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 Table of Contents  
ORIGINAL ARTICLE
Year : 2018  |  Volume : 9  |  Issue : 3  |  Page : 93-100

An odontometric study of arch dimensions among Qatari population sample with different malocclusions


Division of Orthodontic, Hamad Dental Centre, Hamad Medical Corporation, Rumailah Hospital, Doha, Qatar

Date of Web Publication31-Aug-2018

Correspondence Address:
Hayder Abdalla Hashim
Division of Orthodontic, Hamad Dental Centre, Hamad Medical Corporation, Rumailah Hospital, Doha P. O. Box 3050
Qatar
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijor.ijor_12_18

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  Abstract 

Background: Arch dimensions are very important to clinicians in orthodontics, pedodontics, prosthodontics, as well as to anthropologist. The dimensions include arch widths, arch length, and intra-alveolar width which assist in establishing proper diagnosis and treatment planning.
Aims: This study aims to determine the arch dimensions in Qatari sample with different malocclusions, compare the results obtained with other previous studies and also compare the result between the different Angle's malocclusions classes.
Materials and Methods: The sample consisted of 90 pairs of pretreatment orthodontic study casts selected from patients attending the orthodontic clinic. The sample was classified into three groups according to Angle's Classification as follows: Class I, Class, II, and Class III malocclusion and each group consisted of 30 pairs. The age range was between 13 and 20 years old. The intercanine width, inter-premolar width, intermolar width, and intra-alveolar width measurements were made in each dental cast using an electronic digital caliper. Independent t-test was performed for comparative analysis.
Results: Descriptive statistics were presented for the three Angle's classifications. No significant difference was noted between the maxillary variables in Class I and Class III. Statistically significant difference was noticed in maxillary variables in Class II (intermolar II and inter-premolar I and II). Furthermore, significant differences were revealed in mandibular intermolar I and II, inter-premolar II, and inter-alveolar between Class III and Class I and also between Class III and Class II malocclusions. Class III malocclusion showed wider arch dimensions than that in Class I and Class II.
Conclusions: The result of the present study is important to the orthodontist, pedodontist, and also to the prosthodontist and anthropologist.

Keywords: Angle's classification, arch dimension, inter-alveolar width, intercanine width, intermolar width, inter-premolar width


How to cite this article:
Hashim HA, Dweik YG, Al-Hussain H. An odontometric study of arch dimensions among Qatari population sample with different malocclusions. Int J Orthod Rehabil 2018;9:93-100

How to cite this URL:
Hashim HA, Dweik YG, Al-Hussain H. An odontometric study of arch dimensions among Qatari population sample with different malocclusions. Int J Orthod Rehabil [serial online] 2018 [cited 2018 Oct 21];9:93-100. Available from: http://www.orthodrehab.org/text.asp?2018/9/3/93/240310


  Introduction and Review of Literature Top


Arch dimensions are very important to clinicians in orthodontics, prosthodontics, and oral and maxillofacial surgeons, as well as to anthropologist. These arch dimensions include arch widths, arch length, and inter-alveolar width which will be of great help in diagnosis and treatment plan.

Several studies were conducted with different results. AL-Taee[1] carried out study consisted of 56 pairs of study casts with Angle Class I and Class II division 1 malocclusions in AL-Ramadi city. She concluded that the arch widths were smaller in Class II division 1 malocclusion when compared to Class I normal occlusion. However, the mandibular intercanine width and the arch widths were larger in males compared to the females.

Frohlich[2] did study of arch dimensions in 51 children who presented with Angle Class II and normal occlusion. She mentioned that the data of her study were collected earlier by Moorrees.[3] The result of the intercanine and intermolar widths of maxillary and mandibular arches revealed no significant difference. However, Sayin and Turkkahraman[4] carried out an investigation of arch dimensions in patients presented with Angle Class II division 1 malocclusion and with Class I ideal occlusion. They found a significantly increased mandibular intercanine width in the Class II division 1 and reported that the maxillary intermolar widths were larger in the normal occlusion sample.

Ahmed et al.[5] stated that the maxillary intercanine width was significantly decreased in Class II division 1 and division 2. On the other hand, the maxillary and mandibular intercanine and intermolar widths were increased in Class II division 2 malocclusion.

Bishara et al.[6] conducted a study in the maxillary and mandibular dental arch widths and lengths including growth between Class II division 1 malocclusion and normal occlusion. They found no difference in the maxillary and mandibular intercanine width.

