Anatomy has served as a cornerstone in the training of various allied and clinical disciplines and has traditionally been based on dissection of the human body. Thus, to pursue this method of teaching and learning, access to cadavers is of continuing importance. Over a significant period of time unclaimed cadavers have performed an essential role in the teaching of anatomy in South Africa and in Africa. As recent cadaver numbers were declining at the School of Anatomical Sciences, University of the Witwatersrand, Johannesburg and difficulty in procurement was being experienced, the purpose of this study was to critically evaluate the composition of our cadaver population over time so as to provide possible strategies to arrest the decline. A retrospective, quantitative analysis of cadaver records from the School of Anatomical Sciences between 1921 and 2013 was undertaken. Analysis included a comparison of Poisson counts and Fischer's exact test. A significant decrease in the number of cadavers received during the period 2000-2013 and a slow bequest program over the same period of time has led to concerns about the sustainability of teaching anatomy through dissection. Decreases in the numbers of males and cadavers of the black population group occurred between 1990 and 2013, and of bequests from 2000 to 2013. An influence on the cadaver population from a changing political climate and change in socioeconomic status of part of the population was perceived. Changes in sex and population group of the cadavers may have a long-term effect on teaching and research.
Quantification of skeletal data has been shown to be an effective and reliable method of demonstrating variation in human growth as well as for monitoring and interpreting growth. In South Africa as well as internationally, few researchers have assessed mandibular growth in late fetal period and early childhood and therefore standards for growth and age determination in these groups are limited. The purpose of this study was to evaluate growth in the mandible from the period of 31 gestational weeks to 36 months postnatal. A total of 74 mandibles were used. Dried mandibles were sourced from the Raymond A. Dart Collection (University of Witwatersrand), and cadaveric remains were obtained from the Universities of Pretoria and the Witwatersrand. The sample was divided into four groups; 31 to 40 gestational weeks (group 1), 0 to 11 months (group 2), 12 to 24 months (group 3), and 25 to 36 months (group 4). Twenty-one osteological landmarks were digitized using a MicroScribe G2. Ten standard measurements were created and included: the maximum length of mandible, mandibular body length and width, mandibular notch width and depth, mental foramen to inferior border of mandible, mandibular basilar widths bigonial and biantegonial, bigonial width of mental foramen and mental angle. Data were analyzed using PAST statistical software and Morphologika2 v2.5. Statistically significant differences were noted in the linear measurements for all group comparisons except between groups 3 and 4. The mandible morphologically changed from a round, smooth contour anteriorly to adopt a more sharp and narrow adult shape. A progressive increase in the depth and definition of the mandibular arch was also noted. In conclusion, the mandible initially grows to accommodate the developing tongue (up to 11 months), progressive dental eruption and mastication from 12 to 36 months. Mastication is associated with muscle mass development; this would necessitate an increase in the dimensions of the mandibular notch and associated muscle attachment sites. These findings might be valuable in the estimation of age in unidentified individuals and to monitor prenatal growth of the mandible for the early diagnosis of conditions associated with stunted mandibular growth.
Historically, legislature has been utilized to facilitate appropriate use of cadavers in the anatomical sciences. However, cadaver acquisition and use have also been guided by ethically appropriate and morally acceptable principles. Various global and regional frameworks of “ethical practice” guide body donation, including the use of unclaimed bodies by institutions. These frameworks are responsive to, and reciprocal with the various ethical, moral and legal factors that influence the development of body donation programs. This reciprocity supports the notion that anatomists and anatomical societies have a responsibility to advocate for legal reform when required. In this study, two body bequest programs from geopolitically and socially disparate countries are used as cases to contrast existing legal and governance frameworks for body donation and to examine whether anatomists can direct the acquisition of ethically donated cadavers. The study includes an Australian donor program that has exclusively accepted bequests since its inception, and a South African program that has recently transitioned to a bequest system. Elements such as consent by next‐of‐kin and Inspector of Anatomy, use of unclaimed bodies and ethics committee approval amongst others, are compared. It is acknowledged that legal frameworks for cadaver acquisition generally deliver broad guidance on acceptable utilization of bodies for the anatomical sciences. However, professional discretion is of importance in adapting to societal needs and values. Thus, while anatomists have been able to progress toward more ethical practice than that which is required by the law, they must continue to do so as societal values evolve.
The masticatory apparatus is a highly adaptive musculoskeletal complex comprising several relatively independent structural components, which assist in functions including feeding and breathing. We hypothesized that the tongue is elemental in the maintenance of normal ontogeny of the mandible and in its post-natal growth and development, and tested this using a morphometric approach. We assessed tongue and mandibular measurements in 174 (97 male) human cadavers. Landmark lingual and mandibular data were gathered individuals aged between 20 gestational weeks and 3 yr postnatal. In this analysis, geometric morphometrics assisted in visualizing the morphometrical growth changes in the mandible and tongue. A linear correlation in conjunction with principal component analysis further visualized the growth relationship between these structures. We found that the growth of the tongue and mandible were intrinsically linked in size and shape between 20 gestational weeks and 24 months postnatal. However, the mandible continued to change in shape and size into the 3rd yr of life, whereas the tongue only increased in size over this same period of time. These findings provide valuable insights into the allometric growth relationship between these structures, potentially assisting the clinician in predicting the behaviour of these structures in the assessment of malocclusions.
While dissection remains the method of choice for teaching human anatomy, ethical requirements for obtaining cadavers has made the process of acquiring human bodies more strenuous for institutions. In Africa and at the School of Anatomical Sciences in South Africa, dependence on unclaimed bodies has been prevalent. The aim of the present study was to determine whether more rigorous application of ethical consent has altered the provenance of the cadavers in the School of Anatomical Sciences, University of the Witwatersrand. The numbers of bequeathed/donated/unclaimed cadavers received over the period 2013-2017, as well as their sex and population affinity were analyzed. The majority (96.8%) of the cadavers dissected over the period were from bequests/donations. Marginally more females than males were available. In addition, the population affinity of the cadavers had changed from a majority of South African African (unclaimed) bodies to a majority of South African White (bequest/donated) bodies. The study shows that even with ethical constraints it is possible to transition from the use of mainly unclaimed bodies to the acquisition of bequeathed/donor bodies. However, there may be challenges in relation to anatomical collections in the School as few of the bequest/donated cadavers remain in the School to be added to the collections. These changes also affect the demographics of the Schools' collections. Anat Sci Educ 00: 000-000. © 2018 American Association of Anatomists.
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