A Critical Review on Insulin Like Growth Factor-1―A Skeletal Maturity Indicator

In orthodontic treatment planning decisions assessment of growth status plays a vital role and that the
adolescent growth spurt is considered an ideal time to mete out growth modification therapy. Various
radiologic and non-radiologic skeletal maturity indicators have been in use with its attendant
advantages and disadvantages. Insulin like Growth Factor-1 (IGF-1) is one such non-radiologic
biomarker that could be used to estimate the amount of available growth present to help treat jaw
discrepancies in the circumpubertal period of growth as the mean levels of it has been reported to be
high during this period. Internationally peer reviewed and valid indexed reference articles pertaining to
IGF-1 and its predictive usefulness in estimating the peak pubertal growth spurt used alone or in
combination with the other radiologic skeletal maturity indicators was segregated and diligently
perused. Information gleaned from the literature review revealed that IGF-1 was indeed effective in
assessing the circumpubertal growth spurt. It had a high correlation with the cervical stages C3 and
C4 as seen on lateral cephalograms as also with the stages pertaining to peak pubertal growth as
seen on handwrist radiographs and middle phalanx 3 (MP3) on periapical x-rays. IGF-1 was an
effective and alternative biomarker for estimation of peak pubertal growth spurt used alone or in
combination with the other radiologic biomarkers. IGF-1 could be used as a potential skeletal maturity
indicator without the hazard of additional radiographic exposure. In comparison to prepubertal, early
pubertal, and postpubertal stages, late pubertal stages exhibit higher mean IGF-1 blood spot levels.
Mandibular condyle is sensitive and more responsive to IGF-1.