Bolton analysis

Bolton Analysis is a tooth analysis developed by Wayne A. Bolton to determine the discrepancy between size of maxillary and mandibular teeth. This analysis helps to determine the optimum interarch relationship. This analysis measures the Mesio-distal width of each tooth and is divided into two analyses.[1][2]

History

Wayne A Bolton presented this analysis in the year 1958. In 1962, he published another paper which talked about clinical applications of using Bolton Analysis in Orthodontics. He was the graduate of University of Washington's first dental class in 1950 and also the first orthodontic class of 1952. A boley gauge is usually the instrument of choice to measure the widths of each teeth. However, in 1995, Shellhart et al. showed during their study that Vernier caliper can also be used as an alternative for Bolton Analysis.[3] Many other investigation models have been developed, such as measurement from photocopies and traveling microscope but the studies have produced no results.[4]

Recently, digital calipers from companies such as OrthoCad, are being used to measure the mesiodistal widths of the teeth.

Analysis

An Overall Analysis measures the sum of mesio-distal width of all 12 (first molar to first molar) mandibular teeth and compares them to the 12 maxillary teeth. The overall ratio known to be 91.3%.[5] The anterior analysis measures the sum of Mesio-distal width of front 6 mandibular teeth and compares them to maxillary teeth. The anterior ratio is known to be 77.2%. An overall ratio of more than 91.3% means that the mandibular teeth are bigger when compared to normal. A ratio smaller than 91.3% would mean the mandibular teeth are smaller than normal. Anterior analysis follows the same principle. Having a different ratio than normal is referred to as Bolton Discrepancy. A standard deviation of more than 2 yields a significant discrepancy.

Drawbacks

One of the drawbacks of this analysis, is that the sample that Bolton measured in his paper in 1958, consisted of only Caucasian population. Therefore, Bolton's Overall Ratio and Anterior Ratio Mean and Standard Deviations are not representative of samples from other race and population. In addition, because the samples that were measured had perfect malocclusion, any samples after performing Bolton Analysis, will yield a high discrepancy compared to Bolton ratios. It is seen that majority of the populations when studied and compared to Bolton's ratios, are usually not ideal compared to his ratios.

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References
  1. Nalacci, Ruhi (2013). "Comparison of Bolton analysis and tooth size measurements obtained using conventional and three-dimensional orthodontic models". European Journal of Dentistry. 7 (5): S66–70. doi:10.4103/1305-7456.119077. PMC 4054082. PMID 24966731.
  2. Bolton, Wayne (1958). "Disharmony In Tooth Size And Its Relation To Treatment of Malocclusion". The Angle Orthodontist. 28: 113. doi:10.1043/0003-3219(1958)028<0113:DITSAI>2.0.CO;2 (inactive 2020-03-06). Retrieved 6 September 2015.
  3. Shellhart, WC (1995). "Reliability of the Bolton tooth‑size analysis when applied to crowded dentitions". The Angle Orthodontist. 65 (5): 327–34. doi:10.1043/0003-3219(1995)065<0327:ROTBTA>2.0.CO;2 (inactive 2020-03-06). ISSN 0003-3219. PMID 8526291.
  4. Champagne, M (1992). "Reliability of measurements from photocopies of study models". Journal of Clinical Orthodontics. Retrieved 6 September 2015.
  5. Ebadifar, Asghar (2013). "Comparison of Bolton's Ratios before and after Treatment in an Iranian Population". Journal of Dental Research, Dental Clinics, Dental Prospects. 7 (1): 30–5. doi:10.5681/joddd.2013.005 (inactive 2020-03-06). PMC 3593202. PMID 23487005.
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