all articles published in English on DCG, digital subtraction-DCG (DS-DCG), computed tomographic DCG (CT-DCG) and magnetic resonance-DCG (MR-DCG). Data analyzed include the indications, techniques, interpretations, complication and limitations. Results Dacryocystography has been used for illustrating the morphological and functional aspects of the lacrimal drainage system (LDS). Subtraction DCG provides the precise location of the alterations and acceptably delineates stenosis or an obstruction. Transit time for contrast into the nose varies widely across the studies. Low osmolality iodinated contrast media are tolerated well for DS-DCG and CT-DCG. However, normal saline either mixed with lidocaine or alone provided similar image quality as obtained with gadolinium for MR-DCG. CT-DCG provides useful information in complex orbitofacial trauma and lacrimal tumors. MR-DCG allows better 3D visualization of the LDS and dynamic functional evaluation. Sensitivity of CT-DCG and MR-DCG are mostly similar in identifying an LDS obstruction. Conclusion Various forms of DCGs can provide additional information to evaluate patients with maxillo-facial trauma, functional epiphora, suspected lacrimal sac diverticula, partial nasolacrimal duct obstruction, and lacrimal drainage tumors. Canaliculi and the membranous part of the nasolacrimal duct are not yet visualized in detail and further focused studies with advanced techniques are required.

The large intestine from fetal period to adulthood and its impact on the course of colonoscopy Publication date: July 2019 Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 224 Author(s): Slawomir Wozniak, Tomasz Pytrus, Christopher Kobierzycki, Krzysztof Grabowski, Friedrich Paulsen Abstract The human large intestine in the living adult has a total length of about 1300 mm, ranging from 1100 to 2108 mm. The development of the gut continues after birth, up to the age 4–5. The large intestine ascends at the beginning in the right abdominal quadrant, then it traverses the abdominal cavity, and finally it descends to the anus. The left and right colic flexures are the basic flexions between the transverse, ascending and descending colon, respectively. Additionally, there are secondary bendings between intestinal segments. The angles between the neighbouring parts can vary between examined subjects. Most of the angulations can be found in the transverse (range 2–9) and sigmoid colon (range 1–9), making them the most troublesome parts to pass with a colonoscope. Colonoscopy (usually performed in the left lateral or supine position) is one of the most important examination of the large intestine mucus membrane. During this procedure the endoscope is passed through the colon into the cecum or terminal ilium. The individual anatomical features (tortuosity, supernumerary loops and elongation) may slow down or interfere with the progress of the scope. We summarize current knowledge on the human large intestine from the fetal period to adulthood and carve out some aspects that are currently less known to colonoscopists.

Ultrastructure of the lacrimal drainage system in health and disease: A major review Publication date: July 2019 Source: Annals of Anatomy - Anatomischer Anzeiger, Volume 224 Author(s): Mohammad Javed Ali, Friedrich Paulsen Abstract Purpose To provide a systematic review of the literature on the ultrastructural findings of the lacrimal drainage system in healthy state and in few of the disorders studied so far. Methods The authors performed a PubMed search of all articles published with reference to electron microscopic features of the lacrimal drainage pathways. Data captured include demographics, study techniques, scanning or transmission electron microscopic features, presumed or confirmed interpretations and their implications. Specific emphasis was laid on addressing the lacunae and potential directions for future research. Results Ultrastructural studies have led to better understanding of the lacrimal drainage anatomy-physiology correlations. Cellular interactions between fibroblasts and lymphocytes could form a basis for pathogenesis of punctal stenosis. Ultrastructural characterization of peri-lacrimal cavernous bodies and changes in primary acquired nasolacrimal duct obstruction (PANDO) led to them being partly implicated in its etiopathogenesis. Electron microscopic characterization of the dacryolith core promises insights into their evolution. Ultrastructural tissue effects of mitomycin-C during a DCR surgery has provided potential evidence of its role in cases with high-risk of failure. Lacrimal stent biofilms are common but their clinical implications are currently uncertain. Conclusion Ultrastructural exploration of lacrimal drainage system so far has been limited and sparsely explored. The list of unexplored areas is exhaustive. There is a need for the lacrimal Clinician-Scientist to make themselves familiar with techniques and interpretation of electron microscopy to advance the ultrastructural frontier of this science.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Maxillofacial Surgery

