Cochlear Implantation Via the Middle Fossa Approach: Surgical and Programming Considerations

Objectives: To report the results of cochlear implantation via the middle fossa approach in 4 patients, discuss the complications, and present a detailed description of the programming specifications in these cases. Study Design: Retrospective case review. Setting: Tertiary-care referral center with a well-established cochlear implant program. Patients: Four patients with bilateral canal wall down mastoid cavities who underwent the middle fossa approach for cochlear implantation. Interventions: Cochlear implantation and subsequent rehabilitation. A middle fossa approach with cochleostomy was successfully performed on the most superficial part of the apical turn in 4 patients. A Nucleus 24 cochlear implant system was used in 3 patients and a MED-EL Sonata Medium device in 1 patient. The single electrode array was inserted through a cochleostomy from the cochlear apex and occupied the apical, middle, and basal turns. Telemetry and intraoperative impedance recordings were performed at the end of surgery. A CT scan of the temporal bones was performed to document electrode insertion for all of the patients. Main Outcome Measures: Complications, hearing thresholds, and speech perception outcomes were evaluated. Results: Neural response telemetry showed present responses in all but 1 patient, who demonstrated facial nerve stimulation during the test. Open-set speech perception varied from 30% to 100%, despite the frequency allocation order of the MAP. Conclusion: Cochlear implantation via the middle cranial fossa is a safe approach, although it is a challenging procedure, even for experienced surgeons.

New species of Pseudanos Winterbottom, 1980 (Characiformes: Anostomidae), with notes on the taxonomy of P. gracilis and P. trimaculatus

A new species of Pseudanos (Characiformes, Anostomidae) is described from the Rio Negro in Brazil, and the Rio Casiquiare and Rio Atabapo, in Venezuela. Specimens of the new species were previously mistakenly identified as Pseudanos gracilis. The new species is diagnosed by having three branchiostegal rays (vs. four in P. gracilis and most specimens of P. winterbottomi), dark transversal bars on dorsum absent (vs. present in P. trimaculatus), dark spots present on the center of each body scale, forming conspicuous, straight dark lines (vs. dark spots absent in P. gracilis and in some specimens of P. trimaculatus), four midlateral dark blotches on body (vs. usually two, sometimes three or four in P. trimaculatus, or body lacking midlateral blotches and presenting instead a broad midlateral stripe in P. winterbottomi), angle of dorsal and ventralmost radii of body scales between 40 degrees and 90 degrees (vs. angle between 110 degrees and 180 degrees in P. gracilis and P. trimaculatus), and cranial fontanel opened along its entire length (vs. cranial fontanel partially closed in P. trimaculatus). Type specimens and extensive additional material of Pseudanos gracilis and P. trimaculatus were examined and comments on the taxonomy of both species are provided. Pseudanos irinae is herein considered a junior synonym of P. trimaculatus. In addition, an updated key to identification of valid species of Pseudanos is presented.

NADPH- Diaphorase positive cardiac neurons in the atria of mice. A morphoquantitative study

Abstract Background The present study was conducted to determine the location, the morphology and distribution of NADPH-diaphorase positive neurons in the cardiac nerve plexus of the atria of mice (ASn). This plexus lies over the muscular layer of the atria, dorsal to the muscle itself, in the connective tissue of the subepicardium. NADPH- diaphorase staining was performed on whole-mount preparations of the atria mice. For descriptive purposes, all data are presented as means ± SEM. Results The majority of the NADPH-diaphorase positive neurons were observed in the ganglia of the plexus. A few single neurons were also observed. The number of NADPH-d positive neurons was 57 ± 4 (ranging from 39 to 79 neurons). The ganglion neurons were located in 3 distinct groups: (1) in the region situated cranial to the pulmonary veins, (2) caudally to the pulmonary veins, and (3) in the atrial groove. The largest group of neurons was located cranially to the pulmonary veins (66.7%). Three morphological types of NADPH-diaphorase neurons could be distinguished on the basis of their shape: unipolar cells, bipolar cells and cells with three processes (multipolar cells). The unipolar neurons predominated (78.9%), whereas the multipolar were encountered less frequently (5,3%). The sizes (area of maximal cell profile) of the neurons ranged from about 90 μm2to about 220 μm2. Morphometrically, the three types of neurons were similar and there were no significant differences in their sizes. The total number of cardiac neurons (obtained by staining the neurons with NADH-diaphorase method) was 530 ± 23. Therefore, the NADPH-diaphorase positive neurons of the heart represent 10% of the number of cardiac neurons stained by NADH. Conclusion The obtained data have shown that the NADPH-d positive neurons in the cardiac plexus of the atria of mice are morphologically different, and therefore, it is possible that the function of the neurons may also be different.

