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Gv V, Tripathi T, Rai P, Mahajan B, Kanase A. Association, diagnostic accuracy and optimal threshold of salivary IGF-1 and vitamin DBP levels for estimation of pubertal growth spurt: A cross sectional study. Int Orthod 2023; 21:100786. [PMID: 37354889 DOI: 10.1016/j.ortho.2023.100786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/16/2023] [Accepted: 05/18/2023] [Indexed: 06/26/2023]
Abstract
AIM To determine the association of salivary IGF-1 and vitamin D Binding Protein with cervical vertebral maturation index (CVMI) across the pubertal stages and to determine the diagnostic accuracy and optimal threshold of these biomarkers for estimation of pubertal growth. DESIGN Cross-sectional observational study. SETTING Material and methods. All patients in the age group of 8-23 years from the Outpatient Department of Orthodontics and Dentofacial orthopaedics, between the period of July 2020 to December 2020 meeting the eligibility criteria were included. Lateral cephalograms obtained from the patients were divided into pre pubertal, pubertal & post pubertal groups based on CVMI by Baccetti et al. Unstimulated whole saliva was collected by a swab-based method & analyzed with ELISA. RESULTS Ninety-four participants were divided in three stages: prebubertal (30), pubertal (33), post pubertal (31). A significant difference was observed in the salivary IGF-1 & DBP across the three stages. Post-hoc test revealed significantly higher mean salivary IGF-1 & DBP in pubertal group than in pre & post-pubertal group. Receiver operator characteristic curve revealed excellent diagnostic accuracy for salivary IGF-1with areas under the curve (AUC) of 0.962, satisfactory for vitamin DBP with AUC of 0.831 and poor diagnostic accuracy for age with AUC of 0.536. Youden index revealed the optimal threshold to be 3.96ng/ml and 124.13pg/ml for salivary IGF-1 and vitamin DBP respectively. CONCLUSION The levels of Salivary IGF-1 and Vitamin DBP increased during C3 and C4 stages. Compared to vitamin DBP diagnostic accuracy of salivary IGF-1 was excellent and an optimal threshold of 3.96ng/ml can be utilized to distinguish pubertal & non-pubertal participants.
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Affiliation(s)
- Veena Gv
- Maulana Azad Institute of Dental Sciences, Department of Orthodontics and Dentofacial Orthopaedics, Bahadur Shah Zafar Marg, New Delhi 110002, India
| | - Tulika Tripathi
- Maulana Azad Institute of Dental Sciences, Department of Orthodontics and Dentofacial Orthopaedics, Bahadur Shah Zafar Marg, New Delhi 110002, India.
| | - Priyank Rai
- Maulana Azad Institute of Dental Sciences, Department of Orthodontics and Dentofacial Orthopaedics, Bahadur Shah Zafar Marg, New Delhi 110002, India
| | - Bhawna Mahajan
- Govind Ballabh Pant Institute of Postgraduate Medical Education & Research, Department of Biochemistry, New Delhi 110002, India
| | - Anup Kanase
- Maulana Azad Institute of Dental Sciences, Department of Orthodontics and Dentofacial Orthopaedics, Bahadur Shah Zafar Marg, New Delhi 110002, India
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Kapoor P, Balachandran R, Chowdhry A, Perinetti G, Kharbanda OP. Biomarkers in Body Fluids as Indicators of Skeletal Maturity: A Systematic Review and Meta-analysis. Rambam Maimonides Med J 2023; 14:RMMJ.10506. [PMID: 37669407 PMCID: PMC10619988 DOI: 10.5041/rmmj.10506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/07/2023] Open
Abstract
OBJECTIVES This review aimed to critically appraise the evidence for biomarkers in blood serum, gingival crevicular fluid (GCF), saliva, and urine in comparison with standard radiographic indices for skeletal maturation assessment. MATERIALS AND METHODS A thorough literature search in multiple databases was conducted for biomarkers in body fluids for skeletal maturation assessed with cervical vertebrae in lateral cephalograms or on hand-wrist radiographs. Different combinations including free text, MeSH terms, and Boolean operators were used. Two researchers used strict inclusion and exclusion criteria to screen title, abstract, and full text, and used the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 instrument for risk of bias assessment of individual studies. Meta-analysis was performed on eligible studies using RevMan 5 software. RESULTS A total of 344 articles were screened, of which 33 met the inclusion criteria and quality assessment. The skeletal maturity indicators included insulin-like growth factors (IGF-1), alkaline phosphatase (ALP), bone-specific alkaline phosphatase (BALP), dehydroepiandrosterone sulfate (DHEAS), vitamin D binding protein (DBP), parathormone-related protein (PTHrP), osteocalcin, metalloproteins, and serotransferrin (TF) along with different metabolites. At puberty, a significant rise was seen in IGF-1, DBP, ALP, osteocalcin, TF, and BALP. However, the serum DHEAS and PTHrP increased from pre-pubertal to post-pubertal stages. Due to the data heterogeneity, a meta-analysis could be performed on seven studies in total on IGF-1 in serum and blood. Of these, five were included for data in males and six in females, and four studies on IGF-1 in serum and blood. A significant difference in IGF-1 levels was seen between stages of peak pubertal growth spurt (CS3 and CS4) and decelerating pubertal growth (CS5) compared with growth initiation stage (CS2). CONCLUSIONS Pubertal growth spurts were correlated with peak serum IGF-1 and BALP in both sexes individually. Peak ALP levels in GCF were correlated with the pubertal spurt in a combined sample of males and females. Standard biofluid collection protocols and homogeneity in sampling and methodology are strongly recommended for future research.
