NIRF Mixed Dentition Analysis Min

MIXED DENTITION
ANALYSIS
Department of Pediatric and Preventive Dentistry

SRM Dental College, Ramapuram
CONTENTS
Introduction
Factors to be evaluated for space maintainence
Space analysis
Factors that prevents normal posterior occlusion
Indications of Mixed DentitionAnalysis
Principles of space analysis

CONTENTS
Classification
Fundamentals
Methods for mixed dentition analysis
Signs of different types of dentition
Review of literature
Study models
Conclusion
INTRODUCTION
Development of well-aligned dental arches – dependent upon a favorable

relationship between permanent tooth size and available arch space.
Crowding of teeth – may adversely affect periodontal health, caries

resistance, occlusal function & esthetics.
Wei. H.Y. Stephen. Pediatric Dentistry : Total Patient Care. Philadelphia : Lea & Febiger ; 1988.
INTRODUCTION
Early recognition & accurate assessment – wider choice of management

methods than if the situation was ignored until matured into an established
adult malocclusion.
FACTORS TO BE EVALUATED FOR
SPACE MAINTAINENCE
Incidence Early primary molar loss – decrease in arch length –
of space mesial movement of permanent molars / distal
loss movement of anterior teeth
Amount of closure is affected by numerous

variables – tooth involved, time of loss
Dean JA, Avery DR, McDonald RE. McDonald and Avery’s Dentistry for the Child And Adolescent, 9th edition.Maryland
Heights : Mosby; 2012.
Muthu MS, Sivakumar N. Pediatric Dentistry: Principles & Practice, 2nd edition. New Delhi: Elsevier; 2011.
SPACE MAINTAINENCE
Time Space loss – occurs during first 6 months after
elapsed extraction of primary teeth
since Best time to insert the appliance – soon after
loss extraction
If space closure already occurred – space
regainers to be considered
SPACE MAINTAINENCE
Stage of Chronological age is not important for planning
development space maintainence
/ dental age
Developing permanent tooth starts its eruptive
movement after 3/4th of root development
Hence, dental age has to be considered rather than

chronological age
SPACE MAINTAINENCE
Amount Maxillary primary 2nd molar loss – greatest space loss (upto
8mm / quadrant)
of space
closure Mandibular primary 2nd molar loss – next greatest space
loss (upto 4mm / quadrant)
Loss of primary 1st molar – shows equal amounts of space
closure
Space loss potential – high – if primary molar loss occurs in
approximation to permanent 1st molar eruption
Loss of primary 2nd molar – after eruption of permanent
molar – still result in significant space closure
SPACE MAINTAINENCE
Direction Maxillary posterior space closes – mesial bodily
of movement & mesio-lingual rotation around the
palatal root of 1st permanent molar
closure
Mandibular space closes – mesial tipping of 1st
permanent molar along with distal movement &
retroclination of teeth anterior to the space
SPACE MAINTAINENCE
Eruption of Active eruption of 1st permanent molar – causes

neighboring severe space loss (if the primary 2nd molar is
extracted during the eruption of permanent 1 st
teeth
molar)
SPACE MAINTAINENCE
Amount of If the bone covering the unerupted premolar is
bone destroyed – predictions based on root
development are not accurate
covering
the
An erupting premolar takes 4-5 months to travel
unerupted 1mm of bone
tooth
SPACE MAINTAINENCE
Abnormal Strong mentalis muscle patterns – may have
oral pronounced negative effect – after loss of primary
mandibular molars / canines with collapse of arch &
musculatur distal drifting of the anterior segment
e
Thumb / finger habits – produce abnormal forces –
initiates collapse of dental arches after untimely loss
of primary teeth
SPACE MAINTAINENCE
Congenital Congenital absence of teeth – may alter the
absence of eruption path of other teeth
permanent
teeth
SPACE ANALYSIS
Usually completed in the mixed dentition – crucial in determining

whether or no space will be available for unerupted permanent teeth
Predicted - using the dimensions of tooth present in the mouth
Hence, an assessment about the space needed or deficiency in the

arch can be calculated
Braham RL, Morris ME. Textbook of Pediatric Dentistry. Edinburgh: Williams & Wilkins;1980.
Casamassimo P, Field. H, Mctigue. D, Nowak. A. Pediatric Dentistry: Infancy Through Adolescence, 5th edition. St Louis :
Elsevier Health Sciences; 2013.
DEVELOPMENT OF MIXED
DENTITION
Baume’s classification,
1950’s
 Future permanent molar
relationship – based on
primary molar relationship
DENTITION
 Moorees & Reed – arch length decreases 2-3mm - 10-14 years of
age – when the primary molars are replaced by permanent
premolars
 They also demonstrated a reduction in arch circumference of

