Median Suture Research Articles

A safe and reliable technique for fascial closure without special devices after laparoscopic surgery.

To prevent port-site hernia, we established a simple and low-cost closure method that uses a venous catheter needle and suture, without any other special devices. We used the inner needle of a 16-G venous catheter and a 2-0 absorbable bladed suture. To evaluate the efficacy of this technique, the procedure time was noted and compared among three operators (an experienced surgeon and two inexperienced surgeons). The median suturing time was 60.5 seconds (range, 26-130 seconds) per incision. Even an unexperienced surgeon can close the fascia safely and quickly after some experience with the procedure.

Reassessment of the Order Trinucleida (Trilobita)

Trinucleoids have been considered as a superfamily of the Order Asaphida, based on: a pre-occipital glabellar tubercle, a cephalic median suture in most ancestral forms, and the presence of broadly similar globular protaspid larvae in the life cycle. Recent discoveries cast doubts on the monophyly of the two last characters. This study provides a phylogenetic analysis whose main purpose is to test the affiliation of trinucleoids. The topology of the strict consensus tree obtained indicates that trinucleoids share a more recent common ancestor with members of the Order Ptychopariida than they do with any asaphid. The stratigraphically higher and most derived trinucleoids are well defined and easy to recognize. Their basal representatives can also be identified with confidence, in spite of substantial variation in the diagnostic characters of the group. These early trinucleoids are similar enough to the typical basal ‘ptychopariid’ bauplan to suggest ancestry within that diffuse and poorly defined trilobite order. Indeed, Ptychopariida is presently regarded as being paraphyletic. We consider that raising trinucleids to ordinal status, by proposing the Order Trinucleida, will make it easier to decipher higher level relationships among trilobites. This action, sustained by improved morphological and ontogenetic information of Cambro-Ordovician trilobites, reveals convergences of the three characters that have been used to support the inclusion of trinucleids within Asaphida. Based on this new information, we propose six distinct morphotypes of commutavi protaspis and, as a probable sensorial organ, that the cephalic axial tubercle migration might be caused by an increase in the height of the glabella and thus may not bear an important systematic signal. Moreover, the tree topology provided herein offers a preliminary overview of evolution within the order. Alsataspididae and Raphiophoridae are paraphyletic, suggesting that more investigation is needed to define them clearly. Dionidae appears to be more closely related to Raphiophoridae than to Trinucleidae, suggesting that the character state of ‘a perforated fringe’ evolved more than once.

Expansão Maxilar Apoiada em Mini-implantes (MARPE) – guia prático para planejamento e instalação

Rapid maxillary expansion (RME) is an orthodontic treatment alternative that aims to increase the transverse direction of the maxilla by separating the median palatine suture (MPS). miniscrew-assisted rapid palatal expansion (MARPE) aims to enhance the orthopedic effects of RME through skeletal anchorage. Thus, the aim of this article is to provide a guide for MARPE planning in cone beam computed tomography (CBCT) and for installation of the expander device with this technique. In addition, a case report of a Caucasian male patient, 16 years and 3 months old with Class II malocclusion, division 1 right subdivision, posterior crossbite of the right side and atresic upper arch in the post-pubertal growth spurt phase will be presented. The patient was treated with MARPE for a period of 5 weeks, when overcorrection of crossbite, correction of maxillary atresia, opening of MPS and creation of a transient diastema between the upper incisors were achieved, evidencing the success of the MARPE technique in a post-pubertal growth spurt patient.

Effect of rapid maxillary expansion on the morphology of spheno-occipital synchondrosis in rats : Amicro-CT study.