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Affiliation(s)
- Priyanka Kapoor
- School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
- Department of Orthodontics, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Rajiv Balachandran
- Department of Orthodontics and Dentofacial Orthopedics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Aman Chowdhry
- School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
- Department of Oral Pathology & Microbiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | | | - Om Prakash Kharbanda
- Faculty of Dental Sciences, M.S. Ramaih University of Applied Sciences, Bangalore, India
- Health Sciences, M.S. Ramaih University of Applied Sciences, Bangalore, India
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Gavate ND, Shetty S, Nayak RS, K V, Narayan A, K R C. Assessment of dehydroepiandrosterone sulphate (DHEAS) and cortisol levels in saliva and their correlation to cervical vertebrae maturation method in males and females at different growth stages: a clinical study. Dental Press J Orthod 2023; 28:e2322277. [PMID: 37646739 PMCID: PMC10452376 DOI: 10.1590/2177-6709.28.4.e2322277.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/09/2023] [Indexed: 09/01/2023] Open
Abstract
OBJECTIVE The aim of this in-vivo study was to assess the salivary dehydroepiandrosterone sulphate (DHEAS) and cortisol levels, and their correlation to the Cervical Vertebrae Maturation method (CVM) in males and females at pre-pubertal, pubertal and post-pubertal growth stages. METHODS 48 patients (24 males, 24 females) who were to undergo routine orthodontic treatment were screened according to the inclusion and exclusion criteria. Then subjects were grouped according to CVM stages, using lateral cephalogram, in pre-pubertal, pubertal and post-pubertal groups. Unstimulated saliva from the selected subjects was collected. DHEAS and cortisol levels in the salivary samples were estimated by Enzyme-Linked Immunosorbent assay (ELISA). Then they were compared to Cervical Vertebrae Maturation Method stages. One-way ANOVA test followed by Tukey's post-hoc test was used to compare the salivary DHEAS and cortisol levels between different CVM stages in males and females. Independent Student t-test was used to compare the mean salivary DHEAS and cortisol levels between different males and females in each CVM stage. RESULT There was a progressive increase in salivary DHEAS and cortisol concentration as skeletal maturation progressed from CVM stages 1 and 2, CVM stages 3 and 4, reaching the highest value at CVM stages 5 and 6. Their levels were higher in males than females. CONCLUSION The salivary DHEAS and cortisol levels can be useful as a potential indicator of skeletal maturation, to aid in the assessment of pubertal status.
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Affiliation(s)
- Nikita Dattatraya Gavate
- Mathrusri Ramabai Ambedkar Dental College & Hospital, Department of Orthodontics (Bangalore/India)
| | - Smitha Shetty
- Mathrusri Ramabai Ambedkar Dental College & Hospital, Department of Orthodontics (Bangalore/India)
| | - Rabindra S Nayak
- Mathrusri Ramabai Ambedkar Dental College & Hospital, Department of Orthodontics (Bangalore/India)
| | - Vinay K
- Mathrusri Ramabai Ambedkar Dental College & Hospital, Department of Orthodontics (Bangalore/India)
| | - Anjali Narayan
- Mathrusri Ramabai Ambedkar Dental College & Hospital, Department of Orthodontics (Bangalore/India)
| | - Chaitra K R
- Mathrusri Ramabai Ambedkar Dental College & Hospital, Department of Orthodontics (Bangalore/India)
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Salivary IGF-1 and Alkaline Phosphatase-Based Modeling for Skeletal Maturity Prediction in Orthodontic Patients. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2390865. [PMID: 35097113 PMCID: PMC8799341 DOI: 10.1155/2022/2390865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 01/04/2022] [Indexed: 11/17/2022]
Abstract
Results A strong positive correlation was found between CA and cervical stages (r = 0.836, P < 0.001). Based on the regression model analysis, the model which combined IGF-1, ALP, and CA provided the best prediction at P < 0.001 with McFadden's pseudo R2 value of 0.552 for cervical stage prediction and 0.646 for growth phase prediction. In particular, its predictive ability for the prepubertal, pubertal, and postpubertal growth phases was 95%, 80%, and 90%, respectively. Conclusions A new model with the combination of salivary IGF-1 and ALP with CA can be used as a less invasive method to determine the cervical stage and also growth phase with high predictive ability in healthy subjects.