approximately
 3.5mm in boys in mandible during

 4.5mm in girls mixed dentition period
Moorrees CFA and Reed RB. Correlation among crown diameters of human teeth.Archives of Oral Biology 1964; 9 : 685-697.
Welbury RR, Duggal MS, Hosey MT. Pediatric Dentistry. 3rd edition. New York: Oxford University Press; 2005.
DENTITION
3 stages of development
 Early transitional stage
 Inter-transitional stage
 Late transitional stage
Dean JA, Avery DR, McDonald RE. McDonald and Avery’s Dentistry for the Child And Adolescent, 9th edition. Maryland
Muthu MS, Sivakumar N. Pediatric Dentistry: Principles & Practice, 2nd edition. New Delhi: Elsevier;2011.
FACTORS THAT PREVENTS NORMAL
POSTERIOR OCCLUSION
Extensive inter-proximal caries / premature extraction of

primary teeth – reduction of arch length – causes
crowding
Ectopic eruption of permanent maxillary 1st molars –

premature exfoliation of primary 2nd molars & loss of
arch length – crowding & class 2 molar relationship
FACTORS THAT PREVENTS NORMAL
POSTERIOR OCCLUSION
In mandibular arch –
premature loss of primary 1st Reduced arch length –
molar during active eruption normal leeway space will be
of permanent 1st molar – exceeded & crowding will
mesial drifting of primary 2nd occur
molar & permanent 1st molar
INDICATIONS
Nanda, 1993
• Mixed dentition period – 6-12 years
• Premature loss of primary canines
• Rotation or blocking of lateral incisor, because of
lack of space
• Ectopic eruption of permanent first molars
• Distal terminal plane relationships
Mathewson RJ, Primosch RJ. Fundamentals of Pediatric Dentistry, 3rd edition. Chicago : Quintessence Co. Inc ; 1995.
PRINCIPLES OF SPACE ANALYSIS
Field & Profitt, 1988

• First permanent molar and permanent incisors are erupted
• The succedaneous permanent teeth are forming
• Size relationship between unerupted permanent teeth & primary
teeth
• There is size difference in primary canines, molars and the
succedaneous teeth
• Mesio-distal width of primary canines & molars is greater than
permanent successors
CLASSIFICATION
3 approaches - to estimate the mesio-distal crown
width of unerupted canines & premolars
• Use of measurements from erupted teeth
• Use of measurements from radiographs
• Use of a combination (most accurate – lowest standard error

of estimate)
CLASSIFICATION
Profitt & Ackermann :
Combination of
Measurement on Radiographic radiographs &
radiograph analysis prediction charts
• Moyer’s analysis • Nance’s analysis • Hixon & old father
• Tanaka Johnston • Huckaba analysis • Staley Kerber
• Ballard & Wylie
CLASSIFICATION
Irwin, Herold, Richardson, 1995 – reviewed various methods
 Hixon and Old-father method – more accurate, but its disadvantage –

more cumbersome
 Moyers – measure of mandibular incisors alone – 95% of dentition with
a combined width of canine & premolar – within 1mm of predicted value
– clinically acceptable
 Tanaka-Johnston analysis – significant clinical acceptability – minimal
amount of time & effort
FUNDAMENTALS OF ANALYSIS
SPACE SPACE
AVAILABLE REQUIRED
COMPARE
Space Space
Excess OK Deficiency
Space available is calculated by 2 ways
Contour a piece of brass wire to

