CHANGES IN THE FORM AND DIMENSIONS OF DENTAL ARCHES RESULTING FROM ORTHODONTIC TREATMENT

D.A.Acharya

Abstract
Modern orthodontic practice consists of bold attempt to alter the abnormal pattern of dental arches & their malocclusion towards a more normal or ideal pattern by bringing about changes in the teeth positions and dental arches, the bones,the T.M.J, the muscle pattern,functions and aesthetic facial proportions. Very controversial opinions have been expressed and substantiated by clinical data regarding dimentional changes brought about by orthodontic treatment and their stability. n view of above controversies prevailing, the present investigation undertaken to study the changes brought about in the arch width, arch length, overbite and overjet at termination of orthodontic treatment and their stability during and after retention.

Introduction
Modern orthodontic practice consists of bold attempt to alter the abnormal pattern of dental arches & their malocclusion towards a more normal or ideal pattern by bringing about changes in th teeth positions and dental arches,the bones,the T.M.J, the muscle pattern,functions and aesthetic facial proportions. Very controversial opinions have been expressed and substantiated by clinical data regarding dimentional changes brought about by orthodontic treatment and their stability In view of above controversies prevailing,the present investigation undertaken to study the

changes brought aboutin the arch width,arch length,overbite and overjet at termination of orthodontic treatment and their stability during and after retention The cases were selected where first premolars were required to be extracted and were treated with begg light wire technique

Materials and Method

The materials collected for present study consisted of plaster models of dental arches of 67males and females between he age group 15 to 25 years who had undergone orthodontic treatment for correction of malocclusion by begg light wire technique.41 cases were collected from dept of orthodontics,Govt. dental college and hospital Mumbai,treated by post-grad students and 26 cases were collected from the records of private orthodontic practioners.All cases had undergone extraction of 1st bicuspids.The cases were selected at random

Professor.Dept Of Orthodontics Dr D.Y.Patil Dental College and Hospital,Nerul, Navi Mumbai

Scientific Journal

Vol .I - 2007

Form And Dimensions Of Dental Arches...D.A.Acharya

irrespective of age and sex. The collected sample was divided into 2 groups a) Complete data cases b) Partial data cases Both samples were compared with each other to find whether any difference exists between two samples The first sample was termed complete data cases which included & cases in whom observation were made on plaster models obtained before treatment and compared with the models obtained at time of debonding and 6 months after withdrawl of retention appliancesA serial longitudinal sample.Altough the sample is small,the findings indicate the amount of movement to be expected under similar conditions. The partial data cases samples were observed on 3 different groups of 20 cases each namely Before treatment- At the time of debonding Before treatment-during retention Beforetratment-after retention No attempt was made toselect cases on the basis of this 3 stages were compared with corresponding measurement obtained prior to treatment The measurement were taken on models by means of a) A standard mm flexible rule b) A pair of fine pointed divider c) Brass ligature wire of0.010 Cuspid to cuspid arch width was measured for maxillary arch by placing the points of divider on incisal tips of central labial lobe of each canine transevere distance in mm was recorded.similarly 2nd bicuspid measurement was taken by placing the divider on buccal cusp tips.for 1st molars central pit of central fossa wewe used to record the intermolar width due the frequent rotation of these teeth. 1st permanent molar to central incisor both right and left measurements were obtained by using the divider on mesio-buccal surface of molar and tip of contact point of the central incisor on the same side of the arch molar to molar measurement was measured according to a nance by using a brass ligature

The arch measurement (width and length) As given above were duplicated for mandibular arch width in molar area which was taken from summit of mesio-buccal cusp of 1stmolar to the respective mates, since the rotation of lower molars is not as frequent as the upper molars The overbite and overjet measurement were obtained as usual All the above measurements were recorded on the chart.symmetery was determined by direct observation. Relapse tendancies were determined after comparison with pre treatment models with that after removal of retention appliances. The result obtained by treatment was classified as GOODfair or poor

Findings and Statistical Analysis

(To show all representations) photographs and graphic

All the cases were studied for 8 different observations such as 1)arch width from canine to canine 2)arch width from from second bicuspid to second bicuspid 3)arch width from 1st molar to 1st molar 4)arch length on right side from 1st molar to contact point of incisors 5)arch length on left side and right side from 1st molar to incisor 6)arch perimeter from molar to molar 7)overjet 8)overbite

The mean differences of all the above measurements were calculated for comparing the changes occurring in the dental arches due to orthodontic treatment and were tabulated statistical analysis was carried out for testing the

Scientific Journal

Vol .I - 2007

Form And Dimensions Of Dental Arches...D.A.Acharya

difference between pretreatment measurements and post treatment measurements of all the case in both the samples.

were also compared for statically significance differences relapse tendencies were recorded.

