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**Study casts are the essential diagnostic aids.
**

They provide a 3-D view of the maxillary and mandibular dental arches

**What is Study Cast Analysis ?
**

Involves the study of maxillary and mandibular dental arches in all the three planes of space

Valuable tool in orthodontic diagnosis and

treatment planning

Sometimes the space available is not similar to the space required for the alignment of the teeth.Proper alignment of the teeth requires harmony between the tooth sizes and the space required within the dental arch. .

then the arch is crowded If the space available is more than space required . then the arch is well aligned If the space available is less than space required . then the arch is spaced Spaced dentition .Space available = the length of the arch Space required = the total of the mesio distal width of teeth If space available = space required .

.It is thus important for the clinician to determine prior to the onset of the orthodontic treatment the space requirements necessary for favorable results. To accomplish this. a space (study cast) analysis must be done.

ARCH LENGTH = ARCH PERIMETER = ARCH CIRCUMFERENCE S2 S3 S4 2. MESIO-DISTAL WIDTH OF TEETH S1 Arch length = S1 +S2 + S3 +S4 OR Length of the brass wire .Measurements: 1.

ARCH WIDTH Inter premolar width Inter molar width .3.

Bolton Tooth Size Analysis (Ratio) . Ashley Howe s Analysis 4.Permanent Dentition study cast analysis . Carey s Analysis / Arch Perimeter Analysis 1 2. Pont s Analysis 3.

CAREY S ANALYSIS This analysis helps to determine the extent of the space discrepancy. It is performed on the lower cast. Same analysis on the upper cast is called Arch Perimeter Analysis. Space analysis requires a comparison between the amount of space available for the alignment of the teeth and the amount of space required to align them properly .

over the contact points of posterior teeth and incisal edge of anteriors. S2 S1 S3 S4 . There are two basic ways to accomplish this manually: (1) by dividing the dental arch into segments that can be measured as straight line approximations of the arch or (2) by contouring a piece of wire to the line of occlusion and then straightening it out for measurement.STEP 1: Calculation of Space Available This is accomplished by measuring arch perimeter from the mesial of one first molar to the other.

I f available space is larger than the space required (excess space). there is an arch perimeter space deficiency and crowding would occur. If the sum of the widths of the permanent teeth is greater than the amount of space available. gaps between some teeth would be expected. negative discrepancy SPACE REQUIRED LESSER THEN SPACE AVAILABLE = SPACING (in mm) . SPACE REQUIRED GREATER THEN SPACE AVAILABLE = CROWDING (in mm).STEP 2: calculate the amount of space required The mesio-distal width of the teeth anterior to the first molars (second premolar to second premolar) is measured and summed up.

Any of the following methods will have to be adopted if there is a negative discrepancy between arch length and tooth material. whether positive (spacing) or negative (crowding)...e.discrepancy more than 5 mm.. a) Proximal stripping««.The type of discrepancy is noted. .5mm b) Extraction of second premolars.discrepancy up to 2. discrepancy between 2.5mm & 5 mm c) Extraction of first premolars .... i.

Example: .

BOLTON S ANALYSIS Malocclusions occur as a result of abnormalities in tooth size There exists a ratio between the mesio-distal widths of maxillary and mandibular teeth The Bolton s analysis helps in determining disproportion in size Between maxillary and mandibular teeth. .

Add the mesio-distal widths of the mandibular incisors. premolars and the first permanent molars = maxillary tooth size. canines. canines.Bolton Tooth Size Analysis (Ratio) Overall ratio: Add the mesio-distal width of the maxillary incisors. premolars and the first permanent molars = mandibular tooth size. Overall ratio= Mandibular 12 X100 Maxillary 12 The mean value is 91.3% .

3 100 If the calculated overall ratio is smaller than the mean value than it implies that the maxillary tooth size is in excess compared to the mandibular tooth size.3 100 i. Sum of mandibular 12 .3 %) It indicates that the mandibular tooth size is in excess To find the mandibular excess. subtract the correct maxillary tooth size (X) from the calculated maxillary tooth size.e. To find the maxillary excess.3 .If the calculated overall ratio is greater than the mean value (91.sum of maxillary 12 X 91. where X = Mandibular tooth size X 100 91. subtract the correct mandibular tooth size (X) from the calculated mandibular tooth size Where X = sum of maxillary 12 X 91.

2% Inference : If the discrepancy value exceeds 2mm (overall or anterior) suitable measures should be adopted to correct the discrepancy. The calculations are done in the same manner as in the overall ratio. are taken into account.Anterior ratio: The mesio-distal width of the maxillary and mandibular incisors and canines. The mean value for the anterior ratio is 77. .

Conclusion: If the measured arch width is less than calculated width then the arch is narrow and needs expansion. for a given mesio-distal width of the upper incisors. in the premolar and molar region using the' formula SI X 100/80 and SI X 100/64 for the premolar and molar regions respectively. The arch width is calculated.. sum of the above = SI c... Measure the mesio-distal width of the upper central and lateral incisors. f.e. the width from the distal pit of the first premolar to the same point on the otherside d. the width from the mesial pit of the first permanent molar of one side to the other. . Measure the width of the arch in the region of the first premolar i. b. e.PONT S ANALYSIS Determines whether the dental arch is narrow or normal Method: a. The measured and calculated widths are compared. . Measure the width of the arch in the molar region i.e.

Mixed Dentition space Analysis To evaluate the amount of space available in the arch for the erupting permanent canines and premolars Mixed Dentition .

The Moyer s analysis predicts the combined mesio-distal width of 3.4. and 5 based on the Sum of the widths of the four lower permanent incisors .MOYER S MIXED DENTITION ANALYSIS In this analysis size of the cuspids and premolars are derived from the knowledge of the size of permanent teeth already erupted in the mouth. The lower incisors are measured to predict the size of upper as well as lower posterior teeth.

.

.

Tanaka and Johnston prediction values .

Measurement from Radiograph .

Since the major problem with using radiographic images comes in evaluating the canine teeth. it would seem reasonable to use the size of permanent incisors measured from the casts and the size of unerupted premolars measured from the periapical films to predict the size of unerupted canines.HIXON AND OLDFATHER PREDICTION This method of prediction uses both the radiographs and prediction tables. .

the predicted size of the unerupted canines and premolars are found against the measured value. . This method is restricted to the mandible.From the prediction table.

6 22.4 19.0 19.measured value size 23 24 25 26 27 28 29 30 Estimated tooth 18.0 21.7 20.9 .3 21.3 22.

.

Graph showing relationship between size of lower incisors measured from cast plus lower first and second premolars measured from radiographs (x-axis) and size of canine plus premolars (y-axis) .

Digital Cast Analysis .

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