Evidence of secular trend in mandibular pubertal growth

Abstract

Summary Background During puberty, mandibular growth follows a growth curve comparable to somatic growth. This study aimed to review the relationship between mandibular pubertal peak height velocity (PHV) and skeletal age, and to investigate the possibility of a secular trend. Methods Retrospective analysis was performed of two historical craniofacial growth studies (Denver Growth Study; observational time: 1943-1965, and Zurich Growth Study; observational time: 1982-1984) of healthy untreated subjects. Two mandibular growth measures (Articulare-Pogonion [Ar-Pg], Condylion-Pogonion [Co-Pg]) were retrieved from cephalograms (n: 990) and corresponding skeletal age based on hand-wrist radiographs. Mandibular growth velocity was related to skeletal age, PHV was established by use of cubic smoothing splines and variability was calculated by bootstrap resampling for every growth study and gender separately. Results Sexual dimorphism in mandibular growth was apparent in both cohorts. In subjects of the Denver Growth Study, mandibular PHV occurred at a more advanced skeletal age than in subjects of the Zurich Growth Study. This trend was more pronounced in males, for whom PHV of Co-Pg shifted from 14.4 to 13.8 years and of Ar-Pg from 14.6 to 13.7 years. This tendency was more subtle in females: PHV of Co-Pg shifted from 12.7 to 12.4 years and of Ar-Pg from 12.6 to 11.8 years. Conclusions Mandibular growth appears to be subject to a secular trend. When related to skeletal age, this secular trend seems to be more accentuated than the established secular trend for somatic pubertal growth.