Bolton tooth size analysis in a sample of Sudanese adults


  • Raja AbdAlgadir Mustafa Head of department of Orthodontics ,AL NEELAIN UNIVERSITY
  • Amal Hussein Abuaffan Department of orthodontics, Pedodontics and preventive dentistry, University of Khartoum, Khartoum, Sudan.



Introduction: A correct proportion between the upper and lower teeth is critical to achieving proper occlusal interdigitation, ideal overjet, and good molar intercuspation at the end of orthodontic treatment. Objectives: To determine the anterior and overall Bolton’s ratio in the Sudanese population, investigate gender differences in tooth size ratios, and to compare these results with Bolton’s original ratio norm. Material and Methods: The sample consisted of dental casts of 104 Sudanese University students with normal occlusion (52 females, 52 males), aged between 16-26 years randomly selected from AL- Neelain University. An electronic digital caliper was used to measure the mesiodistal tooth size of the maxillary and mandibular teeth anterior to the second molars. These measurements were then used to obtain Bolton’s ratio. Mean, range, and standard deviation of the anterior and overall ratios were computed for each subject. T-Tests were used to compare gender differences and to investigate differences between the results of this study and Bolton’s original ratio. Results: Anterior and overall Bolton ratios for males were 78.43±2.44 and 93.901±9.8 and for females were 78.29±2.6 and 91.67±3.3 percent, respectively. There were no statistically significant differences between males and females for the anterior and overall ratios P>0.05. The anterior and overall Bolton’s ratios among Sudanese University students were 78.37 ± 2.54, and 92.79± 7.43 percent, respectively. statistically significant difference between this study and Bolton’s study were found in both anterior and overall ratio P<0.05. Conclusion: Bolton’s mean ratios may not be applicable to Sudanese.


Bolton’s ratio; Sudanese population; tooth-size.

Author Biography

Raja AbdAlgadir Mustafa, Head of department of Orthodontics ,AL NEELAIN UNIVERSITY

Department of Orthodontics 

Head of the department


Golwalkar SA, Msitry KA. An evaluation of dental crowding in relation to the mesiodistal crown widths and arch dimensions. Journal of Indian Orthodontic Society. 2009;43(2):22.

Faruqui S, Fida M, Shaikh A. Comparison of tooth and arch dimensions in dental crowding and spacing. Pakistan Orthodontic Journal. 2012;4(2):48-55.

Ballard ML. Asymmetry in tooth size: a factor in the etiology, diagnosis and treatment of malocclusion. The Angle orthodontist. 1944;14(3):67-70.

Doris JM, Bernard BW, Kuftinec MM. A biometric study of tooth size and dental crowding. American journal of orthodontics. 1981;79(3):326-36.

Bansal V, Bansal PV, Aggarwal S, Batra M, Gupta M. Tooth size in crowded and spaced dentition among western Uttar Pradesh population: a biometric study. International Journal of Scientific Study. 2013;1(03):81-8.

Brook A, Pitts N, Renson C. Determination of tooth dimensions from study casts using an image analysis system. Journal of the International Association of Dentistry for Children. 1983;14(2):55.

Keating P, Parker R, Keane D, Wright L. The holographic storage of study models. British journal of orthodontics. 1984;11(3):119-25.

Mrtensson B, Rydén H. The holodent system, a new technique for measurement and storage of dental casts. American Journal of Orthodontics and Dentofacial Orthopedics. 1992;102(2):113-9.

Burke P, Beard L. Stereophotogrammetry of the face: A preliminary investigation into the accuracy of a simplified system evolved for contour mapping by photography. American journal of orthodontics. 1967;53(10):769-82.

Van der Linden F, Boersma H, Zelders T, Peters K, Raaben J. Three-dimensional analysis of dental casts by means of the Optocom. Journal of Dental research. 1972;51(4):1100-.

Saatçi P, Yukay F. The effect of premolar extractions on tooth-size discrepancy. American Journal of Orthodontics and Dentofacial Orthopedics. 1997;111(4):428-34.

Moyers RE. Handbook of orthodontics, ed. 2, Chicago, 1963. Year Book Medical Publishers, Inc.542.

Al-Omari IK, Al-Bitar ZB, Hamdan AM. Tooth size discrepancies among Jordanian schoolchildren. The European Journal of Orthodontics. 2008;30(5):527-31.

