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ORIGINAL RESEARCH Table of Contents   
Year : 2006  |  Volume : 17  |  Issue : 4  |  Page : 185-189
Dental arch dimensions in primary dentition of children aged three to five years in Chennai and Hyderabad


Department of Pedodontics and Preventive Dentistry, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai, India

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   Abstract 

OBJECTIVE : The purpose of this study was to assess the arch dimensions in primary dentition of 3-5 years old children in Chennai and Hyderabad. As no primary to the mixed dentition and determining the existence of sexual dimorphism. METHODS : Children were selected fro various schools of both Chennai and Hyderabad, with complte set of primary dentition. Study casts were made and measurements of arch dimensions were made using digital sliding calipers. The data obtained was subjected to statistical analysis. RESULTS : The mean values and standard deviations of the various arch dimensions are given in the tables. CONCLUSION : Generally boys exhibited a greater arch dimensions than girls in both groups. Some of the dimensions showed a statistically significant mean values.

Keywords: Arch dimensions, Digital calipers, Intercanine width

How to cite this article:
Prabhakaran S, Sriram C H, Muthu M S, Rao CR, Sivakumar N. Dental arch dimensions in primary dentition of children aged three to five years in Chennai and Hyderabad. Indian J Dent Res 2006;17:185-9

How to cite this URL:
Prabhakaran S, Sriram C H, Muthu M S, Rao CR, Sivakumar N. Dental arch dimensions in primary dentition of children aged three to five years in Chennai and Hyderabad. Indian J Dent Res [serial online] 2006 [cited 2014 Aug 2];17:185-9. Available from: http://www.ijdr.in/text.asp?2006/17/4/185/29866

   Introduction Top


Dental arch dimension is of primary concern to a pediatric dentist who occupies a pivotal position in providing a smooth transition from the primary, through the mixed to the permanent dentition.

It is a known fact that the dental arch is divided into various segments like incisor segment, canine segment, and molar segment which plays a significant role in determining the space and occlusion in the permanent dentition. There is a generalized interdental spacing in the primary dentition which decreases with age and there is no pattern of spacing common to all primary dentition. The wider spaces found mesial to maxillary cuspids and distal to the mandibular cuspids are known as primate spaces. Dimensional increase in the arches seems to be associated with eruption of the primary teeth. Change in arch width dimension involves the growth of the alveolar process almost totally and little skeletal width increase particularly in the mandiblular arch [1]. There is a clinically significant difference in arch width changes in the maxilla and the mandible and is correlated with the vertical growth of the alveolar process whose direction is different in the upper and lower arches. Specifically, maxillary alveolar processes diverge as the teeth erupt; whereas the growth of the mandiblular alveolar process is more parallel [1]. Generally the maxillary width increases are much greater and can be more easily altered with treatment [1].

The arch dimensions play an important role in determining the alignment of teeth, stability of the arch form, and alleviation of arch crowding, to attain a functionally stable occlusion, balanced facial profile, and normal overjet and overbite. Knowledge of arch dimensions is useful in providing a smooth occurrence of transient malocclusion, in predicting future orthodontic problems, normal occlusal changes in mixed dentition, and proper sequential exchange of permanent teeth. Loss of arch space may lead to ectopic eruption, premature eruption of the permanent teeth, and impactions.

Scientific data pertaining to these arch dimensions reveals the existence of significant variations among different populations. Though such studies have been carried out in different parts of the world, no such data seems to be published for the Indian children. The present study was carried out to evaluate the sexual dimorphism and compare the arch dimensions between two groups of children aged 3-5 years residing at Chennai and Hyderabad, two cities in Southern India.


   Materials and methods Top


This study was carried out in the department of Pedodontics and Preventive Dentistry, Meenakshi Ammal Dental College. The subjects consisted of two hundred children selected from various schools from the city of Chennai and Hyderabad between the ages 3 and 5 years. Both the Chennai and Hyderabad groups consisted of50 boys and 50 girls respectively.

The criteria for selection included

  1. Children with complete primary dentition.
  2. No loss of tooth structure mesiodistally as a result of caries, fracture or excessive wear.
  3. No restoration of any kind present.
  4. No erupted permanent teeth.
  5. No congenital defects or deformed teeth present.


Alginate impressions of both the maxillary and mandibular dental arches were taken for all the two hundred children and dental stone was poured into the impressions immediately. The dental casts obtained were used for measuring various dental arch dimensions. The measurements were made using "Dentaguage-Erskine Dental" digital sliding calipers.

The various measurements made are as follows

  1. Incisor segment width was measured from the midpoint/ mesial contact point of the central incisor to the distal contact point of the lateral incisor.
  2. Canine segment width was measured from the distal contact point of the lateral incisor to the mesial contact point ofthe first primary molar.
  3. Molar segment width was measured from the mesial contact point of the first primary molar to the distal contact point of the second primary molar.
  4. Intercanine width was measured from the cusp tip of canine on one side to the cusp tip of the canine on the other side.
  5. Intermolar width was measured from the central fossa of the second primary molar on one side to the central fossa of the second primary molar on the other side.
  6. Midline spacing if any present were also measured.


