Original Article

Dental Arch Dimensions in Class II division 1 Malocclusions with

Mandibular Deficiency
Omar Gabriel da Silva Filhoa; Flavio Mauro Ferrari Juniorb; Terumi Okada Ozawac
ABSTRACT
Objective: To test the hypothesis that there is no difference in the dimensions of the upper and
lower dental arches in Class II division 1 malocclusion with a mandibular deficiency compared to
normal Class I occlusion dental arches.
Materials and Methods: Photocopies of the dental arches of 48 patients exhibiting Class II division 1 malocclusion with mandibular deficiency and of 51 individuals with normal occlusion were
compared. Mandibular deficiency was diagnosed clinically. All 99 individuals were in the permanent dentition. The ages of the subjects ranged from 11 years 4 months to 20 years (mean age
12 years 5 months).
Results: When compared to subjects with normal occlusion, the upper dental arches of the Class
II division 1 patients presented reduced transverse dimensions and longer sagittal dimensions
while the lower arches were less influenced.
Conclusion: The hypothesis is rejected. Significant differences are present between the dimensions of the upper and lower dental arches in Class II division 1 malocclusion (with a mandibular
deficiency and in the permanent dentition) compared to normal Class I occlusion dental arches.
KEY WORDS: Malocclusion; Angle Class II; Dental arch

INTRODUCTION

showed that about 15% of the students with mixed

dentition in Bauru, Brazil, present with mandibular deficiency, of which 11.5% are division 1 and 3.5% are
division 2.5 Therefore, Class II malocclusion is a frequent type of malocclusion and may be associated
with skeletal patterns I and II. Figure 1 shows a skeletal Class II malocclusion with mandibular deficiency.
Prior to the use of cephalometrics in orthodontics,
mandibular deficiency had already been considered
part of the Class II discrepancy. Cephalometrics confirmed this idea.614 As a consequence, functional orthopedics and orthognathic surgery gained importance
in the treatment of mandibular retropositioning. However, mandibular advancement shows the posterior
crossbite that frequently appears due to the constriction of the upper dental arch in Class II malocclusions
that is associated with mandibular deficiency (Figure
2).
Some changes can be identified in the shape of the
dental arches to differentiate the Class II malocclusion.
Studies that refer to the morphology of the upper and
lower dental arches in Class II are shown in Table 1.
It is suggested that the upper dental arch is vulnerable
to Class II discrepancy. The constriction of the upper
arch may be interpreted as transverse compensation
to mandibular retropositioning. Such constriction re-

The real prevalence of Class II malocclusion is difficult to determine because of different methods used
in studies and ethnic characteristics of the samples.
Studies show that the prevalence of Class II division
1 and division 2 malocclusions varies from 8.6%1 to
33.7%2 and from 0.6%1 to 6.7%,3 respectively. An accurate occlusal analysis performed in Brazil showed
that Class II constitutes almost 50% of the malocclusions in the deciduous4 and mixed5 dentitions.
Class II malocclusion can be constituted by upper
dental proclination, mandibular deficiency, or both. A
study relating Class II malocclusion to facial analysis
Orthodontist, Hospital for Rehabilitation of Craniofacial
Anomalies, University of Sao Paulo, Bauru, Brazil.
b
Associate Professor, PROFIS Interceptive Orthodontics
Course, Bauru, Brazil.
c
Orthodontist, Hospital for Rehabilitation of Craniofacial
Anomalies, University of Sao Paulo, Bauru, Brazil.
Corresponding author: Dr Omar Gabriel da Silva Filho, Setor
de OrtodontiaHRAC/USP, Silvio Marchione, 3-20 Vl. Universitaria, 17012-900 Bauru/SP, Brazil
(e-mail: ortoface@travelnet.com.br)
a

Accepted: July 2007. Submitted: February 2007.

