Original articleIncisor shape and incisor crowding: A re-evaluation of the Peck and Peck ratio
Review articleOpen access

AbstractAlthough lower incisor tooth shapes, defined as mesiodistal length divided by labiolingual width, have been proposed as important factors in lower incisor crowding, the question of whether or not these ratios are more useful than simple measurements of incisor mesiodistal length has not been addressed. In order to test this question, we measured mesiodistal and labiolingual incisor dimensions and lower incisor crowding (defined as the crowding index proposed by Little) on dental casts from two groups: 100 pretreatment orthodontic patients and 100 Hutterites from a religious isolate in Canada. The orthodontic patients are our primary interest. The Hutterites serve mainly to test whether or not results are consistent in another population of different ethnicity, age distribution, and occlusal status. In each population, incisor crowding is correlated with the tooth shape ratios, confirming the general observations of Peck and Peck. However, mesiodistal incisor lengths have slightly higher correlations with crowding than the shape ratios. In multiple regression equations to predict crowding in each population, incisor mesiodistal lengths are the most important variable, and neither the tooth shape ratios nor labiolingual widths significantly improve the equations. Although statistically significant, none of the correlations is higher than 0.30, and they are thus of little clinical value. The use of tooth size measurements or ratios as a guide to clinical procedures is an oversimplification of a complex problem.

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