Arch Width, Arch Length, And Tooth
Size In Young Adult Males
Loren F. Mus, D.D.S.*
Bethesda, Maryland
‘The problem of malocclusion is re-
ceiving great attention by private prac-
titioners and public health dentists.*
Orthodontists have felt that crowding
of teeth may be related to arch width or
length, to disproportionately large teeth,
or to a combination of factors.*~
‘The purpose of this preliminary study
was to determine if well-aligned dental
arches in young adult males differ from
crowded dental arches in width, length,
or tooth size. If consistent differences
could be discovered and defined, they
might be useful in formulating plans of
treatment and possibly in predicting
future needs.
MetHops
Arch width and length and mesio-
distal crown diameters of the right
central and lateral incisors in the
maxillae and mandibles were measured
for volunteer midshipmen at the United
States Naval Academy, Annapolis, Md.
Two hundred and thirty midshipmen,
aged 17-21 years, were selected for
study on the basis of neutroclusion of
molars without complicating factors,
such as cross or open bites, together
with a full complement of teeth mesial
to the second molar in each jaw. None
had a history of orthodontic treatment.
‘The study group was selected from
examinations of 524 midshipmen.
The decision to measure and allow
the right central and lateral incisors in
cach arch to represent the tooth size for
* U.S. Department of Health, Education,
and Welfare, Public Health Service,
National Institutes of Health, National
Institute of Dental Research, Epidemio-
logy and Biometry Branch, Bethesda 14,
Maryland,
each individual in the group was based
on the findings of Seipel’ and a spot
check of 100 randomly selected mid-
shipmen, (Table 3). Seipel has shown
that measurements of mesiodistal crown
diameter are not significantly different
between the right and left side and a
summing up of the entire tooth mate-
rial necd not be made. A certain tooth
or group of teeth can be selected and,
with a reasonable degree of safety, be
made to represent the characteristics or
specific tooth size of an individual or
group of individuals.
The men were of mixed European
ancestry, from all of the 50 states, and
from various socioeconomic _ levels.
Naval regulations governing the ad-
mission of candidates to the academy
state that each applicant be physically
sound, well-formed, and of robust
constitution, Weight must be in propor-
tion to height and general build. The
average height and weight for mid-
shipmen are 7123 inches and
174+ 20.5 pounds, respectively. These
men are above average and are not
representative of the usual 17-21 year
old American male.
Teeth were measured with a Boley
gauge. Points of the calipers were filed
in order to facilitate measurements in
the mouth to the nearest tenth of a
millimeter, Width of dental arches was
determined by a combination of di
viders and sliding scale Helios milli-
meter ruler in the canine, first pre-
molar, and second premolar regions to
the nearest 0.1 mm. Widths of arches in
the canine and premolar regions were
measured with the dividers from the
oeVol. 34, No. 2
FIGURE 1
Tooth Size sb)
Arch length
Canine width
1st premolar width
ftp- 2nd premolar width
DENTAL ARCH WIDTHS AND LENGTHS WERE MEASURED FROM
THE REGIONS INDICATED BY THE BROKEN LINES IN THE DIAGRAM
Fig. 1
tip of the facial cusp of one premolar,
or canine, across the dental arch to the
corresponding point on the homologous
tooth. The distances between the tips
of the dividers were then measured on
the Helios ruler. Arch length was meas-
ured for the maxilla from a uniform
point (Fig. 1) on the mesiolingual sur-
face of the first molar to the conjune-
tion of mesial surfaces of the central
incisors immediately incisal to the pa-
pilla. Similarly, mandibular measure-
ments were made from first molars to
the gingival junction of the central
incisors. Left and right segments of
each were averaged to obtain length
measurements for both maxillae and
mandibles.
Crowding or malalignment was esti-
mated according to the degree of dis-
placement of individual teeth from the
general configuration of the dental
arches. Values of 0, 0.13, 0.25, 0.50,
0.75 or 1.00 were assigned to each tooth
mesial to first molars depending upon
the relative displacement. These values,
illustrated in Figure 2, approximate
that fraction of the tooth outside the
normal arch line. For example, a score
of 0.25 for a maxillary central incisor
with a mesiodistal crown diameter of
9.10 mm would indicate that approxi-
mately 2.28 mm of the tooth was over-
lapped or displaced, Rotated teeth
FIGURE 2
ALIGNMENT SCORE
Fig. 2126 Mills April, 1964
TABLE 1
‘Arch Widths in Region of
Ast 2nd
Alignment Score Canine Premolar Premolar Arch Length
= MAXILLARY ARCH
Zero 35.7 42.7 48.7 326
(n= 82)
0.18 - 0.50 35.0 42.0 473 328
(n = 108) :
0.74 - 1.25 35.1 40.8 46.6 32.9
(n= 77)
1,50 - 3.00 348 411 44.7 32.6
(n = 18) S
All Men Examined 35.13.20 41.60% .17 47.05.18 32.79 + .20*
(n = 230)
MANDIBULAR ARCH
Zero 26.6 34.5 40.5 268
(n = 82)
0.13 - 0.50 26.3 34.3 39.8 26.8
(n = 103)
0.75 - 1.25 25.9 34.8 39.6 214
(n= 77) a
1.50 - 3.00 23.5 33.8 36.6 26.1
(n = 18) a
All Men Examined 26.00+ 15 34.304 .16 39.60.17 26.95 + 32
(n = 280)
* Mean and standard error
which were not displaced were des
nated as zero because tooth space had
been maintained. Total alignment score
for each individual was the sum of the
values assigned to each of his teeth.
