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Erschienen in: Anatomical Science International 4/2017

11.04.2016 | Original Article

Histological and radiographic study of human edentulous and dentulous maxilla

verfasst von: Yukino Kamigaki, Iwao Sato, Takashi Yosue

Erschienen in: Anatomical Science International | Ausgabe 4/2017

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Abstract

Data on the bone trabecular structure and density of the edentulous regions of the first upper molars are important for designing successful dental treatments, especially dental implants. However, no detailed defined morphometric properties on the human maxilla are available at the immunohistochemical and radiographic levels. Cone-beam computed tomography analysis and immunohistochemical observation were applied to the maxillary first molar region of 91 cadavers (46 males and 45 females). The edentulous maxilla can be classified into the following three forms: fully edentulous (FE), partially edentulous (PE), and immediately edentulous (IE). Compared with the first molar dentulous (FMD) specimens, significant differences in cortical bone structure and bone density exist among IE, PE, and FE in maxilla (P < 0.001). According to histochemical observations, the positive CD31 reaction clearly described a large vessel of the PE and small vessels of FMD and IE in maxillary sinus connective tissue. These structural issues were clearly related to tooth extraction. These morphological and radiographic data describing the edentulous region of the maxillary first molar might be useful for improving dental treatments.
Literatur
Zurück zum Zitat Araújo MG, Lindhe J (2005) Dimensional ridge alterations following tooth extraction. An experimental study in the dog. J Clin Periodontol 32:212–218CrossRefPubMed Araújo MG, Lindhe J (2005) Dimensional ridge alterations following tooth extraction. An experimental study in the dog. J Clin Periodontol 32:212–218CrossRefPubMed
Zurück zum Zitat Barngkgei I, Al Haffar I, Khattab R (2014) Osteoporosis prediction from the mandible using cone-beam computed tomography. Imaging Sci Dent 44:263–271CrossRefPubMedPubMedCentral Barngkgei I, Al Haffar I, Khattab R (2014) Osteoporosis prediction from the mandible using cone-beam computed tomography. Imaging Sci Dent 44:263–271CrossRefPubMedPubMedCentral
Zurück zum Zitat Beresford JN, Bennett JH, Devlin C, Leboy PS, Owen ME (1992) Evidence for an inverse relationship between the differentiation of adipocytic and osteogenic cells in rat marrow stromal cell cultures. J Cell Sci 102(2):341–351PubMed Beresford JN, Bennett JH, Devlin C, Leboy PS, Owen ME (1992) Evidence for an inverse relationship between the differentiation of adipocytic and osteogenic cells in rat marrow stromal cell cultures. J Cell Sci 102(2):341–351PubMed
Zurück zum Zitat Bertl K, Heimel P, Rokl-Riegler M, Hirtler L, Ulm C, Zechner W (2015) MicroCT-based evaluation of the trabecular bone quality of different implant anchorage sites for masticatory rehabilitation of the maxilla. J Craniomaxillofac Surg 43:961–968CrossRefPubMed Bertl K, Heimel P, Rokl-Riegler M, Hirtler L, Ulm C, Zechner W (2015) MicroCT-based evaluation of the trabecular bone quality of different implant anchorage sites for masticatory rehabilitation of the maxilla. J Craniomaxillofac Surg 43:961–968CrossRefPubMed
Zurück zum Zitat Billezikian JP, Raisz LG, Rodan GA (1996) Principles of bone biology. Academic, San Diego, pp 1135–1146, 1343–1354 Billezikian JP, Raisz LG, Rodan GA (1996) Principles of bone biology. Academic, San Diego, pp 1135–1146, 1343–1354