 2008 by The EH Angle Education and Research Foundation,
Inc.
Angle Orthodontist, Vol 78, No 3, 2008

466

DOI: 10.2319/022307-89.1

DENTAL ARCH DIMENSIONS IN CLASS II

467

Figure 1. Orthodontic diagnosis is based on facial (1A), radiographic (1B), and occlusal (1C to 1K) analyses. Patient has Class II division 1
malocclusion with mandibular deficiency.

quires that the transverse dimensions of the upper

dental arch are increased during Class II treatment 8,15,16 whenever mandibular advancement is
planned. Involvement of the upper dental arch in Class
II malocclusions has been shown from the time of the
deciduous dentition8,1518 or from 7 years of age,18,19
and it does not self-correct until the individual reaches
mixed8,16 or permanent15,18 dentition.
Studies of permanent dentition demonstrate the influence of the sagittal discrepancy on the intra-arch
relationship. Buschang et al20 found that the upper
dental arch is narrower and longer in women with
Class II division 1 who are between 17 and 68 years
old. Sayin and Turkkahraman21 found constriction in
only the interupper second premolar and interupper
molar widths and an increase in the interlower canine
width in Class II division 1 women in the permanent
dentition at an average age of 16 years. Staley et al22
noticed constriction of the upper dental arch in the in-

tercanine and intermolar distances in Class II malocclusions, without any dimensional change in the lower
dental arch widths in young adults. Uysal et al23 found
constriction in the transverse dimensions of the upper
dental arch and in the widths of the interlower premolars and interlower molars of young adults with
Class II division 1.
Studies also show that the lower dental arch is more
vulnerable to Class II division 2. When Uysal et al23
compared Class II division 1 and 2 malocclusions,
they found that the inter-lower canine and inter-lower
premolar widths were narrower while the inter-upper
molar widths were wider in the division 2 in comparison to division 1. Buschang et al20 found reduced interlower canine and inter-lower molar distances in the
Class II division 2 related to division 1 and to Class I.
Walkow and Peck24 found narrower inter-lower canine
distances in the Class II division 2 malocclusions with
deep overbite when related to division 1.
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DA SILVA, FERRARI, OZAWA

Figure 2. Dental cast models representing Class II division 1 (AE). Simulation of the malocclusion correction (FH) with mandibular advancement shows the posterior crossbite that appears due to the maxillary transverse deficiency.

Staley et al22 suggested that the reduced transverse

dimension of the upper dental arch in Class II division
1 constriction is due to the apical bases, similar to the
data found by Alarashi et al19 and de Lux et al18 in
anteroposterior radiographs. Contrarily, Sayin and
Turkkahraman21 stated that the upper constriction is
due to dental positioning only, as they found no difference in the alveolar widths between women with Class
I and Class II malocclusions.
The current study tests the hypothesis that there is
no difference in the dimensions of the permanent dentition of upper and lower dental arches in Class II division 1 malocclusion with a mandibular deficiency
compared to normal Class I occlusion dental arches.
MATERIALS AND METHODS
Before onset, this retrospective study was revised
and approved by the Institutional Review Board of the
Hospital for Rehabilitation of Craniofacial Anomalies
Angle Orthodontist, Vol 78, No 3, 2008

(HRCA), University of Sao Paulo, Bauru, Brazil. All patients were consecutively selected from an orthodontic
archive that belongs to our hospital (HRCA).
The experimental group was composed of models
of the upper and lower dental arches of 48 patients
exhibiting Class II division 1 malocclusion with mandibular deficiency, equally matched for gender and
ranging in age from 11 years 4 months to 18 years 4
months. All subjects in this group were Caucasians in
permanent dentition, with the second molars either
erupted or erupting, and the patients demonstrated untreated Class II division 1 malocclusions with a symmetric sagittal discrepancy of at least 4 mm in the premolar relationship. The selection of individuals was
clinical and based on a soft-tissue profile analysis, with
special attention to the nasolabial angle, which indicates participation of the maxilla in the malocclusion.
All patients of the sample presented a satisfactory nasolabial angle, showing that the Class II malocclusion

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DENTAL ARCH DIMENSIONS IN CLASS II

Table 1. Studies Relating the Dental Arch Behavior to Class II Malocclusiona
Class II Sample
Author

Year

Age

Control Sample
n

Age

Baccetti et
al8

1997

5 y 8 mo and 8 y 1
mo (longitudinal
study)

25 (13 M,
12 F)

5 y 5 mo and 7 y 8
mo (longitudinal
study)

Bishara et
al15

1996

37 (15 M,
22 F)

Buschang
et al20

1994

Stage 1: 5.1 M, 5 F
Stage 2: 8.2 M, 8.5 F
Stage 3: 12.7 M,
12.8 F (longitudinal study)
Between 17 and 25 y

