Navigating Orthodontic Treatment: A Critical Look at Occlusion, Spacing, and Bolton Analysis

Question:

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This Patient has class 1 occlusion and spacing on the upper and lower. The Bolton says there is a max excess. Is this incorrect because of the spacing? It appears that the lower may need some IPR to get the ideal OJ. I;ll also switch to conventional attachments. Any other feedback would be helpful. Thank you.

Answer by Dr. Schalk:

Orthodontic treatment planning often involves a detailed analysis of occlusion, spacing, and dental discrepancies. This article discusses a case involving Class 1 occlusion, spacing issues, and the implications of Bolton analysis in determining maxillary excess.

Class 1 Occlusion and Spacing

In this case, the patient presents with Class 1 occlusion and spacing in both the upper and lower arches. The Bolton analysis indicates a maxillary excess, raising questions about the accuracy of this assessment due to the observed spacing.

Bolton Analysis and Maxillary Excess

The Bolton analysis reveals measurements of 3.58 and 1.26, suggesting significant maxillary excess. However, the practical implications of these findings are debated, as the final occlusion and overjet do not appear excessively large upon visual inspection.

Interproximal Reduction (IPR) Considerations

While the Bolton analysis suggests potential