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El objetivo del proyecto fue analizar el escenario y las posibilidades de cambio a medio-largo plazo para la mejora del Grado en Odontología por la Universidad Complutense de Madrid.

There is an increase in the worldwide prevalence of congenital abdominal wall defects (CAWD), with gastroschisis (GS) and omphalocele (OC) being the most common. It is widely accepted that folic acid supplementation (FAS) in the maternal diet decreases the incidence of anomalies such as neural tube defects, but there is controversy regarding the possible beneficial role for other congenital malformations. Several epidemiological studies raise controversy regarding a possible relationship between vitamin supplementation with the occurrence of abdominal wall malformations. The aim of the present study is to obtain an updated review of the global frequency of CAWD in neonates and the relationship with FAS in the mothers. For this we have carried out a systematic search of epidemiological studies in different article databases between 2011 and 2022. The analysis of 25 studies conducted in different countries where cases of OC and/or GS are registered directly or together with other congenital defects shows that 60% inquire into the relationship of FAS with the incidence of CAWD. Half of them proposes a beneficial effect of FAS and the other half find no association, concluding that there is no unanimous evidence that FAS in the maternal diet decreases the incidence of CAWD. However, it seems that an influential factor to take into account is the nutritional habits of the mothers., Depto. de Anatomía y Embriología, Fac. de Medicina, TRUE, pub

Introduction: To date, there have been no studies conducted on the development of interosseous muscles (IO) in the human hand. This study aimed to investigate the development of these muscles in order to clarify their terminal insertions and their relationship with the metacarpophalangeal joints. Methods: Serial sections of 25 human specimens (9 embryos and 16 fetuses) between the 7th and 14th week of development, sourced from the Collection of the Department of Anatomy and Embryology at UCM Faculty of Medicine, were analysed bilaterally using a conventional optical microscope. Results: Our findings revealed that, during the 7th week of development, the metacarpophalangeal interzone mesenchyme extended into the extensor apparatus of the fingers. Furthermore, we observed that the joint capsule and the tendon of the IO derive from the articular interzone mesenchyme. By the end of the 7th week, corresponding to Carnegie stage 21, the myotendinous junction appeared, initiating cavitation of the metacarpophalangeal joint. During the fetal period, the terminal insertions of the IO were identified: both the dorsal interosseous (DI) and palmar interosseous (PI) muscles insert into the metacarpophalangeal joint capsule and establish a connection with the volar plate located at the base of the proximal phalanx and the extensor apparatus. Some muscle fibres also attach to the joint capsule at the level of the proximal synovial cul-de-sac. The functional implications of these findings are discussed within this work. Conclusion: This study provides the first detailed description of the development of the interosseous muscles in the human hand., Banco Santander/Universidad Complutense de Madrid, Complutense Research Group, Depto. de Anatomía y Embriología, Fac. de Medicina, TRUE, inpress

Background: Perspectives of patients, parents and professional experts on personalized regenerative implants for regenerative medicine purposes are largely unknown. Method: To better understand these perspectives, we conducted four focus groups with professional experts of mixed European nationality (n = 8), Dutch patients with regular implants (n = 8), Dutch and Belgian (n = 5) and Spanish (n = 8) parents of children with cleft palate. Results: Two overarching themes were identified: ‘patient-centered research and care’ and ‘ambivalent attitudes toward personalized regenerative implants’. Discussion: The results reveal that stakeholders should adopt a participatory rather than an impairment discourse and address the ambivalence among professional experts, patients and parents. Conclusion: Considering stakeholder perspectives facilitates ethical and responsible development and use of personalized regenerative implants.

During routine dissection of a left upper limb of a 68-year-old male human cadaver, an unusual muscle was observed originating from the radius and flexor retinaculum, and continued in the hypothenar region with the muscle belly of the abductor digiti minimi. We checked that it was an accessory abductor digiti minimi (ADM). Its muscular belly was in close relation to the median and ulnar nerves. We review the literature regarding such muscle variations and discuss the potential for compression of the median and ulnar nerves. Although the accessory ADM is usually asymptomatic and only rarely results in nerve compression, it should be taken into account by surgeons when establishing a differential diagnosis in the compression neuropathies of the median and ulnar nerves. An ultrasound scanning can help establish the differential diagnosis., Universidad Complutense de Madrid, Depto. de Anatomía y Embriología, Fac. de Medicina, TRUE, pub

