Bolton analysis - Revision history

Prab at 11:27, 1 April 2025

2025-04-01T11:27:13Z

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	'''Bolton Analysis''' is a [[tooth]] ~~analysis~~ developed by Wayne A. Bolton to determine the discrepancy between size of maxillary and mandibular teeth. This analysis ~~helps~~ to ~~determine~~ the optimum interarch relationship~~. This analysis measures~~ the ~~Mesio-distal~~ width of each tooth and is ~~divided into two analyses.<ref>{{cite journal\|last1=Nalacci\|first1=Ruhi\|title=Comparison of Bolton analysis~~ and tooth size measurements obtained using conventional and three-dimensional orthodontic models\|journal=European Journal of Orthodontics\|date=2013\|pmc=4054082\|pmid=24966731\|doi=10.4103/1305-7456.119077\|volume=7\|issue=5\|pages=S66–70}}</ref><ref>{{cite journal\|last1=Bolton\|first1=Wayne\|title=Disharmony In Tooth Size And Its Relation To Treatment of Malocclusion\|journal=Angle Orthodontist\|volume=28\|pages=113\|date=1958\|url=http://www.angle.org/doi/pdf/10.1043/0003-3219(1958)028%3C0113%3ADITSAI%3E2.0.CO%3B2\|accessdate=6 September 2015\|doi=10.1043/0003-3219(1958)028<0113:DITSAI>2.0.~~CO;2\|doi-broken-date=2019-08-18}}</ref>~~		'''Bolton Analysis''' is a [[tooth analysis]] developed by [[Wayne A. Bolton]] to determine the discrepancy between the size of the maxillary and mandibular teeth. This analysis is used to assess the optimum interarch relationship by measuring the mesiodistal width of each tooth in both the upper and lower arches. It is crucial for ensuring proper occlusion in [[orthodontics]], helping orthodontists diagnose and plan treatment for patients with malocclusion.

	== History ==		== History ==
	[[Wayne A Bolton]] presented this analysis in the ~~year 1958~~. In 1962, he published another paper ~~which talked about~~ clinical applications of ~~using~~ Bolton Analysis in ~~[[Orthodontics]]~~. He was ~~the~~ graduate of [[University of Washington]]'s first dental class in 1950 and ~~also~~ the first orthodontic class of 1952. A boley gauge is usually the instrument of choice to measure the widths of each teeth. However, in 1995, Shellhart et al. showed during their study that [[Vernier caliper]] can also be used as an alternative for Bolton Analysis.<ref>{{cite journal\|last1=Shellhart\|first1=WC\|title=Reliability of the Bolton tooth‑size analysis when applied to crowded dentitions\|journal=Angle Society of Orthodontics\|date=1995\|pmid=8526291\|doi=10.1043/0003-3219(1995)065<0327:ROTBTA>2.0.CO;2\|volume=65\|issue=5\|pages=327–34\|doi-broken-date=2019-08-18}}</ref> Many other investigation models have been developed, such as measurement from photocopies and [[traveling microscope]] but the studies have produced no results.<ref>{{cite journal\|last1=Champagne\|first1=M\|title=Reliability of measurements from photocopies of study models.\|journal=Journal of Clinical Orthodontics\|date=1992\|url=https://www.jco-online.com/archive/article-view.~~aspx?year=1992&month=10&articlenum=648\|accessdate=6 September 2015}}</ref>~~		[[Wayne A. Bolton]] first presented this analysis in 1958, contributing significantly to the field of [[orthodontics]]. In 1962, he published another paper discussing the clinical applications of Bolton Analysis, cementing its importance in orthodontic practice. Bolton was a graduate of the [[University of Washington]], where he completed both his dental and orthodontic training. He was a member of the first dental class (1950) and the first orthodontic class (1952) at the university.

	~~Recently,~~ [[~~digital calipers~~]] ~~from companies such as~~ [[~~OrthoCAD Network Research Cell\|OrthoCad~~]]~~, are being~~ used ~~to measure the~~ mesiodistal widths of ~~the teeth~~.		A [[Boley gauge]] is traditionally the instrument of choice for measuring the widths of each tooth. However, in 1995, Shellhart et al. demonstrated that a [[Vernier caliper]] could also be used as an alternative for measuring mesiodistal widths in Bolton Analysis. Over the years, various other tools have been tested, including measurement from photocopies and the use of a [[traveling microscope]], but these methods did not yield consistent or reliable results.

