MIXED DENTITION ANALYSIS

The purpose of a mixed dentition analysis is to evaluate the amount of space

available in the arch for the erupting permanent canines
and premolars.

The aim of mixed dentition analysis is to compare the space available for the
unerupted permanent canine and premolars with the space needed, the
difference gives us the amount of crowding or spacing that can be expected.

1- MOYER'S MIXED DENTITION ANALYSIS

In this analysis the size of the unerupted permanent cuspids and premolars
are predicted from the knowledge of the sizes of certain permanent teeth
already erupted in the mouth.

The Moyer's mixed dentition analysis predicts the combined mesio-distal width
of 3, 4 and 5 based on the sum of the widths of the four lower permanent
incisors.

- The mesio-distal width of the four lower incisors are measured and summed
up.
- The amount of space available for the 3, 4 and 5 after incisor alignment is
determined by measuring the distance between the distal surface of lateral
incisor and the mesial surface of first permanent molar.

2- MIXED DENTITION ANALYSIS RADIOGRAPHIC METHOD

This technique makes use of a radiograph as well as a study cast to determine

the width of the unerupted teeth.

Radiographic measurements of unerupted teeth are by themselves unreliable

due to the distortion that can occur.

It is possible to determine the measurements of the unerupted teeth by

Dr. Azzam Aljapri

studying the teeth that have already erupted in a radiograph and on a cast.
The following

formula is used:

X
Y1 = X1 Y2
X2

where:
Y1= width of unerupted tooth whose measurement is to be determined.
Y2= width of unerupted tooth on the radiograph.
X1= width of a tooth that has erupted, measured on the cast.
X2 = width of a tooth that has erupted measured on the radiograph.

3- TANAKA JOHNSTON METHOD

This is a non-radiographic method of mixed dentition analysis suggested by

Tanaka and Johnston in 1974.

This method uses the width of the lower incisors to predict the widths of
unerupted canines and premolars of the upper and lower arches.

a) Estimated width of mandibular 3, 4 & 5 in one quadrant is Half of the sum of

mandibular incisor width + 10.5mm

b) Estimated width of maxilla 3, 4 & 5 in one quadrant is Half of the sum of

mandibular incisor width + 11.0mm

Dr. Azzam Aljapri

 SPACE ANALYSIS
Crowding/Spacing = Total arch length - Total teeth width

Calculating the space requirements

Space is required to correct the following:
1- Crowding
2- Incisor anteroposterior change (usually achieving a normal overjet of 2 mm)
3- Leveling of curve of Spee
4- Arch contraction (expansion will create space)
5- Correction of upper incisor angulation (mesiodistal tip)
6- Correction of upper incisor angulation (torque)

i) Crowding
Crowding/Spacing = Total arch length - Total teeth width

The amount of crowding is classified as

a) Mild (< 4mm)
b) Moderate (4 to 8mm)
c) Severe (> 8 mm)

ii) Incisor anteroposterior change

The treatment aim is to achieve an overjet of 2 mm at the end of treatment.

- Every millimeter Of incisor overjet reduction requires 2 mm of space in the

dental arch.
- Every millimeter of incisor overjet increase, 2 mm space are created in the
dental arch.

Dr. Azzam Aljapri

 iii) Leveling Space is curve required of Spee

The aim of treatment is to create a flat curve of Spee

Estimation space requirement to flatten a curve of Spee

Creating space
Space can be created by one or more of the following
Extractions
Distal movement of molars
Enamel stripping
Expansion
Proclination of incisors
A combination of any or all of the above

- Enamel stripping
Enamel interproximal stripping is the removal of a small amount of enamel on
the mesial and distal aspect of teeth approximately 0.5 mm can be removed on
each tooth (0.25 mm from the mesial and distal)
Enamel can be carefully removed with an abrasive strip
Dr. Azzam Aljapri
The teeth are treated with fluoride following the enamel stripping

- Proclination of upper incisors

Space can be created by proclining the incisors teeth, but this is dictated by
the aims of treatment.
Each mm of incisor advancement creates approximately 2 mm of space within
the dental arch.

EXAMPLE :-

Dr. Azzam Aljapri