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Kropla F, Winkler D, Lindner D, Knorr P, Scholz S, Grunert R. Development of 3D printed patient-specific skull implants based on 3d surface scans. 3D Print Med 2023; 9:19. [PMID: 37389692 DOI: 10.1186/s41205-023-00183-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 06/24/2023] [Indexed: 07/01/2023] Open
Abstract
Sometimes cranioplasty is necessary to reconstruct skull bone defects after a neurosurgical operation. If an autologous bone is unavailable, alloplastic materials are used. The standard technical approach for the fabrication of cranial implants is based on 3D imaging by computed tomography using the defect and the contralateral site. A new approach uses 3D surface scans, which accurately replicate the curvature of the removed bone flap. For this purpose, the removed bone flap is scanned intraoperatively and digitized accordingly. When using a design procedure developed for this purpose creating a patient-specific implant for each bone flap shape in short time is possible. The designed skull implants have complex free-form surfaces analogous to the curvature of the skull, which is why additive manufacturing is the ideal manufacturing technology here. In this study, we will describe the intraoperative procedure for the acquisition of scanned data and its further processing up to the creation of the implant.
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Affiliation(s)
- Fabian Kropla
- Department of Neurosurgery, University of Leipzig, 04103, Leipzig, SN, Germany.
- Department of Neurosurgery, University of Leipzig Medical Center, Liebigstr. 20, 04103, Leipzig, Germany.
- Department of Neurosurgery, University Hospital Leipzig, Liebigstr. 20, 04103, Leipzig, Germany.
| | - Dirk Winkler
- Department of Neurosurgery, University of Leipzig, 04103, Leipzig, SN, Germany
| | - Dirk Lindner
- Department of Neurosurgery, University of Leipzig, 04103, Leipzig, SN, Germany
| | - Patrick Knorr
- Department for Automotive and Mechanical Engineering, University of Applied Sciences Zwickau, 08056, Zwickau, SN, Germany
| | - Sebastian Scholz
- Fraunhofer Institute for Machine Tools and Forming Technology, 02763, Zittau, SN, Germany
| | - Ronny Grunert
- Department of Neurosurgery, University of Leipzig, 04103, Leipzig, SN, Germany
- Fraunhofer Institute for Machine Tools and Forming Technology, 02763, Zittau, SN, Germany
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Olsen TB, García-Martínez D, Villa C. Testing different 3D techniques using geometric morphometrics: Implications for cranial fluctuating asymmetry in humans. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2023; 180:224-234. [PMID: 36790697 PMCID: PMC10100329 DOI: 10.1002/ajpa.24657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 10/05/2022] [Accepted: 11/01/2022] [Indexed: 11/17/2022]
Abstract
This study aimed to test the performance of 3D digitizer, CT scanner, and surface scanner in detecting cranial fluctuating asymmetry. Sets of 32 landmarks (6 in the midline and 13 bilateral) were acquired from 14 archeological crania using a 3D digitizer, and from 3D models generated from a CT scanner and surface scanner using Viewbox 4. Levels of shape variation were analyzed in MorphoJ using Procrustes analysis of variance and Principal component analysis. Intra-observer error accounted for 1.7%, 1.8%, and 4.5% of total shape variation for 3D digitizer, CT scanner, and surface scanner respectively. Fluctuating asymmetry accounted for 15%-16% of total shape variation. Variation between techniques accounted for 18% of total shape variation. We found a higher level of missing landmarks in our surface scan data than for both 3D digitizer and CT scanner data, and both 3D model-based techniques sometimes obscured taphonomic damage. All three 3D techniques are appropriate for measuring cranial fluctuating asymmetry. We advise against combining data collected with different techniques.
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Affiliation(s)
- Trine Bottos Olsen
- Laboratory of Advanced Imaging and 3D modelling, Section of Forensic Pathology, Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Daniel García-Martínez
- Physical Anthropology Unit, Department of Biodiversity, Ecology, and Evolution, Faculty of Biological Sciences, Complutense University of Madrid, Madrid, Spain.,Centro Nacional de Investigación sobre la Evolución Humana (CENIEH), Burgos, Spain.,Laboratory of Forensic Anthropology, Centre for Functional Ecology, Department of Life Sciences, University of Coimbra, Coimbra, Portugal
| | - Chiara Villa
- Laboratory of Advanced Imaging and 3D modelling, Section of Forensic Pathology, Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark
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Hou M, Fagan MJ. Assessments of bilateral asymmetry with application in human skull analysis. PLoS One 2021; 16:e0258146. [PMID: 34614014 PMCID: PMC8494363 DOI: 10.1371/journal.pone.0258146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 09/21/2021] [Indexed: 11/19/2022] Open
Abstract
As a common feature, bilateral symmetry of biological forms is ubiquitous, but in fact rarely exact. In a setting of analytic geometry, bilateral symmetry is defined with respect to a point, line or plane, and the well-known notions of fluctuating asymmetry, directional asymmetry and antisymmetry are recast. A meticulous scheme for asymmetry assessments is proposed and explicit solutions to them are derived. An investigation into observational errors of points representing the geometric structure of an object offers a baseline reference for asymmetry assessment of the object. The proposed assessments are applicable to individual, part or all point pairs at both individual and collective levels. The exact relationship between the developed treatments and the widely used Procrustes method in asymmetry assessment is examined. An application of the proposed assessments to a large collection of human skull data in the form of 3D landmark coordinates finds: (a) asymmetry of most skulls is not fluctuating, but directional if measured about a plane fitted to shared landmarks or side landmarks for balancing; (b) asymmetry becomes completely fluctuating if one side of a skull could be slightly rotated and translated with respect to the other side; (c) female skulls are more asymmetric than male skulls. The methodology developed in this study is rigorous and transparent, and lays an analytical base for investigation of structural symmetries and asymmetries in a wide range of biological and medical applications.
