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Sans Malaysana 41(2)(2012): 271275

Comparson of Tooth Sze Dscrepancy of Three Man Ethncs

n Malaysa wth Boltons Rato

(Perbandngan Dskrepans Saz Gg d antara Tga Etnk Majortd Malaysa dengan Nsbah Bolton)

AiDA NUR ASHiKiN ABD. RAHMAN & SiTi ADiBAH OTHMAN

ABSTRACT

The objective of this study was to investigate the applicability of Boltons ratios in orthodontic population of Malaysian

main ethnics; Malay, Chinese and Indians. Ninety convenient samples consisting of 30 pre-orthodontic study casts from

each ethnic that ts the inclusion criteria were selected. The greatest mesiodistal widths of each tooth from six to six

for overall ratio and three to three for anterior ratio were measured using a digital callipers linked to Hamilton Arch

Tooth System software to the nearest 0.01mm. Means of the ratios were calculated using Bolton analysis. One sample

t-test statistic analysis was carried out to compare the means with Bolton values of anterior ratio and overall ratio andone-wayANOVA was used to analyze comparison between ethnic groups of the anterior ratio and the overall ratio with

the level of statistical signicance set at p < 0.05. However, there were no signicant differences when comparing Bolton

values with Chinese and Indian anterior and overall ratios. The Bolton standards could be applied to Malaysian Chinese,

Indians and Malays female. Subsequently, a specic standard should be used for the Malays orthodontic population.

Keywords: Boltons ratio; Malaysian ethnics; tooth size discrepancy

ABSTRAK

Tujuan kajian ini adalah untuk mengkaji pelaksanaan nisbah Bolton dalam populasi ortodontik etnik utama Malaysia

iaitu; Melayu, Cina dan India. Sembilan puluh sampel selesa terdiri daripada 30 tuangan kajian pra-ortodontik daripada

setiap etnik yang sesuai dengan kriteria inklusi telah dipilih. Kelebaran mesiodistal terbesar dari setiap gigi dari gigi

enam ke enam untuk nisbah keseluruhan dan tiga ke tiga untuk nisbah anterior diukur dengan menggunakan kaliperdigital yang di sambung dengan perisian Hamilton Arch Tooth System ke 0.01 mm yang terdekat. Min nisbah dikira

menggunakan analisis Bolton. Satu sampel ujian-t analisis statistik dilakukan untuk membandingkan min dengan nilai

Bolton nisbah anterior dan nisbah secara keseluruhan dan one-wayANOVA digunakan untuk membandingkan antara

kumpulan etnik nisbah anterior dan nisbah secara keseluruhan dengan tahap tekal statistik ditetapkan pada p


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et al. 2000).Second, the populaton and gender composton

of Boltons sample wee not specied, which implies

potental selecton bas (Smth et al. 2000).

Most studes ndcated that normal measurements for

one group should not be consdered normal for other race

and ethnc groups. Dfferent racal group must be treated

accordng to ther own characterstcs. Bolton data has not

meet the same TSD ratos mean for some of other populatons

wth marked statstcal dfferences found n studes carred

out by othe authos in the Peuvian population (Benab et

al. 2004), Turksh populaton (Uysal & Sar 2005), Spansh

populaton (Paredes et al. 2006) and Polsh populaton

(Wedrychowska-Szulc et al. 2010).As for Asan populaton,

n agreement wth results of prevous studes on several other

populatons, Boltons anteror rato was not applcable to the

Southern Chnese (Ta et al. 2000) and Japanese populaton

(Endo et al. 2007) and suestive of specic standad tooth

sze ratos for the populatons.

To date, this is the st study on TSD among Malaysanmajorty ethncs. However there are smlar studes done

only on Malay populaton (Abdullah 2007) and on dental

students in the Univesity of Malaya (Othman et al. 2008).

The purpose of ths study was to assess the applcablty of

Boltons atios by accomplishin the followin; to calculate

and compae the anteio and oveall atios amon the 3

majoity ethnic oups in Malaysia; Malay, Chinese and

Indian. Futhe compaison will be made between the mean

of anteror and overall ratos of each ethnc and the general

Malaysan data wth Boltons orgnal study.

MATERiALS AND METHODS

A total of 90 samples consistin of 30 (15 males and 15

females) orthodontc study casts from each ethnc group

that fit the citeia shown in Fiue 1 wee selected.

The pretreatment study casts were taken from patents

undeoin othodontic teatment in Dental Faculty,

Unversty of Malaya. All subjects were between 14 and

24 years of age.