The incisor, canine, and molar segment width were measured separately on both the right and left sides of the arch. In this study, the primate space was included in the canine segment width.

Repeatability test was done by randomly selecting five dental casts from boys and five from the girls of each group (20 models). All the twenty casts were remeasured to assess the examiner's reliability for the variables. Intraclass correlation coefficient was used to assess the consistency or agreement of values within cases for repeatability.

The data obtained were subjected to statistical analysis. Mean and standard deviation were estimated from the sample for each study group. Mean values were compared by student's independent t-test. Value of p <_ 0.05 was considered as the level of significance.


   Results Top


The mean values and standard deviation for all the parameters and their respective p-value, for group 1, group 2, and males and females of both the groups, are given in [Table - 1].

In group 1 (Chennai study group), the mean width of maxillary right canine segment (Max P2-R) in boys (7.9±0.6) is significantly larger than in girls (7.5±0.8) (p= 0.006). Similarly, the mean width of maxillary canine segment (Max P2-L) is significantly larger in boys than in girls (7.9±0.8 v/s 7.6±0.8; p=0.049).

In group 1, the mean widths of mandibular right and left canine segments (Mand P2- R and Mand P2- L), are significantly larger in boys than in girls (Mand P2-R 6.5±0.7 v/s 6.1±0.7, p=0.02; Mand P2-L 6.6±0.7 v/s 6.3±0.6, p=0.02); Similarly the mean width of mandibular left molar segment (Mand P3-L) is significantly larger in boys than in girls (18.7±0.6 v/s 18.4±0.7, =0.02). The mean widths of all other segments are either larger in boys or equal to that of girls, but are not statistically significant.

In group 2 (Hyderabad group), the mean width of maxillary right canine segment (Max P2-R) is significantly larger in boys than in girls (8.2±-0.6 v/s 7.8±0.7, p=0.007). The mean widths of all other segments are either larger in boys or equal to that of girls, but are not statistically significant.

Comparing the mean width of various arch segments between group 1 and 2, the width of maxillary left canine segment (Max P2-L) is significantly shorter among boys in group 1 than in group 2 (7.9±0.8 v/s 8.2±1.0, p=0.005). Similarly, the mean widths of mandibular right and left molar segments (Mand P3-R and Mand P3-L) among boys of group 1 are larger than that of group 2. (p=0.001 and 0.01 respectively). The mean widths of various segments among girls of group 1 and group 2 did not show any significant difference).

Midline spacing was found in approximately 22.5% of children in maxilla and in 53.5% in mandible. The width of maxillary midline spacing (Max P6) is significantly larger in females of group 2 than in group 1(1.0 mm± 0.4 v/s 0.5 mm ± 0.3, p=0.003). No such difference is found among boys.

Repeatability analysis done on 20 randomly selected cases showed a significant consistency or agreement of values within cases for all parameters estimated (p=0.0001). The results of the repeatability analysis are given in [Table - 2]. The table shows a statistically significant consistency or agreement of values within cases for all the parameters estimated (p <0.0001).


   Discussion Top


Dental arch dimensions and generalized spacing in primary dentition determine to a large extent the alignment of teeth in permanent dentition. After the complete eruption of primary dentition by the age of three, the entire arch and occlusion is relatively stable for the next two years. During this static period, if proper prediction of arch changes and occlusion are done by the pediatric dentist, it helps in establishing an acceptable esthetic and functional occlusion at a later age.

The present study took into consideration this particular age group of 3-5 years. In a sample of 200 children, the arch segment widths were measured using a digital sliding caliper.

The results on sexual dimorphism in dental arch width revealed that males exhibited a larger arch width than females for most of the variables [2]. The results of this study were consistent with the findings of the study conducted by Alhaija ESJA and Qudeimat MA on Jordanian preschool children, who reported a higher mean width for males than that of females in the canine segment width but it was not significant [3]. This significance could be due to the difference in the measurement techniques. In our study, we have measured the canine segment width including the primate space whereas in the study conducted on the Jordanian children the primate space was measured as a separate parameter.

The results of the intercanine width in maxilla for group 1 clearly showed a higher mean value for males (30.0+2.1) than females (29.3+1.4), thereby showing a significant difference (p = 0.04) between both the sexes. But the mandibular intercanine width in group 1 and both maxillary and mandibular intercanine width in group 2 didn't show any significant difference. However the mean value was found to be higher in the males than the females in both groups. The results of this study were consistent with the findings of Sanin C, Savara BS, Clarkson QC and Thomas DR [4] in their study conducted on Caucasian children of Oregon. Similar results have been reported by Cohen JT [5], Meredith HV, and Hopp WM [6].

The mean intercanine width for maxilla in both group 1 and group 2 were 30.0±2.1 and 30.02±1.8 respectively and for the mandible it were 23.0±1.3 and 23.3±1.2. This was in consistent with the results of Bishara SE Jackobson JR, Treder J, Nowak A [7]. They reported a mean intercanine width for the maxilla to be 30.3mm and for the mandible 23.4mm.

