Correlating Salivary Alkaline Phosphatase Level with Cervical Vertebral Maturation, Dental Age and Chronological Age - A Cross-Sectional Study
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Abstract
Introduction: Accurate prediction of the growth spurt is critical for modifying the skeletal malocclusion and in devising the treatment plan. Biochemical markers like saliva renders new non-invasive diagnostic tools for detection of skeletal and dental maturation.
Objectives: To analyse salivary alkaline phosphatase level and relating it with cervical vertebral maturation stages, dental age (modified Demirjian method) and chronological age during pubertal and post-pubertal stages.
Methods: 240 subjects aged between 10 to 18 years were grouped according to their growth phase, pubertal (CVMI 3 & CVMI 4) and post-pubertal (CVMI 5 & CVMI 6) using Bacceti’s method from Lateral Cephalogram taken in natural head position in each gender. The S-ALP levels were detected using a commercially available AutoZyme Alkaline Phosphatase (Accurex Biomedical Pvt. Ltd., Mumbai, India). Acharya’s Indian specific-formula for dental age estimation using Chaillet and Demirjian (2004) stages (0-9) of tooth formation was used to evaluate dental age.
Results: S-ALP activity was higher in pubertal phase than post-pubertal phase. An early dental maturation in girls as compared to boys in both phases except in CVMI 4 of pubertal phase suggesting a variation in dental maturation in the boys and girls. In addition to it, alkaline phosphatase activity is also more in girls as compared to boys. There were variation in the correlation between S-ALP, chronological age, and dental age.
Conclusions: The onset of pubertal & post-pubertal growth phase differs in both genders. S-ALP activity varies across different phases of cervical maturation, with higher levels observed during the pubertal phase compared to post-pubertal phases, which is intricately linked to sexual dimorphism during cervical maturation. Also, dental maturation assessed using Acharya’s modified Demirjian method may not always correlate with chronological age.