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Trehan M, Patil C. Evaluation of Alkaline Phosphatase as Skeletal Maturity Indicator in Gingival Crevicular Fluid. Int J Clin Pediatr Dent 2021; 14:512-517. [PMID: 34824506 PMCID: PMC8585905 DOI: 10.5005/jp-journals-10005-1996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction The aim of this study was a comparison of the mean alkaline phosphatase (ALP) levels in gingival crevicular fluid (GCF) at distinct phases of skeletal maturity with the use of a hand-wrist radiograph and to analyze if GCF ALP levels can be used as a non-invasive biomarker for evaluation of skeletal maturity in patients undergoing orthodontic treatment. Materials and methods In this study, a standardized volume of 5 μL was collected from the subjects in the preadolescent, adolescent, and postadolescent phases from the mesial and distal embrasures of maxillary and mandibular central incisors after which a hand-wrist radiograph was obtained. Eppendorf tubes with buffer solution were used to transfer GCF to the laboratory for estimation of ALP level. Results The data collected were analyzed using Kruskal–Wallis and Mann–Whitney U test to obtain the ALP levels. Gingival crevicular fluid ALP levels were significantly higher in the adolescent stage. The site-wise comparison in the three groups show that there is a statistically insignificant difference between maxilla and mandible or between males and females. Conclusion It was concluded that the mean ALP levels were significantly increased in the adolescent phase in contrast with the pre- and post-adolescent stages. Gingival crevicular fluid ALP can be considered a promising diagnostic tool as a non-invasive biomarker of an adolescence growth spurt. How to cite this article Trehan M, Patil C. Evaluation of Alkaline Phosphatase as Skeletal Maturity Indicator in Gingival Crevicular Fluid. Int J Clin Pediatr Dent 2021;14(4):512–517.
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Affiliation(s)
- Mridula Trehan
- Department of Orthodontics, NIMS Dental College and Hospital, Jaipur, Rajasthan, India
| | - Chirag Patil
- Department of Pedodontics, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan, India
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Gv V, Tripathi T. Non-invasive methods for the assessment of biomarkers and their correlation with radiographic maturity indicators - a scoping review. Prog Orthod 2021; 22:26. [PMID: 34486079 PMCID: PMC8419155 DOI: 10.1186/s40510-021-00372-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 07/01/2021] [Indexed: 11/10/2022] Open
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.
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Affiliation(s)
- Veena Gv
- Department of Orthodontics and Dentofacial Orthopaedics, Maulana Azad Institute of Dental Sciences, Bahadur Shah Zafar Marg, New Delhi, 110002, India
| | - Tulika Tripathi
- Department of Orthodontics and Dentofacial Orthopaedics, Maulana Azad Institute of Dental Sciences, Bahadur Shah Zafar Marg, New Delhi, 110002, India.
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Anusuya V, Nagar A, Tandon P, Singh GK, Singh GP, Mahdi AA. Serum DHEA-S levels could be used as a comparable diagnostic test to assess the pubertal growth spurt in dentofacial orthopedics. Prog Orthod 2020; 21:15. [PMID: 32566987 PMCID: PMC7306481 DOI: 10.1186/s40510-020-00317-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 05/06/2020] [Indexed: 11/10/2022] Open
Abstract
Background Pubertal growth spurt assessment guides the timing of intervention for correcting the skeletal discrepancies in dentofacial orthopedics. Serum hormones are being studied for the skeletal age assessment to avoid unnecessary radiographic exposure. The present study is to evaluate the relationship of serum hormones dehydroepiandrosterone-sulfate (DHEA-S), insulin-like growth factor (IGF-1), and cervical vertebral stages (CS stages) in the skeletal age assessment of orthodontics patients around the circumpubertal age. Methods A total of ninety subjects with age ranging from 7 to 21 years were selected and divided into two groups based on the sex (45 males, 45 females). They were further distributed in each group based on the six CS stages determined from the lateral cephalogram. Blood samples from each subject were collected to evaluate the serum DHEA-S and IGF-1 levels by using the enzyme-linked immunosorbent assay (ELISA). Collected data were analyzed in SPSS software with a test of normalcy, unpaired t test, and one-way analysis of variance (ANOVA) followed by the least significant difference (LSD) post hoc comparison test and univariate regression analysis. Results The highest mean serum hormone levels were found in CS 4 in group A (male) and CS 3 in group B (female). ANOVA results showed that there was a significant difference in the serum hormone levels among the different CS stages in both the groups for both the hormones. Statistically, a significant difference was found between each CS stages for both the hormones except in the DHEA-S levels between CS 5 and CS 6. Conclusions The mean serum DHEA-S levels followed a typical pattern from the CS 1 till CS 6 which was comparable and similar to the mean serum IGF-1 levels in respect to CS stages. Thus, serum DHEA-S levels could be used as a possible diagnostic test for the assessment of the skeletal pubertal growth spurt in dentofacial orthopedics.
