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crown sixe
Carlos Sanin and Bhim S. Savara
Portland, Ore.
488
Volume 59 Permanent mesiodistal crown size 489
Number 5
Table I. Percentile distribution of mesiodistal crown size of individual teeth and the sum
of the teeth, for boys
-
Small Average Large
!rooth Minimum 10 20 -30 40 50 60 70 80 90 Maximum
Maxillary
Central incisor 7.8 8.2 8.3 8.4 8.5 8.7 8.8 9.1 9.3 9.4 10.1
Lateral incisor 5.8 6.2 6.6 6.8 7.0 7.2 7.4 7.5 7.7 7.9 8.8
Canine 6.0 7.3 7.5 7.8 7.9 8.1 8.1 8.2 8.4 8.5 8.8
First premolar 6.1 6.5 6.8 6.9 7.0 7.1 7.2 7.3 7.4 7.5 8.1
Second premolar 5.8 6.2 6.5 6.7 6.8 7.0 7.1 7.2 7.4 7.5 8.0
First molar 9.1 10.0 10.3 10.4 10.6 10.7 11.0 11.2 11.3 11.5 12.0
Second molar 8.4 9.1 9.4 9.8 10.0 10.0 10.1 10.4 10.7 11.1 12.4
Total crown size 83.5 89.3 91.3 95.7 96.9 97.3 98.9 99.4 100.8 103.1 106.9
(excluding
second molars)
Central incisor 4.5 5.0 5.0 5.2 5.3 5.4 5.6 5.6 5.8 5.9 7.1
L,ateral incisor 5.0 5.7 5.8 5.9 6.1 6.2 6.2 6.5 6.6 6.7 7.3
Canine 6.2 6.5 6.6 6.8 7.0 7.1 7.2 7.3 7.5 7.5 7.8
First premolar 6.0 6.5 6.7 6.9 7.1 7.2 7.4 7.5 7.7 7.9 8.4
Second premolar 6.1 6.8 6.9 7.1 7.3 7.4 7.4 7.7 7.7 8.1 8.4
First molar 9.4 10.3 10.5 10.7 11.0 11.2 11.4 11.6 11.8 12.0 12.4
Second molar 8.3 9.1 9.4 9.9 10.0 10.1 10.3 10.5 10.6 10.9 12.3
‘I’otal crown size 79.5 81.9 85.0 86.6 88.5 89.4 90.2 91.6 92.9 94.4 98.0
(excluding
second molars)
means that there are more combinations of crown-size discrepancies than there
a.re stars in our stellar system (4 x lOlo) or approximately the same order of
magnitude as the total number of cellular divisions that occur in the human
blody between the time of the formation of the single egg cell and maturity
( 1014).? As striking as such a huge number is, the facts remain that only one
combination does not have a discrepancy, and, depending on their magnitude,
a.11of them could cause oeclusal and even some facial disharmonies.
It is reasonably easy to isolate a single discrepant tooth or pairs of homologous
discrepant teeth by simple visual examination. Unless the discrepancy is large,
it seldom causes oeclusal irregularities, However, when the discrepancy involves
other teeth, and this frequently is the case, the pattern may become complex and
smaller discrepancies may add up to produce disharmonies. In other words, there
is a direct relationship between the magnitude of the crown-size differences
(regardless of the number of teeth involved) and the presence of oeclusal ir-
regularities. There is also a direct relationship between the number of discrepant
teeth (regardless of the magnitude of the crown-size differences) and the presence
of occlusal irregularities. Consequently, there is a direct relationship between the
interaction of the magnitude of the discrepancy, the number of teeth involved,
and the presence of occlusal irregularities.
