1 Dental Materials Science, Faculty of Dentistry, The University of Hong Kong , Hong Kong .
2 Department of Orthodontics, Dental School, University of Brescia , Brescia, Italy .
Tissue Eng Part B Rev. 2018 Feb;24(1):25-36. doi: 10.1089/ten.TEB.2017.0116. Epub 2017 Jul 21.
Sutures are synarthroses connecting the bones of the head with each other through a fibrous sutural ligament. The knowledge of their biomechanical properties is relevant in the application of regenerative techniques for the treatment of craniofacial conditions, such as the sutural distraction osteogenesis (SDO). However, their mechanical characterization has not received a systematic approach, and both clinical treatments and virtual simulations lack clear mechanical parameters. Online databases (PubMed, Cochrane Library, Google Scholar), references of full-text articles, and previous reviews of the literature were searched. Articles quantifying the biomechanical properties of human sutures were included without date, language, or publication restrictions. A qualitative analysis was carried out based on source, sample, load, and measurement characteristics. Subsequently, mechanical parameters were discussed for each suture analyzed. No previous review was found debating the topic. Seven studies were included, only six sutures were analyzed among the about 39 existing ones, and important situations such as compressive and static loading were not considered. Only three studies analyzing the coronal, sagittal, and metopic sutures provided a clear description of the methods and determined parameters of sutures of infants and children. Although a selective load application on sutures is capable of modifying the craniofacial development, little is known about the optimal forces to be applied. The present findings may help to estimate the forces transferred to the sutural ligament during SDO when the strain is measured, and to advance the rationale of the application of certain parameters to optimize the clinical outcome.
缝合线是通过纤维性缝合韧带将颅骨相互连接的微动关节。了解其生物力学特性对于应用再生技术治疗颅面疾病（如缝牵引成骨术）非常重要。然而，它们的力学特性尚未得到系统研究，临床治疗和虚拟模拟都缺乏明确的力学参数。在线数据库（PubMed、Cochrane Library、Google Scholar）、全文文章的参考文献以及之前的文献综述都进行了检索。纳入了定量评估人类缝合线生物力学特性的文章，不限制发表日期、语言或出版形式。根据来源、样本、载荷和测量特征进行了定性分析。随后，对分析的每个缝合线讨论了力学参数。未发现之前有文献对该主题进行辩论。纳入了 7 项研究，但仅分析了约 39 个现有缝合线中的 6 个，且未考虑压缩和静态载荷等重要情况。仅 3 项分析冠状缝、矢状缝和额缝的研究清楚地描述了方法并确定了婴儿和儿童的缝合线参数。虽然选择性地在缝合线上施加载荷可以改变颅面发育，但对于要施加的最佳力知之甚少。本研究结果可以帮助估计在测量应变时缝牵引成骨术中缝合韧带传递的力，并为应用某些参数优化临床结果提供依据。
