Investigation of salivary biomarkers as indicators of skeletal and dental maturity in children

Abstract

Objective Estimation of patient's skeletal maturity in orthodontics is essential for the diagnosis and treatment planning. The aim of the study was to investigate the potential use of metabolic fingerprint of saliva for bone growth and tooth development estimation. Materials and Methods Saliva samples from 54 young patients were analysed by an untargeted gas chromatography‐mass spectrometry metabolomics‐based method. The skeletal maturity was calculated with the cervical vertebrae maturation method, and the dental age was estimated with the Demirjian method. Multivariate analysis and univariate analysis were performed to investigate differences within skeletal, dental and chronological age groups. Results Metabolomic analysis identified 61 endogenous compounds. Mannose, glucose, glycerol, glyceric acid and pyroglutamic acid levels differentiated significantly with skeletal age (P = .02 to .043), while mannose, lactic acid, glycolic acid, proline, norleucine, 3‐aminoisobutyric acid, threonine, cadaverine and hydrocinnamic acid levels differed within the dental age groups (P = .018 to .04); according to the chronological age, only the levels of mannose and 3‐hydroxyphenylacetic acid showed variation (P = .029 and .048). The principal component analysis did not manage to highlight differences between the groups of the studied parameters. Conclusion Differentiated levels of mannose, glucose, glycerol, glyceric acid and pyroglutamic acid related to skeletal maturation were identified. According to dental development, the levels of mannose, lactic acid, glycolic acid, proline, norleucine, 3‐aminoisobutyric acid, threonine, cadaverine and hydrocinnamic acid differed within the groups, while regarding chronological age, only the levels of mannose and 3‐hydroxyphenylacetic acid showed variations. Further studies are required to prove their relation to skeletal and dental development pathway by applying complementary analytical techniques to wider cover the metabolome.

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

“…Pre-pubertal and post-pubertal stages showed difference in mannose ( P =0.12) and pyroglutamic acid, while pubertal and post-pubertal stages showed difference in glucose and pyroglutamic acid. 41 Besides, the metabolites also differed with dental and chronological age.…”

“…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 biomarkers investigated in most of the studies were IGF-1, 20 – 22 , 37 , 38 , 40 , 42 – 44 , 46 , 49 – 51 , 53 , 55 – 57 , 61 , 62 ALP, 25 , 27 , 40 , 59 , 60 dehydroepiandrosterone sulfate (DHEAS), 39 , 44 , 47 , 58 and BALP, 20 , 21 , 23 with sporadic assessment of DBP 24 , 45 and TF, 24 , 45 IGF binding protein (IGFBP-3), 37 , 38 , 46 IGF-1/IGFBP-3 ratio, 37 , 38 , 46 osteocalcin, 22 PTHrP, 54 and metabolites. 41 …”