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References

Proffit WR., 4th edn. St Louis: Mosby; 2007
Johnston CD, Burden DJ, Stevenson MR. The influence of dental to facial midline discrepancies on dental attractiveness ratings. Eur J Orthod. 1999; 21:517-522
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Levin EI. Dental esthetics and the golden proportion. J Prosthet Dent. 1978; 40:244-252
Bolton WA. Disharmony in tooth size and its relation to the analysis and treatment of malocclusion. Angle Orthod. 1958; 28:113-130
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Stevens DR, Flores-Mir C, Nebbe B, Raboud DW, Heo G, Major PW. Validity, reliability, and reproducibility of plaster vs digital study models: comparison of peer assessment rating and Bolton analysis and their constituent measurements. Am J Orthod Dentofacial Orthop. 2006; 129:707-803
Mullen SR, Martin CA, Ngan P, Gladwin M. Accuracy of space analysis with emodels and plaster models. Am J Orthod Dentofacial Orthop. 2007; 132:346-352
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Diagnosis and management of tooth size discrepancies in orthodontic patients

From Volume 6, Issue 1, January 2013 | Pages 17-20

Authors

TP McSwiney

BDS, MFD RCS(Ire)

Postgraduate Orthodontic Student, Cork University Dental School and Hospital, University College Cork, Ireland

Articles by TP McSwiney

DT Millett

BDSc, DDS, FDS RCPS(Glasg), FDS RCS(Eng), DOrth RCS(Eng), MOrth RCS(Eng)

Professor, Orthodontic Unit, Oral Health and Development, Cork University Dental School and Hospital, University College Cork, Ireland

Articles by DT Millett

Abstract

A tooth size discrepancy (TSD) indicates disproportion in tooth sizes. TSDs should be considered in treatment planning for the orthodontic patient to ensure an optimal occlusal outcome. The method of calculation of a TSD is explained. The prevalence in orthodontic patients, their aetiology and management are outlined.

Clinical Relevance: Clinicians should be aware of how to diagnose and manage TSDs in orthodontic patients.

Article

A tooth size discrepancy (TSD) is defined as a disproportion among the sizes of individual teeth.1 Anterior TSDs relate to the six anterior teeth, whereas overall TSDs involve all teeth excluding second permanent and third molars. TSDs are an important consideration in orthodontic diagnosis and treatment planning, especially in the maxillary anterior segment.

An anterior or overall TSD may influence dental aesthetics and the occlusion. This may arise from spacing or crowding in the dental arch, centre-line discrepancies of greater than 2 mm2 and difficulty in achieving good inter-arch relationships. Smile aesthetics may also be compromised owing to the interplay between the smile arc, buccal corridor width and the Golden Proportion.3 This proportion describes the relative width of teeth in a harmonious smile. When the maxillary permanent teeth are in Golden Proportion, the relative widths of the central incisor, lateral incisor and canine are 1.618:1.0:0.618, respectively.4

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