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Dental arch dimensions in the mixed dentition:

a study of Brazilian children from 9 to 12 years
of age
Fabiane LOULY1, Paulo Roberto Aranha NOUER2, Guilherme JANSON3, Arnaldo PINZAN4

1- DDS, MSc, Graduate student, Department of Pediatric Dentistry, Orthodontics and Community Health, Bauru School of Dentistry, University of São Paulo,
Bauru, SP, Brazil.
2- DDS, MSc, PhD, Professor. Private practice, São Paulo, SP, Brazil.
3- DDS, MSc, PhD, M.R.C.D.C. (Member of the Royal College of Dentists of Canada), Professor and Head, Department of Pediatric Dentistry, Orthodontics
and Community Health, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
4- DDS, MSc, PhD, Associate Professor, Department of Pediatric Dentistry, Orthodontics and Community Health, Bauru School of Dentistry, University of São
Paulo, Bauru, SP, Brazil.

Corresponding address: Dra. Fabiane Louly - Faculdade de Odontologia de Bauru - USP - Departamento de Odontopediatria, Ortodontia e Saúde Coletiva -
Disciplina de Ortodontia - Alameda Octávio Pinheiro Brisolla, 9-75 - Bauru, SP - Brazil - 17012-901 - Phone/Fax: +55-14-3234-4480 - e-mail: fablouly@terra.com.br

Received: June 26, 2009 - Modification: March 16, 2010 - Accepted: May 25, 2010

abstract

O bjective: This study evaluated dental arch dimensional changes of Brazilian children.
Material and methods: Dental casts were taken from 66 children (29 males; 37
females) with normal occlusion selected among 1,687 students from public and private
schools aged 9, 10, 11 and 12 years, according to the following criteria: Class I canine and
molar relationships; well-aligned upper and lower dental arches; mixed dentition; good
facial symmetry; no previous orthodontic treatment. Dental arch dimensions were taken
by one examiner using the Korkhaus’ compass and a digital pachymeter. ANOVA test was
applied to compare the arch dimensions at the different ages and the t-test was used to
compare the arch dimensions of male and female subjects. Arch forms were compared by
means of chi-square tests. Results: Only the maxillary anterior segment length showed a
statistically significant increase from 10 to 12 years of age. Males had a significantly larger
maxillary depth than females at the age range evaluated. The predominant dental arch
form found was elliptical. Conclusions: In the studied age range, anterior maxillary length
increased from 10 to 12 years of age, males had larger maxillary depth than females and
the predominant arch form was elliptical.

Key words: Dental arch. Growth. Mixed dentition.

INTRODUCTION occur in the dental arches are consequences

of tooth movement and growth of supporting
The width, length and depth of dental arches bone, besides modest genetic component8. These
have had considerable implications in orthodontic naturally occurring changes, which happen in
diagnosis and treatment planning in a modern untreated individuals, have been used for many
dentistry based on prevention and early diagnosis times, as comparative “gold standards”, which
of oral disease7. have been employed to assist the diagnosis and
These dental arch dimensions systematically orthodontic planning7.
change during the period of intensive growth and It has been reported that growth and development
development, but lessen at adulthood7. Because period have been influenced by environmental
of this, many studies have investigated arch factors, nutrition, and ethnic variations; systemic,
dimensional changes in various stages of growth health, and individual variations could also occur3.
and development, such as arch width and arch Therefore, a standard measurement definition for
dimensions2,3,7,17,18,23. dental arches has become more difficult in a great
During the mixed dentition, the changes that mixed population and these differences could affect

J Appl Oral Sci. 169 2011;19(2):169-74

 Dental arch dimensions in the mixed dentition: a study of Brazilian children from 9 to 12 years of age

