Die vorliegende Nichtunterlegenheitsstudie zur Versorgung von Symphysensprengungen vergleicht die biomechanische Stabilität zweier neuartiger, additiv hergestellter Kabel- Implantat-Systeme zur Symphysenfixierung (KISS-Fixation) mit der der Symphysenplatte. Letztere weist als aktueller Standard eine erhebliche Komplikationsrate auf. Die Nullhypothese lautet: Die KISS-Fixation mit anteriorer oder transobturatorialer Kabelcerclage ist der Symphysenplatte bei der Versorgung einer Symphysensprengung in Bezug auf biomechanische Stabilität unterlegen. Hierfür erfolgte eine Testung von insgesamt 30 synthetischen Beckenmodellen in einer Materialprüfmaschine unter Nachahmung eines Einbeinstandes. Zeitgleich wurden durch ein Optisches Messsystem Verschiebungen an der Symphyse gemessen. Getestet wurden drei Gruppen à zehn Becken: A) 3,5 mm 4-Loch-Symphysenplatte aus Stahl, B) KISS mit anteriorer Kabelcerclage und C) KISS mit transobturatorialer Kabelcerclage. Nach einer zyklischen Belastung unter dem Kraftniveau von 300 N über 5000 Zyklen erfuhr dasselbe Becken anschließend weitere 5000 Zyklen unter 400 N. In einem zweiten Teil der Studie wurde die KISS-Fixation an insgesamt sechs Körperspendern angebracht. Dies diente der Etablierung des operativen Zugangswegs, Analyse umliegender Strukturen und Prüfung der Passgenauigkeit. Aufgezeichnete Parameter der Materialprüfmaschine waren: Steifigkeit, Peak-to-Peak-Displacement, Total Displacement, Plastische Deformation sowie Dmin5000 – DmaxSZ10. Beim Optischen Messsystem erfolgte eine Auswertung der vertikalen Verschiebung von zwei an der Symphyse befindlichen Messpunkten zum Zeitpunkt des Belastungsmaximums (Symphyseal Displacement). Für die Messwerte der Materialprüfmaschine konnte in 13 von 20 Parametern Nichtunterlegenheit der KISS-Fixation gegenüber der Symphysenplatte nachgewiesen werden. Beim Optischen Messsystem war das KISS in drei der insgesamt vier als relevant betrachteten Werte nichtunterlegen. Im Rahmen der Kadaverstudie bestätigte sich eine Praktizierbarkeit der Implantatanbringung am humanen Präparat. Diese Studie zeigt, dass zur Stabilisierung einer Symphysensprengung die neuartige KISS-Fixation eine biomechanisch und anatomisch mögliche Alternative zur Symphysenplatte darstellt. / This non-inferiority study on the treatment of rupture of the pubic symphysis compares the biomechanical stability of two novel, additively manufactured cable-clamp fixation devices for symphysis fixation with that of the symphyseal plate. As the current standard, the symphyseal plate fixation is associated with a significant rate of complications. The null hypothesis is: The cable-clamp anterior only (CCAO) or the cable-clamp anterior and posterior (CCAP) is inferior to the symphyseal plate in treating a ruptured symphysis in terms of biomechanical stability. For this purpose, a total of 30 synthetic pelvic bone models were tested in a material testing machine imitating a single-leg-stance. At the same time, symphyseal displacements were measured using an optical measuring system. Three groups of ten pelvis each were tested: A) 3.5 mm 4-hole steel symphyseal plate, B) cable-clamp fixation anterior only and C) cable-clamp fixation anterior and posterior. After 5000 test cycles under the load level of 300 N, the same bone model underwent additional 5000 cycles under the load level of 400 N. In a second part of the study, the cable-clamp fixation was attached to a total of six human cadaver specimens in order to establish a surgical approach, analyse surrounding structures and evaluate the accuracy of fit. Recorded parameters of the material testing machine were stiffness, peak-to-peak displacement, total displacement, plastic deformation and Dmin5000 – DmaxSZ10. With the optical measuring system, the vertical displacement of two measuring points located at the symphysis was evaluated at the time of the maximum load (symphyseal displacement). For the measured values of the material testing machine, non-inferiority of the cable-clamp fixation device compared to the symphyseal plate was demonstrated in 13 out of 20 parameters. For the optical measuring system, the cable-clamp fixation device was non-inferior in three out of the four values considered relevant. The cadaver study confirmed the feasibility of attaching the cable-clamp implants to the cadaver specimens. This study demonstrates that the novel cable-clamp fixation device represents a biomechanically and anatomically possible alternative to the symphyseal plate in treating pubic symphysis disruption.

