Gingival crevicular fluid alkaline phosphatase activity as growth marker: A systematic review

Abstract

Background: This review synthesizes the available evidence about the individual skeletal maturity with biological maturity indicators and compares it with the levels of gingival crevicular fluid (GCF) alkaline phosphatase (ALP) activity in growing children. Aims: This systematic review aimed to clarify the question: Is GCF ALP a reliable biomarker to assess skeletal maturity during growth? Objectives: The objective of this systematic review is to collect, compile, and review the existing evidence on the levels of GCF ALP activity in growing children and comparing its reliability with contemporary growth indicators. Materials and Methods: A literature appraisal executed using Entres PubMed, www.ncbi.nim.nih.gov, Scupose, Hinary, Ebsco, Embass, Cochrane; Google Scholar Electronic database search engines were used. The MeSH term used “growth markers in gingival crevicular fluid” or “growth markers in growing children.” Studies published till October, 2020, were included in this study. Data Extraction and Quality Assessment: The data have extracted from the selected articles based on year of publication, study design, age of subjects, instruments used, and author’s conclusions. The quality assessment was executed using BIOCROSS Scale. This scale is exclusive for cross-sectional studies with biomarkers. Results: Literature search identified 731 records from electronic databases and from the partial grey literature (Google scholar) search. Finally, six articles fulfilled eligibility criteria included in the review. Conclusions: All the six studies concluded that GCF ALP activity is a reliable method in determining a skeletal maturity indicator in growing children.

The Correlation between Quantitative Cervical Vertebral Maturation and Mandibular Dimensions in Children Aged 8-16 Years: A Cross-Sectional Analytical Study

“…The mandibular breadth grows as a result of bone deposition on the mandible's outer surface and resorption of the mandibular surface. As a result, the mandible grows posterior-superior (backward-upward), resulting in anteriorinferior displacement [4][5][6][7].…”

“…The literature evidence reveals that mandibular dimensional change attained its maximum size during the pubertal growth phase [4][5][6][7][8][9]. Thus, most of the investigators suggest that mandibular growth spurts occur, but they show individual variations10.…”

“…Mandibular skeletal maturity can be assessed by means of a series of biologic indicators, physiologic and biomarkers. With respect to the cervical vertebral method, it has been shown to be useful for the assessment of mandibular skeletal maturation in growing patients, as each stage of this method corresponds to specific anatomic changes in mandibular growth [4].…”

“…Hellsing, et al 1991 showed, there is significant correlation between change in mandibular dimension and length of the cervical vertebral method; the study concluded that reliability and reproducibility of cervical vertebral method is poor (subjective outcome) [1][2][3][4].…”

Evaluation of reliability of salivary alkaline phosphatase in comparison to other methods of assessing the skeletal maturation

“…2 Bone specific Alkaline Phosphatase is one such biomarker which is highly specific & sensitive to bone metabolism which is taking place during the accelerated growth period of an individual. 3 Hence, the aims & objectives of our study were to test the alternate hypothesis that salivary alkaline phosphatase is a reliable indicator for assessment of skeletal maturation.…”