Prevalence of wormian bones worldwide: a critical review

Wormian bones (WB) are the irregular bone structures developed from additional centers of ossification. Although they are commonly found in healthy individuals, under certain conditions (number >10, mosaic pattern, large size), they can indicate pathology. While their coexistence with numerous diseases is well-documented, and various studies have reported their prevalence in populations of various geographic regions, no qualitative critical review of such studies has been conducted. The aim of this paper is to perform a critical review of research studies on the presence of Wormian bones in populations worldwide, with a particular emphasis on the methodology used and the selection of the samples studied. A sample of 44 original research articles was selected via PubMed and Google Scholar databases. Four criteria were assessed: 1) number of individuals in each group, 2) known sex of individuals, 3) selection criteria of individuals, and 4) implementation of the statistical analysis. The origin of the research sample was determined as well as the method of the WB calculation, and data on the WB prevalence worldwide was collected in tabular form. The reported size of the research samples varies from 22 to 628 individuals, derived from both contemporary and archaeological populations. Four major formulas were used in order to provide the frequency of WB. The sex of individuals was known in 18 (40.9%) articles. Most of the articles focused on Asian samples. The difficulties in comparing data on the Wormian bones are caused by considerable inconsistency in the methodology used to research this phenomenon. Therefore, the interpopulation comparisons currently made may not be correctly estimated. Our study highlights the need for using more comprehensive and consistent data collection as well as processing protocol suitable for populational research on sutural bones.

Cranial morphology in metopism: A comparative geometric morphometric study

BACKGROUND

Cranial sutures are active bone growth sites and any alteration in their normal formation, patency and closure influences the overall cranial morphology. This comparative study aims to establish whether the cranial shape and size are significantly modified when metopic suture persists into adulthood using geometric morphometric analyses.

METHODS

The sample consisted of 63 metopic and 184 non-metopic dry adult male crania. Three-dimensional polygonal models of the crania were generated using a hand-held laser scanner Creaform VIUscan. A total of 50 landmarks were digitized on the three-dimensional models and eight landmark configurations delineating the cranium and its compartments were constructed and analyzed. Geometric morphometric analyses were applied to investigate separately the size and shape differences between the metopic and non-metopic series in each of the landmark configurations.

RESULTS

Significant size differences were established solely in the neurocranium, but not in its total size, rather in its parts. The size modification was expressed by an enlargement of the anterior part of the neurocranium at the expense of the middle and posterior ones. All investigated landmark sets differed significantly between the series regarding the shape. In metopic series, the shape alteration was mainly in a mediolateral widening and an anteroposterior shortening contributing to a more rounded overall shape of the cranium.

CONCLUSIONS

The slight modification of the cranial morphology in metopism suggests that the metopic suture persistence is not an isolated variation limited to the frontal bone. It is rather a complex condition associated with a combination of specific phenotypic characteristics.

Influence of persistent metopic suture on sagittal suture closure

BACKGROUND

Metopic suture lies between the halves of the growing frontal bone and usually closes in early infancy. If the metopic suture fails to close it persists in adulthood and could be considered an anterior continuation of the sagittal suture (SS). This study aimed to investigate if the metopic suture persistence is related to any significant deviations from the normal SS maturation. We also aimed to elaborate linear regression models for age-at-death prediction of the metopic crania and to compare their accuracy with the models developed on the control ones.

METHODS

The SS was investigated in a total of 122 dry adult contemporary male crania of known age-at-death divided in a metopic series (n = 34) and a control one (n = 88). The crania were scanned and high-resolution volumetric images were generated using an industrial μCT system. The SS closure degree was assessed on cross-sectional tomograms using a scale of grades. Both series were compared and linear regression models for age-at-death prediction were elaborated.

RESULTS

The comparison between both series showed that the degree of SS closure differs significantly in all SS sections and bone layers and it is considerably lower in the metopic series. The elaborated linear regression models showed that the error in the age-at-death prediction of the metopic crania is almost two times bigger than that in the control.

CONCLUSIONS

The SS closure in metopic crania is significantly delayed compared to the control, which means that it is entirely unreliable and misleading as an indicator for age-at-death prediction.

Sagittal suture maturation: Morphological reorganization, relation to aging, and reliability as an age-at-death indicator

OBJECTIVES

The sagittal suture (SS) is assumed to be an initial site for the commencement of cranial suture closure as well as the most frequent spot of isolated craniosynostosis. The present study aimed to inspect the reorganization of the SS at the microlevel to assess the relation between its closure and aging and to establish whether it could be used as a reliable indicator in age-at-death prediction.

MATERIALS AND METHODS

The SS was investigated in 68 dry contemporary adult male skulls of known age-at-death. An additional series of 20 skulls was used for verification. The skulls were scanned using a micro-computed tomography system. The SS closure degree was assessed along the three bone layers on cross-sectional tomograms by using a scoring scale.

RESULTS

In the entirely open SS, the bone edges consist of compact bone and are widely separated. With SS maturation, the bone edges come into contact, and the remodeling process leads to a decrease in the sutural area and bone homogenization across all three layers. SS closure is an irregular process roughly related to aging, beginning in the early 20s, reaching its peak at about 30 years of age and abating in the late 40s.

DISCUSSION

Although related to aging, SS closure is not a simple function of it. Rather, the underlying factors inducing and managing this process are multifaceted and complex. Although the etiology of SS maturation remains unclear, it is reasonable to use SS closure cautiously and only as a supportive method for age prediction.