Hashim AaHA, Eldin A-HM, Hashim HA. Bolton tooth size ratio among Sudanese Population sample: A preliminary study. Journal of orthodontic science. 2015;4(3):77.

Bennett JC, McLaughlin RP. Orthodontic management of the dentition with the preadjusted appliance. 1997.

Crosby DR, Alexander CG. The occurrence of tooth size discrepancies among different malocclusion groups. American Journal of Orthodontics and Dentofacial Orthopedics. 1989;95(6):457-61.

Freeman JE, Maskeroni A, Lorton L. Frequency of Bolton tooth-size discrepancies among orthodontic patients. American Journal of Orthodontics and Dentofacial Orthopedics. 1996;110(1):24-7.

Mishra RK, Kafle D, Gupta R. Analysis of Interarch Tooth Size Relationship in Nepalese Subjects with Normal Occlusion and Malocclusions. International Journal of Dentistry. 2019;2019.

Gilpatric WH. Arch predetermination—Is it practical? Journal of the American Dental Association. 1923;10(7):553-72.

Lundström A. Intermaxillary tooth width ratio and tooth alignment and occlusion. Acta Odontologica Scandinavica. 1955;12(3-4):265-92.

Bolton WA. Disharmony in tooth size and its relation to the analysis and treatment of malocclusion. The Angle orthodontist. 1958;28(3):113-30.

Akyalçın S, Doğan S, Dinçer B, Erdinc AME, Öncağ G. Bolton tooth size discrepancies in skeletal Class I individuals presenting with different dental angle classifications. The Angle orthodontist. 2006;76(4):637-43.

Bolton WA. The clinical application of a tooth-size analysis. American journal of orthodontics. 1962;48(7):504-29.

Endo T, Abe R, Kuroki H, Oka K, Shimooka S. Tooth size discrepancies among different malocclusions in a Japanese orthodontic population. The Angle orthodontist. 2008;78(6):994-9.

Othman S, Harradine N. Tooth-size discrepancy and Bolton’s ratios: a literature review. Journal of orthodontics. 2006;33(1):45-51.

Araujo E, Souki M. Bolton anterior tooth size discrepancies among different malocclusion groups. The Angle orthodontist. 2003;73(3):307-13.

Wędrychowska-Szulc B, Janiszewska-Olszowska J, Stepień P. Overall and anterior Bolton ratio in Class I, II, and III orthodontic patients. The European Journal of Orthodontics. 2010;32(3):313-8.

Rudolph D, Dominguez P, Ahn K, Thinh T. The use of tooth thickness in predicting intermaxillary tooth-size discrepancies. The Angle orthodontist. 1998;68(2):133-40.

Smith SS, Buschang PH, Watanabe E. Interarch tooth size relationships of 3 populations:“Does Bolton’s analysis apply?”. American Journal of Orthodontics and Dentofacial Orthopedics. 2000;117(2):169-74.

Lavelle C. Maxillary and mandibular tooth size in different racial groups and in different occlusal categories. American journal of orthodontics. 1972;61(1):29-37.

Freire SM, Nishio C, Mendes AdM, Quintão CCA, Almeida MA. Relationship between dental size and normal occlusion in Brazilian patients. Brazilian dental journal. 2007;18(3):253-7.

Paredes V, Gandia JL, Cibrian R. Do Bolton’s ratios apply to a Spanish population? American Journal of Orthodontics and Dentofacial Orthopedics. 2006;129(3):428-30.

Nie Q, Lin J. Comparison of intermaxillary tooth size discrepancies among different malocclusion groups. American Journal of Orthodontics and Dentofacial Orthopedics. 1999;116(5):539-44.

Uysal T, Memili B, Usumez S, Sari Z. Dental and alveolar arch widths in normal occlusion, class II division 1 and class II division 2. The Angle orthodontist. 2005;75(6):941-7.

Alkofide E, Hashim H. Intermaxillary tooth size discrepancies among different malocclusion classes: a comparative study. Journal of Clinical Pediatric Dentistry. 2002;26(4):383-7.

Al-Tamimi T, Hashim HA. Bolton tooth-size ratio revisited. World journal of orthodontics. 2005;6(3).

Zuhair Murshid B, Hashim HA. Mesiodistal tooth width in a Saudi population: A preliminary report. Saudi Dental Journal. 1993;5(2).

