Josep Potau

The Long-Term Use of Zygomatic Implants: A 10-Year Clinical and Radiographic Report

BACKGROUND The zygoma implant has been an effective option in the short-term management of the atrophic edentulous maxilla. PURPOSE To report on long-term outcomes in the rehabilitation of the atrophic maxilla using zygomatic (ZI) and regular implants (RI). MATERIAL AND METHODS 22 consecutive zygomatic patients in a maintenance program were included. Cumulative survival rate (CSR) of ZI, RI, prostheses, and complications were recorded during, at least, 10 years of loading. Implant mobility was tested using Periotest(®). Sinus health was radiographically and clinically assessed according to Lund-Mackay (L-M) score and Lanza and Kennedy survey, respectively. A satisfaction questionnaire and anatomical measurements were also performed. RESULTS Patients received 22 prostheses, anchored on 172 implants. Forty-one were ZI. Three RI failed (10 years CSR = 97.71%). Two ZI were partly removed due to perimplant infection (10 years CSR = 95.12%). All patients maintained functional prostheses. One patient fractured framework twice. Loosening or fracturing screws happened in 11 patients. Seven patients fractured occlusal material. Four ZI abutments in two patients were disconnected because of uncomfortable prostheses. Alveolar height at the ZI head level on the right and left sides was 2.64 mm and 2.25 mm, respectively. Mean distance of ZI head center to ridge center, on the right and left sides was 4.54 mm and 5.67 mm, respectively. Mean Periotest values (PTv) of ZI were -4.375 PTv and -4.941 PTv before prostheses placement and after 10 years, respectively. Six patients experienced sinusitis 14-127 months postoperatively. 54.55% of the L-M scores did not present opacification (L-M = 0) in any sinus. Osteomeatal obstruction happened in eight patients (two bilateral). Two (9.09%) were diagnosed with sinusitis. Eighty-four percent reported satisfaction levels above 80%. 31.81% reported maximum satisfaction score (100%). CONCLUSIONS The long-term rehabilitation of the severely atrophic maxillae using ZI is a predictable procedure.

Quantitative Analysis of the Deltoid and Rotator Cuff Muscles in Humans and Great Apes

The shoulder is one of the anatomic regions differentiating orthograde primates (gibbons, orangutans, gorillas, chimpanzees, bonobos, and humans) from the rest of the pronograde primates. Orthograde primates are characterized by a dorsal position of the scapula and a more lateral orientation of the glenoid cavity. This anatomic pattern, together with adaptations in related osteological structures and muscles, serves to facilitate the elevation of the upper extremity in the scapular plane. We quantified the proportions of the muscles comprising the principal functional and stabilizing components of the glenohumeral joint —deltoid, subscapularis, supraspinatus, infraspinatus, and teres minor— in 3 species of orthograde primates: Pongo pygmaeus, Pan troglodytes, and Homo sapiens. Our objective was to determine whether quantifiable differences in these muscles relate to the functional requirements of the types of locomotion used by these 3 species: suspension/vertical climbing, knuckle-walking, and bipedalism. We observed a close similarity between the proportional mass of these muscles in Homo sapiens and Pongo pygmaeus, whereas Pan troglodytes displayed a unique anatomic pattern, particularly in the subscapularis, which may be due to differences in how the glenohumeral joint is stabilized in a great ape knuckle-walker. Our findings may help explain the high incidence of subacromial impingement syndrome in humans.

Comparative anatomical study of the forearm extensor muscles of Cebus libidinosus (Rylands et al., 2000; Primates, Cebidae), modern humans, and other primates, with comments on primate evolution, phylogeny, and manipulatory behavior.

Despite its abundance in Latin America, and its remarkable ability to use tools, there are only a few myological studies on the capuchin monkey, Cebus libidinosus. In the present study, we dissected the forearm extensor muscles of six adult males and two adult females of this species. We describe these muscles and compare them with those of other primates dissected by us and by other authors. The forearm extensor muscles of Cebus monkeys are, in general, more similar to those of other platyrrhines than to distantly related taxa that use tools, such as chimpanzees and modern humans, with three main exceptions: contrary to most other platyrrhines, (1) in Cebus, chimpanzees and modern humans the extensor pollicis longus usually inserts onto Digit I, and not onto Digits I and II; (2) in Cebus the abductor pollicis longus has two separate tendons, as is the case in chimpanzees, and in modern humans (where one of these tendons is associated with a distinct belly, forming the muscle extensor pollicis brevis); (3) in Cebus, and in modern humans and chimpanzees, the extensor pollicis longus is not deeply blended with the extensor indicis. Therefore, the Cebus monkeys provide an illustrative example of how phylogenetic constrains and ecological adaptations have been combined to develop a specific myological configuration that, associated with their sophisticated neurological organization, allow them to easily navigate in their arboreal habitats and, at the same time, to finely manipulate objects in order to search for food and to prepare this food for ingestion. Anat Rec, 2010.

