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MODEL ANALYSIS

CONTENTS
• INTRODUCTION
• PERMANENT DENTITION ANALYSIS
• Pont’s analysis
• Linder Harth analysis
• Korkhaus analysis
• Carey’s Analysis
• Bolton’s
• Ashley Howe’s analysis
• Peck and peck analysis

• MIXED DENTITION ANALYSIS


• Moyer’s Mixed dentition analysis
• Tanaka and Johnston analysis
• Nance mixed dentition analysis
• Huckaba’s mixed dentition analysis (Radiographic method)
• Hixon and oldfather/stanley kerber


INTRODUCTION

• Study cast analysis is a 3D assessment of the


maxillary and mandibular dental arches and the
occlusal relationship.

Orthodontic Diagnosis - I. Jonas, T.M. Graber, T. Rakosi


• The first step in assessing study models involves
an assessment of the symmetry.

• Grids and occlusograms are placed over the


occlusal arches of models to determine the exact
location and amount of asymmetry in the arch.

Orthodontic : diagnosis & management of


malocclusion and dentofacial deformities -
O.P.KHARBANDA
ruled grid over the dental cast
• After that, the characteristics of dentition, their
number, mesiodistal width, rotations, crowding,
ectopic positions, or the presence of
supernumeraries are assessed .

• In association with anteroposterior movements


of the dentition, will determine the requirements
for extraction if any or otherwise non-extraction
treatment plan.
Orthodontic : diagnosis & management of
malocclusion and dentofacial deformities -
O.P.KHARBANDA
CLASSIFICATION
TOOTH SIZE-ARCH WIDTH DISCREPANCY
• PONT’S ANALYSIS.
• LINDERHARTH ANALYSIS
• KORKHAUS ANALYSIS
• ASHLEY–HOWE ANALYSIS

UPPER/LOWER TOOTH SIZE DISHARMONY


• BOLTON’S TOOTH RATIO ANALYSIS
TOOTH SIZE-ARCH LENGTH DISCREPENCY

• ARCH-PERIMETER ANALYSIS

• NANCE-CAREY’S ANALYSIS

TOOTH-SHAPE DISHARMONY

• PECK & PECK INDEX.


PERMANENT DENTITION MODEL ANALYSIS

• Pont’s analysis
• Linder Harth analysis
• Korkhaus analysis
• Carey’s Analysis
• Bolton’s Analysis
• Ashley Howe’s analysis
• Peck and peck analysis
MIXED DENTITION MODEL ANALYSIS

• Moyer’s Mixed dentition analysis


• Tanaka and Johnston analysis
• Nance mixed dentition analysis
• Huckaba’s mixed dentition analysis
(Radiographic method)
• Hixon and oldfather/stanley kerber
Pont’s Analysis
• In 1909, Pont devised a method of
predetermining an “ideal” arch width based on
the mesio-distal widths of the crowns of the
maxillary incisors.

• Pont suggested that the ratio of combined


incisor to arch width ( as measured from the
center of the occlusal surface of the teeth) was
ideally 0.80 in the bicuspid area and 0.64 in the
first molar area. A clinical evaluation. Angle, Orthod ; 1970 .
• Pont also suggested that the maxillary arch be
expanded 1 to 2 mm more during treatment
than his ideal to allow for relapse.

• Pont’s analysis helps in ,


a) Determining whether dental arch is narrow or
is normal.
b) Determining the need for lateral arch
expansion.
c) Determining how much expansion is possible
at the premolar and molar regions.
• Determination of sum of incisors (S.I)

• Determination of measured
premolar value (M.P.V)

• Determination of measured
molar value (M.M.V)

Orthodontic Diagnosis - I. Jonas, T.M. Graber, T. Rakosi


• Determination of
calculated premolar
value (C.P.V)

• Determination of
calculated molar value
(C.M.V)
Inference
• If measured value is less than the calculated
value, then arch is narrow for the sum incisors
width and needs expansion.

• If measured value is greater than the calculated


value, then the arch is wider and there is no
scope for the expansion.
Drawbacks
• Analysis is based on study of French population
and hence, its universal validity is questionable.

