Gingival crevicular fluid alkaline phosphatase activity in relation to pubertal growth spurt and dental maturation: A multiple regression study

Abstract

Introduction:The identification of the onset of the pubertal growth spurt has major clinical implications when dealing with orthodontic treatment in growing subjects.Aim: Through multivariate methods, this study evaluated possible relationships between the gingival crevicular fluid (GCF) alkaline phosphatase (ALP) activity and pubertal growth spurt and dentition phase. Materials and methods:One hundred healthy growing subjects (62 females, 38 males; mean age, 11.5±2.4 years) were enrolled into this doubleblind, prospective, cross-sectional-design study. Phases of skeletal maturation (pre -pubertal, pubertal, post -pubertal) was assessed using the cervical vertebral maturation method. Samples of GCF for the ALP activity determination were collected at the mesial and distal sites of the mandibular central incisors. The phases of the dentition were recorded as intermediate mixed, late mixed, or permanent. A multinomial multiple logistic regression model was used to assess relationships of the enzymatic activity to growth phases and dentition phases.Results: The GCF ALP activity was greater in the pubertal growth phase as compared to the pre -pubertal and post -pubertal growth phases. Significant adjusted odds ratios for the GCF ALP activity for the pre -pubertal and post -pubertal subjects, in relation to the pubertal group, were 0.76 and 0.84, respectively. No significant correlations were seen for the dentition phase. Conclusions:The GCF ALP activity is a valid candidate as a non -invasive biomarker for the identification of the pubertal growth spurt irrespective of the dentition phase.

Biomarkers in Body Fluids as Indicators of Skeletal Maturity: A Systematic Review and Meta-analysis

“…Studies employed different indices for SME; the CVM staging developed by Baccetti et al 9 was used in 18 studies ( Table 1 ). 23 – 25 , 37 , 39 – 41 , 44 , 49 – 51 , 53 – 55 , 57 , 59 , 60 , 62 This was followed by using the six cervical stages of Hassel and Farman 12 in six studies; 20 – 22 , 46 , 48 , 56 of Baccetti et al 10 in two studies; 27 , 45 of Hagg and Taranger 11 in one study; 43 of McNamara 31 in one study; 42 and using the quantitative cervical vertebral maturation (QCVM) method by Chen. 52 Hand-wrist radiographs used the Fishman index 6 with 11 SMIs 42 , 47 , 61 and five SMI stages.…”

“…The quality assessment by QUADAS-2 found 33 out of a total of 41 studies to be eligible for inclusion in the review. 20 – 25 , 27 , 37 – 62 The eight studies that were excluded were based on an unclear ROB, 63 high ROB, 64 and an unclear ROB and applicability. 65 – 70 …”

“… 20 – 22 Certain body fluids are advantageous in terms of non-invasive and repeatable collection, hence the current trend has shifted focus on biomarker research in GCF and saliva where variations in levels of alkaline phosphatase (ALP), vitamin D binding protein (DBP), and serotransferrin (TF) at different stages of skeletal maturation have been reported. 24 , 25 Levels of ALP have been studied in the saliva of rats for systemic bone turnover 26 and are currently being explored in human saliva for bone maturation. 27 A recent scoping review 5 studied biomarkers of skeletal maturation in saliva and GCF but did not include other body fluids, i.e.…”

Reliability of Growth Indicators and Efficiency of Functional Treatment for Skeletal Class II Malocclusion: Current Evidence and Controversies

“…Of particular interest are the biomarkers from the GCF, since its sampling involves a very simple, rapid, and noninvasive procedure that can be performed in a clinical setting. However, even though dental permutation has been reported not to influence significantly the GCF ALP activity [ 128 ], variability among the subjects and method errors [ 129 ] have to be taken into account. Moreover, optimal gingival conditions without plaque accumulation or clinically evident inflammation is necessary as the GCF ALP activity reflects local tissue inflammation [ 130 ].…”

The Gingival Crevicular Fluid as a Source of Biomarkers to Enhance Efficiency of Orthodontic and Functional Treatment of Growing Patients

“…The alkaline phosphatase (ALP) has been investigated as reliable biologic indicator of skeletal maturation in different studies, where the ALP levels are compared with other methods to identify the skeletal maturation in growing patients [ 32 , 33 ]. The bone alkaline phosphatase is synthesized by the osteoblasts and is presumed to be involved in the calcification of bone matrix.…”