ORIGINAL ARTICLE J. Med. Sci. (Peshawar, Print) July 2009, Vol. 17, No.

2: 71-77

COMPARISON OF DENT
COMPARISON AL ARCH DIMENSIONS AMONG
DENTAL
VARIOUS MAL OCCL
MALOCCL USION CLAS
OCCLUSION SES
CLASSES
Ghulam Rasool1, Ibadullah Kundi2
Kundi
1
Department of Orthodontics, Khyber College of Dentistry, Peshawar - Pakistan
2
Department of Orthodontics, Sardar Begum Dental College, Peshawar - Pakistan

ABSTRACT
Objective: To compare dental arch length and width among different malocclusion classes.
Material and Methods: This study was conducted during Jan 2007-Dec2008 at orthodontic department of Islamic
International Dental Hospital, Islamabad. The study sample consisted of 200 dental casts (100 male,100 female),
obtained from patients reporting to the department with the age range between 13 to 21 years. The dental arch length
and width were measured with the help of digital vernier caliper from dental casts. Comparison of arch dimensions
was done among different malocclusion classes.
Results: Maxillary and mandibular intermolar and intercanine arch width showed no significant difference among
four malocclusion groups. Class II div 1 showed significantly smaller maxillary arch widths than class I. Class II
malocclusions showed significantly smaller mandibular intermolar widths than class III group. Maxillary and
mandibular arch length showed statistically significant difference among malocclusion groups. Class II div 2 showed
significantly smaller maxillary arch length than other three classes.
Conclusions: Class II division 1 showed the shortest arch width and Class II divison 2 showed the shortest maxillary
arch length. Class III malocclusion showed the largest mandibular arch width and length.
Key words: Dental arch, arch length, arch width, malocclusion.
Abbreviations: ANOVA: Analysis of Variance. Class-I Malocclusion: Normal molar relationship, teeth crowded,
rotated etc. Class-II Malocclusion: Lower molar distal to upper molar relationship of other teeth to line of occlusion
not specified. Class-III Malocclusion: Lower molar musial to upper molar relationship of other teeth to line of
occlusion not specified, div = division, ICW = Intercanine width, IMW = Intermolar width AL = Arch Length,
SD = Standard deviation

INTRODUCTION length have been used to provide estimations of arch

The dimensions of a dental arch which include
arch length and arch widths can have profound
implications in orthodontic diagnosis and treatment
planning, affecting the space available, dental
aesthetics, and stability of the dentition. These
considerations, in association with the anteroposterior
movements of the dentition determine the requirements
for extraction or non extraction treatment.1 The size
and shape of the dental arches could be affected by
many factors such as heredity, growth of the bone,
eruption & inclination of the teeth, racial background
and environmental factors such as muscle forces and
function.2,3,4
Measures and ratios of arch dimensions have
been used to analyse dental arch form. Two easily
obtained linear measurements, arch width and arch
Address for Correspondence:
Dr
Dr.. Ghulam Rasool
Assistant Professor of Orthodontics
Khyber College of Dentistry, Peshawar - Pakistan
Contact No. 0333-9126029
form.5 Arch widths and arch lengths have been used
in the measurement of dental arch area, dental arch
index, and length of arc of dental arcade.6
The growth changes of arch widths in normal
occlusion subjects and a comparison of arch widths
in normal occlusion and different malocclusion
samples have been studied extensively.7-9 Changes in
arch dimensions and their possible correlation with
age, sex, orthodontic treatment and extractions of
permanent teeth have also been investigated.10,11
Investigators have studied an association of crowding
with mesiodistal crown dimensions and dental arch
dimensions.12,13 Crowding is one of the causes of class
I malocclusion. In investigations performed by Howe
et al14 comparisons were made between crowded and
non-crowded groups using study models. They
indicated that arch dimension made a greater
contribution to dental crowding than tooth size. Other
studies showed the same correlation between arch
dimensions and dental crowding.11,12
Information regarding arch dimensions in human
populations is important to clinicians in orthodontics,