Measurements of the greatest mesodstal wdth of

each tooth were taken wth the dgtal callpers tps held

pependicula to the lon axis of each tooth fom the st

mola to the st mola of each cast. The mesiodistal

wdths from the contact ponts of canne to canne for

anteio atio and st mola to st mola fo oveall

rato were measured on each cast to the nearest 0.01 mm.

The callpers were connected to a computer runnng the

Hamlton Arch Tooth System (HATS) software whch

calculates the Bolton analyss and recommends the tooth

sze correcton.

Five study casts wee andomly selected fo assessment

of reproducblty. The same examner repeated the

measuements two weeks afte the st measuement and

was compaed as descibed by Houston (1983). Coefcients

of eliability wee 0.950 and 0.923 fo oveall and anteio

ratos, respectvely and these results showed that the

measurements could be repeated wth hgh accuracy.

Data dstrbuton was evaluated usng hstogram

to check for normal dstrbuton. Analyss of varance

(ANOVA) was used to compare Bolton data between ethnc

groups. One sample t-testwas used to compare the means

from study samples wth Boltons values. All statstcal

analyses were carred out usng Statstcal Package for

Socal Scences (SPSS) system verson 12.0 wth the levelof statistical sinicant deteminant in this study is p

0.05) (Table 3). Table 4 summaizes that Bolton data is

applicable to Malaysian Chinese and Indian (p > 0.05) but

not fo Malays sample (p < 0.05).

FIgUrE 1. incluson and excluson crtera

incluson crtera Excluson crtera

1. Good qualty pretreatment study models

2. Fully eupted and complete pemanent dentitions

fom st mola to st mola

3. Malay, Chinese, and Indian ethnicity. Ethnicity

determnant was accordng to patents name and

race n the regstraton form

1. Clncally vsble dental cares, proxmal restoratons

(Class ii amalgam or composte), buldups, crowns,

onlays that affect the tooths mesodstal dameter

2. Congental defects or deformed teeth

3. Obvious intepoximal o occlusal wea of teeth

4. Prevous or ongong orthodontc treatment


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DiSCUSSiON

Ethncty has a close assocaton wth genetcs and

heredtary. it s of no doubt that the ethncty wll affect

the TSD greatly between populaton and ethncs (Othman

& Harradne 2006). However, ths s an excepton f the

populaton has ntermarred and not consdered pure

ethnc. Smlar trats may be observed n the two dfferent

populatons that orgnate from the same contnent andon the other hand, the same ethnc from dfferent country

may not have the same ndins ofTSD. in agreement wth

this study in which the esults displayed ethnicity specic

means.

Bolton data has not meet the same TSD ratos

mean from some of other populatons wth marked

statstcal dfference found n studes carred out by a

few authos in the Peuvian population (Benab et al.

2004), Turksh populaton (Uysal & Sar 2005), Spansh

populaton (Paredes et al. 2006) and Polsh populaton

(Wedrychowska-Szulc et al. 2010).Generally these studes

concluded of hgh prevalence rate of ether posteror oranteror TSD of more than two standard devaton above

Boltons mean and a specic standad ae equied fo the

populaton for clncal assessment (Othman & Harradne

2007). Contrary wth the current prelmnary study, there

wee no sinicant diffeences noted if compaed the

general Malaysan data n combnaton wth Bolton means.

This conictin esult miht be due to the small sample

sze used n present prelmnary study.

Paredes et al. (2006) reported that for a study

conducted among Spansh populaton, the anteror and

total wdth ratos are greater than Boltons wth mean of

78.32% 2.45% and 91.97% 1.95%, espectively.Smthet al. (2000), on a study of thee populations; discussed

that diffeent populations studied exhibited sinicantly

dfferent relatonshps between the lower and upper teeth.

Whtes showed the smallest overall rato, followed by

Hspancs and Blacks. He concluded that nterarch tooth

size elationships ae population and ende specic.

Boltons orgnal data do not represent Turksh populaton,

and from a study conducted by Uysal & Sar (2005),

a population specic nomative study was pefomed.

in establshng the normatve data, they concluded that

a discepancy in the oveall atio was found in 18% of

Turksh subjects wth normal occlusons, and anteror ratosoutsde two standard devatons from the Bolton mean n

21.3 pe cent of thei sample simila to the ndin of this

study which shows sinicant diffeences of Bolton atios

of Malays sample. A more recent study ofTSD on Turksh

populaton (Oktay & Ulukaya 2010) also demonstrated that

for both overall and anteror ratos, the means and standard

devatons were larger than n Boltons study. They

concluded that the pobable eason fo the ndins may

be the types of populaton that consttuted the samples.

