Changes in the Zygomaticomaxillary Suture During Aging.

Abstract

Trans-sutural distraction osteogenesis (TSDO) has been successfully used to correct midfacial hypoplasia in growing patients for years. The effects of TSDO, however, remain difficult to predict in adult patients. The aim of this study was to determine the biologic basis for the age-related increase in difficulty of performing TSDO. A total of 45 male Sprague Dawley (SD) rats were obtained in 3 age groups: 4 weeks old (4W, N = 15), 3 months old (3M, N = 15), and 13 months old (13M, N = 15). The zygomaticomaxillary sutures (ZMS) were dissected, and their morphology was evaluated by histology and micro-computed tomography (micro-CT). Quantitative real-time polymerase chain reaction of the ZMS and blood samples taken from the abdominal aorta were also used to assess the effects of age at the molecular level. Compared with the 4W rats, the number of fibroblasts in the ZMS was decreased, the bone plate adjacent to the ZMS was thicker, and the texture was denser in the 13M rats. Micro-computed tomography analysis showed the density of the ZMS was significantly increased in the 13M group (P < 0.05). The density ratio of the ZMS to the adjacent bone was increased from 0.14:1 in the 4M group to 0.54:1 in the 13M group. The gene expression of osteocalcin (OC) was significantly lower at 13M than at 3M (P < 0.05). The OC and alkaline phosphatase (ALP) serum levels were significantly lower at 13M than at 4W (P < 0.05). During aging, the decreased osteogenesis activity both systemically and locally may be the biologic effect that limits the application of TSDO in older patients.