Non-invasive methods for the assessment of biomarkers and their correlation with radiographic maturity indicators — a scoping review

Abstract

Background Detection of skeletal maturity is vital in orthodontic treatment timing and planning. Traditional methods include hand-wrist radiography and cervical vertebral maturation index (CVMI). Though the radiographic methods are well established and routinely used to assess skeletal maturation, they carry the drawback of subjective perception and low reproducibility. With evolving concepts, skeletal maturation has been assessed quantitatively through biomarkers obtained from saliva, gingival crevicular fluid (GCF), and urine. The scoping review aims to explore the various biomarkers assessed through non-invasive methods and their correlation with radiographic skeletal maturity. Methodology The literature search was carried out on MEDLINE via Pubmed, Cochrane Library (Cochrane database of systematic reviews), Cochrane central register of controlled trials (CENTRAL), Google Scholar, Semantic Scholar, ScienceDirect, and Opengrey.eu for articles up to and including November 2020. Pertinent articles were selected based on inclusion and exclusion criteria. The results were tabulated based on the type of sample collected, the biomarker assessed, method of sample collection, and the radiographic method used. Results The literature search resulted in 12 relevant articles. Among all the studies, 10 studies showed that the concentration of biomarkers increases during the pubertal growth peak. On the contrary, 2 articles showed no significant difference between the levels of biomarkers and pubertal growth peak. Conclusion It can be concluded that the level of biomarkers increases during the pubertal growth spurt and can provide a quantitative way of assessing skeletal maturity.

Mapping an intelligent algorithm for predicting female adolescents’ cervical vertebrae maturation stage with high recall and accuracy

“…As stated by Houston et al, the use of individual ossification events is of limited use during pubertal growth-spurt prediction [ 40 ]. To date, the primary challenge remains in crafting a resilient, versatile, and sensitive diagnostic tool for clinical practice, with a focus on non-invasive methods for assessing skeletal maturity [ 41 ]. Established based on significant CVM features, our proposed algorithms could indicate the specific stages directly; thus, the workload of clinicians will be reduced and more objective and consistent evaluation outcomes will be materialized.…”

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

“…[2][3][4] Todd developed SME based on hand-wrist radiographs, which Greulich and Pyle popularized by creating an atlas. 5 This method was further developed as a scoring system by Tanner Whitehouse 5 and as 11 skeletal maturity indicators (SMIs) by Fishman 6 and further studied solely for the middle phalanx of the third finger (MP3) for skeletal maturation. 7 The CVMI on lateral cephalograms has been extensively studied for SME, 8,9 primarily in dentofacial disharmonies, [9][10][11][12] and is subject to inter-operator variations.…”

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

“…Furthermore, estimation of a combination of several saliva biomarkers could be potentially effective not only in dentistry, but also for the diagnosis, prognosis and management of patients with a number of medical conditions, such as heart failure 19 . Finally, the finding that the level of certain saliva biomarkers, such as insulin‐like growth factor‐I (IGF‐I), bone‐specific alkaline phosphatase (B‐ALP), alkaline phosphatase (ALP) and dehydroepiandrosterone (DHEA), increases during the pubertal growth spurt is of great importance and provides a quantitative way of assessing skeletal maturity 8,20‐22 . Apart from proteins and peptides, the use of metabolomics, which investigates the smaller molecules (metabolites), may be beneficial to detect metabolic pathways of specific interest.…”