Las restricciones por la pandemia del COVID-19 supusieron la transición abrupta a una enseñanza online tanto del contenido teórico como práctico y de la evaluación final de las asignaturas que imparte el departamento en varias titulaciones. En previsión de que el siguiente curso académico 2020-21 se vería totalmente afectado, se desarrollaron una serie de materiales didácticos propios, como la elaboración de guiones de teoría y práctica que incorporaron imágenes de modelos anatómicos, prosecciones, anatomía radiológica y anatomía ecográfica. La percepción de esta innovación fue evaluada por los estudiantes a través de una encuesta en línea y sus respuestas mediante una escala tipo Likert. Participaron 346 estudiantes de las titulaciones de Fisioterapia (n= 66), Medicina (n= 169), Podología (n= 44) y Terapia Ocupacional (n= 67). Las puntuaciones medias más altas correspondieron a los estudiantes de Podología y Terapia Ocupacional, ambas presentaron diferencias significativas con los otros tres subgrupos de alumnos (p<.0001). El puntaje promedio más bajo correspondió a los estudiantes de Medicina de segundo año académico que presentó significancia con los otros cuatro subgrupos de estudiantes (p<.0001). Se analizaron las carencias del sistema educativo en la Universidad Complutense de Madrid reveladas por la pandemia del Covid19. Esta crisis ha puesto de manifiesto la necesidad de que los educadores médicos en general y los anatomistas en particular estén capacitados en el uso de la tecnología disponible y en la creación de sus propios materiales didácticos multimedia., Depto. de Anatomía y Embriología, Fac. de Medicina, TRUE, pub

Background. Palatoplasty has the undesired side effect of impaired mid-facial growth. To avoid this problem, we propose an alternative to palatoplasty. We hypothesize that if BMP-2 is injected together with a carrier into the periosteum of the cleft palate borders, border volume will increase and connective tissue cells will be activated to produce extra bone. Once these borders supported by bone reach the midline, extraction of their covering epithelia with trypsin will permit adhesion of the underlying tissues. We investigated in vitro the ability of cleft palate connective tissue cells to produce extra bone in the presence of BMP-2 and the possibility of using trypsin to remove the epithelium covering the cleft palate borders without impairing the underlying tissues’ ability to adhere. Materials and methods. We used the cleft palate presented by tgf- 3 null mice and small fragments of human cleft palate mucoperiosteum as models. Immunolabeling BMP-2-treated or untreated cultures with TUNEL and anti-osteocalcin or PCNA antibodies was performed. The epithelium of the cleft palate borders was removed with a trypsin solution, and the deepithelialized tissues were cultured in apposition. Results. BMP-2 induces differentiation toward bone on cleft palate connective tissue cells without producing cell death or proliferation. Trypsin removal of the cleft palate margins’ epithelium does not impair the underlying tissues’ adhesion. Conclusion. It is possible to generate extra bone at the cleft palate margins and to chemically eliminate their covering epithelia without damaging the underlying tissues, which allows further investigation in vivo of this new approach for cleft palate closure., Fondo de Investigación Sanitaria, Comunidad Autónoma de Madrid, Depto. de Anatomía y Embriología, Fac. de Medicina, TRUE, pub

Growth alterations have been described in patients operated on for oral clefts. The purpose of this work was to analyze the craniofacial and palate morphology and dimensions of young adults operated on for oral clefts in early childhood in Spain. Eighty-three patients from eight different hospitals were divided into four groups based on their type of cleft: cleft lip (CL, n = 6), unilateral cleft lip and palate (UCLP, n = 37), bilateral cleft lip and palate (BCLP, n = 16), and cleft palate only (CPO, n = 24). A control group was formed of 71 individuals. Three-dimensional (3D) digital models were obtained from all groups with an intraoral scanner, together with cephalometries and frontal, lateral, and submental facial photographs. Measurements were obtained and analyzed statistically. Our results showed craniofacial alterations in the BCLP, UCLP, and CPO groups with an influence on the palate, maxilla, and mandible and a direct impact on facial appearance. This effect was more severe in the BCLP group. Measurements in the CL group were similar to those in the control group. Cleft characteristics and cleft type seem to be the main determining factors of long-term craniofacial growth alterations in these patients. Prospective research is needed to clearly delineate the effects of different treatments on the craniofacial appearance of adult cleft patients., Ministerio de Ciencia e Innovación, Instituto de Salud Carlos III, Banco Santander, Universidad Complutense de Madrid, Depto. de Anatomía y Embriología, Fac. de Medicina, TRUE, pub

