Diskrepansi Saiz Gigi Intermaksila dan Kesannya terhadap Hasil Rawatan Ortodontik (Intermaxillary Tooth Size Discrepancies and Its Effect on Orthodontic Treatment Outcome) / Jurnal Sains Kesihatan Malaysia

@#Intermaxillary tooth size discrepancy (TSD) is the disproportion in patients’ tooth size that is usually referred to the Bolton analysis. This size imbalance may also affect the outcome of orthodontic treatment. Therefore, this retrospective study was conducted to determine the prevalence of intermaxillary tooth size discrepancy (TSD) beyond 2 standard deviation (2 SD) from Bolton’s mean in orthodontic patients and to evaluate the effect of TSD beyond 2 SD of Bolton’s mean on orthodontic treatment outcomes. A total of 226 sets of orthodontic study models that met the selection criteria were selected from 3077 orthodontic cases. Bolton's analysis of the anterior and overall ratios was performed on each of the pre-treatment models. The orthodontic treatment outcomes for the cases which were identified of having TSD beyond 2 SD were evaluated and any interventional techniques to improve the outcome of the treatment were recorded. The results showed that 29.20% of cases had TSD beyond 2 SD of Bolton’s mean. 26.54% of cases had anterior ratio of more than 2 SD. Meanwhile, 7.08% of cases had an overall ratio greater than 2 SD. Of all cases with TSD beyond 2 SP, most of these cases (62.12%) had affected the outcome of orthodontic treatment. In conclusion, there is more than one quarter of orthodontic patients present with TSD beyond 2 SD of Bolton’s mean which may influence the outcome of orthodontic treatment. Intervention techniques should be carefully planned to achieve satisfactory treatment outcomes.

Rehabilitation of a patient with non-syndromic partial oligodontia

Oligodontia is defined as a congenital tooth agenesis with the absence of six or more permanent teeth. This clinical report describes a patient with non-syndromic partial oligodontia, with retained deciduous teeth and the absence of 16 permanent teeth. Anterior esthetic problems were caused by interarch tooth size discrepancy, interdental space, aberrant tooth dimensions, and the absence of centric contacts of the anterior teeth. Prosthetic restoration after orthodontic and implant treatment was performed with a multi-disciplinary team approach. Favorable functional and esthetic results were obtained using a definitive prosthesis.

Comparison of Anterior Tooth Size Discrepancies Among Different Malocclusion Groups

Background: Discrepancies between tooth sizes can cause orthodontic problems such as crowding and improper occlusion. By identifying these problems, better orthodontic treatment outcome can be achieved. The aim of this study is to identify anterior tooth size discrepancies among 4 different types of malocclusion i.e. Class I; Class II division 1 (II/1); Class II division 2 (II/2); and Class III. Methods: A retrospective study was carried out using 200 orthodontic study models where 50 study models were taken for each of the 4 malocclusion groups. The samples were selected using random sampling technique based on the orthodontic waiting list in the Orthodontic Department, Dental Faculty, UKM. All anterior teeth were measured by the same examiner at the largest mesio-distal dimension, using a digital caliper recorded up to 0.01 mm. Comparison between the 4 groups of malocclusion were made intra-arch using individual tooth size measurement and inter-arch using Anterior Bolton Index (ABI). Results: For the intra-arch assessment, Class II/1 had significantly the largest upper and lower anterior tooth size except for its upper canine and lower central incisor. Class III group had insignificantly the smallest mandibular anterior teeth compared to other malocclusion groups. For inter-arch assessment, Anterior Bolton Index (ABI) of all samples was 79.2 ± 3.94%. The highest ABI was noted in Class II / 2 of 80.3 ± 4.71%. However, no significant differences were found among the 4 malocclusion groups (p>0.05). Conclusion: Most of the anterior teeth in Class II division 1 were the largest of all. No significant difference in the inter-arch tooth size discrepancies were detected among all malocclusion groups.

