Holiat, Dominika

Skrzat, Janusz

Walocha, Jerzy

Folia Morphologica

English

Jagiellonian Univeristy Repository

Folia Morphol. Vol. 62, No. 2, pp. 1–9Copyright © 2003 Via MedicaISSN 0015–5659www.fm.viamedica.plO R I G I N A L  A R T I C L E123Address for correspondence: Dr Janusz Skrzat, Department of Anatomy, Collegium Medicum, Jagiellonian University, ul. Kopernika 12,31–034 Kraków, Poland, tel: +12 422 95 11, fax: +12 430 30 06, e-mail: jskrzat@poczta.onet.plA morphometrical study of the humanpalatine suturesJanusz Skrzat, Dominika Holiat, Jerzy WalochaDepartment of Anatomy, Collegium Medicum, Jagiellonian University, Kraków, Poland[Received 20 February 2003; Accepted 26 March 2003]The paper presents metrical data on the palatine sutures of a dry skull collectioncomprising 29 male and 33 female specimens. The length and mutual propor-tions of the mid-palatal, interpalatine and transverse palatine sutures were con-sidered. These properties led to a conclusion as to the extent to which the pa-latine process of the maxilla and palatine bones dominate in the formation ofthe hard palate. We discovered that the palatine process of the maxilla is preva-lent and that it constitutes approximately 65% of the hard palate in both sexes.Moreover our findings indicated a significant correlation in the diameters of thepalatine sutures that are arranged sagittally.key words: palatine sutures, cranial sutures, hard palateINTRODUCTIONA knowledge of the structure of palatine su-tures and the anatomical relations between themis important for a better understanding of the etio-pathogenesis of malformations of this cranial re-gion. The hard palate and its sutures are struc-tures of the utmost importance because they aresubject to a cleft palate related defect of the max-illa and palatine bones.The hard palate consists of two palatal process-es of the maxilla and two horizontal plates of thepalatine bones that are connected by the palatinesutures. The sutural system of the hard palatebasically comprises premaxillary, mid-palatal, pala-tomaxillary, and interpalatal articulations. The pre-maxillary suture exists between the premaxillarybones and the maxilla [4, 12]. The mid-palatal su-ture extends from the incisive canal to the trans-verse palatine (palatomaxillary) suture posteriorly,which joins the horizontal plates of the palatalbones and the palatal processes of the maxilla. Thetwo horizontal plates of palatine bones are joinedby the interpalatal suture [5]. The median andtransverse palatine sutures mark the lines of con-nection between the bones of the palate and sotheir length corresponds to the diameter of therespective bones, which are joined by these su-tures. Thus metrical features of the palatine su-ture become a counterpart of the diameters of thebones which form the hard palate and make itpossible to deduce to what extent both horizontalplates of the palatine bone and palatine processesof the maxilla are engaged in the formation of thehard palate.The goal of this paper is to present the metri-cal variation in the length of the palatine suturesand to establish the correlation, if any, betweenthem. We focused only on analysis of the mid-pal-atal, transverse palatine suture and the interpa-latine sutures, as these occur in adults and wereobserved in the skulls investigated. Hence we triedto estimate to what extent the palatine bones andthe horizontal plates of the maxilla contribute tothe formation of the hard palate.124Folia Morphol., 2003, Vol. 62, No. 2MATERIAL AND METHODSThe palatine sutures were investigated of 29male and 33 female adult skulls belonging to theAnthropological Museum of the Jagiellonian Uni-versity. The skulls are dated to a period betweenthe XV and XVIII century and were excavated inKraków.The lengths of the palatine sutures was measuredwith a spreading calliper following anthropologicalprinciples [7, 8]. The following measurements wereapplied (Fig. 1):— alv-sr — length of the interpalatine suture;— sr-inc — length of the mid-palatal suture;— alv-inc — length of sagittal sutural system of thehard palate, regarded as the sum of the lengthsof the mid-palatal and interpalatine suture;— spal-spal — length of the transverse palatal suture.Additionally, a new measurement was intro-duced. This concerned the length of the chord be-tween the staurion (sr) and the landmark that is fixedin a place of direct contact between the mid-palatalsuture and the posterior margin of the incisive fora-men. This landmark was assigned for measurementswith the inc symbol and was termed incisulare. Thechord sr-inc expresses the length of the mid-palatalsuture of the hard palate that originates from thesame palatine shelves.The percentage of palatine bones and maxilla inthe formation of the hard palate was calculated asthe following ratios: (alv-sr)/(alv-inc) ¥ 100 and(sr-inc)/(alv-inc) ¥ 100. Statistical analyses were per-formed on a file of collected data. As a first step werejected outliers, those values, which were far fromthe middle of the distribution. Such values were de-tected using a box-whisker plot that describes thecentral tendency of the variable in terms of the me-dian of the values (represented by the smallest boxin the plot). The spread (variability) in the values isrepresented in this plot by the quartiles (the 25th and75th percentiles, the larger box in the plot) and theminimum and