Maturation indicators and the pubertal growth spurt.

The pubertal growth spurt and dental, skeletal, and pubertal development have been investigated in a prospective longitudinal study of 212 randomly selected Swedish children by means of maturation level indicators suitable for use in clinical orthodontics. The sample was examined from birth to adulthood and included a representative proportion of early-, average-, and late-maturing subjects. The number of dropouts and missing examinations was low and was allowed for in the statistical analysis. The results may therefore be considered representative for Swedish children. There was a 2-year sex difference in age at the beginning, peak, and end of the pubertal growth spurt in standing height. The individual variation was about 6 years at each event in both sexes. Dental development in relation to the pubertal growth was more advanced in boys than in girls, but the individual variation was great in both sexes. Skeletal development at the beginning and peak was more advanced in girls than in boys, whereas at the end of the pubertal growth spurt the skeletal development was more advanced in boys. Dental development, determined by means of dental emergence stages (DES), was not useful as an indicator of the pubertal growth spurt. The peak and end--but not the beginning--of the pubertal growth spurt could be assessed by means of indicators taken from the skeletal development of the hand and wrist and the pubertal development (menarche and voice change).