The document provides an overview of methods for analyzing dental records, including cast analysis and radiographic analysis. It describes evaluating symmetry, arch form, alignment, dental relationships, and space analysis using dental casts. Radiographic analysis includes assessing teeth, bone, and relationships using techniques like panoramic radiographs, lateral cephalograms, and CBCT. Lateral cephalograms allow evaluation of skeletal, dental, and soft tissue measurements and relationships to assess growth, treatment needs, and outcomes.

1. ANALYSIS OF RECORDS
Dr. Zafar Ul Islam
Assistant Professor Orthodontics

2. Analysis of Records
 Cast analysis
 Radiographic Analysis

3. Cast Analysis
 Symmetry
 Arch form
 Alignment
 Dental relations
 Space analysis
 Bolton ratio

4. Arch Symmetry
 Transparent ruled grid
placed on maxillary cast
and oriented to mid
palatal raphe

5. Computer Software
 Alternately we can use
software program to see
asymmetry of the dental
arch

6. Arch Form
 Tapered
 Squarish
 Ovoid

7. Alignment
 Buccoversion
 Plato/lingo version
 Torsi version

8. Dental Relations
 Class I
 Class II
 Class III
 Overjet
 Overbite
 Cross bite
 Midlines

9. Molars and Canine Relations
class I
Class II
Class III

10. Incisor Class II Relations
Class II div 1 Class II div 2

11. Overjet
 Horizontal overlap of the
lower incisors by upper
incisors
 Positive overjet
 Reverse overjet

12. Overbite
 Vertical overlap of the
lower incisors by upper
incisors
 Normal overbite is 1 to
3mm
 Openbite
 Deepbite

13. Crossbite
 Transverse discrepancy
of the position of upper
and lower teeth
 May be unilateral or
bilateral
 Anterior crossbite
 Posterior crossbite
 Single tooth crossbite

14. Midlines
 Upper dental midline to
midpalatal raphae
 Lower midline to lingual
frenum
 Upper midline to lower
midline

15. SPACE ANALYSIS

16. Space Analysis
 Space available
 Space required
 Space available – space required = crowding/spacing

17. Space Available
 Also called arch
perimeter
 Extends between mesial
of first permanent
molars of either side of
arch
 Measured by two
methods
1. Brass wire
2. Varnier caliper/divider

18. Space Available
 Use of brass wire
 Adapt along arch from mesial of first molar on one
side to other

19. Space Available
 Use of vernier caliper
 Measured in 4 quadrants

20. Space Required
 Space required is the combined mesiodistal widths of
premolars, canines and incisors

21. Mixed Dentition Analysis

22. Mixed Dentition Analysis
 Space available
 Space required

23. Space Available
 Measured from mesial of first permanent molars to
mesial of deciduous canine

24. Space Required
 Three methods to find out mesiodistal width of
unerupted canine and premolars
1. Tanaka and Johnston
2. Moyer’s predictability table
3. Radiographic

25. Tanaka and Johnston
 Measure mesiodistal width of mandibular incisors
 Sum the mesiodistal widths of mandibular incisors
and divide by 2
 For mandibular canine and premolars MD width add
10.5
 For maxillary canine and premolars MD width add 11

26. Tanaka and Johnston

27. Moyer’s Methods
 Measure the mesiodistal width of mandibular
incisors
 See for the value of premolars and canine at 75% in
the table

28. Moyer’s Table

29. Moyer’s Table

30. Radiographic Method
 Dental cast and patient radiograph is required
 Radiograph may be periapical or OPG
 Mesiodistal width of teeth is measured on cast and
radiograph
 Calculate with formula x = x’y/y’
 X is unerupted tooth
 Y is erupted tooth on cast
 X’ is unerupted tooth on radiograph
 Y’ is erupted tooth on radiograph

31. Radiographic Method

32. Total space required
 I + 2X + ceph correction + curve of Occlusion
 I is the MD width of permanent incisors
 2X is the combined MD width of canines and
premolars
 Ceph correction is Proposed FMIA – Actual FMIA ×
0.8
 Curve of occlusion is depth of curve of spee
bilaterally/2 + 0.5

33. Total Space Required
 FMIA  Measure curve of
Occlusion

34. Bolton Analysis
 Tooth size discrepancy of maxillary and mandibular
arch
 More than 2mm discrepancy need revision and
diagnostic setup
 7th key of occlusion
 Discrepancy will not allow perfect class I occlusion

35. Bolton Analysis
 Measure mesiodistal width of all teeth in maxilla and
mandible from first molar to first molar
 Add the widths of teeth in mandible and maxilla
separately

36. Bolton Analysis
 Overall Ratio (X)
 X = Sum of mandibular 12/sum of maxillary 12 ×100
 Normal value is 91.3
 If X is more than 91.3
 Desired sum of mand 12 = actual sum of max 12×91.3
100
 Overall mandibular tooth excess =
Actual sum of man 12 - desired sum of man 12 = ------mm

37. Bolton Analysis
 If X is less than 91.3
 Desired sum of max 12 = actual sum of mand 12 × 100
91.3
 Overall maxillary tooth material excess =
Actual sum of max 12 – desired sum of max 12 = ------mm

38. Bolton Analysis
 Anterior Ratio (Y)
 Y = Sum of mandibular 6/sum of maxillary 6 ×100
 Normal value is 77.2
 If Y is more than 77.2
 Desired sum of mand 6 = actual sum of max 6×77.2
100
 Anterior mandibular tooth excess =
Actual sum of man 6 - desired sum of man 6 = ------mm