Divide the dental arch into the line of occlusion & straighten
segments it for measurement
Space required is calculated by
Dimensions of mandibular
permanent central & lateral Mandibular incisors – used as
incisors standards
They erupt earlier than

maxillary incisors & offer the They are least susceptible for
earliest opportunity of morphologic variations
measurement
Wei. H.Y. Stephen, Nakata M. Occlusal guidance in Pediatric Dentistry. Missouri, USA: Ishiyaku EuroAmerica. Inc; 1988.
If spacing between
Measure arch length central incisors – disto-
segments from the buccal gingival surfaces of
& labial sides of the arch lateral incisors to a
at the contact points midline point on the
between the teeth alveolar crest between
the teeth is measured
Wei. H.Y. Stephen, Nakata M. Occlusal guidance in Pediatric Dentistry. Missouri, USA: Ishiyaku EuroAmerica. Inc; 1988.
METHODS FOR
MIXED DENTITION
ANALYSIS
HAYS NANCE ANALYSIS
This analysis is similar to arch perimeter analysis of permanent

dentition
ARMAMENTARI Dental casts
UM
Boley gauge, millimeter ruler
Peri-apical radiographs
Oldfather, R. H.: Estimation of the combined widths of certain mandibular teeth, M.S. thesis, Department of Orthodontics,
University of Iowa, 1957.
HAYS NANCE ANALYSIS
PROCEDURE
(Nanda, 1993)
Space required – measure the width of each unerupted
tooth (cuspids & bicuspids) from the IOPA
Total M-D width of all the teeth in each quadrant –

indicate space required to accommodate permanent teeth
Space available – measure arch perimeter from mesial

of permanent 1st molar to the other side
Compare the space required & available –arch length

discrepancy
HAYS NANCE ANALYSIS
ADVANTAGES
• Minimal error
• It can be performed with reliability
• Allows analysis of both arches
LIMITATIONS
• Requires cephalometric radiograph,
knowledge of tweed analysis & an accurate
tracing
• Time consuming
• Complete mouth radiographs are needed
MOYER’S ANALYSIS
Introduced by Moyer, in 1967
Moyer’s probability tables – formulated at the University of

Michigan
Arch perimeter analysis
Most commonly used mixed dentition analysis
Moyer RE. Handbook of orthodontics.Analysis of the dentition and occlusion. 4th ed. Year Book Medical Publishers; 1988. p.
235-8.
MOYER’S ANALYSIS
ARMAMENTARI Dental casts
UM
Boley gauge
Probability chart
235-8.
MOYER’S ANALYSIS
PROCEDURE Measure the width of mandibular central & lateral incisors
This value is used in the probability chart (75% of the value)
SPACE NEEDED - predicted value gives the predicted width of unerupted

canine & premolar
SPACE AVAILABLE – measured with a brass wire extending from the mesial
side of 1st permanent molar from one side to other (after incisal alignment)
Brass wire is straightened & measured with Boley’s gauge
Difference between space available & space needed gives the DISCREPANCY
235-8.
MOYER’S ANALYSIS
235-8.
MOYER’S ANALYSIS
ADVANTAGES
• Minimal systematic error
• Even beginners can carry out this analysis with equal
reliability
• Less time consuming
• No special equipment / radiographs are required
• Can be carried out for both arches
LIMITATIONS
• It’s a probability analysis
• It does not account for tipping of mandibular incisors
• Maxillary teeth size is predicted by mandibular teeth
• It may have population variations, thus it cannot
universally be applied
235-8.
TANAKA-JOHNSTON ANALYSIS
 A variation of moyer’s analysis except that a prediction table is not

needed
 Very useful – requires no additional radiographs or tables to predict

tooth size
 It can be applied to both the arches, has reasonable accuracy
Tanaka MM, Johnston LE. The prediction of the size of unerupted canines and premolars in a contemporary orthodontic
population. J Am Dent Assoc1974;88:798-801.
ARMAMENTARIUM
Study casts, boley’s gauge
TECHNIQU Determine the available arch length = distance from mesial of first
E permanent molar to the contralateral tooth
(Tanaka & Width of four mandibular incisors to be calculated

Johnston,
1974) Half the mesio-distal width of 4 lower incisors + 10.5 = Mandibular
canines & premolars in one quadrant
Half the mesio-distal width of 4 lower incisors + 11 = Maxillary canines &
premolars in one quadrant
Subtract this dimension from remaining space available – to give a
positive / negative for total arch space
 If the patient is not of the Northwestern European descent, Tanaka