During routine undergraduate dissections of the upper limb, variations on the usual arterial and muscular patterns were observed in a 68 year-old male cadaver. The arterial and muscular pattern found in our specimen is similar to that of some primates in the following terms. 1) Brachial artery duplicity, on the right side, with a superficial brachio-ulnoradial artery. 2) In the right upper limb, the biceps brachii muscle continued with the superficial muscles of the forearm. 3) The brachial artery on the left side, cross over in front of the median nerve, as the only artery of the arm with a network axillary pattern. 4) On both sides, the ulnar artery was superficial and originated at the elbow from superficial brachial arteries. 5) The right anterior interosseous artery intervened in the vascularization of the hand. These results suggest that this may be a case of early detention of human embryonic development and/or the persistence of phylogenetic older patterns. In the literature, we have found no reference to the presence of all these variations in the same individual. The objective of our study was to analyze these variations from an embryological and phylogenetic perspective., Depto. de Anatomía y Embriología, Fac. de Medicina, TRUE, pub

Among the non-metrical variants of the mandible that have been proven to be a key issue for dental practitioners, the retromolar foramen constitutes one of the most controversial details regarding its prevalence and associated variables. Thus, this study evaluated the prevalence of the retromolar foramen and the variables associated with its presence in a large Spanish collection of human dry mandibles from the nineteenth century. Six hundred Spanish human dry mandibles (1200 sides) belonging to an osteology collection were examined. The presence of teeth, the presence or absence of retromolar foramen, as well as its side, diameter, number, and location were evaluated. Descriptive analysis and analysis of the associations between the variables were performed. The retromolar foramen was observed in 184 mandibles (31%) and was predominantly present unilaterally (60.8%). Most mandibles (54.9%) had a single foramen. The most common location was the retromolar trigone region (84%). On analysis of the association of variables, it was observed a strong association (p < 0.001) between the presence or absence of the foramen and the presence of teeth. Moreover, a significant association was also found between sex vs. presence of teeth (p = 0.033), sex vs. presentation side of the foramen (p = 0.028), sex vs. number of foramina found (p = 0.004), and diameter vs. number of foramina found (p < 0.001). This study reveals that the retromolar foramen showed a high prevalence of 31% in nineteenth century Spaniards and was located primarily in the retromolar trigone, suggesting that dentists should be aware of and consider the relevant findings of this study., Ministerio de Ciencia e Innovación/Instituto de Salud Carlos III, Banco de Santander/Universidad Complutense de Madrid, Depto. de Anatomía y Embriología, Fac. de Medicina, TRUE, pub

Sheep are recognized as useful species for translational neurodegeneration research, in particular for the study of Huntington disease. There is a lack of information regarding the detailed anatomy and connections of the basal ganglia of sheep, in normal myeloarchitectonics and in tract-tracing studies. In this work, the organization of the corticostriatal projections at the level of the putamen and globus pallidus (GP) are explored. For the first time, the myeloarchitectonic pattern of connections between the internal (IC) and the external (EC) capsules with the GP have been investigated in the sheep. Formaldehyde-fixed blocks of the striatum were treated with a metallic stain containing potassium dichromate and visualized using micro-CT (µ-CT). The trivalent chromium (Cr3+), attached to myelin phospholipids, imparts a differential contrast to the grey and white matter compartments, which allows the visualization of myelinated fascicles in µ-CT images. The fascicles were classified according to their topographical location in dorsal supreme fascicles (X, Y, apex) arising from the IC and EC; pre-commissurally, basal fascicles connecting the ventral part of the EC with the lateral zone of the ventral pallidum (VP) and, post-commissurally, superior (Z1 ), middle (Z2 ) and lower (Z3 ) fascicles, connecting at different levels the EC with the GP. The results suggest that the presumptive cortical efferent and afferent fibres to the pallidum could be organized according to a dorsal to ventrolateral topography in the sheep, similar to that seen in other mammals. The proposed methodology has the potential to delineate the myeloarchitectonic patterns of nervous systems and tracts., Depto. de Anatomía y Embriología, Fac. de Medicina, TRUE, pub