A mandíbula dos Squamata é composta por duas hemimandíbulas cada uma composta por diversos ossos. Na região posterior, as hemimandíbulas se conectam ao crânio através do osso quadrado e na região anterior se encontram conectas pela sínfise mandibular, que tem um importante papel anatômico, limitando o movimento independente das hemimandíbulas influenciando assim o grau de cinese da mandíbula. A existência de variação morfológica na sínfise mandibular já foi apontada por diversos autores, no entanto somente alguns estudos detalhados foram feitos sobre esta estrutura, a grande maioria deles em Serpentes. Segundo estes autores os lagartos e as serpentes Scolecophidia apresentariam a sínfise mandibular rígida, enquanto que os mosassaurídeos e as demais serpentes possuiriam uma sínfise mandibular livre. A sínfise livre é um dos caracteres utilizados por diversos autores para unir as Serpentes e os mosassauros no clado Pythonomorpha, esta hipótese foi questionada por alguns autores que acreditam que a sínfise mandibular livre é uma convergência evolutiva nestes dois clados. Diversas famílias de lagartos não apresentaram as cartilagens de Meckel fundidas como era esperado e somente uma das famílias de Scolecophidia apresentava a fusão das cartilagens de Meckel na região sinfisial. A perda da conexão das cartilagens de Meckel seria o primeiro passo para a formação de uma sínfise livre, sua ocorrência em diversas famílias reforça a hipótese de que a sínfise mandibular livre presente nos mossasauros e serpentes Alethinophidia seria uma convergência evolutiva. Também foi possível estabelecer, com base nas morfologias observadas, as transformações necessárias para o surgimento de uma sínfise livre como a das serpentes Alethinophidia. / The Squamate mandible is formed by two hemimandibles each one composed of several bones. In the posterior region, the hemimandibles are connected to the skull by the quadrate bone. In the anterior region these are connected to each other by the mandibular symphysis, which has an important anatomical role, limiting the independent movement of the hemimandibles. Several authors noted the existence of morphological variation in the mandibular symphysis, but only a few detailed studies were made about this structure, the majority of them focusing on Serpentes. These authors claim the lizards and the Scolecophidia snakes possess a rigid mandibular symphysis while the mosasaurs and the rest of the snakes would possess a free mandibular symphysis. The free symphysis is one of the characters used by several authors to support the existence of the Pythonomorpha clade formed by the mosasaurs and the snakes, the existence of this clade is questioned by several authors that believe the presence o the free symphysis to be a convergence in this two groups. Contrary to what was expected, the connection of Meckels cartilages were absent in several lizards families while it was present in only one scolecophidian family. The loss of Meckels cartilages connection would be the first step to the formation of a free symphysis, its occurrence in several families reinforces the hypothesis that the free symphysis could have evolved independently in the mosasaurs and the Alethinopidia snakes. Based on the morphologies observed in this study it was also possible determinate the steps necessary for the evolution of a free symphysis.

Thesis (MA)--University of Montana, 2009. / Contents viewed on January 14, 2010. Title from author supplied metadata. Includes bibliographical references.

