Salivary hormonal analysis as a tool for skeletal maturity assessment

Current evidence suggests a strong correlation between specific body hormones and skeletal maturation; however, there is very limited literature available on salivary hormonal levels and their correlation with craniofacial skeletal growth. The primary objective of this study was to collect preliminary data on the salivary Growth Hormone, Cortisol, Testosterone, and 17β-Estradiol levels of orthodontic patients with specific age groups. In this cross-sectional cohort study, a total of 80 patients (40 females and 40 males) were recruited. 5 ml saliva was collected by a passive drooling method for an ELISA test of Cortisol, 17β-Estradiol, Testosterone, and Growth Hormone (GH). Lateral cephalograms were acquired for the middle phalanx of the third figure (MP3) stages and Cervical Vertebral Maturity Indicator (CVMI). We observed that the GH concentration was highest for females between the ages of 10-11 years (12.0 ± 4.2 pg/ml) and for males between the ages of 13-14 years (13.4 ± 11.6 pg/ml). The prepubertal stage (10-12 years) for female subjects, MP3, and CVMI stages were observed to be 2.5. This study concludes that the salivary growth hormone was highest for ages 10-11 females and age 13-14 males, then gradually declined as the age of the subjects increased. The trend for the Testosterone level was identical between males and females till the age of 13; thereafter, males showed higher salivary Testosterone than female subjects. These findings show promising application of salivary hormonal analysis for the growth prediction. Specifically, level of salivary GH can be used as a non-invasive tool for the skeletal maturation assessment.