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prosthodontics, and oral surgery. It is also of interest
to anthropologists and other students of human oral
biology. 15 Diagnosis of arch length and width
discrepancies are important diagnostic aids, with the
help of which an orthodontist can predict the functional
and aesthetic outcome of a particular case.
Furthermore the results of the current investigation are
of great value to the anthropologist as well as to the
orthodontist in understanding the dimensional arch
criteria. For the orthodontist, this can also assist in
orthodontic arch wire selection. It would also be
helpful to the prosthodontist in the selection of the
correct shape and size of stock impression trays for
fixed and removable prostheses for four groups of
malocclusions. However, there is little information
regarding this issue among the Pakistani population
where there is a relatively large demand for
orthodontic treatment.
The aim of our study was to compare the
mandibular and maxillary arch dimensions in various
malocclusion groups to set a baseline data to
encourage the researchers of this region to carry out
more research on this subject in the Pakistani
population.
MATERIAL AND METHODS
MATERIAL
Pretreatment orthodontic casts of 200 patients
(100 male and 100 female) with the age range of 13 to
21 years were selected from the records of the
Orthodontic Department of Islamic International
Dental Hospital, Islamabad. All patients had all teeth
from first molar to first molar fully erupted to the
occlusal plane and presented with no proximal caries,
morphological anomalies, missing teeth or proximal
abrasion. Impressions were taken in Alginate
impression material (Lygin Chromatic, Dentamerica)
and were poured in orthodontic plaster within half an
hour to avoid any shrinkage of impressions.
Measuring Technique
Technique
The arch dimensions which include inter-canine
widths, inter first molar widths and arch length were
measured as indicated by Hashim and Al Ghamdi16.
The Inter canine width and Inter molar width were
measured with a digital vernier caliper (Fig. 1)
specially designed for dental use (Mitu-toyo; Kawasaki,
Kanakawa, Japan).
Inter Canine width was measured as the
horizontal distance between cusp tips of right and left
canines of maxillary and mandibular arches. Inter
molar width was measured as the horizontal distance
between the central fossae of right and left first
permanent molars (Fig. 2).
Arch length was measured by adapting a length
of brass wire (diameter, 0.25 in) on the maxillary and
mandibular arches.
The maxillary arch length was measured as the
distance from mesial marginal ridge of maxillary first
permanent molar passing through the central fissures
of first and second premolars and the cingulam of the
canine to the midline passing through the cinguliae of
the lateral and central incisors. This was repeated on
the other side. These values were then summed up to
determine the maxillary dental arch length (Fig. 2).
The mandibular arch length was measured as
the distance from mesial marginal ridge of the first
mandibular molar passing through the buccal cusp tips
of the premolars and cusp tip of the canine to the
distal surface of the lateral incisors and from there to
the midline passing through the incisal edges of the
lateral and central incisors. This was repeated on the
other side. These values were then summed up to
determine the mandibular dental arch length.
The data obtained were computerized and
analyzed using SPSS for windows version 10. The
variables of this study were maxillary intercanine and
intermolar arch width and mandibular intercanine and
intermolar arch width, maxillary arch length and
mandibular arch length. One-way analysis of variance
(ANOVA) was used to check the statistical significance
of the variables among Class I, Class II Div 1, Class II
Div 2 and Class III malocclusions. Least significant
difference (LSD) was used when two of the four
malocclusion groups were compared in varying
combinations. The level of significance was set at
P < 0.05 .
RESULTS
RESULTS
The distribution of subjects according to gender
and malocclusion is given in Table 1.The descriptive
statistics (mean and standard deviation) of the
variables compared in this study are summerized in
Table 2, figure 3 and figure 4.
Table 1: Distribution of subjects according to
gender and malocclusion groups
Malocclusion Number of Number of Total
group females males
Class I 25 25 50
Class II division 1 25 25 50
Class II division 2 25 25 50
Class III 25 25 50
Grand Total 100 100 200
Maxillar
Maxillaryy Intermolar Width
Class I group showed highest mean maxillary
intermolar width followed by Class III, followed by Class
II div 2, while the lowest value was noted for Class II
div 1 group. The difference in maxillary intermolar
widths among the four groups was found to be