Johnston space analysis will either over-predict or under-predict the
size of the unerupted teeth – this could cause serious treatment
planning problems
HUCKABA ANALYSIS
Introduced by Huckaba, in 1964.
It makes use of radiograph & study casts – to determine the width of

unerupted teeth
HUCKABA ANALYSIS
PRINCIPLE
 With any type of radiograph, it is necessary to compensate for
enlargement of radiographic image
 Enlargement ratio for each unerupted permanent tooth is computed by

measuring the nearest erupted tooth first in the mouth & then in the
radiograph
HUCKABA ANALYSIS
ARMAMENTARIUM
• Dental casts
• Boley gauge, millimeter ruler
• Peri-apical radiograph
PROCEDURE
• Width of primary tooth on IOPA Y’
• Width of its underlying successor on IOPA X’
• Width of primary tooth on the cast Y
• Width of unerupted permanent tooth X
X = X’Y / Y’
HUCKABA ANALYSIS
ADVANTAGES
• Very easy, practical & relatively accurate method
• Does not require any prediction table
• Can be used in maxillary & mandibular arches
DISADVANTAGES
• Inherent distortion of radiographic image causes
error
HIXON-OLD FATHER ANALYSIS
Developed by Iowa Facial Growth Study, in 1956
Developed to avoid the difficulty involved in obtaining an accurate

radiographic measurement of mandibular cuspid & reduce error
found in other statistical & radiographic methods
Hixon EH, Oldfather RE. Estimation of the sizes of unerupted cuspid and bicuspid teeth. Angle Orthod 1958;28:236-40.
 Original equation – primarily obtained from the measurements of

the teeth on left side of the arch of each subject (Hixon & Oldfather,
1956)
 Revised equation – derived from the mean of measurements taken

from both right & left side in each subject (Staley & Kerber, 1980)
 It is stated that it to be the most accurate
ARMAMENTARIUM Boley’s gauge
Study cast
Peri-apical radiograph
Hixon & Oldfather prediction chart
METHOD From model – on one side, measure mesio- MEASUR
ESTIMAT
distal width of permanent mandibular central ED
ED
TOOTH
& lateral incisors VALUE
SIZE
(mm)
(mm)
From peri-apical radiograph – measure mesio-
23 18.4
distal width of unerupted 1st & 2nd premolars
24 19.0
Total the mesio-distal width of four teeth 25 19.7

26 20.3
27 21.0
Compare the measured value to estimated 28 21.6
tooth size from the prediction chart
29 22.3
30 22.9
Staley RN, Kerber PE. A revision of Hixon and Oldfather mixed dentition prediction method. Am J Orthod 1980;78:296-302.
Staley & Kerber,1980 – revised equation
Significantly reduced standard error of estimate
Co-efficient of correlation of revised equation
Significantly higher than that of original

equation
A graph was made – for clinical use – in prediction

of mandibular canine & premolar widths
It is accurate to the nearest
PROCEDURE
• Measure & add up widths of mandibular incisors on one side
• Measure widths of unerupted premolars from IOPA of same side
• Add 1 and 2
• Use the prediction graph to calculate width of unerupted canine & premolar
ADVANTAGES
• Only study casts & peri-apical radiographs
are needed
• It has a co-efficient of correlation of 0.87
or 75% reliability
• Very accurate analysis
LIMITATIONS
• It can be used only for lower arch
SIGNS OF DIIFFERENT TYPES OF
DENTITION
TYPE OF
SIGNS
DENTITION
Not crowded • Spacing between incisors
(Excess space) • Radiograph – long axes of maxillary molars vertical
• MDA – space available in arch exceeds that required
for eruption of premolars & canines
Not crowded • Normal contacts between incisors

(Just sufficient space) • Radiograph – long axes of maxillary molars vertical
or with slight distal inclination
• MDA – space available in arch equals space required
SIGNS OF DIIFFERENT TYPES OF
DENTITION
TYPE OF SIGNS
DENTITION
Mild crowding • Slight overlapping of incisors
• Radiograph – distal inclination of maxillary molars
• MDA – space available in arch upto 4mm less than
that required for eruption of canines & premolars
Severe crowding • Overlapping, rotation or displacement of incisors

• Radiograph – marked distal inclination of maxillary
molars with “Stacking”; distal inclination of
mandibular molars
• MDA – space available in arch over 4mm less than
that of space required
Galvao. M.A.B et al, 2013 – Applicability of Moyer’s analysis
in mixed dentition: A systematic review
Moyer’s analysis must be carefully used, since the probability of

