GOVERNMENT DENTAL COLLEGE AND HOSPITAL,

CUDDALORE

DEPARTMENT OF ORTHODONTICS AND DENTOFACIAL

ORTHOPAEDICS

MASTER OF DENTAL SURGERY (M.D.S)

SEMINAR TOPIC: MODEL ANALYSIS

GUIDED BY

[Link] ARAFATH,MDS
PROFESSOR AND HOD
DEPARTMENT OF ORTHODONTICS AND DENTOFACIAL ORTHOPAEDICS
PRESENTED BY

DR .BAVANA R
FIRST YEAR POST GRADUATE
INTRODUCTION

 Model analysis is the study of dental casts, which helps to study

the occlusion& dentition from all three dimensions &analyze the
degree & severity of malocclusion & to derive the diagnosis
&plan for treatment.
 Models accurately reproduce the teeth & their surrounding soft
tissue.
 Soft tissue must not be altered.
 Models should be well finished
ANALYSES

1. Mixed dentition analysis

2. Tooth size arch length discrepancy
3. Tooth size arch width discrepancy
4. Upper / lower tooth size discrepancy
5. Tooth shape disharmony
6. Photograhic analysis of study models
MIXED DENTITION ANALYSES

Whether there will be enough space to accommodate the unerupted

canine and 1st & 2nd premolars.
 Arch length and width achieved adult dimension following
eruption of permanent incisors.
 Early intervention
 6-12years
 NON RADIOGRAPHIC
 Moyers
 Tanaka johnson
 Ballard and wylie
 RADIOGRAPHIC
 Nance
 Huckaba
 COMBINATION
 Hixon and old father
 Stanley kerber

MOYERS MIXED DENTITION ANALYSIS

 Robert moyers in 1971

 Materials
o Boley’s gauge
 o Dental cast
o Probability chart
 75th level of accuracy

PROCEDURE
 Measure the sum of m-d width of lower permanent incisors.
 place 1 tip of gauge in midline & other at distal surface of
mandibular lateral incisor. mark this point & repeat this on other
side.
 2nd mark will be on deciduous canine in case of crowding.
 distance from mesial surface of mandibular 1st M to marked
point is space available for eruption of mandibular canine &
pms
 predict the size of canine & pms
from probability chart
 if space available is > the predicted space the excess space can
be used for late mesial shift of molars.
 is space available < predicted space = indication of future
crowding.
Advantages :
 Quick analysis
 No radiation
 High corelation among
groups of teeth
 Fair degree of accuracy
Disadvantages
 Probability analysis
 Specified population
TANAKA & JOHNSTON ANALYSIS
 After the study done in 504 orthodontic patients.
 This analysis takes three measurements into account:
 M-D width of mandibular incisors.
 Predicted size of permanent canines and premolars.
 Space available after the incisors are correctly aligned.
 They combined the sexes in the study whereas have separate
index for both sexes.
 sum of mandibular incisors + 10.5
2
( for mand. canine & pm)
 sum of maxillary incisors + 11
2
(for max. canine & pm)
 Space available = total arch length – [ sum of lower incisors
+ 2 x ( calculated width of canine and premolars)]

HIXON AND OLD FATHER &

STALEY AND KERBER’S ANALYSIS
 Original equation measurements was primarily obtained from
the measurements of the teeth on the left side.
 Whereas new one on both sides.
 IOWA facial growth studies.
 Arnamentarium:
 Boley’s gauge, Study cast,IOPA.
  Helios double caliper (staley and Kerber analysis).
 Premolars that were rotated were not used in staley and Kerber
analysis
 From the casts, on one side, measure the m-d widths of the
permanent mandibular central and lateral incisor.
 From the periapical radiographs, measure the m-d width of
unerupted first and second premolars
 Total the m-d widths of four(4) teeth. Compare the measured
value to estimated tooth size from the Hixon- Oldfather chart.
 Repeat steps 1 to 3 for the other side of the arch.


NANCE MIXED DENTITION

(RADIOGRAPHIC METHOS)
 This is similar to arch perimeter analysis of the permanent
dentition.