The associations between crown size and overbite, overjet, crowding, and
arch width are small (coefficients of correlation are 0.01, 0.14, 0.26, and 0.33,
Table II. Percentile distribution of mesiodistal crown size of individual teeth and the sum
of the teeth, for girls
Central incisor i.1 7.5 X.1 s.3 8.3 X.6 s.7 8 .7 9.0 9.2 9.9
Lateral incisor 4.9 G.1 G.2 G.4 G.5 6.7 Ii.9 7.1 7.2 i.1 8.4
Canine 6.8 7.1 7.3 7.4 i-5 7.5 7.7 7.9 7.9 x.2 9.2
First premolar 5.7 6.1 6.6 6.7 6.9 6.9 7.1 7.2 7.:: 7.5 x.2
Second premolar 5.5 G.0 6.2 6.4 G.G ti.i GA ti.9 7.1 '7.3 7.6
First molar 8.9 9.6 9.9 10.0 10.3 10.4 10.3 10.G 10.7 11.0 11.8
Second molar 8.0 8.8 9.3 9.5 9.6 9.8 10.0 10.0 10.3 10.5 11.1
Total crown size 82.5 86 . 1 89 .4 L.‘. ” 92.7 97L. G 9.k.s
01 I 95.4 97.3 98.4 104.3
(excluding
second molars)
Mandibttln~
Central incisor 4.5 4.9 5.0 5.0 5.3 5.4 5.3 5.6 5.7 6.8 6 *<5
Lateral incisor 5.0 5.5 5.6 5.8 5.9 6.0 6.0 6.1 6.2 6.4 6.9
Canine 5.6 6.1 6.2 6 .4 6.5 6.7 6.8 6.9 7.0 7.1 7.7
First premolar 6.1 6.4 6.7 8.8 6.9 7.0 7.1 7.1 7.2 7.5 8.0
Second premolar 6.1 6.5 6.8 6.9 7.1 7.2 7.3 7.4 7.5 7.5 5.4
First molar 8.7 10.0 10.3 10.4 10.6 10.8 10.9 11.0 11.1 11.6 12.4
Second molar 7.8 8.8 9.0 9.3 9.5 9.7 9.9 10.0 10.4 10.7 11.0
Total crown size 75.7 80.5 83.0 83.5 84.4 85.:: 86.4 87.6 89.1 90.0 97.0
(excluding
second molars)
Procedure
The me&distal crown sizes of fifty-one boys and fifty girls of Northwest
European ancestry selected from the Child Study Clinic of the University of
Oregon Dental School are presented in Tables I and II. These tables were applied
to selected cases for the analysis of their size relationships. The measurements
were taken by the data-acquisition method described by us in a previous publica-
tion.g The method permits programming of distances between any of the mesial
and distal landmarks recorded. Most distances obtained with a Boley gauge were
not significantly different from similar measurements obtained with our previous
procedure. The reproducibility of measurements in study casts varies from
+0.05 to ~0.11 mm. for the central incisors and canines. Crown size was defined
anthropometrically as the greatest distance between the points of interproximal
contact. Teeth of the right and the left sides were considered independently;
Volume 59 Permanent mesiodistal crown size 491
Number 5
that is, 102 maxillary permanent central incisors were used to compute the
statistics in the group of boys.
The elements utilized for the analysis of each subject were (1) a Boley gauge
that allows readings accurate to 0.1 mm., on which the tips of the gauge are
trimmed to facilitate the measurements, (2) measurements from study casts of
the right or left mesiodistal crown size (whichever allowed a more accurate
estimate), (3) the norms of mesiodistal crown size shown in Table I. The
mesiodistal crown size of each tooth, discriminated by sex and arch, is located
in the table and the rank along the percentile scale is plotted along the similar
percentile scale of the figure. The points representing the maxillary teeth are
joined with straight lines, the same as the points representing the mandibular
teeth, and the lines facilitate the comprehensive examination of the differences,
as well as the patterns. The upper part of the figures appraise the maxillary and
th.e mandibular anterior teeth, whereas the lower part appraise the posterior
teeth.
The analysis of the crown-size patterns as factors associated with malocclu-
sion should be preceded by an evaluation of the role that skeletal and muscular
factors may have played in its development. As a unit, they contribute to a more
accurate diagnosis of the dental problem.
Some of the characteristics that may be studied with the assistance of the
table are (1) the size of the maxillary teeth as a whole relative to the size of the
mandibular teeth as a whole, (2) the size of individual teeth or groups of teeth
relative to individual teeth or groups of teeth and individual or groups of
antagonist teeth, (3) discrepancies between right and left sides and, in all cases,
the direction of the discrepancy if present (small, average, large) and their
mlagnitude (difference in percentiles) .
1 x ’ I I / 1 , I / /
8.1 ,N, I I i I I I1 /
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/ I I I I I I I I
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X Moxil. Total Crown Sire
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N Mond. Total Crown Size
Inc. I J--L-J--L-J--I
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,
N blond. Totol Crown Size
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9.61 : : I iI I !I I, 1I IX!
’ N ’
Inc. 2 L-J--L-J--L-J--L-J--L
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----1 I I I I
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---1 I I I I I I I 4
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/ X Maxil. Crown
Total Size
/ N Mand. Total Crown Size
the mesial migration of posterior teeth reduced the space available for the
canines. Similarly, the large mandibular premolars and central and lateral
-incisors contributed to the displacement of the left mandibular canine and the
.right central incisor. The size relationships between pairs of antagonist teeth
*are excellent. This, in turn, should reflect on the interdigitation during ortho-
adontic treatment.
Fig. 5 illustrates bimaxillary protrusion and mesiodistal crown-size discrep-
ancy in a 14-year-old boy. The eephalogram illustrates a profile that could be
modified favorably by orthodontic treatment. The study casts show a Class I
molar relationship, considerable labial inclination of the maxillary and man-
dibular incisors, large overjet, and moderate overbite. The vertical nomograph
shows the pattern of the discrepancy. The large mandibular teeth contributed
to the crowding of the mandibular canines. The marked labial inclination of the
maxillary incisors is due in part to their large crown size. The large teeth, the
overjet, and the labial inclination of the incisors determined the protrusive facial
profile.