clinical treatment. the total length and the anterior segment length of
Not only it is obvious that the clinician treats the the arch (Figure 1).
individual and not a segment of population, but it is The intercanine width was observed by the
also true that people from different ethnic groups distance between the cusp tips of the right and left
present different modal conditions. The clinician canines. Inter-first-premolar width was given by the
should anticipate the differences in size and form distance between the central sulcus of the right and
rather than treating all cases with a single ideal. left first premolars or primary second molar. Inter-
A number of researches have attempted to first-molar width was evaluated by the distance
identify dental arch characteristics, which have between the central sulcus of the right and left first
been unique to a certain ethnic group. Nojima, et molars. Inter-second-molar width was observed by
al.20 (2001) compared Caucasian and Japanese the distance between the central sulcus of the right
mandibular clinical arch forms. Defraia, et al.11 and left second molars (Figure 1).
(2006) studied dental arch dimensions in the mixed Maxillary depth (Figure 2) was measured from
dentition of Italian children. Lindsten, et al.16 (2002) a line which connects the occlusal plane up to the
evaluated transverse dental arch dimension and greatest palatal depth. The form of the dental
dental arch depth dimensions in mixed dentition of arch was defined based on cusp tips and incisor
Norwegian children. Yuen, et al.30 (1988) performed edges and then classified as: ellipse9, parabola13,
a mixed dentition analysis for Hong Kong Chinese segments of circles joined to straight lines, or
children. Burris and Harris6 (2001) evaluated the modified spheres5,26.
maxillary arch size and shape in American Black Some maxillary and mandibular second molar
and White children. widths were not measured because these teeth
The Brazilian population, which has a great were not present yet.
ethnic diversity, can present different characteristics
from those observed in the studies carried out in Error study
samples of Caucasian countries, Eastern countries Every 66 dental casts were measured again after
or other countries. Based on the hypothesis that 10 days from the first measurement, by the same
these dental occlusion maturation characteristics examiner. The casual error was calculated according
could have been influenced by this ethnic diversity to Dahlberg’s formula (S2=Σd2/2n), where S2 was
pattern and that occlusal changes could have the error variance and d was the difference between
occurred even in patients with normal occlusion, the
aim of this study was to evaluate the changes that
could occur in dental arches, in the mixed dentition
of Brazilian children.

MATERIAL AND METHODS

Dental casts were taken from 66 children (29

males; 37 females) with normal occlusion that
were selected among 1,687 students from public
and private Brazilian schools aged 9, 10, 11 and
12 years, who met the following criteria: Class I
canine and molar relationships; well-aligned upper
and lower dental arches; mixed dentition; good
Figure 1- Maxillary and mandibular dental width
facial symmetry clinically determined; no significant
measurements: 1.intercanine distance; 2.inter-premolar
medical history; no history of trauma and no
previous orthodontic or prosthodontic treatment. distance; 3.first inter-molar distance; 4.dental arch total
Dental arch dimensions of width, length and length; 5.anterior segment length; 6.posterior segment
depth were taken by one examiner using the length
Korkhaus’ compass and a digital pachymeter.
To examine the total length of dental arch,
the perpendicular distance from the line which
connects the central incisors and the raphe point
up to the line of depth of the first molar was used.
The length of the anterior segment of the arch was
evaluated through the perpendicular distance from
the line which connects the central incisors up to the
canine’s distal line. Length of the posterior segment
of the arch was observed by the difference between
Figure 2- Maxillary depth

J Appl Oral Sci. 170 2011;19(2):169-74

 LOULY F, NOUER PRA, JANSON G, PINZAN A

the two determinations of the same variable10. RESULTS

Kappa test was used to evaluate the systematic
error of the dental arch form. Intraexaminer Casual errors varied from 0.0 for the anterior
agreement was tested with intraclass coefficients mandibular segment length to 0.076 mm for the
generated by Kappa statistics15. posterior maxillary segment length. The systematic
error of dental arch form, according to Kappa
Statistical analysis statistical coefficients, showed a moderate level of
The intergroup comparisons of the ages were intraexaminer agreement.
performed with one-way ANOVA, followed by Descriptive statistics (mean, standard deviation)
Tukey’s test as a second step. T-tests were applied are shown in Table 1. The total length and all
for comparison between males and females. The maxillary measurements increased, but did not
form of the arch was evaluated with chi-square obtain statistical significance. The maxillary anterior
test. Results were considered statistically significant segment length was significantly larger at 12 as
at P<.05. compared to 10 years of age (Table 1).
Mandibular measurements had small changes
and no statistically differences were found.

Table 1- Means and standard deviations of age and results of ANOVA test

Variable 9 years 10 years 11 years 12 years P

(n=8) (n=18) (n=22) (n=18)
Mean sd Mean sd Mean sd Mean sd
Maxillary arch 38.9a 1.2 39.2a 1.4 39.5a 2.3 40.2a 2.3 0.355
total length
Anterior maxillary 13.8ab 1.2 13.9a 1.2 14.5ab 1.4 15.3b 1.7 0.022*
segment length
Posterior maxillary 25.1a 1.0 25.3a 1.6 24.9a 1.5 24.9a 2.0 0.874
segment length
Maxillary 26.2a 2.1 26.7a 1.8 26.8a 2.0 27.4a 1.5 0.498
intercanine width
Maxillary first 36.3a 1.2 35.8a 2.2 35.9a 1.8 36.5a 1.8 0.619
premolar width
Maxillary first 46.7a 2.5 47.5a 2.6 47.9a 2.5 48.4a 2.7 0.459
molar width
Maxillary depth 10.1a 1.4 10.5a 1.0 10.9a 2.2 11.6a 2.3 0.275
Mandibular 36.0a 1.1 35.0a 1.7 35.5a 1.8 36.0a 2.0 0.303
arch total length
Anterior mandibular 9.8a 1.1 10.0a 1.0 10.5a 0.8 10.6a 0.9 0.102
segment length
Posterior mandibular 26.2a 1.7 24.9a 2.0 25.0a 1.6 25.4a 1.8 0.358
segment length
Mandibular 21.9a 1.7 21.6a 2.1 21.3a 1.7 20.7a 1.1 0.334
intercanine width
Mandibular first 36.3a 1.2 35.8a 2.2 35.9a 1.8 36.5a 1.8 0.619
premolar width
Mandibular first 42.3a 1.8 42.9a 2.1 42.6a 2.4 43.5a 1.4 0.436
molar width
9 years 10 years 11 years 12 years
(n = --- ) (n = 4) (n=11) (n=13)
Maxillary ---- --- 51.8a 2.9 52.6a 2.3 53.5a 1.7 0.328
second molar width
9 years 10 years 11 years 12 years
(n = 1 ) (n = 9) (n=14) (n=17)
Mandibular 47.0a ---- 47.8a 3.0 47.6a 2.5 48.9a 1.5 0.374
second molar width

