MODEL
ANALYSIS
TABLE OF CONTENTS
• Introduction
• Study models – objectives & uses
• Model analysis – definition, armamentarium
• Permenant dentition analysis – Bolton’s analysis, Ashley howe’s analysis,linder
hearth index, korkhaus analysis, arch perimeter analysis, peck and peck index
• Mixed dentition analysis- moyers mixed denition analysis, tanaka Johnston
prediction method, radiographic method.
INTRODUCTION
• Success in orthodontic treatment is depended on proper diagnosis of any
cases.
• Many diagnostic aids are available today but study models are the oldest.
• Despite a comprehensive clinical examination it is still better to have a set of
plaster casts to correlate additional information from intraoral and
cephalometric radiographs.
• Hence a nearly perfect Model cast and its analysis is one of the important
diagnostic aids in orthodontics practice.
OBJECTIVES OF IDEAL ORTHODONTIC STUDY MODELS
• Models should accurately reproduce the teeth and their
surrounding soft tissues.
• Models are to be trimmed so that they are symmetrical and also
the asymmetrical arch form can be readily recognized.
• Models should trimmed so to meet the proposed ideal
measurement.
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• Models are to be trimmed in such a way that the occlusion shows by setting
the models on their backs.
• Models are to have clean, smooth, bubble free surfaces with sharp angles
where the cuts meet.
• The finished models will be treated with a soap solution to give a glassy mar-
proof finish.
6
USES OF STUDY MODELS
• They enable the study of occlusion from all aspects.
• They enable accurate measurements to be made in a dental arch.
• They help in assessment of the treatment progress.
• They help in motivation of the patient and to explain the treatment plan.
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MODEL ANALYSIS
DEFINITION
• Model analysis is the study of maxillary
and mandibular dental arches in all the
three planes of spaces using study models
and radiographs which is a valuable tool in
orthodontic diagnosis and treatment
planning.
ARMAMENTARIUM
Commonly used armamentarium for model analysis are,
Divider
Ruler / Wedge ruler
Vernier calipers or Boley gauge
Brass wires
Electronic digital dial calipers
ANALYSIS IN PERMANENT DENTITION
• BOLTON'S ANALYSIS
• PONTS ANALYSIS
• ASHLEY HOWE'S ANALYSIS
• LINDER HARTH INDEX
• KORKHAUS ANALYSIS
• ARCH PERIMETER ANALYSIS (upper cast)
• CAREY’S ANALYSIS
• PECK AND PECK INDEX
ANALYSIS IN MIXED DENTITION
• Moyers mixed dentition analysis
• Tanaka – Johnston’s prediction method
• Radiographic method
BOLTON’S ANALYSIS
Tooth size is an important factor to be taken
into consideration in orthodontic diagnosis and
treatment planning.
According to Bolton 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.
PROCEDURE
A. Sum of mandibular 12
The mesio-distal width of all the teeth mesial to the mandibular second
permanent molars is measured and added
b. Sum of maxillary 12
The mesio-distal width of all the teeth mesial to the maxillary
second permanent molars is measured and summed up.
d. Sum of mandibular 6
The mesio-distal width of all the teeth mesial to the
mandibular first premolars is measured and summed up.
Sum of maxillary 6
The mesio-distal width of all the teeth mesial to the maxillary
first premolars is measured and summed up.
• Determination of overall Ratio.
According to Bolton, a mean ratio of 91.3will result is an ideal overjet-
overbite relationships, as well as posterior occlusion.
Overall Ratio = Sum of mandibular 12 X 100
Sum of maxillary 12
1) If ratio is less than 91.3%, it indicates maxillary tooth material excess.
2) If ratio is more than 91.3%, it indicates Mandibular tooth material
excess.
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• Amount of maxillary excess :
sum of maxillary 12 – (sum of mandibular 12x 100)
91.3
• Mandibular tooth material excess :
sum of mandibular 12 – (sum of maxillary 12 x 91.3)
100
• Determination of anterior ratio.
The sum of mesio distal width of the mandibular anteriors to the mesio
distal width of the maxillary anteriors should be 77.2%.
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.