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Affiliation(s)
- V Anusuya
- Department of Dentistry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, 751019, India. .,, Tamilnadu, India.
| | - Amit Nagar
- Department of Orthodontics and Dentofacial Orthopaedics, King George's Medical University, Lucknow, UttarPradesh, 226003, India
| | - Pradeep Tandon
- Department of Orthodontics and Dentofacial Orthopaedics, King George's Medical University, Lucknow, UttarPradesh, 226003, India
| | - G K Singh
- Department of Orthodontics and Dentofacial Orthopaedics, King George's Medical University, Lucknow, UttarPradesh, 226003, India
| | - Gyan Prakash Singh
- Department of Orthodontics and Dentofacial Orthopaedics, King George's Medical University, Lucknow, UttarPradesh, 226003, India
| | - A A Mahdi
- Department of Biochemistry, King George's Medical University, Lucknow, Uttarpradesh, 226003, India
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Caplin J, Han MD, Miloro M, Allareddy V, Markiewicz MR. Interceptive Dentofacial Orthopedics (Growth Modification). Oral Maxillofac Surg Clin North Am 2019; 32:39-51. [PMID: 31699583 DOI: 10.1016/j.coms.2019.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Although all dentofacial deformities involve deviation of skeletal and dental units that require correction, the timing and method of treatment can vary considerably. Growth is a key consideration when managing dentofacial deformities, because it has a direct impact on the timing and method of management. Some deformities may be intercepted and managed during growth, whereas others can only be definitively managed after cessation of growth. This article focuses on clinical considerations of growth in managing dentofacial deformities, and discusses methods of growth evaluation and interceptive orthodontic management strategies in different types of dentofacial deformities.
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Affiliation(s)
- Jennifer Caplin
- Department of Orthodontics, University of Illinois at Chicago, 801 South Paulina Street, M/C 841, Chicago, IL 60612, USA.
| | - Michael D Han
- Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago, 801 South Paulina Street, M/C 835, Chicago, IL 60612, USA
| | - Michael Miloro
- Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago, 801 South Paulina Street, M/C 835, Chicago, IL 60612, USA
| | - Veerasathpurush Allareddy
- Department of Orthodontics, University of Illinois at Chicago, 801 South Paulina Street, M/C 841, Chicago, IL 60612, USA
| | - Michael R Markiewicz
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, University at Buffalo, 112 Squire Hall, Buffalo, NY 14214, USA
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Alhazmi N, Trotman CA, Finkelman M, Hawley D, Zoukhri D, Papathanasiou E. Salivary alkaline phosphatase activity and chronological age as indicators for skeletal maturity. Angle Orthod 2019; 89:637-642. [PMID: 30840495 DOI: 10.2319/030918-197.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To investigate the relationship between salivary alkaline phosphatase activity (ALP), protein concentration, and chronological age with cervical vertebral maturation stages (CVMS) as noninvasive biomarkers for skeletal maturity assessment. MATERIALS AND METHODS This cross-sectional study included 79 subjects (48 females, 31 males; 7 to 23 years old) categorized into five CVMS based on lateral cephalographs evaluated by three examiners. ALP activity and protein concentration in unstimulated whole saliva were compared among five CVMS. The association between age and CVMS was assessed and five multinomial logistic regression models were utilized to predict CVMS based on salivary ALP activity, protein concentration, and chronological age. RESULTS Salivary ALP reached the peak at early pubertal stage and then declined with a significant difference between CVMS I and CVMS II (P < .001) and between CVMS I and CVMS V (P = .004). A significant positive correlation between age and CVMS was found (rs = 0.763, P < .001). The models' overall correct classification rates for predicting CVMS were 32.9% using protein concentration, 35.4% using ALP activity, and 53.2% using both ALP activity and age. CONCLUSIONS The combination of salivary ALP activity and chronological age may provide the best CVMS prediction.
