Reliability of Gingival Crevicular Fluid Biomarkers for Detecting the Pubertal Growth Spurt: A Critical Review

In recent years, components of gingival crevicular fluid (GCF), including alkaline phosphatase (ALP), serotransferrin (TF), and vitamin D-binding protein (DBP), have attracted attention as biomarkers for determining stages of pubertal growth in orthodontic treatments. In this review article, we critically evaluated the reliability of biomarkers present in GCF for the accurate identification of the pubertal growth spurt.

A systematic search of scientific sources was conducted in the PubMed, Web of Science, and Scopus databases. In this search, the relationship between biomarkers present in gingival crevicular fluid and key stages of skeletal development, particularly the mid-pubertal stages of jaw growth (CS3–CS4 stages in the CVM index), was examined. The main focus of this article was to determine the association of biomarkers such as ALP with specific maturation milestones in the cervical vertebrae.

The results obtained from the literature search in this article showed that there is a significant association between the concentration of some GCF biomarkers and the peak growth velocity.

If the obtained data are confirmed, it can be expected that the diagnostic accuracy and treatment timing in growth-modification-based orthodontic interventions will improve considerably.

This non-invasive diagnostic approach appears to have promising clinical potential. However, its current clinical application is limited due to heterogeneity in study methodologies. Standardized protocols need to be developed as a fundamental prerequisite for the reliable use of these biomarkers in routine orthodontic practice.