75% was not as accurate as expected, leading to the need of
adapting the probability leads depending on the study population
S.N Title of the article Background / Aim Conclusion / Inference
o
1. Suruchi Juneja, et al. To evaluate the accuracy of • Found to be inaccurate and
Comparative Evaluation of • Tanaka-Johnston they overestimate the
Three Mixed Dentition • Moyers mesio-distal widths
Analyses and Formulation of •Bernabe & Flores-Mir • Revised linear regression
Regression Equations for In forecast M-D equations were derived
North Indian Population: A dimensions of permanent using the data obtained
Cross-sectional Study. Biomed canine & premolars from this population
J.2015: Vol 38(5). 450-55.
Suruchi Juneja, et al. Comparative Evaluation of Three Mixed Dentition Analyses and Formulation of Regression Equations for
North Indian Population:A Cross-sectional Study. Biomed J.2015: Vol 38(5). 450-55.
o
1. Durgekar GS, Naik V. • To test the reliability of • Moyers- not accurate to this
Evaluation of Moyers Moyers mixed dentition sample
mixed dentition analysis in analysis in school • Differences are the result of
school children. Indian J children of Belgaum racial and ethnic diversity
dent res. 2009;20:26-30. • Age group – 13-16 years • Tooth dimension shows sexual
dimorphism.
• Mesio-distal dimension in buccal
segment of mandibular arch is
larger in males than in females.
Durgekar GS, Naik V. Evaluation of Moyers mixed dentition analysis in school children. Indian J dent res. 2009;20:26-30.
o
1. Baheti K et al. Evaluation of • To evaluate the • Moyers prediction chart
Moyers mixed dentition applicability of Moyers was not comparable with
space analysis in Indian analysis in the Marwari the study population group
children. J Ind Soc Prev community of • There was statistically
Community Dent, 2016: 6(5). Rajasthan, India differences present
453-8. • 200 adolescents
Baheti K et al. Evaluation of Moyers mixed dentition space analysis in Indian children. J Ind Soc Prev Community Dent, 2016:
6(5). 453-8.
o
1. Nishi Grover, et al. To test the reliability of • Both methods are
Applicability of different • Moyers considering it to be
mixed dentition analysis in •Tanaka- Johnston inapplicable for the
Lucknow population. 2017: Among Lucknow Lucknow population
35(1). 68-74. population. • Regression equations
proposed – one of the most
accurate method for
Lucknow population
Males:
Maxilla : y = 15.935+0.315*Mdl
Mandible : y = 8.556+0.620*Mdl
Females:
Maxilla : y = 15.133+0.269*Mdl
Mandible : y = 11.350+0.403*Mdl
Nishi Grover, et al.Applicability of different mixed dentition analysis in Lucknow population. 2017: 35(1). 68-74.
S.No Title of the article Background / Conclusion / Inference
Aim
1. Sonaware. S, Bettigiri A. To examine & Both methods have
Comparison of two non- compare the comparable standard errors of
radiographic techniques of accuracy of estimate
mixed dentition analysis & Moyers Moyers chart at 50%
evaluation of their Tanaka-Johnston confidence level gives more
applicability for Marathi realistic estimate as compared
population. Scientific to 75% confidence level for
Journal, 2008: 2. 385-9. Marathi population
Y = a + b (x)
X = independent variable (mandibular incisors)
Y = dependent variable (sum of canine & premolars)
Maxilla : Y = 12.143+0.481 (x)
Mandible: Y = 10.830+0.563 (x)
Sonaware. S, Bettigiri A. Comparison of two non-radiographic techniques of mixed dentition analysis & evaluation of their
applicability for Marathi population. Scientific Journal, 2008:2. 385-9.
S.No Title of the article Background / Aim Conclusion / Inference
1. Priya S, Munshi AK. To formulate a prediction • Moyers method – developed
Formulation of a chart from the combined for northern European
prediction chart for width of mandibular ancestry – difficult to apply
mixed dentition incisors on Moyers pattern in other populations –
analysis. J Indian for a section of Indian variation in tooth size
Soc Pedod Prev population – different • Over-estimation / under-
Dent. 1994;12:7-11. schools in Mangalore estimation – when applied to
Aged 12-15 years of different populations –
similar ethnic background prompted to make new
probability tables for
different populations
• Sexual dimorphisms – noted
in tooth sizes
Priya S, MunshiAK. Formulation of a prediction chart for mixed dentition analysis.J Indian Soc Pedod Prev Dent. 1994;12:7-11.
S.No Title of the article Background / Aim Conclusion / Inference
1. Umapathy Thimmegowda et • To test the reliability of • Found that 50% is more
al., Validity of Moyers Moyer’s method applicable to boys and
Analysis and a New • To produce new regression 75% to girls
Regression Equation. J Clin equation for Bangalore • Canine-premolar segment
Diag Res. Aug 2015: 9(8): 1- population – 400 subjects, in both arches -
6. aged – 13-16 years statistically larger in men
than in women
Umapathy Thimmegowda et al., Validity of Moyers Analysis and a New Regression Equation. J Clin Diag Res. Aug 2015: 9(8): 1-6.
STUDY MODELS / STUDY CASTS
Prominent role in diagnosis & treatment planning
Widespread in use even before skull radiography became