Uysal et al.[7] performed a study on dental casts of 150 normal occlusion, 106 Class II division 1, and 108 Class II division 2 malocclusions. They observed narrower maxillary inter-premolar width, maxillary canine, premolar and molar alveolar widths, and mandibular premolar and molar alveolar widths when comparing between Class II division 1 malocclusion and normal occlusion. They also observed significantly narrower maxillary inter-premolar width, canine and alveolar widths, and all mandibular alveolar widths were significantly narrower in the Class II division 2 group than in the normal occlusion. Furthermore, the mandibular intercanine and inter-premolar widths were narrower, and the maxillary intermolar width measurement was larger in the Class II division 2 when compared with the Class II division 1. They concluded that the maxillary molar teeth in Class II division 1 malocclusions tend to incline to the buccal to compensate the insufficient alveolar base.

Further, Staley et al.[8] conducted a comparative study in arch dimension in patients within a normal occlusion and Class II division 1 dentally and skeletally. They found that the maxillary intermolar width, intercanine width, and inter-alveolar width were significantly greater in the Class I than the Class II, division 1. In normal occlusion, males had significantly larger dimensions than females in five of the six arch width variables, whereas in Class II, division 1, the males had larger dimensions when compared with females; however, the difference was not significant only in the maxillary and mandibular inter-alveolar widths.

Diwan and Elahi[9] measured the intermolar width and intercanine width in 91 adults Filipinos. The results were compared to other reported studies of maxillary arch dimensions for adult Egyptians and Saudis. They found that the Filipinos had narrower intermolar width compared to that of the Egyptians and greater intercanine width than that of Saudis.

Buschang et al.[10] performed an investigation in dental arch morphology in untreated adult females had Class I, Class II division 1, and Class II division 2 malocclusions. They observed that females with Class II, division 1 malocclusion had the longest and narrowest arches when compared to the other malocclusion.

In 2002, Walkow and Peck[11] studied maxillary and mandibular dental arch widths of 23 dental casts of patients presented with Class II division 2 malocclusions and compared with control sample. They dental arch form of Class II division 2 was normal with the exception of reduced mandibular intercanine width. Further, they observed that the maxillary and mandibular posterior arch widths of Class II division 2 patients were similar to those of other orthodontic patients.

Varrela[12] reported that the cause of the typical Class II occlusion was due to the deficiency of the transversal growth of the maxilla and also due to the sagittal growth of the mandible. Further, McNamara[13] found that maxillary arch was narrower in patients with Class II division 1 malocclusion, and recommended that expansion was needed during or before orthodontic treatment.

Recently, Adil et al.[14] investigated the differences in inter- first premolar, molar width, and arch depth in different malocclusions in 112 dental cast of nonorthodontically treated Pakistani patients with age more than 14 years. Significant differences in inter- first premolar and intermolar width arch between Class I and Class II and in inter- first molar width in Class II and III were observed. They concluded that in Angle's Class III the palate was shallowest and the maxillary inter- first premolar and molar width is the largest in Angle's Class I and Class II, whereas the narrowest arch was in Class II.

Very recently Herzog et al.[15] conducted a study on patient presented with Angle's Class I. Thirty-one patients treated with extraction of four first premolars and 31 patient treated without extraction. The maxillary and mandibular intercanine and intermolar widths and perimeters were assessed by digital scanning of their dental cast. They concluded that patients treated with extraction had reduced maxillary and mandibular intermolar and arch perimeter measurements compared to the nonextraction, and no significant difference was observed in intercanine width in both arches and between the extraction and nonextraction patients.

When searching the literature no research or data was published for the Qatari population. Therefore, the aim of the present investigation was to obtain arch in Angle's Class I, II and III malocclusion and compares the result obtained with previous reports as well as between the different malocclusion Classes.


  Materials and Methods Top


Materials

A total of 90pairs of pretreatment orthodontic study models with Angle's Class I, Class II division 1, and Class III malocclusion were selected from orthodontic records. Each malocclusion class consists of 30 study models of participants seeking orthodontic treatment.

Criteria for sample selection

  1. All participants should be Qatari national
  2. Age ranged from 13 to 20 years
  3. Bilateral buccal segment, Class I, II, and III molar relationship
  4. Good quality study models without severe crowding, rotations, or Class II restorations
  5. Presence of all fully erupted permanent teeth in both arches.