Análise de Bolton: uma proposta alternativa para a simplificação de seu uso / Bolton analysis: an alternative proposal for simplification of its use

INTRODUÇÃO: as discrepâncias entre o tamanho mesiodistal dos dentes superiores e inferiores e seus efeitos sobre a oclusão têm sido relatados há muito tempo. O método proposto por Bolton para o diagnóstico de discrepância de tamanho dentário é, inegavelmente, um dos mais difundidos no meio ortodôntico, devido à sua relativa simplicidade. Entretanto, a aplicação desse método requer cálculos matemáticos e o uso de tabelas que, muitas vezes, inviabilizam a sua utilização durante a avaliação clínica. OBJETIVO: avaliar o método proposto por Wolford, que não requer o uso de tabelas, como alternativa ao método tradicional de Bolton. MÉTODOS: a amostra foi composta por 90 pares de modelos dentários iniciais de pacientes adultos, com diferentes más oclusões. A proporção entre os dentes inferiores e superiores foi calculada para cada paciente, resultando na obtenção de dois índices (a razão total e a razão anterior). Os índices foram obtidos por meio do método originalmente proposto por Bolton e por um método alternativo, composto por duas fórmulas (uma simplificada e a variação da mesma), que foram analisadas separadamente. RESULTADOS: comparadas ao método de Bolton, as fórmulas simplificadas mostraram uma tendência de superestimar as discrepâncias dentárias inferiores (total e anterior), embora em pequena proporção. CONCLUSÕES: ambas as fórmulas do método alternativo podem ser utilizadas em substituição ao método tradicional, uma vez que mostraram diferenças médias menores que 0,58mm quando comparadas ao método de Bolton, não apresentando, portanto, significância clínica.

INTRODUCTION: Mesiodistal size discrepancies of upper and lower teeth and their effect on occlusion have been related. Bolton's method for tooth size discrepancies is, undeniably, one of the most commonly-used methods in orthodontics because of its simplicity. However, the application of this method requires mathematical calculations and use of tables, which often prevents its clinical use. PURPOSE: Evaluate an alternative method for Bolton's analysis proposed by Wolford that does not require table information. MATERIAL AND METHODS: The sample was composed of 90 initial dental casts of adult patients, with different malocclusions. The ratio between the sum of widths of maxillary and mandibular teeth was calculated for each patient, resulting in the attainment of two indices: The overall ratio and the anterior ratio. Indices were calculated by Bolton's method and by an alternative method, using two different formulas (one simplified and a variation of the same formula) that were separately analyzed. RESULTS: In comparison with Bolton's method, the Simplified Formulas demonstrated a slight trend towards an overestimation of the inferior dental discrepancies (overall and anterior). CONCLUSION: Both formulas employed for the alternative method may be used to substitute the traditional method, since each demonstrated, on average, differences of less than 0.58 mm when compared with Bolton's method and no clinical significance.

Discrepancia dentaria de Bolton y finalización de ortodoncia: consideraciones clínicas / Bolton tooth size discrepancy and orthodontics finalization: clinical considerations

Las discrepancias entre el tamaño mesiodistal de los dientes superiores e inferiores, así como sus efectos sobre la oclusión han sido reportadas desde mediados del siglo XX. El objetivo de este estudio fue determinar la importancia de la aplicación del análisis de discrepancias dentaria de Bolton con finalidad ortodontica. Fueron seleccionados casos de pacientes de raza blanca de ambos sexos, con edades comprendidas entre 12 y 25 años. El análisis de las discrepancias dentarias fue realizado en la fase previa al tratamiento y posterior a la contención. Como criterio básico para la inclusión en la muestra de pacientes en el pre-tratamiento deberían presentar todos los dientes permanentes (de primeros molares a primeros molares del lado opuesto, en ambos arcos). Fueron eliminados los casos que presentaron dientes con grandes destrucciones, restauraciones inadecuadas y dientes mal posicionados donde no fue posible la medición adecuada entre los puntos de contacto. La medición del tamaño mesiodistal de los dientes se realizó con un caliper (Odin, Alemania), precisión de 0,01 mm, por un solo examinador, previamente calibrado para realizar este procedimiento. Se midió el diámetro mesiodistal mayor de todos los dientes. Las relaciones totales y anteriores fueron calculadas por las fórmulas respectivas, según lo propuesto por Bolton (1958). Al finalizar, los casos mostraron que una discrepancia dentaria de Bolton maxilar o mandibular por exceso o falta dentaria, puede ser compensada por la alteración en la forma del arco, dimensión vestibulolingual y por la inclinación axial de los dientes anteriores, utilizadas en conjunto o aisladamente en la arcada, sin perjuicio estético y funcional.

