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VOLUME 14 , ISSUE 12 ( December, 2023 ) > List of Articles


Tooth Size Discrepancy in Prospective Orthodontic Patients

Aparna Mohan Anitha, Mala Ram Manohar

Keywords : Bolton's ratio, Mandibular anterior excess, Tooth size discrepancy

Citation Information : Anitha AM, Manohar MR. Tooth Size Discrepancy in Prospective Orthodontic Patients. World J Dent 2023; 14 (12):1070-1074.

DOI: 10.5005/jp-journals-10015-2351

License: CC BY-NC 4.0

Published Online: 31-01-2024

Copyright Statement:  Copyright © 2023; The Author(s).


Aim: The present study was designed to investigate the anterior and overall tooth size discrepancy in patients seeking orthodontic treatment irrespective of the malocclusion in the South Trivandrum population. Materials and methods: Good quality study models of both maxillary and mandibular arch of 55 subjects from the age of 13–30 years were selected randomly irrespective of malocclusion. A digital Vernier caliper was used to measure the mesiodistal tooth width. Bolton's anterior ratio and overall ratio were determined. Results: For the present study descriptive statistical analysis is being used. A clinically significant anterior discrepancy was found in only one-third, while the overall discrepancy was encountered in almost two-thirds of our sample. 69.1 and 32.7% of the sample had higher anterior and overall ratios, respectively compared to Bolton's ratio indicating larger mandibular tooth size. Conclusion: Mandibular anterior excess was found in more than double the subjects with maxillary excess. Clinicians should be aware of this discrepancy that may influence orthodontic treatment goals and outcomes substantially. Thus, the Bolton tooth-size index must be a primordial tool in the quotidian orthodontic diagnosis process and treatment planning. Clinical significance: Orthodontic treatment may vary from patient to patient but once we reach the finishing stage, it's almost similar in most of the cases. In pursuit of achieving an ideal and optimal occlusion, the orthodontic community has always looked to the six keys of normal occlusion laid down by Andrews. Unfortunately, tooth size imbalances were not critically looked at by Andrews prompting McLaughlin and Bennett to include a seventh key to address the issue of tooth size imbalances.

  1. Turtinen H, Sarja M, Hyvärinen J, et al. Associations between Bolton ratio and overjet deviations in a Finnish adult population. Acta Odontol Scand 2021;79(8):593–599. DOI: 10.1080/00016357.2021.1918348
  2. Hashim H, Al-Sayed N, Al-Hussain H. Bolton tooth size ratio among Qatari population sample: an odontometric study. J Orthod Sci 2017;6(1):22–27. DOI: 10.4103/2278-0203.197395
  3. Mollabashi V, Soltani MK, Moslemian N, et al. Comparison of Bolton ratio in normal occlusion and different malocclusion groups in Iranian population. Int Orthod 2019;17(1):143–150. DOI: 10.1016/j.ortho.2019.01.005
  4. Andrews LF. The six keys to normal occlusion. Am J Orthod 1972;62(3):296–309. DOI: 10.1016/s0002-9416(72)90268-0
  5. McLaughlin, Richard P, John C, et al. Systemized orthodontic treatment mechanics. Edinburgh: Mosby, 2002.
  6. Bolton W. Disharmony in tooth size and its relation to the analysis and treatment of malocclusion. Angle Orthod 1958;28:115–130. DOI: 10.1043/0003-3219(1958)028<0113:DITSAI>2.0.CO;2
  7. Bolton W. The clinical application of a tooth-size analysis. Am J Orthod 1962;48:504–528. DOI: 10.1016/0002-9416%2862%2990129-X
  8. Araujo E, Souki M. Bolton anterior tooth size discrepancies among different malocclusion groups. Angle Orthod 2003;73(3):307–313. DOI: 10.1043/0003-3219(2003)073<0307:BATSDA>2.0.CO;2
  9. Freeman JE, Maskeroni AJ, Lorton L. Frequency of Bolton tooth-size discrepancies among orthodontic patients. Am J Orthod Dentofacial Orthop 1996;110(1):24–27. DOI: 10.1016/s0889-5406(96)70083-5
  10. Saatci P, Yukay F. The effect of premolar extractions on tooth size discrepancy. Am J Orthod Dentofac Orthop 1997;111(4):428–434. DOI: 10.1016/s0889-5406(97)80025-x
  11. NEFF CW. Tailored occlusion with the anterior coefficient. Am J Orthod 1949;35(4):309–313. DOI: 10.1016/0002-9416(49)90045-7
  12. Bernabe E, Major PW, Flores-Mir C. Tooth-width ratio discrepancies in a sample of Peruvian adolescents. Am J Orthod Dentofacial Orthop 2004;125:361–365. DOI: 10.1016/j.ajodo.2003.04.008
  13. Machado V, Botelho J, Mascarenhas P, et al. A systematic review and meta-analysis on Bolton's ratios: normal occlusion and malocclusion. J Orthod 2020;47(1):7–29. DOI: 10.1177/1465312519886322
  14. Crosby DR, Alexander CG. The occurrence of tooth size discrepancies among different malocclusion groups. Am J Orthodont Dentofac Orthop 1989;95(6):457–461. DOI: 10.1016/0889-5406(89)90408-3
  15. Othman SA, Harradine NWT. Tooth size discrepancies in an orthodontic population. Angle Orthodontist 2007;77(4):668–674. DOI: 10.2319/031406-102
  16. Kundi U, Bashir U, Zahid S Bolton. Tooth size analysis of Pakistanis of 13 to 20 years in Islamabad City. Pak Oral Dental J 2012;32(3):421–426. Corpus ID: 74739777
  17. Maamar E, Bukhari SAA, Hakami R, et al. Frequency of Bolton tooth-size discrepancy among Saudi orthodontic subjects and relevance in concordance with gender predilection. World J Dent 2019;10:23–28. DOI: 10.5005/jp-journals-10015-1597
  18. Proffit WR. Contemporary Orthodontics, 6th edition. St Louis: Mosby-Year Book 2018;568–570.
  19. Abdalla Hashim AA, Eldin AH, Hashim HA. Bolton tooth size ratio among Sudanese Population sample: a preliminary study. J Orthod Sci 2015;4(3):77–82. DOI: 10.4103/2278-0203.160240
  20. Roopesh R, Manoj KM, Sidharthan B, Manjusha KK. Evaluation of Prevalence and Severity of Malocclusion in South Travancore Population. J Int Oral Health 2015;7(7):94–97. PMID: 26229379.
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