 Armamentarium
Dental cast, Boley gauge, millimeter ruler, Periapical radiograph.
ADVANTAGES
 It results in minimal errors
 It can be performed with reliability
 It allows analysis of both arches
LIMITATION
 It is time consuming
Complete mouth radiograph is needed
BALLARD AND WYLIE’S MODIFICATION
 Ballard and Wylie were so concerned about the distortions of
the X- ray films that they devised a scheme for estimating the
widths of the mandibular canine and the premolars on the basis
of the combined widths of the four lower incisors.
 Using the plaster models of 441 cases, they measured and
recorded the widths of all the mandibular teeth including the
first molars.
 On the average, the sum of the four permanent lower incisors
were 23.84 +/- 0.08 mm.
 The average sum of the canine,first and the second premolars
turned out to be 21.97 +/- 0.06mm
 Although not particularly high, the co-efficient of correlation of
+0.64 seemed sufficiently high to justify a predicton. They
modified the equation as Y = 9.41 + 0.527 ( X )
 Testing these calculations on 60 cases , Ballard and Wylie came
to a conclusion that their method had only 2.6% error as
compared to the 10.5% error when using only the X-rays.
 They do indicate that good X rays should be used and suggest
that their method was an adjunct to the Nance’s method.
 This analysis makes use of a radiograph and study cast to
determine the width of unerupted teeth.

Armamentarium
 Dental cast, Boley gauge, millimeter ruler,Periapical radiograph
 With any type of radiograph, it is necessary to compensate for
enlargement of radiographic image.
 This can be done by measuring an object that can be seen both
in the radiograph and on the cast, such as primary molar tooth.
  It is possible to determine the measurements of un- erupted teeth
by studying the teeth that have already erupted in a radiograph
and on a cast
 A simple relationship can be established

IRWIN R,HEROLD J,RICHARDSON A(1985)

 They concluded thata) Both Tanaka Johnson and moyers have
comparable standard errors of estimate,thus their accuracy is
fairly comparable.
 b) Moyers chart at 50% confidence level gives more realistic
estimate of width of unerupted canine and premolars as
compared to 75% confidence level for Marathi population.
c) Sugessted the use of newly developed regression equations is
suggested

Tooth size arch width discrepancy

ASHLEY HOWE’S ANALYSIS
 Relationship exists between the sum of m-d width of the teeth
ant. to 2nd molar & width of the dental arch in the 1st pm
region.
 He considered tooth crowding to be due to deficiency in arch
width rather than arch length.
 Determination of total tooth material (TTM)
 Determination of premolar diameter (PMD)
 Determination of premolar basal arch width (PMBAW)
 Determination of basal arch length(BAL)

P.M.B.A.W.%=P.M.B.A.W X 100
T.T.M
 The PMBAW & PMD are compared
 if PMBAW > PMD then it indicates that arch expansion is
possible.
 PMBAW < PMD it indicates that arch expansion is not possible.
 In 1909 Pont presented a system whereby the mere
measurement of 4 maxillary incisors automatically established
the width of the arch in the premolar and molar region.
 This Index is a maxillary Expansion index
 The distance between 14 - 24 (i.e. the distal end of the occlusal
groove) is recorded and called as measured premolar value
(MPV)
 The distance between 16 - 26 (i.e. the mesial position of the
occlusal surface) is recorded and is termed as measured molar
value (MMV).
 Where as on the mandibular teeth the points used are the
distobuccal cusps of the first permanent molar.
 Sum of incisors (SI)
 The distance between 14 - 24 is recorded and called as (MPV)
 The distance between 16 - 26 is recorded and is termed as
(MMV).
 Calculated premolar value =
(CPV)

 Calculated molar value =

(CMV)

 The difference between the measured and calculated values

determines the need for expansion.
 If measured value is less, expansion is required.
 Drawbacks :
 Analysis is based on study of French population and hence, its
universal validity is questionable.
 Does not consider skeletal mal-relationships and relationship of
teeth to the supporting bone.

LINDERHARTH ANALYSIS
This analysis is very similar to Pont’s analysis except that a new
formula has been proposed to determine the calculated premolar
and molar value
The calculated premolar value is determined using the formula:
S.I.x100/ 85
The calculated molar value is determined using the formula:
S.I.x100/ 64

KORKHAV’S ANALYSIS
This analysis is also similar to Pont’s analysis. In addition, this
analysis utilizes a measurement made from the midpoint of the
inter-premolar line to a point in between the two maxillary
incisors.
For upper anterior arch length -:
Maxillary arch length (Lu) = SuI x100/ 160
SuI=Sum of upper incisors

Correlation between maxillary and mandibular arch length -:

The anterior arch length of the mandible (Ll) is shorter than the
maxillary arch length (Lu) by labiolingual width of the incisal
edge of the upper central incisor
Standard value Ll= standard value of Lu-2mm
  Increased measurements – Proclined upper anterior teeth
 Decreased measurements – retroclined upper anterior teeth.

