This analysis was formulated in the year 2014 at Al-Badar Dental College and Hospital, Gulbarga, Karnataka. Formulation of this analysis is done, taking the reference of literature and proved facts about the cephalograms and superimpositions, along with the lines and concepts used in various stable analyses [11–15].

The materials required for analysis are as follows:

Landmarks Used:

On lateral cephalogram:

On OPG:

Analysis on Lateral Cephalogram [Table/Fig 1]:

[Table/Fig-1]:

Lateral Cephalogram Tracing

SN Plane – Sella Nasion Plane

TH plane – True Horizontal plane (7 degree to SN Plane)

TV Plane – True Vertical Plane (Perpendicular line to True horizontal at Sella)

A line – Line parallel to TH plane and Perpendicular to TV plane to the mesial surface of molar.

B line - Line parallel to TH plane and Perpendicular to TV plane to the mesial root tip of molar.

MDP – Perpendicular bisector of line joining cusp tips of molar.

Alpha angle – Distal angle of MDP to TH plane

Similarly, can make use of OPG for analysis of the type of tooth movement.

OPG Analysis [Table/Fig-2]:

[Table/Fig-2]:

OPG tracing

OO Line – Line joining Orbital points

MDP – Perpendicular bisector of line joining cusp tips of molar.

Beta angle – Distal angle of MDP to OO line

Other assessments:

Uses: This analysis can be used for assessing the following:

Advantages:

Limitations:

Various types of tooth movement are performed orthodontically among which bodily tooth movement is the dream tooth movement for orthodontists. Various types of tooth movements are Tipping (Controlled and Uncontrolled), Bodily tooth movement, torquing, & rotations. The easiest type of tooth movement is uncontrolled tipping which frequently occurs in the initial wires during fixed mechanotherapy. The most difficult of all is torquing. Thereby to prevent torque loss, the bodily tooth movement is tried to be achieved.

Various appliances are used to perform molar distalization, which again should move bodily [17]. Various appliances presently available claims to achieve bodily tooth movement & the method to assess the relative amount and type of tooth movement achieved is by superimposition but no literature is available till date to quantify or suggest the type and amount of tooth movement achieved during molar distalization. Thereby the need for the same was tried to be fulfilled by introduction of this Analysis. The idea behind this concept is based on the mathematical geometry, which suggests that if two lines are placed at a distance but maintains same angulation to a line intersecting them, they are parallel. This also suggests that if a line moves along another line, maintaining same angulation to that before moving, the final position of line will be parallel to its previous position.

The same occurs in bodily tooth movement. Therefore, if the angulation of long axis of tooth is maintained same as that before treatment, means bodily tooth movement is achieved, and if the angulation is changed, it suggests tipping of the tooth. The distance between the two will quantify the amount of tooth moved from initial to final position. This is as explained in the literature above. Thereby, this analysis is a pure mathematical concept, which is a proof in itself because mathematics is something which doesn’t change. The counterpart cross check of the same is done on OPG which also gives same readings, which suggests that both the analysis is valid. Furthermore, this analysis fulfilling the KISS principle (Keep It Simple Sir) [18], which doesn’t strains the patient & the clinician, neither expose patients to extra radiation like CT, CBCT, etc nor it add extra costs for the patients.

Therefore this analysis is the only one of its kind which quantifies the molar distalization and type of tooth movement, and it could be clinically used for the same, both in private practice and also by Orthodontic Post Graduate students to validate their findings.

Example of a case [Table/Fig-3,4 and 5]:

[Table/Fig-3]:

Pre Distalization and Post Distalization Intra Oral Occlusal Photographs showing the amount of distalization achieved

[Table/Fig-4]:

Superimposition of Lateral cephalogram along TV and TH plane at Sella - pre distalization and post distalization

[Table/Fig-5]:

Superimposition of OPG pre distalization and post distalization along OO line at Orbitale points

Distalization was performed in a female patient aged 12 years with Class II div 1 subdivision malocclusion. She had a mild convex profile, yaw in upper arch and minor crowding. Distalization was performed by a customized distalization appliance designed by the Author. The pre and post distalization occlusal photographs and superimposition results are shown in the [Table/Fig-3, 4 and 5] respectively having following values.

Alpha angle = 65 degree

Beta Angle = 65 degree

Difference between A and A’ in Lateral Cephalogram = 3 mm

Difference between B and B’ in lateral cephalogram = 3 mm

Difference between MDP and MDP’ on OPG = 3 mm

As noted, the pre and post distalization Alpha and Beta angles are same and the linear distance between the perpendicular lines is 3 mm, this implies that there was a bodily movement of molar achieved in this case.

This is how we could apply the same analysis for distalization, tipping, and anchor loss evaluation.

This analysis thereby is based on mathematical facts and Geometry which is a proof in itself for its validity. The angulations and linear measurements and geometrical concepts need no further support to say whether the lines are parallel or angulated. Thereby, this analysis is valid in itself fulfilling the KISS principle, which neither expose patients to extra radiation like CT, CBCT, nor does it add extra costs for the patients. Thus, this is a noble, easy, effective and conceptual analysis for the assessment of the type of tooth movement achieved by distalization. The use of this method in our department is a testimony of its usefulness.