Pubertal status of children and adolescents during orthodontic treatment

Most orthodontic therapy in Germany takes place during puberty. However, since boys and girls experience puberty very differently, we can expect differences in their pubertal status when undergoing orthodontic therapy. In this study we addressed the stages of pubertal development in male and female children and adolescents undergoing orthodontic treatment.

A total of 1011 individuals were randomly selected from a population-based representative sample of school students aged 10-18 years in the German city of Halle/Saale. This cohort was evaluated for the prevalence of orthodontic treatment and--using a modified German version of the Pubertal Development Scale--for pubertal status. An orthodontic subgroup of these boys and girls was analyzed for age distribution and pubertal stage (χ(2) test).

The orthodontic subgroup included 296 boys and girls (accounting for 29.3% of the total sample), 50% of whom (n=148) had already attained advanced stages of pubertal development. Broken down by gender, we observed advanced stages in 60% of the girls versus 38% of the boys (p<0.001). However, this gender-specific difference was not reflected in the orthodontic subgroup's age distribution (p>0.05). Irrespective of gender, most subjects undergoing orthodontic treatment were 12 or 13 years old.

Boys and girls in Germany undergo orthodontic treatment at the same age. Given the delayed onset of puberty in boys, most are still pre-pubertal, whereas most girls have reached an advanced stage of puberty by the time they undergo treatment--a discrepancy that could have therapeutic implications.