Timing of adolescent growth spurt among children with different skeletal classes

Abstract

Introduction: Treatment with growth modification appliances is only successful if commenced at the right stage of the adolescent growth spurt.  The aim of this study was to determine and compare the mean age of the adolescent growth spurt among children with three skeletal malocclusions.

Material and Methods: A retrospective cross-sectional study was conducted on the lateral cephalograms of 440 children (203 boys and 237 girls) aged 9-17 years. Subjects were categorized into three skeletal classes (Class I=187, Class II=169, Class III=84) according to the sagittal jaw relationship. The cervical vertebral maturation (CVM) stage of each subject was recorded using Baccetti’s method. The mean age at each CVM stage was compared between males and females using Mann-Whitney U test and among the three malocclusion groups using Kruskal-Wallis test.

Results: Pubertal growth peak occurred on average 1.5 years earlier in girls than boys. The mean difference in the time of adolescent growth spurt between Class I and Class II girls was of 7.5 months (p = 0.026) and between Class I and Class III boys was of 10.5 months (p = 0.022). All boys >16.5 years and girls >16.0 years were found to be in cervical stage 6.

Conclusions: Girls experience adolescent growth spurts on average 1.5 years earlier than boys. Adolescent growth spurt in Class II girls occurs earlier than Class I girls, while Class III boys mature later than Class I boys. However, timing of completion of adolescent growth spurt was comparable among the three skeletal classes.