Dynamic relationships of the mandibular

anterior segment
Stanley Braun, DDS, MME, a and William P. Hnat, PhD b

Indianapolis, Ind., and Louisville, Ky.

The hyperbolic cosine function is shown to be an accurate representation of the form of the
mandibular anterior teeth from the canine/first premolar contact on one side around the perimeter
to the opposite side (r = 0.951). On the basis of this mathematical function, the changes in canine
width, anterior segment depth, arch perimeter, and their related incisor angular alterations are
forecastable. This knowledge will allow the clinician to predict the effects on various aspects of the
anterior segment arch form as one or more of these variables are altered without resorting to trial
and error or performing a wax-up. For example, the clinician can predict the change in the anterior
segment arch depth and incisor angulation that would occur with alterations in canine width. (Am J
Orthod Dentofac Orthop 1997;111:518-24.)

number of orthodontic treatment modalities incorporate intercanine width expansion to

reconcile arch length deficiencies. 14 Incisor flaring
has also been used to achieve this same goal, as well
as to provide increased lip support. 6-9 In addition,
altering the arch perimeter through reproximation
of the anterior teeth has been used to reconcile
small arch length deficiencies. These alterations in
the form of the anterior segment may influence the
stability of the dentition. Clinicians may therefore
choose to introduce long-term retention. 1-13 Various investigators have also documented a natural
change in the form of the anterior segment through
a decrease in the intercanine width over time in both
treated and untreated persons. 14-2
These changes, whether occurring naturally or
through orthodontic treatment, are not isolated. For
example, when the intercanine width is altered,
there is a related change in the arch perimeter and
in the position of the incisors. In addition, as the arch
perimeter is changed, the anterior segment depth is
altered (Fig. 1). The interrelationships between intercanine width, anterior segment depth, anterior arch
perimeter, and incisor angulation are not known with
any degree of surety. Ricketts et al., 22 suggested that
for each millimeter of incisor advancement, the anterior arch perimeter is increased by 2 mm, and that 1
mm of intercanine width increase creates a 1 mm
increase in anterior arch perimeter.
~Clinical professor of orthodontics, Vanderbilt University and University
of Illinois at Chicago.
bAssociate professor of mechanical engineering, Speed Scientific School,
University of Louisville.
Reprint requests to: Dr. Stanley Braun, 7940 Dean Rd., Indianapolis, IN
46240.
Copyright 1997 by the American Association of Orthodontists.
0889-5406/97/$5.00 + 0 8/1/71079

518

Canine/F'LrSt Premolax
Normal Contact

I~
- -

~l

Intercanine Width (W)

Segment Depth (D)

M3
tan = - 9.4+4.8

o= t,.

.,:.

)I/

14.22

Fig. 1. Illustration of dimensions of mandibular anterior

segment and of typical mandibular central incisor. 21

This investigation establishes the mathematical

relationships between the related variables previously mentioned so that the effects of a particular
treatment modality may be forecast with increased
accuracy.
METHODS AND MATERIALS

Twenty-one mandibular casts of untreated patients

that showed zero to minimal anterior segment irregularities were selected. In addition, each cast showed a fully

Braun and Hnat

American Journal of Orthodontics and Dentofacial Orthopedics

Volume 111, No. 5

519

Fig. 2. Brown and Sharp MicroVal Coordinate Measuring Machine.

developed, complete dentition less third molars. Casts
exhibiting incisal or cuspal attrition, or fracture, or ectopically erupted teeth were not included.
Each cast was oriented in a Brown and Sharp MicroVal
Coordinate Measuring Machine (Brown and Sharp) as seen
in Fig. 2. This device is used extensively in the precision
machine tool industry. A frictionless air-bearing probe resolves the coordinates of a point in space in each of the three
orthogonal axes to 0.001 mm. Linear accuracy is 0.006 mm,
and reproducibility is 0.004 ram. The casts were each secured
to a fixed plane, and the touch trigger probe used to identify
each measurement point, recording the corresponding X, Y,
and Z coordinates automatically to a data file.
Measurements were made at each canine cusp tip, the
center of each incisor incisal edge, and the normal contacts between the first premolars and canines. The coordinate components of the anterior dental arch form in
three-dimensional space for each of the 21 casts were
recorded in this manner. A planar projection of the
mandibular anterior segment was subsequently obtained
by reducing the Z coordinates of each point to zero. A
reproducibility study that used one cast was conducted to
evaluate the variation of these measurements. The results
revealed the mean deviation to be less than 0.5%. All
measurements were made by the same operator (W.H.).
An analytical equation of the anterior segment shape
is required to describe the relationships between the
intercanine width, anterior segment depth, anterior arch
perimeter, and incisor angulation. This shape closely
resembles a hyperbolic cosine function as illustrated in
Fig. 3. 24 Thus the generalized equation of the mandibular
anterior segment shape may be expressed as

