BackgroundDetermination of skeletal maturation and remaining growth potential is an essential part of treatment planning in orthodontics. The aim of our study was to determine the relationship between IGF-1 levels, IGFBP-3 levels with CVM staging to track the pre pubertal and pubertal growth spurts in female patients in North Indian population.MethodsThis cross-sectional study was conducted on ninety female subjects in the age group of 8-20 years. Blood samples were collected and centrifuged and serum samples were then analysed by Human IGF-1 and IGFBP-3 enzyme-linked immunosorbent assay kits, specific for IGF-1 and IGFBP-3, respectively. CVM staging on lateral cephalometric radiograph was determined for all patients. Analysis of variance test followed by a post hoc test was used to compare mean IGF-1 and IGFBP-3 corresponding to six stages of cervical vertebrae maturation stages. Linear Pearson’s correlations were performed to determine the trends of IGF-1, IGFBP-3, and its ratio relating to CVM stage. The kappa statistic was used to measure inter and intra examiner reliability. P value <0.05 was considered as statistically significant.ResultsMean serum IGF-1 levels were found to be highest (403.3 ± 12.3 ng/ml) at CVMI3 stage of CVMI. The post-hoc test revealed a significant difference in IGF-1 levels between all stages of CVMI, thereby indicating a specific range of IGF-1 levels for a specific skeletal stage. Mean serum IGFBP-3 levels were found to be highest (5186.8 ± 1384.2 ng/ml) at CVMI4 stage of CVMI. The mean serum IGFBP-3 levels at CVMI4 were found to be significantly higher than the levels at all other CVMI stages except CVMI3 stage.ConclusionsIGF-1 and IGFBP-3 can serve as a potential biochemical indicator for assessment of skeletal maturity.

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BackgroundOptimal positioning of orthodontic mini-implants is essential for a successful treatment with skeletal anchorage. This study aims to compare the accuracy of two-dimensional radiographs with a cone beam computed tomography (CBCT) for mini-implant placement.MethodsAn ideal site for mini-implant placement at the buccal interradicular space between the second premolar and the first molar was determined for 40 sites (in 13 patients aged 14 to 28 years) by using CBCT data. The mini-implant placement procedure was then divided into two groups. In CBCT group, mini-implants were placed at the sites determined from CBCT data. In RVG group, mini-implants were placed with the help of two-dimensional digital radiographs and a custom made guide. Postplacement CBCT scans were obtained to determine the accuracy of the mini-implant placement. The results were statistically analyzed with a Mann-Whitney test.ResultsA statistically significant difference (p value = 0.02) was observed between the two groups for deviation from an ideal height of placement of the mini-implants. Deviations in mesiodistal positioning and angular deviation showed a statistically non-significant difference. Three out of twenty mini-implants in the RVG group showed root contact in the mandibular arch that may be attributed to the narrower interradicular space and reduced accessibility in the mandibular posterior region.ConclusionsAlthough CBCT provides an accurate three-dimensional visualization of the interradicular space, the two-dimensional intraoral radiograph of the interradicular area provides sufficient information for mini-implant placement. Considering the amount of radiation exposure and cost with the two techniques, it is recommended to use two-dimensional radiographs with a surgical guide for a routine mini-implant placement.

BackgroundWith change in concepts of growth determination methods, there is a surge in the measurement of biomarkers for appraisal of growth status. Osteocalcin is a bone-specific protein and was observed to parallel the normal growth curve. Hence, the present study was intended to assess the levels of serum osteocalcin and serum insulin-like growth factor-1 (IGF-1) and compare them with cervical vertebral maturation index (CVMI) stages.MethodsThe cross-sectional study was performed on 150 subjects (75 males and 75 females) in the age group of 8–20 years and segregated into six CVMI stages. Serum osteocalcin and IGF-1 were estimated by ELISA. Mann-Whitney U test was used to compare the mean ranks of serum osteocalcin and serum IGF-1 with different CVMI stages. Spearman correlation was performed to find association between serum osteocalcin and serum IGF-1 across six CVMI stages.ResultsPeak serum IGF-1 levels were obtained at CVMI stages 4 and 3 for males and females, respectively, with insignificant difference between stages 3 and 4 in females. Peak serum osteocalcin levels were found at stage 5 and 3 for males and females with insignificant difference from other stages except stages 5 and 6 in males. A statistically significant correlation was seen between serum IGF-1 and serum osteocalcin across six CVMI stages (P < 0.01).ConclusionsOsteocalcin followed IGF-1 across all CVMI stages but showed insignificant interstage differences.

BALP showed promising results and can be employed as a potential biomarker for the estimation of growth status.