Reliability of maxillary canine calcification stages and salivary alkaline phosphatase for pubertal growth prediction (cross-sectional study)

Abstract

Orthodontic growth estimation for growing individuals is essential for diagnosis and treatment planning, essentially in managing cases with skeletal growth defects. Research has revealed a substantial correlation between tooth calcification stages and skeletal maturity. Also, many biomarkers have been investigated as maturity indicators, and studies show promising results. Therefore, the present research assessed if salivary alkaline phosphatase (ALP) level and maxillary canine calcification stages with developmental stages of modified middle phalanx of the third finger (MP3) are reliable skeletal maturity indicators. No previous study conducted the reliability of both canine calcification stages and ALP level as skeletal maturity indicators. In this prospective observational study with a cross-sectional design, 80 subjects aged 8- 16 years were selected. Unstimulated saliva to assess ALP, periapical radiographs for the maxillary canine to assess the dental calcification by relying on the Dermirjian's stages, and periapical radiographs for the middle phalanx of the third finger region were taken from 80 individuals (from eight to sixteen years old) to assess the skeletal maturation state. The data were analyzed using the statistical package of social science (SPSS version 26), using the Spearmen correlation test and the Kruskal-Wallis test. The maxillary canine's calcification stages and MP3 stages showed a significant correlation coefficient; however, the correlation coefficient of MP3 stages and maxillary canine calcification stages with salivary ALP was non-significant. The maxillary canine calcification stages can practically be utilized as an indicator for assessing skeletal maturity, but the salivary ALP level showed no correlation with skeletal maturity indicators. Keywords: Skeletal maturity indicator; Canine calcification stages; Alkaline phosphatase; Middle phalanx of third finger.