The pterional craniotomy: tips and tricks

This review intended to describe in a didactic and practical manner the frontotemporosphenoidal craniotomy, which is usually known as pterional craniotomy and constitute the cranial approach mostly utilized in the modern neurosurgery. This is, then, basically a descriptive text, divided according to the main stages involved in this procedure, and describes with details how the authors currently perform this craniotomy.

Distribuição do nervo fibular comum em fetos de equinos e descrição anatômica de pontos para bloqueio anestésico

Analisou-se a distribuição do nervo fibular comum em 30 fetos de equinos, sem raça definida, provenientes do acervo do Laboratório de Anatomia Animal da Faculdade de Medicina Veterinária da Universidade Federal de Uberlândia, que foram injetados e conservados em solução aquosa de formaldeído a 10%. Contatou-se que o referido nervo deriva do isquiático, divide-se em nervos fibulares superficial e profundo, distribuindo-se para os músculos extensores lateral e longo do dedo, fibular terceiro e tibial cranial. Traçando-se uma linha imaginária na região médio-lateral da tuberosidade do osso tíbia, o nervo fibular comum pode ser bloqueado em sua parte proximal, no terço caudal, entre o tendão de inserção do músculo bíceps femoral e a face lateral do músculo gastrocnêmio lateral (terço médio); e o nervo fibular profundo, na parte proximal da tíbia, crânio-distalmente ao fibular comum. O bloqueio do nervo fibular superficial pode ser realizado em duas regiões da tíbia: na proximal, considerando-se a linha imaginária, distalmente ao ponto citado para o fibular comum e caudalmente ao descrito para o fibular profundo; e na distal, na face lateral da articulação tíbio-társica, entre os tendões de inserção dos músculos extensores lateral e longo do dedo.

Aspectos morfométricos do timo em gatos domésticos (Felis domesticus)

O timo é um órgão linfático primário que desenvolve sua atividade em organismos jovens. Apesar de sua função ser responsável por mecanismos fundamentais na aquisição das defesas e conseqüentes respostas orgânicas, ela ainda não está totalmente esclarecida, nem tampouco as bases morfológicas que respondem por tais funções, como o processo de desenvolvimento e involução do órgão. Objetivou-se analisar e caracterizar os aspectos morfológicos do timo, tais como seu tamanho e volume, e aspectos histológicos do timo em gatos, correlacionando o sexo e o desenvolvimento etário. Doze timos provenientes de fetos de gatos domésticos (Felis domesticus) sem raça definida (SRD), machos e fêmeas, separados em três grupos etários. O timo apresentou-se com uma coloração rosa-pálida e com duas porções, a torácica e a cervical, sendo que cada uma delas possuía um lobo direito e um lobo esquerdo em sua maioria. A porção torácica localizava-se em região de mediastino cranial, entre os pulmões e à base do coração. E a porção cervical estendia-se além das costelas em sentido cranial, estando localizada ventralmente à traqueia. A estrutura celular do timo demonstrou-se organizada com a presença de agregados concêntricos, os chamados corpúsculos tímicos, formados por células epiteliais, sustentada por uma cápsula de tecido conjuntivo de onde partiam septos que ao penetrar no órgão dividia-o em lóbulos. Ocorreram variações significativas quanto à lobação e as dimensões do timo entre indivíduos da mesma faixa etária, e entre sexos diferentes. Os valores relativos ao comprimento, espessura e largura, de maneira geral, apresentaram aumento, em conformidade ao desenvolvimento dos animais, mas com diferenças entre os sexos.

Seeking tools for image fusion between computed tomography, structural and functional magnetic resonance methods for applications in neurosurgery

OBJECTIVE: To evaluate tools for the fusion of images generated by tomography and structural and functional magnetic resonance imaging. METHODS: Magnetic resonance and functional magnetic resonance imaging were performed while a volunteer who had previously undergone cranial tomography performed motor and somatosensory tasks in a 3-Tesla scanner. Image data were analyzed with different programs, and the results were compared. RESULTS: We constructed a flow chart of computational processes that allowed measurement of the spatial congruence between the methods. There was no single computational tool that contained the entire set of functions necessary to achieve the goal. CONCLUSION: The fusion of the images from the three methods proved to be feasible with the use of four free-access software programs (OsiriX, Register, MRIcro and FSL). Our results may serve as a basis for building software that will be useful as a virtual tool prior to neurosurgery.

