A statistical shape model for estimating missing soft tissues of the face in a black South African population.

PURPOSE: Facial disfigurement may affect the quality of life of many patients. Facial prostheses are often used as an adjuvant to surgical intervention and may sometimes be the only viable treatment option. Traditional methods for designing soft-tissue facial prostheses are time-consuming and subjective, while existing digital techniques are based on mirroring of contralateral features of the patient, or the use of existing feature templates/models that may not be readily available. We aim to support the objective and semi-automated design of facial prostheses with primary application to midline or bilateral defect restoration where no contralateral features are present. Specifically, we developed and validated a statistical shape model (SSM) for estimating the shape of missing facial soft tissue segments, from any intact parts of the face. MATERIALS AND METHODS: An SSM of 3D facial variations was built from meshes extracted from computed tomography and cone beam computed tomography images of a black South African sample (n = 235) without facial disfigurement. Various types of facial defects were simulated, and the missing parts were estimated automatically by a weighted fit of each mesh to the SSM. The estimated regions were compared to the original regions using color maps and root-mean-square (RMS) distances. RESULTS: Root mean square errors (RMSE) for defect estimations of one orbit, partial nose, cheek, and lip were all below 1.71 mm. Errors for the full nose, bi-orbital defects, as well as small and large composite defects were between 2.10 and 2.58 mm. Statistically significant associations of age and type of defect with RMSE were observed, but not with sex or imaging modality. CONCLUSION: This method can support the objective and semi-automated design of facial prostheses, specifically for defects in the midline, crossing the midline or bilateral defects, by facilitating time-consuming and skill-dependent aspects of prosthesis design.

Are endocasts reliable proxies for brains? A 3D quantitative comparison of the extant human brain and endocast.

Endocasts (i.e., replicas of the inner surface of the bony braincase) constitute a critical proxy for qualifying and quantifying variations in brain shape and organization in extinct taxa. In the absence of brain tissues preserved in the fossil record, endocasts provide the only direct evidence of brain evolution. However, debates on whether or not information inferred from the study of endocasts reflects brain shape and organization have polarized discussions in paleoneurology since the earliest descriptions of cerebral imprints in fossil hominin crania. By means of imaging techniques (i.e., MRIs and CT scans) and 3D modelling methods (i.e., surface-based comparisons), we collected consistent morphological (i.e., shape) and structural (i.e., sulci) information on the variation patterns between the brain and the endocast based on a sample of extant human individuals (N = 5) from the 3D clinical image database of the Steve Biko Academic Hospital in Pretoria (South Africa) and the Hôpitaux Universitaires Pitié Salpêtrière in Paris (France). Surfaces of the brain and endocast of the same individual were segmented from the 3D MRIs and CT images, respectively. Sulcal imprints were automatically detected. We performed a deformation-based shape analysis to compare both the shape and the sulcal pattern of the brain and the endocast. We demonstrated that there is close correspondence in terms of morphology and organization between the brain and the corresponding endocast with the exception of the superior region. By comparatively quantifying the shape and organization of the brain and endocast, this work represents an important reference for paleoneurological studies.

Reassessment of the TM 1517 odonto-postcranial assemblage from Kromdraai B, South Africa, and the maturational pattern of Paranthropus robustus.

OBJECTIVES: The Pleistocene taxon Paranthropus robustus was established in 1938 following the discovery at Kromdraai B, South Africa, of the partial cranium TM 1517a and associated mandible TM 1517b. Shortly thereafter, a distal humerus (TM 1517g), a proximal ulna (TM 1517e), and a distal hallucial phalanx (TM 1517k) were collected nearby at the site, and were considered to be associated with the holotype. TM 1517a-b represents an immature individual; however, no analysis of the potentially associated postcranial elements has investigated the presence of any endostructural remnant of recent epiphyseal closure. This study aims at tentatively detecting such traces in the three postcranial specimens from Kromdraai B. MATERIALS AND METHODS: By using µXCT techniques, we assessed the developmental stage of the TM 1517b's C-M3 roots and investigated the inner structure of TM 1517g, TM 1517e, and TM 1517k. RESULTS: The M2 shows incompletely closed root apices and the M3 a half-completed root formation stage. The distal humerus was likely completely fused, while the proximal ulna and the distal hallucial phalanx preserve endosteal traces of the diaphyseo-epiphyseal fusion process. DISCUSSION: In the hominin fossil record, there are few unambiguously associated craniodental and postcranial remains sampling immature individuals, an essential condition for assessing the taxon-specific maturational patterns. Our findings corroborate the original association of the craniodental and postcranial remains representing the P. robustus type specimen. As with other Plio-Pleistocene hominins, the odonto-postcranial maturational pattern of TM 1517 more closely fits an African great ape rather than the extant human pattern.