Discrepancies of the mesiodistal dimensions between upper and lower teeth as well as their effects on occlusion have been reported since the middle of the twentieth century. The aim of this study was to elucidate the importance of the applicability of the analysis of the Bolton tooth size discrepancy in the orthodontic finalizing. Cases involving Caucasian male and female patients aged between 12 and 25 years were selected for study. Analyses of the dental discrepancies were carried out before orthodontic treatment and after contention. Basically, only patients having all permanent teeth before treatment (with first molars in both arches) were included. Those cases of severely mutilated teeth, inadequate restorations, and tooth malalignment were ruled out because accurate measurement of the contacting points could not be performed. Measurement of the mesiodistal tooth dimension was performed by only one operator using a digital calliper of a resolution of 0.001 mm (Odin, Germany) which had been previously calibrated for such procedures. It was measured the largest mesiodistal diameter. Both previous and total relationships were calculated through their respective formulas according to Bolton (1958). The orthodontic finalisation showed that Bolton tooth size discrepancies involving either crowded dentition or lack of teeth can be compensated by mandibular or maxillary arch shape, buccal-lingual dimension, and axial inclination of the anterior teeth with no aesthetic or functional impairment.

A busca da estética em casos de discrepância ósseo-dentária / In searching of esthetic in case of tooth-size discrepancy

Em Odontologia, o desafio não é apenas produzir boa oclusão, mas obter boa oclusão com bom resultado estético. E a escolha da solução mais adequada depende das características específicas de cada caso e da interação com as especialidades afins devem ser consideradas na elaboração e execução do plano de tratamento. A ausência de proporcionalidade dimensional entre os dentes maxilares e mandibulares impossibilita a intercuspidação, overjet e overbite adequados, além de um bom resultado estético. Nos casos de discrepância ósseodentária estão indicados stripping ou acréscimo e abertura ou fechamento de espaço na arcada oposta. Nesses casos, as dificuldades envolvidas devem ser ponderadas. No caso clínico apresentado os recursos biomecânicos da Ortodontia e os benefícios da Dentística foram aplicados com sucesso.

In Dentistry the challenge is not to produce a good occlusion, but an aesthetic smile in a good occlusion. The choice of best solution depends on the specific characteristics of each case and the interaction with the similar specialties. The elaboration and execution of the treatment plan must be considered. The absence of dimensional proportionality between mandibular and maxillary teeth disables the intercuspation, overjet and overbite adjusted with a good aesthetic result. In cases of tooth-size discrepancy stripping or addition and opening or closing of space in opposite arch are indicated. In these cases, the involved difficulties and specific needs must be considered altogether. In the clinical case presented orthodontic biomechanic resources and the benefits of the Cosmetic Dentistry had been applied successfully.

Aplicação clínica da análise de bolton em dentística e ortodontia / Clinical application of the bolton analysis in dentistry and orthodontics

A discrepância de tamanho dentário ocorre em um número considerável de pacientes que procuram por tratamento ortodôntico, e pode influenciar de maneira negativa os objetivos do tratamento e os seus resultados finais, impedindo a busca da excelência na finalização do caso. Tal deficiência na finalização pode ser detectada e considerada na fase de diagnóstico e planejamento do tratamento, pela análise da discrepância de tamanho dentário. O artigo está ilustrado com o caso clínico de um paciente do sexo masculino, 13,2 anos de idade, que após a realização da análise de Bolton, constatou-se a discrepância de tamanho dentário, com proporção total igual a 95,3 (média de 91,3), demonstrando um déficit na arcada superior devido à anomalia de forma nos incisivos laterais superiores. Sendo assim foi planejado um tratamento multidisciplinar com a Ortodontia para devolver a oclusão e macroestética do sorriso e a Dentística para obter a microestética. Esse planejamento multidisciplinar permitiu o tratamento mais adequado e a excelência na finalização do caso. Portanto a análise de Bolton é uma ferramenta importante na fase de diagnóstico e planejamento do tratamento ortodôntico.