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• Amount of maxillary anterior excess :
sum of maxillary 6 – (sum of mandibular 6x 100)
77.2
• Mandibular anterior excess :
sum of mandibular 6 – (sum of maxillary 6 x 77.2)
100
PONTS ANALYSIS
Devised by Ponts in (1909)
Helps in:
a. Determining dental arch width based on mesiodistal width of
crowns of maxillary incisorrs
b. Estimating the required maxillary expansion in eliminating the
crowding.
• Determination of sum of incisors (S.I)
• Determination of measured premolar value
(M.P.V)
• Determination of measured molar value
(M.M.V)
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DETERMINATION OF
Premolar value (CVP)
expected arch width in the premolar region is determined by the
formula
S.I. x 100
80
Molar value (CMV)
expected arch width in the molar region is determined by the
formula
S.I. x 100
64
d. Determination of measured premolar value (MPV)
Width of the arch in the premolar region is measured from the
deepest point in the transverse fissure of the 1st premolar to its
counterpart on the other side.
4. Determination of measured molar value (MMV)
The width of the arch in the molar region is measured from the
point of intersection of transverse fissure with the buccal fissure
of the first permanent molar to its counterpart on the other side.
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.
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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 12 teeth anterior to
the second molars and the width of the dental arch in the first premolar
region.
PROCEDURE
a. Determination of total tooth material (T.T.M.)
The mesio-distal width of all the teeth mesial to the maxillary second permanent
molars is measured and added
b. Determination of premolar diameter (P.M.D.)
The premolar diameter refers to the arch width from the tip of the buccal cusp of
one first premolar to the tip of buccal cusp of the opposite first premolar.
c. Determination of premolar basal arch width (PMBAW)
The measurement of the width from canine fossa of one side to the other from a point
close to the apices of first premolars.
The canine fossa is found distal to canine eminence.
If the canine fossa is not clearly distinguishable the measurement is made from a point
that is 8 mm below the crest of the inter-dental papilla distal to the canine.
Expansion can be carried out to relieve crowding, if the PMBAW is greater than PMW.
Arch expansion is not possible if the values are otherwise.
According to Ashley Howe, to achieve normal occlusion with a full complement of
teeth the basal arch width at the premolar region should be 44% the sum of mesio-
distal widths of all the teeth mesial to the second permanent molar (total tooth
material).
This ratio is called the premolar basal arch width percentage. It is determined using
the formula:
[Link].W% = [Link].W x 100
T.T.M.
a. If P.M.B.A.W % is 37% or less, it indicates a need for extraction.
b. If P.M.B.A.W % is 44% or more, the case can possibly be treated without
extracting any teeth.
c. If P.M.B.A.W % is 37 - 44%, the case is referred to as a borderline case.
LINDER HEARTH ANALYSIS
This analysis is very similar to Pont's analysis except that a new formula has been
proposed to determine the ideal arch width based on mesiodistal width of crowns of
maxillary incisors.
It is a maxillary expansion index.
The calculated premolar value
is determined using the formula, molar value = SI x 100
S.I. x 100 65
85
ARCH PERIMETER ANALYSIS
• Many malocclusions are as a result of discrepancy between arch length and
tooth material.
• This analysis helps us to find the difference between the space available for
the teeth in the dental arch and the space required for accommodating the
teeth.
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Procedure
A. DETERMINATION OF ARCH LENGTH
Measured using a soft brass wire.
From the mesial surface of the first permanent molar of one side
to the opposite first permanent molar.
In case of proclined anteriors the wire is passed along the cingulum
of anterior teeth.
If the anterior teeth are retroclined, the brass wire in the anterior
segment passes labial to the teeth.
If the anterior teeth are well aligned the wire passes over the incisal
edge of anteriors.
B. DETERMINATION OF TOOTH MATERIAL
The mesio-distal width of the teeth anterior to the first molars is
measured and summed up.
INFERENCE
If tooth material is more than the space available then there
can be crowding due to space shortage.
If tooth material is less than the space available then there
can be spacing due to excess space.
Depending on this suggested treatment planning is,
a. If the discrepancy is 0 to 2.5 mm, it indicates minimum tooth material
excess. In such cases proximal stripping can be carried out to reduce
the tooth material.
b. If the discrepancy is between 2.5 to 5mm it indicates the need to extract
the second pre molars.
c. If the discrepancy of more than 5mm indicates the need to extract the
first pre molars.