Fig. 6 shows occlusal irregularities and mesiodistal crown-size discrepancies
in a girl 14 years of age. The cephalogram illustrates a profile that could be
modified favorably by orthodontic treatment. The study casts show a Class I
molar relationship, crowding of the mandibular incisors, small overjet, and
moderate overbite. The vertical nomograph illustrates several discrepancies. The
small mandibular second premolars resulted in an end-to-end first premolar
relationship. The large maxillary second premolars and the small mandibular
second premolars resulted in an end-to-end second premolar relationship. The
larger mandibular lateral incisors, canines, and first premolars contributed to
the development of crowding of the mandibular central incisors.
A treatment alternative may include selective mesiodistal grinding of dis-
crepant teeth and minor tooth movement.
Summary
This article refers to the mesiodistal size of the permanent teeth and presents
an effective way of locating and analyzing crown-size discrepancies. The analysis
proposed contributes to a more complete study of intraoral etiologic factors and
a more precise diagnosis and prognosis of the dental problem. It has been
illustrated that crown-size patterns differ greatly, even among good occlusions
(Figs. 1 and 2). Common to both subjects are the small premolars and molars.
Favorable crown-size discrepancies (Fig. 2) usually involve smaller teeth, par-
ticularly posterior teeth, which allow flexibility for the self-correction of minor
anterior space deficiencies.
In contrast, the remaining figures illustrate various crown-size discrepancies
and the resulting malocclusions, Irregularities associated with the size dis-
harmonies include (I) crowding of the mandibular incisors, (2) labial displace-
ment of canines, (3) end-to-end premolar relationships, and (4) marked labial
inclination of the anterior teeth.
The effects on interdigitation of discrepant teeth must be differentiated from
the effects of rotations and tipping of the teeth. Fig. 5 shows Class I molar and
Small Average Large
r 1 r---1
Min IO 20 30 40 510 60 70 RO 90 Max
I 9.41
I Inc. I -’ L-J--L-J--L-J.--L-
5.81 j ; ; ; I I
_---
I I I I / I
7.7: I I I I 1 I
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Inc. 2
6.4; I ; ; ; / ;
---- 1 I I I I 1 I
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7.7; ; / ; ; ; ; I I
----7 I I I I I
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I I
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----1 I I I ! I )
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Y. I L-J--L-J- - L--.-- L--l--
I /
il.81 / / I I /
---- I I
11.5: I I- Maxil. Teeth
M.2 L-i--l-- Mond. Teeth “ii L-J
X Maxil. Total Crown Size
11.3;
N Mand. Total Crown Size
Fig. 5. Bimaxillary protrusion and mesiodistal
crown-size discrepancy in a 14-year-old boy.
Volume 59 Permana~~t mesiodistal crown size 499
iTumber 5
Inc. I L -J--L-J--L-J--L
I , I I I I
5.6; I I I I I l
---- I I I I I I
7.0: I I I I I I
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6.4 I
----_ 1
8.1 I
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C.
I
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l-
7.4 I I
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----1 ’ c
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I
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----1
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L -JJ-
M. I
I I I I I I I I
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X Maxil.Total Crown Size
I N Mand. Total Crown Size
REFERENCES
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2. LundstrFm, A.: Intermaxillary tooth width ratio and tooth alignment and orrlusion,
Acta Odont. Stand. 12: 265-292, 1954.
3. Bolton, TV. A.: The clinical application of a tooth size analysis, Antsa. ,J. ORTIIODONT.
48: 504-529, 1962.
4. Steadman, S. R.: Predetermining the overbite and overjet, Angle Orthodont. 19: 101.
105, 1949.
5. Neff, C. W.: The size relationship between maxillary and mandibular segments of the
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6. Neff, C. W.: Tailored occlusion with the anterior coefficient, AMER. J. ORTHODONT. 35:
309-333, 1949.
7. Gamow, G.: One two three . . . infinity, Bantam Science and Mathematics, New York, 1967,
Bantam Books, Inc., pp. 242.
S. Solow, B.: The pattern of craniofacial associations, Acta Odont. &and. 24: Supp. 46,
1966.
9. Savara, B. S., and Sanin, C.: A new data acquisition method for measuring dentitions
and tests of accuracy, Amer. J. Phys. Anthrop. 30: 315-318, 1969.
10. Horowitz, S. L., and Hixon, E. H.: The nature of orthodontic diagnosis, St. Louis, 1966,
The C. V. Mosby Company, p. 155.
11. Sanin, C., Savara, B. S., Clarkson, Q. D., and Thomas, D. R.: Prediction of occlusion by
measurements of the deciduous dentition, AMER. 5. ORTHODONT. 57: 561-572, 1970.
12. Hunter, W. S., and Priest, W. R.: Errors and discrepancies in measurement, .r. Dent.
Res. 39: 405-414, 1960.
13. Riedel, R. A.: Retent,ion. 1% Graber, T. M. (editor): Current orthodontic concepts and
techniques, Philadelphia, 1969, W. B. Saunders Compan.v, chap. 9.