The discrepancy of dental size occurs in a considerable number of patients who search for orthodontic treatment and may negatively influence the treatment objectives and compromise its final results. This size deficiency can be detected and considered in the diagnosis and treatment plan phases through the analysis of tooth size discrepancy. This article illustrates a case report of a male patient, 13.2 years old, who had a tooth size discrepancy identified through the Bolton analysis with a total proportion of 95.3 (average of 91.3), demonstrating a deficit in the superior arch due to a shape anomaly of the superior lateral incisors. Thus, a multidisciplinary treatment course was planned including orthodontic, to reestablish occlusion and macro-esthetic elements of the smile; and restorative dentistry, to improve micro-esthetic quality. This multidisciplinary plan enabled a more adequate course of treatment and higher rate of overall success. Therefore, the Bolton analysis is an important tool in the diagnosis and orthodontic treatment planning phases.

Bolton tooth-size discrepancies among University of Malaya's dental students

The objective of this retrospective study was to investigate what percentage of the dental students in the University of Malaya has a tooth size discrepancy. The sample comprised 40 good quality pre-treatment study models with fully erupted and complete permanent dentitions from first molar to first molar, which were selected from the dental students of the University of Malaya. The mesiodistal diameter tooth sizes were randomly measured manually from first molar to first molar using digital calliper (Mitutoyu) accurate to 0.01 mm, and the Bolton analyses for anterior and overall ratios were calculated by scientific calculator. Reproducibility analysis for intra- and interexaminer calibrations was assessed by measuring 10 study models twice, a week apart. A paired sample t-test and the correlation coefficient were used to evaluate the systematic and random errors of the measurements using Statistical Package for Social Sciences (SPSS) version 12.0. The reproducibility of the intra and inter-examiners for the sum of upper and lower mesiodistal tooth size were high (average mean difference = 0.62, r = 0.82). This study found 47.5% of the samples had anterior, and about 10% had overall· tooth width ratios greater than 2 standard deviations from Bolton's mean. Large percentage of the dental students of the University of Malaya has tooth size discrepancies outside of Bolton 2 standard deviations. It would seem prudent to routinely perform the tooth size analysis and include the findings into orthodontic treatment planning.

A Clinical Analysis of Tooth Size Discrepancy (Bolton Index) among Orthodontic Patients in Wuhan of Central China / 华中科技大学学报（医学）（英德文版）

The purpose of this study was to determine the total Bolton index (TBI) and anterior Bolton index (ABI), evaluate the clinical significance of tooth size discrepancies and the influence of gender variation of mesiodistal tooth width on Bolton Index and estimate which tooth has the greatest influence on Bolton Index. A total of 110 pairs of pretreatment dental study casts (41 male and 69female) were selected from patients treated in Department of Orthodontics of Union Hospital in Wuhan, China. A sliding dental Vernier caliper was used for the measurement of the mesiodistal tooth width. Descriptive statistical mean values, standard deviation, standard error of the mean values, coefficient of variance and the t-test were used for the statistical analysis of the data. The study found that TBI, ABI and the total sum of teeth width had no significant difference between male and female.Male group indicated that Bolton Index (BI) was mostly influenced by the width of lower right second premolar, whereas female group showed that BI was mostly influenced by the width of both the right and left maxillary lateral incisor.

Study on mesiodistal teeth size and the relationship between upper and lower teeth dimension of normal occlusion from Han Chinese in Xi'an / 实用口腔医学杂志

Objective:To study the mesiodistal teeth size and the relationship between upper and lower teeth dimension of normal occlusion from Han Chinese in Xi'an. Methods: 52 males and 55 females with normal occlusion were selected. The mesiodistal width of each tooth was measured using a vernier gauge caliper. Statistical analysis was performed. Results: For the 107 cases with normal occlusion, the mean and standard deviation of the teeth size were calculated. There were significant differences between males and females in maxillary incisors, canines, first molar and mandibular canines, premolars. The normal range was obtained for the anterior and overall tooth size ratio(anterior ratio:78.32?3.01 overall ratio:91.10?2.27); and the regression equation that was used to quantify the tooth size discrepancies was expressed according to the significant correlation between the upper and lower tooth (r anterior=0.754, rtotal=0.851). Conclusion: There is a relationship between upper and lower teeth dimension. Sex difference should be considered when tooth size was used in clinic.