Same letters mean no intergroup difference. *Statistically significant at P<.05

J Appl Oral Sci. 171 2011;19(2):169-74

 Dental arch dimensions in the mixed dentition: a study of Brazilian children from 9 to 12 years of age

Descriptive statistics and comparisons of the length greater than 10-year old children (Table
males and females in each age-group (according 1). Significant changes occurred in the dental
to independent samples t-test P<0.05) were arches during the early mixed development period.
described in Table 2. Males showed a significantly Eruption of the permanent incisors resulted in an
larger maxillary depth than females to 10 years
of age (Table 2). The ellipse form9 was the most Table 3- Form of the dental arch (chi-square test)
frequent dental arch form found in the sample
studied (Table 3).
Form Females Males Total

DISCUSSION N (%) N (%) N (%)

Ellipse 31 (83.8) 26 (89.7) 57 (86.4)
In this study, when comparing children ages, Round 3 (8.1) 2 (6.9) 5 (7.6)
only the maxillary anterior segment length showed
Parabola 3 (8.1) 1 (3.5) 4 (6.0)
statistically significant differences and the 12-year
old children exhibited a maxillary anterior segment X2=0.49 df=2 p=0.781

Table 2- Descriptive statistics and comparisons of the males and females in each age-group (according to independent
samples t-test P<0.05)

Arch total Anterior Posterior Intercanine First First molar Second Maxillary
length segment segment width premolar width molar depth
length length width width
Maxillary measurements
9 years
M=3 40.00 14.50 25.50 27.99 36.89 48.06 --- 11.00
F=5 38.40 13.30 25.10 27.04 35.89 45.74 --- 9.40
p 0.056 0.159 0.558 0.450 0.277 0.251 --- 0.159
10 years
M=7 39.00 13.57 24.42 26.72 35.28 46.69 50.70(n=1) 11.71
F=11 39.36 14.09 25.27 26.73 36.06 48.05 52.16(n=3) 9.72
p 0.602 0.379 0.850 0.994 0.481 0.288 0.745 0.042*
11 years
M=9 39.05 14.27 24.77 26.56 35.57 47.14 52.02(n=4) 11.00
F=13 39.76 14.63 25.13 26.91 36.14 48.47 52.98(n=7) 10.84
p 0.462 0.564 0.567 0.686 0.482 0.223 0.535 0.877
12 years
M=10 40.45 15.37 25.08 26.51 36.48 48.93 53.44(n=8) 12.20
F=8 39.87 15.12 24.75 25.78 36.47 47.61 53.56(n=5) 10.87
p 0.618 0.773 0.734 0.488 0.982 0.320 0.908 0.241
Mandibular measurements
9 years
M=3 36.66 9.66 27.00 22.73 31.30 43.26 ------- ------
F=5 35.60 9.90 25.70 21.43 29.69 41.69 47.00(n=1) ------
p 0.206 0.789 0.321 0.336 0.156 0.258 ---- ------
10 years
M=7 34.78 10.28 24.50 21.79 30.45 42.80 47.67(n=4) ------
F=11 35.13 9.86 25.27 21.42 31.99 43.03 47.90(n=5) ------
p 0.667 0.387 0.422 0.727 0.411 0.828 0.920 ------
11 years
M=9 35.22 10.44 24.77 21.04 30.45 42.13 47.42(n=5) ------
F=13 35.76 10.55 25.21 21.34 31.16 42.79 47.68(n=9) ------
p 0.499 0.769 0.542 0.704 0.461 0.525 0.855 ------
12 years
M=10 35.95 10.35 25.60 20.96 31.65 43.48 48.63(n=9) ------
F=8 36.12 10.87 25.25 20.46 31.13 43.37 49.18(n=8) ------
p 0.862 0.252 0.700 0.329 0.418 0.882 0.745 ------