popular
Reproduce teeth & investing structures with a fair degree of

accuracy
Proffit WR, Fields HW. Contemporary Orthodontics. 3rd Ed. St. Louis: Mosby Inc.; 2000.
Graber TM. Incidence and recognition of malocclusion. In: Graber TM, editor. Orthodontics: principles and practice. 3rded.
Philadelphia: W.B. Saunders; 2001:p. 204-5.
Artistic
portion Ratio between anatomic
to artistic portion – 2:1
Anatomic
portion Ratio between tooth
portion, soft tissue
portion & artistic portion
Anatomic – 1:1:1
portion
Completed model should
be 13mm in height –
Artistic anterior & posterior
portion regions
Impression technique Pouring the impression
• Pre-impression mouth • Impression – rinsed &

wash – removes debris, excess water removed –
reduces surface tension & removes mucin & debris
bubble formation • Good grade of white stone
• Alginate impression – – poured as layers
ideally suited
• Greatest concentration of
material – anterior region
of tray
Forming the base Finishing of cast
• Base is poured with rubber • Bubbles at gingival margin –

base moulds removed with small universal
• Orientation of the model – sealer
anatomic portion is in center • Bubbles reproduced from
of rubber mould & occlusal impression in muco-buccal
plane parallel with the cast fold – removed with kingsley
base of the base former type sealer
• Final finishing – fine
waterproof sand paper with
Arkansas stone & water
Study cast –
symmetrical
after trimming
Upper cast – 7
sides
Lower cast – 6
sides
Uses
• 3-Dimensional precise record
• Enables the study of malocclusion from all sides
• Essential diagnostic aid
• Valuable aids in patient education & communication
• Evaluation of inter-arch relationships in all 3 planes
• To assess & record the curves of occlusion
• Used in mixed dentition analysis along with charts &
radiographs
CONCLUSION
None of the mixed dentition analyses are as precise as one might

like, and all must be used with judgement and knowledge of
development.
Use of prediction chart personalized to the particular population

is more accurate than the conventional prediction chart.
REFERENCES
 Mathewson RJ, Primosch RJ. Fundamentals of Pediatric Dentistry, 3rd edition. Chicago :
Quintessence Co. Inc ; 1995.
 Dean JA, Avery DR, McDonald RE. McDonald and Avery’s Dentistry for the Child And
Adolescent, 9th edition. Maryland Heights : Mosby;2012.
 Muthu MS, Sivakumar N. Pediatric Dentistry: Principles & Practice, 2nd edition. New
Delhi: Elsevier; 2011.
 Braham RL, Morris ME. Textbook of Pediatric Dentistry. Edinburgh: Williams &
Wilkins; 1980.
 Casamassimo P, Field. H, Mctigue. D, Nowak. A. Pediatric Dentistry: Infancy Through
Adolescence, 5th edition. St Louis : Elsevier Health Sciences; 2013.
 Welbury RR, Duggal MS, Hosey MT. Pediatric Dentistry. 3rd edition. New York:
Oxford University Press; 2005.
 Wei. H.Y. Stephen, Nakata M. Occlusal guidance in Pediatric Dentistry. Missouri, USA:
Ishiyaku EuroAmerica. Inc; 1988.
 Wei. H.Y. Stephen. Pediatric Dentistry : Total Patient Care. Philadelphia : Lea &
Febiger ; 1988.
REFERENCES
 Hixon EH, Oldfather RE. Estimation of the sizes of unerupted cuspid and bicuspid
teeth. Angle Orthod 1958;28:236-40.
 Moyer RE. Handbook of orthodontics. Analysis of the dentition and occlusion. 4thed.
Year Book Medical Publishers; 1988. p. 235-8.
 Tanaka MM, Johnston LE. The prediction of the size of unerupted canines and
premolars in a contemporary orthodontic population. J Am Dent Assoc 1974;88:798-
801.
 Staley RN, Kerber PE. A revision of Hixon and Oldfather mixed dentitionprediction
method. Am J Orthod 1980;78:296-302.
 Moorrees CFA and Reed RB. Correlation among crown diameters of human teeth.
Archives of Oral Biology 1964; 9 : 685-697.
 Bernabe E, Flores-Mir C. Are the lower incisors the best predictions for the [32]
unerupted canine and premolars sums? An analysis of a Peruvian sample. AngleOrthod.
2005;75:198-203.
 Durgekar GS, Naik V. Evaluation of Moyers mixed dentition analysis in school [34]
children. Indian J dent res. 2009;20:26-30.
REFERENCES
 Priya S, Munshi AK. Formulation of a prediction chart for mixed dentition analysis.J
Indian Soc Pedod Prev Dent. 1994;12:7-11.
 Ngan P, Alkire RG, Fields H Jr. Management of space problems in the primary and
mixed dentitions. J Am Dent Assoc1999;130:1330-9.
 American Academy of Pediatric Dentistry Clinical Affairs Committee. Guideline on
management of the developing dentition and occlusion in pediatric dentistry.
Reference Manual 2006-07. Pediatr Dent 2006;28:157-69.
 Proffit WR, Fields HW. Contemporary Orthodontics. 3rd Ed. St. Louis: Mosby Inc.;
2000.
 Graber TM. Incidence and recognition of malocclusion. In: Graber TM, editor.
Orthodontics: principles and practice. 3rd ed. Philadelphia: W.B. Saunders; 2001:p.
204-5.
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MIXED DENTITION