Stage 1: 4.9 M, 5 F
Stage 2: 7.8 M, 8.1 F
Stage 3: 13 M, 13.1
F (longitudinal
study)
Between 17 and 25 y

Lux et al18b

2003

Between 25 and 35 y
More than 35 y
From 7 to 15 y (longitudinal study)

145 F

121 Cl II/2
24 Cl II/1
Cl II/1: 17 (8
M, 9 F)
Cl II/2: 12 (8
M, 4 F)

Between 25 and 35 y
More than 35 y
From 7 to 15 y (longitudinal study)

Sayin and
2004
Turkkaharaman21

16.07 y

30 F

19.17 y

Staley et
al22

1985

22.1 y M, 18 years F

39 (20 M
and 19 F)

20.6 y M, 16 y F

Uysal et al23

2005

17.2 y (Cl II/1) 18.5

y (Cl II/2)

Walkow and
Peck24

2002

12.4 y

Cl I/1: 106
(45 M, 61 F)
Cl II/2: 108
(45 M, 63 F)
23 Cl II/2
(20 M, 3 F)

a
b

21.6 y

12.4 y

n
22 (9 M, 13 F)

55 (28 M,
27 F)

241 F

150 (72 M,
78 F)

46 (paired
with Cl II/2
group)

Measurements

University of
Michigan/
University of
Florence
University of
Iowa

Transverse
(upper and
lower dental
arches)
Sagittal and
transverse
(upper and
lower dental
arches)
Sagittal, transverse, and
condition of
the incisors

CL I: 37 (19
M, 18 F)
Normal occlusion: 18
(10 M, 8 F)
30 F

36 (19 M,
17 F)

Origin

Belfast Growth
Study

Transverse
(upper and
lower dental
arches)

University of
Suleyman
Demirel,
Turkey
University of
Iowa

Transverse
(upper and
lower dental
arches)
Transverse
(upper and
lower dental
arches)
Transverse
(upper and
lower dental
arches)
Transverse

University of
Selcuk, Turkey
Harvard University

Most studies were made on the basis of cast models.

The method included anteroposterior radiographs.

was due to mandibular deficiency. To standardize the

sample, patients with protrusive maxillas (ie, obtuse
nasolabial angle) were not included. Figures 1 and 2
illustrate the characteristics of the Class II sample.
The control group was composed of cast models of
the upper and lower arches of 29 females and 22
males (n 51) with normal occlusion and harmonious
faces ranging in age from 11 to 20 years. The mean
age for the experimental and control groups was 12
years 5 months (SD 1 year 3 months).
All cast models were selected from the archive of
the HRCA. The control normal occlusion patients were
selected from the normal occlusion archive of the
HRCA.
The transverse and sagittal dimensions of the dental
arches were measured on photocopies of the upper
and lower cast models of the experimental and control

groups. All dental casts were placed on the central

part of the glass surface of a photocopy machine
(PRO 40; Xerox, Hertfordshire, UK) with the occlusal
aspects of the teeth facing the glass. Photocopies of
the models were obtained in a standardized manner.
Care was taken to maintain the occlusal plane of the
models parallel to the glass copying surface. Previous
studies have shown no distortion in images obtained
from photocopies.16,25,26
The images of the models were measured with a
digital caliper. The transverse distances of the canines
were measured between their cusp tips. The premolar
widths were measured between their buccal cusps.
The molar widths were measured between the mesiobuccal cusps of the first molars. The sagittal dimension
of the models was determined by the distance from
the midpoint of the central incisors to the midpoint of
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DA SILVA, FERRARI, OZAWA