Methods

Measurements were performed on the orthodontic study models using an electronic digital caliper measuring to the nearest 0.01 mm (Mitutoyo U. K.). One operator (Y. D) measured the following parameters on both jaws [Figure 1] and [Figure 2]:
Figure 1: Reference points of maxillary arch width

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Figure 2: Reference points of mandibular arch width

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  1. Maxillary and mandibular intercanine width: Distance between the cusp tips of the right and left permanent canines
  2. Maxillary and mandibular inter-premolar width I: Distance between buccal cusp tips of the right and left permanent first premolars
  3. Maxillary and mandibular inter-premolar width II: Distance between buccal cusp tips of the right and left permanent second premolars
  4. Maxillary and mandibular intermolar width I: Distance between the mesiobuccal cusp tips of the right and left permanent first molars
  5. Maxillary and mandibular intermolar width II: Distance between the central fossa of the right and left permanent first molars
  6. Maxillary and mandibular inter-alveolar width: Distance between the mucogingival junctions above the mesiobuccal cusp tips of the right and left permanent first molars.


Statistical analysis

The descriptive statistics were presented for each variable, and independent t-test was used for comparison between the different malocclusion classes and previous study results. The level of statistical significance was P < 0.05.

Error of the method

A total of 10 pairs of pretreatment study casts were randomly selected measured and remeasured by the same operator with 1-week interval. Independent t-test was used for analyzing the error of the method.


  Results Top


[Table 1] shows the result of the error of the method. The independent t-test result showed no statistically significant differences were observed between the first and second readings for all variables.
Table 1: Error of the method

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[Table 2] and [Table 3] exhibit the mean, standard deviation, standard error, and minimum and maximum values in the maxilla and the mandible for Angle's Class I, Class II, and Class III malocclusions groups.
Table 2: Mean, standard deviation, standard error, minimum value, and maximum value for maxillary arch widths in Class I, II, and III (n=30 in each malocclusion group)

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Table 3: Mean, standard deviation, standard error, minimum value, and maximum value for mandibular arch widths in Class I, II, and III (n=30 in each malocclusion group)

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[Table 4] indicates that the maxillary inter-premolar width I and II was very statistically significant in Class I than that of Class II. Intermolar width I and II, intercanine width, and inter-alveolar width showed slightly higher mean values in Class I but no statistically significant difference was reached (P > 1.000).
Table 4: Comparison between Class I and Class II arch width of the present study

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No statistically significant difference was observed in the mandibular arch between Class I and Class II in all variables (P > 0.05).

[Table 5] demonstrates that no statistically significant difference was noticed in the maxillary arch between Class I and Class III in all variables (P > 0.05).
Table 5: Comparison between Class I and Class III arch width of the present study

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Statistically significant differences were observed in the mandibular intermolar width I and II and inter-premolar width II in Class III than that of Class I (P < 0.05) and no significant difference was reached in the other variables (P > 0.05).

[Table 6] shows that there was a statistically significant difference at 5% level of maxillary intermolar width II in Class III than that of Class II. The extremely significant difference was found in inter-premolar width II in Class III, whereas very extremely significant difference was observed in inter-premolar width I in Class III than that of Class II.
Table 6: Comparison between Class II and Class III malocclusion arch width of the present study

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The very statistically significant difference was noticed in the mandibular intermolar width I and inter-premolar width II in Class III than that of Class II. Inter-alveolar width was statistically significant at 1% level in Class III compared to Class II.

NB: [Table 7], [Table 8], [Table 9] comparison results were interpreted in the discussion section to help the reader, instead of looking for the article of Asiry and Hashim 2012 study in Saudis.
Table 7: Comparison between Class I arch width of the present study result and Class I arch width of Moshabab and Hashim 2012 study among Saudis

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Table 8: Comparison between arch width of the present study Class I and Class II arch width of Moshabab and Hashim 2012 study among Saudis

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Table 9: Comparison between Class II malocclusion of the present study and Moshabab and Hashim (2012) study among Saudis

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  Discussion Top


When searching the literature, it shows that different arch dimensions were observed between the different races. This leads to establishing diagnostic mean values for each race which will be of great value in diagnosis and treatment plan. Therefore, the aim of the present study was to establish arch dimensions in Qatari sample with Angle's Class I, Class II, and Class III malocclusion and to compare the results between the different Angle's Classes.

The age range of the participants in the present study was between 13 and 20 years of age. This is because it was reported by several investigators that little or no change occurred in the intercanine and intermolar widths after the age of 13 years in females and 16 years in males[3],[16] The same observation was confirmed by Bishara et al.[17] Therefore, it was considered that the arch dimensions of the selected sample in the present study were stable.

