Relationship between blood-spot insulin-like growth factor 1 levels and hand-wrist assessment of skeletal maturity

Introduction: Accurate prediction of the timing of the pubertal growth spurt and the amount of remaining growth are factors that affect treatment decisions in orthodontics, orthognathic surgery, and dental implantology. For many years, medical and dental professionals have considered hand-wrist radiographs the method of choice for the assessment of skeletal maturity. Insulin-like growth factor 1 (IGF-1) mirrors growth hormone levels and is used by endocrinologists to diagnose growth hormone disturbances. Methods: The objective of this study was to establish a relationship between IGF-1 levels collected from blood-spot samples and hand-wrist radiographs at various skeletal stages. Eighty-four subjects (45 female, 39 male) between the ages of 5 and 25 were included in the study. Each subject had personal information, a hand-wrist radiograph, and a blood-spot sample collected on the same day. Results: The IGF-1 levels were highest at the hand-wrist skeletal stages that were previously associated with the greatest amount of mandibular growth. These levels were significantly higher than at prepuburtal and postpubertal stages. In the postpubertal group, the IGF-1 levels were lower as the subjects' ages increased and they moved away from the onset of puberty. Conclusions: Longitudinal data are necessary to confirm the usefulness of this technique in predicting the timing, the intensity, and the end of the growth spurt. (Am J Orthod Dentofacial Orthop 2009; 136: 59-64)