Sulcal pattern variation in extant human endocasts.

Our knowledge of human brain evolution primarily relies on the interpretation of palaeoneurological evidence. In this context, an endocast or replica of the inside of the bony braincase can be used to reconstruct a timeline of cerebral changes that occurred during human evolution, including changes in topographic extension and structural organisation of cortical areas. These changes can be tracked by identifying cerebral imprints, particularly cortical sulci. The description of these crucial landmarks in fossil endocasts is, however, challenging. High-resolution imaging techniques in palaeoneurology offer new opportunities for tracking detailed endocranial neural characteristics. In this study, we use high-resolution imaging techniques to document the variation in extant human endocranial sulcal patterns for subsequent use as a platform for comparison with the fossil record. We selected 20 extant human crania from the Pretoria Bone Collection (University of Pretoria, South Africa), which were detailed using X-ray microtomography at a spatial resolution ranging from 94 to 123 µm (isometric). We used Endex to extract, and Matlab to analyse the cortical imprints on the endocasts. We consistently identified superior, middle and inferior sulci on the frontal lobe; and superior and inferior sulci on the temporal lobe. We were able to label sulci bordering critical functional areas such as Broca's cap. Mapping the sulcal patterns on extant endocasts is a prerequisite for constructing an atlas which can be used for automatic sulci recognition.

A geometric morphometric approach to the study of variation of shovel-shaped incisors.

OBJECTIVES: The scoring and analysis of dental nonmetric traits are predominantly accomplished by using the Arizona State University Dental Anthropology System (ASUDAS), a standard protocol based on strict definitions and three-dimensional dental plaques. However, visual scoring, even when controlled by strict definitions of features, visual reference, and the experience of the observer, includes an unavoidable part of subjectivity. In this methodological contribution, we propose a new quantitative geometric morphometric approach to quickly and efficiently assess the variation of shoveling in modern human maxillary central incisors (UI1). MATERIALS AND METHODS: We analyzed 87 modern human UI1s by means of virtual imaging and the ASU-UI1 dental plaque grades using geometric morphometrics by placing semilandmarks on the labial crown aspect. The modern human sample was composed of individuals from Europe, Africa, and Asia and included representatives of all seven grades defined by the ASUDAS method. RESULTS: Our results highlighted some limitations in the use of the current UI1 ASUDAS plaque, indicating that it did not necessarily represent an objective gradient of expression of a nonmetric tooth feature. Rating of shoveling tended to be more prone to intra- and interobserver bias for the highest grades. In addition, our analyses suggest that the observers were strongly influenced by the depth of the lingual crown aspect when assessing the shoveling. DISCUSSION: In this context, our results provide a reliable and reproducible framework reinforced by statistical results supporting the fact that open scale numerical measurements can complement the ASUDAS method.

The dorsal nerve of the clitoris in relation to urinary incontinence sling procedures.

INTRODUCTION AND HYPOTHESIS: To avoid injury to the perineal branches of the pudendal nerve during urinary incontinence sling procedures, a thorough knowledge of the course of these nerve branches is essential. The dorsal nerve of the clitoris (DNC) may be at risk when performing the retropubic (tension-free vaginal tape) procedure as well as the inside-out and outside-in transobturator tape procedures. The purpose of this study was to identify the anatomical relationships of the DNC to the tapes placed during the procedures mentioned and to determine the influence of body variations. METHODS: In this cadaveric study, the body mass index (cBMI) of unembalmed cadavers was determined. Suburethral tape procedures were performed by a registered urologist and gynecologist on a sample of 15 female cadavers; six retropubic, seven inside-out and nine outside-in transobturator tapes were inserted. After embalmment, dissections were performed and the distances between the DNC and the tapes measured. RESULTS: In general the trajectory of the outside-in tape was closer to the DNC than that of the other tapes. cBMI was weakly and nonsignificantly correlated with the distance between the trajectory of the tape and the DNC for the inside-out tape and the tension-free vaginal tape, but not for the outside-in tape. CONCLUSIONS: The findings suggest that the DNC is less likely to be injured during the inside-out tape procedure than during the outside-in procedure, regardless of BMI. Future studies on larger samples are desirable to confirm these findings.

Changes in the mandibular angle during adulthood in South Africans.