Crenicichla chicha, a new species of pike cichlid (Teleostei: Cichlidae) from the rio Papagaio, upper rio Tapajós basin, Mato Grosso, Brazil

Crenicichla chicha, new species, occurs in clear, fast-running waters with rocky substrates in the rio Papagaio and tributaries. It is distinguished from all other Crenicichla species by the combination of two character states: infraorbitals 3 and 4 co-ossified (vs. separated) and 66-75 scales in the row immediately above to that containing the lower lateral line (E1 row scales). Crenicichla chicha shares a smooth preopercular margin, co-ossification of infraorbitals 3 and 4, and some color features with C. hemera from the adjacent rio Aripuanã drainage, rio Madeira basin. It differs from Crenicichla hemera in more E1 scales (66-75 vs. 58-65) and presence of a conspicuous black narrow stripe running from infraorbital 3 obliquely caudoventrad toward the preopercular margin vs. a rounded and faint suborbital marking present on infraorbitals 3-4. Examination of the type series and additional material from the rio Aripuanã confirms that Crenicichla guentheri Ploeg, 1991 is a junior subjective synonym of C. hemera Kullander, 1990.

The performance of four molecular methods for the laboratory diagnosis of congenital toxoplasmosis in amniotic fluid samples

Introduction Toxoplasmosis may be life-threatening in fetuses and in immune-deficient patients. Conventional laboratory diagnosis of toxoplasmosis is based on the presence of IgM and IgG anti-Toxoplasma gondii antibodies; however, molecular techniques have emerged as alternative tools due to their increased sensitivity. The aim of this study was to compare the performance of 4 PCR-based methods for the laboratory diagnosis of toxoplasmosis. One hundred pregnant women who seroconverted during pregnancy were included in the study. The definition of cases was based on a 12-month follow-up of the infants. Methods Amniotic fluid samples were submitted to DNA extraction and amplification by the following 4 Toxoplasma techniques performed with parasite B1 gene primers: conventional PCR, nested-PCR, multiplex-nested-PCR, and real-time PCR. Seven parameters were analyzed, sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and efficiency (Ef). Results Fifty-nine of the 100 infants had toxoplasmosis; 42 (71.2%) had IgM antibodies at birth but were asymptomatic, and the remaining 17 cases had non-detectable IgM antibodies but high IgG antibody titers that were associated with retinochoroiditis in 8 (13.5%) cases, abnormal cranial ultrasound in 5 (8.5%) cases, and signs/symptoms suggestive of infection in 4 (6.8%) cases. The conventional PCR assay detected 50 cases (9 false-negatives), nested-PCR detected 58 cases (1 false-negative and 4 false-positives), multiplex-nested-PCR detected 57 cases (2 false-negatives), and real-time-PCR detected 58 cases (1 false-negative). Conclusions The real-time PCR assay was the best-performing technique based on the parameters of Se (98.3%), Sp (100%), PPV (100%), NPV (97.6%), PLR (â^ž), NLR (0.017), and Ef (99%).

Effect of rearing technique over skeletal deformities incidence and osteological development in red porgy Pagrus pagrus (Linnaeus, 1758) larvae

[EN]Red porgy is a candidate species for marine aquaculture diversification.The objective of the present study was to describe the osteological development and the occurrence of skeletal deformities in Pagrus pagrus larvae in relation to the intensification of the rearing system. Fish samples were periodically collected along the development from hatching to juveniles (95days after hatching). Osteological development and the presence of skeleton abnormalities were evaluated. X-ray studies revealed a high number of fish (Semi-intensive:38.8%; Intensive:46.5 %) with skeletal deformities. No significant interaction was found on the incidence of lordosis and fused vertebrae with the rearing tecnique. However, cranial abnormalities and kyphosis incidences were significantly higher in intensive system cultured red porgy. Also, the position of fused vertebrae in this fish was located mainly in the caudal area instead of pre-hemal area for semi-intensive system reared red porgy. Present results, suggest a relationship among feeding sequence, osteological development and deformity incidence and location in red porgy larvae

Significato prognostico dell'ecografia cerebrale nei neonati con infezione congenita da citomegalovirus