was close to 0.5 mm, which gives high reliability to the

measurements obtained in this study.
Descriptive statistics were illustrated by means of
tables and graphs. A Students t-test was used to
check whether gender and malocclusion influenced
the dimensions of the dental arches. Significance levels were 5% (P .05) and 1% (P .01).
RESULTS
Means and standard deviations were obtained for
the transverse and sagittal measurements of the upper
and lower dental arches of the sample groups, separated by gender. A Students t-test was applied to verify sexual dimorphism. Statistical values are expressed
in Tables 2 and 3. Table 2 shows that all dimensions
of the upper and lower dental arches with normal occlusion presented higher values for males, about 2.25
mm for the upper arch and 1.6 mm for the lower arch.
Table 3 shows the results for the study group and
demonstrates that the widths of the interupper first
premolars, interupper molars, interlower canines, interlower first premolars, and interlower second premolars showed statistically significant differences related to gender. Figures 4 and 5 depict the measurements shown in Tables 2 and 3 for the upper and lower dental arches, respectively.
Tables 4 and 5 show the differences in the Class II
and normal occlusion groups. The measurements of
the upper (Table 4) and lower (Table 5) dental arches
were compared separately for the groups with normal
occlusion and Class II division 1. Except for the intercanine distance in the females, all measurements of
the upper dental arch in patients with Class II were
different from those of subjects with normal occlusion.
Table 6 presents the differences in the sagittal and
transverse dimensions of the upper arch with Class II
when compared to the normal occlusion group, while
Table 7 shows that the average difference between
the dental arch widths in the normal occlusion group
gradually decreases from 8.7 mm in the canine area
to 6.7 mm in the molar area. This difference is clearly

Figure 3. Assessment of the dimensions of the upper and lower

arches obtained from the measurement of the intercanines (3-3),
interfirst premolars (4-4), intersecond premolars (5-5), interfirst
molars (6-6), and sagittal dimensions.

a line tangent to the distal aspect of the first molars

(Figure 3). Means and standard deviations were obtained for the transverse (3-3, 4-4, 5-5, 6-6) and sagittal dimensions for the upper and lower dental arches
in both groups.
The measurements were repeated by two examiners in some pairs of randomly selected models within
1 week. In all measurements, the error of the method

Table 2. Means (x), Standard Deviations (SD), and Students t-Test for the Transverse and Sagittal Dimensions of the Upper and Lower
Dental Arches in the Normal Occlusion Group, According to Sex
Upper Dental Arch
Male (n 22)

Lower Dental Arch

Female (n 29)

Male (n 22)

Female (n 29)

Dimension

SD

SD

SD

SD

Anteroposterior
Intercanines
Interfirst premolars
Intersecond premolars
Interfirst molars

38.88
35.98
43.78
49.37
54.21

2.02
2.32
2.37
2.96
3.58

36.34
33.73
41.72
46.88
52.24

1.94
2.19
2.18
2.34
2.81

**
**
**
**
*

34.28
26.88
35.51
41.23
46.91

1.86
1.84
2.15
2.42
2.81

32.15
25.44
33.62
39.86
45.62

1.96
1.96
2.16
2.42
2.58

**
**
**
**
*

* Significant at 5%.
** Significant at 1%.
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DENTAL ARCH DIMENSIONS IN CLASS II

Table 3. Means (x), Standard Deviations (SD), and Students t-Test for the Transverse and Sagittal Dimensions of the Upper and Lower
Dental Arches in the Class II Group, According to Sexa
Upper Dental Arch
Male (n 24)

Lower Dental Arch

Female (n 24)

Male (n 24)

Female (n 24)

Dimension

SD

SD

SD

SD

Anteroposterior
Intercanines
Interfirst premolars
Intersecond premolars
Interfirst molars

41.33
34.25
39.58
44.25
49.77

2.92
2.92
2.43
3.55
2.53

41.18
32.91
37.30
42.54
47.45

2.36
1.88
2.11
2.48
2.09

NS
NS
**
NS
**

35.19
27.32
34.35
40.22
45.06

3.05
2.14
2.59
2.81
2.33

34.96
26.12
32.56
38.07
43.79

1.52
1.78
2.36
3.19
2.81

NS
*
*
*
NS

DP indicates ; NS, nonsignificant.

* Significant at 5%.
** Significant at 1%.

Figure 4. Sagittal and transverse dimensions of the upper arch in

normal and Class II division 1 males and females.
Figure 5. Sagittal and transverse dimensions of the lower arch in
normal and Class II division 1 males and females.

smaller in the Class II group (Table 8), decreasing

from 6.8 mm to 4.2 mm.

permanent dentition. Forty-eight subjects exhibited untreated Class II division 1, while 51 showed normal
occlusion. The sample included patients in permanent
dentition because the sagittal and transverse dimensions of the dental arches at this time are practically
defined and because this is the age when most patients seek orthodontic treatment. Longitudinal studies
suggest that the dimensions of the dental arches tend
to stabilize after 13 years of age in girls and 16 years
in boys,9,2730 although the dimensional changes that