A mandíbula dos Squamata é composta por duas hemimandíbulas cada uma composta por diversos ossos. Na região posterior, as hemimandíbulas se conectam ao crânio através do osso quadrado e na região anterior se encontram conectas pela sínfise mandibular, que tem um importante papel anatômico, limitando o movimento independente das hemimandíbulas influenciando assim o grau de cinese da mandíbula. A existência de variação morfológica na sínfise mandibular já foi apontada por diversos autores, no entanto somente alguns estudos detalhados foram feitos sobre esta estrutura, a grande maioria deles em Serpentes. Segundo estes autores os lagartos e as serpentes Scolecophidia apresentariam a sínfise mandibular rígida, enquanto que os mosassaurídeos e as demais serpentes possuiriam uma sínfise mandibular livre. A sínfise livre é um dos caracteres utilizados por diversos autores para unir as Serpentes e os mosassauros no clado Pythonomorpha, esta hipótese foi questionada por alguns autores que acreditam que a sínfise mandibular livre é uma convergência evolutiva nestes dois clados. Diversas famílias de lagartos não apresentaram as cartilagens de Meckel fundidas como era esperado e somente uma das famílias de Scolecophidia apresentava a fusão das cartilagens de Meckel na região sinfisial. A perda da conexão das cartilagens de Meckel seria o primeiro passo para a formação de uma sínfise livre, sua ocorrência em diversas famílias reforça a hipótese de que a sínfise mandibular livre presente nos mossasauros e serpentes Alethinophidia seria uma convergência evolutiva. Também foi possível estabelecer, com base nas morfologias observadas, as transformações necessárias para o surgimento de uma sínfise livre como a das serpentes Alethinophidia. / The Squamate mandible is formed by two hemimandibles each one composed of several bones. In the posterior region, the hemimandibles are connected to the skull by the quadrate bone. In the anterior region these are connected to each other by the mandibular symphysis, which has an important anatomical role, limiting the independent movement of the hemimandibles. Several authors noted the existence of morphological variation in the mandibular symphysis, but only a few detailed studies were made about this structure, the majority of them focusing on Serpentes. These authors claim the lizards and the Scolecophidia snakes possess a rigid mandibular symphysis while the mosasaurs and the rest of the snakes would possess a free mandibular symphysis. The free symphysis is one of the characters used by several authors to support the existence of the Pythonomorpha clade formed by the mosasaurs and the snakes, the existence of this clade is questioned by several authors that believe the presence o the free symphysis to be a convergence in this two groups. Contrary to what was expected, the connection of Meckels cartilages were absent in several lizards families while it was present in only one scolecophidian family. The loss of Meckels cartilages connection would be the first step to the formation of a free symphysis, its occurrence in several families reinforces the hypothesis that the free symphysis could have evolved independently in the mosasaurs and the Alethinopidia snakes. Based on the morphologies observed in this study it was also possible determinate the steps necessary for the evolution of a free symphysis.

Although the pubic symphysis remains the most commonly utilized osteological feature to ascertain age-at-death estimations by forensic anthropologists (Garvin and Passalacqua, 2012), these aging methods do not accurately age elderly individuals. Through the re-examination of a Balkan sample, Berg (2008) noted a morphological variant, which may be correlated to osteoporosis expression by the increasing presence of macroporosity, present on female individuals that had previously been unexplained. This morphological variant can assist in the application of the Suchey-Brooks method to age elderly female individuals with the inclusion of a seventh phase (Berg, 2008). Hartnett (2010) also re-examined the pubic symphysis to better estimate age for modern populations and noted morphological variants similar to those described by Berg (2008). Hartnett (2010) attributed this variant to a decrease in bone quality associated with age-related morphological change. The present study examined the 330 female skeletons housed at Lisbon Collection, with the specific aim to provide a comparison of pubic symphysis age estimation methods, including Suchey-Brooks (1990), Berg (2008), Hartnett (2010), and Boldsen et al. (2002), on a known modern skeletal collection geographically dissimilar from the collections originally examined by Berg (2008) and Hartnett (2010). This dissimilar population was important because Berg's original study noted regional differences in the appearance and applicability of the seventh phase. The morphological variants present in female elderly individuals in the Lisbon Skeletal Collection support the introduction of a seventh phase to the standard Suchey-Brooks pubic symphysis method. Using the seventh phase, the Berg (2008) and Hartnett (2010) method improved their accuracy rates for aging older individuals. However, when the entire female population sample is considered the established age-at-death estimation methods do not perform well. The relationship between bone quality, aging method estimation assessment, and known age are discussed with considerations made for the influencing factors on bone preservation. A major difficulty in this analysis was parsing out information regarding bone density loss that occurred as natural degeneration and had a relationship to age-related change. The most significant confounding factor for the analysis of bone density loss and its importance to age-related change is the influence of bone preservation. While it is clear that the seventh phase provides more valuable information for the age estimation of the elderly, the poor correlation of bone quality suggests that this feature is not particularly important for the assessment of elderly phases in this population. This research supports the induction of a seventh phase to help provide more accurate age estimations for elderly populations, as it has been found in various populations, including the Portuguese population.

