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Premaxillary–maxillary suture development in the first trimester

An ultrasound study

Entwicklung der Sutur zwischen Maxilla und Prämaxilla im ersten Trimenon

Eine Ultraschalluntersuchung

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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Purpose

Our study was designed to investigate premaxillary–maxillary suture growth in fetuses from the first trimester of pregnancy using the B‑ultrasound technique in order to determine the suture fusion time.

Methods

We selected 169 healthy Han singleton pregnancies as subjects. All subjects received routine pregnancy tests and were divided into three groups based on the gestational age of the fetus: group 1, the 11th gestational week; group 2, the 12th gestational week; and group 3, the 13th gestational week. Fetal biometric measurements were recorded during consecutive prenatal ultrasonographic examinations. These measurements included nuchal translucency thickness, crown–rump length, and premaxillary–maxillary length. Intergroup comparisons were performed using analysis of variance (ANOVA).

Results

The premaxillary–maxillary suture grows gradually and its measured length at the 11th, 12th and 13th week was 0.54 cm, 0.65 cm, and 0.74 cm, respectively. We observed a significant linear correlation between the premaxillary–maxillary length and the week of gestation in the first trimester. The growth rate of the maxilla at the 11th, the 12th and the 13th week are significantly different with a descending order of growth rates being week 12, week 11 and week 13, with the 12th week rate being the most rapid.

Conclusion

The premaxillary and maxillary growth at 11 and 12 gestational weeks in the first trimester steadily accelerated, peaking at the 12th week. The rate of growth slows down after week 12 which may be associated with the fusion of the premaxillary–maxillary suture.

Zusammenfassung

Ziel

Die vorliegende Studie wurde durchgeführt, um die Entwicklung der Sutur zwischen Prämaxilla und Maxilla bei Föten im ersten Schwangerschaftsdrittel mittels B‑Ultraschalltechnik zu untersuchen und den Zeitpunkt der Suturverknöcherung zu bestimmen.

Methode

An der Studie nahmen 169 gesunde Schwangere (Mehrlingsgebärende ausgeschlossen) teil. Alle Teilnehmerinnen wurden regelmäßig routinemäßig untersucht und wurden in drei Gruppen eingeteilt, basierend auf dem Gestationsalter des Fötus: Gruppe 1: 11. Schwangerschaftswoche (SSW); Gruppe 2: 12. SSW, und Gruppe 3: 13. SSW. Die biometrische Vermessung der Föten wurde während der konsekutiven pränatalen Ultraschalluntersuchungen durchgeführt. Diese Messungen enthielten Nackentransparenzmessung, Schädel-Steiß-Länge und Länge der Prämaxilla-Maxilla. Vergleiche zwischen den Gruppen wurden mittels Varianzanalyse (ANOVA) durchgeführt.

Ergebnisse

Die Sutur Prämaxilla-Maxilla entwickelte sich kontinuierlich, wobei ihre Länge in der 11., 12. und 13. SSW 0,54 cm, 0,65 cm und 0.74 cm beträgt. Wir konnten eine signifikante lineare Korrelation zwischen Prämaxilla-Maxilla-Länge und der SSW im ersten Schwangerschaftsdrittel beobachten. Das maxilläre Wachstum in der 11., 12. und 13. SSW unterscheidet sich signifikant, wobei die Wachstumsrate in der 12. SSW am höchsten ist, gefolgt von der 11. und 13. SSW.

Schlussfolgerung

Das Wachstum der Prämaxilla und Maxilla nahm in der 11. und 12. SSW stetig zu, und wies einen Wachstumsgipfel in der 12. SSW auf. Die Wachstumsrate verlangsamte sich nach der 12. SSW, was sich möglicherweise auf die Verknöcherung der Sutur Prämaxilla-Maxilla zurückführen lässt.

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Acknowledgements

This study was funded by the key project of the medical science and technology plan of Zhejiang province (2012ZDA028).

The authors are very grateful to James L. Borke, Professor and Assistant Dean of the College of Dental Medicine, Western University of Health Sciences, Pomona, CA, USA and Raymond Wong, Professor of Pediatric Dentistry from California, San Francisco, CA, USA, for reviewing this manuscript.

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Authors and Affiliations

  1. Department of Stomatology, The Children’s Hospital, Zhejiang University, School of Medicine, 3333 Binsheng Road, 310052, Hangzhou, China

    Wen-hua Ruan, Kei-li Huang & Ling-ling Jin

  2. Department of Ultrasonography, Fuyang’s Maternal and Children Care Hospital, 311400, Hangzhou, China

    Wu-qun Han

  3. Department of ENT Head and Neck Nursing Unit, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 310016, Hangzhou, China

    Mei-li Huang

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  1. Wen-hua Ruan
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Correspondence to Wen-hua Ruan.

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Conflict of interest

W.-H. Ruan, W.-Q. Han, M.-l. Huang, K.-l. Huang and L.-l. Jin declare that they have no competing interests.

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Ruan, Wh., Han, Wq., Huang, Ml. et al. Premaxillary–maxillary suture development in the first trimester. J Orofac Orthop 80, 25–31 (2019). https://doi.org/10.1007/s00056-018-0163-z

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