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 Table 2: Mean arch dimensions in four malocclusion groups
Dental arch Class I Class II div 1 Class II div 2 Class III
Dimensions

Mean SD
SD++ Mean SD
SD++ Mean SD
SD++ Mean SD
SD++
Maxillary ICW 32.98 31.85 2.82 32.52 1.99 32.68 2.47
Maxillary IMW 44.49 3.35 43.30 2.24 43.62 2.82 44.20 2.23
Maxillary AL 75.34 5.58 72.64 7.13 70.37 4.86 73.24 6.30
Mandibular ICW 26.05 3.59 26.44 2.73 26.25 2.41 26.81 1.87
Mandibular IMW 40.99 2.41 40.42 3.93 40.59 1.97 41.70 1.78
Mandibular AL 68.16 4.65 66.99 3.23 66.68 3.61 69.65 3.92

Table 3: Comparison of maxillary and mandibular arch dimensions among four malocclusion groups (n=200)
Dimensions Class No. of patients Mean SD
SD++ P-value

Maxillary ICW I 50 32.39 3.18

II div 1 50 31.84 2.81 0.161
II div 2 50 32.51 1.98
III 50 33.76 3.04
Maxillary IMW I 50 44.48 3.34
II div 1 50 43.29 2.23 0.113
II div 2 50 43.61 2.81
III 50 44.19 2.22
Maxillary AL I 50 75.33 5.57
II div 1 50 73.70 6.51 0.000*
II div 2 50 70.36 4.85
III 50 73.23 6.29
Mandibular ICW I 50 26.04 3.58
II div 1 50 26.43 2.72 0.548
II div 2 50 26.24 2.40
III 50 26.80 1.86
Mandibular IMW I 50 40.26 3.49
II div 1 50 40.41 3.91 0.078
II div 2 50 41.35 2.22
III 50 41.69 1.77
Mandibular AL I 50 68.15 4.64
II div 1 50 66.98 3.22 0.001*
II div 2 50 66.67 3.60
III 50 69.64 3.91
* = Significant p-value

insignificant (p = 0.113) as shown in Table 3. No two
individual groups showed significant difference except
between Class I and Class II div 1 groups (Table 4),
implying that maxillary arches were more constricted
in Class II div 1 group than in class I malocclusion.
Maxillar
Maxillaryy Intercanine Width
The highest mean intercanine width was found
in Class III followed by Class II division 2 group with
the smallest value found in Class II div1 group. A
comparison among the four groups was not
statistically significant (P < 0.05) as shown in Table
3. No group showed significant difference except
class 1 and classs II div 1 when individual groups
were compared as shown in Table 4. This can be
interpreted that patients with class II div 1
malocclusion have narrow intercanine widths than
those with class I.

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Table 4 : Comparison of maxillary and mandibular arch dimensions between individual malocclusion groups
Dimensions Class I vs Class I vs Class I vs Class II div 1 Class II div I Class II
Class II Class II Class III vs Class II vs Class III div 2 vs
div 1 div 2 (P-value)
(P-value) div 2 (P-value)
(P-value) Class III
(P-value)
(P-value) (P-value)
(P-value) (P-value)
(P-value) (P-value)
(P-value)
Maxillary IMW 0.028* 0.108 0.591 0.553 0.096 0.283
Maxillary ICW 0.029* 0.371 0.559 0.193 0.107 0.755
Maxillary AL 0.165 0.000** 0.074 0.005* 0.688 0.015*
Mandibular IMW 0.300 0.467 0.182 0.757 0.017* 0.038*
Mandibular ICW 0.474 0.713 0.163 0.727 0.497 0.304
Mandibular AL 0.134 0.057 0.056 0.690 0.001* 0.000**
* = Significant p-value

76

75

74
74
73
72

Fig. 1: Electronic digital vernier caliper (Mitu-toyo, 70 70

Kawasaki, Kanakawa, Japan) 70

68
68

67
67
66
Maxillary AL
Mean

64 Mandibular AL
group 1 group 2 group 3 group 4

CLASS

Fig. 4: Mean Maxillar and Mandibular length of four

groups of malocclusions.