In humans, cleft palate (CP) is one of the most common malformations. Although surgeons use palatoplasty to close CP defects in children, its consequences for subsequent facial growth have prompted investigations into other novel surgical alternatives. The animal models of CP used to evaluate new surgical treatments are frequently obtained by creating surgically induced clefts in adult dogs. This procedure has been ethically criticized due to its severity and questionable value as an animal model for human CP. Dogs born with a congenital CP would be much better for this purpose, provided they developed CP at a sufficient rate and could be fed. Up until now, feeding these pups carried the risk of aspiration pneumonia, while impeding normal suckling and chewing, and thus compromising orofacial growth. We developed a technique for feeding dog pups with CP from birth to the time of surgery using two old Spanish pointer dog pups bearing a complete CP. This dog strain develops CP in 15-20% of the offspring spontaneously. Custom-made feeding teats and palatal prostheses adapted to the pups' palates were made from thermoplastic plates. This feeding technique allowed lactation, eating and drinking in the pups with CP, with only sporadic rhinitis. To determine whether the use of this palatal prosthesis interferes with palatal growth, the palates of three littermate German shorthaired pointer pups without CP, either wearing or not wearing (controls) the prosthesis, were measured. The results showed that the permanent use of this prosthesis does not impede palatal growth in the pups., Miisterio de Sanidad de España, Comunidad de Madrid, Depto. de Anatomía y Embriología, Fac. de Medicina, TRUE, pub

We have recently presented the Old Spanish Pointer dog, with a 15-20% spontaneous congenital cleft palate rate, as a unique experimental model of this disease. This study aimed to describe the cleft palate of these dogs for surgical research purposes and to determine whether congenital cleft palate influences maxillofacial growth. Seven newborn Old Spanish Pointer dogs of both sexes, comprising a cleft palate group (n = 4) and a normal palate group (n = 3), were fed using the same technique. Macroscopic photographs and plaster casts from the palate, lateral radiographs and computer tomograms of the skull were taken sequentially over 41 weeks, starting at week 5. The cleft morphology, the size and the tissue characteristics in these dogs resembled the human cleft better than current available animal models. During growth, the cleft width varies. Most of the transverse and longitudinal measures of the palate were statistically lower in the cleft palate group. The cleft palate group showed hypoplasia of the naso-maxillary complex. This model of congenital cleft palate seems suitable for surgical research purposes. A reduced maxillofacial pre- and post-natal development is associated to the congenital cleft palate in the Old Spanish Pointer dog., Ministerio de Sanidad de España, Osteology Foundation, Universidad Complutense de Madrid, Banco Santander, Depto. de Anatomía y Embriología, Fac. de Medicina, TRUE, pub