Spheno-occipital synchondrosis (SOS) plays asignificant role in the anterior growth of the midface. Orthopaedic forces acting during rapid maxillary expansion (RME) are transferred to the skull base and thus could alter the morphology of SOS. The aim of this study was to assess the influence of experimental RME on the rats' SOS by means of micro-computed tomography (micro-CT). In all, 40male 8‑week-old Wistar rats were enrolled into the study, among which 30 underwent experimental RME for 7, 14 and 21days by means of custom designed spring-coil expander. Specimens were scanned by micro-CT and median palatal suture area, maxillary skeletal base and SOS width were analysed. Experimental RME resulted in asignificant increase of the median palatal suture space and maxillary skeletal base which was particularly pronounced between day14 and 21 of expansion. SOS width increased significantly during the first 7days at the lowest point of the synchondrosis. However, the SOS width assessed at its highest point was temporarily even decreased between days 8 and 14 of therapy. Early SOS widening could be identified in the lowest part before median palatal suture opening. Similarly, narrowing of the SOS at its top was observed before the most significant median palatal suture expansion. Thus it can be hypothesized that changes within the SOS complex result from the transmission of the orthopaedic forces rather than from adisplacement of the maxillary halves.

Clinical effect of bone-anchored pendulum in treatment for class II malocclusion

Objective To study the clinical effect of bone-anchored pendulum in treatment for class Ⅱ malocclusion. Methods Twelve patients treated by bone-anchored pendulum were chosen. In each patient, two microscrews were inserted in the anterior paramedian region of the median palatal suture, 6-9 mm posterior to the incisive foramen and 3–6 mm lateral to the median line. Pendulum that based on the microscrews was used to distalize maxillary first molar, and the force applied was 250 g. Skeletal and dental changes were measured on cephalograms before (T1) and after (T2) distalization. Results Class Ⅰ molar relationship had been obtained 7 month after distalization. The average distal movement of the maxillary first molars was 7.07 mm, and the inclination was 9.93°. The second premolars were distalized an average of 5.44 mm with inclinations of 5.22°. The first premolars were distalized an average of 4.09 mm with inclinations of 3.95°. The maxillary anterior teeth were retruded 0.93 mm and palatally inclined 1.66°. There was statistical difference in that change. Conclusions By the use of microscrew, pendulum can distalize maxillary molar effectively without mesial movement of premolar and labial movement of incisor, and no loss of dental anchorage is observed during the distal movement. Key words: Malocclusion, Angle Class Ⅱ; Orthotic Devices; Dental implantation; Bone-anchored pendulum

Cribrilinids (Bryozoa, Cheilostomata) associated with deep-water coral habitats at the Great Bahama Bank slope (NW Atlantic), with description of new taxa

Four cribrilinid bryozoans associated with deep-water corals (578-682 m depth) from the Great Bahama Bank slope, are described, two of them are new. The generic allocation of some species prompted us to raise the subgenera Puellina, Cribrilaria, and Glabrilaria to genus rank. The new combination Cribrilaria saginata (Winston, 2005) n. comb. is proposed. Genus Glabrilaria is reported from the NW Atlantic for the first time based on the description of Glabrilaria hirsuta Rosso n. sp. and Glabrilaria polita Rosso n. sp. The new genus Teresaspis Rosso n. gen. is erected, and Teresaspis lineata (Canu Bassler, 1928) n. comb. is proposed as its type species. The new genus Harmelinius Rosso n. gen. is erected for Cribrilina uniserialis (Harmelin, 1978). Both genera have uniserial colonies formed by slightly caudate zooids with extensive gymnocyst and a frontal shield of flattened costae. Teresaspis lineata n. comb., however, has costae with pelmatidia that are connected by few intercostal bridges and separated by intercostal spaces, four orificial costa-like processes with the proximal pair arching above the orifice, hyperstomial acleithral ovicells with a pseudoporous ooecium formed by the distal zooid or a kenozooid, two types of kenozooids (large with costate frontal shield and small with smooth shield and central opesia), and an ancestrula with costate frontal shield. Avicularia are apparently absent in this species. In contrast, the type species of Harmelinius Rosso n. gen. has costae lacking pelmatidia and which are separated by slit-like intercostal spaces. The hyperstomial cleithral ovicells have smooth ooecia with a median suture and without pseudopores, and are formed by a distal kenozooid associated with a small avicularium. Additional paired oral avicularia are occasionally present, as are large kenozooids with a central opesia. Oral spines or spine-like processes are absent. Taxonomy of the above reported cribrilinid genera is discussed in detail together with the geographic distribution of all mentioned taxa.

