* Dr . Girish Chaudhary ** Dr . Saurabh Goyal *** Dr . Anshul Chaudhry
The Journal
Bolton analysis of Punjabi ethnic population
This study was carried out to establish the mean overall tooth size ratios and anterior ratios of the Bolton analysis in 100 North Indian ( Punjab ) subjects from age 12-28 years . Materials and Methods : The measurements were taken on pre treatment dental casts of 100 patients ( 50 males and 50 females ). The mesiodistal width from first molar to first molar was measured on each pretreatment cast using digital calipers , and the anterior and overall ratios were calculated . Student ’ s t-test was performed for statistical analysis .
Introduction
Orthodontic treatment comprises different phases , and each segment presents unique characteristics and challenges . The orthodontic ‘‘ finishing ’’ phase is recognized for the multitude of details necessary to achieve an excellent result . In some cases , the finishing phase is very difficult , requiring the production of complicated biomechanical forces to reach a satisfactory orthodontic solution . A high percentage of these finishing-phase difficulties arise because of tooth size imbalances that could have been detected and considered during initial diagnosis and treatment planning . An excellent orthodontic treatment result with ideal intercuspation , overjet , and overbite is often jeopardized by tooth size discrepancies or problematical tooth anatomy .
There are many factors that will influence the attainability of optimal occlusion , one of which is the relationship of the total mesiodistal width of the maxillary teeth to that of the mandibular teeth . Specific dimensional relationships must exist between the maxillary and mandibular teeth to ensure proper interdigitation , overbite , and overjet . Because patients with interarch tooth size discrepancies require either removal ( eg , interdental stripping ) or addition ( eg , composite build-ups / porcelain veneers ) of tooth structure to open or close spaces in the opposite arch , it is important to determine the amount and location of a tooth size discrepancy before starting treatment .
Tooth size ratios represent a valid diagnostic tool that allow for an educated prediction of treatment outcomes and may also limit the necessity for diagnostic setups for complex
cases . A proper relationship of the total mesiodistal width of the maxillary dentition to the mesiodistal width of the mandibular dentition will favor an optimal post treatment occlusion . Treatment planning should always take into consideration a discrepancy of the tooth size ratios and should include compensating esthetic procedures such as composite bonding , prosthetic reconstruction , stripping , and crown recontouring . Pioneer investigations
1 on tooth sizes were conducted by Black in 1902
2
and Neff in 1949 . These studies were followed
3,4
by the classic work of Bolton , who quantified the maxillary-to-mandibular tooth size relationship and provided the accepted normative data .
There has long been an understanding that a certain maxillary-to-mandibular tooth size relationship is important for proper occlusal relationships . Over the years many investigators have attempted to quantify this
5
relationship . In 1923 Gilpatric calculated that the total mesiodistal tooth diameters in the maxillary arch exceeded that in the mandibular
6
arch by 8 to 12 mm . Ballard , in 1944 , evaluated 500 sets of models of orthodontic patients and found that 90 % possessed mesiodistal crown discrepancies of at least 0.25 mm between one
* Reader , Department of Orthodontics , Baba Jaswant Singh Dental College , Hospital and Research Institute , Chandigarh Road , Ludhiana , Punjab , India
** Reader , Department of Orthodontics , Baba Jaswant Singh Dental College , Hospital and Research Institute , Chandigarh Road , Ludhiana , Punjab , India
*** Senior Lecturer , Department Of Orthodontics , Christian Dental College , Ludhiana , Punjab , India
29 23 22 10 3 21 18 Vol . 12 13 No . 23 1 May-August Sept-Dec Jan-April 2016 2017