Zurück zum Zitat Blok Y, Gravesteijn FA, van Ruijven LJ, Koolstra JH (2013) Micro-architecture and mineralization of the human alveolar bone obtained with micro CT. Arch Oral Biol 58:621–627CrossRefPubMed Blok Y, Gravesteijn FA, van Ruijven LJ, Koolstra JH (2013) Micro-architecture and mineralization of the human alveolar bone obtained with micro CT. Arch Oral Biol 58:621–627CrossRefPubMed
Zurück zum Zitat Cardaropoli G, Araujo M, Lindhe J (2003) Dynamics of bone tissue formation in tooth extraction sites. An experimental study in dogs. J Clin Periodontol 30:809–818CrossRefPubMed Cardaropoli G, Araujo M, Lindhe J (2003) Dynamics of bone tissue formation in tooth extraction sites. An experimental study in dogs. J Clin Periodontol 30:809–818CrossRefPubMed
Zurück zum Zitat Chappard D, Retailleau-Gaborit N, Legrand E, Basle MF, Audran M (2005) Comparison insight bone measurements by histomorphometry and microCT. J Bone Miner Res 20:1177–1184CrossRefPubMed Chappard D, Retailleau-Gaborit N, Legrand E, Basle MF, Audran M (2005) Comparison insight bone measurements by histomorphometry and microCT. J Bone Miner Res 20:1177–1184CrossRefPubMed
Zurück zum Zitat Civelek AC, Pacheco EM, Natarajan TK, Wagner HN Jr, Iliff NT (1995) Quantitative measurement of vascularization and vascular in growth rate of coralline hydroxyapatite ocular implant by Tc-99m MDP bone imaging. Clin Nucl Med 20:779–787CrossRefPubMed Civelek AC, Pacheco EM, Natarajan TK, Wagner HN Jr, Iliff NT (1995) Quantitative measurement of vascularization and vascular in growth rate of coralline hydroxyapatite ocular implant by Tc-99m MDP bone imaging. Clin Nucl Med 20:779–787CrossRefPubMed
Zurück zum Zitat Cortet B, Chappard D, Boutry N, Dubois P, Cotten A, Marchandise X (2004) Relationship between computed tomographic image analysis and histomorphometry for microarchitectural characterization of human calcaneus. Calcif Tissue Int 75:23–31CrossRefPubMed Cortet B, Chappard D, Boutry N, Dubois P, Cotten A, Marchandise X (2004) Relationship between computed tomographic image analysis and histomorphometry for microarchitectural characterization of human calcaneus. Calcif Tissue Int 75:23–31CrossRefPubMed
Zurück zum Zitat Covani U, Ricci M, Bozzolo G, Mangano F, Zini A, Barone A (2011) Analysis of the pattern of the alveolar ridge remodelling following single tooth extraction. Clin Oral Implants Res 22:820–825CrossRefPubMed Covani U, Ricci M, Bozzolo G, Mangano F, Zini A, Barone A (2011) Analysis of the pattern of the alveolar ridge remodelling following single tooth extraction. Clin Oral Implants Res 22:820–825CrossRefPubMed
Zurück zum Zitat Croucher PI, Garrahan NJ, Compston JE (1996) Assessment of cancellous bone structure: comparison of strut analysis, trabecular bone pattern factor, and marrow space star volume. J Bone Miner Res 11:955–961CrossRefPubMed Croucher PI, Garrahan NJ, Compston JE (1996) Assessment of cancellous bone structure: comparison of strut analysis, trabecular bone pattern factor, and marrow space star volume. J Bone Miner Res 11:955–961CrossRefPubMed
Zurück zum Zitat Davies JE (2003) Understanding peri-implant endosseous healing. J Dent Educ 67:932–949PubMed Davies JE (2003) Understanding peri-implant endosseous healing. J Dent Educ 67:932–949PubMed
Zurück zum Zitat de Oliveira RC, Leles CR, Lindh C, Ribeiro-Rotta RF (2012) Bone tissue microarchitectural characteristics at dental implant sites. Part 1: identification of clinical-related parameters. Clin Oral Implants Res 23:981–986CrossRefPubMed de Oliveira RC, Leles CR, Lindh C, Ribeiro-Rotta RF (2012) Bone tissue microarchitectural characteristics at dental implant sites. Part 1: identification of clinical-related parameters. Clin Oral Implants Res 23:981–986CrossRefPubMed