Morphology of the human hard palate: a study on dry skulls

To determine morphological variations of the hard palate in dry human skulls, 85 skulls of unknown age and sex from nine medical schools in Khyber Pakhtunkhwa, Pakistan were examined. The transverse diameter, number, shape and position of the greater (GPF) and lesser (LPF) palatine foramina; canine to canine inter-socket distance; distance between greater palatine foramen medial margins; on each side, the distances between greater palatine foramen and base of the pterygoid hamulus, median maxillary suture and posterior border of the hard palate; palatal length, breadth and height; maximum width and height of the incisive foramen; and the angle between the median maxillary suture and a line between the orale and greater palatine foramen were determined. Palatine index and palatal height index were also calculated. An oval greater palatine foramen was present in all skulls, while a mainly oval lesser palatine foramen was present in 95.8% on the right and 97.2% on the left. Single and multiple lesser palatine foramina were observed on the right/left sides: single 44.1%/50.7%; double 41.2%/34.8%; triple 10.2%/11.6%. The greater palatine foramen was located above the third molar in 74.7% (right)/87.8% (left), between the second and third molars in 25.3%/9.5%, and above the second molar in 2.7% (left). A single oval-shaped incisive foramen was observed in 87.1%. The median maxillary suture angle was 13.74±1.58° on the right and 13.14±1.68° on the left. In conclusion, no significant differences were observed in any distances on the right and left side related to greater palatine foramen; however a significant difference (p <0.05) was observed between the right and left sides for median maxillary suture angle.

Aegla chilota, new species of anomuran freshwater crab from Chiloé Island, western Patagonia

Abstract We describe a new species of freshwater crab, Aegla chilota, from two small streams at Yaldad Bay, in the southern end of Chiloe Island, western Patagonia. The new taxon is distinguished from the remaining Chilean species of Aegla Leach, 1820 by the following morphological diagnostic features: rostrum neatly triangular, short, scarcely surpassing eyes; orbital sinus wide, shallow, limited by tiny extra-orbital spine and wide extra-orbital sinus; carpal lobe prominent, triangular, tipped by at least two coalescent acute conical scales; second abdominal epimeron little produced, armed with acute scale; telson plate roughly pentagonal, with functional median suture. Molecular phylogenetic analyses also support the separation and diagnosis of A. chilota from its sister taxon, A. hueicollensis Jara and Palacios, 1999. The type locality for A. chilota n. sp. is a small river that drains a small hilly portion of the south-eastern coast of Chiloe Island; the other river in which the species was found is isolated from the type locality by the Yaldad Bay into which both rivers drain.

Study of the Tissue Reaction of the Region of the Midpalatine Suture of Rats after Disjunction with Spring Anchored in Mini-Implants

Midpalatine suture disjunction is a routine procedure in the orthodontic clinic; however, the cellular events involved in the procedure have not yet been completely explained. The aim of this study was to verify the tissue events, particularly those related to osteogenic differentiation, which occur in the region of the palatal suture after disjunction, by means of histologic and immunohistochemical analyses of the following noncollagenous proteins: BSP, OCC, OPN and ONC. In this study, 10 male Wistar rats aged two months and weighing approximately 250 g were used. The animals were divided into two groups of five animals: Group I – control (mini-implant placement) and group II – experimental (placement of mini-implant and disjunction spring made of 0.60mm steel wire, with an initial load of 2N (200 grams)). After 21 days, the animals were sacrificed and histological and immunohistochemical analyses were performed for the noncollagenous proteins. The use of the spring anchored to mini-implants promoted the disjunction of the median palatal suture, with a V-shaped opening, in which the base faced the superior region (at the nasal cavity) and the vertex was in the inferior region of the oral cavity (at the palatal bone). It could be concluded that after disjunction, there was presence of osteoblasts in an osteoid matrix in the region of the median palatal suture, and the immunohistochemical expression of the noncollagenous proteins increased in all the analyzed parameters, expression being most significant for ONC.

