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Article: Volume 15 Number 3 Page 118 - July 2022

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  Orthodontic Update 59: 118-122

Orthodontics:  Lost in Space: Orthodontic Space Analysis. Part 1

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Abstract: Orthodontic diagnosis is complex and multifactorial and an initial space analysis informing a decision on whether to extract teeth is consistently highlighted as the most significant diagnostic factor, with other clinical factors being secondary. Although the majority of clinicians are taught a method of space analysis, few subsequently place their confidence in any formal method and furthermore, may not consider the space implications of the curve of Spee. A survey of orthodontists revealed a surprising variability in the assessment of crowding, as well as a tendency to make a different diagnostic decision on the same case sometime later. This two-part series explores the current status of space analysis and suggests how we may be able to limit the potential for making poor extraction decisions. Part 1 explores the various factors that need to be considered in an orthodontic space analysis and in particular the space implications of the curve of Spee. Part 2 examines the various methods and tools available to the clinician in assessing orthodontic crowding. We also look at ways in which potentially poor extraction decisions may be mitigated in clinical practice.

Clinical relevance: To help understand the clinical significance of space analysis as the key diagnostic factor informing a decision whether to extract teeth or not.

Author notes: Colin Wallis, BA, BDS, MSc, LDS, MOrth RCS, Specialist Practitioner, The Specialist Orthodontic Practice, Epping, Essex. NE Atack, BDS, MSc, FDS RCS(Orth) Eng, MOrth RCS Edin, Consultant Orthodontist, Bristol Dental Hospital. AJ Ireland, PhD, MSc, BDS, FDS, MOrth RCS, Professor of Orthodontics, Bristol Dental School, University of Bristol. email:

Objective: The reader should understand the clinical implications of an orthodontic space analysis and the occasional need to ‘self-calibrate’ to limit the possibility of making poor extraction decisions.

Christie & Co_Aug22