Suture Growth Modulated by the Oscillatory Component of Micromechanical Strain

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Abstract
Sutures are fibrous connective tissue articulations between intramembranous craniofacial bones. Sutures are composed of fibroblastic cells with their matrices in the center and osteogenic cells in the periphery producing a matrix that is mineralized during skeletal growth. Whether oscillatory forces stimulate sutural growth is unknown. In the present work, we applied static and cyclic forces with the same peak magnitude of 5N to the maxilla in growing rabbits and quantified (1) acute in vivo sutural bone strain responses and (2) chronic growth responses in the premaxillomaxillary suture (PMS) and nasofrontal suture (NFS). Bone strain recordings showed that the waveforms of static force and 1-Hz cyclic force were expressed as corresponding static and cyclic sutural strain patterns in both the PMS and NFS, with the mean peak PMS strain (-1451 +/- 137 microepsilon for the cyclic and -1572 +/- 138 microepsilon for the static) approximately 10-fold higher than the mean peak NFS strain (124 +/- 9 microepsilon for the cyclic and 134 +/- 9 microepsilon for the static). Strain polarity was the opposite: compressive for the PMS but tensile for the NFS. However, on application of repetitive 5N cyclic and static forces in vivo for 10 minutes/day over 12 days, cyclic loading induced significantly greater sutural widths for the compressed PMS (95.1 +/- 8.3 microm) than sham control (69.8 +/- 8.2 microm) and static loading (58.9 +/- 2.8 microm; p < 0.01). Interestingly, the same trend was true for the NFS under tensile strain: significantly greater sutural width for cyclic loading (267.4 +/- 64.2 microm) than sham control (196.0 +/- 10.1 microm) and static loading (169.9 +/- 11.4 microm). Cell counting in 110 x 110 microm grids laid over sutures disclosed significantly more sutural cells on repetitive cyclic loading than sham control and static loading (p < 0.05) for both the PMS and NFS. Fluorescent labeling of newly formed sutural bone demonstrated more osteogenesis on cyclic loading in comparison with sham control and static loading. Thus, the oscillatory component of cyclic force or more precisely the resulting cyclic strain experienced in sutures is a potent stimulus for sutural growth. The increased sutural growth by cyclic mechanical strain in the tensed NFS and compressed PMS suggests that both microscale tension and compression induce anabolic sutural growth response.