The measurements in the present study were made directly on the study cast by one operator using an electronic digital caliper (Mitutoyo, U. K.). However, other investigators used different methods and devices; among those were Schirmer and Wiltshire[18] and Champagne[19] where the measurements were done manually on dental casts compared with those made on digitized casts obtained from a photocopier. They stated that the method and device produce the most accurate and reproducible measurements. Further, Bhatia and Harrison[20] used the traveling microscope and declaring that the method was more precise than some alternatives. Further, Mårtensson and Rydén[21] utilize a holographic system, and also consider it more precise than previous methods with the advantage of saving storage space. However, the method used in the present study was simple, easy, precise, and more practical.

In the present study, very statistical significant differences were found between Class I and Class II and between Class II and Class III in inter-premolar width I in the maxillary arch and intermolar width I, inter-premolar II and inter-alveolar width in the mandibular arch. On the other hand, an extremely significant difference was observed in maxillary inter-premolar II when comparing Class II and Class III.

Further, in the present study, significant differences were observed between the Angle's malocclusion classes. The maxillary arch widths were narrower in Class II and wider in Class III. This finding in agreement with the result obtained by Ahmed et al.[5] Moreover, several studies on arch dimensions in different races reported differences in arch dimensions between British and Nigerian[22] and between Egyptian and Filipino and Saudis,[9] between Negroid and Caucasian.[23],[24] Comparison between these studies is difficult due to the fact that different reference points were used and also due to the differences in criteria of sample selection, methodology, and measuring tools.

Furthermore, the arch widths results of the present study were compared with those obtained in an early study conducted among Saudis with Class I occlusion[25] and Class II.[26] The results show that no significant difference was exhibited in the maxillary intermolar width II which was relatively smaller in Qatari than that of the Saudis with Class I malocclusion.[25] A similar result was noticed in mandibular intermolar width II, whereas the mandibular intercanine width was significantly greater in Qatari (P < 0.05) [Table 7]. The same observation was reported by Staley et al.[8]{Table 7}

Moreover, the comparison between Class I and Class II indicated that the maxillary intermolar width II and intercanine width in Qatari were relatively greater than that of the Saudis. On the other hand, the mandibular intermolar width II and the intercanine width were almost similar. Hence, no statistically significant was noticed in the maxilla and the mandible [Tables 8]. This finding was in line with the result of Frohlich.[2] On the other hand, Staley et al.[8] found both Class II malocclusion and Class I occlusion patients had similar mandibular intercanine widths. The same result was reported by Asiry and Hashim[26] and also by Adil et al.[14] However, the findings of Sayin and Turkkahraman[4] were in agreement with Adil et al.[14] in a study carried out among Pakistani patients and in disagreement with the present study results. When the result of Class II malocclusion of the present study were compared with the result of Class II malocclusion in a study carried out among Saudis by Asiry and Hashim;[26] no statistically significant differences were found in all variables [Table 9].{Table 9}

The outcome of these arch dimensions studies let many manufacturers introduce ready-made stock impression trays and maxillary and mandibular archwires to maintain the mandibular and maxillary relationship and to avoid treatment relapse during the retention period. The result of the present study is invaluable to the orthodontist and pedodontist as well as to the prosthodontist and anthropologist. However, the large sample size is recommended to draw strong and firm conclusions.


  Conclusion Top


The result of the present study is invaluable to the orthodontist and pedodontist as well as to the prosthodontist and anthropologist. However, large sample size is recommended in order to draw strong and firm conclusions.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
AL-Taee ZH. A comparison of arch width in adults with normal class I occlusion and adults with class II division 1 malocclusion in Ramadi city. Anb Med J 2012;10:75-80.  Back to cited text no. 1
    
2.
Frohlich FJ. A longitudinal study of untreated class II type malocclusion. Trans Eur Orthod Soc 1961;37:137-59.  Back to cited text no. 2
    
3.
Moorrees CF. The Dentition of the Growing Child, a Longitudinal Study of Dental Development Between 3 and 18 Years of Age. Cambridge: Harvard University Press; 1959. p. 87-110.  Back to cited text no. 3
    
4.
Sayin MO, Turkkahraman H. Comparison of dental arch and alveolar widths of patients with class II, division 1 malocclusion and subjects with class I ideal occlusion. Angle Orthod 2004;74:356-60.  Back to cited text no. 4
    