Zurück zum Zitat Dias DR, Leles CR, Batista AC, Lindh C, Ribeiro-Rotta RF (2015) Agreement between histomorphometry and microcomputed tomography to assess bone microarchitecture of dental implant sites. Clin Implant Dent Relat Res 17:732–741CrossRefPubMed Dias DR, Leles CR, Batista AC, Lindh C, Ribeiro-Rotta RF (2015) Agreement between histomorphometry and microcomputed tomography to assess bone microarchitecture of dental implant sites. Clin Implant Dent Relat Res 17:732–741CrossRefPubMed
Zurück zum Zitat Donos N, Retzepi M, Wall I, Hamlet S, Ivanovski S (2011) In vivo gene expression profile of guided bone regeneration associated with a microrough titanium surface. Clin Oral Implants Res 22:390–398CrossRefPubMed Donos N, Retzepi M, Wall I, Hamlet S, Ivanovski S (2011) In vivo gene expression profile of guided bone regeneration associated with a microrough titanium surface. Clin Oral Implants Res 22:390–398CrossRefPubMed
Zurück zum Zitat Farina R, Pramstraller M, Franceschetti G, Pramstraller C, Trombelli L (2011) Alveolar ridge dimensions in maxillary posterior sextants: a retrospective comparative study of dentate and edentulous sites using computerized tomography data. Clin Oral Implants Res 22:1138–1144CrossRefPubMed Farina R, Pramstraller M, Franceschetti G, Pramstraller C, Trombelli L (2011) Alveolar ridge dimensions in maxillary posterior sextants: a retrospective comparative study of dentate and edentulous sites using computerized tomography data. Clin Oral Implants Res 22:1138–1144CrossRefPubMed
Zurück zum Zitat Gonzalez-Garcia R, Monje F (2013) Is micro-computed tomography reliable to determine the microstructure of the maxillary alveolar bone? Clin Oral Implants Res 24:730–737CrossRefPubMed Gonzalez-Garcia R, Monje F (2013) Is micro-computed tomography reliable to determine the microstructure of the maxillary alveolar bone? Clin Oral Implants Res 24:730–737CrossRefPubMed
Zurück zum Zitat Goto T, Nishinaka H, Kashiwabara T, Nagao K, Ichikawa T (2012) Main occluding area in partially edentulous patients: changes before and after implant treatment. J Oral Rehabil 39:677–683CrossRefPubMed Goto T, Nishinaka H, Kashiwabara T, Nagao K, Ichikawa T (2012) Main occluding area in partially edentulous patients: changes before and after implant treatment. J Oral Rehabil 39:677–683CrossRefPubMed
Zurück zum Zitat Ibrahim N, Parsa A, Hassan B, van der Stelt P, Aartman IH, Wismeijer D (2014) Accuracy of trabecular bone microstructural measurement at planned dental implant sites using cone-beam CT datasets. Clin Oral Implants Res 25:941–945CrossRefPubMed Ibrahim N, Parsa A, Hassan B, van der Stelt P, Aartman IH, Wismeijer D (2014) Accuracy of trabecular bone microstructural measurement at planned dental implant sites using cone-beam CT datasets. Clin Oral Implants Res 25:941–945CrossRefPubMed
Zurück zum Zitat Kennedy E (1928) Partial denture construction. Dental Items of Interest, Brooklyn Kennedy E (1928) Partial denture construction. Dental Items of Interest, Brooklyn
Zurück zum Zitat Kopecka D, Simunek A, Brazda T, Rota M, Slezak R, Capek L (2012) Relationship between subsinus bone height and bone volume requirements for dental implants: a human radiographic study. Int J Oral Maxillofac Implants 27:48–54PubMed Kopecka D, Simunek A, Brazda T, Rota M, Slezak R, Capek L (2012) Relationship between subsinus bone height and bone volume requirements for dental implants: a human radiographic study. Int J Oral Maxillofac Implants 27:48–54PubMed
Zurück zum Zitat Krings A, Rahman S, Huang S, Lu Y, Czernik PJ, Lecka-Czernik B (2012) Bone marrow fat has brown adipose tissue characteristics, which are attenuated with aging and diabetes. Bone 50:546–552CrossRefPubMed Krings A, Rahman S, Huang S, Lu Y, Czernik PJ, Lecka-Czernik B (2012) Bone marrow fat has brown adipose tissue characteristics, which are attenuated with aging and diabetes. Bone 50:546–552CrossRefPubMed