Estimating sex and age at death are two crucial processes during the creation of a biological profile for a set of skeletal remains. Whether the remains are archaeological or forensic, estimating the sex and age of the individual is necessary for further analysis and interpretation. Specifically, in a medicolegal context, knowing the biological sex and approximate age of the remains assists law enforcement or government agencies in identifying unknown individuals. Since the inception of the field of forensic anthropology, practitioners have been developing methods to perform the aforementioned tasks. It is crucial that these methods be consistent, repeatedly tested, validated, and improved for multiple reasons. Firstly, to conform to Daubert (1993) standards, and additionally, to make sure that they are accurate and applicable to modern forensic cases. The present study was performed to validate the efficacy of the method for estimating sex from the os pubis originally proposed in Klales et al. (2012), as well as the efficacy of the “transition analysis” method for estimating age, originally outlined in Boldsen et al. (2002). Considering the recent popularity of using these methods to create a biological profile for forensic cases, it is necessary to develop error rates on a large, modern, American autopsy sample. These two methods are not only being readily utilized, but are additionally being taught to students in training. The utilization of these models involves a “logistic regression model” created by Klales et. al (2012) to process ordinal scores, and the Bayesian statistics software program “ADBOU” that was created for processing data collected using the method in Boldsen et. al (2002). These statistical systems which produced age estimates are relatively young compared to methods developed for the same purpose. The new generation of forensic anthropologists is fully responsible for objectively critiquing and validating these methods that are being disseminated by their professors and senior practitioners. The goal of the present study is to do just that. A skeletal reference sample of 630 pubic bones, all removed from modern autopsy cases and housed at the Maricopa County Forensic Science Center in Phoenix, Arizona, was utilized for data collection in the present study. Each pubic bone was assessed and scored according to the exact instructions outlined in the materials for each method, which was the Klales et al. (2012) paper for sex estimation, and the UTK Data Collection Procedures for Forensic Skeletal Material 2.0 for age estimation (Langley et al. 2016). Additionally, the observers recorded their “gestalt” estimates for sex using the Phenice (1969) system, as well as Brooks and Suchey (1990) and Hartnett (2010a) phases for each pubis. Demographic information labels were hidden, and the collection demographic information was not viewed until the completion of data collection. The null hypothesis in the present study is that both methods (the Klales et al. method (2012) and “transition analysis” method (Boldsen et al. 2002) will perform as well as they did in the original studies. The alternate hypothesis is that they do not result in the same accuracy rates reported in the original studies. Statistical analysis of the data indicates that there is sufficient evidence to reject the null hypothesis as it applies to the Klales et al. (2012) method. The classification accuracies achieved applying the logistic regression equation to the sample of pubic bones was found to be significantly lower than reported in the original study (86.2%), averaging around 70% between observers. The level of both intraobserver and interobserver agreement was only moderate for this method. It was also found that asymmetry occurred in some individuals, producing differing estimates of sex when the left and right pubes were scored separately. When utilizing the Boldsen et al. (2012) method and the ADBOU software package on only pubic symphyseal components to estimate age, the method was found to perform reasonably well. The majority (about 82%) of individuals had actual ages at death that fell within the predicted range produced by the statistical analysis. The majority of the symphyseal component scores showed moderate to good levels of interobserver agreement, and the estimated maximum likelihood (point estimate) of age at death predicted by the software package correlated moderately well with the actual age of death of the individual. These methods did not perform as well as reported in the original studies, and they should be further validated and recalibrated to improve their accuracy and reliability.

