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We would like to dedicate our thesis to
Our Dear Parents,
there are not enough words that can thank you for
everything you have done for us in all these years.
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With special regards to Dr Sh Ajami
Dr HR Fattahi, thank you for all your support and help.
Acknowledgement
The authors thank the Vice-Chancellory of Shiraz University of
Medical Science for supporting this research (Grant #6143). This
article is based on the thesis by Dr Mahsa Zare & Dr Peyman Jenabi.
The authors also thank Dr Mehrdad Vossoughi of the Dental
Research Development Center, of the school of Dentistry for the
statistical analysis in the manuscript.
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Content
Abstract ------------------------------------------------------------------ VII
Chapter 1: Introduction and goals ------------------------------------ 1
1.1 Background and Importance of the study------------------------------------------------------------------------------------------------ 2
1.2 Statement of the problem ----------------------------------------- 3
1.3 Hypotheses and research questions ------------------------------ 4
1.4 Research Objective ------------------------------------------------ 5
Chapter 2: Present knowledge regarding the study --------------- 6
2.1 Background --------------------------------------------------------- 7
2.2 Word definitions ------------------------------------------------- 18
2.3Review of literature ----------------------------------------------- 20
Chapter 3: Materials and methods --------------------------------- 23
3.1 Type of study ----------------------------------------------------- 24
3.2 Study population -------------------------------------------------- 24
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3.3 Sampling method ------------------------------------------------- 24
3.4inclusion criteria -------------------------------------------------- 24
3.5 exclusion criteria ------------------------------------------------- 25
3.6 Data acquisition methods --------------------------------------- 25
3.7 Statistical analysis ------------------------------------------------ 28
Chapter 4: Results----------------------------------------------------29
4.1 text, charts and grap--------------------------------------------30
4.1.1 Size and distribution of TSD ------------------------- 30
4.1.2 Reliability ----------------------------------------------- 33
4.1.3 Quick Look Test ---------------------------------------- 35
Chapter 5: Discussion ------------------------------------------------- 37
5.1 Interpretation of the findings and data analysis --------------- 38
5.2 Conclusion -------------------------------------------------------- 42
Chapter 6: References ------------------------------------------------- 42
References -------------------------------------------------------------- 43
IV
List of Tables
Table1a-Comparison of Bolton’s study and the present study: Anterior ratio--30
Table1b-Comparison of Bolton’s study and the present study: Overall ratio---31
Table 2- the prevalances of TSD beyond 1.5, 2 and 3mm---------------------------33
Table3- inter examiner error analysis--------------------------------------------------33
Table 4- Intra-examiner 1 error analysis-----------------------------------------------34
Table 5- Intra-examiner 2 error analysis-----------------------------------------------34
Table 6-Summery of Sensitivity and Specificity for anterior TSD and theQuick
Look test------------------------------------------------------------------------------------35
Table 7- summery of TSD calculated in different populations---------------------39
V
List of Figures and Graphs
Figure 1- Digital caliper used for measurements------------------------------------26
Figure 2- Measuring the Height of Contour------------------------------------------27
Graph 1- The distribution of anterior tooth ratios in this study categorized by
Bolton’s original means and SD--------------------------------------------------------31
Graph 2- The distribution of overall tooth ratios in this study categorized by
Bolton’s original means and SD--------------------------------------------------------32
Graph3- ROC curve analysis of anterior TSD---------------------------------------36
Graph4- ROC curve analysis of the Quick Look test-------------------------------36
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Abstract
Introduction: A significant percentage of any random or orthodontic
population will have a discrepancy>2 of Bolton’s standard deviations from
Bolton’s means, especially for the anterior ratio. More fundamental than this
is the question of the absolute size of discrepancy thought to be incompatible
with an acceptable occlusal fit. Method:The sample comprised 150
randomly selected pretreatment study casts with fully erupted permanent
teeth from 6 to 6. The mesiodistal diameter tooth sizes were measured using
digital calipers, and the Bolton analysis were calculated manually. Simple
visual estimation of Bolton discrepancy was also performed. To examine the
sensitivity and specificity of clinically significant TSD using Bolton’s SD
and Proffit’s eyeballing suggestion ROC curve analysis was done. Results:
In the sample group 34.7% had anterior tooth-width ratios and 20.7% had
overall ratios greater than 2SD of Bolton’s means, and about half of the
patients require correction for the anterior ratio, following Proffit’s visual
suggestion. The sensitivity of clinically significant TSD further 2SD of
Bolton’s means and the “Quick Look” test was 96.0% and a cut off point of
-0.12mm was obtained.Conclusion: Bolton's analysis should be routinely
performed in all orthodontic patients and the findings should be included in
orthodontic treatment planning. Visual estimation of TSD wuold be
suggested instead of careful measurements and set-ups.
Key words: Bolton analysis, Tooth Size Discrepancy, lateral incisor
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