Individuals with ideal tooth alignment
scored zero.
Resuurs
Average arch widths for the maxilla
and mandible in the canine, first pre-
molar, and sccond premolar regions
were determined according to align-
ment scores, (Table 1). Some relation
between arch width and alignment
score was apparent in each of the six
measurements, The most consistent re~
lation was seen in the measurement of
the second premolar axis. At this point,
the average width of both maxillary
and mandibular arches across the sec-
ond premolar region steadily decreased
in size as malalignment increased in
severity. Individuals with an ideal
alignment score of zero had dental
arches in the second premolar region
which were, on the average, approxi-
mately four millimeters larger than
those with alignment scores ranging
from 1.50-3.00. This difference is sta-
tistically significant (p < 0.01).
None of the 32 persons with ideal
tooth alignment measured less than 45
mm across the maxillary second pre-
molar region or less than 40.5 mm
across the same region in the mandible.
Fourteen of the 18 persons (78%)
with the most severely crowded teethVol. 34, No. 2 Tooth Size
TABLE 2
MAXILLARY ARCH
Central Lateral
Incisor Incisor Total
9.0 6.8 168
9.0 68 158
2 Ca
7 ot 69 16.0
‘All Men Examined 9.01204 6824.07 15.8321"
n= 280
____ MANDIBULAR ARCH
Central Lateral
Alignment Score Incisor Incisor Total
Zero — 55 59 14
n= 22
0.18 - 0.50 5.5 6.0 15
n= 108
5.5 5.9 114
ee 60 115
n=18
All Men Examined 5.50 + 05, 5.95 + 10 11.45 + .08
n= 230
* Mean and standard error
had width measurements in both the
maxillary and mandibular second pre-
molar regions that were less than 45
mm and 40.5 mm, respectively, while
four (22%) had width up to one milli-
meter greater than these values. Three-
quarters of the individuals (103 out of
135) with almost perfectly aligned
teeth, (scores ranging from 0-0.5), had
widths of 45 mm or greater in the
maxilla and 40.5 mm or greater in the
mandible, while three-quarters of the
persons (77 out of 95) with alignment
scores ranging 0.75-3.00 had widths less
than 45 mm and 40.5 mm in the maxilla
and mandible, respectively. The use of
arch width in the second premolar re-
gion to estimate the alignment of teeth
would have miscategorized 50 (21.7%)
of the midshipmen.
Linear regression coefficients were
calculated between the arch width
measurements across the second pre-
molar region and alignment scores for
the 230 persons studied. These coeffi-
cients indicate the w of change in
alignment score for a given unit of
change in arch width and were —0.21
+ 07 and —0.13 + .04, respectively, in
the maxilla and mandible. These in-
verse regression coefficients were sta-
tistically significant (p < 0.01).
No relation was demonstrated be-
tween the severity of malalignment and
maxillary or mandibular arch length.
There was very little difference in128
TABLE 3
between
“0.98
0.78
0.95
0.57
0.55
0.58
0.55
0.56
0.55
0.57
0.56
0.59
0.56
0.52
0.51
mean mesiodistal crown diameters of
maxillary and mandibular central and
lateral incisors in men with teeth in
excellent alignment compared with men
with teeth in varying degrees of crowd-
ing. These findings are shown in Table
2. Ninety-five per cent of all maxillary
central incisors measured between 8.0
and 10.0 in mesiodistal diameter, while
ninety-five per cent of maxillary laterals
were within the range of 5.5 and 8.0
mm. Range of variation for mandibular
incisors was of a similar magnitude.
There was a pronounced positive corre-
lation of crown diameters of various
tooth types within individuals, (Table
3). The results are similar to those of
other investigators.*
Discussion
In this group of men, mean arch
width in the second premolar region
would have been a good index of group
scores for tooth crowding. Excellent
alignment would have been predicted
for four individuals who actually had
severe crowding and for nineteen per-
Mills
April, 1964
sons whose alignment scores ranged
from 0.75-1.25. For these reasons it is
doubtful whether width measurements
across the second premolar region could
be used with confidence in individual
cases. However, the present findings do
tend to support the suggestion of
Howes! that lack of arch width in the
premolar area may be an important
factor in malalignment. Further testing
of this relationship and refinement of
the methods appear to be indicated
The present findings did not show a
relation of tooth size or arch length,
mesial to Ma, to alignment. Mesiodistal
crown diameter of incisors in this study
were similar to the dimensions reported
by others" Mean incisor crown
diameters did not differ much between
persons with high and low alignment
scores,
The present results were obtained in
a unique population of midshipmen
selected according to superior standards
of health and physical development.
The association between alignment of
teeth and second premolar arch width
should be studied further in more near-
ly representative populations,
Summary
Arch width, arch length, incisor
crown diameter, and malalignment
scores were determined for 230 young
adult males with neutroclusion of mo-
lars at the United States Naval Acad-
emy, Annapolis, Md. Results indicated
a significant association between mal-
alignment of teeth and arch width.
Arch length mesial to Mz and incisor
crown diameter did not vary in persons
with and without malalignment.
ACKNOWLEDGMENTS
Gratitude is expressed to the United
States Navy Dental Service, especially
to Captains William R. ‘Stanmeyer,
Kenneth Longeway, Paul Moore, and Lt.
F. M. Richardson’ for their assistance
and cooperation.Vol. 34, No. 2
Angle's molar classification and the
other characteristics of malocclusion
were determined independently by Dr.
Peter J. Coccaro, Oral Pharyngeal De-
velopment Section, Oral Medicine and
Surgery Branch, National Institute of
Dental Research.
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