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BACKGROUND: The Bolton analysis is one of the commonly used tooth size analysis or diagnostic tools in deriving a treatment plan for orthodontic patients. Many studies have indicated and concluded that normal measurements for one group should not be considered normal for other ethnic groups. The aims and objectives of this study were to investigate the applicability of Bolton's ratios in the orthodontic population of Malaysian main ethnics, Malay, Chinese, and Indians. Comparisons were made in terms of size and distribution of tooth size discrepancy in the Malaysian orthodontic population and the findings were converted in terms of millimeters. METHODS: Hundred fifty pre-orthodontic study casts comprised of 52 Malay, 54 Chinese, and 44 Indian patients were selected. Digital calipers (Fowler Pro-Max) linked to Hamilton Tooth Arch Software were used to measure the tooth width and ratios. Statistical analysis was carried out to test for gender differences (independent t-test), to identify the effects of malocclusion and ethnic groups (Two-way ANOVA), and to compare the means of the current study with Bolton's standards (one sample t-test). RESULTS: This study showed that there was no significant difference between the genders of the sample of each ethnicity. There was no correlation found between ethnic groups and malocclusion classes. There was a significant difference when comparing Bolton values with the Malay sample for both ratios. It was found that more Malay subjects presented with maxillary excess contrary to Chinese and Indians who presented more maxillary deficiency for the anterior and overall ratio. CONCLUSION: There was a significant difference found between the TSD of the three major ethnicities in Malaysia. The Bolton standards can be applied to Malaysian Chinese and Indians but not to Malays orthodontic populations for both anterior and overall ratios. Subsequently, a specific standard should be used for the Malays orthodontic population. It was found that more Malay subjects presented with maxillary excess contrary to Chinese and Indians who presented more maxillary deficiency for the anterior and overall ratio.

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Orthodontists often encounter significant clinical challenges in the finishing stages of treatment due to a disproportion in interarch tooth size relationships. Despite the increasing presence of digital technology and concomitant focus on customized treatment approaches, there is a gap in the knowledge of how generating tooth size data using digital versus traditional methods may impact our treatment regime. OBJECTIVE: This study aimed to compare the prevalence of tooth size discrepancies using digital models and a digitally based cast analysis in our cohort based on (i) Angle's Classification; (ii) gender and (iii) race. MATERIALS AND METHODS: The mesiodistal widths of teeth in 101 digital models were assessed using computerized odontometric software. A Chi-square test was used to determine the prevalence of tooth size disproportions among the study groups. The differences between all three groups of the cohort were analysed using a three-way analysis of variance (ANOVA). RESULTS: An overall Bolton tooth size discrepancy (TSD) prevalence of 36.6% was observed in our study cohort; 26.7% had an anterior Bolton TSD. No differences existed in the prevalence of tooth size discrepancies between male and female subjects as well as between the different malocclusion groups (P > .05). Caucasian subjects had a statistically significant smaller prevalence of TSD compared to Black and Hispanic patients (P < .05). CONCLUSION: The prevalence results in this study illuminate how relatively common TSD is and underscores the importance of proper diagnosis. Our findings also suggest that racial background may be an influential factor in the presence of TSD.

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Background Dental impressions have been required to obtain proper study models. This procedure is time- and labor-consuming for the orthodontist and could be exhausting to the patient, especially when braces are fitted in the context of a research project. This study aimed to assess the accuracy, reliability, and reproducibility of using intraoral photographs and plaster models' photographs in measuring Little's Irregularity Index (LII), tooth size-arch length discrepancy (TSALD), and Bolton's ratios. Methods A total of 52 dental arches of 26 patients were included in this study. Plaster models, occlusal intraoral photographs, and photographs of the collected plaster models were obtained for each patient. Then, LII, TSALD, and Bolton's ratios were measured using a manual caliper for plaster models' measurements and a software-based on-screen method for the photographs. Results The intraclass correlation coefficients (ICCs) of measurements made on intraoral photographs and photographs of plaster models were high (ranging from 0.90 to 0.99 and from 0.88 to 0.99, respectively), indicating a high level of agreement with the gold standard measurements. In addition, the differences were insignificant. The intra-/inter-examiner ICCs ranged from 0.90 to 0.99/0.92 to 0.99 and from 0.85 to 0.99/0.88 to 0.98 for plaster models and intraoral photographs of the dental arches, respectively. The analysis of reproducibility of capturing intraoral photographs of the dental arches on two different occasions showed high ICCs ranging from 0.96 to 0.99 with almost no significant differences between repeated measurements (P > 0.05). Conclusion LII, TSALD, and Bolton's overall and partial ratios can be measured from intraoral photographs of the dental arches with high accuracy, reliability, and reproducibility. Therefore, this methodology can be suggested for use in research projects when multiple records of the dental arches are required instead of depending on time- and labor-consuming procedures of ordinary dental impressions.