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Affiliation(s)
- M. Hou
- Department of Engineering, Medical and Biological Engineering, Faculty of Science & Engineering, University of Hull, Hull, United Kingdom
| | - M. J. Fagan
- Department of Engineering, Medical and Biological Engineering, Faculty of Science & Engineering, University of Hull, Hull, United Kingdom
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Investigating Human Torso Asymmetries: An Observational Longitudinal Study of Fluctuating and Directional Asymmetry in the Scoliotic Torso. Symmetry (Basel) 2021. [DOI: 10.3390/sym13101821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The presence of directional and fluctuating asymmetry in adolescent idiopathic scoliosis has not been deeply studied. We aimed to test the presence of both in a scoliosis group and a control group. 24 patients with adolescent idiopathic scoliosis and 24 control subjects were subjected to geometric morphometrics analyses to address our main hypotheses and to make qualitative visualizations of the 3D shape changes in patients with scoliosis. Our results support the hypothesis that both asymmetric traits are present in the scoliosis and control groups, but to a greater degree in patients. A qualitative visualization tool that allows us to measure the impact that directional and fluctuating asymmetry have on the 3D shape of our patients has been developed. Adolescent idiopathic scoliosis is the result of developmental instabilities during growth and the visualization of the 3D shape changes in response to both asymmetric variables has shown different morphological behaviors. Measuring these variables is important, as they can prevent the localization and deformation that is expected to occur during the course of scoliosis in every individual patient and therefore acts as a key clinical finding that may be used in the prognosis of the condition.
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Symmetry of the Human Head—Are Symmetrical Models More Applicable in Numerical Analysis? Symmetry (Basel) 2021. [DOI: 10.3390/sym13071252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The study of symmetrical and non-symmetrical effects in physics, mathematics, mechanics, medicine, and numerical methods is a current topic due to the complexity of the experiments, calculations, and virtual simulations. However, there is a limited number of research publications in computational biomechanics focusing on the symmetry of numerical head models. The majority of the models in the researched literature are symmetrical. Thus, we stated a hypothesis wherever the symmetrical models might be more applicable in numerical analysis. We carried out in-depth studies about head symmetry through clinical data, medical images, materials models, and computer analysis. We concluded that the mapping of the entire geometry of the skull and brain is essential due to the significant differences that affect the results of numerical analyses and the possibility of misinterpretation of the tissue deformation under mechanical load results.
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McPherson CB. Examining developmental plasticity in the skeletal system through a sensitive developmental windows framework. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2021; 176:163-178. [PMID: 34105143 DOI: 10.1002/ajpa.24338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 05/12/2021] [Accepted: 05/23/2021] [Indexed: 12/19/2022]
Abstract
Developmental plasticity facilitates energetically costly but potentially fitness-enhancing adjustments to phenotypic trajectories in response to environmental stressors, and thus may significantly impact patterns of growth, morbidity, and mortality over the life course. Ongoing research into epigenetics and developmental biology indicate that the timing of stress exposures is a key factor when assessing their impact on developmental processes. Specifically, stress experienced within sensitive developmental windows (SDWs), discrete developmental periods characterized by heightened energy requirements and rapid growth, may alter the pace and tempo of growth in ways that significantly influence phenotypic development over both the short and long term. In human skeletal biology, efforts to assess how developmental environments shape health outcomes over the life course could be enhanced by incorporating the SDW concept into existing methodological approaches. The goal of this article is to outline an interpretive framework for identifying and interpreting evidence of developmental stress in the skeletal system using the SDW concept. This framework provides guidance for the identification of elements most likely to capture evidence of stress most relevant to a study's core research questions, the interpretation of developmental stress exhibited by those elements, and the relationship of skeletal indicators of stress to the demographic patterning of morbidity and mortality. Use of the SDW concept in skeletal biology has the potential to enrich traditional approaches to addressing developmental origins of health and disease hypotheses, by targeting periods in which individuals are most susceptible to stress and thus most likely to exhibit plasticity in response.
