Seminar presentation on

Orthodontic Study Models

By: Dr. Fekadu (Ortho RI)

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 Outline of presentation
• Introduction
• Objectives of ideal orthodontic study models
• Why we make study models?
• Uses of study models
• Parts of the study model
• Study model fabrication and trimming

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 Outline of presentation
• Model analysis
 Pont's analysis
Linder Harth index
 Korkhaus analysis
 Ashley Howe's analysis
 Wayne A. Bolton analysis
 Carey's analysis
 Moyer's mixed dentition analysis
 Tanaka and Johnson analysis
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 Introduction
• Orthodontic study models are essential diagnostic
records, which help to study the occlusion and
dentition from all three dimensions.
• They are accurate plaster reproductions of the teeth
and their surrounding soft tissues.

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 Ideal requirements of orthodontic study
model

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 Why we make study models?
• They are invaluable in planning treatment.
• Occlusion can be visualized from the lingual aspect.
• They provide a permanent record of the intermaxillary
relationships and the occlusion at the start of therapy.
Medicolegal issue.
• Visual aids in monitoring of changes during Rx.
• Help to motivate the patient.
• Act as a reference for post treatment changes.
• In case the patient has to be transferred to another
clinician ….. As a record.
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 Uses of study models
1. Assess and record dental anatomy
2. Assess and record intercuspation
3. Assess and record arch form
4. Assess and record the curves of occlusion
5. Evaluate occlusion with the aid of articulators
6. Measure progress during treatment
7. Calculate total space requirements/discrepancies
8. Provide record before, immediately, after and
several years following treatment for the purpose
of studying treatment procedures and stability.
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 Parts of study models

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 Study model fabrication and trimming
• Preliminary procedures in the fabrication of study
models are:
1. Remove any excess flash or obviously
excessive bulk on the periphery of the models
2. Remove any nodules that may be present on
the occluding surfaces of the teeth
3. Remove any extensions in the posterior
areas that prevent occluding of the models
4. Using the wax bite, occlude the models.
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 Steps in art portion fabrication

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 Steps in art portion fabrication cont..

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 Steps in art portion fabrication cont..

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 Lower

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 Lower

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 Upper

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 Upper

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 Model analysis

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 Different types of model analysis and their
use in specific conditions

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 General Classification of Models

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 Pont’s Analysis

1) Sum of incisors (SI)

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 Pont’s Analysis

2) MPV (1st premolar)

• From the distal end
of the occlusal groove
3) MMV
• the mesial pits on
the occlusal surface

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 Pont’s Analysis

• MMV: distobuccal
cusps of the first
permanent molar

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 Pont’s Analysis
• Calculated premolar value (CPV): The expected arch
width in the premolar region is calculated by the
formula: SI x 100
80
• Calculated molar value (CMV): The expected arch
width in the molar region is calculated by the
formula: SI x 100
64

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 Pont’s Analysis
• If the measured value is less than the calculated value,
then expansion is indicated.
• How much expansion is needed in the premolar and
molar region is determined by CPV – MPV and CMV –
MMV, respectively.
• Pont's index gives an approximate indication of the
degree of narrowness of the dental arches in a case of
malocclusion and also the amount of lateral expansion
required for the arch to be of sufficient size to
accommodate the teeth in perfect alignment.

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 Drawback of Pont's Analysis
1. Maxillary laterals are the teeth most commonly
missing from the oral cavity.
2. Maxillary laterals may undergo morphogenetic
alteration like 'peg' shaped lateral.
3. This analysis is derived solely from the casts
of the French population.
4. It does not take skeletal malrelationships into
consideration.
5. It does not account for the relationship
of the teeth to the supporting bone.
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 Cont…
• It should always be remembered that the patient's
original mandibular and maxillary arch form should
be considered as the ultimate guide for arch width
rather than the values arrived at by using the Pont's
index.

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 Linder Harth index
• Linder Harth index is a modification of Pont’s analysis where
the formula for calculated premolar value is modified.
• However, the formula for calculated molar value is not
changed.
• The calculated premolar value is determined using
the formula: SI x 100
85
• The calculated molar value is determined using the
formula: SI x 100
64

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 Korkhaus Analysis
• use of the Linder Harth's formula to determine the
ideal arch width in the premolar and molar region.
• An additional measurement is made from the
midpoint of the inter-premolar line to a point in
between the two maxillary incisors.
• According to Korkhaus, for a given width of upper
incisors a specific value of the distance between the
midpoint of interpremolar line to the point between
the two maxillary incisors should exist.