• Maxillary laterals are the most commonly


missing and malformed teeth (i.e.Peg shaped).

• Does not consider skeletal mal-relationships and


relationship of teeth to the supporting bone.

Textbook of orthodontics- Gurkeerat Singh 2 nd edition


Re–assessment of Pont’s index in
Class I normal occlusion

• Pont had proposed an index in 1909 to estimate


maxillary arch width depending upon the sum of
maxillary incisors mesiodistal dimensions.

• The present study tried to investigate the


reliability of Pont's index in estimating dental
arch width.

Al–Sarraf HA, Abdul–Mawjood AA, Al–Saygh NM. Re–assessment of Pont’s index in Class I normal occlusion. Al–Rafidain Dent
J. 2006; 6(1): 1-5.
CONCLUSION
• The findings of the present study revealed that
the use of Pont' s index for estimation of
maxillary dental arch width is not so reliable and
can not be considered to be of great clinical value
in diagnosis and treatment planning
considerations.
Linder Harth analysis
• Similar to Pont's analysis.
• A variation was made in the formula to
determine the calculated premolar and molar
value.

 Calculated premolar value : S.I X 100 (Where S.I is sum of


85 mesio distal widths of incisors)
 Calculated molar value : S.I X 100
64

Textbook of orthodontics- Gurkeerat Singh 2 nd edition


Korkhaus Analysis
• Similar to Pont’s analysis.

• Only difference is that it make use of Linder


Harth’s formula to determine the ideal width
in the premolar & molar regions.

• The measurement should reveal the


anteroposterior malpositioning of the anterior
teeth
Orthodontic Diagnosis - I. Jonas, T.M. Graber, T. Rakosi
The anterior arch length
according to Korkhaus (Lu
in the maxilla, LL in the
mandible) is defined as the
perpendicular from the
most anterior labial surface
of the central incisors to
the connecting line of the
reference points of the
anterior arch width.

Orthodontic Diagnosis - I. Jonas, T.M. Graber, T. Rakosi


Inference
• This analysis tells about the arch width.

• In case of proclined upper anteriors, an increase


in this measurement is seen .

• A decrease in this value denotes retroclined


upper anteriors.

Textbook of orthodontics- Gurkeerat Singh 2 nd edition


• For the values noted the mandibular value (Ll)
should be equal to the maxillary value (Lu) in
millimeters minus 2mm.

LL(mm) = Lu(mm)-2 mm

Orthodontic Diagnosis - I. Jonas, T.M. Graber, T. Rakosi


Carey’s analysis
• The discrepancy between the arch length and the
tooth material is a common cause of
malocclusion.

• Carey’s analysis helps in determining the extent


of this discrepancy.

• 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.
Orthodontic : diagnosis & management of
malocclusion and dentofacial deformities -
O.P.KHARBANDA
Determination of arch length.

• By contouring a piece
of brass wire touching
the mesial surface of
first molars, passed
over the buccal cusp of
premolars and along
the incisors from one
side to the other .

Orthodontic : diagnosis & management of


malocclusion and dentofacial deformities -
O.P.KHARBANDA
• If the anterior teeth are well aligned and not
protrusive, the wire passes over the incisal edge of
anterior.

• In case the incisors are proclined, then the wire is


passed along the cingulum of anterior teeth .

• if the anterior teeth are retroclined, the wire in


the anterior segment passes labial to the teeth.

Orthodontic : diagnosis & management of


malocclusion and dentofacial deformities -
O.P.KHARBANDA
Determination of tooth material
• The tooth material is
determined by sum of the
mesiodistal width of the
teeth anterior to the first
molars (i.e. 2nd
premolars to 2nd
premolars).
Determination of the Discrepancy.
• The discrepancy refers to the difference between
the arch length and total tooth material.

Discrepancy Inference
0-2.5mm proximal stripping
2.5 and 5 mm Extraction of 2nd
premolars.
more than 5 mm Extraction of 1st premolars.
Bolton Analysis (1958)

• The Bolton analysis determines the ratio of the


mesiodistal widths of the maxillary versus the
mandibular teeth (i.e .tooth size discrepancy).

