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SCOPING REVIEW

Physiological Maturation Indicators as Determinants of Pubertal Growth in Orthodontic Treatment: A Scoping Review

The Open Dentistry Journal 22 Oct 2025 SCOPING REVIEW DOI: 10.2174/0118742106409365251020104042

Abstract

Introduction

The pubertal growth period is a critical phase for orthodontic treatment, as its evaluation directly influences diagnostic accuracy and treatment outcomes. Pubertal growth evaluation can be conducted by assessing individual physiological maturation. This study aims to conduct a scoping review to map and determine physiological maturation indicators that are highly correlated with pubertal growth.

Methods

A scoping review was conducted using literature searches in Scopus, PubMed, ScienceDirect, and Google Scholar. The articles used in this review are articles published within the period from 2014 to 2024.

Results

A total of 18 articles out of 279 met the inclusion criteria in this scoping review. Fourteen studies assessed pubertal growth using dental maturation indicators, predominantly the Demirjian method. Two studies used biomarkers such as IGF-1 and ALP. One study evaluated skeletal maturation using fractal dimension analysis, and one study assessed sexual maturation based on menarche status. All studies compared the selected indicators to skeletal maturation.

Discussion

Dental maturation indicators were the most frequently investigated and exhibited a high correlation with skeletal maturation, supporting their use as a practical, non-invasive tool for pubertal growth assessment. Biomarkers such as IGF-1 offer a promising non-radiographic alternative, while supporting evidence for fractal dimension analysis and menarche status remains limited.

Conclusion

Dental maturation is the most reliable indicator of pubertal growth due to its strong correlation with skeletal maturation, while evidence for other indicators, such as fractal dimension and menarche, remains limited. Variations in age range and population may affect the generalizability of these findings.

Keywords: Physiological maturation indicators, Biological maturation, Orthodontic treatment, Pubertal growth, Pubertal assessment, Growth prediction.
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