coshE cosh
X

1,] +D+,

where W represents half the crossarch distance from the

normal canine/first premolar contact on one side to the
opposite side in millimeters, and D the perpendicular
distance from the most anterior point between the two
central incisors to the crossarch dimension in millimeters.
The arch perimeter may then be calculated using

L=

f+w~

1+

(d~)2

dX

where L is the anterior segment arch perimeter from the

canine/first premolar normal contact along the arch to the
opposite side in millimeters. Taking the derivative of Y
with respect to X in the first equation and substituting it
into the second equation yields

lw

.,.2r

,rXcosh-'(D+

2 + [cosh_l(D + 1) j [ csnL

L =

+w

[cosh-l(D + 1)]2
W2

1)

]]2
dX

The relationship between anterior arch depth (/7)), anterior arch perimeter (L), and arch intercanine/first premolar
arch width (W), is thus described. The millimetric measurements are obtained through numerical integration of the
coordinates of each point of the anterior segment previously
described with MathCad 5.0 for Windows (MathSoft Inc.).
The related angular change for a typical mandibular incisor
is given by the formula

\14.2/
where ZXDis the change in depth of the anterior segment
in millimeters (Fig. 1).

520 Braun and Hnat

American Journal of Orthodontics and Dentfacial Orthopedics

May 1997

i 4

~ 21
3 ~

__

Y.... h[~ cosh-1(?.9842

+I) +?.9842+I, r =49.0

-15

-12

-9

-6

-3

12

15

Intercanine Width (2W) (mm)

Fig. 3. Anterior dental arch shape of hyperbolic cosign function for cast no. 1. (Typical of
21 casts.)
T a b l e I. C a l c u l a t e d d a t a o f 21 c a s t s f r o m m e a s u r e d
coordinates

Cast measurements
Intercanine
width

Anteriorsegment
depth

Segment
perimeter

(mm)

(ram)

(mm)

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21

28.880
24.722
26.978
27.868
23.983
25.867
28.168
26.786
22.496
24.672
31.289
24.400
28.838
28.183
27.063
28.874
28.993
27.996
28.498
27.084
27.352

8.284
10.364
7.610
8.405
6.985
8.100
8.496
10.200
7.839
8.597
10.074
8.717
10.034
7.694
7.945
9.490
10.443
10.762
8.866
6.965
8.430

33.848
33.506
31.436
33.053
28.095
31.484
34.091
35.321
27.158
32.566
38.040
29.153
36.282
33.547
32.153
36.827
37.570
37.238
34.944
33.472
34.865

Mean
SD
Maximum
Minimum

27.095
2.042
31.289
22.496

8.776
1.128
10.762
6.965

33.555
2.905
38.040
27.158

Cast

RESULTS

The calculated data of each of the 21 casts are

shown in Table I. Each of the integrations was based
on the X and Y coordinates obtained from the
MicroVal Coordinate Measuring Machine.

The m e a n value of the canine/first premolar

normal contact crossarch dimension (W) is 27.0 m m
with a standard deviation of _+2 mm. The maximum
dimension is 31.3 m m and the minimal dimension
22.5 mm. The mean value of the anterior segment
depth (D) is 8.8 m m with a standard deviation of _+1
ram. The maximum depth is 10.8 m m and the
minimum 7 mm. The mean anterior segment perimeter (L), is 33.6 m m with a standard deviation of
_+3 mm. The maximum perimeter is 38 m m and the
minimum 27.2 mm.
The relationship of the anterior segment arch
depth (D) to various intercanine widths for the
m e a n arch perimeter is given by the formula D =
-0.655W. The correlation coefficient of this relationship is r = 0.922. This relationship alters to D =
- 0 . 6 2 2 W (r = 0.995) for an arch length of +1
standard deviation from the mean, and to D =
- 0 . 7 1 4 W (r = 0.983) for - 1 standard deviation.
These relationships are shown graphically in
Fig. 4.
The relationship of the incisor angular change
(A) to the intercanine width (W) is shown
graphically in Fig. 5, and is expressed by the
formula A = - 2 . 6 0 9 W (r = 0.992) for the m e a n
arch p e r i m e t e r of 33.5 m m . This alters to A =
- 2 . 4 8 0 W (r = 0.995) for + 1 standard deviation in
arch p e r i m e t e r , and to A = - 2 . 8 3 4 W (r = 0.984)
for - 1 standard deviation in arch perimeter.
The alteration of incisor angle with respect to
arch perimeter change is given by the equation
2~ = 2.874 (2xL) - 1.678 (r = 0.993) for the

