This finding is similar to IGF-1 levels in serum and to another study depicting salivary IGF-1 peak (6.15±1.04 pg/mL) at puberty.37,38,43,89 According to previous literature, the factors influencing levels of free circulating IGF-1 in saliva are body mass index (BMI) and malnutrition status,90 which may be further explored as contributing factors to skeletal maturation status. This evidence concerns the gene IGF1 and nutritional deficiency disease.