Sookhakian Asma, Zahed Maryam, Pakshir Hamidreza, Ajami Shabnam, Zangooi Booshehry Maryam
Postgraduate Student, Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
Oral and Dental Disease Research Center, Dept. of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
J Dent (Shiraz). 2025 Sep 1;26(3):241-249. doi: 10.30476/dentjods.2025.103220.2431. eCollection 2025 Sep.
In orthodontics, radiography-based methods are frequently used for the assessment of skeletal maturity. Concerning X-ray exposure hazard, a new objective and less invasive method is needed to identify the optimal orthodontic treatment timing.
In this study, the pattern of salivary alkaline phosphatase and insulin-like growth factor-1 in the circumpubertal period was investigated. Moreover, new regression models were built to predict skeletal maturity more accurately.
In this cross-sectional study, fifty-five subjects aged 7 to 20 years were enrolled to compare the levels of salivary alkaline phosphatase and insulin-like growth factor-1 at different skeletal maturity stages by using 6-stage cervical vertebral maturation method. Moreover, three new multinomial logistic regression models based on these biomarkers, as well as chronological age, and gender were built to predict the cervical stage. Statistical analysis was performed using SPSS (version 24) software. In addition to descriptive statistics, the Shapiro-Wilk test, the one-way analysis of variance test, the independent Samples T-test, the Pearson correlation coefficient, the Chi-square test, and the overall correct classification rate was performed.
A significant difference was observed for salivary alkaline phosphatase and also insulin-like growth factor-1 levels between cervical stages (< 0.001). The peak level in both salivary alkaline phosphatase and insulin-like growth factor-1 levels was observed at CS3. The levels of these biomarkers had a significant positive correlation with the cervical stages from CS1 to CS3 and a significant negative correlation from CS3 to CS6. Based on the regression model analysis, we found that Model 3´ which combined gender with chronological age, alkaline phosphatase, and insulin-like growth factor-1 had the highest predictive ability (76.4%).
The notably larger predictive ability of the new model which combined gender with chronological age, salivary alkaline phosphatase, and salivary insulin-like growth factor-1 might be responsible for the identification of the optimal orthodontic treatment timing in an objective and less invasive manner in healthy growing individuals.
在正畸学中，基于放射成像的方法经常用于评估骨骼成熟度。考虑到X射线暴露危害，需要一种新的客观且侵入性较小的方法来确定最佳正畸治疗时机。
本研究调查了青春发育期唾液碱性磷酸酶和胰岛素样生长因子-1的变化模式。此外，建立了新的回归模型以更准确地预测骨骼成熟度。
在这项横断面研究中，招募了55名年龄在7至20岁的受试者，采用6期颈椎成熟度方法比较不同骨骼成熟阶段的唾液碱性磷酸酶和胰岛素样生长因子-1水平。此外，基于这些生物标志物以及实际年龄和性别建立了三个新的多项逻辑回归模型来预测颈椎阶段。使用SPSS（版本24）软件进行统计分析。除描述性统计外，还进行了Shapiro-Wilk检验、单因素方差分析、独立样本t检验、Pearson相关系数、卡方检验和总体正确分类率分析。
在不同颈椎阶段之间，唾液碱性磷酸酶和胰岛素样生长因子-1水平存在显著差异（<0.001）。唾液碱性磷酸酶和胰岛素样生长因子-1水平的峰值均出现在CS3阶段。这些生物标志物的水平与CS1至CS3阶段的颈椎阶段呈显著正相关，与CS3至CS6阶段呈显著负相关。基于回归模型分析，我们发现将性别与实际年龄、碱性磷酸酶和胰岛素样生长因子-1相结合的模型3´具有最高的预测能力（76.4%）。
将性别与实际年龄、唾液碱性磷酸酶和唾液胰岛素样生长因子-1相结合的新模型具有显著更高的预测能力，这可能有助于以客观且侵入性较小的方式确定健康生长个体的最佳正畸治疗时机。