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@#Intermaxillary tooth size discrepancy (TSD) is the disproportion in patients’ tooth size that is usually referred to the Bolton analysis. This size imbalance may also affect the outcome of orthodontic treatment. Therefore, this retrospective study was conducted to determine the prevalence of intermaxillary tooth size discrepancy (TSD) beyond 2 standard deviation (2 SD) from Bolton’s mean in orthodontic patients and to evaluate the effect of TSD beyond 2 SD of Bolton’s mean on orthodontic treatment outcomes. A total of 226 sets of orthodontic study models that met the selection criteria were selected from 3077 orthodontic cases. Bolton's analysis of the anterior and overall ratios was performed on each of the pre-treatment models. The orthodontic treatment outcomes for the cases which were identified of having TSD beyond 2 SD were evaluated and any interventional techniques to improve the outcome of the treatment were recorded. The results showed that 29.20% of cases had TSD beyond 2 SD of Bolton’s mean. 26.54% of cases had anterior ratio of more than 2 SD. Meanwhile, 7.08% of cases had an overall ratio greater than 2 SD. Of all cases with TSD beyond 2 SP, most of these cases (62.12%) had affected the outcome of orthodontic treatment. In conclusion, there is more than one quarter of orthodontic patients present with TSD beyond 2 SD of Bolton’s mean which may influence the outcome of orthodontic treatment. Intervention techniques should be carefully planned to achieve satisfactory treatment outcomes.

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PURPOSE: The aim of the study is to present a photogrammetric technique using standardized occlusal photographs to perform Bolton's analysis and assess reliability of this new method with plaster study casts. MATERIALS AND METHODS: The study was conducted on 16 subjects (8 males, 8 females), aged 18-25 years. Standardized occlusal photographs and plaster study casts were obtained. The occlusal photographs were calibrated in Nemoceph® software. Mesio-distal dimensions of all teeth up to first molars were calculated and Bolton's analysis was performed. Similarly, a digital calliper with 0.1 mm sensitivity was used to measure mesio-distal dimensions of all teeth on plaster study casts to perform Bolton's analysis. 28 parameters were measured on study models and corresponding occlusal photographs. Paired t test and intraclass correlation tests were carried out to test validity and reliability of the photogrammetric method. An intraclass correlation test was calculated for 4 derived parameters to test reliability of Bolton's analysis measurements obtained from occlusal photographs as compared to study models. RESULTS: All 28 parameters showed a statistically significant and excellent correlation (r>.80) in the Intra Class Correlation test. 4 variables used to calculate Bolton's analysis showed statistically significant correlation (r>.96) in the intraclass correlation test. CONCLUSION: Photogrammetry is a reliable tool to measure mesio-distal tooth size. Bolton's analysis from standardized occlusal photographs using the described photogrammetric technique can be used as an effective clinical tool.

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AIMS AND OBJECTIVES: Attainment of ideal occlusion is often restricted by disproportionate sizes of individual teeth, which is otherwise termed as tooth size discrepancy (TSD). While extraction of teeth for orthodontic purposes is not uncommon, there is considerable resistance against this school of thought. The extraction of premolars, in particular, received considerable attention because of the potential TSD that could result following the extraction of premolars. The aim of the present study was to identify the consequence of premolar extractions on Bolton's overall ratios in South Indian population. MATERIALS AND METHODS: One hundred participants were recruited into the study through purposive nonproportionate quota sampling. Pretreatment dental casts of the study participants were measured for mesiodistal tooth widths to determine Bolton's overall ratio before the hypothetical tooth extractions were performed. The hypothetical extractions were executed in four different combinations as follows: (a) Maxillary and mandibular first premolars, (b) maxillary first premolars and mandibular second premolars, (c) maxillary second premolars and mandibular first premolars, and (d) maxillary and mandibular second premolars. Bolton's overall ratios were calculated after the hypothetical tooth extractions were performed. Statistical analysis was done using the Statistical Package for the Social Sciences, version 20 software. RESULTS: It was observed that extractions performed in any of the combinations followed in this study resulted in a decrease of overall Bolton's ratios. However, the discrepancy in tooth size was highest with the extraction of all first premolars, whereas least discrepancy was recorded with all second premolars extraction. It was also found that, based on the combination of teeth chosen for extraction, there was significant difference in Bolton's overall ratios between males and females. CONCLUSION: In formulating a treatment plan involving premolar extraction, significant tooth size discrepancies could change mutually after extraction.