Background: Congenital cytomegalovirus (CMV) infection may lead to cerebral injury and neurodevelopmental delay. Cranial computed tomography (CT) is currently the standard imaging technique for predicting the outcome of CMV infected patients. Ultrasound (US) is a safe means to assess the extent of cerebral injury due to CMV infection in neonates, and unlike CT, is readily available at the bedside. Aim: To report the accuracy of US in predicting neurodevelopmental and sensorineural outcome in patients with congenital CMV infection. Study design: 57 newborns with congenital CMV infection underwent brain US and were followed prospectively for motor skills, developmental quotient and hearing function. Results: An abnormal US was found in 12/57 newborns. At least one sequela (Developmental Quotient < 85, motor delay, sensorineural hearing loss) was present in 10/11 surviving children with abnormal US (1 patient died in the neonatal period) vs 3/45 newborns with normal US (OR for death or poor outcome: 154, CI 17.3-1219.6, p<0.001, positive predictive value 91.7%, negative predictive value 93.3%). Conclusion: A good correlation is shown between ultrasound abnormalities and the prediction of outcome, suggesting that US may be used to study and follow CMV infected neonates. Our findings await confirmation in a larger population.

Anatomic study of the feline bronchial and vascular structures with a 64 detector-row computed tomography

Multidetector row computed tomography over the last decade is commonly used in veterinary medicine. This new technology has an increased spatial and temporal resolution, could evaluate wider scanning range in shorter scanning time, providing an advanced imaging modality. Computed tomography angiographic studies are commonly used in veterinary medicine in order to evaluate vascular structures of the abdomen and the thorax. Pulmonary pathology in feline patients is a very common condition and usually is further evaluating with computed tomography. Up to date few references of the normal computed tomographic aspects of the feline thorax are reported. In this study a computed tomographic pulmonary angiography (CTPA) protocol is reported in normal cats and is compared with the up to date anatomical references. A CTPA protocol using a 64 MDCT in our study achieved high resolution images of the pulmonary arteries, pulmonary veins and bronchial lumen till the level of minor segmental branches. Feline pulmonary bronchial parenchyma demonstrates an architecture of mixed type with a monopedial model observed in the most anatomical parts and the dichotomic aspect is seen at the accessory lobe. The arterial and venous architecture is similar to the bronchial. Statistical analysis demonstrates the linear correlation of tracheal diameter to the felines weight. Vascular variations were noticed. The pulmonary venous system enters into the left atrium through three ostia (left cranial ostia: consisted of the anastomosis of the cranial and caudal portion of the left cranial pulmonary vein; right ostia: consisted of the anastomosis of the right cranial and middle pulmonary vein; and the caudal ostia: consisted of the anastomosis of the right and left caudal pulmonary vein). In conclusion CTPA is applicable in feline patients and provides an excellent imaging of the pulmonary arterial, venous and bronchial system till the level of minor segmental branches.

Analisi clinica ed ex-vivo dei punti isometrici durante tecnica tightrope nella ricostruzione del legamento crociato craniale del cane

La rottura del Legamento Crociato Craniale (LCCr) rappresenta una delle patologie ortopediche di maggiore riscontro clinico nella specie canina. In seguito a rottura del LCCr si presenta un continuo slittamento craniale della tibia il quale esita in un processo osteoartrosico. La risoluzione chirurgica rappresenta la migliore soluzione terapeutica. Le tecniche chirurgiche extra-articolari con sfruttamento dei punti isometrici del ginocchio si presentano come delle procedure molto diffuse e utilizzate. Questa tesi propone di validare l’uso di un nuovo sistema di navigazione computerizzato-assistito per la valutazione cinematica durante la ricostruzione del LCCr nel cane, ma soprattutto di studiare e confrontare il comportamento e l’efficacia dopo ricostruzione TightRope (TR) in due diverse coppie di punti isometrici. Abbiamo effettuato due analisi in parallelo. La prima eseguendo interventi chirurgici con tecnica TR su 18 casi clinici e sfruttando il punto isometrico del femore (F2) e due diversi punti isometrici della tibia (T2 o T3). L’analisi prevedeva dei controlli postoperatori a 1, 3 e 6 mesi. Ad ogni controllo veniva effettuata una visita ortopedica, esami radiografici, un questionario di valutazione clinico e di soddisfazione del proprietario. Mentre nella ricerca Ex-Vivo abbiamo eseguito dei test su 14 preparati anatomici con l’utilizzo di un sistema di navigazione computerizzato per la rilevazione dei dati. L’analisi prevedeva la valutazione dell’articolazione in diversi stadi: LCCr intatto; LCCr rotto; dopo ricostruzione con TR in F2-T2 e tensionato a 22N, 44N e 99N; dopo ricostruzione con TR in F2-T3 e tensionato a 22N, 44N e 99N. Ad ogni stadio si eseguivano cinque test di valutazione, tra cui: Test del Cassetto, Test di compressione tibiale (TCT), Rotazione Interna/Esterna, Flesso/Estensione e Varo/Valgo. Lo scopo di tale studio è quello di confrontare tra loro i punti isometrici del ginocchio e di analizzare l’efficacia della tecnica TR nelle due differenti condizioni di isometria (F2-T2 e F2-T3).