Zurück zum Zitat Lecka-Czernik B (2012) Marrow fat metabolism is linked to the systemic energy metabolism. Bone 50:534–539CrossRefPubMed Lecka-Czernik B (2012) Marrow fat metabolism is linked to the systemic energy metabolism. Bone 50:534–539CrossRefPubMed
Zurück zum Zitat Lekholm U, Zarb GA (1985) Patient selection and preparation. In: Branemark PI, Zarb GA, Albrektsson T (eds) Tissue integrated prostheses: osseointegration in clinical dentistry. Quintessence, Chicago, pp 199–209 Lekholm U, Zarb GA (1985) Patient selection and preparation. In: Branemark PI, Zarb GA, Albrektsson T (eds) Tissue integrated prostheses: osseointegration in clinical dentistry. Quintessence, Chicago, pp 199–209
Zurück zum Zitat Lee NK, Karsenty G (2008) Reciprocal regulation of bone and energy metabolism. Trends Endocrinol Metab 19:161–166CrossRefPubMed Lee NK, Karsenty G (2008) Reciprocal regulation of bone and energy metabolism. Trends Endocrinol Metab 19:161–166CrossRefPubMed
Zurück zum Zitat Marquezan M, Osorio A, Sant’Anna E, Souza MM, Maia L (2012) Does bone mineral density influence the primary stability of dental implants? A systematic review. Clin Oral Implants Res 23:767–774CrossRefPubMed Marquezan M, Osorio A, Sant’Anna E, Souza MM, Maia L (2012) Does bone mineral density influence the primary stability of dental implants? A systematic review. Clin Oral Implants Res 23:767–774CrossRefPubMed
Zurück zum Zitat Martinez H, Davarpanah M, Missika P, Celletti R, Lazzara R (2001) Optimal implant stabilization in low density bone. Clin Oral Implants Res 12:423–432CrossRefPubMed Martinez H, Davarpanah M, Missika P, Celletti R, Lazzara R (2001) Optimal implant stabilization in low density bone. Clin Oral Implants Res 12:423–432CrossRefPubMed
Zurück zum Zitat Misch CE (2015) Dental implant prosthetics. In: Misch CE (ed) Bone density, 2nd edn. Elsevier Health Sciences, St. Louis, pp 237–252 Misch CE (2015) Dental implant prosthetics. In: Misch CE (ed) Bone density, 2nd edn. Elsevier Health Sciences, St. Louis, pp 237–252
Zurück zum Zitat Monje A, Monje F, Gonzalez-Garcia R, Galindo-Moreno P, Rodriguez-Salvanes F, Wang HL (2014) Comparison between microcomputed tomography and cone-beam computed tomography radiologic bone to assess atrophic posterior maxilla density and microarchitecture. Clin Oral Implants Res 25:723–728CrossRefPubMed Monje A, Monje F, Gonzalez-Garcia R, Galindo-Moreno P, Rodriguez-Salvanes F, Wang HL (2014) Comparison between microcomputed tomography and cone-beam computed tomography radiologic bone to assess atrophic posterior maxilla density and microarchitecture. Clin Oral Implants Res 25:723–728CrossRefPubMed
Zurück zum Zitat Monje A, Gonzalez-Garcia R, Monje F, Chan HL, Galindo-Moreno P, Suarez F, Wang HL (2015) Microarchitectural pattern of pristine maxillary bone. Int J Oral Maxillofac Implants 30:125–132CrossRefPubMed Monje A, Gonzalez-Garcia R, Monje F, Chan HL, Galindo-Moreno P, Suarez F, Wang HL (2015) Microarchitectural pattern of pristine maxillary bone. Int J Oral Maxillofac Implants 30:125–132CrossRefPubMed
Zurück zum Zitat Muller R (2003) Bone microarchitecture assessment: current and future trends. Osteoporos Int 14(Suppl 5):S89–S95 (discussion S95–S99)CrossRefPubMed Muller R (2003) Bone microarchitecture assessment: current and future trends. Osteoporos Int 14(Suppl 5):S89–S95 (discussion S95–S99)CrossRefPubMed
Zurück zum Zitat Muller R, van Campenhout H, van Damme B, van Der Perre G, Dequeker J, Hildebrand T, Ruegsegger P (1998) Morphometric analysis of human bone biopsies: a quantitative structural comparison of histological sections and micro-computed tomography. Bone 23:59–66CrossRefPubMed Muller R, van Campenhout H, van Damme B, van Der Perre G, Dequeker J, Hildebrand T, Ruegsegger P (1998) Morphometric analysis of human bone biopsies: a quantitative structural comparison of histological sections and micro-computed tomography. Bone 23:59–66CrossRefPubMed