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Wen X, Franchi L, Chen F, Gu Y. Proteomic analysis of gingival crevicular fluid for novel biomarkers of pubertal growth peak. Eur J Orthod 2019; 40:414-422. [PMID: 29092020 DOI: 10.1093/ejo/cjx082] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background Detection of pubertal growth peak is vital in orthodontic treatment timing and planning. Gingival crevicular fluid (GCF) contains abundant proteins from different sources and is an ideal source of biomarkers. The aim of this research is to detect candidate GCF biomarkers of pubertal growth by tandem mass tags (TMT) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) to help diagnosis and treatment planning of functional treatment. Methods Forty subjects were recruited and were divided into pubertal and post-pubertal groups according to cervical vertebral maturation method. GCF samples were collected by paper points. GCF proteome of pubertal and post-pubertal subjects was compared by TMT labelling coupled with LC-MS/MS. Results A total of 537 proteins were detected in GCF samples, with 183 proteins detected in GCF for the first time. These proteins were involved in processes of immune response, ion transport, and signal transduction. The GCF concentration of vitamin D binding protein (DBP) and seroserotransferrin (Tf) was significantly higher in pubertal than that in post-pubertal subjects. DBP and Tf, therefore, were considered to be candidate biomarkers of pubertal growth. This result was validated using GCF samples from new subjects (P < 0.05). Conclusion Our results indicate that TMT labelling coupled with LC-MS/MS were proved to be a useful method for proteomic analysis of GCF with high accuracy. The expression of DBP and Tf was increased in children at circumpubertal stage and can be considered candidate biomarkers of pubertal growth.
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Affiliation(s)
- Xi Wen
- Department of orthodontics, Peking University School and Hospital of Stomatology, Haidian District, PR. China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Haidian District, PR. China
| | | | - Feng Chen
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Haidian District, PR. China.,Central Laboratory, Peking University School and Hospital of Stomatology, Haidian District, PR. China
| | - Yan Gu
- Department of orthodontics, Peking University School and Hospital of Stomatology, Haidian District, PR. China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Haidian District, PR. China
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Sinha M, Tripathi T, Rai P, Gupta SK. Serum and urine insulin-like growth factor-1 as biochemical growth maturity indicators. Am J Orthod Dentofacial Orthop 2017; 150:1020-1027. [PMID: 27894523 DOI: 10.1016/j.ajodo.2016.04.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Revised: 04/01/2016] [Accepted: 04/01/2016] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Biochemical markers are agents directly involved in bone growth and remodeling and can be quantitatively evaluated from various biologic fluids. The aim of this study was to assess the changes in the levels of insulin-like growth factor-1 (IGF-1) in serum and urine as a growth maturity indicator and to compare them with the cervical vertebral maturation radiographic stages. METHODS The study was conducted with 72 female subjects aged 8 to 20 years. Cervical vertebral maturation stages, and serum and urine IGF-1 levels were recorded for all subjects, and the subjects were equally divided into the 6 cervical vertebral maturation groups. Median values of IGF-1 for each stage of cervical vertebral maturation were calculated and statistically compared with those of the other stages. RESULTS The levels of serum and urine IGF-1 at stage 4 of cervical vertebral maturation were significantly higher than those from the other stages (P <0.01). Stage 4 corresponded to a mean age of 13.67 years. A significant correlation was observed between serum and urine IGF-1 (P <0.001). CONCLUSIONS Urine IGF-1 follows the growth curve similar to serum IGF-1. Thus, urine IGF-1 may be regarded as a promising noninvasive tool for growth assessment. Further research is necessary to validate these results in a different population and with a larger sample.
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Affiliation(s)
- Mohita Sinha
- Postgraduate student, Department of Orthodontics and Dentofacial Orthopaedics, Maulana Azad Institute of Dental Sciences, New Delhi, India.