The neglected aspect of applied biomaterials in medicine! Mahdi Ebrahimi Annals of Maxillofacial Surgery 2019 9(1):1-2

Evidence-based maxillofacial surgery SM Balaji Annals of Maxillofacial Surgery 2019 9(1):3-3

Orthopantomography and cone-beam computed tomography for the relation of inferior alveolar nerve to the impacted mandibular third molars Nirmalendu Saha, NS Kedarnath, Madhumati Singh Annals of Maxillofacial Surgery 2019 9(1):4-9 Context: Relation of inferior alveolar nerve to the impacted mandibular third molars (IMTMs). Aims: The aim of this study was to assess the reliability of seven specific radiographic signs of mandibular third molar root that are observed on orthopantomography (OPG) and to predict the proximity and the absence of corticalization between the mandibular canal and IMTM root on cone-beam computed tomography (CBCT) images. Settings and Design: The present study was conducted in the Department of Oral and Maxillofacial Surgery, Raja Rajeswari Dental College and Hospital. Subjects and Methods: Data set of 30 panoramic images was retrieved between the year of 2015 and 2016 indicated for extraction of lower third molars. The sample consisted of 30 individuals, who underwent preoperative radiographic evaluation before the extraction of impacted mandibular third molars (IMTM). Patients aged above 18 years with any of the seven specific signs observed on the panoramic radiograph which includes darkening, deflection, narrowing of roots, bifid root apex, diversion, narrowing of canal and interruption in the white line of the canal were included in the study. If any of the above mentioned seven specific sign were present, the patient was subjected to CBCT. On the CBCT images, the canal was traced in three planes. The acquired images were assessed for the presence or absence of corticalization. Statistical Analysis Used: Descriptive and inferential statistical analyses were used. Proportions were compared using the Chi-square test and Student's t-test. Results: Among the 4 subjects, diagnosed with an absence of corticalization, patients with isolated darkening of root P = 0.001 and patients with isolated interruption in white line P = 0.69. Patients with darkening of root in association with interruption in white lines on OPG showed the absence of corticalization on CBCT findings P = 0.001, respectively. Conclusions: This study showed the poor reliability of radiographic signs seen on OPG on predicting the proximity of third mandibular root with mandibular canal related to CBCT finding. Four were diagnosed with the absence of corticalization in CBCT findings.

High-density polyethylene material versus autogenous grafts in craniofacial augmentation procedures Kshitij Agarwal, Rajesh B Dhirawani, Sauvik Singha, Anshalika Agrawal Annals of Maxillofacial Surgery 2019 9(1):10-14 Aim: The objective was to do a comparative study and to evaluate the outcome in overall acceptance for correction of residual facial deformity with autogenous graft versus porous polyethylene implants. Materials and Methods: A total of 16 patients in the age group of ≥15 years irrespective of sex, caste, religion, and socioeconomic status presenting with signs and symptoms of residual facial deformities and who were declared fit for surgery were included in the study. The study patients were further divided into two groups, of eight each. Deformity correction using autogenous grafts was performed in Group A and using high-density polyethylene (HDPE) alloplastic implants was performed in Group B. During the follow-up period, patients' and doctor rating of overall acceptance between autogenous and alloplastic (HDPE) bone grafts was recorded on 100-mm visual analog scale (VAS) on the 2nd day and 7th day and at 3, 6, and 12 weeks. Results: The unpaired t-test is used for evaluation. VAS score at all the follow-up periods above stated was significantly higher in alloplastic group than in the autogenous group for both in patients and doctor evaluation. Conclusion: From the present study, it can be concluded that porous HDPE implants are an effective alternative to autogenous grafts in accordance of overall acceptance for correction of residual facial deformity when proper case selection, exclusion of negative prognostic factors, and meticulous surgical procedure are followed.