Extensiometric analysis of strain in craniofacial bones during implant-supported palatal expansion.

Palatal expansion has several orthodontic and orthopedic applications, such as increasing maxillary transverse dimensions and correcting maxillary atresia, oral breathing, and skeletal cross-bites. Little is known about the strain to which craniofacial bones are submitted when a palatal expander is loaded. The objectives of the present work were to propose a new palatal bone-borne titanium device (expansion screw), to determine patterns of strain distribution in craniofacial bones during palatal expansion and to show the clinical results of a new palatal expander supported by implants. For in vitro testing, the palatal expander supported by two commercially pure titanium (cp Ti) implants was inserted parallel to the median palatine suture of four dry adult human skulls. Uniaxial and triaxial strain gauges were attached to craniofacial bones and connected to a signal acquisition system. An expansion screw was turned and strain data were collected during palatal expansion. The results showed that the bone strain distribution in craniofacial bones loaded by the palatal bone-borne titanium device was complex: the strain was tensile in the palatine cortical bone and compressive in pterygopalatine processes, nasal bones, and orbital floor. The maximum compressive strain occurs in the upper portion of the pterygopalatine processes and the strain changes from compressive to tensile in the zygomatic process. The experimental results suggest that the bone strain due to the palatal expander is distributed over all craniofacial bones and that the upper portions of pterygopalatine processes are the main sites of resistance to palatal expansion. The new palatal expander supported by two cp Ti implants proposed was employed on adult patient as an illustrative report, where adequate palatal expansion was achieved. The new protocol proposed was less invasive, risky, painful and costless for the correction of moderate maxillary transverse deficiency.

An adult case of skeletal Class II with high mandibular plane angle treated by anterior rotation of the mandible with miniscrew anchorage

This case report illustrates the successful treatment of anterior rotation of the mandible due to intrusion of the entire maxillary arch, using miniscrew anchorage in an adult. A woman, aged 24 years and 8 months, had a convex profile, which she desired to improve. She was diagnosed with a skeletal Class II jaw-base relationship with a high mandibular plane angle. After extraction of four premolars, three miniscrews were implanted at the median palatine suture and the distal alveolus of the maxillary lateral incisors. Anterior rotation of the mandible was achieved by intrusion of the entire maxillary arch. The total active treatment period was 32 months. Acceptable occlusion and an improved facial profile were maintained after 29 months of retention.

The modern view on the rare purulent-necrotic diseases of the external genitalia in men (review of literature)

В представленном обзоре литературы освещаются современные аспекты эпидемиологии, этиологии, патогенеза, клинико-лабораторной картины, лучевой диагностики и лечения редких гнойно-некротических заболеваний мужских наружных половых органов, к которым относятся карбункул мошонки, гидраденит лона, кавернозный и бульбарный абсцессы полового члена, подкожный абсцесс срединного шва полового члена, абсцесс мошонки и молниеносная гангрена мошонки (гангрена Фурнье). Эти заболевания обычно наблюдаются у мужчин социально активного и репродуктивного возраста с иммунодефицитным коморбидным фоном. Обсуждаются новые методы адьювантного лечения пациентов с гангреной Фурнье, такие как гипербарическая оксигенотерапия и вакуум-терапия. Обращается внимание, что прогноз гнойно-некротических заболеваний наружных половых органов зависит, прежде всего, от своевременной диагностики и сроков хирургического вмешательства.Ключевые слова: гнойно-некротические заболевания мужских наружных половых органов, этиопатогенез, диагностика, лечение

A new western European Cretaceous bryozoan genus from the early Cenomanian radiation of neocheilostomes