PECK AND PECK ANALYSIS
It is done in lower arch in persons with incisal crowding. On basis of observation,
Peck and Peck suggested certain clinical guidelines.
Procedure
1. calculate mesio-distal widths of mandibular incisors individually called (M.D.).
2. calculate labio-lingual width of mandibular incisors individually called
(L.L.).
3. Mean value is calculated by the formula
M.D. X 100
L.L.
According to peck and peck
• Mean value for lower central incisor should be 88 to 92%.
• Mean value for lower lateral incisor should be 90 to 95%.
Inference
If the value for a given case is more than the mean value proximal stripping is
indicated.
MIXED DENTITION
ANALYSIS
Mixed dentition period is the best time to analyses and predict the
future dental arch condition thereby preventing any malocclusion
that may occur in permanent dentition.
For this purpose various authors have suggested different
techniques to determine the space available and the space required
for the permanent dentition to erupt and this is called mixed
dentition space analysis.
Indications for a mixed dentition analysis
Premature loss of primary canine
Rotation or blocking of permanent teeth
Ectopic eruption of permanent first molars.
Distal terminal plane relationships
Cross bite
The purpose of a mixed dentition analysis is to evaluate the
amount of space available in the arch for the erupting
permanent canines and premolars.
MOYER’S MIXED DENTITION ANALYSIS
In this analysis the size of the unerupted permanent cuspids and premolars
are predicted from the knowledge of the sizes of certain permanent teeth
already erupted in the mouth.
The Moyer's mixed dentition 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 with a fair degree of accuracy.
The mesio-distal width of the four lower incisors are measured with boley’s
guage and summed up.
The amount of space available for the 3, 4 and 5 after incisor alignment is
determined by measuring the distance between the distal surface of lateral
incisor and the mesial surface of first permanent molar.
Based on the mesio-distal width of the four mandibular incisors, the expected
width of the canines, first and second premolars are predicted by referring the
probability chart. While doing so, the 75% level of probability is considered
reliable.
The predicted tooth size of 3,4 and 5 is compared with the arch length
available for them so as to determine the discrepancy.
If the space available is greater than the predicted space, the excess space can
be used for late mesial shift of molars.
If the space available is lesser than the predicted space, it is an indication of
future crowding.
Reason for choosing the mandibular incisors
1. They erupt first and offer the earliest opportunity of measurement.
2. They are less variable and more reliable than maxillary incisors.
TANAKA & JOHNSTON
It predicts the widths of unerupted canines and premolars based on the sum of
the widths of lower incisors.
Advantages:
This analysis is considered the easiest and quickest way and most clinically
useful as no additional tables or x-rays are required.
Reasonably accurate.
METHOD
• Measure the total arch length.
• Measure the mesiodistal widths of lower four incisors and sum it up.
• Divide the value obtained by 2 and add 10.5 mm to obtain the sum of widths of
mandibular canines and premolars in one quadrant.
• Divide the value by 2 and add 11 mm to obtain the sum of widths of maxillary
canines and premolars in one quadrant.
• Space available in the arch after the eruption of canines and premolars is
calculated by the following formula
space available = total arch length- [ sum of lower incisors + 2 x
(calculated width of canine and premolar)]
RADIOGRAPHIC METHOD
• It uses both the models and radiographs to assess the size of the erupting tooth.
• It requires an undistorted radiographic image and hence individual periapical
radiographs are advisable rather than panoramic radiographs.
• This method relies on intraoral radiograph to predict the size of the unerupted premolar
using the formula
true width of primary molar X radiographic width of unerupted premolar
radiographic width of primary molar
INTERPRETATION OF MIXED DENTITION ANALYSIS
• If analysis predicts no crowding continue with routine dental care
• If analysis predicts borderline crowding (1mm-4mm) maintain arch length with an
appliance and periodically examine the patient. If arch length is lost, regain it before
placing and maintain space.
• If the analysis predicts crowding of an excess of 4mm the patient will likely develop
crowding that will require orthodontic treatment
• If crowding in excess of 6mm is predicted it may require serial extraction treatment
Thank you