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Objective To measure Bolton index with malocclusions in Shanghai Fengxian district,and ana-lyze the distinction among different malocclusions patients in respect of gengder,age,and different Angle classifica-tion.Methods Measure Bolton index of plaster models of 348 eligible malocclusions patients who were selected ran-domly from Shanghai Fengxian District,and divided them into different groups by gender,age and Angle classification. Then,Bolton overall ratio and Bolton anterior ratio among these groups were analyzed and compared.Results The results showed that there were no significant differences of Bolton analysis in respect of gender or age(all P >0.05). It exsisted obvious differences in anterior ratios among the three Angle malocclusion class(P <0.05).Bolton anterior ratios were (79.88 ±3.15)%,(78.91 ±2.86)% and (80.59 ±1.55)%,mean of Class I and mean of ClassⅢwere bigger than that of Class Ⅱ.Bolton overall ratios of Angle class Ⅰ,classⅡ and class Ⅲ were (79.88 ± 3.15)%,(79.88 ±3.15)% and (79.88 ±3.15)%,and there were no obvious differences in overall ratios among them.Conclusion Bolton index with malocclusions for Shanghai Fengxian District accord with normol Bolton index of our country.Gender and age are not the influencing factors of Bolton index in Fengxian District.Bloton index anomalies are the important fator in malocclusions.We should pay more attention to the Bolton analysis of class Ⅱ malocclusions in clinical practice,and draw up a treatment plan combined with specific classification.

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AIM: The aim of the present study was to evaluation and comparison of intermaxillary tooth size discrepancy among Class I, Class II division 1, and Class III subjects using Bolton's analysis. MATERIALS AND METHODS: The pre-treatment casts were selected from the records of patients attending the Department of Orthodontics of Meenakshi Ammal Dental College, Chennai. The sample consists of 180 pre-treatment casts with both sexes evenly distributed with 60 casts in each type of malocclusion, i.e., Class I, Class II div 1, and Class III malocclusion. The sample was selected according to angles classification. All patients were Indian nationals, between the age group of 12 to 20 years and Bolton's analysis done on all the casts. RESULTS: Statistically no significant difference in all types of malocclusion except anterior Bolton's discrepancy in Class III. CONCLUSION: Mean Bolton's anterior ratio for angles Class III subjects was significantly greater than for Class I and Class II subjects. When Bolton's overall ratio was compared there was no statistically significant difference among Class I, Class II div 1, and Class III malocclusions.

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BACKGROUND: For proper intercuspation, the teeth must be proportional in size. If teeth are mismatched, with unusually large teeth in one arch compared to the other, then an ideal occlusion cannot be attained. This study has been done to determine the prevalence of tooth size discrepancies among orthodontic patients in general and also between different malocclusion groups, sex, and to analyze the change in the degree of severity in Bolton discrepancy before and after the hypothetical premolar extraction. METHODS: The study was carried out on randomly collected 100 pre-treatment dental casts. Tooth size analyses were performed on these pre-treatment models and Mesio distal tooth size ratios were measured as described by Bolton before and after various patterns of hypothetical extraction. RESULT: The results were statistically evaluated using ANOVA and paired samples t-test. 5 out of 100 patients are seen with severe Bolton discrepancy with Bolton values (BV) ranging above and below 2 standard deviation. Statistically insignificant difference is seen between males and females and also between various groups of malocclusion. The difference between the pre-treatment and post extraction BV was found statistically significant for the first premolar extraction and insignificant for others. CONCLUSION: The results of this study indicate a new point of view to the question of which teeth to extract when evaluated for tooth size aspect only.