OBJECTIVE: To test reliability of 3D mandibular landmarks, planes of reference and surfaces and assess their correlation to conventional 2D cephalometric measurements. To analyze changes in three-dimensional shape of the symphysis due to growth and orthodontic treatment. METHODS: This was a retrospective analysis of CBCTs of healthy orthodontic patients. 32 subjects were included, 16 males and 16 females. Mean ages of 10.6 ± 1.5 years and 15.0 ± 0.9 years before and after treatment, respectively. The mean follow up time was 4.3 years. Subjects free of any craniofacial anomalies, and no observable pathology on panoramic radiograph were. 15 subjects had CVM 1 and 17 subjects had CVM 2 before orthodontic treatment. All subjects had CVM 5 after orthodontic treatment. For the first phase, 3D mandibular landmark identifications were digitized. Planes and landmarks were constructed and compared with conventional 2D mandibular measurements. For the second phase, mandibles were isolated by removing surrounding structures. Pearson correlation and paired t-test were performed to test for correlation and differences between 2D and 3D measurements, respectively. Statistical analysis was performed using SAS 9.4. Software. MorphoJ software (Version 2.0, www.flywings.org.uk) was used for symphysis shape analysis; and Discriminant Function Analysis (DFA) between pre-treatment and post-treatment was used for statistical analysis of the symphysis. RESULTS: We found statistical significant positive correlation between 2D and 3D pre-treatment ramus height (P-value =0.01), post-treatment ramus height (P-value < 0.0001), pre-treatment corpus length (P-value 0.0003), post-treatment corpus length (P-value 0.04), pre-treatment gonial angle (P-value <0.0001), and post-treatment gonial angle (P-value=0.05). Also, statistically significant differences in 2D ramus height (P=0.001), 3D ramus height (P-value=0.002), 2D corpus length (P-value <0.01), and 3D corpus length (P-value <0.01). For symphysis shape comparing between pre-treatment and post-treatment, we found that there is no statistically significant difference between them (P-value= 0.99). CONCLUSION: These results demonstrated statistically significant positive correlation between certain 2D and 3D measurements, pre-treatment and post-treatment differences in 2D and 3D measurements showed consistent results. Symphysis shapes do break out as distinctly separate groups, but the differences between the means is small.

Orientador: Paulo Pinto Joazeiro / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-15T06:40:15Z (GMT). No. of bitstreams: 1 Nascimento_MariaAmaliaCavinato_M.pdf: 2973013 bytes, checksum: eef160eabbd2d1426a9f2e0795702488 (MD5) Previous issue date: 2009 / Resumo: É reconhecido que a sínfise púbica de algumas espécies de mamíferos, incluindo camundongos, passa por transformações estruturais durante a prenhez e no período pós-parto. Estas transformações incluem o surgimento de um ligamento interpúbico e o amolecimento deste tecido nos dois últimos dias antes do parto. Este ligamento permite a separação dos ossos púbicos, garantindo a passagem segura do feto pelo canal de parto. Após o parto ocorre a involução deste ligamento. Ambos os períodos de remodelação tecidual envolvem grandes modificações da matriz extracelular e de seus componentes, bem como um balanço entre proliferação e morte celular programada. A galectina-3, uma lectina animal com especificidade de ligação por ß-galactosídeos, é uma proteína amplamente distribuída entre diferentes tipos de células e tecidos, podendo ser encontrada dentro das células tanto no núcleo quanto no citoplasma, ou ainda na superfície celular ou no espaço extracelular. Através de interações específicas com diversos ligantes intra e extracelulares, a galectina-3 participa de numerosos processos fisiológicos e patológicos, como por exemplo, desenvolvimento, reações imunes, controle do ciclo celular, apoptose e metástase. Este estudo teve como objetivo localizar a expressão de galectina-3 nas populações celulares que compõem esta articulação durante o período de prenhez, a fim de investigar seu possível envolvimento nos processos de remodelação da sínfise. Foi observado que a galectina-3 está presente em todas as populações celulares que compõem a sínfise púbica e o ligamento interpúbico de todos os grupos estudados. Além disso, a galectina-3 é co-localizada com a a-actina de músculo liso em alguns tipos celulares. A quantificação da detecção de galectina-3 nos permitiu observar que ela é expressa em diferentes concentrações durante o período estudado. Esses resultados nos permitiram concluir que a galectina-3 parece estar envolvida na remodelação da sínfise púbica, através de sua participação na ativação de células semelhantes a fibroblastos, no ciclo celular, na diferenciação e nos processos de morte celular programada. / Abstract: It is recognized that the pubic symphysis of some mammal species, including mice, undergoes structural transformations during pregnancy and post-partum. These transformations include the emerging of an interpubic ligament and softening of this tissue in the two last days of pregnancy. This ligament allows the pelvic bones separation, warranting fetus self