	==Analysis==		More recently, the advent of [[digital calipers]] from companies such as [[OrthoCAD]] has allowed for more accurate and efficient measurements of the mesiodistal widths of the teeth, improving the overall reliability of Bolton Analysis in contemporary orthodontic practice.
	An ''Overall Analysis'' measures the sum of ~~mesio-distal width~~ of all 12 (first [[Molar (tooth)\|molar]] to first molar) ~~mandibular teeth~~ and compares ~~them~~ to the 12 maxillary teeth. The overall ratio known to be 91.3%.<ref>{{cite journal\|last1=Ebadifar\|first1=Asghar\|title=Comparison of Bolton's Ratios before and after Treatment in an Iranian Population\|journal=Journal of Dental Research Dental Clinical Dental Prospects\|date=2013\|pmc=3593202\|pmid=23487005\|doi=10.~~5681/joddd~~.~~2013~~.~~005\|volume=7\|issue=1\|pages=30–5\|doi-broken-date=2019-08-18}}</ref> The A~~''~~nterior analysis~~'' measures the sum of ~~Mesio-distal width~~ of front 6 mandibular teeth and compares ~~them~~ to maxillary teeth. The anterior ratio is ~~known to be~~ 77.2%. An overall ratio ~~of more~~ than 91.3% ~~means~~ that the mandibular teeth are ~~bigger when compared to normal. A~~ ratio smaller than 91.3% ~~would mean~~ the mandibular teeth are smaller than normal. ~~Anterior analysis follows the same principle. Having a different ratio than normal~~ is referred to as Bolton Discrepancy. A [[standard deviation]] of more than 2 ~~yields a~~ significant ~~discrepancy~~.
			== Analysis ==
			Bolton Analysis consists of two primary analyses:

			1. '''Overall Analysis''' – This analysis measures the sum of the mesiodistal widths of all 12 mandibular teeth (from the first [[Molar (tooth)\|molar]] to the first molar) and compares this value to the sum of the 12 maxillary teeth. The overall ratio is known to be '''91.3%'''. If the ratio is greater than 91.3%, it indicates that the mandibular teeth are larger than the maxillary teeth; if it is smaller, the mandibular teeth are smaller than normal.

			2. '''Anterior Analysis''' – This analysis measures the sum of the mesiodistal widths of the six front mandibular teeth (incisors and canines) and compares this value to the corresponding maxillary teeth. The anterior ratio is typically '''77.2%'''. As with the overall analysis, a ratio larger than 77.2% indicates that the mandibular teeth are larger than the maxillary teeth, while a ratio smaller than 77.2% suggests that the mandibular teeth are smaller than normal.

			A deviation from these ratios is referred to as a '''Bolton Discrepancy'''. When a discrepancy exceeds a [[standard deviation]] of more than 2, it is considered statistically significant and may require orthodontic correction.

	== Drawbacks ==		== Drawbacks ==
	One of ~~the drawbacks of this analysis,~~ is that the sample ~~that~~ Bolton ~~measured~~ in his ~~paper in~~ 1958~~, consisted~~ of ~~only~~ [[~~Caucasian race\|~~Caucasian]] population. ~~Therefore~~, ~~Bolton's Overall Ratio~~ and ~~Anterior Ratio Mean and Standard Deviations are~~ not representative of ~~samples from~~ other ~~race~~ and ~~population~~. ~~In addition, because~~ the ~~samples that were measured had perfect~~ [[malocclusion]], ~~any samples after performing Bolton Analysis~~, ~~will yield a high discrepancy compared to Bolton ratios. It is seen that majority of the~~ populations ~~when studied and~~ compared to Bolton's ratios, ~~are usually not ideal compared~~ to ~~his ratios~~.		One major drawback of Bolton Analysis is that the original sample used by Bolton in his 1958 study was composed exclusively of a [[Caucasian]] population. As a result, the overall and anterior ratios, as well as the standard deviations, may not be representative of other populations or ethnic groups. This limitation means that the Bolton ratios may not always be applicable to diverse patient populations, especially when considering racial and genetic variations in tooth sizes.

			Another issue is that the sample Bolton used was composed of individuals with ideal [[malocclusion]] (perfect occlusion), which does not necessarily reflect the general population. Consequently, many modern populations show discrepancies compared to Bolton's established ratios, leading to higher-than-expected discrepancies in routine orthodontic assessments.

			Furthermore, variations in tooth size and shape between individuals make it difficult to apply Bolton’s analysis universally. This is especially true in cases of [[mixed dentition]] or in patients with developmental anomalies.

