Tuesday, October 15, 2013

UG Model analysis Ashley Howe's index

ASHLEY  HOWE’S  ANALYSIS
Parameters
·      TTM - Refers to sum of the mesiodistal width of the teeth from first molar to first molar

·      Premolar width (PMD) - Arch width is measured from the buccal cusp tips of the first premolar on one side to the buccal cusp tip on other side

·      PMBAW (premolar basal arch width) -  measured from the root apices of the first premolar on one side to the first premolar on other side

FIG 20  : Placement of dividers distal to the canine eminence to measure PMBAW
·      





Canine Fossa width - Measurement of width from canine fossa (immediate distal to canine root eminence) of one side to the other (Fig 20) gives us the width of the dental arch at the apical base or the junction between the basal bone & alveolar process

       If canine fossa is not clear,  measurement is made from a point that is 8 mm below the crest of interdental papilla distal to canine




Following measurements have to be obtained
1.    Percentage of PMD to TTM
                  PMD X 100
                      TTM
2.    Percentage of PMBAW to TTM
                 PMBAW X 100
                         TTM
       
       Inference           
  If PMBAW > PMD :-
   it is an indication that basal arch is sufficient to allow expansion
  If PMD > PMBAW :-
    Can be three possibilities
   1) Contraindicated for expansion
   2) Move teeth distally
   3) Extract some teeth

       According to Ashley Howe, to achieve normal occlusion with a full complement of teeth PMBAW should be 44% of TTM

       Therefore if PMBAW X 100/TTM is:
   a) if 37% or less             case requires extraction   
   b) if 44% or more             treatment by non-extraction

   c) if between 37-44%             (border line case) may/may not require extraction                 

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