The mandibular dental arch: part III. Buccal expansion.

The tendency toward relapse in intercuspid width has been examined with those cases having final intercuspid width less than 27 mm showing significantly less relapse than those cases with final intercuspid width of 28 mm or more. The point of contact between the cuspid and first premolar has been introduced as a key point on the arch, determining arch width. An individualized norm has been derived for this measurement as a function of the patient's tooth size, facial pattern, and other variables based upon stable normal occlusions in treated cases. Those cases expanded to a dimension exceeding the norm by more than 1 mm showed a greater propensity toward relapse. The group following the norm was significantly more stable than the over- and underexpansion groups at the .025 significance level. An individual norm for intermolar width based upon the patient's facial pattern (using frontal and lateral X-rays) has been established. Cases showing relapse showed considerably less space between the lower molar and the JAG plane, and greater lower face height than stable cases. The results show that the space available for the permanent dentition can be estimated in advance of treatment based on the patient's own skeletal measurements, thus minimizing unnecessary extractions, relapse, and extended treatment time due to errors in diagnosis.