American Journal of Orthodontics and Dentofacial Orthopedics

Volume 111, No. 5

Braun and Hnat

521

ir'o ~
~ ' - O ~
~

,
"'''m'-

+ 1 S.D. Segment Perimeter = 36.5 m m

Mean Slope = -0.622
r = 0.995

~ ~11
~ ~ ~

~
"1!""""

",

.'~/'/

"'"""-...

""
"'"'""-..,.

-1 S.D. Segment Perimeter = 30.5 m m

.,, '-.

Mean Segment Perimeter = 33.6 m m

Mean Slope = -0.655
r = 0.992
0
20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

Intereanine Width (ram)

Fig. 4. Relationship between anterior segment depth to intercanine width for given arch
perimeters.

.%

o
" .,,

+1 S.D. Segment Perimeter = 36.5 m m

/
Mean Slope =-2.480
/ "
r = 0.995

~ ~
O ~

~'11~

~ ~1"~ ,,.
~

"'-'..

-.J

"..'.....,.

6
~" " "" ~ "
=
<

" ~

" ~ l l

-5

~= -10

-1 S.D. Segment Perimeter = 30.5 m m

Mean Slope = -2,834
r =0.984

-15

\
\

Mean Segment Perimeter = 33.6 m m

Mean Slope = -2.609
r - 0.992

-20

-25
20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

lntereanine Width (ram)

Fig. 5. Incisor angular change versus intercanine width alterations for given anterior
segment perimeters.
complete range of intercanine widths from 22.5 to
31.3 mm. This is seen graphically in Fig. 6.
Anterior depth changes (AD) related to changes
in arch perimeter (AL) are given by the equation

AD = 0.743 (AL) - 0.439 (r = 0.993) for the range

of intercanine widths from 22.5 to 31.3 mm. This is
seen graphically in Fig. 7.
The change in intercanine widths AW, related to

522 Braun and Hnat

American Journal of Orthodontics and Dentofacial Orthopedics

May 1997

25

20
15

1o
~ ~ ~

AO = 2,874(&L) - 1.678, r = 0.993

o
-5

-4

-3

-5

-2 ~

~ . , ~
..~,~

-10

Intercanine Width

"w-

,It

~
~ /

-15
~
-20

22.5
25.0
27.0
29.0

mm
mm
ram
mm

-~-2 31.2emFit

/~,/"

Corresponding Initial
Arch Perimeter
27.0
31.0
33.6
36.0

mm
mm
mm
mm

38.0 m m

-25

Change in Anterior Arch Perimeter from Initial Mean Value (ram)

Fig. 6. Incisor angular change versus anterior arch perimeter for given intercanine widths.

I
o~
o
r~

u~

.=
<

.=.
=%

-----e--- 22.5 gtm (Min. Width)

"-..4f"

- - 1 1 - - 2 5 . 0 ram (-1 S. D.)

~ / ~

~ / "

27.0 m m (Mean)

- - - A - - 29.0 m m (+1 S. D.)

~ . ~

- - - e - - 31.2 m m 0Vlax. Width)

-- - - Linear Fit

Change in Arch Perimeter from InitialMean Value (ram)

Fig. 7, Change in anterior segment depth versus change in anterior arch perimeter for
various intercanine widths.

changes in arch perimeter AL, is given by the

equation 2iW = 1.284 (AL) - 0.143 (r = 0.998) for
the complete range of arch depths from 7.00 to
10.76 mm. This is seen graphically in Fig. 8.
DISCUSSION