Department of Pediatric and Preventive Dentistry

Factors to be evaluated for space maintainence

Factors that prevents normal posterior occlusion

Indications of Mixed DentitionAnalysis

Principles of space analysis

Signs of different types of dentition

Development of well-aligned dental arches – dependent upon a favorable

Crowding of teeth – may adversely affect periodontal health, caries

Early recognition & accurate assessment – wider choice of management

Amount of closure is affected by numerous

Hence, dental age has to be considered rather than

Eruption of Active eruption of 1st permanent molar – causes

Usually completed in the mixed dentition – crucial in determining

Predicted - using the dimensions of tooth present in the mouth

Hence, an assessment about the space needed or deficiency in the

 They also demonstrated a reduction in arch circumference of

 3.5mm in boys in mandible during

Extensive inter-proximal caries / premature extraction of

Ectopic eruption of permanent maxillary 1st molars –

Field & Profitt, 1988

• Use of measurements from radiographs

• Use of a combination (most accurate – lowest standard error

 Hixon and Old-father method – more accurate, but its disadvantage –

Contour a piece of brass wire to

Space required is calculated by

They erupt earlier than

This analysis is similar to arch perimeter analysis of permanent

Total M-D width of all the teeth in each quadrant –

Space available – measure arch perimeter from mesial

Compare the space required & available –arch length

Introduced by Moyer, in 1967

Moyer’s probability tables – formulated at the University of

Arch perimeter analysis

Most commonly used mixed dentition analysis

This value is used in the probability chart (75% of the value)

SPACE NEEDED - predicted value gives the predicted width of unerupted

Brass wire is straightened & measured with Boley’s gauge

 A variation of moyer’s analysis except that a prediction table is not

 Very useful – requires no additional radiographs or tables to predict

 It can be applied to both the arches, has reasonable accuracy

(Tanaka & Width of four mandibular incisors to be calculated

 If the patient is not of the Northwestern European descent, Tanaka

Introduced by Huckaba, in 1964.

It makes use of radiograph & study casts – to determine the width of

 Enlargement ratio for each unerupted permanent tooth is computed by

Developed by Iowa Facial Growth Study, in 1956

Developed to avoid the difficulty involved in obtaining an accurate

 Original equation – primarily obtained from the measurements of

 Revised equation – derived from the mean of measurements taken

 It is stated that it to be the most accurate

Total the mesio-distal width of four teeth 25 19.7

Staley & Kerber,1980 – revised equation

Significantly reduced standard error of estimate

Co-efficient of correlation of revised equation

Significantly higher than that of original

A graph was made – for clinical use – in prediction

Not crowded • Normal contacts between incisors

Severe crowding • Overlapping, rotation or displacement of incisors

Moyer’s analysis must be carefully used, since the probability of

Prominent role in diagnosis & treatment planning

Widespread in use even before skull radiography became