Craniofacial Suture Maturation in Pycnodysostosis: A CBCT-Based Assessment of the Midpalatal, Zygomaticomaxillary Sutures and the Spheno-Occipital Synchondrosis.

ObjectiveThis study aimed to evaluate the maturation stages of the midpalatal (MPS) and zygomaticomaxillary (ZMS) sutures, as well as the spheno-occipital synchondrosis (SOS), in patients with pycnodysostosis (PYCD) compared with controls, and to explore their associations with age and sex.DesignCross-sectional study was matched by sex and age with a control group.SettingIn a secondary care center for patients with rare diseases in the state of Ceara (Brazil).Participants18 participants (9 PYCD, 9 controls).InterventionsSutures were analyzed using cone-beam computed tomography (CBCT) based on established classification systems.Main Outcome MeasuresThe stage of suture maturation was the main evaluation parameter. MPS and ZMS were evaluated for fusion stages, while SOS ossification was assessed using a 5-stage maturation scale. Statistical analyses included Pearson's chi-square, Fisher's exact tests, and Spearman's correlations to assess associations between suture stages and demographic or clinical variables.ResultsSignificant differences were observed between the groups in the maturation stages of the ZMS (p = .009) and MPS (p = .029), with earlier fusion in patients with PYCD, independent of age. SOS showed no significant differences between groups but exhibited a strong correlation with age (p = .001, r = .727). Associations with sex were observed only for the SOS (p < .001), indicating earlier fusion in females.ConclusionsOur findings confirm differences in the fusion stages of the MPS, and ZMS. However, further studies are needed to better understand the influence of sex and age on suture fusion, with age being a particularly significant parameter for the SOS.