Conclusion Discussion
The primary concern of the present study was to assess dimentional changes brought About in dental arch width, arch length, arch perimeter, overjet and overbite coincide with orthodontic treatment and their stability after the ample period following removal of retentive devices. All the cases were treated with lightwire tech and correction were achived by four 1st bicuspid extraction 67 males and females between the age group of 15-25 were selected out of which 7 cases were termed complete. Data cases in whom observations were made on plaster Models obtained at the time of debanding and after removal of retentive appliance corresponded to a serial longitudinal sample Remaining 60n cases were termed partial data cases because in this sample observations are made on three diff groups of 2-0 cases each obtained before treatment, immediately after debanding during retention and after retention this sample Corresponded to a mixed longitudinal sample both the samples were collected irrespective of age and sex. The data recorded in the present study provided information concerning the amount of positional changes which was necessary for the establishment of normal occlusion. The findings of the present study show the final amount by which the dental relationship were modified by orthodontic management. These values represent toothy movement brought about by active therapy plus or minus the modification of the new relationship which were occasioned by tooth movements during retention and in that following its removal. Changes occurring immediately after debanding during retention and after retention Relapse or recovery after orthodontic treatment does occur but the findings of present study indicate no significant relapse following orthodontic treatment. The following conclusions were made from present study 1) Increased intercanine width after orthodontic treatment relapse to a certain extent , upper canines show greater tendency to relapse as compared to lower canines. 2) Maxillary bicuspid width showed increase in arch width and lower bicuspid showed narrowing following treatment. 3) Molar width behaved the same way as premolar width. 4) Arch length and perimeter of arch reduced after active treatment and slightly increased after retention. These changes observed after retention are either due to extraction spaces opeing (fig-8) or relapse in rotated teeth. 5) Relapse in overjet and overbite is a reality overbite relapse is comparatively more than overjet. 6) The changes occurring in dental arch dimension immediately debonding during retention and after retention were statically non significant. The finding of present investigation indicate that dental arches can be permanently widened or lengthened. Ultimate position of the teeth is not necessarily the result of orthodontic movement but the muscular functional balance and growth of each particular patient.

Scientific Journal

Vol .I - 2007

Form And Dimensions Of Dental Arches...D.A.Acharya

References
1. Anderson K.T- Experimental findings on mesial relapse of maxillary 1st molar 2. Angle orthodontic Journal 38:51-55 Jan 1968 3. Anderson V- Quoted by Prof.Carl Haupl,W.J.Grossman and Petric Clarkson in the text of functional jaw orthopaedic-By Henry Clinton,London 1952 4. Bishara.S.E, Chaadha.J.M & Potter R.B. -Stability of intercell width in overjet and overbite correction A.M.J Orthodont 63588-595.Jun 1973 5. Black G.V - A computerized geometric analysis of human dental arch form. A.M.J Orthodont 56:164-179 Nov 1969 6. Bredy.E & Jugto.H (Quoted by Karrine,Haaviko & E.Backman.)- The Effect of one or two maxillary premolar extraction on bite and arch dimensions in natural occlusionProf.Finn dent society 69:56-62 year 1973 7. Fischer.B Study of occlusal interference in orthodontically treated occlusal and utreated normal occlusion casesA.M.J orthodont 51:647-689.Sept 1965

8. Grano.d.j-A critical review f clinical cephalometric radiographs. A.M.J orthodont 40:1-26.jan 1954 9. Nance hays.N changes in the form& dimension of dental arches resulting from orthodontic treatment A.M.J Orthodont 23:1-18.Jan 1953 10. Rietan.K An evaluation of retention and relapse following orthodontic therapy A.M.J Orthodont 51:779-781. Oct 1965(editorial) 11. Salzman J.A An evaluation of retention and relapse following orthodontic therapy A.M.J Orthodont 51:779-781. Oct 1965(editorial) 12. Strang R.H.W Factors of associated successful orthodontic treatment A.M.J Orthodont 38:790-800.Oct-1952 13. Wood.G Dental arch depth and width studied longitudinally from 12 years of age to dulthoodA.M.J Orthodont 62:5666.July- 1972

Scientific Journal

Vol .I - 2007