The prehistoric inhabitants of the Wadi Howar : an anthropological study of human skeletal remains from the Sudanese part of the Eastern Sahara

All currently available human skeletal remains from the Wadi Howar (Eastern Sahara, Sudan) were employed in an anthropological study. The study’s first aim was to describe this unique 5th to 2nd millennium BCE material, which comprised representatives of all three prehistoric occupation phases of the region. Detecting diachronic differences in robusticity, occupational stress levels and health within the spatially, temporally and culturally heterogeneous sample was its second objective. The study’s third goal was to reveal metric and non-metric affinities between the different parts of the series and between the Wadi Howar material and other relevant prehistoric as well as modern African populations. rnThe reconstruction and comprehensive osteological analysis of 23 as yet unpublished individuals, the bulk of the Wadi Howar series, constituted the first stage of the study. The analyses focused on each individual’s in situ position, state of preservation, sex, age at death, living height, living weight, physique, biological ancestry, epigenetic traits, robusticity, occupational stress markers, health and metric as well as morphological characteristics. Building on the results of these efforts and the re-examination of the rest of the material, the Wadi Howar series as a whole, altogether 32 individuals, could be described. rnA wide variety of robusticity, occupational stress and health variables was evaluated. The pre-Leiterband (hunter-gatherer-fisher/hunter-gatherer-fisher-herder) and the Leiterband (herder-gatherer) data of over a third of these variables differed statistically significantly or in tendency from each other. The Leiterband sub-sample was characterised by higher enamel hypoplasia frequencies, lower mean ages at death and less pronounced expressions of occupational stress traits. This pattern was interpreted as evidence that the adoption and intensification of animal husbandry did probably not constitute reactions to worsening conditions. Apart from that, the relevant observations, noteworthy tendencies and significant differences were explained as results of a broader spectrum of pre-Leiterband subsistence activities and the negative side effects of the increasingly specialised herder-gatherer economy of the Leiterband phase. rnUsing only the data which could actually be collected from it, multiple, separate, individualised discriminant function analyses were carried out for each Wadi Howar skeleton to determine which prehistoric and which modern comparative sample it was most similar to. The results of all individual analyses were then summarised and examined as a whole. Thus it became possible to draw conclusions about the affinities the Wadi Howar material shared with prehistoric as well as modern populations and to answer questions concerning the diachronic links between the Wadi Howar’s prehistoric populations. When the Wadi Howar remains were positioned in the context of the selected prehistoric (Jebel Sahaba/Tushka, A-Group, Malian Sahara) and modern comparative samples (Southern Sudan, Chad, Mandinka, Somalis, Haya) in this fashion three main findings emerged. Firstly, the series as a whole displayed very strong affinities with the prehistoric sample from the Malian Sahara (Hassi el Abiod, Kobadi, Erg Ine Sakane, etc.) and the modern material from Southern Sudan and, to a lesser extent, Chad. Secondly, the pre-Leiterband and the Leiterband sub-sample were closer to the prehistoric Malian as well as the modern Southern Sudanese material than they were to each other. Thirdly, the group of pre-Leiterband individuals approached the Late Pleistocene sample from Jebel Sahaba/Tushka under certain circumstances. A theory offering explanations for these findings was developed. According to this theory, the entire prehistoric population of the Wadi Howar belonged to a Saharo-Nilotic population complex. The Jebel Sahaba/Tushka population constituted an old Nilotic and the early population of the Malian Sahara a younger Saharan part of this complex. The pre-Leiterband groups probably colonised the Wadi Howar from the east, either during or soon after the original Saharo-Nilotic expansion. Unlike the pre-Leiterband groups, the Leiterband people originated somewhere west of the Wadi Howar. They entered the region in the context of a later, secondary Saharo-Nilotic expansion. In the process, the incoming Leiterband groups absorbed many members of the Wadi Howar’s older pre-Leiterband population. The increasing aridification of the Wadi Howar region ultimately forced its prehistoric inhabitants to abandon the wadi. Most of them migrated south and west. They, or groups closely related to them, probably were the ancestors of the majority of the Nilo-Saharan-speaking pastoralists of modern-day Southern Sudan and Eastern Chad.

