Changes of arch form at the end of orthodontic treatment, based on the Ricketts pentamorphic arch forms

Maintenance of the intercanine and intermolar distances reduces the risk of relapse and increases the chance of stability; these values represent the limits of the arch, resulting from the muscular balance of each patient. The ideal would be to reproduce the patient's arch form individually. The Ricketts pentamorphic arch forms allow the clinician to choose among 5 shapes, the one that best fits the patient's arch form. The objective of this study was to evaluate the effect of orthodontic treatment without extraction according to the pentamorphic arch forms on mandibular arches of different forms.

Fifty patients were included in the study. For each patient, the pretreatment and end-of-treatment models were scanned by 3Shape Trios (3Shape, Copenhagen, Denmark) and transferred to the OrthoAnalyzer software (3Shape) version 2017-11.7.1.3 for measurements and superimpositions. The following measurements were made on the mandibular arches for both initial and final digital models: arch depth; intercanine distance, the distance between the first premolars, the distance between the second premolars, the distance between the first molars, and the distance between the second molars. Three superimpositions were made: superimposition between the initial arch and the corresponding form of the pentamorphic arch forms, superimposition between the final arch and the corresponding form of the pentamorphic arch forms, and superimposition between the initial arch and the final arch. The largest difference between the superimposed arches in each region was measured.

This study showed that intercanine distance (P = 0.236), the distance between the first premolars (P = 0.074), and the distance between the first molars (P = 0.616) did not significantly change after orthodontic treatment. In contrast, the distance between the second molars (P = 0.028) and the arch depth (P <0.001) increased significantly after orthodontic treatment. The mean of the largest difference in the absolute value of all the superimpositions is significantly different from the theoretical value 0 (P <0.001), but clinically, this difference is significant only in certain premolars and molars regions.

This study has shown that the pentamorphic arch forms maintained the arch shape in the sagittal and transverse directions, except for an expansion of the distance between the mandibular second molars.