A Comparison of Qualitative and Quantitative Methodological Approaches to Characterizing the Dorsal Side of the Scapula in Hominoidea and Its Relationship to Locomotion

Hominoidea have adapted to various forms of locomotion, each of which has specific requirements that are reflected in the shape of the scapula. We compared several qualitative and quantitative methods for characterizing the dorsal side of the scapula to detect morphological differences that reflect the adaptations of the scapula to locomotor behaviors. Our sample included 55 specimens of Hominoidea, representing five genera, including Homo, focusing specifically on the relative sizes of the scapular supraspinous and infranspinous fossae. In addition, we weighed the supraspinatus and infraspinatus muscles of 23 of the specimens to examine the feasibility of extrapolating muscle characteristics from osteological data. Our findings confirmed that the five genera exhibit significant differences in the relative size of the supraspinous and the infraspinous fossae that are related to their forms of locomotion. The supraspinous fossa was relatively small in Homo and Pongo but large in Pan, Gorilla, and Hylobates. The analysis of muscle weights showed that a substantial amount of information about soft tissues is lost in osteological analyses, leading us to recommend caution when drawing conclusions regarding forms of locomotion based only on osteological analyses.

3D geometric morphometric analysis of the proximal epiphysis of the hominoid humerus

In this study we perform a three‐dimensional geometric morphometric (3D GM) analysis of the proximal epiphysis of the humerus in extant great apes, including humans, in order to accurately describe the functional anatomical differences between these taxa. In addition, a fossil hominin specimen of Australopithecus afarensis was included in a multivariate GM analysis in order to test the potential of this methodological approach for making locomotor inferences from fossil remains. The results obtained show significant differences in proximal humeral morphology among the taxa studied, which had thus far largely remained unnoticed. Based on morphofunctional considerations, these anatomical differences can be correlated to differences in the locomotor repertoires of the taxa, thus confirming that the proximal humerus is suitable for constructing paleobiological inferences about locomotion. Modern humans display markedly divergent features, which set them apart from both the extant great apes and the fossil hominin A. afarensis. The morphology of the proximal epiphysis of the humerus of the latter more closely resembles that of the orangutans, thus suggesting that despite hindlimb adaptations to bipedalism, the forelimb of this taxon was still functionally involved in arboreal behaviors, such as climbing or suspension.

Brief communication: Developmental versus functional three-dimensional geometric morphometric-based modularity of the human proximal humerus.

The proximal humerus is formed by three secondary ossification centers during the postnatal trajectory of the human infant. The ossification centers later grow into the structures of the articular surface, major tubercle, and minor tubercle. There is a purported functional division between the articular surface and the tubercles, with the articular surface mainly responsible for the range of movement of the shoulder joint, and the tubercles bearing the insertions of the rotator cuff muscles, mainly devoted to securing the joint against humeral displacement. Using three-dimensional geometric morphometrics, we tested the presence of such developmental and functional divisions in the proximal humerus, applying the RV coefficient of Escoufier to these a priori hypothesized modules. Our results indicate that the proximal humerus might be a generally integrated structure. However, a weak signal for modular configuration was present, with slightly stronger support for the two modules depicting the boundaries between the purported functional regions of the epiphysis: the articular surface and the tubercles.

The Head and Neck Muscles of the Serval and Tiger: Homologies, Evolution, and Proposal of a Mammalian and a Veterinary Muscle Ontology

Here we describe the head and neck muscles of members of the two extant felid subfamilies (Leptailurus serval: Felinae; Panthera tigris: Pantherinae) and compare these muscles with those of other felids, other carnivorans (e.g., domestic dogs), other eutherian mammals (e.g., rats, tree‐shrews and modern humans), and noneutherian mammals including monotremes. Another major goal of the article is to discuss and help clarify nomenclatural discrepancies found in the Nomina Anatomica Veterinaria and in veterinary atlases and textbooks that use cats and dogs as models to understand the anatomy of domestic mammals and to stress differences with modern humans. We propose a unifying nomenclature that is expanded to all the head and neck muscles and to all mammalian taxa in order to help build veterinary and mammalian muscle ontologies. Our observations and comparisons and the specific use of this nomenclature point out that felids such as tigers and servals and other carnivorans such as dogs have more facial muscle structures related to the mobility of both the auricular and orbital regions than numerous other mammals, including modern humans, which might be the result of an ancient adaptation related to the remarkable predatory capacities of carnivorans. Interestingly, the skeletal differences, mainly concerning the hyoid apparatus, pharynx, and larynx, that are likely associated with the different types of vocalizations seen in the Felinae (mainly purring) and Pantherinae (mainly roaring) are not accompanied by clear differences in the musculature connected to these structures in the feline L. serval and the pantherine P. tigris. Anat Rec, 2012.