This study has developed a hyperbolic cosine

equation that describes the mandibular anterior
segment with a high degree of accuracy (r = 0.951).
Through numerical integration, mathematical relationships have been developed between intercanine
width (W), the anterior segment perimeter (L), the
anterior segment arch depth (D), and the change in
mandibular incisor angulation (19).
Specifically, if the anterior segment perimeter is

not reduced by reproximation or increased through

realignment of overlapped teeth, the mean relationship of the anterior segment depth (D) to the
intercanine width (W) is given by the formula D =
-0.655(W)*(r = 0.992). The corresponding mean
incisor angular change (A), is given by the formula
A = -2.609(AW) (r = 0.992). As an example, the
clinician may use this information as follows: If the
anterior arch perimeter is kept constant, and the
intercanine width increased 4 ram, the segment
depth will decrease 2.6 mm (D = -0.655 4). That
is, the central incisor incisal tip will fall back 2.6 mm.
The corresponding angular decrease in the incisor
*It is important that the W be plus or minus, corresponding to an
intercanine width increase or decrease.

Braun and Hnat

American Journal of Orthodontics and Dentfacial Orthopedics

Volume 111, No. 5

523

10

8
6
4
2
0

J
-2
-4

7 . 6 ; ~ n ' ( - 1 S. D~) "

-6

-a!

----

Linear Fit

-10

Changein Arch Perimeter (mm)

Fig. 8. Alteration of intercanine width versus change in arch perimeter for various anterior
segment depths.

Table II. M a t h e m a t i c a l r e l a t i o n s h i p s o f t h e a n t e r i o r s e g m e n t f o r s e l e c t e d t r e a t m e n t o b j e c t i v e s
Variable factor

Constant factor*

Arch segment depth

Intercanine width

Arch p e r i m e t e r
AL = 0
Intercanine width
AW = 0
Segment depth
AD = 0

AD = - 0 . 6 5 5 (_+AW)

AW = - 1 . 5 2 7 ( + A D )

AD = 0.743 (_+AL) - 0.439

AW = 0

AD = 0

AW = 1.284 (--AL)

Incisor angulation

0.143

A =

2.609 (_+AW)

Segment perimeter
~L = 0

A = 2.874 ( + A L ) - 1.678

AL = 1.346 (+_AD) + 0.591

A = 0

AL - 0.779 (-+AW) + 0.111

* T r e a t m e n t objective.

inclination will be 10.4 . (A = -2.609 4). If the

intercanine width is held constant and the arch
perimeter is either increased or decreased, the arch
depth (D) is altered to the formula AD = 0.743 (AL)
- 0.439* (r = 0.993). The corresponding mean
incisor angular change (AO), is given by the formula
A = 2.874 (AL) - 1.678 (r = 0.993). This information may be used by the clinician as follows: If an
arch length inadequacy of 7 mm exists and the
clinician desires to align the anterior teeth by flaring
the incisors without altering the intercanine width,
the anterior arch depth will increase 4.8 mm (AD =
0.743(7) - 0.439). This relates to the incisal tip
moving anteriorly the same distance. The angular
*It is important the A L be plus or minus, corresponding to an arch
p e r i m e t e r increase or decrease.

change will be +18.4 (A = 2.874(7) - 1.678). In

the case where the clinician may wish to reduce the
inadequacy by 4 mm reproximation, the arch depth
will increase 1.8 mm (AD = 0.743(7 - 4) - 0.439)
instead of 4.8 mm, and the corresponding incisor
angular change will be 6.9 (AO = 2.874(7 - 4) 1.678) in lieu of 18.4 .
If the anterior segment depth is kept constant for
reasons of facial profile or perceived dental stability,
the relationship between intercanine width alterations to anterior segment perimeter changes is
given by the formula AW = 1.284(AL) - 0.143 (r =
0.998). The clinician may use these relationships
as follows: If a 5 mm arch perimeter deficiency is
present (teeth overlapped) and the A-P incisor
position (arch depth) is to be maintained, then the

524 Braun and Hnat

intercanine width must be increased 6.3 mm (AW =

1.284(5) - 0.143) to achieve this objective.
CONCLUSIONS

The above relationships are of value in treatment

planning. The outcome in anterior arch perimeter, depth,
and incisor angular change can be forecast with accuracy
(r = 0.951) without resorting to trial and error or doing a
wax-up. For ready access, these mathematical relationships are summarized in Table II.
Although this study has established the interrelationships of important clinical factors in altering the form of
the anterior segment, this study should not be construed
as an endorsement of any particular treatment modality.
Because the hyperbolic cosine function has provided
high correlation coefficients for the anterior dental segment, further analysis should be considered as to whether
this function can be applied to the entire dental arch.
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