RESUMEN: Las fisuras orofaciales representan un grupo heterogéneo de malformaciones congénitas que afectan a distintas estructuras de la cavidad oral y de la cara. Globalmente, los bebés con estos trastornos presentan una mayor morbilidad y mortalidad a lo largo de su vida en comparación con individuos no afectados. Por ello, los avances en la investigación biomédica resultan ineludibles. Así, el objetivo general de este trabajo fue llevar a cabo una revisión bibliográfica para analizar narrativamente los 10 principales estudios primarios sobre fisuras orofaciales llevados a cabo en España, publicados del 2018 hasta la actualidad. Según esto, a nivel institucional, destaca la Universidad Complutense de Madrid (UCM) con cuatro artículos publicados por el grupo de investigación UCM 920202. También sobresale la Universidad Rey Juan Carlos de Madrid, con tres artículos relacionados con diferentes aspectos de la personalidad y la calidad de vida de los pacientes fisurados, así como otras muchas variables cognitivo-emocionales. En relación con la Universidad de Valencia, encontramos dos artículos llevados a cabo en amplias muestras de pacientes con fisuras. Por último, en Barcelona resulta destacable un estudio observacional sobre problemas otorrinolaringológicos en pacientes operados de fisura palatina. En conclusión, si bien en los últimos años se han publicado varios artículos sobre distintos aspectos relacionados con las fisuras, aún queda mucho trabajo por hacer. España debería seguir potenciando proyectos con líneas de trabajo centradas en estas alteraciones del desarrollo craneofacial. Se necesitan estudios amplios, multicéntricos y colaborativos, para ahondar en los mecanismos etiológicos y, en última instancia, en las posibles herramientas para su prevención. Del mismo modo, se necesitan ayudas para dilucidar mejor las cuestiones relacionadas con los tratamientos en todas las dimensiones de la salud, preferentemente a partir de ensayos clínicos controlados aleato, SUMMARY: Orofacial clefts represent a heterogeneous group of congenital malformations affecting different structures of the oral cavity and face. Overall, infants with these disorders have a higher lifetime morbidity and mortality compared to unaffected individuals. Therefore, advances in biomedical research are unavoidable. Thus, the overall objective of this work was to conduct a literature review to narratively analyse the 10 main primary studies on orofacial clefts carried out in Spain, published from 2018 to date. According to this review, at an institutional level, the Complutense University of Madrid (UCM) is notable with 4 articles published by the UCM 920202 research group. The Rey Juan Carlos University of Madrid also stands out, with three papers related to different aspects of the personality and quality of life of cleft patients, as well as many other cognitive-emotional variables. In relation to the University of Valencia, we found two studies carried out on large samples of cleft patients. Finally, in Barcelona, an observational study on otorhinolaryngological problems in cleft palate patients is noteworthy. In conclusion, although several studies have been published in recent years on different aspects related to clefts, there is still much work to be done. Spain should craniofacial development. Large, multicenter and collaborative studies are needed to delve deeper into the aetiological mechanisms and, ultimately, into the possible tools for their prevention. Similarly, support is needed to better elucidate questions related to treatments in all dimensions of health, preferably randomised controlled clinical trials, which facilitate the transfer of knowledge and its universal accessibility within the Spanish public health system., Depto. de Anatomía y Embriología, Fac. de Medicina, TRUE, pub

En este proyecto se ha desarrollado un sistema interactivo para mejorar el proceso de enseñanza-aprendizaje en la docencia de la anatomía macroscópica de la órbita y su contenido por medio de preparaciones anatómicas. Se pretende facilitar el aprendizaje de forma autónoma en español e inglés y, la autoevaluación sobre los conocimientos adquiridos.

Se ha desarrollado un sistema interactivo para mejorar el proceso de enseñanza-aprendizaje en la docencia de la anatomía microscópica de la órbita y su contenido, a través de preparaciones histológicas. Se pretende facilitar el aprendizaje de forma autónoma en español e inglés y, la autoevaluación sobre los conocimientos adquiridos.

desarrollo de un sistema interactivo para mejorar el proceso de enseñanza-aprendizaje en la docencia de las prácticas del Aparato Locomotor, que pudiera ser utilizado por los alumnos de Grado de Fisioterapia, Medicina, Podología y Terapia Ocupacional, titulaciones en las que el Aparato Locomotor tiene una importante presencia en sus temarios de prácticas.

Objetivos: Hace unos años, nuestro grupo de investigación demostró que el Perro Pachón Navarro es un excelente modelo animal para lograr avances en el conocimiento y mejorar la calidad de vida de los pacientes fisurados, ya que estos perros pueden presentar fisuras labiopalatinas espontáneas y, con un manejo adecuado, es posible que alcancen la edad adulta sin ser operados, utilizando dispositivos que les permiten alimentarse normalmente como cualquier otro perro. Gracias a la puesta a punto del modelo y de las técnicas necesarias para lograr su desarrollo hasta la edad adulta, ensayamos una nueva técnica experimental, mínimamente invasiva, como alternativa a la palatoplastia convencional. Así, pudimos compararlas y examinar sus efectos, tanto entre sí como respecto a otros perros de paladar normal o fisurados sin tratar., Objectives: A few years ago, our research group demonstrated that the Pachón Navarro dog is an excellent animal model to advance the understanding of cleft palate and improve the quality of life of patients. Since these dogs can present spontaneous cleft lip and palate, with an appropiate management it is possible for them to reach adulthood without being subjected to an operation by using devices that allow them to feed normally like any other dog. Thanks to the establishment of the model and the necessary techniques to achieve this development into adulthood, we tested a new minimally invasive experimental technique as an alternative to conventional palatoplasty. Thus, we were able to examine and evaluate the effects of both intervention techniques as well as comparing the results with untreated dogs with either a normal or cleft palate.