DISCUSSION
This study aimed to determine the influence that the
Class II malocclusion with a mandibular deficiency has
on the dimensions of the dental arches. Studies rarely
include Class II patients with mandibular retropositioning; thus, we decided to standardize our sample on
the basis of mandibular deficiency. All 99 cast models
analyzed represented the occlusion of subjects with

Table 4. Statistical Comparison (Students t-Test) for the Transverse and Sagittal Dimensions of the Upper Dental Arch Between Normal and
Class II Groups for Males and Femalesa
Males
Normal (n 22)

Females

Class II (n 24)

Normal (n 29)

Class II (n 24)

Dimension

SD

SD

SD

SD

Anteroposterior
Intercanines
Interfirst premolars
Intersecond premolars
Interfirst molars

38.88
35.98
43.78
49.37
54.21

2.02
2.32
2.37
2.96
3.58

41.33
34.25
39.58
44.25
49.77

2.92
2.92
2.43
3.55
2.53

**
*
**
**
**

36.34
33.73
41.72
46.88
52.24

1.94
2.19
2.18
2.34
2.81

41.18
32.91
37.30
42.54
47.45

2.36
1.88
2.11
2.48
2.09

**
NS
**
**
**

NS indicates nonsignificant.
* Significant at 5%.
** Significant at 1%.

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DA SILVA, FERRARI, OZAWA

influence the intra-arch dental positioning are unpredictable and may occur anytime in normal occlusions.31
The results in Table 2 show higher values for males
and are consistent with prior studies that assessed
dental arch dimensions.2729 However, in our study, the
Class II group did not show the same differences (Table 3). Only the widths of the interupper first premolars, interupper molars, interlower canines, inter
lower first premolars, and interlower second premolars showed statistically significant differences related
to gender. Class II malocclusion seems to minimize
the influence of gender on the dimensions of the lower
and, mainly, upper dental arch. Therefore, sexual dimorphism influenced all sagittal and transverse dimensions of the dental arches in individuals with normal
occlusion and some transverse dimensions in Class II
individuals. Because many dimensions were influenced by gender, the normal occlusion and the Class
II groups were compared according to gender. This
comparison is shown in Tables 4 and 5.
Class II malocclusions seem to induce changes in
the dimensions and, consequently, the upper dental
arch shape. With regard to the sagittal dimensions, the
findings show statistically significant differences between the normal and Class II groups. Subjects with
Class II malocclusion presented with longer upper
dental arches, most likely due to the proclination of the
upper incisors. The upper dental arch in the Class II
subjects presented with lesser transverse dimensions
(Table 4) and a typical triangular shape (Figures 1 and
2). A statistically significant difference was noticed in
all measurements except in the upper intercanine distance in females.
Table 6 shows the sagittal and transverse differences between both groups, which indicate the average
amount of expansion needed in the upper arch to
transversely fit it to the advanced mandible in Class I
patients. Therefore, constriction of the upper dental
arch is not generally accompanied by posterior cross-

bite in the Class II division 1 patients. It has been suggested that constriction of the upper arch in the Class
II patients is due to constriction of the nasomaxilary
complex, identified in posteroanterior radiographs.19,25
Frontal cephalograms show alterations in the upper
dental arch with no transverse changes in the mandible and lower dental arch.19,25
Similar to other researchers (Table 1), Frohlich32
studied a longitudinal sample of 51 children aged 6 to
12 years and noticed that the sagittal discrepancy remained during the follow-up period, with an increase
of the overjet and overbite after eruption of the permanent incisors. However, no difference was found in
the dimensions of the dental arches with Class II. Such
a contradiction is probably explained because the
Class II divisions 1 and 2 subjects were gathered together in that sample. The current research does not
confirm Frohlichs32 results. On the contrary, our results agree with several other studies that have shown
changes in the shapes of dental arches with Class II
malocclusion.19,2123,27
Despite other factors related to the upper arch constriction, such as oral breathing, prolonged sucking
habits, and inadequate positioning and function of the
tongue, the transverse adaptation of the upper arch to
the lower arch may not be neglected. Such adaptation
happens naturally as a transverse compensation of
the upper arch to the retropositioning of the lower arch
and is typical of Class II division 1 malocclusions.
Therefore, dental compensation in Class II is neither
restricted to the sagittal dimensions nor to the incisors.
An accurate orthodontic tridimensional morphologic
evaluation (Figures 1 and 2) would provide a complete
and correct interpretation of the sagittal, transverse,
and vertical alterations found in Class II malocclusions. The current study focuses on the transverse
changes and corroborates the need for expanding the
upper arch prior to mandibular advancement. The clinical confirmation of the upper arch constriction is evidenced by the posterior crossbite that results when the

