Serum Insulin Like Growth Factor-1– A Skeletal Maturity Indicator for the Assessment of Orthopedic Treatment Timing of Skeletal Class II Malocclusion

Abstract

Orthodontic treatment planning decisions are dependent on the assessment of growth status. Skeletal maturity could be assessed with various radiologic and non-radiologic biologic markers.The purpose of our study was to investigate the reliability of serum Insulin like Growth Factor – 1(IGF-1) as a skeletal maturity indicator in comparison to the stages in cervical vertebral maturation (CVM). Twenty five subjects with skeletal class II malocclusion in the age range of 11-19 years were recruited for the study. The cervical vertebrae staging was assessed by lateral cephalograms. Blood was collected aseptically and serum was separated. The serum levels of IGF- 1 were quantitatively assessed using a commercial ELISA kit, IGF-1 600 ELISA (DRG Instruments GmbH, Germany). There was a significant decline in the mean IGF-1 levels with increase in age in both the sexes. Statistically significant difference was observed in the concentration of IGF-1 among the different age groups. There was a significant decline in the mean IGF-1 levels with increase in CVM staging from stage 2 to stage 4. IGF-1 could be a more reliable biologic skeletal maturity indicator in comparison to cervical vertebral maturity indicator and thus could predict more accurately the growth status of the mandible to facilitate correction of skeletal class II jaw discrepancies.

Non-invasive methods for the assessment of biomarkers and their correlation with radiographic maturity indicators — a scoping review

“…Similarly, the results of Sharmila et al [29] showed the levels of salivary IGF1 to reach a peak during the pubertal stage. This was in agreement with previous studies which correlated the serum IGF and found peak levels during pubertal growth [34,[46][47][48][49][50][51][52]. Few studies also found a disparity in IGF1 levels in males and females across the CVMI stages as IGF1 levels are influenced by sex [53].…”

Serum biomarkers associated with radiographic skeletal maturity indicators: A systematic review and meta-analysis

“…A total of 11 studies (13 articles) with the cross-sectional study design (Anusuya et al, 2020; Gupta et al, 2015; Hussain et al, 2013; Ishaq et al, 2012; Jain et al, 2013, 2017; Masoud, 2008; Nancy et al, 2019; Sadiq et al, 2020; Sharmada et al, 2014; Sinha et al, 2016; Tripathi, 2017) utilised lateral cephalograms as the sole method of radiographic skeletal maturity assessment. Out of these studies, four (Ishaq et al, 2012; Jain et al, 2017; Sinha et al, 2016; Tripathi, 2017) used the Hassel and Farman (1995) CVMI staging, while seven (Anusuya et al, 2020; Gupta et al, 2015; Hussain et al, 2013; Jain et al, 2013; Nancy et al, 2019; Sadiq et al, 2020; Sharmada et al, 2014; Tripathi, 2017) used Baccetti et al (2005) CS staging.…”

“…A total of 11 studies (13 articles) with the cross-sectional study design (Anusuya et al, 2020; Gupta et al, 2015; Hussain et al, 2013; Ishaq et al, 2012; Jain et al, 2013, 2017; Masoud, 2008; Nancy et al, 2019; Sadiq et al, 2020; Sharmada et al, 2014; Sinha et al, 2016; Tripathi, 2017) utilised lateral cephalograms as the sole method of radiographic skeletal maturity assessment. Out of these studies, four (Ishaq et al, 2012; Jain et al, 2017; Sinha et al, 2016; Tripathi, 2017) used the Hassel and Farman (1995) CVMI staging, while seven (Anusuya et al, 2020; Gupta et al, 2015; Hussain et al, 2013; Jain et al, 2013; Nancy et al, 2019; Sadiq et al, 2020; Sharmada et al, 2014; Tripathi, 2017) used Baccetti et al (2005) CS staging. Though the CS staging by Baccetti et al (2005) was employed by eight studies, five studies—namely Anusuya et al (2020), Gupta et al (2015), Hussain et al (2013), Masoud (2008) and Sharmada et al (2014)—allocated their respective participants into six stages (CS 1–6) whereas Nancy et al (2019) and Sadiq et al (2020) did not include participants in the CS1 stage.…”

“…Out of these studies, four (Ishaq et al, 2012; Jain et al, 2017; Sinha et al, 2016; Tripathi, 2017) used the Hassel and Farman (1995) CVMI staging, while seven (Anusuya et al, 2020; Gupta et al, 2015; Hussain et al, 2013; Jain et al, 2013; Nancy et al, 2019; Sadiq et al, 2020; Sharmada et al, 2014; Tripathi, 2017) used Baccetti et al (2005) CS staging. Though the CS staging by Baccetti et al (2005) was employed by eight studies, five studies—namely Anusuya et al (2020), Gupta et al (2015), Hussain et al (2013), Masoud (2008) and Sharmada et al (2014)—allocated their respective participants into six stages (CS 1–6) whereas Nancy et al (2019) and Sadiq et al (2020) did not include participants in the CS1 stage. The article by Jain et al (2013) evaluated the study participants only in CS 3–5.…”

“…The type of sample, timing of collection, type of biomarker and the biomarker detection technique for the 19 studies are described in Table 2. Different biomarkers such as IGF-1, Gupta et al (2012Gupta et al ( , 2015, Ishaq et al (2012), Jain et al (2013), Nancy et al (2019), Phogat et al (2015), Sadiq et al (2020) and Sinha et al (2014Sinha et al ( , 2016. Srinivasan and Premkumar (2012) and Venkatagiriappa et al (2016) assessed the DHEA levels in serum and blood spot, respectively.…”