Craniofacial development requires extremely fine-tuned developmental coordination of multiple specialized tissues. It has been evidenced that a folate deficiency (vitamin B9), or its synthetic form, folic acid (FA), in maternal diet could trigger multiple craniofacial malformations as oral clefts, tongue, or mandible abnormalities. In this study, a folic acid-deficient (FAD) diet was administered to eight-week-old C57/BL/6J female mouse for 2–16 weeks. The head symmetry, palate and nasal region were studied in 24 control and 260 experimental fetuses. Our results showed a significant reduction in the mean number of fetuses per litter according to maternal weeks on FAD diet (p < 0.01). Fetuses were affected by cleft palate (3.8%) as well as other severe congenital abnormalities, for the first time related to maternal FAD diet, as head asymmetries (4.6%), high arched palate (3.5%), nasal septum malformed (7.3%), nasopharynx duct shape (15%), and cilia and epithelium abnormalities (11.2% and 5.8%). Dysmorphologies of the nasal region were the most frequent, appearing at just four weeks following a maternal FAD diet. This is the first time that nasal region development is experimentally related to this vitamin deficiency. In conclusion, our report offers novel discoveries about the importance of maternal folate intake on midface craniofacial development of the embryos. Moreover, the longer the deficit lasts, the more serious the consequent effects appear to be., Instituto de Salud Carlos III (ISCIII), Ministerio de Sanidad, CEU-Banco Santander, Depto. de Anatomía y Embriología, Depto. de Medicina, Fac. de Medicina, TRUE, pub

Background: The first wave of the COVID-19 pandemic in Spain posed a major challenge for Spanish dental professionals. The objective of this work is to describe the dental hygienists’ work status and employment patterns during the de-escalation phase in order to analyse the standards of knowledge, compliance with official recommendations, and dental activities both in the public health service and in the private sector. Material and Methods: A cross-sectional questionnaire was answered by Spanish dental hygienists via WhatsApp, Facebook, and Instagram. The questionnaire was piloted before it was distributed and carried out during June 2020. Results: Here, 517 dental hygienists were surveyed, of which 86.2% followed the official recommendations to avoid contagion and 63.8% agreed with the gradual return to work by limiting the use of aerosols. Private dental hygienists identified more with returning to work without restrictions (14.5%) versus those working for the public service (1.2%) (p < 0.005). Conclusions: Dental hygienists’ return to work has involved different strategies, aimed at controlling infection and guaranteeing the safety of patients and the rest of the dental team. The availability of personal protective equipment, the adaptation of clinical infrastructure, and patient care management have differed between professionals working in the private and public sectors., Depto. de Anatomía y Embriología, Depto. de Especialidades Clínicas Odontológicas, Fac. de Medicina, Fac. de Odontología, TRUE, pub

CRUE-CSIC (Acuerdos Transformativos 2021), Universidad Complutense de Madrid/Banco de Santander, Depto. de Anatomía y Embriología, Fac. de Medicina, TRUE, pub

Objetivos: Hace unos años, nuestro grupo de investigación demostró que el Perro Pachón Navarro es un excelente modelo animal para lograr avances en el conocimiento y mejorar la calidad de vida de los pacientes fisurados, ya que estos perros pueden presentar fisuras labiopalatinas espontáneas y, con un manejo adecuado, es posible que alcancen la edad adulta sin ser operados, utilizando dispositivos que les permiten alimentarse normalmente como cualquier otro perro. Gracias a la puesta a punto del modelo y de las técnicas necesarias para lograr su desarrollo hasta la edad adulta, ensayamos una nueva técnica experimental, mínimamente invasiva, como alternativa a la palatoplastia convencional. Así, pudimos compararlas y examinar sus efectos, tanto entre sí como respecto a otros perros de paladar normal o fisurados sin tratar.

Desarrollo de una infografía con los huesos y articulaciones del miembro inferior para mejorar el proceso de enseñanza-aprendizaje en la docencia de la anatomía topográfica de estas estructuras a través del campus virtual (Grados de CC. de la Salud).