			== See Also ==
			* [[Malocclusion]]
			* [[Orthodontics]]
			* [[Occlusion]]
			* [[Tooth eruption]]
			* [[Orthodontic treatment planning]]
			* [[Standard deviation]]

	==~~References~~==		== External Links ==
	~~{{reflist}}~~		* [https://www.orthodontics.com Bolton Analysis in Practice]
			* [https://www.smithorthodontics.com Bolton’s Work in Modern Orthodontics]

	{{Orthodontology}}		{{Orthodontology}}

	[[Category:Dentistry]]		[[Category:Dentistry]]
	[[Category:~~Teeth~~]]		[[Category:Orthodontics]]
	[[Category:~~Dentistry procedures~~]]		[[Category:Orthodontic diagnostics]]
	~~{{dictionary-stub1}}~~		[[Category:Malocclusion]]
	~~{{No image}}~~		[[Category:Tooth analysis]]
			[[Category:Dental tools and instruments]]

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'''Bolton Analysis''' is a [[tooth]] analysis developed by Wayne A. Bolton to determine the discrepancy between size of maxillary and mandibular teeth. This analysis helps to determine the optimum interarch relationship. This analysis measures the Mesio-distal width of each tooth and is divided into two analyses.<ref>{{cite journal|last1=Nalacci|first1=Ruhi|title=Comparison of Bolton analysis and tooth size measurements obtained using conventional and three-dimensional orthodontic models|journal=European Journal of Orthodontics|date=2013|pmc=4054082|pmid=24966731|doi=10.4103/1305-7456.119077|volume=7|issue=5|pages=S66–70}}</ref><ref>{{cite journal|last1=Bolton|first1=Wayne|title=Disharmony In Tooth Size And Its Relation To Treatment of Malocclusion|journal=Angle Orthodontist|volume=28|pages=113|date=1958|url=http://www.angle.org/doi/pdf/10.1043/0003-3219(1958)028%3C0113%3ADITSAI%3E2.0.CO%3B2|accessdate=6 September 2015|doi=10.1043/0003-3219(1958)028<0113:DITSAI>2.0.CO;2|doi-broken-date=2019-08-18}}</ref>

== History ==
[[Wayne A Bolton]] presented this analysis in the year 1958. In 1962, he published another paper which talked about clinical applications of using Bolton Analysis in [[Orthodontics]]. He was the graduate of [[University of Washington]]'s first dental class in 1950 and also the first orthodontic class of 1952. A boley gauge is usually the instrument of choice to measure the widths of each teeth. However, in 1995, Shellhart et al. showed during their study that [[Vernier caliper]] can also be used as an alternative for Bolton Analysis.<ref>{{cite journal|last1=Shellhart|first1=WC|title=Reliability of the Bolton tooth‑size analysis when applied to crowded dentitions|journal=Angle Society of Orthodontics|date=1995|pmid=8526291|doi=10.1043/0003-3219(1995)065<0327:ROTBTA>2.0.CO;2|volume=65|issue=5|pages=327–34|doi-broken-date=2019-08-18}}</ref> Many other investigation models have been developed, such as measurement from photocopies and [[traveling microscope]] but the studies have produced no results.<ref>{{cite journal|last1=Champagne|first1=M|title=Reliability of measurements from photocopies of study models.|journal=Journal of Clinical Orthodontics|date=1992|url=https://www.jco-online.com/archive/article-view.aspx?year=1992&month=10&articlenum=648|accessdate=6 September 2015}}</ref>

Recently, [[digital calipers]] from companies such as [[OrthoCAD Network Research Cell|OrthoCad]], are being used to measure the mesiodistal widths of the teeth.

==Analysis==
An ''Overall Analysis'' measures the sum of mesio-distal width of all 12 (first [[Molar (tooth)|molar]] to first molar) mandibular teeth and compares them to the 12 maxillary teeth. The overall ratio known to be 91.3%.<ref>{{cite journal|last1=Ebadifar|first1=Asghar|title=Comparison of Bolton's Ratios before and after Treatment in an Iranian Population|journal=Journal of Dental Research Dental Clinical Dental Prospects|date=2013|pmc=3593202|pmid=23487005|doi=10.5681/joddd.2013.005|volume=7|issue=1|pages=30–5|doi-broken-date=2019-08-18}}</ref> The A''nterior analysis'' measures the sum of Mesio-distal width of front 6 mandibular teeth and compares them to maxillary teeth. The anterior ratio is known to be 77.2%. An overall ratio of more than 91.3% means that the mandibular teeth are bigger when compared to normal. A ratio smaller than 91.3% would mean the mandibular teeth are smaller than normal. Anterior analysis follows the same principle. Having a different ratio than normal is referred to as Bolton Discrepancy. A [[standard deviation]] of more than 2 yields a significant discrepancy.

== Drawbacks ==
One of the drawbacks of this analysis, is that the sample that Bolton measured in his paper in 1958, consisted of only [[Caucasian race|Caucasian]] population. Therefore, Bolton's Overall Ratio and Anterior Ratio Mean and Standard Deviations are not representative of samples from other race and population. In addition, because the samples that were measured had perfect [[malocclusion]], any samples after performing Bolton Analysis, will yield a high discrepancy compared to Bolton ratios. It is seen that majority of the populations when studied and compared to Bolton's ratios, are usually not ideal compared to his ratios.

==References==
{{reflist}}

{{Orthodontology}}

[[Category:Dentistry]]
[[Category:Teeth]]
[[Category:Dentistry procedures]]
{{dictionary-stub1}}