Mandibular Intermolar Width

Fig. 2: Arch dimensions The largest width was noted for Class III group
followed by class II div 2 while the Class I group showed
50 the smallest value of mandibular intermolar width.
However the difference among the four groups was
not statistically significant (P > 0.05) as shown in Table
3. A comparison between individual groups showed
44 44
43 44

40 41
40 41
42
that class II div 1 and Class III and class II div 2 and
Class III were significantly different (Table 4).

33
Mandibular Intercanine Width
33 33
32
30
Maxillary ICW
The highest mean intercanine width was noted
26 27
Maxillary IMW for Class III followed by Class II div 1, followed by
26
class II div 2 malocclusion group with the least width
26
Mandibular ICW
Mean

20 mandibular IMW
found for class I malocclusion (Table 2 and Figure
group 1 group 2 group 3 group 4 3). However, no statistically significant difference
CLASS
(p=0.548) was found when the results were
compared among the four malocclusion groups
Fig. 3: Mean Maxillar and Mandibular inter canine and (Table 3). No group showed any significant differ-
intermolar arch widths of four groups of ence when compared individually using LSD test
malocclusions. (Table 4).

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Maxillar
Maxillaryy Arch Length
The highest value was noted for Class I followed
by Class II div 1 followed by class III while the smallest
value was recorded for Class II div 2 malocclusion
group. The difference among the four groups was
statistically significant (P= 0.000) as shown in Table 3.
When individual malocclusion groups were compared
to see any significant differences, it was found that
Class I and class II div 2, Class II div 1 and Class II div
2 and class II div 2 and class III showed significant
differences as shown in Table 4.
Mandibular Arch Length
Class III groups showed highest mean
mandibular arch length followed by class I while the
smallest was found for class II div 2. Significant
difference (P = 0.001) was found among the four
malocclusion groups as shown in Table 3. While
comparing the individual groups the Class II div 1 and
class III, and Class II div 2 and class III, showed
significant differences (Table 4).
DISCUS SION
DISCUSSION
Investigators, who studied growth changes in the
arch widths, found that inter-canine and inter-molar
widths did not change after the age of thirteen years in
females and sixteen years in males while some have
indicated that molar and canine arch widths were
mostly stabilized after 13 years of age with very little or
no changes thereafter.17,18 Therefore the minimum age
of the subjects included in this study was chosen on
the basis of these previous studies and it was
considered that the arch widths of the subjects
studied, were fully developed. Therefore, it was
assumed that intercanine and inter-molar widths of the
subjects selected in the present study were stable.
As class II division 2 and class III malocclusions
are seen less frequently in the population, the sample
size in the present study was therefore kept as large
as possible, as previous studies have considered a
decreased sample size to be a limiting problem when
conducting studies on these malocclusions.19-22
In our study we found no significant difference
in maxillary intermolar widths among the four
malocclusion groups. Similar results were reported by
other investigators21,23,24,25. A comparison between
individual groups showed significant difference in
maxillary intermolar widths between Class I and Class
II div 1 subjects. This can be interpreted that Class II
malocclusion subjects had the narrowest maxillary
intermolar widths as compared to other malocclusion
groups. Similar results were found by other
authors21-23,25 who reported a significant difference in
intermolar widths between Class I and Class II
malocclusions. Quraishi26 compared maxillary and
mandibular arch dimensions among different
J. Med. Sci. (Peshawar
malocclusion groups in a sample of Pakistani
population. He concluded that mean intermolar width
of Class I group was larger than Class II group and
significant difference was found when the maxillary
intermolar width was compared between Class I and
Class II malocclusion groups.
The comparison of maxillary intercanine widths
among the four malocclusion groups showed no
statistically significant differences among malocclusion
groups. Smiliar results were found by other
investigators.21,22,25,27,28 However, we found a significant
difference between Class I and Class II div 1
malocclusions. Staley et al 23 reported that the
maxillary dental arches as a whole were narrower in
adults with Class II Division 1 malocclusion than in
adults with normal occlusion. Quraishi26 reported a
significant difference in maxillary intercanine width
between Class I and Class II subjects with Class I group
having larger intercanine width than Class II group.
