Evidence favoring a secular reduction in mandibular leeway space

Abstract

Objective: Researchers have documented secular trends in tooth size among recent generations. This study was a test for a change in mandibular leeway space. Materials and Methods: Dental casts from participants in the Denver Growth Study (23 boys, 22 girls; born in the 1930s) were compared with casts from a contemporary series of orthodontic patients (23 boys, 22 girls; born in the 1990s). All were phenotypically normal, healthy American whites. Results: Analysis of variance (accounting for sex) showed that the cumulative mandibular primary canine plus first and second primary molar size (c+m1+m2) was slightly larger in the recent cohort (23.53 mm earlier vs 23.83 mm recent cohort; mean difference: 0.30 mm; P=.009), principally due to larger second primary molars (m2) in the recent cohort. In turn, the sum of the permanent canine and two premolars (C+P1+P2) was significantly larger in the recent cohort (21.08 mm earlier vs 21.80 mm recent cohort; mean difference: 0.72 mm; P=.002). Larger teeth in the contemporary series produced a mean leeway space per quadrant of 2.03 mm versus 2.45 mm in the earlier cohort-a clinically and statistically significant reduction (P=.030). Some tooth types (primary second molar and permanent canine) were significantly larger in boys than in girls, but the sex difference in leeway space was not statistically significant. Conclusion: Results suggest that mandibular leeway space is decreasing in 21st century American whites and may present a challenge to orthodontists in managing tooth size-arch length discrepancies. (Angle Orthod. 2017;87:576-582).