Correlation Between Salivary Dehydroepiandrosterone Sulfate Levels, Dental Age, and Cervical Vertebral Maturation in Typically Developing Children and Children with Down Syndrome Aged 8 to 14 Years

This study aimed to analyze the correlation between salivary dehydroepiandrosterone sulfate (DHEA-S) levels, dental age, and cervical vertebral maturation (CVM) stages in typically developing children and children with Down syndrome aged 8 to 14 years. This observational analytical study employed a cross-sectional design and included 80 children, consisting of 56 typically developing children and 24 children with Down syndrome. Unstimulated saliva samples were collected and analyzed for DHEA-S levels using enzyme-linked immunosorbent assay (ELISA). Dental age was assessed using the Demirjian method on panoramic radiographs, while skeletal maturation was evaluated using cervical vertebral maturation stages on lateral cephalometric radiographs. Correlations between salivary DHEA-S levels and growth parameters were analyzed using Spearman's rank correlation test. Differences between groups were evaluated using the Mann–Whitney U-test. In typically developing children, salivary DHEA-S levels showed significant positive correlations with chronological age (ρ = 0.304; p = 0.023), dental age (ρ = 0.378; p = 0.004), and CVM stage (ρ = 0.774; p < 0.001). In children with Down syndrome, significant correlations were observed between salivary DHEA-S levels and dental age (ρ = 0.439; p = 0.032) as well as CVM stage (ρ = 0.703; p < 0.001). Comparison between groups showed higher mean salivary DHEA-S levels in children with Down syndrome; however, the difference was not statistically significant (p = 0.076). Salivary DHEA-S levels were positively correlated with dental age and CVM stages in both typically developing children and children with Down syndrome, with the strongest correlation observed with CVM. These findings support salivary DHEA-S as a noninvasive adjunctive biomarker for biological maturation assessment, including in children with Down syndrome.