Condylar fractures: Surgical versus conservative management Abhishek Karan, NS Kedarnath, G Santhosh Reddy, T V. S. Harish Kumar, C Neelima, M Bhavani, Abhishek Singh Nayyar Annals of Maxillofacial Surgery 2019 9(1):15-22 Background and Objectives: Condylar fractures can be treated with one of the two methods, including the conservative (closed reduction and immobilization) and/or surgical (open reduction and internal fixation) methods. Both these modalities of treatment have their indications and contraindications and merits and demerits. The present study was designed with the purpose of comparing the outcomes of surgical versus conservative management of moderately displaced subcondylar and condylar neck fractures. Materials and Methods: The present study included a total of 20 patients with moderately displaced condylar fractures in patients > 18 years of age who were randomly divided into nonsurgical and surgical group and were managed accordingly. In the present study, the outcomes of conservative versus surgical management of subcondylar and condylar neck fractures were discussed in terms of seven parameters, including the maximal interincisal mouth opening, protrusive and lateral excursive movements of the mandible, status of occlusion, deviation of mandible during mouth opening, pain (in terms of visual analog scale) and the height of ascending ramus (radiographically) which were measured and evaluated pre- and post-operatively at different intervals of time. The follow-up was done for a period of up to 6 weeks postoperatively. Statistical Analysis Used: Descriptive and analytical statistics were calculated using the Statistical Package for Social Sciences version 19. The Mann–Whitney U-test was used to assess the significance of the difference between the groups, whereas the Wilcoxon signed-rank test was used to assess the significance of the difference between the paired observations in each group. Results: Patients treated surgically showed better improvement in maximal interincisal mouth opening, lateral excursions with minimal deviation, early relief from pain, and restoration of height of the ramus with symmetry in comparison with the patients managed conservatively where prolonged periods of pain apart from obvious deviation and minimal restoration of height of the ramus was observed over a follow-up period of 6 weeks postoperatively. The results were also found to be statistically significant with the value of P < 0.05. Interpretation and Conclusion: Surgery is inarguably preferred over conservative management of moderately displaced condylar fractures as per the results of the present study. The present study provided valuable information and mandated further studies with larger sample sizes to come to definitive conclusions.

Efficacy of spirulina along with different physiotherapeutic modalities in the management of oral submucous fibrosis Varsha Kanjani, Rajeshwari G Annigeri, Manjunath M Revanappa, Abha Rani Annals of Maxillofacial Surgery 2019 9(1):23-27 Context: Oral submucous fibrosis (OSMF) is an insidious, chronic, disabling disease that mainly affects the oral mucosa. Spirulina is a freshwater microalga which is considered as superfood by the WHO. Due to its antioxidant, anti-inflammatory, and immunomodulating properties, spirulina has shown promising results in the management of OSMF. A wide range of treatment modalities have been tried ranging from medical, physical, or surgical interventions, but combinations of these have shown better results. Aims: The study aimed to evaluate the efficacy of spirulina along with different physiotherapeutic modalities in the management of OSMF. Setting and Design: The present comparative study was conducted in the Department of Oral medicine and radiology, College of Dental Sciences, Davangere, Karnataka, India. The block randomization technique was used in the present study to enroll patients into three different groups. Methods: The study consisted of 45 OSMF patients who were divided randomly into three groups. All patients were given spirulina 500 mg twice a day for 3 months. Group A patients were instructed to perform isometric mouth exercises for 20 min, twice daily. Group B patients and Group C patients perform exercises using threaded tapered screw and mouth stretching device (MSD), respectively, ten times bilaterally twice a day. Clinical parameters such as burning sensation, mouth opening, tongue protrusion, and cheek flexibility were assessed every 15 days. Statistical Analysis Used: Descriptive data that included mean, numbers, and percentages were calculated for each group and were used for analysis. For intra- and inter-group comparison, paired t- and unpaired t-test was used, respectively. For all the tests, P = 0.05 or less was considered for statistical significance. Results and Conclusion: All the groups have shown statistically significant improvement in burning sensation, mouth opening, tongue protrusion, and cheek flexibility (P < 0.05). Group C patients have shown better results followed by Group B and Group A patients. In the present study, spirulina along with different physiotherapeutic modalities was well tolerated by the patients, and significant improvement was seen in the MSD group.