However, Knott VB [8] in his longitudinal study quantified changes in intercanine widths between the deciduous (mean age-5.4 years) and mixed dentition (mean age-9.4 years), in both male and female subjects. In the mandibular arch, the mean change between the deciduous and the mixed was 2.9 mm and the corresponding mean change in the maxillary arch was 2.8 mm. He also observed individual variation in the total amount of intercanine width change between the deciduous and the permanent to be 3.2 mm, but ranged between 0 and 6.0 mm.

Also Sillman JH [9] studied longitudinally a mixed sample form birth to 25 years of age. He observed an increase in intercanine width of 5.0 mm in the maxilla and 3.5 mm in the mandible from birth to 2 years of age, after which the intercanine width continued to increase until 13 years of age in the maxilla and until 12 years of age in the mandible. Thereafter the intercanine width remained stable.

Moyers RE, Van der Linden PGM, Riolo ML, McNamara JA [10] found an increase in difference between the maxillary and mandibular intercanine widths from 4.0mm at 4 years to 7.5mm at 17years.

Moorrees CFA, Gran AM, Lebert LM, Yen PK, Frolich FJ [11] stated that arch width does not change "materially" during the deciduous dentition (4-6years), but increases markedly by 3.0mm during the eruption of the maxillary and mandibular incisors and then stabilizes.

The mean intermolar width for the maxilla and mandible were 40.0±2.2 and 34.7±1.7, which was also in consistent with the values reported by Bishara SE, Jackobson JR, Treder J, Nowak A [7], they reported a mean intermolar width of 43.5 mm for the maxilla and 36.9 mm for the mandible.

On comparing the two groups for males only, all the parameters showed no significant difference between them except for maxillary canine segment and right and left mandibular molar segment. Similarly when the females of the two groups were compared, all arch measurement showed no significant difference between group 1 and group 2. Since most of the parameters exhibited no significant difference between group 1 and group 2 for both males and females exclusively, three parameters which showed a significant difference for males alone need not be taken into the consideration.

To conclude, the dental arch dimensions were found to be higher in males when compared to females in both the groups. This showed that a sexual dimorphism does exist in both the groups. Some of the parameters showed a statistical significance which was consistent with other studies. There was no significant difference when males and females of the two groups were compared separately. This study provides an insight into the state of dental arch dimensions in the primary dentition of Chennai and Hyderabad children. Further longitudinal studies with a greater sample size are necessary to follow the dental arch dimensions from the primary to the mixed dentition period.

 
   References Top

1.Burdi AR and Moyers RE: Development of the dentition and occlusion, In Moyers RE(Editor), Handbook of Orhodontics, (4th ed), Year Book Medical Publishers, Chicago, 1988.  Back to cited text no. 1    
2.Bishara SE, Khadivi P, Jackobson JR: Changes in tooth size arch length relationships from the deciduous to the permanent dentition: A longitudinal study, Am J Orthod Denofac Orthop 108:607-613,1995.  Back to cited text no. 2    
3.Alhaija ESJA and Qudeimat MA: Occlusion and tooth/arch dimensions in the primary dentition of preschool Jordanian children, Int J Paediatr Dent 13: 230-239,2003.  Back to cited text no. 3    
4.Sanin C, Savara BS, Clarkson QC and Thomas DR: Prediction of occlusion by measurements of the deciduous dentition, Am J Orthod 57: 561-572,1970.  Back to cited text no. 4    
5.Cohen JT: Growth and development of the dental arches in children, J Am Dent Assoc 27: 1250-1260, 1940.  Back to cited text no. 5    
6.Meredith HV and Hopp WM: A longitudinal study of dental arch width at the deciduous second molars on children 4-8 years of age, J Dent Res 35: 879-889, 1956.  Back to cited text no. 6    
7.Bishara SE Jackobson JR, Treder J, Nowak A: Arch width changes from 6 weeks to 45 years of age, Am J Orthod Dentofac Orthop 111: 401-409,1997.  Back to cited text no. 7    
8.Knott VB: Longitudinal study of dental arch width at four stages of dentition, Angle Orthod 42: 387-395, 1972.  Back to cited text no. 8    
9.Sillman JH: Dimensional changes of the dental arches- longitud ina l study from birh to 25 years, Am J Orthod 50:824-842,1964.  Back to cited text no. 9    
10.Moyers RE, Van der Linden PGM, Riolo ML, McNamara JA: Standards of human occlusal development, Monograph 5, Craniofacial Growth Series, Ann Arbor Center for Human Growth and Development, University of Michigan, 1976.  Back to cited text no. 10    
11.Moorrees CFA, Gron AM, Lebert LM, Yen PK, Frolich FJ: Growth studies of the dentition- a review, Am J Orthod 55:600-616,1969.  Back to cited text no. 11    

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Correspondence Address:
M S Muthu
Department of Pedodontics and Preventive Dentistry, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai
India
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DOI: 10.4103/0970-9290.29866

PMID: 17217215

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    Figures

[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4]

    Tables

[Table - 1], [Table - 2]

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