| | - Tulika Tripathi
- Professor and head, Department of Orthodontics and Dentofacial Orthopaedics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Priyank Rai
- Professor, Department of Orthodontics and Dentofacial Orthopaedics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Santosh Kumar Gupta
- Director and professor, Department of Biochemistry, Maulana Azad Medical College, New Delhi, India
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The Gingival Crevicular Fluid as a Source of Biomarkers to Enhance Efficiency of Orthodontic and Functional Treatment of Growing Patients. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3257235. [PMID: 28232938 PMCID: PMC5292379 DOI: 10.1155/2017/3257235] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 12/18/2016] [Accepted: 01/04/2017] [Indexed: 01/22/2023]
Abstract
Gingival crevicular fluid (GCF) is a biological exudate and quantification of its constituents is a current method to identify specific biomarkers with reasonable sensitivity for several biological events. Studies are being performed to evaluate whether the GCF biomarkers in growing subjects reflect both the stages of individual skeletal maturation and the local tissue remodeling triggered by orthodontic force. Present evidence is still little regarding whether and which GCF biomarkers are correlated with the growth phase (mainly pubertal growth spurt), while huge investigations have been reported on several GCF biomarkers (for inflammation, tissue damage, bone deposition and resorption, and other biological processes) in relation to the orthodontic tooth movement. In spite of these investigations, the clinical applicability of the method is still limited with further data needed to reach a full diagnostic utility of specific GCF biomarkers in orthodontics. Future studies are warranted to elucidate the role of main GCF biomarkers and how they can be used to enhance functional treatment, optimize orthodontic force intensity, or prevent major tissue damage consequent to orthodontic treatment.
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Reliability of Growth Indicators and Efficiency of Functional Treatment for Skeletal Class II Malocclusion: Current Evidence and Controversies. BIOMED RESEARCH INTERNATIONAL 2017; 2017:1367691. [PMID: 28168195 PMCID: PMC5266812 DOI: 10.1155/2017/1367691] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 12/14/2016] [Indexed: 11/18/2022]
Abstract
Current evidence on the reliability of growth indicators in the identification of the pubertal growth spurt and efficiency of functional treatment for skeletal Class II malocclusion, the timing of which relies on such indicators, is highly controversial. Regarding growth indicators, the hand and wrist (including the sole middle phalanx of the third finger) maturation method and the standing height recording appear to be most reliable. Other methods are subjected to controversies or were showed to be unreliable. Main sources of controversies include use of single stages instead of ossification events and diagnostic reliability conjecturally based on correlation analyses. Regarding evidence on the efficiency of functional treatment, when treated during the pubertal growth spurt, more favorable response is seen in skeletal Class II patients even though large individual responsiveness remains. Main sources of controversies include design of clinical trials, definition of Class II malocclusion, and lack of inclusion of skeletal maturity among the prognostic factors. While no growth indicator may be considered to have a full diagnostic reliability in the identification of the pubertal growth spurt, their use may still be recommended for increasing efficiency of functional treatment for skeletal Class II malocclusion.
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Sagittal and Vertical Craniofacial Growth Pattern and Timing of Circumpubertal Skeletal Maturation: A Multiple Regression Study. BIOMED RESEARCH INTERNATIONAL 2016; 2016:1728712. [PMID: 27995136 PMCID: PMC5138437 DOI: 10.1155/2016/1728712] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Accepted: 10/26/2016] [Indexed: 11/17/2022]
Abstract
The knowledge of the associations between the timing of skeletal maturation and craniofacial growth is of primary importance when planning a functional treatment for most of the skeletal malocclusions. This cross-sectional study was thus aimed at evaluating whether sagittal and vertical craniofacial growth has an association with the timing of circumpubertal skeletal maturation. A total of 320 subjects (160 females and 160 males) were included in the study (mean age, 12.3 ± 1.7 years; range, 7.6-16.7 years). These subjects were equally distributed in the circumpubertal cervical vertebral maturation (CVM) stages 2 to 5. Each CVM stage group also had equal number of females and males. Multiple regression models were run for each CVM stage group to assess the significance of the association of cephalometric parameters (ANB, SN/MP, and NSBa angles) with age of attainment of the corresponding CVM stage (in months). Significant associations were seen only for stage 3, where the SN/MP angle was negatively associated with age (β coefficient, -0.7). These results show that hyperdivergent and hypodivergent subjects may have an anticipated and delayed attainment of the pubertal CVM stage 3, respectively. However, such association remains of little entity and it would become clinically relevant only in extreme cases.
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Gingival Crevicular Fluid as a Novel Potential Source of Biomarkers Distinguishes Pubertal from Post-Pubertal Subjects. Diagnostics (Basel) 2016; 6:diagnostics6040041. [PMID: 27869666 PMCID: PMC5192516 DOI: 10.3390/diagnostics6040041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 11/07/2016] [Accepted: 11/09/2016] [Indexed: 12/14/2022] Open
Abstract
Detection of pubertal growth peak is vital in orthodontic treatment timing and planning. Gingival crevicular fluid (GCF) contains abundant proteins from different sources and has been proven to be an ideal source of biomarkers. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF/MS) is an advanced technique that can detect low-molecular-weight peptides with high sensitivity and resolution. The aim of this research was to identify novel candidate biomarkers in GCF to help the diagnosis of pubertal growth peak by MALDI-TOF/MS. Results showed that the peak intensities of six peptides were significantly different between two groups: 1660.2 Da, 1783.0 Da, 2912.5 Da, 4178.6 Da, 5064.9 Da, and 6108.9 Da and are considered to be potential candidate biomarkers to identify pubertal growth peak. Further studies are needed to identify sequence information of these candidate biomarkers.