OBJECTIVES: The purpose of this study was to measure the mandibular angle as a reflection of the biomechanical forces acting on the mandible and relate it to aging and loss of teeth. METHODS: A total of 717 mandibles of adult individuals were selected from the Pretoria Bone Collection. These mandibles were allocated to dentition subgroups according to their pattern of tooth loss. The angle of the mandible was measured with a mandibulometer. The variation in the mandibular angle was statistically analyzed by age regressions and comparisons between adjusted means of dentition subgroups. RESULTS: Aging per se was not associated with a greater mandibular angle. With limited tooth loss, aging was associated with a smaller mandibular angle in females. Generally the mandibular angle increased with tooth loss and was accentuated when an even occlusion pattern was lost rather than with more extensive tooth loss. A more pronounced increase in mandibular angle with tooth loss was noted in females and individuals of European ancestry. CONCLUSIONS: Tooth loss and not aging is associated with an increase in the mandibular angle. Masculinity and being from African ancestry provided some protection against an increase in the mandibular angle with tooth loss. The accentuated increase in the mandibular angle when an even occlusion pattern was disturbed supports the notion that an uneven loss of teeth was indeed associated with inefficient mastication. The unexpected decrease in angle noted in females with aging but limited tooth loss may be indicative of constructive changes beyond puberty. Am. J. Hum. Biol. 28:681-686, 2016. © 2016 Wiley Periodicals, Inc.

A micro-computed tomographic evaluation of maxillary first molar root canal morphology in Black South Africans.

PURPOSE: This study was conducted to investigate the root canal anatomy of maxillary first molars in Black South Africans. METHODS: Micro-computed tomography was used to investigate 101 maxillary first molars (53 teeth from the right, 48 from the left; 50 male and 51 female teeth). The number of root canals in each tooth was determined, and the relationship between side, sex and age was analyzed using chi-squared test. To determine intra- and inter-observer reliability, Cohen's kappa coefficients were calculated. RESULTS: Intra- and inter-rater agreements of 96.92% and 98.08% were achieved, respectively. Most teeth contained either three or four canals, but a second, third and fourth mesio-buccal canal was found in 60.39%, 5.94% and 0.99% of teeth, respectively. The disto-buccal and palatal roots contained predominantly single canals, but additional canals were noted in 2.97% and 1.98% of teeth. Four canals were common in females and teeth on the right side often contained a second mesio-buccal canal. However, the prevalence of a third mesio-buccal canal was higher in males than in females. CONCLUSION: The teeth studied showed diversity and variations between sexes and arch sides. These findings will aid clinicians in endodontic treatment and will be applicable for educational purposes.

Evaluation of age, sex, and ancestry-related variation in cortical bone and dentine volumes in modern humans, and a preliminary assessment of cortical bone-dentine covariation in later Homo.

Cortical bone and dentine share similarities in their embryological origin, development, and genetic background. Few analyses have combined the study of cortical bone and dentine to quantify their covariation relative to endogenous and exogenous factors. However, knowing how these tissues relate in individuals is of great importance to decipher the factors acting on their evolution, and ultimately to understand the mechanisms responsible for the different patterns of tissue proportions shown in hominins. The aims of this study are to examine age-, sex-, and ancestry-related variation in cortical bone and dentine volumes, and to preliminary assess the possible covariation between these tissues in modern humans and in five composite Neandertals. The modern analytical sample includes 12 immature individuals from France and 49 adults from France and South Africa. Three-dimensional tissue proportions were assessed from microtomographic records of radii and permanent maxillary canines. Results suggest ontogenic differences and a strong sexual dimorphism in cortical bone and dentine developments. The developmental pattern of dentine also seems to vary according to individual's ancestry. We measure a stronger covariation signal between cortical bone and dentine volumes than with any other dental tissue. A more complex covariation pattern is shown when splitting the modern sample by age, sex, and ancestry, as no signal is found in some subsamples while others show a covariation between cortical bone and either crown or radicular dentine. Finally, no difference in cortical bone volume is noticed between the modern young adults and the five young adult composite Neandertals from Marine Isotopic Stages (MIS) 5 and 3. Greater dentine Cortical bone and dentine (co)variation volumes are measured in the MIS 5 chimeric Neandertals whereas a strong interpopulation variation in dentine thickness is noticed in the MIS 3 chimeric Neandertals. Further research on the cortical bonedentine covariation will increase understanding of the impact of endogenous and exogenous factors on the development of the mineralized tissues.

The influence of age, sex, population group, and dentition on the mandibular angle as measured on a South African sample.

The mandibular angle is measured in physical anthropological assessments of human remains to possibly assist with the determination of sex and population affinity. The purpose of this investigation was to establish how the mandibular angle changes with age and loss of teeth among the sexes in South African population groups. The angles of 653 dried adult mandibles from the Pretoria Bone Collection were measured with a mandibulometer. Males and females of both South African whites and blacks were included. To compensate for imbalances in numbers among subgroups, type IV ANOVA testing was applied. No association was found between age and angle within either of the populations, within sexes, or within dentition groups. The angle was the most obtuse in individuals without molars and with an uneven distribution of molars, and most acute in the group with an even distribution of molars on both sides. Statistically significant differences (P < 0.001) were found in the angle between the two population groups and sexes in the overall sample as well as in the subgroup with absent molar teeth (P = 0.003 for sex, males more acute angle, and P = 0.001 for population group, blacks more acute angle), although a very large overlap existed. No significant differences could be demonstrated between the sexes or populations within the subgroups with molars. We concluded that the loss of molars, especially if complete or uneven, has a considerable effect on the mandibular angle. In the assessment of human remains, the mandibular angle is not very usable in determining sex.