Zurück zum Zitat Naitoh M, Hirukawa A, Katsumata A, Ariji E (2010) Prospective study to estimate mandibular cancellous bone density using large-volume cone-beam computed tomography. Clin Oral Implants Res 21:1309–1313CrossRefPubMed Naitoh M, Hirukawa A, Katsumata A, Ariji E (2010) Prospective study to estimate mandibular cancellous bone density using large-volume cone-beam computed tomography. Clin Oral Implants Res 21:1309–1313CrossRefPubMed
Zurück zum Zitat Naveiras O, Nardi V, Wenzel PL, Hauschka PV, Fahey F, Daley GQ (2009) Bone-marrow adipocytes as negative regulators of the haematopoietic microenvironment. Nature 460:259–263CrossRefPubMedPubMedCentral Naveiras O, Nardi V, Wenzel PL, Hauschka PV, Fahey F, Daley GQ (2009) Bone-marrow adipocytes as negative regulators of the haematopoietic microenvironment. Nature 460:259–263CrossRefPubMedPubMedCentral
Zurück zum Zitat NIH Consensus Development Panel (2001) Osteoporosis prevention, diagnosis, and therapy. JAMA 285:785–795CrossRef NIH Consensus Development Panel (2001) Osteoporosis prevention, diagnosis, and therapy. JAMA 285:785–795CrossRef
Zurück zum Zitat Pabst AM, Walter C, Ehbauer S, Zwiener I, Ziebart T, Al-Nawas B, Klein MO (2015) Analysis of implant-failure predictors in the posterior maxilla: a retrospective study of 1395 implants. J Craniomaxillofac Surg 43:414–420CrossRefPubMed Pabst AM, Walter C, Ehbauer S, Zwiener I, Ziebart T, Al-Nawas B, Klein MO (2015) Analysis of implant-failure predictors in the posterior maxilla: a retrospective study of 1395 implants. J Craniomaxillofac Surg 43:414–420CrossRefPubMed
Zurück zum Zitat Parsa A, Ibrahim N, Hassan B, Motroni A, van Der Stelt P, Wismeijer D (2012) Reliability of voxel gray values in cone beam computed tomography for preoperative implant planning assessment. Int J Oral Maxillofac Implants 27:1438–1442PubMed Parsa A, Ibrahim N, Hassan B, Motroni A, van Der Stelt P, Wismeijer D (2012) Reliability of voxel gray values in cone beam computed tomography for preoperative implant planning assessment. Int J Oral Maxillofac Implants 27:1438–1442PubMed
Zurück zum Zitat Parsa A, Ibrahim N, Hassan B, van Der Stelt P, Wismeijer D (2015) Bone quality evaluation at dental implant site using multislice CT, micro-CT, and cone beam CT. Clin Oral Implants Res 26:e1–e7CrossRefPubMed Parsa A, Ibrahim N, Hassan B, van Der Stelt P, Wismeijer D (2015) Bone quality evaluation at dental implant site using multislice CT, micro-CT, and cone beam CT. Clin Oral Implants Res 26:e1–e7CrossRefPubMed
Zurück zum Zitat Pramstraller M, Farina R, Franceschetti G, Pramstraller C, Trombelli L (2011) Ridge dimensions of the edentulous posterior maxilla: a retrospective analysis of a cohort of 127 patients using computerized tomography data. Clin Oral Implants Res 22:54–61CrossRefPubMed Pramstraller M, Farina R, Franceschetti G, Pramstraller C, Trombelli L (2011) Ridge dimensions of the edentulous posterior maxilla: a retrospective analysis of a cohort of 127 patients using computerized tomography data. Clin Oral Implants Res 22:54–61CrossRefPubMed
Zurück zum Zitat Pusztaszeri MP, Seelentag W, Bosman FT (2006) Immunohistochemical expression of endothelial markers CD31, CD34, von Willebrand factor, and Fli-1 in normal human tissues. J Histochem Cytochem 54:385–395CrossRefPubMed Pusztaszeri MP, Seelentag W, Bosman FT (2006) Immunohistochemical expression of endothelial markers CD31, CD34, von Willebrand factor, and Fli-1 in normal human tissues. J Histochem Cytochem 54:385–395CrossRefPubMed