Long-term cryopreservation of human donor corneas

The purpose of the present study was to develop an optimal freezing method for cryopreservation of human donor corneas for transplantation. Three groups of ten human donor corneas each were cryopreserved using cooling rates of 0.5°C/min, 1 °C/min and 9°C/min. The freezing medium contained 10% fetal calf serum and 7% dimethylsulphoxide. Ten additional human donor corneas were used as controls. Endothelial cell survival after complete thawing was assessed by calculating the mean endothelial cell density and percentage of non-viable endothelial cells from vital staining and scanning electron micrographs. Significant differences in endothelial cell survival between all groups were detected by analysis of variance (p<0.001), but paired contrast found no real differences between corneas frozen at 0.5°C/min or 1°C/min. Nevertheless, 60% of the corneas cryopreserved at 1°C/min but only 10% of those cryopreserved at 0.5°C/min fulfilled both requirements to be considered suitable for transplantation (endothelial cell density > 2000 cells/mm2 and less than 10% dead cells). None of the corneas frozen at 9°C/min fulfilled these requirements. Mean endothelial cell density of corneas frozen at 1°C/min was 2084 cells/mm2 (range 2020 to 2630 cells/mm2). Except for isolated corneas frozen at 0.5°C/min, only corneas cryopreserved at a cooling rate of 1°C/min achieved satisfactory endothelial cell survival for their use in transplantation. However the significant interindividual variability among corneas frozen at 1°C/min (ANOVA: p<0.001) prevents prediction of the condition of the cornea after the complete cryopreservation process. Until this high variability can be drastically reduced, systematic corneal cryopreservation in eye banking remains unattainable.

Scanning Electron Microscopy of the Human Zonule of the Lens (Zonula ciliaris)

In the present study eight human eyeballs were specifically prepared for scanning-electron-microscopic observation of the zonule. The zonule consisted of two main layers of radial fibres, an anterior and a posterior one, that inserted on the anterior and the posterior lens capsules, respectively. Some fibres inserted on the equator of the lens. Posterior zonular fibres originated at the pars plana, entered the dorsal part of the ciliary valleys and then changed their direction towards the posterior face of the lens. Posterior fibres inserted on the posterior capsule of the lens by branched endings 1 mm behind the equator of the lens. Anterior zonular fibres originated mainly at the pars plana and occasionally at the ciliary valleys. After running completely through the ciliary valleys in close contact with the lateral walls of the ciliary processes, they changed their direction at the anterior endings of the pars plicata and reached the anterior lens capsule. Anterior zonular insertions were achieved by webbed endings that diffused into the anterior capsule 2 mm in front of the lens equator. The extraordinary distension capacity of the zonular fibres was demonstrated by pulling the anterior lens capsule after hydrodissection. As a consequence, the anterior fibres were stretched up to four times their original length without breaking or disinserting.

Expression of Myosin Heavy Chain Isoforms in the Supraspinatus Muscle of Different Primate Species: Implications for the Study of the Adaptation of Primate Shoulder Muscles to Different Locomotor Modes

The supraspinatus muscle is a key component of the soft tissues of the shoulder. In pronograde primates, its main function, in combination with the other rotator cuff muscles (subscapularis, infraspinatus, and teres minor), is to stabilize the glenohumeral joint, whereas in orthograde primates it functions together with the deltoid, to elevate the upper extremity in the scapular plane. To determine whether these functional differences are also reflected in the molecular biochemistry of the supraspinatus muscles involved in these different locomotor modes, we used real-time polymerase chain reaction (RT-PCR) to analyze the expression of the myosin heavy chain (MHC) isoforms in supraspinatus muscles from modern humans and 12 species of pronograde and orthograde primates. The MHC expression pattern in the supraspinatus muscle of pronograde primates was consistent with its function as a tonic and postural muscle, whereas the MHC expression pattern observed in the supraspinatus muscle of nonhuman orthograde primates was that of a muscle that emphasizes speed, strength, and less resistance to fatigue. These findings are consistent with the role of the supraspinatus in the posture and locomotor modes of these groups of nonhuman primates. The humans included in the study had an expression pattern similar to that of the nonhuman orthograde primates. In conclusion, molecular analysis of skeletal muscles via RT-PCR can contribute to a better understanding of the morphological and functional characteristics of the primate musculoskeletal system.