Orthodontic model analysis form



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Graduate Program in Orthodontics
Orthodontic Clinic

ORTHODONTIC MODEL ANALYSIS FORM

Patient’s Name



Date of Birth




Date of Examination







Models Related by

 Static/Maximum Intercuspation

 Mounted/Centric Relation

Dentition Stage

 Primary

 Early Mixed

 Late Mixed

 Permanent

Teeth Present, Missing:

18 17 16 15 14 13 12 11

21 22 23 24 25 26 27 28

48 47 46 45 44 43 42 41

31 32 33 34 35 36 37 38

Right Buccal

Left Buccal


Overjet (mm)

mm

Overjet (mm)

mm

Angle Classification – Molar




Angle Classification – Molar




Angle Classification – Canine




Angle Classification – Canine




Crossbites




Crossbites




Curve of Spee (Depth: mm)

mm

Curve of Spee (Depth: mm)

mm

Overbite (%, mm)

%, mm

Dental Midlines (Diastema-mm)

Maxillary Occlusal

Mandibular Occlusal


Arch Form, Width – (Shape: P, U, V, O)




Arch Form, Width – (Shape: P, U, V, O)




Symmetry




Symmetry




Rotations




Rotations




Abnormal Teeth Position




Abnormal Teeth Position




Morphology, Wear, Fracture




Morphology, Wear, Fracture




Canine Width (mm)

mm

Canine Width (mm)

mm

Molar Width (mm)

mm

Molar Width (mm)

mm

Incisor Inclination




Incisor Inclination




Space Analysis:

Available Space (Arch Circum)

mm

Available Space (Arch Circum)

mm

#13

mm

#16

mm

#33

mm

#46

mm

#12

mm

#15

mm

#32

mm

#45

mm

#11

mm

#14

mm

#31

mm

#44

mm

#21

mm

#24

mm

#41

mm

#34

mm

#22

mm

#25

mm

#42

mm

#35

mm

#23

mm

#26

mm

#43

mm

#36

mm

Total Space Required (5-5)

mm

Total Space Required (5-5)

mm

Discrepancy (Def./Excess)

mm

Discrepancy (Def. /Excess)

mm

Anterior Bolton Ratio:

Overall Bolton Ratio:

Sum of Mand. 3-3

mm

Sum of Mand. 6-6

mm

Sum of Max. 3-3

mm

Sum of Max. 6-6

mm

Anterior Ratio (Norm = 77.2%)

%

Overall Ratio (Norm = 91.3%)

%

If exceeds 77.2%

mm Mandibular Excess

If exceeds 91.3%

mm Mandibular Excess

If less than 77.2%

mm Maxillary Excess

If less than 91.3%

mm Maxillary Excess

Mixed Dentition Space Analysis (Tanaka and Johnston):

Sum of Max. 2-2




Sum of Mand. 2-2




Predicted (3, 4, 5)

X ½ + 11 = mm

Predicted (3, 4, 5)

X ½ + 10.5 = mm

Space Required (2-2 + 3,4,5 X 2)

mm

Space Required (2-2 + 3,4,5 X 2)

mm

Net Arch Length (Def./Excess)




Net Arch Length (Def./Excess)







Abdullah M. Aldrees, BDS, DMSc – 2013



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