Facial approximations: Characteristics of the eye in a South African sample.

Although guidelines for facial approximations, including those for the eye, are in use in South Africa, limited data on African populations exist to confirm its validity. As precise placement of the eyes in facial approximations is of importance for facial recognition, this study tested established guidelines by measuring specific instrumental dimensions. Forty-nine cadavers from the Sefako Makgatho Health Sciences University and the University of Pretoria were dissected to determine the position of the canthi and the size and position of the eyeball in the orbit. Thirty cone beam computer tomography scans and 30 computer tomography scans from the Oral and Dental and Steve Biko Hospitals respectively were used to determine the size of the eyeball. Results from this study were compared to the published guidelines. The most prominent discrepancies included a more rectangular shape of the orbit, an oval shaped eyeball and a different position of the canthi. In African faces, the medial canthus was found to be located higher than the lateral canthus. The distance between the endocanthion and superior orbital margin was 17.7mm and the exocanthion and superior orbital margin 19.5mm. Inter-population differences may have an effect on facial approximations and its accuracy as is often demonstrated in practice. The findings of this study should be taken into consideration when designing population specific guidelines for reconstruction of the eye in South Africans of African ancestry.

Dento-alveolar measurements and histomorphometric parameters of maxillary and mandibular first molars, using micro-CT.

BACKGROUND: Micro-CT is a high-resolution, non-invasive, and non-destructive imaging technique, currently acknowledged as a gold standard modality for assessing quantitatively and objectively dental morphology and bone microarchitecture parameters. PURPOSE: The aim of this study was to analyze critical dental and periodontal measurements characterizing the mandibular (MandFM) and maxillary (MaxFM) first molar architecture, as well as the corresponding bony socket, using micro-CT. MATERIALS AND METHODS: Thirty-eight human dried skulls (22-76 years) were scanned to enable the virtual analysis of 61 first molars. Depending on the type of measurement, the parameters were recorded on two-dimensional sections or directly on three-dimensional models. Tooth morphology was described by four aspects (e.g., tooth width, trunk length, root length, and root span), while the socket architecture was assessed by buccal plate thicknesses and bone density measurements. RESULTS: Minimum, maximum, and mean distances as well as cortical and trabecular bone densities were recorded in MandFM and MaxFM. It is noteworthy that the buccal plate thickness was found to be less than 1 mm in more than 55% of cases in MaxFM, whereas only in 20.8% of cases in MandFM (and even 0% at two sites). A wide range of bone densities was observed and the comparison between MandFM and MaxFM did not show a significant difference. Furthermore, cortical densities were negatively correlated with aging, while trabecular densities were not influenced. CONCLUSIONS: Using micro-CT, three-dimensional aspects of the human first molar morphology and microstructural parameters of the surrounding bone were evaluated in the mandible and in the maxilla. These comprehensive measurements and their correlation with aging may be of great importance for the use of immediate implant placement in molar extraction sockets and thus the potential long-term success of this treatment modality.

Ancestral Variations in the Shape and Size of the Zygoma.

The variable development of the zygoma, dictating its shape and size variations among ancestral groups, has important clinical implications and valuable anthropological and evolutionary inferences. The purpose of the study was to review the literature regarding the variations in the zygoma with ancestry. Ancestral variation in the zygoma reflects genetic variations because of genetic drift as well as natural selection and epigenetic changes to adapt to diet and climate variations with possible intensification by isolation. Prominence of the zygoma, zygomaxillary tuberosity, and malar tubercle have been associated with Eastern Asian populations in whom these features intensified. Prominence of the zygoma is also associated with groups from Eastern Europe and the rest of Asia. Diffusion of these traits occurred across the Behring Sea to the Arctic areas and to North and South America. The greatest zygomatic projections are exhibited in Arctic groups as an adaptation to extreme cold conditions, while Native South American groups also present with other features of facial robusticity. Groups from Australia, Malaysia, and Oceania show prominence of the zygoma to a certain extent, possibly because of archaic occupations by undifferentiated Southeast Asian populations. More recent interactions with Chinese groups might explain the prominent cheekbones noted in certain South African groups. Many deductions regarding evolutionary processes and diversifications of early groups have been made. Cognisance of these ancestral variations also have implications for forensic anthropological assessments as well as plastic and reconstructive surgery. More studies are needed to improve accuracy of forensic anthropological identification techniques. Anat Rec, 300:196-208, 2017. © 2016 Wiley Periodicals, Inc.