Zurück zum Zitat Razavi R, Zena RB, Khan Z, Gould AR (1995) Anatomic site evaluation of edentulous maxillae for dental implant placement. J Prosthodont 4:90–94CrossRefPubMed Razavi R, Zena RB, Khan Z, Gould AR (1995) Anatomic site evaluation of edentulous maxillae for dental implant placement. J Prosthodont 4:90–94CrossRefPubMed
Zurück zum Zitat Scardina GA, Pisano T, Messina M, Rallo A, Messina P (2011) “In vivo” evaluation of the vascular pattern in oral peri-implant tissues. Arch Oral Biol 56:148–152CrossRefPubMed Scardina GA, Pisano T, Messina M, Rallo A, Messina P (2011) “In vivo” evaluation of the vascular pattern in oral peri-implant tissues. Arch Oral Biol 56:148–152CrossRefPubMed
Zurück zum Zitat Schropp L, Wenzel A, Kostopoulos L, Karring T (2003) Bone healing and soft tissue contour changes following single-tooth extraction: a clinical and radiographic 12-month prospective study. Int J Periodontics Restor Dent 23:313–323 Schropp L, Wenzel A, Kostopoulos L, Karring T (2003) Bone healing and soft tissue contour changes following single-tooth extraction: a clinical and radiographic 12-month prospective study. Int J Periodontics Restor Dent 23:313–323
Zurück zum Zitat Sharan A, Madjar D (2008) Maxillary sinus pneumatization following extractions: a radiographic study. Int J Oral Maxillofac Implants 23:48–56PubMed Sharan A, Madjar D (2008) Maxillary sinus pneumatization following extractions: a radiographic study. Int J Oral Maxillofac Implants 23:48–56PubMed
Zurück zum Zitat Trisi P, Rao W (1999) Bone classification: clinical-histomorphometric comparison. Clin Oral Implants Res 10:1–7CrossRefPubMed Trisi P, Rao W (1999) Bone classification: clinical-histomorphometric comparison. Clin Oral Implants Res 10:1–7CrossRefPubMed
Zurück zum Zitat Ulm C, Kneissel M, Schedle A et al (1999) Characteristic features of trabecular bone in edentulous maxillae. Clin Oral Implants Res 10:459–467CrossRefPubMed Ulm C, Kneissel M, Schedle A et al (1999) Characteristic features of trabecular bone in edentulous maxillae. Clin Oral Implants Res 10:459–467CrossRefPubMed
Zurück zum Zitat Wang C, Meng H, Wang X, Zhao C, Peng J, Wang Y (2016) Differentiation of bone marrow mesenchymal stem cells in osteoblasts and adipocytes and its role in treatment of osteoporosis. Med Sci Monit 22:226–233CrossRefPubMedPubMedCentral Wang C, Meng H, Wang X, Zhao C, Peng J, Wang Y (2016) Differentiation of bone marrow mesenchymal stem cells in osteoblasts and adipocytes and its role in treatment of osteoporosis. Med Sci Monit 22:226–233CrossRefPubMedPubMedCentral
Zurück zum Zitat White SC, Pharoah MJ (2014) Oral radiology: principles and interpretation. In: White SC (ed) Cone-beam computed tomography, 7th edn. Elsevier Health Sciences, St. Louis, pp 185–213 White SC, Pharoah MJ (2014) Oral radiology: principles and interpretation. In: White SC (ed) Cone-beam computed tomography, 7th edn. Elsevier Health Sciences, St. Louis, pp 185–213
Zurück zum Zitat Wirth AJ, Goldhahn J, Flaig C, Arbenz P, Muller R, van Lenthe GH (2011) Implant stability is affected by local bone microstructural quality. Bone 49:473–478CrossRefPubMed Wirth AJ, Goldhahn J, Flaig C, Arbenz P, Muller R, van Lenthe GH (2011) Implant stability is affected by local bone microstructural quality. Bone 49:473–478CrossRefPubMed
Metadaten
Titel
Histological and radiographic study of human edentulous and dentulous maxilla
verfasst von
Yukino Kamigaki
Iwao Sato
Takashi Yosue
Publikationsdatum
11.04.2016
Verlag
Springer Japan
Erschienen in
Anatomical Science International / Ausgabe 4/2017
Print ISSN: 1447-6959
Elektronische ISSN: 1447-073X
DOI
https://doi.org/10.1007/s12565-016-0344-z

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