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      The Tooth Size Discrepancy among Orthodontic Patients and Normal Occlusion Individuals from Saudi Arabia: A Three-Dimensional Scan Analysis of Diagnostic Casts

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          Abstract

          Background/Purpose:

          Tooth size discrepancy is one of the causative factors of malocclusion. This study aimed to establish the TDS among various malocclusion classes and normal occlusion subjects in a Southern Saudi population.

          Materials and Methods:

          The study casts of orthodontic patients from Southern Saudi Arabia (mean age: 19.6 years ± 2.45; n = 120) were randomly selected and grouped into eight equal classes based on Angle's classification and gender. An additional 30 study casts, devoid of malocclusion, having excellent intercuspation and class I occlusion, were grouped into two controls ( n = 15) based on gender. The study casts were three-dimensional scanned to measure mesiodistal widths of all the teeth. The calculated anterior ratios (AR) and overall ratio (OR) were statistically analyzed with analysis of variance and t-tests.

          Results:

          There were no significant differences in “OR” and “AR” between the genders ( P > 0.05) and among the malocclusion and control subgroups ( P > 0.05). The mean “OR” (92.01 ± 0.18) and “AR” (78.60 ± 0.27) of the malocclusion group were significantly higher than that of Bolton's ratios ( P > 0.05). The “AR” of the control group was significantly higher than Bolton's standards ( P = 0.048). However, “OR” was no different ( P = 0.105). Malocclusion patients displayed a discrepancy (±2 standard deviation) in “AR” of 22.5% and 'OR' of 6.7% from Bolton's mean (BM). Similarly, the control group displayed a discrepancy in “AR” of 20% and “OR” of 10% from BM.

          Conclusion:

          The mean “OR” and “AR” of the Southern Saudi population showed no sexual dimorphism and no significant difference among various malocclusion and control subgroups. The “AR” of the malocclusion and control subgroups did not comply with Bolton's standards.

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          Most cited references47

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          Malocclusion and occlusal traits in an urban Iranian population. An epidemiological study of 11- to 14-year-old children.

          The aim of this cross-sectional study was to determine the prevalence of malocclusions, occlusal traits, and their gender distribution in urban Iranian school children. Five hundred and two subjects (253 females and 249 males, aged 11-14 years) were examined. Molar relationship, overjet (OJ), overbite, midline deviation, crossbite, and crowding/spacing were recorded. Gender dimorphism was evaluated by the chi-square test. According to the classification of Angle, the prevalence of Class I, Class II division 1, Class II division 2, and Class III malocclusions was 41.8, 24.1, 3.4, and 7.8 per cent, respectively. Symmetric molar relationship was present in 69.5 per cent. An OJ of at least 3.5 mm or more was present in 28.1 per cent; an OJ of more than 6 mm in 3.6 per cent, and 4.2 per cent had a reverse OJ. A normal overbite was observed in 60.4 per cent, while 34.5 per cent had an increased and 2.2 per cent a very deep overbite. An anterior open bite (AOB) was present in 1.6 per cent and a scissor bite or anterior crossbite in 2 and 8.4 per cent, respectively. A posterior crossbite was observed in 12.4 per cent (8.4 per cent unilateral, 2 per cent bilateral, and 2 per cent in association with an anterior crossbite). Midline deviation was present in 23.7 per cent. Severe crowding (>or=5.1 mm) was observed in 16.7 and 10.8 per cent and spacing in 18.9 and 20.7 per cent of the maxillary and mandibular arches, respectively. Significant gender differences were found for overbite (P < 0.001), midline deviation (P < 0.05), and maxillary and mandibular arch crowding/spacing (P < 0.05). The prevalence of Class II malocclusions was comparable with Caucasians; however, the most severe forms of Class II malocclusions were rare in this Iranian population. The relative prevalence of Class III malocclusions in the present study was greater than in Caucasians. Crowding was the most common dental anomaly in both arches.
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            The clinical application of a tooth-size analysis

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              Interarch tooth size relationships of 3 populations: "does Bolton's analysis apply?".

              This study evaluates whether Bolton's interarch ratios extend across populations and genders. The data were derived from systematically collected preorthodontic casts of 180 patients, including 30 males and 30 females from each of 3 populations (black, Hispanic, and white). Forty-eight mesiodistal contact points were digitized on each model, and the lengths of the anterior, posterior, and overall arch segments were calculated. The results showed significant (P <.05) ethnic group differences in all 6 arch segment lengths and in all 3 interarch ratios. Whites displayed the lowest overall ratio (92.3%), followed by Hispanics (93.1%), and blacks (93.4%). The group differences were due primarily to the relationships between the posterior segments. The arch segments of males were significantly larger than females; the overall and posterior ratios were also significantly larger in males than in females. Multiple regression analyses showed that individual differences in the overall ratio were most closely associated with the size of the lower second premolar, followed by the upper lateral incisors, upper second premolars, and the lower central incisors. In combination, these 4 teeth explained approximately 50% of the variation in the overall ratio between subjects. We conclude that interarch tooth size relationships are population and gender specific. Bolton ratios apply to white females only; the ratios should not be indiscriminately applied to white males, blacks, or Hispanics.
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                Author and article information

                Journal
                Contemp Clin Dent
                Contemp Clin Dent
                CCD
                Contemporary Clinical Dentistry
                Wolters Kluwer - Medknow (India )
                0976-237X
                0976-2361
                Apr-Jun 2020
                07 August 2020
                : 11
                : 2
                : 141-149
                Affiliations
                [1] General Dentist, M.O.H, Asir Central Hospital, Abha, Saudi Arabia
                [1 ] Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Khalid University, Abha, Saudi Arabia
                [2 ] Department of Prosthetic Dentistry, College of Dentistry, King Khalid University, Abha, Saudi Arabia
                [3 ] Dental Intern, College of Dentistry, King Khalid University, Abha, Saudi Arabia
                [4 ] Consultant Restorative Dentist, M.O.H, Asir Central Hospital, Abha, Saudi Arabia
                Author notes
                Address for correspondence: Dr. Sharaz Shaik, Department of Prosthetic Dentistry, College of Dentistry, King Khalid University, Abha 62529, Saudi Arabia. E-mail: sharazshaik@ 123456gmail.com
                Article
                CCD-11-141
                10.4103/ccd.ccd_455_19
                7583543
                33110327
                b56393e6-b1b6-4d39-9240-5c23e2c01b32
                Copyright: © 2020 Contemporary Clinical Dentistry

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 13 December 2019
                : 16 April 2020
                : 01 May 2020
                Categories
                Original Article

                Dentistry
                bolton's anterior ratio,bolton's overall ratio,malocclusion,odontometric analysis,orthodontics,tooth size discrepancy

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