AbstractNeocheilostomes possessing ovicells for larval brooding originated in the late Albian and radiated explosively in the Late Cretaceous. Our understanding of this radiation is hampered by poor knowledge of the taxonomy of the earliest neocheilostomes. Here we describe a new neocheilostome genus, Ehrhardina, from shallow‐water sediments in the early Cenomanian of Western Europe. Two species (Ehrhardina voigti sp. nov. and E. pikeae sp. nov.) are referred to the new genus. Ehrhardina gen. nov. is an onychocellid characterized by large opesiae with proximolateral, symmetrical opesiular constrictions and proximolateral, long opesiular indentations, bilaterally symmetrical interzooidal avicularia and lacking spine bases, but with hyperstomial ovicells that have ectooecia formed of exterior wall calcification. Colonies are unusually large for encrusting onychocellids and multilaminar; ovicells are primitive in showing a median suture in the ectooecium. Similarities between Ehrhardina gen. nov. and Aechmella, Floridina, Floridinella, and Onychocella are discussed, and a key for the discrimination of these genera is provided. Ehrhardina gen. nov. is the oldest neocheilostome known to construct large, multilaminar colonies.

The origin of bedding-parallel fibrous calcite veins in the Lower Permian Chihsia Formation in western Hubei Province, South China

Bedding-parallel fibrous veins occurring as lenticular to flattened intercalations were found in the organic-rich marlstone/calcareous shale of the upper Lower Permian Chihsia Formation in western Hubei Province, South China. They dominantly consist of fibrous calcite crystals with smooth and tight boundaries, forming fence-like inward, syntaxial growth clusters toward the vein center along which a median suture line generally occurs. Petrographic evidence indicates that these veins may form at relatively shallow burial depth, where fluid overpressures would have incrementally created the bed-parallel vein space, resulting in displacive growth of fibrous calcite. On the other hand, the C, O and S isotopic data across the vein reveal slightly depleted δ13Ccarb values (−3.32‰ to +0.19‰ VPDB) and moderately depleted δ18Ocarb values (−9.6‰ to −7.3‰ VPDB) with respect to those of coeval seawaters and slightly heavier δ34Spyrite values (−7.88% CDT) with respect to those of ambient rocks. Stable isotope evidence consistently suggests significant contribution of bacterial sulfate reduction (BSR) to the formation of the fibrous calcite cements in the vein. The BSR could have been intensive with the availabilities of residual sulfate and abundant organic matters in the Chihsia sediments during shallow burial, increasing the alkalinity of pore waters and further promoting carbonate precipitation. Thus, the bedding-parallel fibrous calcite vein in the upper Lower Permian Chihsia Formation is an important time-specific petrographic capsule, providing clues for understanding the diagenetic process in organic-rich sediments.

Abstract T P92: Remote Ischemic Conditioning (RIC) Attenuates Post-TBI Ischemic Injury and Improves Behavioral Outcomes

Background: Others and we reported that RIC-therapy is safe in humans, and protective in rodents that can be repeatedly used under both, hemorrhagic and ischemic stroke. Since TBI shares some common features of ischemic and hemorrhagic injury as in stroke, we hypothesized that RIC-therapy will remain protective in TBI, too. Methods: We tested RIC-therapy in a closed-head injury model of pediatric TBI in male mice (28 days old). Mice were later randomized for either RIC-therapy or its sham-procedure once daily starting 1-hour post-TBI until sacrifice. Cerebral blood flow (CBF) was measured by laser speckle imager (LSCI), and MRI was used to estimate edema and cerebral perfusion. Mice were also tested for functional outcomes. Statistical significance was determined at p&lt;0.05. Results: Micro-CT showed a shallow dent along the median suture of skull. Closed-head TBI led to progressive acute ischemia, which was attenuated with time. However, reduced CBF and significant edema was observed at 48-hours post-TBI, which was attenuated by RIC-therapy. Open-field test showed no significant difference at 3 days post-TBI but in the narrow beam-walk challenge, TBI mice showed significantly impaired activity, which was improved by RIC-therapy. Flowcytometry in brain tissue confirmed significantly increased opening of mitochondrial permeability transition pore and necro-apoptotic cell death at 3 days post-TBI that was blocked by RIC-therapy. In a 3-weeks follow up, the mice with TBI were apparently normal but showed depressive phenotype in challenged environments, such as lesser mobility during forced swim test, and reduced cerebrovascular reserve capacity (CVRC). Flowcytometric analysis of the brain tissue at 3-weeks post-TBI showed reduced neuronal activity as detected by the poor population of cFOS positive neurons. RIC-therapy after TBI significantly attenuated the depressive phenotype, improved CVRC and cFOS positive neurons, collectively indicating improved neurovascular coupling and function. Conclusion: Post-TBI RIC-therapy is safe and beneficial, and can be translated to prevent ischemic injury.