passage through the birth channel. After delivery this ligament involutes. Both periods of tissue remodeling involve changes in extracellular matrix and its components, as so a balance between cell proliferation and death. Galectin-3, an animal lectin with specificity for ß-galactosídes, is widely spread among different types of cells and tissues, thus being found inside the cells in the cytoplasm and in the nucleus, on cell surface or in the extracellular space. Through specific interactions with a variety of intra and extracellular ligands galectin-3 participates of numerous physiological and pathological processes, like for example, development, immune reactions, cell cycle control, apoptosis and metastasis. This research had the objective to localize galectin-3's expression in mouse pubic symphysis cells during pregnancy, and to investigate its involvement in the pubic remodeling process. It was observed that galectin-3 is present in all pubic cells populations of all of the studied groups. Besides that, galectin-3 is colocalized with a-smooth muscle actin in some cell types. Quantifying of galectin-3 detection revealed that this protein is expressed in different concentrations during the studied period. These results allowed us to conclude that galectin-3 seems to be involved in mouse pubic symphysis remodeling, probably working in the activation of fibroblast like cells, on cell cycle, on differentiation and in the processes of programmed cell death. / Mestrado / Biologia Celular / Mestre em Biologia Celular e Estrutural

Much research has been done to understand the complex process of facial growth and development for decades. Recently, the form and function of the human mandibular symphysis has been of interest. The human symphysis theoretically experiences three types of strains during function, which may influence symphyseal shape and development. These forces are influenced by the size and position of the mandible relative to the muscles that act upon it. The purpose of this study is to determine whether an increase in mandibular length through surgery leads to increased skeletal indicators of resistance to wishboning forces. We retrospectively collected a sample of 47 subjects who had undergone mandibular advancement surgery and compared their pre- and post-surgical radiographs to examine for any changes. The results of our analysis did not provide any evidence to suggest increased wishboning resistance as a result of surgical lengthening. Perhaps there were truly not changes in the symphysis, or that we were unable to detect them due to limitations of using two-dimensional images on an adult population with a relatively short follow-up. Further research is needed to understand the role of function in the form of the human mandibular symphysis.

The application of 3D laser scanning to the analysis of human skeletal remains provides the opportunity for new methodological approaches, including for the assessment of age at death. The focus of this new perspective revolves around the question of whether morphological development of skeletal features can be captured with quantitative measurements taken from 3D scanned representations of physical specimens, with the aims of adding an increased level of accuracy and precision over currently employed age estimations methods that focus on visual, and often subjective, assessments based comparisons with plaster casts and written descriptions. The current research was conducted to determine if specific morphological features of the pubic symphysis could be isolated and quantified on 3D models, and whether these measurements captured the general age related trends of symphyseal development. Using CAD software, each symphyseal face was divided into half and quadrant specific sections in an attempt to better capture the development of symphyseal morphology. A sample of left male pubic symphyses (n = 40) scanned from a well-documented collection of known-age individuals (Coimbra Identified Skeletal Collection) was selected for this study. Seven symphyseal features were identified from the Suchey-Brooks method unisex age phase descriptions. Eight measurements were generated to quantify these features. The data for each feature was subjected to linear regression analyses to test for statistical correspondence to known chronological age at death. Rim completeness, billowing height and area, and depth of symphyseal face depression demonstrated the strongest relationships with chronological age, while curvature of the ventral rampart and the angle of the dorsal aspect, showed significant but weak relationships with known age. Degree of dorsal lipping and dorsal rampart curvature showed no relationship with age. The results of the study suggest that quantitative assessments of morphological changes at the pubic symphysis are possible and therefore can potentially add further insights into age at death estimations based on the pubic symphysis, as measurements taken within CAD software are far more precise than traditional measuring implements. This study illustrates the potential for 3D imaging to improve the methods of osteological analyses applied particularly in the fields of bioarchaeology and forensic anthropology. / Graduate