Anterior fontanelle closes by: AP 07
**Core Concept:** The anterior fontanelle is a soft, gelatinous protrusion on a newborn infant's skull, located at the junction of the frontal and ethmoid bones. Its closure marks the end of the period of rapid skull growth and indicates the beginning of the secondary dentition.
**Why the Correct Answer is Right:** The anterior fontanelle, also known as the "soft spot," closes around the age of 18 months as the infant's skull bones fuse together. This process is primarily driven by the synthesis and deposition of bone matrix by osteoblasts, which results in the closure of the fontanelle.
**Why Each Wrong Option is Incorrect:**
A. **Closure due to growth retardation:** This option is incorrect because the anterior fontanelle actually closes due to the fusion of bones, not a decrease in growth rate.
B. **Closure due to bone resorption:** While bone resorption does occur, the primary cause of fontanelle closure is the deposition of bone matrix by osteoblasts.
C. **Closure due to tooth eruption:** The anterior fontanelle closes prior to the onset of secondary dentition (around 18 months), making this option incorrect.
D. **Closure due to skull growth slowdown:** Similar to option A, this option is incorrect because the fontanelle actually closes due to bone fusion.
**Clinical Pearl:** A closed anterior fontanelle in an infant indicates complete skull fusion and is a normal finding. However, delayed closure may be concerning for possible craniosynostosis, a disorder where the skull bones fuse prematurely, leading to abnormal head shape and increased intracranial pressure.
**Correct Answer:** B. **Closure due to bone deposition by osteoblasts.** The anterior fontanelle closes as the infant's skull bones fuse, a process driven by the synthesis and deposition of bone matrix by osteoblasts. This results in the gradual reduction in fontanelle size and, eventually, closure.