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 Korkhaus Analysis

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 Korkhaus Analysis
• In case of proclined upper anteriors, an increase in
this measurement is seen while a decrease in this
value denotes retroclined upper anteriors.
• For the values noted the mandibular value (LI) should
be equal to the maxillary value (Lu) in millimeters
minus 2 mm

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 Ashley Howe’s analysis
• Ashley Howe considered tooth crowding to be
due to deficiency in arch width rather than
arch length.
• He found a relationship between the total
width of the mesiodistal diameters of teeth
anterior to the second permanent molars and
the width of the dental arch in the first
premolar region.

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 Procedure

Total tooth material

(TTM) Refers to the sum
of the mesiodistal width
of the teeth from first
molar to first molar

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 procedure
BAL (basal arch length):
It is perpendicular distan-
ce from the tangent drawn
on distal aspect of 1st perma-
nent molar to the anterior
limit of the arch.

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 Procedure
Premolar diameter (PMD)
Is the arch width
measured at the top of
the buccal cusp tip of
the first premolar.

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 procedure
Premolar basal arch width (PMBAW): measurement of
width from canine fossa of one side to another gives us the
width of the dental arch at the apical base or junction
between the bone and alveolar process.
 Following measures have to be obtained
• % of PMD to TTM= PMDx100
TTM
• % of PMBAW to TTM= PMBAWx100
TTM
• % of BAL to TTM= BALx100/TTM
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 Inference
• If PMBAW > PMD: indication that basal arch is sufficient to allow
expansion of premolars.
• If PMD > PMBAW: can be three possibilities
1. Contraindicated for expansion
2. Move teeth distally
3. Extract some teeth
• If PMBAWx100/TTM
1. Less than 37%..... require extraction
2. If 44% an ideal case…… extraction not require
3. If between 37-44% (border line case)…..may or may not require
extraction

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 Wayne A. Bolton analysis
• Bolton pointed out that the extraction of one tooth or
several teeth should be done according to the ratio of
tooth material between the maxillary and mandibular
arch, to get ideal interdigitation, overjet, overbite and
alignment of teeth.
• To attain an optimum inter-arch dental relationship, the
maxillary tooth material should approximate desirable
ratios, as compared to the mandibular tooth material.
• Bolton's analysis helps to determine the disproportion
between the size of the maxillary and mandibular teeth.

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 Procedure for doing Bolton Analysis
• The sum of the mesiodistal diameter of the 12
maxillary teeth and the sum of the mesiodistal
diameter of the 12 mandibular teeth are determined.

• In the same manner, the sum of 6 maxillary anterior

teeth and the sum of 6 mandibular anterior teeth
from canine to canine is determined.

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 Procedure cont…

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 Inference
• Overall ratio = sum of mand. 12 x 100
sum of max. 12
Mean = 91.3% plus or minus 1.91
• If the overall ratio is greater than 91.3%, then the
mandibular tooth material is excessive.
• The amount of mandibular tooth material excess is
calculated by using the formula:

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 Inference
• If the overall ratio is less than 91.3 percent,
then the maxillary tooth material is excessive.
• The amount of maxillary tooth material excess
is calculated by using the formula:

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 Inference
• Anterior ratio= sum of mand. 6 x 100
sum of max. 6
Mean = 77.2% plus or minus 1.65
• If the anterior ratio is greater than 77.2 percent, then
the mandibular anterior tooth material is excessive.
• The amount of mandibular tooth material excess is
calculated by using the formula:

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 Inference
• If the anterior ratio is less than 77.2 percent, then
the maxillary anterior tooth material is excessive.
• The amount of maxillary tooth material excess is
calculated by using the formula:

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 Bolton’s TSD Management
• Disharmony b/w the width of upper and lower
teeth can be improved by:
1. Extraction
2. Interproximal stripping
3. Expansion procedures, depending on cortical
plate thickness and age
4. In some case by increasing the mesiodistal
tooth size of the disproportionate tooth
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 Bolton’s TSD Management cont…
• Bolton advocated the reduction of tooth material in
the anterior region if the anterior ratio shows an
excess of tooth material.
• He prefers to do proximal stripping on the upper arch
if the upper anterior tooth material is excess and
• extraction of a lower incisor, if necessary, to reduce
tooth material in the lower arch.