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Affiliation(s)
- Cait B McPherson
- School of Anthropology, University of Arizona, Tucson, Arizona, USA.,Arizona State Museum, University of Arizona, Tucson, Arizona, USA
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Bertsatos A, Papageorgopoulou C, Valakos E, Chovalopoulou ME. Investigating the sex-related geometric variation of the human cranium. Int J Legal Med 2018; 132:1505-1514. [PMID: 29380124 DOI: 10.1007/s00414-018-1790-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 01/22/2018] [Indexed: 11/30/2022]
Abstract
Accurate sexing methods are of great importance in forensic anthropology since sex assessment is among the principal tasks when examining human skeletal remains. The present study explores a novel approach in assessing the most accurate metric traits of the human cranium for sex estimation based on 80 ectocranial landmarks from 176 modern individuals of known age and sex from the Athens Collection. The purpose of the study is to identify those distance and angle measurements that can be most effectively used in sex assessment. Three-dimensional landmark coordinates were digitized with a Microscribe 3DX and analyzed in GNU Octave. An iterative linear discriminant analysis of all possible combinations of landmarks was performed for each unique set of the 3160 distances and 246,480 angles. Cross-validated correct classification as well as multivariate DFA on top performing variables reported 13 craniometric distances with over 85% classification accuracy, 7 angles over 78%, as well as certain multivariate combinations yielding over 95%. Linear regression of these variables with the centroid size was used to assess their relation to the size of the cranium. In contrast to the use of generalized procrustes analysis (GPA) and principal component analysis (PCA), which constitute the common analytical work flow for such data, our method, although computational intensive, produced easily applicable discriminant functions of high accuracy, while at the same time explored the maximum of cranial variability.
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Affiliation(s)
- Andreas Bertsatos
- Department of Animal and Human Physiology, Faculty of Biology, National and Kapodistrian University of Athens, Panepistimiopolis, 157 81, Athens, GR, Greece
| | - Christina Papageorgopoulou
- Laboratory of Physical Anthropology, Department of History and Ethnology, Democritus University of Thrace, 1 P. Tsaldari Street, 69100, Komotini, Greece
| | - Efstratios Valakos
- Department of Animal and Human Physiology, Faculty of Biology, National and Kapodistrian University of Athens, Panepistimiopolis, 157 81, Athens, GR, Greece
| | - Maria-Eleni Chovalopoulou
- Department of Animal and Human Physiology, Faculty of Biology, National and Kapodistrian University of Athens, Panepistimiopolis, 157 81, Athens, GR, Greece.
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Gawlikowska-Sroka A, Dabrowski P, Szczurowski J, Dzieciolowska-Baran E, Staniowski T. Influence of physiological stress on the presence of hypoplasia and fluctuating asymmetry in a medieval population from the village of Sypniewo. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2017; 19:43-52. [PMID: 29198399 DOI: 10.1016/j.ijpp.2017.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 10/03/2017] [Accepted: 10/09/2017] [Indexed: 06/07/2023]
Abstract
This study aims to estimate the levels of physiological stress in the medieval rural population of Sypniewo by evaluating patterns of fluctuating asymmetry (FA) and enamel hypoplasia (EH), and provide information on the influence of physiological stress during the prenatal and perinatal period on early childhood development. Stress is defined as any external or internal condition that challenges homeostasis of an organism. FA is associated with physiological stress occurring mainly during prenatal development and early childhood. The level of FA is thought to reflect the intensity of the stressor(s). EH is caused by physiological stress such as nutritional instability during the first years of life. The studied material consisted of 126 skulls from the village of Sypniewo (Poland). Cranial radiographs were taken in postero-anterior (P-A) and basal views. The images were scanned and calibrated. Measurements of the cranium were used to estimate FA. The presence of EH was assessed using standard anthropological methods The highest levels of FA were observed in the region of the cranial base. EH was observed in 29% of individuals from the rural skeletal series. There was no statistically significant correlation between FA and EH occurrence or between sex and the studied stress indicators.
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Affiliation(s)
| | - Pawel Dabrowski
- Department of Anatomy, Wroclaw Medical University, ul. Chalubinskiego 6a, 50-368 Wroclaw, Poland.
| | - Jacek Szczurowski
- Department of Anthropology, Wroclaw University of Environmental and Life Sciences, ul. Kozuchowska 5, 51-631 Wroclaw, Poland
| | | | - Tomasz Staniowski
- Department of Conservative Dentistry and Pedodontics, Wroclaw Medical University, ul. Krakowska 26, 50-425 Wroclaw, Poland
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