When does midpalatal suture close ?

Summerized by : Dr.Hani Alhebshi.

When does midpalatal suture close ?

Upon searching the web , I found some useful articles answering this question.

It has been stated that there is quite wide variation among individuals that it ossifies at different age groups.

The amount of ossification increases in the growth spurt ( approximately 12-13 years in females , 14-15 years in males) leading to some obliteration at the suture.

There is evidence of continuous ossification in later ages upto 20s (young adults) and even to later age in other studies reaching 32 years! showing marked degree of closure.

The importance of this point lies in whether we can use rapid palatal expansion in adults or not to achieve an opening in the midpalatal suture.Several papers showed clinical cases that palatal sutures were opened in late teens and early twenties.

The following links are of valuable articles I found useful for our discussion.

Here are some important excerpts from these articles.

1. Correction of these deficiencies with a maxillary rapid palatal expander, first popularized more than 40 years ago by Haas, yielded well-controlled and predictable results. However, once patients are past their growth spurt, which occurs at about the age of 12–13 years in females and 14–15 years in males, the protocol for rapid palatal expansion (RPE) is not quite so clear. According to some authors, expansion of the maxillary arch in mature patients is not feasible.Proffit reports that “by the late teens, interdigitation and areas of bony bridging across the suture develop to the point that maxillary expansion becomes impossible,” a belief based on Melsen’s study on histological suture appearance.Other recent evidence suggests that it is indeed possible to successfully expand the palate in young adult.

2. Histological and radiological evidence indicates that the maxillary suture is not fused enough to inhibit the opening of the maxillary palatal suture in patients who are in their late teens or their early twenties.

3.There are conflicting views about the closure of midpalatal suture. The chronological age does not seem to be a reliable indicator for a real morphological status of the midpalatal suture closure. According to earlier studies, sutures of the cranial vault start to obliterate during the third decade of life. According to Persson and Thilander15 earliest obliteration can be seen in the posterior palate of a 15-year-old girl and there may be no obliteration at all in a 27-year-old female. Earliest obliteration in male was found in a 21 years and no obliteration at all in a 32-year-old male. According to Sperber,16 obliteration may start in adolescence, but complete fusion is rarely found before 30 years of age.

Your comments will be appreciated.

Press on the links below to download the articles ..

1. Rapid Palatal Expansion in the Young Adult.

2. Midpalatal Suture Ossification and Skeletal … – Jaypee Journals

3. Rapid Maxillary Expansion – JCDR – Journal of Clinical and …

4. The mid-palatal suture in young adults. A radiological – ResearchGate

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