• In the analysis of the overall ratio the


relationship of the 12 mandibular teeth to the 12
maxillary teeth is assessed (second and third
molars are excluded).

Orthodontic Diagnosis - I. Jonas, T.M. Graber, T. Rakosi


• A further analysis is performed to evaluate the
ratio between the six upper and lower anterior
teeth (anterior ratio).

• In normal occlusal relationships and good


incisor position tooth size discrepancies are
often the cause of rotations, space formations,
crowding and incorrect intercuspation.
• Sum of maxillary 12
• Sum of mandibular 12
• Sum of maxillary 6
• Sum of mandibular 6
• Overall ratio
• Anterior ratio
Determination of overall Ratio

Overall Ratio = Sum of mandibular 12 X 100


Sum of maxillary 12

1) If ratio is less than 91.3%, maxillary tooth


material excess.
2) If ratio is more than 91.3%, Mandibular tooth
material excess.
• The amount of mandibular tooth material excess is
calculated by using the formula:

Mandibular overall excess =sum of mand.12 -{sum of max.12 x 91.3}


100

• The amount of maxillary tooth material excess is


calculated by using the formula

Overall maxillary excess = sum of max. 12 –(sum of mand.12 x100)


91.3
Determination of anterior ratio.

Anterior Ratio = Sum of mandibular 6 X 100


Sum of maxillary 6

1) If ratio is less than 77.2%, maxillary anterior


excess.
2) If ratio is more than 77.2%, Mandibular
anterior excess.
• The amount of mandibular tooth material excess
is calculated by using the formula:

Mandibular anterior tooth material excess = sum 0f mand.6- (sum of max 6 X 77.2)
100

• The amount of maxillary tooth material excess is


calculated by using the formula:

Maxillary anterior tooth material excess = sum of max 6 – (sum of mand.6 x lOO)
77.2
Bolton ratio in a North Indian population with different malocclusions

• The objective was to evaluate the Bolton ratio in


a North Indian population in Lucknow with
different malocclusion.

• 110 study cast were taken and Subjects were


divided into three groups: Group I (Angle's Class
I, n = 40), Group II (Angle's Class II, n = 50) and
Group III (Angle's Class III, n = 20)
J Orthod Sci. 2015 Jul-Sep; 4(3): 83–85.
Mean (SD) of tooth size ratios for different malocclusion groups
Results

• Significantly higher mean anterior tooth ratios


were found for Group II (Angle's Class II)
patients .

• All other ratios were within close range of


Bolton's norms.
Howes' Analysis
• Relationships of Tooth Size to Size of Supporting
Structures.

• He considered tooth crowding to be due to


deficiency in arch width rather than arch length.

Handbook of orthodontics – Robert E.Moyers


Procrdure
• Total Tooth material (TM) :

The sum of the mesiodistal width


of the teeth from first molar to first
molar (inclusive of the first molars)
• Basal arch length (BAL)

Basal arch length is measured at the midline from


the estimated anterior limits of the apical base to a
perpendicular that is tangent to the distal surfaces
of the two first molars.
• Premolar diameter
(PMD) : the arch width
measured at the top of the
buccal cusps of the first
premolars.

• Premolar basal arch


width (PMBAW) : By
measuring the diameter of
the apical base from canine
fossa on one side to the
canine fossa on the other
side.
1. Percentage of premolar diameter to tooth
material is obtained by : PMD x 100
TTM

2. Percentage of premolar basal arch width to


tooth material is obtained by : PMBAW x 100
TTM

3.Percentage of basal arch length to tooth


material is obtained by : BAL x 100
TTM
• Comparison between PMBAW and PMD gives an
idea of the need and the amount of expansion
required

• PMBAW% gives an indication towards an


extraction or non-extraction treatment plan.
Inference
• Howes believed that the premolar basal arch width
(he called it the canine fossa diameter) should
equal approximately 44% of the mesiodistal widths
of the 12 teeth in the maxilla if it is to be
sufficiently large to accommodate all the teeth.