Observable stages and scheduling for alveolar remodeling following antemortem tooth loss

Zahnverlust zu Lebzeiten („antemortem tooth loss“, AMTL) kann als Folge von Zahnerkrankungen, Traumata, Zahnextraktionen oder extremer kontinuierlicher Eruption sowie als Begleiterscheinung fortgeschrittener Stadien von Skorbut oder Lepra auftreten. Nach dem Zahnverlust setzt die Wundheilung als Sekundärheilung ein, während der sich die Alveole mit Blut füllt und sich ein Koagulum bildet. Anschließend erfolgt dessen Umwandlung in Knochengewebe und schließlich verstreicht die Alveole derart, dass sie makroskopisch nicht mehr erkannt werden kann. Der Zeitrahmen der knöchernen Konsolidierung des Kieferkammes ist im Detail wenig erforscht. Aufgrund des gehäuften Auftretens von AMTL in menschlichen Populationen, ist die Erarbeitung eines Zeitfensters, mit dessen Hilfe durch makroskopische Beobachtung des Knochens die Zeitspanne seit dem Zahnverlust („time since tooth loss“, TSL) ermittelt werden kann, insbesondere im archäologischen Kontext äußerst wertvoll. Solch ein Zeitschema mit Angaben über die Variabilität der zeitlichen Abläufe bei den Heilungsvorgängen kann nicht nur in der Osteologie, sondern auch in der Forensik, der allgemeinen Zahnheilkunde und der Implantologie nutzbringend angewandt werden. rnrnNach dem Verlust eines Zahnes wird das Zahnfach in der Regel durch ein Koagulum aufgefüllt. Das sich bildende Gewebe wird rasch in noch unreifen Knochen umgewandelt, welcher den Kieferknochen und auch die angrenzenden Zähne stabilisiert. Nach seiner Ausreifung passt sich das Gewebe schließlich dem umgebenden Knochen an. Das Erscheinungsbild des Zahnfaches während dieses Vorgangs durchläuft verschiedene Stadien, welche in der vorliegenden Studie anhand von klinischen Röntgenaufnahmen rezenter Patienten sowie durch Untersuchungen an archäologischen Skelettserien identifiziert wurden. Die Heilungsvorgänge im Zahnfach können in eine prä-ossale Phase (innerhalb einer Woche nach Zahnverlust), eine Verknöcherungsphase (etwa 14 Wochen nach Zahnverlust) und eine ossifizierte bzw. komplett verheilte Phase (mindestens 29 Wochen nach Zahnverlust) eingeteilt werden. Etliche Faktoren – wie etwa die Resorption des Interdentalseptums, der Zustand des Alveolarknochens oder das Individualgeschlecht – können den normalen Heilungsprozess signifikant beschleunigen oder hemmen und so Unterschiede von bis zu 19 Wochen verursachen. Weitere Variablen wirkten sich nicht signifikant auf den zeitlichen Rahmen des Heilungsprozesse aus. Relevante Abhängigkeiten zwischen verschiedenen Variabeln wurden ungeachtet der Alveolenauffüllung ebenfalls getestet. Gruppen von unabhängigen Variabeln wurden im Hinblick auf Auffüllungsgrad und TSL in multivariablen Modellen untersucht. Mit Hilfe dieser Ergebnisse ist eine grobe Einschätzung der Zeitspanne nach einem Zahnverlust in Wochen möglich, wobei die Einbeziehung weiterer Parameter eine höhere Präzision ermöglicht. rnrnObwohl verschiedene dentale Pathologien in dieser Studie berücksichtigt wurden, sollten zukünftige Untersuchungen genauer auf deren potenzielle Einflussnahme auf den alveolaren Heilungsprozess eingehen. Der kausale Zusammenhang einiger Variablen (wie z. B. Anwesenheit von Nachbarzähnen oder zahnmedizinische Behandlungen), welche die Geschwindigkeit der Heilungsrate beeinflussen, wäre von Bedeutung für zukünftige Untersuchungen des oralen Knochengewebes. Klinische Vergleichsstudien an forensischen Serien mit bekannter TSL oder an einer sich am Anfang des Heilungsprozesses befindlichen klinischen Serie könnten eine Bekräftigung dieser Ergebnisse liefern.