Patient Name: Date



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BOLTON ANALYSIS

Patient Name:__________________________________ Date:___________________




Maxillary

Mandibular


6 =

6 =




6 =

6 =

5 =

5 =

5 =

5 =

4 =

4 =

4 =

4 =

3 =

3 =

3 =

3 =

2 =

2 =

2 =

2 =

1 =

1 =

1 =

1 =



6 –6




+

=




+

=

3 –3




+

=




+

=



Overall = ________ Mx Md Excess Anterior = ________ Mx Md Excess


(Star significant size differences in teeth on right vs. left.)
Notes:__________________________________________________________________________________________________________________________________________________________________________________________________________________
3 cusp tip width = 3 cusp tip width =

6 central fossa width = 6 central groove width =



BOLTON ANALYSIS

Patient Name:__________________________________ Date:___________________




Maxillary

Mandibular


6 =

6 =




6 =

6 =

5 =

5 =

5 =

5 =

4 =

4 =

4 =

4 =

3 =

3 =

3 =

3 =

2 =

2 =

2 =

2 =

1 =

1 =

1 =

1 =



6 –6




+

=




+

=

3 –3




+

=




+

=



Overall = ________ Mx Md Excess Anterior = ________ Mx Md Excess


(Star significant size differences in teeth on right vs. left.)
Notes:__________________________________________________________________________________________________________________________________________________________________________________________________________________
3 cusp tip width = 3 cusp tip width =

6 central fossa width = 6 central groove width =


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