Clinical management of tooth size discrepancies

A selection of abstracts of clinically relevant papers from other journals. The abstracts on this page have been chosen and edited by John R. Radford.

Abstract

As if it is a disease, it has been reported that as many as one third of orthodontic patients have 'clinically significant ITSD'.

Main

Grauer D, Heymann GC. J Esthet Restor Dent 2012; 24: 155–159

If the ratio of the widths of the mesiodistal dimensions of the anterior teeth is <77.2%, the authors argue that 'either the lower teeth are too narrow, the upper teeth are too wide, or a combination of both' and vice versa if >77.2% (from Bolton WA. Angle Orthod 1958; 28: 113–130). When ITSD is <2 mm, orthodontic treatment is the preferred approach. If ITSD >2 mm, 1) the teeth could be reduced in size by judicial interproximal enamel stripping, or 2) the width of the teeth increased by restorative techniques, in addition to possible orthodontic treatment. If the patient is uncomfortable with these more invasive approaches, 'the orthodontist could finish the case' by accepting a sub-optimal overjet and/or overbite, and/or altering the inclination of the incisor teeth.