However no significant difference was found between
Class I and Class III groups. We found that Class III
malocclusions showed a larger mean maxillary
intercanine width than both Class II division 1 and Class
II division 2, which might indicate a restricted growth
in this region in Class II malocclusion.
A comparison of mandibular intermolar width
among the four malocclusion groups did not show any
significant difference among these groups which is in
agreement with some other studies22,25,27. When two
individual groups were compared only two groups
showed significant differences i.e. between class II div
1 and class III and between class II div 2 and class III
which shows that class III had an increased intermolar
arch widths. This is in agreement with studies of
Al-Khateeb and Abu-Alhaija 21 who reported wider
mandibular arches in Class III individuals than Class II
subjects. Uysal et al20 found that subjects with Class II
Division 2 malocclusion had significantly larger
mandibular intermolar and intercanine widths as
compared to normal occlusion group.
Mandibular intercanine width was also compared
among the four malocclusion groups and then between
individual groups but none of the results was
statistically significant. This is in agreement with other
studies by Staley et al23, Bishara et al27, Hashim and
Al-Ghamdi22 and Huth et al28. However some other
researchers have found a significant difference in
mandibular intercanine widths when comparison was
made between different malocclusion groups.
Al-Khateeb and Abu-Alhaija21 reported significantly
larger mandibular intercanine widths in Class III group
when compared to other malocclusion groups. Sayin
and Turkkahraman 25 reported significantly larger
mandibular intercanine width in Class II Division 1
patients when compared with Class I malocclusion
group. Uysal et al20 found larger values of intercanine
widths in Class II Division 1 group as compared to
Class II Division 2 group.
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 The difference in the results from these studies
could be due to different measuring techniques such
as selection of different reference points and secondly
the use of different devices for recording the arch
dimensions. For example, in the present study we used
electronic digital vernier caliper while others used the
simple dial vernier caliper. The maxillary arch length
comparison among different malocclusion groups
showed significant difference (P = 0.000).
Comparison among individual groups showed that
Class II division 2 was significantly different from the
rest of three groups. Also class II div 2 showed
smallest mean maxillary arch length which is an
expected result, considering the retroclination of the
maxillary central incisors in Class II division 2
malocclusions. This is in agreement with the study of
Al-Khateeb and Abu Alhaija 21 who showed that
maxillary arch length in class II div 1 was significantly
larger than class II div 2. On the other hand Hashim
and Al Ghamdi 22 found no statistically significant
difference for the maxillary arch length among Class I,
Class II and class III groups.
The mandibular arch length in our study showed
significant difference among the malocclusion groups
with the largest mean mandibular arch length for class
III. Also both the sub divisions of Class II malocclusion
showed significant differences from class III
malocclusion when individual groups were compared.
This shows that both Class II division 1 and Class II
division 2 were shorter than Class III malocclusion
group. This finding is also in agreement with the
results of Alkhateeb and Abu Al Haija21. Similarly,
Lavelle29, Nie and Lin30 and Hnat et al31 showed that
Class III cases are characterized by smaller maxillary
tooth dimensions and bigger lower teeth. They
suggested that when mandibular teeth size is
increased, they will occupy more space in the arch
and thus the arch length will ultimately increase. This
suggestion supports our result of increase
mandibular arch length in class III malocclusion. The
increased madibular arch length in class III
malocclusion than other malocclusions found in our
study suggests that there might be increased growth
potential of mandible in Class III patients due to
hereditary or environmental factors.
CONCLUSIONS
CONCLUSIONS
Class II div 1 malocclusion showed significantly
shorter maxillary intermolar and intercanine arch widths
than that of Class I malocclusion. Mandibular
intermolar arch width of Class III malocclusion was
significantly larger than class II div 1 and Class II div 2
malocclusion suggesting wider mandibular arches in
Class III subjects.
Class II div 2 malocclusion showed significantly
shorter maxillary arch length as compaed to Class II
div 1 and class 1 groups, while Class III group showed
the largest mean mandibular arch length.
76 J. Med. Sci. (Peshawar
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