Deathspawner: On one of my PCs, the game scales just fine to the monitor (24" @ 1920x1200), but on another, one with a 20" @ 1680x1050, it doesn't. To run on that PC, I had to create a new profile through ScummVM, and use the 2x option (well, 2xSAI for some smoothing) and then run it that way. It seems on some PCs, full-screen just isn't going to work that well.
There is no general solution to this, since every PC configuration is different. Most importantly, Intel integrated graphics, Nvidia and AMD all handle this a little differently in their drivers. But it also depends if you are on a laptop with built-in display or an external monitor.
On Laptops, most graphics card drivers offer switching between the following scaling settings for the built-in laptop display:
-Center Image
-Scale Full Screen
-Maintain Aspect Ratio
If these options do not appear in your graphics settings, try reducing your desktop resolution to something lower than native screen resolution, the scaling options should now appear and should also be applied if you start the game now. If you are lucky the scaling option will be remembered even when you change you desktop resolution back to native and start the game then (but don't hold your breath).
If you do not have a Laptop and/or use an external Monitor, then most drivers will not offer you the scaling options at all. The Monitor is responsible for scaling whatever it receives, and hopefully you can set scaling options on the monitor.
I know that the latest Nvidia drivers offer the option to do the scaling on the graphics card and then deliver a predefined resolution to the monitor, but I'm not sure if there is a general solution for Intel and AMD.