Sleepiness score-specific outcomes of a novel tongue repositioning procedure for the treatment of continuous positive airway pressure-resistant obstructive sleep apnea Rushdi Hendricks, Malika Davids, Hoosain Khalfey, Hilda J Landman, Anne E Theron, Eugene Engela, Keertan Dheda Annals of Maxillofacial Surgery 2019 9(1):28-36 Background: The gold standard of treatment for obstructive sleep apnea (OSA) is continuous positive airway pressure (CPAP). However, more than a third of patients have such difficulty with its chronic use such that they seek other options or choose to remain untreated. We evaluated sleepiness score-specific outcomes and the use of CPAP after tongue repositioning surgery for the treatment of OSA. Patients and Methods: A self-administered questionnaire was completed pre- and postoperatively by 10 patients who underwent tongue repositioning surgery for the treatment of OSA from October 2010 to December 2012. The questionnaire included the Epworth Sleepiness Scale (ESS) for the assessment of daytime somnolence and questions regarding CPAP use and overall satisfaction. Results: Preoperatively, 6 patients were “very sleepy” (ESS ≥16), 4 patients were “sleepy” (ESS = 10–16), and 0 patients were “not sleepy” (ESS ≤10). 30 days postoperatively, sleepiness scores decreased (10 patients were “not sleepy” (ESS ≤10) with 0 patients “very sleepy” or “sleepy;” P = 0.002). Thus, the median ESS score for the “very sleepy” and “sleepy,” decreased from 20 to 4 and 13 to 5, respectively, and the “nonsleepy” group increased from 0 to 4. After a 180-day review, the improved ESS scores remained unchanged (the median for “very sleepy” decreased to 3.5 that for “sleepy” remained at 5, and the median for “not sleepy” decreased to 3.5). Surgery decreased CPAP use by 100%. The surgery was judged to be worthwhile by all 10 of patients using a questionnaire, and all 10 patients said that they would recommend the treatment to other patients with OSA. Conclusions: These preliminary data indicate that tongue-repositioning surgery for the treatment of OSA may be effective in improving excessive daytime sleepiness. These proof-of-concept data require confirmation in an appropriately powered controlled study.

Management of central giant cell granulomas of the jaws: An unusual case report with critical appraisal of existing literature Priya Jeyaraj Annals of Maxillofacial Surgery 2019 9(1):37-47 Central giant cell granuloma (CGCG) is an uncommon, benign but aggressive osteolytic neoplasm of the craniomaxillofacial region, histologically characterized by an abundance of evenly distributed multinucleated giant cells within a sea of spindle-shaped mesenchymal stromal cells, scattered throughout the fibrovascular connective tissue stroma containing areas of hemorrhage. A rapid diagnostic assessment, together with an adequate histopathologic verification, is essential to improve the management and the prognosis of this locally destructive lesion. A rare case of a large destructive CGCG involving the entire right angle of mandible, causing extensive bony resorption, and buccal, medial as well as inferior border cortical expansion with multiple perforations, in a young child is presented. It was treated successfully by enucleation and aggressive curettage followed by peripheral ostectomy preserving the continuity of the mandible. Two adjunctive measures were employed; first, chemical cauterization of the residual bony walls to prevent possible recurrence, for which this tumor is notorious, and second, placement of fresh autologous platelet-rich fibrin within the bony defect to hasten bone fill and reossification, thus obviating the need for a bone graft.

Radiographic evaluation of low-level laser therapy-enhanced maxillary sinus augmentation with simultaneous dental implant placement Ilham Mehdiyev, Ugur Gülsen, Mehmet Fatih Sentürk, Nejat Bora Sayan Annals of Maxillofacial Surgery 2019 9(1):48-52 Background: To evaluate the effect of low-level laser therapy (LLLT) on bone healing in patients undergoing bilateral sinus lifting and simultaneous dental implant application. Methods: Twelve patients with total/partial posterior maxillary edentulism who needed bilateral sinus bone augmentation were included in the study. Dental implants were inserted in the same session. LLLT (λ = 630–660 nm, 25 mW/cm2, 6 min) was used for one operation side on the 1st, 3rd, 5th, and 7th days, whereas contralateral side served as control side. Preoperative and postoperative 1st, 3rd, and 6th month orthopantomograms were obtained using the aluminum step-wedge technique. Optic density analyses were performed using a Cardinal Health Digital Densitometer (Fluke Biomedical 07-443) with 1 mm diameter. Digital densitometry results were obtained as the equivalent aluminum thickness for each radiograph. These data were used to evaluate the changes in optical bone density and to compare the treatment side with the control side for each patient. Results: The LLLT side showed better results than the control side according to the densitometry results. Increase in the bone density at all the postoperative intervals was statistically significant (P < 0.05). Conclusions: LLLT enhances bone regeneration in sinus augmentation with simultaneous dental implant placement.