5.
Ahmed I, Wahaj A, Erum G. Comparison of intercanine and intermolar width among Angle's malocclusion groups. J Pak Dent Assoc 2012;21:202-5.  Back to cited text no. 5
    
6.
Bishara SE, Bayati P, Jakobsen JR. Longitudinal comparisons of dental arch changes in normal and untreated class II, division 1 subjects and their clinical implications. Am J Orthod Dentofacial Orthop 1996;110:483-9.  Back to cited text no. 6
    
7.
Uysal T, Memili B, Usumez S, Sari Z. Dental and alveolar arch widths in normal occlusion, class II division 1 and class II division 2. Angle Orthod 2005;75:941-7.  Back to cited text no. 7
    
8.
Staley RN, Stuntz WR, Peterson LC. A comparison of arch widths in adults with normal occlusion and adults with class II, division 1 malocclusion. Am J Orthod 1985;88:163-9.  Back to cited text no. 8
    
9.
Diwan R, Elahi JM. A comparative study between three ethnic groups to derive some standards for maxillary arch dimensions. J Oral Rehabil 1990;17:43-8.  Back to cited text no. 9
    
10.
Buschang PH, Stroud J, Alexander RG. Differences in dental arch morphology among adult females with untreated class I and class II malocclusion. Eur J Orthod 1994;16:47-52.  Back to cited text no. 10
    
11.
Walkow TM, Peck S. Dental arch width in class II division 2 deep-bite malocclusion. Am J Orthod Dentofacial Orthop 2002;122:608-13.  Back to cited text no. 11
    
12.
Varrela J. Early developmental traits in class II malocclusion. Acta Odontol Scand 1998;56:375-7.  Back to cited text no. 12
    
13.
McNamara JA Jr. Early intervention in the transverse dimension: Is it worth the effort? Am J Orthod Dentofacial Orthop 2002;121:572-4.  Back to cited text no. 13
    
14.
Adil M, Adil S, Syed K, Aziz T, Badshah A. Comparison of Inter premolar, molar widths and arch depth among different malocclusions. Pak Oral Dent J 2016;36:241-4.  Back to cited text no. 14
    
15.
Herzog C, Konstantonis D, Konstantoni N, Eliades T. Arch-width changes in extraction vs. nonextraction treatments in matched class I borderline malocclusions. Am J Orthod Dentofacial Orthop 2017;151:735-43.  Back to cited text no. 15
    
16.
Knott VB. Longitudinal study of dental arch widths at four stages of dentition. Angle Orthod 1972;42:387-94.  Back to cited text no. 16
    
17.
Bishara SE, Jakobsen JR, Treder J, Nowak A. Arch width changes from 6 weeks to 45 years of age. Am J Orthod Dentofacial Orthop 1997;111:401-9.  Back to cited text no. 17
    
18.
Schirmer UR, Wiltshire WA. Manual and computer-aided space analysis: A comparative study. Am J Orthod Dentofacial Orthop 1997;112:676-80.  Back to cited text no. 18
    
19.
Champagne M. Reliability of measurements from photocopies of study models. J Clin Orthod 1992;26:648-50.  Back to cited text no. 19
    
20.
Bhatia SN, Harrison VE. Operational performance of the travelling microscope in the measurement of dental casts. Br J Orthod 1987;14:147-53.  Back to cited text no. 20
    
21.
Mårtensson B, Rydén H. The holodent system, a new technique for measurement and storage of dental casts. Am J Orthod Dentofacial Orthop 1992;102:113-9.  Back to cited text no. 21
    
22.
Mack PJ. Maxillary arch and central incisor dimensions in a Nigerian and British population sample. J Dent 1981;9:67-70.  Back to cited text no. 22
    
23.
Burris BG, Harris EF. Maxillary arch size and shape in American blacks and whites. Angle Orthod 2000;70:297-302.  Back to cited text no. 23
    
24.
Merz ML, Isaacson RJ, Germane N, Rubenstein LK. Tooth diameters and arch perimeters in a black and a white population. Am J Orthod Dentofacial Orthop 1991;100:53-8.  Back to cited text no. 24
    
25.
Al-Tamimi T, Hashim HA. Bolton tooth-size ratio revisited. World J Orthod 2005;6:289-95.  Back to cited text no. 25
    
26.
Asiry M, Hashim H. Arch widths in Saudi subjects with class II division 1 malocclusion. J Int Oral Health 2012;4:23-31.  Back to cited text no. 26
    


    Figures

  [Figure 1], [Figure 2]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9]



 

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