UPPER / LOWER TOOTH SIZE

DISCREPANCY
BOLTONS TOOTH RATIO ANALYSIS
 In 1958, Bolton published his work on interpreting m-d tooth
size dimensions and their effect on occlusion.
 The m-d widths of the 12 maxillary teeth (1st molar to 1st
molar) were summed up & compared with the sum derived by
the same procedure carried out on the 12 mandibular teeth.
 The ratio derived between the two is the percentage relationship
of mandibular arch length to maxillary arch length.
 If the overall ratio is > 91.3% = mandibular tooth material
excess
 If the overall ratio is < 91.3% = maxillary tooth material excess
  if ant. ratio is > 77.2% = mandibular tooth material excess
 if ant ratio is < 77.2% maxillary tooth material excess

TOOTH SHAPE DISHARMONY

Peck and Peck index
 It is done in lower arch
 Peck and Peck suggested :
- Persons with ideal incisal arrangement had smaller mesio-distal
width and comparatively larger labio-lingual width than in persons
with incisal crowding.

PROCEDURE:
 m-d widths of mandibular incisors = (M.D.).
 l-l width of mandibular incisors = (L.L.).
 Calculate proportion of the M.D of each tooth to the
L.L of the tooth by using the formula:
M.D. X 100.
L.L
 Mean value for central incisor 88-92
  Mean value for lateral incisor 90-95%
INFERENCE:
 If the value for a given case is more than the mean value then,
mesio-distal width of the tooth is more than the labio-lingual
width, proximal stripping is indicated in such cases.

TOOTH SIZE ARCH LENGTH

DISCREPANCY
CAREY’S ANALYSIS /ARCH PERIMETER
ANALYSIS
 Carey’s Analysis helps in determinining the extent of
discrepancy b/n arch length & tooth material discrepency.
 It is performed in lower cast & same on upper is called arch –
perimeter analysis
 The arch anterior to the first permanent molar is measured using
soft brass wire touching mesial surface of 1 st molar of one side
and passed over buccal cusps of the premolar & along anteriors
& is continued opposite side first molar.
SANIN & SAVARA ANALYSIS
 This makes use of precise mesiodistal measurements of the
crown size of each tooth
 Appropriate tables of tooth size distributions in the population &
charts for plotting the patiets measurements
 Commonly used is a boleys gauge to measure the teeth.

DIAGNOSTIC SETUP
KESLING DIAGNOSTIC SET-UP
 HD Kesling introduced the diagnostic set-up
 it helps the clinician in t/t planning as it simulates various tooth
movements, which are to be carried out in the patient.
 The individual teeth along with their alveolar process are
sectioned off from the model using a saw and replaced back in
the desired final position
PROCEDURE
• Dental cast arranged at 65`to FH plane
Mandibular Incisors are arranged at same angle
Canine and Premolars are placed in correct contact relationship
 The maxillary teeth according to the mandibular teeth.

 If the remaining space on each side is adequate to receive the

permanent first molar, then extraction is not required.
 If space is inadequate then some teeth must be removed usually
the first premolar.
 Aids treatment planning as it helps to visualize tooth size-arch
length discrepancies and determine whether extraction is
required or not.
 The effect of extraction and tooth movement following it on
occlusion can be visualized.
 It also acts as a motivational tool as the improvements in tooth
positions can be shown to the patient.
 Total space analysis:
Developed by Levern Merrifield of the Charles H. Tweed
International Foundation For Orthodontic Research) .
This method was divided into 3 areas
 Anterior area
 Middle area
 Posterior area
 Tooth measurement
 Measurement of mandibular incisors widths on the cast were
added to values obtained from the radio graphic measurements
of the canines.
 Space available-
by passing brass wire from mesiobuccal cusp 1 primary M on 1 side
to other.
 the wire was straighten & measured.
 this value is subtracted from total space required.