Basaran G, Selek M, Hamamcı O, Akkuş Z. Intermaxillary Bolton tooth size discrepancies among different malocclusion groups. The Angle orthodontist. 2006;76(1):26-30.

Uysal T, Sari Z, Basciftci FA, Memili B. Intermaxillary tooth size discrepancy and malocclusion: is there a relation? The Angle orthodontist. 2005;75(2):208-13.

Ismail MA, Abuaffan AH. Tooth size discrepancy among different malocclusion groups in Sudanese sample. Orthodontic Waves. 2015;74(2):37-41.

Poosti M, Jalali Ta. Tooth size and arch dimension in uncrowded versus crowded Class I malocclusions. J Contemp Dent Pract. 2007;8(3):45-52.

Moorrees CF, Reed RB. Correlations among crown diameters of human teeth. Archives of Oral Biology. 1964;9(6):685-97.

Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. Journal of chiropractic medicine. 2016;15(2):155-63.

Dahlberg G. Statistical methods for medical and biological students. Statistical methods for medical and biological students. 1940.

Othman S, Harradine N. Tooth size discrepancies in an orthodontic population. The Angle orthodontist. 2007;77(4):668-74.

Endo T, Shundo I, Abe R, Ishida K, Yoshino S, Shimooka S. Applicability of Bolton's tooth size ratios to a Japanese orthodontic population. Odontology. 2007;95(1):57-60.

Kachoei M, Ahangar-Atashi M-H, Pourkhamneh S. Bolton’s intermaxillary tooth size ratios among Iranian schoolchildren. Med Oral Patol Oral Cir Bucal. 2011;16(4):e568-72.

Puri N, Pradhan KL, Chandna A, Sehgal V, Gupta R. Biometric study of tooth size in normal, crowded, and spaced permanent dentitions. American Journal of Orthodontics and Dentofacial Orthopedics. 2007;132(3):279. e7-. e14.

Al-Gunaid T, Yamaki M, Saito I. Mesiodistal tooth width and tooth size discrepancies of Yemeni Arabians: A pilot study. Journal of orthodontic science. 2012;1(2):40.

Singh S, Goyal A. Mesiodistal crown dimensions of the permanent dentition in North Indian children. Journal of Indian Society of Pedodontics and Preventive Dentistry. 2006;24(4):192.

Merz ML, Isaacson RJ, Germane N, Rubenstein LK. Tooth diameters and arch perimeters in a black and a white population. American Journal of Orthodontics and Dentofacial Orthopedics. 1991;100(1):53-8.

Dempsey Pa, Townsend G. Genetic and environmental contributions to variation in human tooth size. Heredity. 2001;86(6):685-93.

Proffit WR, Fields HW, Sarver DM. Contemporary orthodontics: Elsevier Health Sciences; 2014.

Mirzakouchaki B, Shahrbaf S, Talebiyan R. Determining tooth size ratio in an Iranian-Azari population. J Contemp Dent Pract. 2007;8(7):86-93.

Stuart Hunter W, Priest WR. Errors and discrepancies in measurement of tooth size. Journal of Dental research. 1960;39(2):405-14.

Bernabe E, Major PW, Flores-Mir C. Tooth-width ratio discrepancies in a sample of Peruvian adolescents. American Journal of Orthodontics and Dentofacial Orthopedics. 2004;125(3):361-5.

Al-Duliamy MJ, Othman SS, Hussien FA. Comparison of Bolton’s Ratios in a Sample of Iraqi and Egyptian Populations. Journal of baghdad college of dentistry. 2016;28(4):172-5.

Nourallah AW, Splieth CH, Schwahn C, Khurdaji M. Standardizing interarch tooth-size harmony in a Syrian population. The Angle orthodontist. 2005;75(6):996-9.

Mohammad MG, Din SN-u, Khamis AH, Athanasiou AE. Overall and Anterior Tooth Size Ratios in a Group of Emiratis. The open dentistry journal. 2018;12:655.

Santoro M, Ayoub ME, Arthur Pardi V, Cangialosi TJ. Mesiodistal crown dimensions and tooth size discrepancy of the permanent dentition of Dominican Americans. The Angle orthodontist. 2000;70(4):303-7.

Ta TA, Ling JY, Hägg U. Tooth-size discrepancies among different occlusion groups of southern Chinese children. American Journal of Orthodontics and Dentofacial Orthopedics. 2001;120(5):556-8.






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