Description of transverse maxillary expansion in patients with bilateral cleft lip and palate undergoing gingivoperiosteoplasty with alveolar bone graft. A preliminary study

Cleft lip and palate (CLP) is one of the most common facial deformities. Treatment is long and complex, requiring a multidisciplinary team, including an orthodontist, who plays a prime role in ensuring that dental phenomena occur under the best possible conditions allowed by often unfavorable anatomy and growth and healing factors. Orthodontic preparation by maxillary expansion is a key step in management, mandatory ahead of gingivoperiosteoplasty and alveolar bone graft. Since 2000, Pr Vasquez’s maxillofacial and plastic surgery team in the Necker Hospital (Paris, France) has used a treatment protocol involving alveolar cleft repair by gingivoperiosteoplasty and alveolar bone graft at 4-6 years of age.Orthopedic mechanics induces not only strictly orthopedic effects but also orthodontic dento-alveolar compensation. In CLP, physiology is exceptional in that there is no median palatine suture between fragments, and it can be supposed that the behavior of surrounding structures during maxillary expansion differs from that is a classical patient.We therefore undertook a radiologic study of the dento-alveolar phenomena accompanying preoperative orthodontic expansion in bilateral CLP patients, in a group selected from those jointly managed by Pr Vazquez’s team and Dr Vi Fane’s team in the Rothschild Hospital (Paris), under the auspices of the MAFACE rare diseases reference center.

Use of self-retaining barbed suture for rectal wall closure in transanal endoscopic microsurgery

The aim of this study was to investigate the safety and efficacy of self-retaining barbed sutures in comparison with monofilament clip-fixated sutures for rectal wall closure in transanal endoscopic microsurgery. Horizontal full-thickness wall defects (3.5cm) of cattle rectal specimens were closed via transanal endoscopic microsurgery using a monofilament suture with clips at the end (Surgipro(®) 2/0; Covidien, Mansfield, MA, USA, n=25) or a self-retaining barbed suture (V-Loc™ 180 3/0; Covidien, Mansfield, MA, USA, n=25). The primary endpoint was the pneumatic leakage pressure of the suture line. As a secondary endpoint, suture time was evaluated. The median pneumatic leakage pressure for barbed sutures was 45.5mbar (range 17-106mbar) and 33.5mbar (range 19-106mbar) for monofilament sutures (p=0.58). A pneumatic leak at a critical pressure below 25mbar occurred in 3 cases with barbed sutures and in 7 cases with monofilament sutures (p=0.29). Median suturing time [19:25min:s (range 12:00-33:30) vs. 20:41 (17:00-28:33), p=0.23] did not differ between the two groups. Barbed sutures display the same bursting pressure as monofilament sutures and their use for rectal wall closure seems feasible.

