腭中缝成熟度评估体系与颅颌面骨缝发育关联性的研究进展

Advances in the association between the midpalatal suture maturation assessment system and craniofacial suture development

摘要:

该文系统综述腭中缝成熟度评估体系与颅颌面骨缝发育的关联性研究进展。通过解析腭中缝的分段解剖特征及5个阶段影像学分类（A～E），揭示其与颅颌面骨缝系统在发育时序、生物力学耦合和分子调控网络中的协同作用。传统组织学分型（Melsen分级）因侵入性和主观性限制，逐渐被锥形束计算机断层扫描三维重建和磁共振T2 mapping技术取代，而人工智能辅助影像分析显著提升了评估精度。Wnt/BMP信号通路通过时间-空间特异性调控骨缝发育，间充质干细胞（如具有机械感知能力的Piezo²⁺细胞）通过力学响应介导骨缝改建，而上颌快速扩弓产生的机械应力可激活骨缝适应性生长，三者共同构成骨缝发育的关键调控网络。临床应用中，微种植体辅助快速扩弓通过优化应力分布实现无创性骨骼效应，为颅颌面畸形治疗提供新策略。未来需融合影像、生物力学与分子检测技术，阐明骨缝发育的动态调控规律，并开发基于干细胞靶向调控的新型治疗策略，最终实现颅颌面畸形的精准诊疗。

Abstract:

This article systematically reviews recent advances in research on the association between the midpalatal suture maturation assessment system and craniofacial suture development. By analyzing the segmental anatomical characteristics of the midpalatal suture and its five-stage imaging-based classification (stages A-E), we elucidate the coordinated roles of the midpalatal suture and the craniofacial suture systems in developmental timing, biomechanical coupling, and molecular regulatory networks. Traditional histological classification methods (e.g., the Melsen classification), limited by their invasiveness and subjectivity, are gradually being replaced by cone-beam computed tomography (CBCT) three-dimensional reconstruction and magnetic resonance T2 mapping techniques, while artificial intelligence-assisted image analysis has significantly improved assessment accuracy. The Wnt/BMP signaling pathways regulate suture development in a spatiotemporally specific manner; mesenchymal stem cells, such as mechanosensitive Piezo²⁺ cells, mediate suture remodeling through mechanical responses; and mechanical stress generated by rapid maxillary expansion can activate adaptive growth of sutures. Together, these mechanisms constitute a key regulatory network governing suture development. In clinical practice, micro-implant-assisted rapid maxillary expansion optimizes stress distribution to achieve noninvasive skeletal effects, offering novel strategies for the treatment of craniofacial deformities. Future research should integrate imaging, biomechanical, and molecular detection techniques to elucidate the dynamic regulatory mechanisms of suture development and to develop novel therapeutic strategies based on targeted stem cell modulation, ultimately enabling precision diagnosis and treatment of craniofacial deformities.