maximum values of the variable (the„whiskers” in the plot). The correlation matrix of allthe variables was then run and examined for signif-icant relations. The significance level calculated foreach correlation was equal 0.05 and Pearson’s cor-relation coefficients were used to assess the associ-ations between analysed variables. A comparison wasalso performed of the means of all the variables at-tributed to male and female skulls to determinewhether there were any differences between thesexes in length of palatine sutures.RESULTSThe box-whisker plot shows the statistical char-acter of the metrical data studied for the palatinesutures (Fig. 2). The mean values of the metricalfeatures investigated for the bony palate of themale and female skulls and the range of their varia-bility is presented in Table 1. The correlation be-tween the metrical features studied for the  bonypalate and their sutures is demonstrated in Table2 and 3. Table 4 presents the percentage of theinterpalatine suture and the mid-palatine suturein the whole sagittal suture system of the hardpalate in both sexes.The comparison of means of the palatine suturelength indicated a lack of statistically significant dif-ferences (p > 0.05) between the male and femalegroups. The length of the subsequent palatine su-tures was almost equal in both sexes. In the sagittalsuture system of the hard palate the mid-palatalsuture (sr-inc) was nearly twice as long as the inter-palatine suture (alv-sr).The percentage of the interpalatine suture (alv-sr)and the mid-palatal suture (sr-inc) in the whole sag-ittal system of palatine sutures (alv-inc) is also simi-lar in male and females skulls. The mid-palatal su-ture dominates in both sexes and thus indicates thatpalatal processes of the maxilla constitute about 65%of the bony palate, whereas the horizontal plates ofthe palatine bone constitute about 35%.In the male skulls studied an increase in the in-terpalatine suture length results in a decrease inthe mid-palatal suture length and this relation isstatistically significant. Such a rule was not observedin the female skulls. There is also a difference inboth sexes concerning the significance of the cor-relation between the lengths of the interpalatinesuture and mid-palatal suture on the one hand andFigure 1. Measurements of the palatine sutures.125Janusz Skrzat et al., The morphometry of the human palatine suturesTable 2. Correlation matrix of diameters of the bonypalate in female skullsFeature alv-sr sr-inc  alv-inc spal-spalalv-sr 1.00 –0.27 0.49* 0.24sr-inc –0.27 1.00 0.70* 0.18alv-inc 0.49*  0.70* 1.00 0.35spal-spal 0.24 0.18 0.35 1.00* Denotes statistically significant correlation, p < 0.05Table 3. Correlation matrix of diameters of the bonypalate in male skullsFeature alv-sr sr-inc  alv-inc spal-spalalv-sr 1.00 –0.63* 0.35 –0.07 sr-inc –0.63* 1.00 0.50* 0.28alv-inc 0.35 0.50* 1.00 0.23spal-spal –0.07 0.28 0.23 1.00* Denotes statistically significant correlation, p < 0.05Table 4. Percentage of the palatine suture segment in the male and female skullsSuture segment Sample Mean Minimum MaximumM F M F M F M F(alv-sr)/(alv-inc) ¥ 100 28 29 34.3 35.3 20.9 25.6 46.3 42.5(sr-inc)/(alv-inc) ¥ 100 28 29 65.7 64.7 53.7 57.5 79.1 74.4M — male, F — femaleFigure 2. Box-whisker plot for variables, which represent the length of the palatine sutures after rejection outliers.Table 1. Means and range of variation of the length of the palatine sutureSuture Sample Mean Minimum Maximum SDsegment M F M F M F M F M Falv-sr 28 29 14.3 14.1 9. 0 10.0 20.0 17.0 2. 393 2.110sr-inc 28 29 27.3 25.8 22.0 22.0 34.0 30.0 3.193 2.555alv-inc 28 29 41.5 39.8 37.0 36.0 47.0 45.0 2.560 2.610spal-spal 28 29 32.5 32.1 28.0 25.0 39.0 39.0 2.848 2.615M — male, F — female126Folia Morphol., 2003, Vol. 62, No. 2the length of the whole sagittal sutural system ofthe hard palate on the other. The length of thewhole sagittal sutural system of the hard palatesanalysed correlates significantly with the length ofthe mid-palatal suture in the male skulls, while inthe female skulls it correlates significantly both withthe length of the interpalatine suture and the lengthof the mid-palatal suture. In neither sex was thereany significant correlation between the length ofthe transverse palatine suture and other palatinesutures in the cranial set under examination.On the basis of these considerations it may beconcluded that the size of the palatal bones, demar-cated by the length of the interpalatine suture, hasa significant effect on the longitudinal dimensionsof the bony palate, both in the female and male skull.DISCUSSIONThe human osseous palate consists of the pa-latine processes of the maxillary bone anterior tothe transverse palatine suture and the horizontalprocesses of the palatine bone posterior to thatsuture. These bones are joined by the sutures ar-ranged into two systems, the sagittal and the trans-verse, running at right angles to each other andthis enables two-directional growth of the palate(antero-posterior elongation and lateral widening).The increase in total length results predominantlyfrom an increase in the antero-posterior dimen-sion of the maxillary component [10] and this ispossible owing to the presence of the transversepalatine suture (palatato-maxillary), which servesas a site of growth [6]. The mid-palatal and inter-palatine sutures belong to the sagittal suture sys-tem, and