Magister Scientiae Dentium - MSc(Dent) / BACKGROUND: Plaster models form an integral part of the traditional orthodontic records. They are necessary for diagnosis and treatment planning, case presentations as well as for the evaluation of treatment progress. The accuracy of the measurements taken for space assessment is crucial prior to treatment planning. The introduction of digital models overcomes some problems experienced with plaster models. Digital models have shown to be an acceptable alternative for plaster models. AIM: The aim of the study was to determine the accuracy of traditional measurement techniques when compared to the CAD/ CAM measurements in the assessment of tooth widths and arch perimeter from plaster models. METHOD: The mesio-distal tooth widths and arch perimeter of thirty archived plaster models were measured using a digital caliper to the nearest 0.01 mm and divider to the nearest 0.1 mm. Corresponding digital models were produced by scanning them with a CAD/CAM (InEos X5) and space analysis completed by measurements using InEos Blue software. Measurements were repeated after 1 week from the initial measurement. The methods were compared using descriptive analysis (mean difference and standard deviation). RESULTS: The operator reliability was high for digital models as well as the plaster models when the measurement tool was the digital caliper (analyzed using the Pearson correlation coefficient in the paired t-test). The mean values of tooth widths measurements of CAD/CAM, digital caliper and divider were 6.82 (±0.04), 6.94 (± 0.04) and 7.11 (± 0.04). There was a significant difference between the measurements made by the CAD/CAM and the divider. Additionally significant differences between the measurements by digital caliper and divider measurements (p < 0.05) were observed. No significant difference was found when comparing CAD/CAM to digital caliper. Positive correlation was displayed between CAD/CAM, digital caliper and the divider, but the measurements completed with the digital caliper had the highest correlation with the CAD/CAM. The difference was not significant between the aforementioned measurement tools (p > 0.05). Arch perimeter measurements showed no statistical significant difference between CAD/CAM, digital caliper and divider (p < 0.05). CONCLUSION: Archived plaster models stored as records can be converted to digital models as it will have the same accuracy of measurements. The value of doing a space analysis with the CAD/CAM system can be performed with similar reliability on the digital models as a caliper on plaster models.

This thesis compared tooth widths, arch widths, and arch lengths; their differences between males and females, and changes from early mixed dentitions to adult dentitions. Comparing subjects who were known to have Angle Class I normal occlusion in their permanent dentitions to subjects who were known to be Class I or Class II crowded malocclusions in their permanent dentitions. These comparisons can only be achieved utilizing data from a longitudinal study, such as the Iowa Growth Study. Dental casts in the early mixed dentition (average age of 8.85 years) and in the adult dentition (average age 15.45 years) taken from subjects who did not receive orthodontic treatment during or in the dates prior to data collection were measured for this study. The casts utilized were from the Iowa Growth Study; all of the subjects were of European descent. The longitudinal sample of casts in the Iowa Growth study were made from white dental stone poured into alginate impressions from 1946 until 1960. The objectives of this study were to compare individual tooth widths, mean sum tooth widths, arch widths, arch length segments, and arch perimeters of Class I Normal (CIN) and Class I and II crowded dentitions (CD) in the early mixed (MD) and permanent (PD) dentitions to explore new methods of predicting crowding. The goal was to evaluate the significance of differences between MD and PD for tooth widths, arch lengths, and arch widths in both arches of CIN and CD subjects to determine values that may be useful for MD space analysis. Thirty males and thirty females from the Iowa Growth Study with CIN and CD occlusions were selected from the longitudinal study. Casts of MD and PD subjects were double measured with digital calipers by both the primary and secondary investigators. The average of each investigator's two measurements were used to determine measurement error. All other statistical analysis was based on the mean measurements taken by CPW. Descriptive statistics were computed. The normal non-crowded and crowded samples were compared with two-sample t-test, and changes from MD to PD with paired-sample t-test. Examiner measurement errors were tested with intra-class correlation coefficients. When the mean sums of MD and PD tooth widths were compared, using data from all 60 subjects, the CD group had a significantly greater mean sum of tooth widths than the CIN group. In both genders, crowded dentitions had significantly greater mean sum of tooth widths than CIN's for both the maxilla and mandible in MD and PD. When the mean sums of the arch lengths [Perimeters] were compared using data from all 60 subjects, the arch perimeters of the CD and CIN samples did not differ. It was concluded that total arch lengths Perimeters] were not significant indicators for crowding. Gender comparisons: Within the CIN group, males had numerically larger tooth width sums and arch length sums than females. The sum of maxillary and mandibular tooth widths for CIN's and CD (both males and females) mandibular tooth widths for CIN's and CD (both males and females pooled together and sexes separately. In the MD stage the mean sum of maxillary and mandibular arch lengths in the MD were significantly greater than those in the PD, because arch perimeters decrease during the transition from mixed to permanent dentitions. In summary, the results of this research thesis study showed that the sum of tooth widths in both arches had a significant association with dental crowding. In contrast, the sum of arch lengths [perimeter in both arches] did not differ between the normal and crowded samples. Additional analysis of the measurements taken in this thesis research project, the individual arch length segments, especially the canine and posterior arch length segments in the right and left sides of the lower arch in the mixed dentition casts, and their relation to the sum of the widths of the lower permanent canines and premolars in the normal and crowded malocclusions may give us important information about the development of crowded malocclusions.