• When the ratio between basal arch width and


tooth material is less than 37%, he considered this
to be a basal arch deficiency necessitating
extraction of premolars.
• If the premolar basal width is greater than the
premolar coronal arch width PMBAW>PMD,
expansion of the premolars may be undertaken
safely.
Advantages
• Howe’s analysis is useful in treatment planning
of problems with suspected apical base
deficiencies and deciding to whether to,
1) Extract teeth,
2) Widen the dental arch, or
3) Expand rapidly the palate.

• Howe’s analysis is applicable to each arch.


Reliability of Ashley Howe’s analysis in
South Indian population
• any index developed for a particular group of
population cannot be applied as such to another
group.

• The main aim of this study is to evaluate the


reliability of Ashley Howe’s analysis on South Indian
population.

• Diagnostics models of 30 dental students and patients


with Angle’s Class 1 malocclusion with crowding or
spacing
Govindaraj, et al January 2019
• Results: The results showed that there is a
significant difference between the values
obtained from the original study of Ashley Howe
and the current study in South Indian
population.

• Conclusion: Ashley Howe’s analysis is not


reliable in South Indian population.
Peck and Peck Index
• Tooth shape (mesio distal and faciolingual) is
determining factor in the presence and absence
of lower incisor crowding.

• Harvey peck and Sheldon Peck present a new


method of detecting and evaluating tooth shape
deviations of the mandibular incisors.

Index for assessing tooth shape deviations


Am. J. Orthod. April 1972
• According to Peck and Peck, persons with ideal
incisal arrangement had smaller mesiodistal
width and comparatively larger faciolingual
width than in persons with incisal crowding.

• On the basis of this observation, Peck and Peck


suggested certain clinical guidelines.
Index = Mesiodistal (MD) crown diameter in mm x 100
Faciolingual (FL) crown diameter in mm

• Mean value for lower


central incisor should
be 88% to 92%.

• Mean value for lower


lateral incisor should
be 90% to 95%.

Index for assessing tooth shape deviations


Am. J. Orthod. April 1972
Inference :

• a) Lower incisors within or below these


ranges are considered favorably
shaped.
b) Lower incisors with MD/FL index above
these ranges considered to have crown
shape deviations contributing to
crowding phenomenon.
• In a given case if the value is more, then authors
recommend Proximal stripping or Tooth
Reproximation.

• Reproximation: Tooth reproximation is a clinical


procedure involving the reduction, anatomic
recontouring, and protection of the mesial
and/or distal enamel surfaces of a permanent
tooth.
MIXED DENTITION ANALYSIS
Analysis of arch length during mixed
dentition
• In some situations, eruption of the permanent incisors
result in marked crowding during mixed dentition as
permanent incisors of children are much larger in
mesiodistal widths .

• Methods of analysis of arch length during mixed


dentition are:

1. Radiographic
2. Non-radiographic
Orthodontic : diagnosis & management of
3. A combination of above. malocclusion and dentofacial deformities -
O.P.KHARBANDA
Radiographic method
HUCKABA’S MIXED DENTITION ANALYSIS
• To analyse the space requirement in mixed
dentition, it is necessary to estimate the size of
unerupted permanent teeth on radiographs and
calculate the space required using study models
Advantage
Disadvantage

• This method is a very easy, • The measurement of tooth size


practical and relatively from the radiograph is not free
accurate method that does not from error due to the inherent
require any prediction tables distortion of the radiographic
and can be used in maxillary image.
and mandibular arches.

Orthodontic : diagnosis & management of


malocclusion and dentofacial deformities -
O.P.KHARBANDA
Non-radiographic method
• By measuring the size of an erupted anterior
tooth, it is possible to predict the size of the
unerupted canine/premolar from the prediction
table.
Moyer’s analysis
• This mixed dentition analysis utilises Moyer’s
prediction tables.

• Prediction is based on the premise that there is a


reasonably good correlation between the size of
erupted permanent incisors and the unerupted
canines and premolars

Orthodontic : diagnosis & management of


malocclusion and dentofacial deformities -
O.P.KHARBANDA
Mandibular Incisor have been chosen because they-
• Erupted early in the mouth.
• Easily measured accurately.