Ontogeny of a New Species of the Cambrian Series 3 (Middle Cambrian) Trilobite Genus Liostracina Monke, 1903 from North China and the Taxonomic Position of the Superfamily Trinucleoidea

The Order Asaphida was grouped by the presence of a ventral median suture and a globular protaspis. The Superfamily Trinucleoidea has been assigned to the Order Asaphida, based on the recognition of a globular protaspis in the Ordovician representatives of the group, and the presence of a ventral median suture in the middle Cambrian genus Liostracina which has been regarded as a primitive sister-group to the post-Cambrian trinucleoideans. Recent studies demonstrate that the ventral median suture and the globular protaspis could have evolved multiple times in the trilobite evolutionary history, casting doubt on the traditional concept of the Order Asaphida. Inclusion of the Trinucleoidea into the Order Asaphida, therefore, has to be tested. It has recently been revealed that Liostracina simesi Jago and Cooper, 2005 did not possess a ventral median suture, implying that there could have been variable types of ventral suture within the genus Liostracina. Here we report the ontogeny of Liostracina tangwangzhaiensis n. sp. from the Cambrian Series 3 (middle Cambrian) strata of Shandong Province of North China. The material for this study includes protaspides, which are of flat, benthic morphology, contrasting to the globular protaspid morphology of the Ordovician trinucleoideans. The benthic protaspid morphology of L. tangwangzhaiensis indicates an independent evolution of the globular protaspis within the Superfamily Trinucleoidea. Together with the variable types of ventral suture within the genus Liostracina, the benthic protaspid morphology of Liostracina leads us to propose that the Superfamily Trinucleoidea be excluded from the Order Asaphida.

Palate Mucocele

Woman, 63, complained of a “wart in the palate” that had developed over 6 months. It was asymptomatic, of normal color, had well-defined edges, and was situated near the median suture. The presumptive diagnosis was mucocele or a minor salivary gland tumor. Histopathological analysis identified adenoid cystic carcinoma. Microscopic analysis revealed numerous hyperchromatic, cuboidal epithelial cells with scanty and clear cytoplasm. Perineural infiltration was scarce. Adjacent to it was a dilated duct with mucus inside that suggested a mucous retention cyst. These cells were arranged in small strands and nests, with tubular and ductal aspects. The patient was treated surgically. This case emphasizes the importance of biopsy in identifying tumors associated with mucocele.

Establishment of the craniofacial three-dimensional finite element models with the sutures defined alone

To develop a child craniofacial three-dimensional (3D) finite element model (FEM) with sutures defined alone. The CT data for this study was developed from sequential computed tomography scan images taken at 0.625 mm intervals of an 8 years children skull. Data set was imported into Mimics 10.0 and processed with Geomagic 9.0, and exported as initial graphics exchange specification(IGES) files. The IGES files were then imported into Ansys 13.0 to set up two FEM with or without the median palatine suture being opened. The FEM contained nine craniofacial sutures and eight teeth which were defined alone.For simulating orthopedic maxillary protraction, three forces (F1-F2) were loaded on FEM.F1(1 N) was loaded at 1 cm above the geison. F2(1 N) was loaded at articular fossa of temporal bone. F3(2 N) was directed anteriorly and paralleled with occlusal plane near the canine. The stress distribution and the values distributed in each point gained in the two models were compared. Two craniofacial 3D FEM of the child were developed with the median palatine suture opened or not .With median palatine suture being opened or not, the two models showed the similar von Mises stresses (VMS). The distribution of the VMS was in the bridge of the nose and dextro-ala nasi.When the median palatine suture was opened, the max VMS value was 18916.00×10(-4) MPa which appeared in the nose point and the min VMS value was 1.61×10(-4) MPa which appeared in the maxillary central incisor point. At the same time, the max stress value at the direction Y was -3985.30×10(-4) MPa and appeared in the frontomaxillary suture point, and the min Y value was 0.08×10(-4) MPa which appeared in the maxillary central incisor point. When the median palatine suture was not opened, the max VMS value was 19 244.00×10(-4) MPa and appeared in the nose point. The min VMS value was 1.62×10(-4) MPa and appeared in the maxillary central incisor point. At the same time, the max stress value at the direction Y was -4258.20×10(-4) MPa and appeared in the frontomaxillary suture point, and the min Y value was 0.08×10(-4) MPa which appeared in the maxillary central incisor point. To define the sutures as entities alone contributed to develop child craniofacial 3D FEM which consist nine sutures. There was tiny difference in stress distribution in both the VMS and in Y direction with the median palatine suture being opened or not.