Sutures

Question 1

Cranial and Facial Sutures

• Sutures are ____ joints formed between bones via short fibers of ____ connective tissue.
• The bones are locked together like a puzzle. These joints allow ____ movement at all (____).
• Examples include the joints between the bones of the skull.

Answer 1

fibrous
dense
no
synarthrotic

Question 2

Cranial Sutures at Birth

• ____
• Lambdoid
• ____
• Metopic
• ____

Answer 2

squamosal
coronal
sagittal

Question 3

Circummaxillary sutures involved in the growth of the nasomaxillary complex

• ____
• Nasomaxillary
• ____
• Zygomaticotemporal
• ____
• Intermaxillary
• ____
• ethmomaxillary

Answer 3

frontomaxillary
zygomaticomaxillary
pterygopalatine
lacrimomaxillary

Question 4

Which sutures are involved with downward & forward displacement growth

• ____
• ____
• ____
• ____

Answer 4

frontonasal
zygomaticotemporal
zygomaticomaxillary
pterygopalatine

Question 5

With aging, suture becomes more rigid by inter-digitation of the opposing bony margins and ultimately fusion across the suture

• Metopic suture -> start to close after the ____ year. After a period of major broadening of the forehead, it is obliterated by ____ years of age.
• Most calvarial sutures fuse between in age of ____ years old
• Most facial suture remain patent until ____ years old.
• Intermaxillary suture -> fuses between age ____

Answer 5

first
7
25-30
70-80
30-35

Question 6

Sutural Bone Growth:
• Sutures are major ____ in the skull
• ____ ossification
• Lacks ____ growth potential. Instead bone formation in the
suture occurs in response to external signal
• Accommodates brain and facial growth
• Sutures must remain patent during growth period

Answer 6

growth “sites”
intramembranous
intrinsic

Question 7

Craniosynostosis
• Premature fusion of ____ sutures
• ____ births
• Associated with increased intracranial ____,
difficulties with vision, hearing and craniofacial deformities
• Associated with ____ mutations of FGFR1, 2, 3 genes and Twist ____ mutation.

Answer 7

cranial
1 in 2500
pressure
activating
null

Question 8

A proposed molecular pathways in cranial suture formation:

Twist:
Twist ____ FGFR expression to maintain ____ state in the suture mesenchyme

FGFR2:
FGFR2 is expressed in the osteogenic ____ and stimulate osteogenic cell ____

FGFR1:
FGFR1 is expressed close to the ____ surface and stimulate osteogenic differentiation via ____ of Runx2

RunX2:
Runx2 turns on ____

Answer 8

inhibits
undifferentiated

front
proliferation

bone
activation

osteogenic differentiation

Question 9

Treatment for Pfeiffer syndrome (craniosynostosis):

____

Answer 9

monoblock distraction osteogenesis

Question 10

Face Mask:
Stimulates Downward and Forward Growth of the ____

cannot use with craniosynostosis patient because they are ____

Answer 10

maxilla

fused

Question 11

Face Mask growth

• ____ growth
• Maxillary ____ growth

Answer 11

vertical

sagittal

Question 12

Difficient midfacial growth, Class III malocclusion was restored with facemask treatment for ____

Answer 12

6 months

Question 13

Palatal sutures

• ____
• ____
• ____

Answer 13

transverse palatine suture
incisive suture
median palatine suture

Question 14

Median Palatine Suture:
Important for ____ growth of the maxilla

Fuses/Ossifies at Age ____

Answer 14

transverse

30-35

Question 15

Palatal Expansion

Achieved by separation of ____ suture and subsequent bone formation in the gap.

Answer 15

median palatine suture

Question 16

Surgically Assisted Rapid Palatal Expansion (SARP)

• Premature fusion of the ____
• For these cases, palatal expansion requires ____ of the mid-palatal suture

Answer 16

median palatine suture

surgical re-ceation

Question 17

Gomphosis

A joint that connects the teeth to ____ in the maxillary and mandibular alveolar bone. The dense fibrous connection between a tooth and its socket is ____. One end of the ligament is inserted into the ____ of a tooth root and the other end is inserted into ____.

Answer 17

bony sockets
periodontal ligament
cementum
bone

Question 18

Gomphosis
• Only presents in the ____
• Minimal amount of ____
• Absorbs ____
• Allows orthodontic tooth movement
• Allows tooth eruption, which is required for ____
growth of the alveolar bone of the maxilla and mandible

Answer 18

skull
movement
vertical

Question 19

Tooth ankylosis: loss of ____

Answer 19

periodontal ligament

Question 20

Failure of tooth eruption leads to decreased ____ growth of the alveolar bone

Answer 20

vertical

Question 21

Cleidocranial Dysostosis
•  Delayed \_\_\_\_ of the primary teeth
•  Delayed/failed eruption of \_\_\_\_
•  Multiple \_\_\_\_ teeth
•  \_\_\_\_ deficiency
•  Deficient alveolar bone \_\_\_\_
•  \_\_\_\_ open bite

Answer 21

loss
permanent teeth
supernumerary
midfacial
height
anterior