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AIM: The purpose of this study was to evaluate the Bolton overall ratio in a north Indian population reporting for orthodontic treatment and to determine the effect of extractions on the Bolton ratios. Another aim of the study was to check the effects of different extraction patterns on the final Bolton ratio. MATERIALS AND METHODS: One hundred and twenty pre-treatment dental casts (60 males and 60 females) of orthodontic patients were selected randomly. Mesio-distal dimensions of the mandibular and maxillary teeth were measured before treatment, and subjected to Bolton analysis. Hypothetical tooth extraction by the following combinations: All the first premolars, all the second premolars, upper first and lower second premolars and upper second and lower first premolars were performed for each patient. The measurement results were again subjected to Bolton analysis to see whether any tooth-size discrepancy had been created. RESULTS AND CONCLUSION: The tooth material ratio of the studied north Indian population shows a mild maxillary tooth material excess. Extraction of premolars in any combination causes the maxillary tooth material to further increase. There is no significant sex difference in the tooth material ratios with or without extractions. In patients requiring extraction; all first premolar extraction or maxillary first and mandibular second premolar extraction should be preferred. For deciding a treatment plan involving extraction of teeth, we need to consider that the maxillary tooth mass may increase after extraction. Furthermore, the normal or the clinically significant tooth size discrepancies may change following extraction of teeth.

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This study was undertaken to compare the Bolton's anterior and overall ratios among males and females in Jaipur population. One hundred study models (50 males and 50 females) of orthodontic patients were randomly selected from the Department of Orthodontics, Mahatma Gandhi Dental College, Jaipur. The normative data for the mesiodistal widths of males and females were established and the anterior and overall ratios were obtained for both males and females. It was observed that were no significant differences in both the ratios in males and females. Hence, both the ratios were obtained for the sample as a whole. These ratios were found to be similar to the Boltons standard with no significant differences. Therefore, it can be concluded that Boltons standards can be applied to this population irrespective of sex or ethnic background. How to cite this article: Trehan M, Agarwal S, Sharma S. Applicability of Bolton's Analysis: A Study on Jaipur Population. Int J Clin Pediatr Dent 2012;5(2):113-117.

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INTRODUÇÃO: as discrepâncias entre o tamanho mesiodistal dos dentes superiores e inferiores e seus efeitos sobre a oclusão têm sido relatados há muito tempo. O método proposto por Bolton para o diagnóstico de discrepância de tamanho dentário é, inegavelmente, um dos mais difundidos no meio ortodôntico, devido à sua relativa simplicidade. Entretanto, a aplicação desse método requer cálculos matemáticos e o uso de tabelas que, muitas vezes, inviabilizam a sua utilização durante a avaliação clínica. OBJETIVO: avaliar o método proposto por Wolford, que não requer o uso de tabelas, como alternativa ao método tradicional de Bolton. MÉTODOS: a amostra foi composta por 90 pares de modelos dentários iniciais de pacientes adultos, com diferentes más oclusões. A proporção entre os dentes inferiores e superiores foi calculada para cada paciente, resultando na obtenção de dois índices (a razão total e a razão anterior). Os índices foram obtidos por meio do método originalmente proposto por Bolton e por um método alternativo, composto por duas fórmulas (uma simplificada e a variação da mesma), que foram analisadas separadamente. RESULTADOS: comparadas ao método de Bolton, as fórmulas simplificadas mostraram uma tendência de superestimar as discrepâncias dentárias inferiores (total e anterior), embora em pequena proporção. CONCLUSÕES: ambas as fórmulas do método alternativo podem ser utilizadas em substituição ao método tradicional, uma vez que mostraram diferenças médias menores que 0,58mm quando comparadas ao método de Bolton, não apresentando, portanto, significância clínica.

INTRODUCTION: Mesiodistal size discrepancies of upper and lower teeth and their effect on occlusion have been related. Bolton's method for tooth size discrepancies is, undeniably, one of the most commonly-used methods in orthodontics because of its simplicity. However, the application of this method requires mathematical calculations and use of tables, which often prevents its clinical use. PURPOSE: Evaluate an alternative method for Bolton's analysis proposed by Wolford that does not require table information. MATERIAL AND METHODS: The sample was composed of 90 initial dental casts of adult patients, with different malocclusions. The ratio between the sum of widths of maxillary and mandibular teeth was calculated for each patient, resulting in the attainment of two indices: The overall ratio and the anterior ratio. Indices were calculated by Bolton's method and by an alternative method, using two different formulas (one simplified and a variation of the same formula) that were separately analyzed. RESULTS: In comparison with Bolton's method, the Simplified Formulas demonstrated a slight trend towards an overestimation of the inferior dental discrepancies (overall and anterior). CONCLUSION: Both formulas employed for the alternative method may be used to substitute the traditional method, since each demonstrated, on average, differences of less than 0.58 mm when compared with Bolton's method and no clinical significance.