39. Bolton Analysis
 If Y is less than 77.2
 Desired sum of max 6 = actual sum of mand 6 × 100
77.2
 Anterior maxillary tooth material excess =
Actual sum of max 6 – desired sum of max 6 = -------mm

40. Radiographic Analysis
 OPG
 Lateral cephalograph

41. OPG
 Number of teeth
 Carious teeth
 Impacted teeth
 Eruption of teeth
 Root parallelism
 Alveolar bone loss

42. OPG

43. Adjunctive Radiographs
 Periapical
 Bite wing
 Occlussal
 CBCT

44. Guidelines for Radiographs

45. Periapical Radiograph
 Periapical pathology
 Root resorption
 Root development
 Fillings/RCTs
 Bone loss
 Ankylosis
 Dilacerations

46. Bite wing Radiograph
 Primarily used for
detection of multiple
crown caries

47. Occlussal Radiographs
 Impacted teeth
 Dilacerations

48. CBCT
 More complex relations
of the structures can be
seen
 Cleft lip palate
 Multiple
supernumeraries
 Impactions difficult to
locate with other
radiographs

49. Lateral Cephalograph
 Standardization
 Soft tissue visible
 Used for skeletal, dental
and soft tissue relations
 Growth prediction
 Treatment planning

50. Ceph Tracing
 Trace the lateral ceph
landmarks on acetate
paper

51. Ceph Tracing

52. Ceph Analysis
 Sagittal skeletal analysis
 Vertical skeletal analysis
 Dental analysis
 Soft tissue analysis

53. Sagittal skeletal analysis
 SNA
 SNB
 ANB
 Witt’s value

54. SNA
 Anteroposterior relation
of maxilla to cranial base
 Normal value is 82 ± 2

55. SNB
 Anteroposterior relation
of mandible to cranial
base
 Normal value 80 ± 2

56. ANB
 Difference of SNA and
SNB
 Normal value is 2 ± 2

57. Witt’s Value
 Anteroposterior relation
of maxilla and mandible
 Confirmation of the
angle ANB
 Normal value is -1 – 0

58. Interpretation
 Class I : ANB 0 – 4
 Class II : ANB > 4
 Class III : ANB < 0

59. Vertical Skeletal Analysis
 SN-MP
 FMA
 SN-PP
 PP-MP
 Y axis
 Inclination angle
 Gonial angles
 Facial height ratios

60. SN-MP
 Vertical mandibular
relation to cranial base
 Normal value is 32 ± 4

61. FMA
 Frankfort to mandibular
plane angle
 Normal value is 25±4

62. SN-PP
 Vertical relation of
maxilla to cranial base
 Normal value is 8 ± 3

63. PP-MP
 Rotation of maxilla to
mandible
 Normal value is 21±5

64. Y axis
 Rotation of the mandible
 Normal value is 60±4

65. Inclination angle
 Rotation of the maxilla
 Normal value is 84±4

66. Gonial angles
 Rotation of the mandible
 Normal value 124±3
 Upper gonial angle
 Normal value 50±2
 Lower gonial angle
 Normal value 74±2

67. Face height ratios
 Anterior face height ratio
 Normal value 54±4%
 Posterior face height
ratio
 Normal value 65±4%

68. Vertical skeletal interpretation
 Normal angle case
 Low angle case
 High angle case

69. Linear Measurement
 Anterior cranial base
 Maxilla length
 Mandible length
 Ramus height

70. Anterior cranial base
 Sella entrance to nasion
 Assess the proportional
lengths of maxilla and
mandible
 Mean value at age 8 is
68.6mm for males and
65.9mm for females
 Incremental increase of
.7mm/year for males and
.5mm/year for females
up to age 18

71. Maxillary Length
 From PNS to Point A
perpendicular on Palatal
plane
 Mean value is 45mm at
age 8
 Annual increase of
1.2mm for males and
.8mm for females up to
age 16

72. Mandibular Length
 Measured from gonion to
perpendicular from
pogonion on mandibular
plane
 Mean value is 68mm at
age 8
 Annual increase of 2mm
for males and 1.4mm for
females up to age 16

73. Ramus Height
 Measured from condylon
to gonion
 Mean value is 46mm at
age 8
 Annual increase is 2mm
for males and 1.2mm for
females up to age 16

74. Dental Analysis
 UI-NA distance
 UI-NA angle
 LI-NB distance
 LI-NB angle
 UI-SN
 IMPA
 Holdaway ratio

75. UI-NA
 Position of the upper
incisor to maxilla
 Normal distance is 4mm
 Normal angle is 22
degrees

76. LI-NB
 Position of the lower
incisor to mandible
 Normal distance is 4 mm
 Normal angle is 25
degrees

77. UI-SN
 Inclination of maxillary
incisor
 Normal value is 102±5
 Proclined
 Retroclined

78. IMPA
 Lower incisor inclination
 Normal value is 90±4
 Proclined
 Retroclined

79. Holdaway Ratio
 Balance of lower incisor
and bony chin for
stability
 Normal ratio is 1:1

80. Soft Tissue Analysis
 Rickets' E plane
 Nasolabial angle

81. Rickets’ E Plane
 Shows the position of
upper and lower lip to
chin and nose
 Normal value for upper
lip is -3±2mm
 Normal value for lower
lip is -2±2
 Recumbent lips
 Procumbent lips

82. Nasolabial Angle
 Shows the position of the
upper lip
 Normal ranges from 90
degrees to 110 degrees
 Obtuse
 Acute

83. THANK YOU