Table 5. Statistical Comparison (Students t-Test) for the Transverse and Sagittal Dimensions of the Lower Dental Arch Between Normal and
Class II Groups for Males and Femalesa
Males
Normal (n 22)

Females

Class II (n 24)

Normal (n 29)

Class II (n 24)

Dimension

SD

SD

SD

SD

Anteroposterior
Intercanines
Interfirst premolars
Intersecond premolars
Interfirst molars

34.28
26.88
35.51
41.33
46.91

1.86
1.84
2.15
2.42
2.81

35.19
27.32
34.35
40.22
45.06

3.05
2.14
2.59
2.81
2.33

NS
NS
NS
NS
*

32.15
25.44
33.62
39.86
45.62

1.96
1.96
2.16
2.42
2.58

34.96
26.12
32.56
38.07
43.79

1.52
1.78
2.36
3.19
2.81

**
NS
NS
*
*

a
NS indicates nonsignificant.
* Significant at 5%.
** Significant at 1%.

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DENTAL ARCH DIMENSIONS IN CLASS II

Table 6. Differences in the Transverse and Sagittal Dimensions of
the Upper Dental Arch Between Normal and Class II Groups (mm)a

InterAnteroposterior canines
Males
Females
Mean

2.45
4.84
3.64

1.17
0.82
0.99

Inter
First
Premolars

Inter
Second
Premolars

Inter
First
Molars

4.20
4.42
4.31

5.12
4.34
4.73

4.44
4.79
4.61

The numbers represent the error in the upper dental arch in

Class II malocclusion.
a

by Sayin and Turkkahramam21 and Frohlich.32 The former authors noticed changes in the lower intercanine
width in women (mean age 16 years) that were
greater in Class II subjects, while the latter did not find
any influence of Class II on the lower dental arch in
growing children.
Constriction of the upper dental arch in Class II division 1 malocclusion is reflected in the differences between the transverse dimensions of the upper and
lower arches.
CONCLUSION

Table 7. Differences Between the Dimensions of the Upper and

Lower Dental Arches in the Normal Occlusion Sample (mm)

Anteroposterior
Intercanines
Interfirst premolars
Intersecond premolars
Interfirst molars

Males

Females

Mean

4.60
9.10
8.27
8.14
7.30

4.20
8.29
8.10
7.02
6.62

4.40
8.70
8.20
7.60
6.70

The hypothesis is rejected. Significant differences

are present between the dimensions of the upper
and lower dental arches in Class II division 1 malocclusion (with a mandibular deficiency and in the
permanent dentition) compared to normal Class I occlusion dental arches.
REFERENCES

Table 8. Differences Between the Dimensions of the Upper and

Lower Dental Arches in the Class II Sample (mm)

Anteroposterior
Intercanines
Interfirst premolars
Intersecond premolars
Interfirst molars

Males

Females

Mean

6.14
6.93
5.23
4.03
4.71

6.22
6.79
4.74
4.47
3.66

6.20
6.80
5.00
4.20
4.20

mandible is advanced and implies the achievement of

a well-balanced final lateral relationship between the
upper and lower arches following mandibular advancement.
The lower dental arch in Class II malocclusion (Table 5) shows more subtle changes that are restricted
to its greater length and to the smaller interpremolar
and intermolar dimensions, with statistical significance
for females only. The longer lower arch is due to proclination of the lower incisors, which characterizes the
dental compensation in Class II. The wide variation in
the positioning of the lower incisors in Class II, from
proclination to retroclination, has possibly camouflaged the statistical significance in males. Therefore,
even if the lower arch tends to be longer, the difference between the upper and lower arches in comparison to normal occlusion (Table 7) is greater in Class
II (Table 8).
The tendency for posterior constriction of the lower
arch may be interpreted as accommodation to the upper arch constriction. In our study, the characteristic of
the lower arch was similar to that registered by Uysal
et al,23 who found reduced interpremolar and intermolar widths. Our results are not similar to those found

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