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A discrepância de tamanho dentário ocorre em um número considerável de pacientes que procuram por tratamento ortodôntico, e pode influenciar de maneira negativa os objetivos do tratamento e os seus resultados finais, impedindo a busca da excelência na finalização do caso. Tal deficiência na finalização pode ser detectada e considerada na fase de diagnóstico e planejamento do tratamento, pela análise da discrepância de tamanho dentário. O artigo está ilustrado com o caso clínico de um paciente do sexo masculino, 13,2 anos de idade, que após a realização da análise de Bolton, constatou-se a discrepância de tamanho dentário, com proporção total igual a 95,3 (média de 91,3), demonstrando um déficit na arcada superior devido à anomalia de forma nos incisivos laterais superiores. Sendo assim foi planejado um tratamento multidisciplinar com a Ortodontia para devolver a oclusão e macroestética do sorriso e a Dentística para obter a microestética. Esse planejamento multidisciplinar permitiu o tratamento mais adequado e a excelência na finalização do caso. Portanto a análise de Bolton é uma ferramenta importante na fase de diagnóstico e planejamento do tratamento ortodôntico.

The discrepancy of dental size occurs in a considerable number of patients who search for orthodontic treatment and may negatively influence the treatment objectives and compromise its final results. This size deficiency can be detected and considered in the diagnosis and treatment plan phases through the analysis of tooth size discrepancy. This article illustrates a case report of a male patient, 13.2 years old, who had a tooth size discrepancy identified through the Bolton analysis with a total proportion of 95.3 (average of 91.3), demonstrating a deficit in the superior arch due to a shape anomaly of the superior lateral incisors. Thus, a multidisciplinary treatment course was planned including orthodontic, to reestablish occlusion and macro-esthetic elements of the smile; and restorative dentistry, to improve micro-esthetic quality. This multidisciplinary plan enabled a more adequate course of treatment and higher rate of overall success. Therefore, the Bolton analysis is an important tool in the diagnosis and orthodontic treatment planning phases.

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The purpose of this study was to measure the average tooth size of Korean with normal occlusion. According to the study, the average tooth ratios between the upper and lower teeth which could assure the proper ovebite, overjet and good interdigitation were calculated. The normal occluson sample of this study consisted of 43 Korean male adults and 51 Korean female adults. Among them, 22 Korean male adults and 51 Korean female adults were from KAO(Korean Association of Orthodontists), 21 Korean male adults were from Department of Orthodontics, College of Dentistry, Yonsei University. The results from this study were as follows : 1. The average tooth size of Korean Norm classified by male and female was measured. 2. The average tooth size of Korean male adults with normal occlusion was significantly larger than that of Korean female adults except upper and lower first molars.(p<0.05) 3. The tooth ratio which could predict the proper overbite and overjet in anterior teeth and proper occlusion in posterior teeth was calculated. 1) Sum of inciosrs = 4 : 2.97 2) Neff's anterior coefficient = 1.22 3) Bolton's anterior ratio = 78.29%, overall ratio = 91.14% 4. A positive correlation was observed between the sum of lower anterior incisors and the sum of unilateral canine and premolars in each jaw. Based this correlation, the regression equation was made which could predict the sum of unerupted unilateral canine and premolars in mixed dentition. 1) Sum of unilateral unerupted upper canine and premolars' width = 10.435018 + 0.513346x(sum of lower 4 incisors' width) 2) Sum of unilateral unerupted lower canine and premolars' width = 9.654002 + 0.502565x(sum of lower 4 incisors' width)

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Objective:To investigate whether the changes of anterior arch dimension have an impact on the precision of Bolton analysis. Methods:A mathematic-geometric model was used to evaluate the data. Results:The ideal anterior tooth size ratio may need adjustments, depending on the dimensions in radii of the upper and lower anterior dental arches. The ideal ratio is lower for dental arches with a high anterior curvature. There is a deficiency in the upper arch, a flatter anterior segment may compensate for some of the discrepancy and vice versa. Conclusion:An ideal Bolton value may not guarantee an ideal occlusion. Anterior tooth size ratio is not precise in predicting the anterior inter relationship post-treatment.