Cuddling teeth: A new terminology Anmol Agarwal, Gaurav Mittal, Uday Kiran Uppada Annals of Maxillofacial Surgery 2019 9(1):53-56 Literature is replete with information on the diverse patterns exhibited by impacted teeth and a clinical scenario in which >1 impacted teeth appears in close proximity is documented very rarely. Occasionally, molars are found to be impacted in interesting patterns which were described previously as “rosette teeth” or “kissing molars”. This article intends to introduce a new term, namely, “cuddling teeth” to broadly describe the clinical presentations where 2 or >2 impacted teeth are found in close approximation.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Forensic Radiology and Imaging

Accuracy and reliability of enamel and dentin thickness measurements on micro-computed tomography and digital periapical radiographs# Publication date: Available online 4 June 2019 Source: Journal of Forensic Radiology and Imaging Author(s): Ceren Aktuna Belgın, Gozde Serindere, Kaan Orhan Abstract In the application of scientific human skeletal variation in medico-legal matters, virtual anthropology is the current technique performed to examine skeleton and its body parts. Digital imaging techniques are used in many areas of dentistry and forensic dentistry. Among all digital imaging modalities, digital periapical radiography (PR) are the most widely used, however, new contemporary imaging techniques micro-computed tomography (Micro-CT) can be also used. The aim of this study was to assess the accuracy and reliability of enamel and dentin thickness measurement through intra and inter-observer error analysis, and comparison was made between periapical radiographs and Micro-CT methods. In this study 15 maxillary first premolar were used which extracted for various reasons. Enamel and dentin thicknesses and maximum cervical crown widths (MCCW) of 15 premolar teeth were examined in both Micro-CT and periapical radiographs. The results obtained with the exact maximum cervical crown widths were compared Image J software version. A digital caliper was used to measure the actual MCCW of the teeth. Results exhibited no significant differences in the measurements by the intra or inter-observer error analyses. The intraclass correlation coefficients (ICC) were more than 0.95 by both intra and inter-observer error analyses. There was significant differences in the measurements by PR and Micro-CT methods. By parameters, Micro-CT showed the highest R value (0.962) with the least error in different methods and observers. In conclusion, dentin and enamel measurements by Micro-CT was highly accurate and reliable as in the conventional method (PR). Micro-CT evaluations should be recommended for implementation in the future anthropological studies especially in countries with limited source of dental data.

Morphological analysis of frontal sinuses registered in an occlusal film by intraoral radiographic device – A case report Publication date: June 2019 Source: Journal of Forensic Radiology and Imaging, Volume 17 Author(s): Rhonan Ferreira Silva, Lívia Graziele Rodrigues, Fernando Fortes Picoli, Juliano Martins Bueno, Raquel Porto Alegre Valente Franco, Ademir Franco Abstract Frontal sinuses have a distinctive morphology that may support human identifications in the routine of medico-legal institutes. On the other hand, forensic facilities in developing countries may be limited in radiologic technology. This study aims to report a case of human identification in which the frontal sinuses were assessed by means of an adapted radiographic technique. An unknown charred victim of car crash was referred to the local medico-legal institute for human identification. The antemortem (AM) data provided by the alleged relatives of the victims consisted of a posteroanterior (PA) radiograph of the skull. In order to reproduce the AM radiograph for comparison of the frontal sinuses, and adapted technique was performed by positioning an occlusal film on the anterior surface of the frontal bone of the victim to and the radiographic cylinder on the posterior surface of the skull. A PM radiograph of the frontal sinuses was obtained in PA projection. A qualitative radiographic analysis of the morphology of the frontal sinuses revealed the convergence of AM and PM evidences and contributed to the human identification process.

