Age-dependent Three-dimensional Microcomputed Tomography Analysis of the Human Midpalatal Suture*

Abstract

The necessity for surgical weakening can neither be explained by sutural interdigitation increasing with age nor by a higher obliteration index. Sutural bone density (hence the fracture resistance increasing with age) seems to be the parameter limiting conservative RME.

Hounsfield Units: A new indicator showing maxillary resistance in rapid maxillary expansion cases?

“…Notably, only 5% of sutures are closed by 25 years, and 5% of suture closures with mechanical interlocking and circummaxillary rigidity can be broken without a corticotomy. 1 In a more recent microcomputed tomography study, Korbmacher et al 11 concluded that the suture obliteration index was generally low, varied between individuals, and did not correlate with chronological age. Interdigitation was also independent of age.…”

Measurement of the midpalatal suture width

“…We found highly significant differences in mean values of the suture width between the younger and the older groups, with no parts of obliteration in the midpalatal suture. A previous three-dimensional micro-CT study 27 demonstrated an increase in bone density in the region of the midpalatal suture in older subjects. According to these findings as well as to the observations made in the present study, the morphological changes in the condition of the sutural complex and the changes in the bony structures connected to the maxilla presumably cause the increase in resistance against the expansion force in older subjects.…”

“…According to these findings as well as to the observations made in the present study, the morphological changes in the condition of the sutural complex and the changes in the bony structures connected to the maxilla presumably cause the increase in resistance against the expansion force in older subjects. 10,27,31 In addition to this, a functional influence on the sutural bone apposition and the general cranial suture morphology was demonstrated in many studies. 7,[32][33][34] In this context, Katsaros et al 7 revealed that a reduced masticatory function caused by a soft diet is accompanied by less bone apposition in the facial sutures of rats.…”

“…3 Hand wrist radiographs typically used for the evaluation of skeletal maturity are not indicative for estimation of the condition in the midpalatal suture. 27,28 The assumption that the total obliteration in the midpalatal suture in adults is the main factor for the increasing resistance in adult patients 29,30 lacks evidence but is still popular in the actual literature. 6,21 Knaup et al 8 found significant differences in the human midpalatal suture width between younger and older subjects.…”

“…42 It was used to evaluate animal and human craniofacial sutures, but micro-CT studies 27,43,44 limited the sample size to approximately 1 cm and are therefore not applicable.…”