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Applicability of Bolton's Analysis and Regression-Based Tooth-Size Prediction Methods in a Young Adult Cohort
Beenamol Boben1, Ravindra Vangala2, Divya Swapna Maraka3
1Dentistry, Narayana Dental College and Hospital, Nellore, IND.
Cureus
|June 9, 2026
Summary
Existing orthodontic tooth-size analysis methods show bias in young adults. Population-specific regression equations offer improved accuracy for interarch tooth-size relationships in diagnosis and treatment planning.
Area of Science:
- Dentistry
- Orthodontics
- Dental Morphology
Background:
- Accurate assessment of interarch tooth-size relationships is crucial for orthodontic diagnosis, space analysis, and treatment planning.
- Commonly used methods like Bolton's analysis and regression formulas (Tonn's, Abhi's) may have uncertain applicability across diverse populations.
Purpose of the Study:
- To validate the accuracy of Bolton's analysis, Tonn's formula, and Abhi's formula in predicting incisor dimensions in a specific young adult cohort.
- To develop and validate population-specific regression equations for improved interarch tooth-size assessment.
Main Methods:
- An observational study involving 56 dental study models of young adults (aged 18-25 years).
- Mesiodistal widths of maxillary and mandibular anterior teeth were measured using a digital Vernier caliper.
- Comparison of actual tooth dimensions with predicted values from Bolton's, Tonn's, and Abhi's methods, employing statistical analyses including Bland-Altman and linear regression.
Main Results:
- Bolton's anterior ratio (78.02%) was significantly higher than the standard (77.2%, p=0.003).
- Tonn's formula overestimated maxillary incisor width (+1.67 mm, p<0.001), and Abhi's formula underestimated mandibular incisor width (-0.67 mm, p<0.001).
- A derived regression equation demonstrated good internal validation, with a predicted Bolton's ratio (78.11%) not significantly different from the actual ratio (78.02%, p=0.977).
Conclusions:
- Bolton's analysis, Tonn's formula, and Abhi's formula exhibited significant bias within the studied cohort.
- Population-specific regression equations demonstrated enhanced predictive accuracy.
- These tailored equations may offer more reliable guidance for orthodontic diagnosis and treatment planning.
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