Fom a study on the white, blacks and Hispanics,

sinicant diffeences wee also found in the oveall,

anteror and posteror nterarch ratos between the threepopulatons (Smth et al. 2000). They found that from the

TABLE 1. ANOVA - Anteror rato n each ethnc group

Ethnc

Group

N Mean

(%)

SD

(%)

F-statistic

(df)

P

value

Malay 30 78.93 2.67

Chnese 30 76.55 2.68 5.57(2) 0.005*

indan 30 77.77 2.89

*Statistical sinicant at the level of sinicance 0.05

TABLE 2. ANOVA - Overall rato n each ethnc group

Ethnc

Group

N Mean

(%)

SD

(%)

F-statistic

(df)

P

value

Malay 30 92.51 2.21

Chnese 30 90.93 1.87 4.40(2) 0.015*

indan 30 91.37 2.26


TABLE 3. One sample t-test. Compaison of bolton study and

the present study: mean values

Varable Malaysan

Mean

Bolton

Mean

P

Value

N 90 55

Anteror Rato 77.7 (2.89) 77.2 (1.65) 0.07

Overall rato 91.6 (2.20) 91.3 (1.91) 0.19

TABLE 4. One sample T-Test to compare boltons value to each ethnc

Anteror Rato Overall rato

Ethnc Malay Chnese indan Malay Chnese indan

Mean 78.93 76.55 77.77 92.51 90.93 91.37

SD (2.68) (2.68) (2.89) (2.13) (1.87) (2.26)

Bolton Mean (SD) 77.20 (1.65) 91.30 (1.91)

P Value 0.001* 0.200 0.290 0.290 0.850



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study on 180 peothodontic casts, the Bolton atio ae only

applcable to ther whte females sample and concluded

the ratos should not be ndscrmnately appled to whte

males, blacks or Hspancs. it s because the relatonshps

between the szes of the mandbular and maxllary teeth

are dependent on populaton, gender and arch segment

lengths. The larger the maxllary arch segment length,

the greater the dscrepancy between Boltons ratos and

the actual atios. These ndins is in aeement with the

cuent ndins of Malaysian majoity ethnics in which

the Bolton anteror rato cannot be appled to Malays

sample.

As for Asan populaton, n agreement wth results

of prevous studes on several other populatons, Boltons

anteror rato was not applcable to the Southern Chnese

(Ta et al. 2000) and Japanese (Endo et al. 2007) populaton,

and suestive of specic standad tooth size atios fo the

populatons. The study on the Southern Chnese chldren

(Ta et al. 2000) comprses of 1247 samples of early

permanent dentton, the Bolton standards s applcable

only to those wth Class i chldren, but not to those wth

Class ii or Class iii occlusons. They also found that tooth

sze dscrepancy to be more frequent n the anteror regon

especally n the Class iii occluson group. A study on

Sinapoean Chinese by Lew and Ken (1991) reported

that the anteror rato was comparable wth the Bolton

standard n excellent Class i occluson, even though

Sngaporean Chnese had smaller maxllary central ncsors

and larger maxllary lateral ncsors.

Thee wee no statistically sinicant diffeences

found n the Bolton ratos for the sx anteror teeth and the12 teeth wthn the dfferent malocclusons n the Jordanan

sample accordng to Al-Khateeb and Abu Alhaja (2006).

in ther dscusson, t was mentoned that the dfference n

the results between ths study and the other nvestgatons

mght be attrbuted to the sample sze, method of analyss

and large standard devaton found n ths study. Although

tooth size is stonly inuenced by enetic and heeditay,

but ndvdual varatons due to envronment and det may

also play an mportant role n the populaton varablty.

Consderaton has to be taken as each ndvdual from

dfferent populaton may practce a dfferent lfestyle.

The lmtaton of the current study s the sample szedoes not represents the populaton ratos and further

recommendaton s to carry out study on bgger samples

and varous centres n order for the data to be vald and to

be accepted as a norm for each ethnc.

CONCLUSiON

Thee wee no sinicant diffeence displayed between

Bolton value and Malaysan value n combnaton. The

Bolton standards can be appled to Malaysan Chnese

and indans but not to Malays orthodontc populaton.

Subsequently, a specic standad should be used fo theMalays othodontic population. Sinicant diffeences

n the rato between Malays and Chnese suggest that

population specic standads ae necessay fo clinical

assessments.

ACKNOWLEDGEMENT

We would lke to express our grattude to Dr Marhazlnda

Jamaludn for her statstcal help. Ths study was supportedby grants from the insttute of Postgraduate Studes,

Unversty Malaya, grant number (PPP)/P0076/2008C and

(PPP)/P0094/2009C.

rEFErENCES

Abdullah, Y. 2007. A study of the occlusal trats of adult Malay

populaton. Master of Orthodontcs, Thess, Unversty of

Malaya (unpublshed).

