Mechanobiology of craniofacial sutures

Craniofacial sutures are soft connective-tissue joints between mineralized skull bones. Suture mechanobiology refers to the understanding of how mechanical stimuli modulate sutural growth. This review's hypothesis is that novel mechanical stimuli can effectively modulate sutural growth. Exogenous forces with static, sinusoidal, and square waveforms induce corresponding waveforms of sutural strain. Sutural growth is accelerated upon small doses of oscillatory strain, as few as 600 cycles delivered 10 min/day over 12 days. Interestingly, both oscillatory tensile and compressive strains induce anabolic sutural responses beyond natural growth. Mechanistically, oscillatory strain likely turns on genes and transcription factors that activate cellular machinery via mechanotransduction pathways. Thus, sutural growth is determined by hereditary and mechanical signals via the common pathway of genes. It is concluded that small doses of oscillatory mechanical stimuli have the potential to modulate sutural growth effectively: either accelerating it or initiating net sutural bone resorption for various therapeutic objectives.