Age-dependent three-dimensional microcomputed tomography analysis of the human midpalatal suture.

AIM

The success of rapid maxillary expansion is hard to predict in patients from the age of 20. There are as yet no reliable parameters enabling us to define success or failure a priori. The aim of this study was thus to use micro-CT techniques to quantify suture morphology three-dimensionally, and investigate its relation to age.

MATERIAL AND METHODS

The morphology of the midpalatal suture was evaluated by documenting 28 human-palate specimens from individuals aged 14-71 using computed tomography. The software AMIRA 3.00 was used for 3D (three-dimensional) reconstruction of the datasets. Sutural morphology was quantified and examined for age-dependent morphological characteristics with the software Image Tool 3.00. To that end, the specimens were assigned to three age groups (< 25 years, 25 years to < 30 years, >/= 30 years) and the following parameters were considered: obliteration index in the frontal plane, and suture length, linear sutural distance, and interdigitation index in the horizontal plane, as well as bone density (BV/TV [%]) in the sagittal plane.

RESULTS

Significant differences between age groups were only found for bone density in sagittal dimension. The middle-aged group exhibited the highest bone density (53.2%). In comparison to that group, bone density was significantly lower in the youngest and the oldest age groups. The mean obliteration index exhibited substantial inter-individual variation, was generally low, and did not correlate with chronological age. The extent of interdigitation was independent of age.

CONCLUSIONS

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.