The effect of tooth size discrepancy on occlusion: An experimental study

Abstract

The purposes of this experimental study are the following: (1) to compare the anterior and overall tooth size ratios reported by Bolton to values reported in epidemiologic studies, (2) to assess the accuracy of tooth size discrepancy measurements, (3) to investigate to what extent generalized tooth size discrepancy affects occlusion, (4) to investigate the effect of leveling the curve of Spee, and (5) to evaluate the effect of extraction therapy of 4 premolars on occlusion. For the first part of the study, Bolton’s mean anterior and overall tooth size ratio (as well as the extraction values) were compared with calculations derived from 4 publications reporting mean mesiodistal tooth width by using the t test ( P ≤ .05). The second part of the study was carried out on a setup made from 1 dental cast of a male patient judged to have an ideal occlusion at the end of a nonextraction treatment. Our data reveal (1) no significant difference between the overall tooth size ratios of the Bolton values compared to 4 studies, but the anterior ratios were significantly different, (2) high reproducibility (99%) of tooth size discrepancy measurements, (3) that severe tooth size discrepancy affects the occlusion only a little, (4) that an excessive (6 mm) curve of Spee creates the poorest setup result, and (5) that extraction therapy only slightly affected the final occlusion. The effect of generalized tooth size discrepancy appears to be limited. (Am J Orthod Dentofacial Orthop 2000;117:184-91)