Applicability and reliability of foramen magnum for sex determination in contemporary Western Indian population: A computed tomographic study Publication date: June 2019 Source: Journal of Forensic Radiology and Imaging, Volume 17 Author(s): Mitalee Mehta, Vineeta Saini, M.N. Patel, S.K. Menon Abstract Establishing sex of fragmentary skeletal remains is a critical issue in forensic anthropology and is of prime importance, since it helps to significantly narrow down the number of potential victims. Forensic anthropologists have always advocated for population specific sex discriminant formula for each population using different skeletal parts. Till date Gujarati population of India has not have any discriminant formulae for sex determination from fragmentary crania. So, the current research aims to examine the usefulness of foramen magnum variables in sex estimation of Western Indian (Gujarati) population and to provide population data which can be used as reference in cases of establishing identity in unknown fragmentary skulls. A total of 553 adult individuals [♂ = 291, ♀ = 262] of Gujarati origin with age range 18–60 years were subjected to Computed Tomography (CT) scan of skull. Length and width of foramen magnum were measured and based on these, three other variables (areas by Radinsky and Teixeria formulae and foramen magnum index) were calculated. Descriptive and discriminant function analysis was performed using SPSS 20.00. Significant difference was observed in all variables except foramen magnum index, but sexing accuracy didn't exceed 69.1%, even after using multivariate discriminant analysis. It is concluded that the foramen magnum region is not suitable for sexing Gujarati population in forensic context.

Comparison of accuracy of the maxillary sinus area and dimensions for sex estimation lateral cephalograms of Iranian samples Publication date: June 2019 Source: Journal of Forensic Radiology and Imaging, Volume 17 Author(s): Pegah Abasi, Arash Ghodousi, Roshanak Ghafari, Somayeh Abbasi Abstract Background Sex estimation is a critical issue in forensic medicine. Since anthropologic evaluations on radiographs can contribute to more accurate sex estimation, this study measured the length and height, as well as area, of the maxillary sinus on lateral cephalometric radiography. Methods and materials In this descriptive-analytic study, 80 images obtained from 20 to 40-year-old individuals (40 males and 40 female) were selected. The height and anterior-posterior length of the maxillary sinus was performed using CATIA V5R20 (a software package for image analysis). Maxillary sinus area was determined using discriminant analysis in AutoCAD. Findings The mean maxillary sinus height was 40.48 mm in males and 38.7 mm in females. The mean maxillary sinus length was 40.31 mm in males and 37.31 mm in females. The area of the maxillary sinus was 1201.2 mm2 in males and 1043.4 mm2 in females. Two discriminant analysis models, one based on the height and length of the maxillary sinus and the other based on sinus area) were developed for sex estimation. The area under the receiver operating characteristic (ROC) curve was used for quality assessment of the fitted models and determination of their prediction ability. Conclusion The mean height, length and area of the maxillary sinus were significantly larger in males than in females (P < 0.05). While sex estimation can be performed based on either the area or a combination of the height and length of the maxillary sinus. The length/width perform better than area for sex estimation but, it is greatly overshadowed by the fact that both measures perform barely better than chance. Since classification accuracy is less than 80%, the method is not reliable and therefore not recommended for sex estimation.

Radiological image processing advantages applied to human age estimation based on dental parameters Publication date: June 2019 Source: Journal of Forensic Radiology and Imaging, Volume 17 Author(s): Luiz Eugenio Nigro Mazzilli, Rodolfo Francisco Haltenhoff Melani, Cesar Angelo Lascala, Gabriel Gonçalves Mariano, Nelson M. Sakaguti, Roberto Cameriere

Imaging of resuscitation and emergency resuscitation devices—Lessons learned from post mortem computed tomography Publication date: June 2019 Source: Journal of Forensic Radiology and Imaging, Volume 17 Author(s): Ferdia Bolster, Zabiullah Ali, David Fowler, Barry Daly Abstract This pictorial essay describes the use and value of post mortem computed tomography (PMCT) in imaging potential complications related to cardiopulmonary resuscitation and those related to commonly used pre-hospital medical resuscitation devices.

The use of dental CT for age profiling Publication date: June 2019 Source: Journal of Forensic Radiology and Imaging, Volume 17 Author(s): Pamoda Balasuriya, Edel Doyle

Development of three-dimensional facial approximation system using head CT scans of Japanese living individuals Publication date: June 2019 Source: Journal of Forensic Radiology and Imaging, Volume 17 Author(s): Kazuhiko Imaizumi, Kei Taniguchi, Yoshinori Ogawa, Kazutoshi Matsuzaki, Hidemasa Maekawa, Takeshi Nagata, Tsuyoshi Moriyama, Itsuko Okuda, Hideyuki Hayakawa, Seiji Shiotani Abstract We developed software for three-dimensional (3D) facial approximation from the skull based on computed tomography (CT) scans of the head obtained from 59 Japanese adult volunteers (40 males, 19 females). CT scanning was performed while participants raised their head in an upright position while in a prone body posture. The positional relationships between the skull and head surface shape were analyzed by creating anatomically homologous shape models. Before modeling, skull shapes were simplified by concealing hollow structures of the skull using in-house software. Surficial tissue thickness (STT), represented by the distances between corresponding vertices of the simplified skull and head surface, was calculated for each individual, and averaged for each sex. Although the approximate head shapes of known individuals showed a relatively good resemblance in both the shape of the whole head and facial parts, some errors were identified, particularly in areas with thick surficial tissue. The results revealed sexual dimorphism of STT, with males exhibiting thinner surficial tissue at the cheek, and thicker tissue at the glabella, nose, mouth, and chin. Moreover, we created referential models for craniofacial superimposition from average models of the skull and head surface shape for each sex.

