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Unilateral coronal synostosis: a histomorphometric study.

H Vastardis1, J B Mulliken, J Glowacki

  • 1Department of Growth and Development, Harvard School of Dental Medicine, Boston, Massachusetts, USA.

The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
|June 30, 2004
PubMed
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Unilateral coronal synostosis (UCS) involves sutures with more lamellar bone and increased osteoclast activity, suggesting abnormal bone remodeling rather than defective osteoclasts in its development.

Area of Science:

  • Craniofacial surgery
  • Pediatric orthopedics
  • Histomorphometry

Background:

  • Unilateral coronal synostosis (UCS) is a condition affecting skull development.
  • The exact pathogenesis of UCS remains incompletely understood.

Purpose of the Study:

  • To compare the histomorphometric and cellular characteristics of prematurely fused and open coronal sutures in infants with nonsyndromic UCS.
  • To investigate the role of osteoclastic activity in UCS pathogenesis.

Main Methods:

  • Histological and histomorphometric analysis of coronal suture specimens from seven infants with UCS.
  • Evaluation of sutural patterns, osseous morphology, calvarial thickness, tartrate-resistant acid phosphatase (TRAP)-positive cells, and marrow spaces.
  • Microscopic examination using light and polarizing microscopy.

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Main Results:

  • Prematurely fused sutures exhibited more lamellar bone compared to normal sutures.
  • Fused sutures were significantly thicker with larger marrow spaces and increased numbers of TRAP-positive osteoclasts.
  • Calvarial thickness increased with age in both normal and affected sutures, with trends for age-related osteoclast decline.

Conclusions:

  • Findings challenge the hypothesis that defective osteoclastic activity is central to UCS pathogenesis.
  • Results support the theory that UCS arises from abnormally active bone remodeling processes.