Maxillary Incisors are not chosen because they


have-
• Variability in size and their co-relation with other
group of teeth and have lower predicted value.
Procedure
I. Measure with the tooth-measuring gauge or a
pointed Boley gauge, the greatest mesiodistal
width of each of the four mandibular incisors.

II. Determine the amount of space needed for


alignment of the incisors : Set the Boleys guage to a
value equal to the sum of the widths of the left central &
lateral incisors .
Place one point of the midline of the crest b/w the central incisors & let the other point
lie along the line of the dental arch on the left side.
3. Compute the amount of space available after
incisor alignment.

• Measure the distance from the point marked in the


line of the arch to the mesial surface of the first
permanent molar.
• This distance is the space available for the cuspids &
two bicuspids and for any necessary molar
adjustment after the incisors have been aligned.
• Predict the size of the combined width of the
mandibular cuspids and bicuspids
• Moyer used 75% of probability rather than the
mean of 50% .

• The predicted value is compared with the


available arch length to determine the
discrepancy.
• If the predicted value is greater than the
available arch length, crowding of the teeth can
be expected.

• If the predicted value is lesser than the available


arch length, it will result in the spacing of the
teeth.
Tanaka and Johnston method (1974)

• Tanaka and Johnston developed prediction


tables that were similar to those of Moyer’s.

• the correlation coefficient (r) of Tanaka and


Johnston method were 0.63 for maxillary teeth
and 0.65 for the mandibular teeth

Orthodontic : diagnosis & management of


malocclusion and dentofacial deformities -
O.P.KHARBANDA
Procedure
• Estimated width of the mandibular canine and
premolars in one quadrant is determined by
adding 10.5 mm to the measured value of half of
mesiodistal width of four mandibular incisors.

• Estimated width of the maxillary canine and


premolars in one quadrant is determined by
adding 11 mm to the measured value.

Orthodontic : diagnosis & management of


malocclusion and dentofacial deformities -
O.P.KHARBANDA
• It requires neither radiographs nor reference
tables which makes it very convenient.
Evaluation and Applicability of Tanaka–
Johnston and Moyers’ Mixed Dentition
Analysis for North Indian Population

• A sample of 200 North Indian population


within the age group 12–15 years was randomly
drawn.

Doda A, Saraf BG, Indushekhar KR, et al. Evaluation and Applicability of Tanaka–Johnston and Moyers’ Mixed
Dentition Analysis for North Indian Population. World J Dent 2021;12(1):57–63.
CONCLUSION

• Tanaka–Johnston equations overestimated the


actual widths of the unerupted canine and
premolars in both maxillary and the mandibular
arches and may be therefore less appropriate to
be used in this population from North India for
mixed dentition analysis.
• Moyers’ prediction tables could be used for
mixed dentition analysis in this population but
at different probability levels for males and
females.

• 35th percentile may be appropriate for both


males and females in the mandibular arch.
Combination method
1) Stanley and Kerber method

A revision of Hixon and Oldfather mixed dentition


prediction method (1958) was undertaken by
Stanley and Kerber on the same group of subjects
used initially by Hixon and Oldfather.
• This method requires measurement of the
incisors on models or directly in the mouth and
of mandibular premolars on radiographs.
Procedure
• 1. Measure and add up widths of mandibular
central and lateral incisors on one side.
• 2. Measure the widths of unerupted premolars
from IOPA radiograph of the same side.
• 3. Sum of 1 + 2.
• 4. Use the prediction graph to calculate widths of
unerupted canine and premolars.
• Stanley and Kerber method was comparatively
more accurate than the Hixon and Oldfather
method.

• Oldfather’s measurements were taken on one side


of the arch only, most commonly the left side,
whereas measurements were taken on both sides
of the arch for the Stanley and Kerber method.

• Hixon and Oldfather used a Boley gauge that read


to the nearest 0.1 mm, whereas Helios dial
calipers reading to the nearest 0.05 mm were
used in the Staley and Kerber method.
Orthodontic : diagnosis & management of
malocclusion and dentofacial deformities -
O.P.KHARBANDA
Nance’s analysis
• This analysis takes into account the reduction in
arch length which is consequent to the mesial
migration of the permanent first molars
occurring after the loss of deciduous second
molars.