Spleen measurements with reference to cause of death and spleen weight estimation: A study on postmortem computed tomography Publication date: Available online 10 May 2019 Source: Journal of Forensic Radiology and Imaging Author(s): Vasiliki Chatzaraki, Janette Verster, Carlo Tappero, Michael J Thali, Wolf Schweitzer, Garyfalia Ampanozi Abstract Purpose The spleen is the largest lymphatic organ in the human body. Its appearance and weight during autopsy can be relevant for the determination of cause of death. Postmortem computed tomography (PMCT) supplements traditional autopsy. The aims of this study were to investigate spleen radiodensity on PMCT with regards to prior hospitalization, spleen macroscopy, cause of death, and the utility of PMCT for estimation of spleen weight (SW). Methods Spleen density, width (W), thickness (T), greatest axial surface (S) and presence or absence of contrast medium (CM) residues were evaluated on PMCT axial images of 1035 cadavers retrospectively. Corresponding autopsy reports were reviewed for cause of death, evidence of prior hospitalization, SW at autopsy and macroscopic features of the spleen, like congestion, pallor or contraction. Results Spleen density on PMCT was significantly higher for cases with CM and lower for hospital deaths. Multiple organ failure as cause of death showed significantly lower spleen density than fatal hemorrhage, intoxication, asphyxia-strangulation, hypothermia and metabolic disorders. No significant density differences were noted for different macroscopic spleen findings. Spleen W, T and S strongly correlate with SW at autopsy and formulas for estimating SW were derived based on linear regression models. Conclusions Presence of CM, prior hospitalization and organ failure, fatal hemorrhage, intoxication, asphyxia-strangulation, hypothermia and metabolic disorders as causes of death have an influence on spleen's radiodensity on PMCT. Routine spleen measurements on PMCT can be used to predict SW prior to autopsy or estimate SW when complete forensic autopsy is not conducted.

Quantifying and comparing the radiopacity of five bulk fill composites in digital dental radiographs – a contribution to human identification Publication date: Available online 6 May 2019 Source: Journal of Forensic Radiology and Imaging Author(s): Daphne Azambuja Hatschbach de AQUINO, Ângela FERNANDES, Luiz Roberto Coutinho MANHÃES JUNIOR Abstract Objectives : To compare the quantified radiopacity of five bulk fill composites in digital dental radiographs. Material and methods : An in-vitro observational study was performed with five dental restoration materials: I) Bulk Fill Surefil SDR+ flow® (Dentsply Sirona®, York, PA, USA), II) Bulk Fill Sonic Fill® (Kerr Corp.®, Orange, CA, USA); III) Filtek Bulk Fill flow® (3M Company®, Maplewood, MN, USA); IV) Tetric N Ceram Bulk Fill® (Ivoclar Vivadent®, Schaan, Liechtenstein); and V) Aura® (SDI Ltd.®, Victoria, Australia). Digital radiographs were taken standardly from four samples of each composite (n = 20). The radiopacity inherent detected in the radiographs was quantified using a 9-level aluminum scale. Results : ANOVA and Tukey's test showed statistically significant differences between the radiopacity of all bulk fill composites (p<0.0001), except between I and IV (p = 1.0). Spearman's outcomes revealed that only composite I had positive moderate (rS=0.63) correlation with the respective radiopacity level in the aluminum scale (p = 0.027). Conclusion : Most of the bulk fill composites addressed in this study were distinguishable from each other based on their radiopacity. The identification of type and even brand of composites may be a promising task in human identification. However, this procedure remains challenging and the scientific evidence behind it is still scarce in the forensic literature.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com