permit growth into width of the facialskeleton, while the transverse palatine suture (pala-to-maxillary) facilitates longitudinal growth of themaxilla [11].The metrical comparison between the length ofthe palatine sutures of the male and female skullsrevealed that they are of similar proportions. How-ever, there are differences between the sexes in thecorrelation between the lengths of the subsequentsutures of the hard palate. This can be a result ofa different pattern of growth that occurs in the hardpalate of the male and female skulls. The resultsobtained allow us to conclude that in the femaleskulls both the palatine processes of the maxilla andthe horizontal laminae of the palatine bones mayindependently influence the length of the bony pala-te. An increase in the participation of the palatinebones in palate formation results in a decrease inthe size of the maxilla and this is characteristic ofthe male skulls studied.No statistically significant correlation was detec-ted between the length of the transverse palatinesuture and the interpalatine suture or the mid-pala-tal suture in the cranial set studied. The lack of cor-relation between the lengths of these sutures prob-ably suggests that the palatine sutures, as the sitesof growth, increase independently of diameters ofthe bony palate. Thus the interpalatine and mid-pal-atal sutures allow the transverse growth of the pa-late, while the transverse palatine suture provideslongitudinal growth of the palate, as it remains inaccordance with embryological evidence [1, 12].The morphological relations of the palatine bonesto the maxilla are important in any consideration ofmultidirectional enlargement of the hard palate inaccordance with the growth of the whole skull [3].Morphometrical analysis of the palatal sutures sup-plies information about anatomical dependencesresulting from the principles of craniofacial deve-lopment. It would seem important to evaluate towhat extent diameters of the bony palate increasewith an increase in the sutural length. Palatine su-tures could be regarded as a keystone in the properco-ordination of the growth of the whole skull. AsPersson stated, palatine suture formation is a re-sponse to the displacement of the bones involved inthe growth process during enlargement of the skull[9]. Results of the primary observations and metricalanalysis of the palatine sutures may lead to a newconcept of anatomical research into co-ordinatedcraniofacial growth that can be controlled by diffe-rent factors such as age or ethnicity [2].It should  be emphasised that our analysis wasperformed on a relatively small sample, which pre-vents definitive conclusions from being drawn, whichwould have to be supported by results obtained fromnumerous sets of human skulls. Detailed studies ofmetrical relations among the palatal sutures shouldalso be concerned with age changes. However, suchlongitudinal studies are hard to perform because ofthe limitations imposed by the lack of numerous maleand female cranial series composed of different agegroups.Our study suggests that palatine sutures appearto be important structures, which are engaged incraniofacial growth. Together with other maxillarysutures they allow the maxilla to displace in an ante-ro-posterior direction relative to the adjacent suturemargins of the palatine bones. The morphometricalrelations between palatine sutures reflect the mode127Janusz Skrzat et al., The morphometry of the human palatine suturesof interaction between the palatine bones and max-illa during their growth.REFERENCES1. Burdi AR, Faist K (1967) Morphogenesis of the palatein normal human embryos with special emphasis onthe mechanisms involved. Am J Anat, 120: 149–160.2. Ferrario VF, Sforza C, Colombo A, Tartaglia GM, Carva-jal R, Palomino H (2000) The effect of ethnicity andage on palatal size and shape: a study in a northernChilean healthy population. Int J Adult Orthod Orthog-nath Surg, 15 (3): 233–240.3. Hahn von Dorsche S, Fanghänel J, Kubein-Messenburg D,Nägerl H, Hanschke M (1999) Interpretation of thevertical and longitudinal growth of the human skull.Ann Anat, 181: 99–103.4. Lathan RA (1971) Maxillary development and growth:the septo-premaxillary ligament. J Anat, 107 (3): 471––478.5. Lathan RA (1971) The development, structure andgrowth pattern of the mid-palatal suture. J Anat, 108(1): 31–41.6. Liu C, Song R, Song Y (1999) Tissue response in circum-maxillary sutures after transverse palated suture expan-sion. Chinese J Plast Surg & Burns, 15 (5): 329–331.7. Malinowski A, Wolański N (1988) Metody badańw biologii człowieka. PWN, Warszawa.8. Malinowski A, Bożiłow W (1997) Podstawy antro-pometrii. Metody, techniki, normy. PWN, WarszawaŁódź.9. Persson M (1995) The role of sutures in normal andabnormal craniofacial growth. Acta Odontol Scand,53: 152–161.10. Silau AM, Nijo B, Solow B, Kjaer I (1994) Prenatal sag-ittal growth of the osseous components of the humanpalate. J Craniofac Gen Dev Biol, 14 (4): 252–256.11. Scott JH (1956) Growth at facial sutures. Am J Orthod,42: 381–387.12. Woo JK (1949) Ossification and growth of the humanmaxilla, premaxilla and palate bone. Anat Rec, 105:737–753.

A morphometrical study of the human palatine sutures

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A morphometrical study of the human palatine sutures

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