*Statistically significant for P<.05

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 LOULY F, NOUER PRA, JANSON G, PINZAN A

increase of the anterior segment, especially in ethnic variations.

the maxilla, and with eruption of the permanent The variation of the premolar width was greater
canines, a further minor increase occurred27. for the mandibular arch, but it was not statistically
It was found an insignificant increase in significant. The findings of this study, as well as,
maxillary arch total length, from 9 to 12 years. A those of Bishara, et al.3 (1997) and the Michigan
little decrease in mandibular arch total length was Growth Study19 (1976) indicated that most arch
also found and this arch length seemed to remain widths dimensions have been established in the
constant after 12 years. These results are similar mixed dentition. The results of the Michigan Growth
to those of a longitudinal study of dental arches Study19 (1976) showed that the premolar width have
in a Turkish population, where the maxillary arch increased in both jaws, which have been greater in
length increased until 13 years and showed a little the maxillary than in the mandibular dental arch. In
decrease starting from 9 years1. our study, although without statistically significant
Arch length decreased between the ages of 9 difference, maxillary and mandibular first and
and 14 years due to changes in the dentition and second intermolar widths increased, confirming
it remained constant after the age of 142,18. The that the studied period of time represented when
main causes of these length changes have been most of the transverse growth of the molar region
the closure of posterior interproximal spaces by have occurred1.
the replacement of the primary dentition with the In a study conducted in the United Kingdom,
permanent dentition, and the interproximal contacts decreases have been found in intermolar widths
made by the permanent teeth2,18. between the ages of 11 and 1429. Lindstron16 (2002)
There was an insignificant decrease in maxillary found minimal increases in permanent intermolar
and mandibular posterior segment length. This width between ages of 9 and 19. Moorrees 18
decrease should be related to the mesial shifting of (1959) found that the mandibular intermolar
the first molars due to leeway space closure27. This is width increased between the ages of 9 and 14 and
in agreement with the dental arches measurements remained constant after the age of 14. Our results
found on a Turkish population1. Lundstrom17 (1969) are consistent with these increases during the
evaluated age-related changes in dental arches, and studied period of time. Odajima21 (1990) performed
followed 41 pairs of twins, males and females, from a longitudinal study on growth and development
an initial age of 9 to 19 years and found decreases of dental arches of primary, mixed and permanent
in maxillary and mandibular length. dentitions and found a gradually increase for the
Our study found a mandibular decrease and width at the region of the permanent maxillary
a maxillary increase in intercanine widths. This and mandibular first molars, which have reached a
was similar to the Iowa growth study and the stable condition at about 12 years of age.
untreated UMGS (University of Michigan Growth Cassidy, et al.8 (1998), Staley, et al.25 (1985),
Series) study sample19. This trend was observed Raberin, et al. 22 (1993), studying the widths
for the mandibular and maxillary results, but these of dental arches, found several maxillary or
variations were not statistically significant. mandibular widths larger in male than in female
Intercanine widths were studied by Barrow and subjects. However, in the present investigation, just
White2 (1952), Moorrees18 (1959), and Sillman23 one variable (maxillary depth) showed a statistically
(1964) who observed a rapid increase between significant sexual dimorphism to 10 years of
the ages of 6 and 9, which have been associated age (Table 2). From the studies of dentofacial
to the eruption of the permanent canines and development, it is known that sagittal growth of
incisors. According to Moorrees18 (1959) a decrease the nasomaxillary complex is the result of anterior
have occurred between the ages of 10 and 12, displacement of the maxilla due to bone deposition
with no change after that. However, other authors at the tuberosity and adjacent structures, thus
suggested that intercanine width have continued creating space for eruption of the posterior teeth.
to decrease after age 122,18,23. Vertical growth is the combined result of a sutural
In a longitudinal study performed by Knott14 lowering of the maxilla as a whole and remodeling at
(1972) there has been an average change in the the bone surfaces4. This lowering creates space for
intercanine width during the transition from primary the nasal cavity, which continues to be lowered due
to the permanent dentition, however, with high to resorption nasally with simultaneous deposition
individual variations. Sinclair and Little24 (1983) of bone orally on the palate. Vertical growth is
found a decrease in mandibular intercanine width hence a result of two separate processes: drift
between the mixed and early permanent dentitions. resulted of remodeling growth, and displacement
In our study, there was a non-significant slight of the maxilla as a whole, a procedure that occurs
increase for the maxillary intercanine width and without any kind of rotation28. With premolars and
a decrease for the mandibular intercanine width. molars in occlusion, there should not be any further
These differences could be related to genetic or increase of the alveolar process and hence no

J Appl Oral Sci. 173 2011;19(2):169-74

 Dental arch dimensions in the mixed dentition: a study of Brazilian children from 9 to 12 years of age

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J Appl Oral Sci. 174 2011;19(2):169-74