Orthodontic : diagnosis & management of


malocclusion and dentofacial deformities -
O.P.KHARBANDA
Procedure
1. The actual width of four mandibular incisors is
measured on the cast.
2. The width of the unerupted canine &
premolars is measured from the radiographs.
3. The total value indicates the amount of the
space needed to accommodate all the
permanent teeth anterior to the first
permanent molars.

Orthodontic : diagnosis & management of


malocclusion and dentofacial deformities -
O.P.KHARBANDA
4. The space available for the permanent teeth is
determined with a brass wire passing over the
buccal cusp and incisal edges of teeth from the
first molar to first molar.

5. Space required – space available = amount of


discrepancy

Orthodontic : diagnosis & management of


malocclusion and dentofacial deformities -
O.P.KHARBANDA
Disadvantages :

• Time consuming
• Complete mouth radiograph is needed.
RECENT
ADVANCES IN
MODEL
ANALYSIS
• 3D imaging and modelling have undergone
significant advancement that there is possibility
of “virtual orthodontic patient”.

• Prompted particularly by advent of CBCT and


digital study model scanning.

Orthod Craniofac Res 2011; 14 :1-16


• The replacement of plaster orthodontic models
with virtual information has potential benefits
including:

• (1) instant accessibility of 3D information


without need for retrieval of plaster models
from a storage area.

• (2) the ability to perform accurate and simple


diagnostic set-ups of various extraction patterns.

• (3) virtual images may be transferred anywhere


in the world for instant referral or consultation.
E models or digital models
• These are 3D models which helps to eliminate
the need for traditional plaster stone models.

• Produced by 2 different technologies:

3D scanners -work either on models or directly


mouth or impression.
3D CT based-uses alginate or rubber based
impression.
Comparison of space analysis
evaluations with digital models
and plaster dental casts

American Journal of Orthodontics and Dentofacial Orthopedics


Leifert et al
July 2009
• The purpose of this study was to compare space
analysis measurements made on digital models
with those from plaster dental casts.

• Two sets of 25 alginate impressions were taken


of patients who had a permanent Class I
crowded dentition. Each impression was made
into a plaster cast and a 3-dimensional virtual
orthodontic model (OrthoCad)
Model Analysis on a Smartphone

• An app to simplify the mathematical calculations


required for analysis of orthodontic casts has
been developed .This app, is called
iModelAnalysis.

Model Analysis on a Smartphone


MAMILLAPALLI, NEELA, SESHAM
June 2012
The app performs quick and accurate
mathematical calculations for:

• Bolton analysis
• Tooth-size/arch-length discrepancies in the
maxillary and mandibular arches
• Howes analysis
• Pont and Linder-Harth arch-width analyses
• Tanaka-Johnston mixed-dentition analysis
CONCLUSIONS
• No significant difference was found between the
space analysis measurements of the 2 examiners.

• The statistical difference in maxillary arch length


calculations was small (<0.5 mm) and not
clinically significant.

• It appears that digital models produced by


OrthoCad and with its software can be reliably
used to analyze arch length discrepancies.
Summary
• The dentition and occlusion are analyzed
directly by studying the patient and indirectly by
studying data such as casts, radiographs and
photographs . Orthodontic records are an
essential supplement to history and clinical
diagnosis for the formulation of a
comprehensive treatment plan. Orthodontic
records help to diagnose a malocclusion and
develop an orthodontic treatment plan.
References
• Handbook of orthodontics – Robert E.Moyers
• Orthodontic : diagnosis & management of
malocclusion and dentofacial deformities -
O.P.KHARBANDA
• Orthodontic Diagnosis - I. Jonas, T.M. Graber, T. Rakosi
• Contemporary Orthodontics - William R. Proffit - 6th Ed
• Textbook of orthodontics- Gurkeerat Singh 2nd edition
• American Journal of Orthodontics and Dentofacial
Orthopedics ,Leifert et al, July 2009

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