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Fernández-Pérez MJ, Alarcón JA, McNamara JA, Velasco-Torres M, Benavides E, Galindo-Moreno P, Catena A. Spheno-Occipital Synchondrosis Fusion Correlates with Cervical Vertebrae Maturation. PLoS One 2016; 11:e0161104. [PMID: 27513752 PMCID: PMC4981417 DOI: 10.1371/journal.pone.0161104] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 07/30/2016] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to determine the relationship between the closure stage of the spheno-occipital synchondrosis and the maturational stage of the cervical vertebrae (CVM) in growing and young adult subjects using cone beam computed tomography (CBCT). CBCT images with an extended field of view obtained from 315 participants (148 females and 167 males; mean age 15.6 ±7.3 years; range 6 to 23 years) were analyzed. The fusion status of the synchondrosis was determined using a five-stage scoring system; the vertebral maturational status was evaluated using a six-stage stratification (CVM method). Ordinal regression was used to study the ability of the synchondrosis stage to predict the vertebral maturation stage. Vertebrae and synchondrosis had a strong significant correlation (r = 0.89) that essential was similar for females (r = 0.88) and males (r = 0.89). CVM stage could be accurately predicted from synchondrosis stage by ordinal regression models. Prediction equations of the vertebral stage using synchondrosis stage, sex and biological age as predictors were developed. Thus this investigation demonstrated that the stage of spheno-occipital synchondrosis, as determined in CBCT images, is a reasonable indicator of growth maturation.
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Affiliation(s)
| | - José Antonio Alarcón
- Department of Orthodontics, School of Dentistry, University of Granada, Granada, Spain
- * E-mail:
| | - James A. McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, Michigan, United States of America
| | - Miguel Velasco-Torres
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
| | - Erika Benavides
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
| | - Andrés Catena
- Mind, Brain, and Behavior Research Center, University of Granada, Granada, Spain
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Angelieri F, Franchi L, Cevidanes LH, McNamara Jr JA. Diagnostic performance of skeletal maturity for the assessment of midpalatal suture maturation. Am J Orthod Dentofacial Orthop 2015; 148:1010-6. [DOI: 10.1016/j.ajodo.2015.06.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 06/01/2015] [Accepted: 06/01/2015] [Indexed: 10/22/2022]
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Perinetti G, Perillo L, Franchi L, Di Lenarda R, Contardo L. Maturation of the middle phalanx of the third finger and cervical vertebrae: a comparative and diagnostic agreement study. Orthod Craniofac Res 2014; 17:270-9. [PMID: 25230196 DOI: 10.1111/ocr.12052] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Diagnostic agreement on individual basis between the third middle phalanx maturation (MPM) method and the cervical vertebral maturation (CVM) method has conjecturally been based mainly on overall correlation analyses. Herein, the true agreement between methods according to stage and sex has been evaluated through a comprehensive diagnostic performance analysis. SUBJECTS AND METHODS Four hundred and fifty-one Caucasian subjects were included in the study, 231 females and 220 males (mean age, 12.2 ± 2.5 years; range, 7.0-17.9 years). The X-rays of the middle phalanx of the third finger and the lateral cephalograms were examined for staging by blinded operators, blinded for MPM stages and subjects' age. The MPM and CVM methods based on six stages, two pre-pubertal (1 and 2), two pubertal (3 and 4), and two post-pubertal (5 and 6), were considered. Specifically, for each MPM stage, the diagnostic performance in the identification of the corresponding CVM stage was described by Bayesian statistics. RESULTS For both sexes, overall agreement was 77.6%. Most of the disagreement was due to 1 stage apart. Slight disagreement was seen for the stages 5 and 6, where the third middle phalanx shows an earlier maturation. CONCLUSIONS The two maturational methods show an overall satisfactorily diagnostic agreement. However, at post-pubertal stages, the middle phalanx of the third finger appears to mature earlier than the cervical vertebrae. Post-pubertal growth phase should thus be based on the presence of stage 6 in MPM.
