TY - JOUR
T1 - A systematic review and meta-analysis on Bolton's ratios
T2 - Normal occlusion and malocclusion
AU - Machado, Vanessa
AU - Botelho, João
AU - Mascarenhas, Paulo
AU - Mendes, José João
AU - Delgado, Ana
PY - 2020/3/1
Y1 - 2020/3/1
N2 - INTRODUCTION: The purpose of this study was to seek and summarise the Bolton overall index (OI) and anterior index (AI) regarding normal occlusion and Angle's malocclusion according to gender, and to assess if these indices support Bolton's standards as general references. METHODS: PubMed, LILACS, Embase, CENTRAL and Google Scholar databases were searched up to June 2019 (CRD42018088438). Non-randomised clinical studies, published in English and assessing Bolton's OI and/or AI in normal occlusion and Angle's malocclusion groups, were included. OI and AI means, sample size and SDs were collected. The National Heart, Lung, and Blood Institute's Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess the risk of bias. Pairwise random-effects and multilevel Bayesian network meta-analyses were used to synthesise available data. RESULTS: Fifty-three observational studies were included (11,411 participants; 3746 men, 4430 women; 15 studies lacked gender information). For normal occlusion, pooled estimates for OI and AI means were 91.78% (95% confidence interval [CI] = 91.42-92.14; I2 = 92.87%) and 78.25% (95% CI = 77.87-78.62; I2 = 90.67%), respectively. We could identify in Angle's Class III patients meaningful OI and AI mean deviations from normal occlusion (0.76, 95% credible interval [CrI] = 0.55-0.98 and 0.61, 95% CrI = 0.35-0.87, respectively), while in Class II patients we found a meaningful mean deviation from normal occlusion only for OI (-0.28, 95% CrI = -0.52--0.05). Concerning gender impact, male patients presented higher OI (0.30, 95% CI = 0.00-0.59) and AI (0.41, 95% CI = 0.00-0.83) mean values than female patients in Class I. CONCLUSION: Normal occlusion OI and AI mean values differ from Bolton's original values. Class II division 2, for OI mean values, and Class III, for both OI and AI, are proportionally larger than normal occlusion patients. Gender had almost no impact on teeth mesiodistal proportion.
AB - INTRODUCTION: The purpose of this study was to seek and summarise the Bolton overall index (OI) and anterior index (AI) regarding normal occlusion and Angle's malocclusion according to gender, and to assess if these indices support Bolton's standards as general references. METHODS: PubMed, LILACS, Embase, CENTRAL and Google Scholar databases were searched up to June 2019 (CRD42018088438). Non-randomised clinical studies, published in English and assessing Bolton's OI and/or AI in normal occlusion and Angle's malocclusion groups, were included. OI and AI means, sample size and SDs were collected. The National Heart, Lung, and Blood Institute's Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess the risk of bias. Pairwise random-effects and multilevel Bayesian network meta-analyses were used to synthesise available data. RESULTS: Fifty-three observational studies were included (11,411 participants; 3746 men, 4430 women; 15 studies lacked gender information). For normal occlusion, pooled estimates for OI and AI means were 91.78% (95% confidence interval [CI] = 91.42-92.14; I2 = 92.87%) and 78.25% (95% CI = 77.87-78.62; I2 = 90.67%), respectively. We could identify in Angle's Class III patients meaningful OI and AI mean deviations from normal occlusion (0.76, 95% credible interval [CrI] = 0.55-0.98 and 0.61, 95% CrI = 0.35-0.87, respectively), while in Class II patients we found a meaningful mean deviation from normal occlusion only for OI (-0.28, 95% CrI = -0.52--0.05). Concerning gender impact, male patients presented higher OI (0.30, 95% CI = 0.00-0.59) and AI (0.41, 95% CI = 0.00-0.83) mean values than female patients in Class I. CONCLUSION: Normal occlusion OI and AI mean values differ from Bolton's original values. Class II division 2, for OI mean values, and Class III, for both OI and AI, are proportionally larger than normal occlusion patients. Gender had almost no impact on teeth mesiodistal proportion.
KW - Bolton ratios
KW - meta-analysis
KW - systematic review
KW - tooth size
KW - tooth size discrepancy
UR - http://www.scopus.com/inward/record.url?scp=85080848559&partnerID=8YFLogxK
U2 - 10.1177/1465312519886322
DO - 10.1177/1465312519886322
M3 - Article
C2 - 31718451
AN - SCOPUS:85080848559
SN - 1465-3125
VL - 47
SP - 7
EP - 29
JO - Journal of Orthodontics
JF - Journal of Orthodontics
IS - 1
ER -