Al-Khateeb, S.N. & Abu Alhaja, E.S.J. 2006. Tooth Sze

Dsrepances and Arch Parameters among Dfferent

Malooclusons n a Jordanan Sample. Angle Orthodontists

76: 459-465.Benab, E., Majo, P.W. & Floes-Mi, C. 2004. Tooth-width atio

dscrepances n a sample of Peruvan adolescents.American

Journal of Orthodontics and DentofacialOrthopaedics 125:

361-365.

Bolton, W.A. 1958. Dishamony in tooth size and its elation to the

analyss and treatment of maloccluson.Angle Orthodontist

28: 113-130.

Bolton, W.A. 1962. The clinical application of a tooth size

analyss.American Journal ofOrthodontics 48: 504-529.

Cosby, D.r. & Alexande, C.g. 1989. The occuence of

tooth sze dscrepances among dfferent maloccluson

groups.American Journal of Orthodontics and Dentofacial

Orthopaedics 95: 457-461.

Endo, T., Shundo, i., Abe, R., ishda, K., Yoshno, S. & Shmooka,S. 2007. Applcablty of Boltons tooth sze ratos to a

Japanese orthodontc populaton. Odontology 95: 57-60.

Feeman, J.E., Maskeoni, A.J. & Loton, L.1996. Fequency

of Bolton tooth sze dscrepances among orthodontc

patents.American Journal of Orthodontics and Dentofacial


Houstan, W.J.B. 1983. The analysis of eos in Othodontic

measurements. American Journal of Orthodontics and

DentofacialOrthopaedics 83: 382-390.

Lew, K.K. & Ken, S.B. 1991. Anteio cown dimensions and

relatonshp n an ethnc Chnese populaton wth normal

occlusons.Australian Orthodontic Journal 12: 105-109.

Oktay, H. & Ulukaya, E. 2010. intermaxllary tooth szedscrepances among dfferent maloccluson groups.

European Journal of Orthodontics 32: 307-312.

Othman, S.A, Mookn, H., Asbollah, M.A. & Hashm, N.A.

2008.Bolton Tooth-Size Discrepancies Among University Of

Malayas Dental Students.Annals ofDentistry 15: 40-47.Othman, S.A. & Harradne, N.W.T. 2006. Tooth sze dscrepancy

and Boltons ratos: a lterature revew.Journal of Orthodontic

33: 45-51.

Othman, S.A. & Harradne, N.W.T. 2007. Tooth sze dscrepances

n an Orthodontc Populaton.Angle Orthodontists 77: 668-

674.

Paredes, V., Ganda, J.L. & Cbran, R. 2006. Do Boltons

ratos apply to a Spansh populaton?American Journal of

Orthodontics and DentofacialOrthopaedics 129: 428-430.Poft, W.r. & Fields, H.W. 2000. Contemporary Orthodontics.

3rd edton. St Lous: Mosby. Elsever Publcaton.


5/5

275

Poft, W.r., Fields, H.W. & Save, D.M. 2007. Contemporary

Orthodontics . 4th edton. St Lous, Mosby: Elsever

Publcaton.

Smth, S.S., Buschang, P.H. & Watanabe, E. 2000. interarch tooth

size elationships of 3 populations: Does Boltons analysis

apply?.American Journal of Orthodontics and Dentofacial

Orthopaedics 117: 169-174.Stifte, J. 1958. A Study Of Ponts, Howes, rees, Neffs

And Bolton analyses on Class i adult denttons. Angle

Orthodontist28: 215-225.

Ta, T.A., Lng, J.Y.K. & Hgg, U. 2000. Tooth-sze dscrepances

among dfferent occluson groups of southern Chnese

chldren.American Journal of Orthodontics and Dentofacial


Uysal, T. & Sar, Z. 2005. intermaxllary tooth sze dscrepancy

and mesodstal crown dmensons for a Turksh populaton.

Amer ican Journa l of Or thodon ti cs and Dentofac ia l


Wdychowska-Szulc, B., Janiszewska-Olszowska, J. & Stpien,

P. 2010. Overall and anteror Bolton rato n Class i, ii and

iii orthodontc patents.European Journal of Orthodontics

32: 313-318.

Ada Nur Ashkn Abd. Rahman

Faculty of Dentisty

Unverst Teknolog MARA

40450 Shah Alam

Malaysa

St Adbah Othman*Department of Chldrens Dentstry and Orthodontcs

Faculty of Dentisty

Unversty of Malaya

50603 Kuala Lumpu

Malaysa

*Coespondin autho; email: [email protected]

received: 30 Septembe 2010

Accepted: 21 July 2011

perbandingan diskrepansi saiz gigi di antara tiga etnik majoriti

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