Ree’s analysis
 Given by Denton J. Rees.
 All the measurements are made on study models which should
be essentially accurate.
 Special attention given to the extension into the mucobuccal
fold in order to approximate basal bone to at least the distal of
first permanent molar.
Method
 A ruler is placed against the side of the cast, at right angles to
the occlusal surface, and a line is drawn at the mesial contact
point of each first permanent molar.
 The third line is drawn through the midline contact of upper and
lower central incisor.
 This line is extended to a point 8-10mm from the gingival
margin in the apical direction
 A piece of scotch tape 5 inches long is cut into strips
approximately 1/8th inch wide and a thin strip of tape is then
placed so that one end is superimposed on the molar mark.
 The tape is pressed firmly to the cast to pass through the incisor
point, and then trough the opposite molar point.
 The teeth on each cast from second premolar to second premolar
are recorded at their greatest mesio distal diameter.
Calculations
 Following chart permits a quick analysis on any sets of casts.
 UB to UT =1.5 to 5 - mean 3.5 - range 3.5
 LB to LT =2 to 7 - mean 4.5 - range 5
 UB to LB =3 to 9.5 - mean 6.5 - range 6.5
 UT to LT =5 to 10 - mean 7.5 - range 5
 Where U = MAXILLA; L= MANDIBLE; B= APICAL BASE;
T= TOOTH CROWN
 Inference 1) By comparing the average normals to the
measurements taken on the set up casts, following points of
diagnostic importance can be derived.
 UB to UT or LB to LT.
 If discrepancy exists, in borderline cases, internal and external
muscular forces, facial esthetics, and other factors will
determine the treatment plan
 UB to LB. If discrepancy exists, reduction of teeth and base may
be necessary in one arch, or if not indicated, expansion of other
arch is the only alternative.
 UT to LT. If discrepancy beyond normal range are present,
tooth mass is reduced in one arch or increased in the other by
judicious placement of crown or inlays.

IRREGULAR INDEX
 Given by Robert M. Little.
 Anterior dental crowding is perhaps the most frequently
occurring characteristics of malocclusion.
 Adjectives such as mild, moderate and severe etc. are
descriptively helpful but still allow a wide range of
interpretation.
 The proposed scoring method involves measuring the linear
displacement of anatomic contact points, of each mandibular
incisors from the adjacent tooth anatomic points.
 The sum of these five displacements represent the degree of
anterior irregularity
 Each of five measurements represents, in horizontal linear
distance between the vertical projection of the anatomic contact
points of adjacent teeth.
 Calculations/ Inferenence: The results of the irregularity index
can be correlated with the scale ranging from 0 to 10 formed by
the subjective ranking.
 0 – Perfect Alignment.
 1,2,3 - Minimum irregularity.
 4,5,6 - Moderate irregularity.
 7,8,9 – Severe irregularity.
 10 to 20 – Very severe irregularity.

 PHOTOGRAPHIC ANALYSIS OF
STUDY MODELS
sterophotogrametry
Occlusograms
The value of plaster models in permitting three-dimensional studies of
malocclusions for diagnosis and treatment planning and as a reference
throughout treatment has obscured the value of other methods of
viewing malocclusions, such as by two-dimensional occlusograms

 An occlusogram is a 1:1 reproduction of the occlusal surfaces of

plaster models on a sheet of acetate tracing paper. A central
groove cut into the backs of both models can be used to orient
upper tracing to lower tracing.
 For the occlusograms photographic copies of max. & mand.
study models are made.
 copies are taken parallel to the occlusal plane.
 tracing of the teeth of both the arches can be superimposed to
match the occlusion.
USES
 to develop ideal natural individualized arch form.
 permits clinician to make accurate & reliable arch length
discrepancy measurements.
 to identify problems in transverse plane.
 for predicting occlusal relationships.
3D DIGITAL ANALYSIS

ADVANTAGES:
 More accurate
 Easy method
More information
 arch form
 determine asymmetrical arch
 Space analysis
 Rotation
 Prediction
CONCLUSION:
There are numerous model analysis based on different criterias.
Now it is left to the orthodontist to accept which ever analysis he
feels best suits his group of patients and his diagnosis and treatment
planning.

REFERENCES:
 Proffit WR: Contemporary Orthodontics
 Graber, Vandersdall: Orthodontics; Current Principles and
Techniques.
 Digital models : a new diagnostic tool: W Ronald Redmond
JCO 2001, 06, 386.
 The clinical use of occlusograms: Larry W White
JCO 1982 feb 92- 103.