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Affiliation(s)
- G Perinetti
- Department of Medical, Surgical and Health Sciences, School of Dentistry, University of Trieste, Trieste, Italy
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Perinetti G, Caprioglio A, Contardo L. Visual assessment of the cervical vertebral maturation stages: A study of diagnostic accuracy and repeatability. Angle Orthod 2014; 84:951-6. [PMID: 24665865 DOI: 10.2319/120913-906.1] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the diagnostic accuracy and repeatability of the visual assessment of the cervical vertebral maturation (CVM) stages. MATERIALS AND METHODS Ten operators underwent training sessions in visual assessment of CVM staging. Subsequently, they were asked to stage 72 cases equally divided into the six stages. Such assessment was repeated twice in two sessions (T1 and T2) 4 weeks apart. A reference standard for each case was created according to a cephalometric analysis of both the concavities and shapes of the cervical vertebrae. RESULTS The overall agreement with the reference standard was about 68% for both sessions and 76.9% for intrarater repeatability. The overall kappa coefficients with the reference standard were up to 0.86 for both sessions, and 0.88 for intrarater repeatability. Overall, disagreements one stage and twp stage apart were 23.5% (T1) and 5.1% (T2), respectively. Sensitivity ranged from 53.3% for CS5 (T1) to 99.9% for CS1 (T2), positive predictive values ranged from 52.4% for CS5 (T2) to 94.3% for CS6 (T1), and accuracy ranged from 83.6% for CS4 (T2) to 94.9% for CS1 (T1). CONCLUSIONS Visual assessment of the CVM stages is accurate and repeatable to a satisfactory level. About one in three cases remain misclassified; disagreement is generally limited to one stage and is mostly seen in stages 4 and 5.
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Affiliation(s)
- Giuseppe Perinetti
- a Research Fellow, Department of Medical, Surgical and Health Sciences, School of Dentistry, University of Trieste, Trieste, Italy
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Perinetti G, Westphalen GH, Biasotto M, Salgarello S, Contardo L. The diagnostic performance of dental maturity for identification of the circumpubertal growth phases: a meta-analysis. Prog Orthod 2013; 14:8. [PMID: 24325853 PMCID: PMC4384951 DOI: 10.1186/2196-1042-14-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 04/22/2013] [Indexed: 01/18/2023] Open
Abstract
The present meta-analysis initially evaluates the reliability of dental maturation in the identification of the circumpubertal growth phases, essentially for determining treatment timing in orthodontics. A literature survey was performed using the Medline, LILACS and SciELO databases, and the Cochrane Library (2000 to 2011). Studies of the correlation between dental and cervical vertebral maturation methods were considered. The mandibular canine, the first and second premolars, and the second molar were investigated. After the selection, six articles qualified for the final analysis. The overall correlation coefficients were all significant, ranging from 0.57 to 0.73. Five of these studies suggested the use of dental maturation as an indicator of the growth phase. However, the diagnostic performance analysis uncovered limited reliability only for the identification of the pre-pubertal growth phase. The determination of dental maturity for the assessment of treatment timing in orthodontics is not recommended.
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Affiliation(s)
- Giuseppe Perinetti
- Department of Medical, Surgical and Health Sciences, University of Trieste, Ospedale Maggiore, Piazza Ospitale 1, Trieste, 34129, Italy.
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21
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Perinetti G, Di Lenarda R, Contardo L. Diagnostic performance of combined canine and second molar maturity for identification of growth phase. Prog Orthod 2013; 14:1. [PMID: 24326062 PMCID: PMC3847850 DOI: 10.1186/2196-1042-14-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 04/16/2013] [Indexed: 11/18/2022] Open
Abstract
Background The objective of this research is to analyze the diagnostic performance of the circumpubertal dental maturation stages of the mandibular canine and second molar, as individual teeth and in combination, for the identification of growth phase. Methods A total of 300 healthy subjects, 192 females and 108 males, were enrolled in the study (mean age, 11.4 ± 2.4 years; range, 6.8 to 17.1 years). Dental maturity was assessed through the calcification stages from panoramic radiographs of the mandibular canine and second molar. Determination of growth phase (as pre-pubertal, pubertal, and post-pubertal) was carried out according to the cervical vertebral maturation method. The diagnostic performances of the dental maturation stages, as both individual teeth and in combination, for the identification of the growth phase were evaluated using positive likelihood ratios (LHRs), with a threshold of ≥10 for satisfactory performance. Results For the individual dental maturation stages, most of these positive LHRs were ≤1.6, with values ≥10 seen only for the identification of the pre-pubertal growth phase for canine stage F and second molar stages D and E, and for the post-pubertal growth phase for second molar stage H. All of the combined dental maturation stages yielded positive LHRs up to 2.6. Conclusions Dental maturation of either individual or combined teeth has little role in the identification of the pubertal growth spurt and should not be used to assess timing for treatments that are required to be performed at this growth phase.
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Affiliation(s)
- Giuseppe Perinetti
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
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