Space analysis
Dr. Bassam Ali Al-Turaihi
BDS MSc(Ortho.) MFDS RCSEdin MFD RCSI
Definition :
procedure of quantifying the space required in each arch, which aids in diagnosis,
assessment of need for extraction, treatment planning and anchorage planning.
Space Analysis requires a comparison between the amount of space available
for the alignment of the teeth and the amount of space required to align
them properly.
Space Analysis can be done either directly on the dental casts or by a
computer method after appropriate digitization of the arch and tooth
dimensions.
Crowding in the arch is denoted as a negative number (-) while excess
spacing in the arch is denoted as a positive number (+).
Benefits of Comprehensive Space Planning
A disciplined approach to treatment planning.
Defining whether the objectives are attainable.
Anticipating shortage of anchorage or excess of space.
Identifying whether extractions are necessary.
Planning the mechanics of anchorage.
Planning the mechanics of arch relationship correction.
Improving pretreatment patient information.
Obtaining valid informed consent.
Space is required to correct the following:
• Crowding and spacing .
• Incisor anteroposterior change (usually aiming to achieve a normal
overjet of 2 mm).
• Levelling of occlusal curves (flattening the curve of Spee).
• Arch contraction (expansion will create space).
• Correction of upper incisor angulation (mesiodistal tip).
• Correction of upper incisor inclination (torque)
Mesiodistal tip Flattening the curve of Spee
Space Analysis of Permanent Dentition
The first step is calculation of space available. This is accomplished by measuring arch
perimeter from the mesial of one first molar to the other, over the contact points of posterior
teeth and incisal edge of anteriors. There are two basic ways to accomplish this manually:
By dividing the dental arch into segments that can be measured as straight line
approximations of the arch.
By contouring a piece of wire (or a curved line on the computer screen) to the line of
occlusion and then straightening it out for measurement.
The first method is preferred for manual calculation because of its greater reliability. Either
method can be used with an appropriate computer program.
The second step is to calculate the a mount of space required for
alignment of the teeth. This is done by measuring the mesiodistal width of
each erupted tooth from contact point to contact point (from its highest
contour) and then summing the widths of the individual teeth.
The subtraction of the space required from space available will give *space analysis*
Space Analysis of Mixed Dentition
The purpose of mixed dentition analysis is to
evaluate the mount of space available in the arch
for erupting permanent canines and premolars. A
meaningful mixed dentition analysis depends on
an accurate prediction of the mesiodistal widths
of the unerupted permanent canines and
premolars which is essential part of this analysis.
The approach in measuring arch length in the mixed dentition is essentially the same as that described for the
permanent dentition. The only difference is the need to predict the mesiodistal widths of the unerupted
permanent canines and premolars in mixed dentition.
There are three different approaches to estimate the size of
unerupted permanent teeth:
1. Measurement of the teeth on radiographs : this requires an undistorted radiographic
image, which is more easily achieved with individual periapical radiographs than with
panoramic radiographs. With any type of radiograph, it is necessary to compensate for
enlargement of the radiographic image by measuring an object that can be seen both in the
radiograph and on the cast, usually a primary molar tooth. A simple proportional
relationship can then be set up:
2. Estimation from proportionality tables: there is good correlation between the size of the
erupted permanent incisors and the unerupted canines and premolars. These data have been
tabulated by Moyers for white American children. The mesiodistal width of lower incisors is
measured and this number is used to predict the size of both the lower and upper unerupted
canine and premolars. The size of the lower incisors correlates better with the size of the
upper canines and premolars than does the size of the upper incisors, because upper lateral
incisors are extremely variable teeth.
Tanaka and Johnston developed another way to use the width of the lower incisors to
predict the size of unerupted canine and premolars. For children from a European population
group, it not requires radiographs or reference tables (once the simple equation is
memorized), which makes it very convenient. The method, however, is less accurate for
other population groups.
TANAKA AND JOHNSTON PREDICTION VALUES
One half of the +10.5 m estimated width of mandibular canine
mesiodistal = and premolars in one quadrant
width of the four
lower incisors +11.0mm estimated width of maxillary canine
= and premolars in one quadrant
3. Combination of radiographic and prediction table methods: since the
major problem with using radiographic images comes in evaluating the canine
teeth, it would seem reasonable to use the size of permanent incisors measured
from the dental casts and the size of unerupted premolars measured from the
radiographs to predict the size of unerupted canine. graph developed by Staley
and Kerber from Iowa growth data allows canine width to be read directly
from the sum of incisor and premolar widths. This method can be used only for
the mandibular arch and, of course, requires periapical radiographs. For children
of European ancestry, it is quite accurate.
Graph showing relationship between size of
lower incisors measured from cast plus lower
first and second premolars measured from
radiographs (x-axis) and size of canine plus
premolars (y-axis).
For Asian and African child, direct measurement
from the radiographs is the best since the
Moyers, Tanaka-Johnston, and Staley-Kerber
predictions are all based on data from white
school children of northern European descent.
Leeway Space
The combined mesiodistal widths of deciduous canine, first and second
molars is more than that of the combined mesiodistal widths of permanent
canine first and second premolars. The difference between the two is called
Leeway Space.
Maxilla = 0.9 mm segment 1.8 mm total Mandible 31.7
mm segment 33.4 mm total
If space analysis is done in the mixed dentition, it is necessary to adjust the
space available measurement to reflect the shift in molar position that can be
anticipated