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 Tooth Size Relationships standard table
(Bolton’s)

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• After calculation of Bolton ratio, the arch with
relatively smaller tooth material is determined and
the actual figure corresponding to the arch tooth size
is located in the table.
• The ideal value for the size of opposing teeth is read
off from the accompanying column.
• The difference b/w the actual and ideal value
(according to the table) for the relatively enlarged
tooth material represents in mm the amount of
excess tooth in the arch.
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 Drawbacks of the Analysis
1. This study was done on a specific population
and the ratios obtained need not be applicable
to other population groups.
2. Bolton analysis doesn't take into account the
sexual dimorphism in the maxillary canine
widths.

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 Clinical manifestations of Bolton’s
discrepancy

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 Clinical manifestations of Bolton’s
discrepancy cont…

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 Carey’s analysis
• The arch length- tooth material discrepancy is the
main cause for most malocclusions.
• This analysis is usually done in the lower arch.
• The same analysis when carried out in the upper arch
is called as arch perimeter analysis.
Methodology
Determination of arch length: The arch length is
measured anterior to the first permanent molar
using a soft brass wire.
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 Methodology cont…
• The wire is placed touching the mesial aspect of lower
first permanent molar, then passed along the buccal cusps
of premolars, incisal edges of the anteriors and finally
continued the same way up to the mesial of the first
molar of the contralateral side.
• The wire should be passed along the cingulum of anterior
teeth if anteriors are proclined and along the labial
surface if anteriors are retroclined.
• The mesiodistal width of teeth anterior to the first molars
are measured and summed up as the Total tooth material.

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 Methodology cont…
• The difference between the
arch length and the
actual measured tooth
material gives the
discrepancy.

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 Interpretation
• The amount of discrepancy between arch length and
tooth material is calculated.
If the arch length discrepancy is
• 0 to 2.5 mm-Proximal stripping can be carried
out to reduce the minimal tooth material excess.
• 2.5 to 5 mm-Extraction of 2nd premolar is indicated
• Greater than 5 mm-Extraction of first premolar
is usually required.

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 Mixed dentition analysis
• The purpose of a mixed dentition analysis is to
• evaluate the amount of space available in the arch for
succeeding permanent teeth and necessary occlusal
adjustments.
• Two methods have been suggested
1. Those in which the sizes of the unerupted cuspids
and premolars are estimated from measurements
of the radiographic image, and
2. Those in which the sizes of the cuspids and premolars
are derived from knowledge of the sizes of
permanent teeth already erupted in the mouth.

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 Mixed dentition analysis cont..
• The correlation between the sizes of the mandibular incisors
and the combined sizes of cuspids and bicuspids in either
arch is high enough to predict the amount of space required
for the unerupted teeth during space management
procedures.
• The mandibular incisors have been chosen for measuring,
since they erupt into the mouth early in the mixed dentition.
• The maxillary incisors are not used in any of the predictive
procedures, since they show too much variability in size, and
their correlations with other groups of teeth are of lower
predictive value.

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 Moyer’s Analysis
• According to Moyer high correlation exists among the
size of different groups teeth in an individual,
• thus by measuring one group of teeth, it is possible to
make prediction of the other group of teeth.
Procedure in mandibular arch:
 Measure the mesiodistal width of the four mandibular
four incisors
 Measure the space left from the distal aspect of lateral
incisor to mesial aspect of 1st permanent molar

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 Moyer’s Analysis
 By using moyer’s chart, find out the mesiodistal with
of cuspid and bicuspids for the given some of
mesiodistal with of incisor.
 Compare the space available and space required to
determine the arch length discrepancy.

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 Moyer’s Analysis
Procedure in maxillary arch:
The procedure is similar to that for the lower arch, with two
exceptions
1. A different probability chart is used for
predicting the upper cuspid and bicuspid sum.

2. Allowance must be made for overjet correction when

measuring the space to be occupied by the aligned incisors.

Remember that the width of the lower incisors is used to predict

upper cuspid and bicuspid widths

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 Upper Probability Chart

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 Lower Probability chart

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 Tanaka and Johnson Analysis
they have simplified Moyers 75 percent
level of the prediction table into a formula

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 Radiographic method

• This technique makes use of radiographs, as well as

study cast model to determine the width of the
unerupted teeth.
• Radiographic measurement of an unerupted tooth
may not be precise because of distortion and thus is
unreliable.
• However, it is possible to predict the width of
unerupted tooth by comparing the measurement of
an already erupted permanent tooth on the cast as
well as on the radiograph.
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 Radiographic method

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 Reference
• Gurkeerat 2nd edition
• Basavaraj 2nd edition

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