Child's mouth with baby teeth and adult teeth visible through a futuristic cone-beam computed tomography scan.

Mixed Dentition Analysis: Is Advanced Tomography Worth It?

Avery Sinclair in Health & Wellness December 2025 • 4 min read.

"Cone-beam computed tomography (CBCT) offers new precision in assessing children's teeth, but how does it compare to traditional methods?"

For parents and orthodontists alike, ensuring proper dental development in children is a top priority. Malocclusions, or misalignments of teeth, often stem from imbalances between tooth size and the available space in the jaw. While some crowding is normal during the mixed dentition phase—when children have both baby and permanent teeth—it's crucial to monitor development to identify potential issues early.

Traditional methods for mixed dentition analysis, such as those developed by Moyers and Tanaka-Johnston, have long been used to estimate the size of unerupted permanent teeth. These methods rely on tables, formulas, and standard radiographs to predict tooth size and arch length. However, with advancements in technology, cone-beam computed tomography (CBCT) has emerged as a potential game-changer in orthodontic diagnostics.

This article will explore a study evaluating the effectiveness of CBCT in mixed dentition analysis, comparing its accuracy to traditional radiographic methods. By understanding the strengths and limitations of each approach, parents and professionals can make informed decisions about the best course of action for achieving optimal dental health for children.

CBCT vs. Traditional Radiography: What the Research Reveals

Child's mouth with baby teeth and adult teeth visible through a futuristic cone-beam computed tomography scan.

A research study published in the Dental Press Journal of Orthodontics sought to compare the accuracy of CBCT to traditional methods for mixed dentition analysis. The study aimed to determine if CBCT could offer a more precise assessment of intra-osseous (unerupted) tooth diameters compared to established techniques. Researchers evaluated measurements obtained from plaster cast models, traditional radiographs, and CBCT scans, using statistical analysis to compare the results.

The study focused on comparing CBCT measurements with those obtained through:

Moyers' Analysis: A method using tables to predict the size of unerupted canines and premolars based on the measurements of erupted lower incisors.
Tanaka-Johnston Formula: A formula-based approach to estimating the size of unerupted teeth, also relying on the measurements of erupted lower incisors.
45-Degree Oblique Radiographs: A type of X-ray that provides a clearer, unilateral view of posterior teeth.

The results indicated a high level of agreement between CBCT and traditional radiographic methods (45-degree oblique radiographs). However, there was low agreement between CBCT and the Moyers' table and Tanaka-Johnston’s formula. This suggests that while CBCT aligns well with radiographic assessments, it may offer different insights compared to prediction-based methods.

Making Informed Decisions: The Future of Mixed Dentition Analysis

CBCT offers several advantages, including the ability to observe and measure intra-osseous teeth individually without superimposition of anatomical structures. It also allows for viewing teeth from different perspectives, providing a comprehensive assessment of tooth development. However, the availability and cost of CBCT technology should be considered when making diagnostic decisions. Ultimately, a combination of clinical expertise, thorough evaluation, and appropriate imaging techniques will lead to the best possible outcomes for patients undergoing mixed dentition analysis. As technology advances, integrating CBCT where beneficial can help orthodontists provide more precise and individualized care.

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Everything You Need To Know

What is mixed dentition analysis and why is it important?

Mixed dentition analysis is the process of assessing dental development in children who have a mix of both baby teeth and permanent teeth. It's crucial for identifying potential issues like malocclusions (misaligned teeth) that arise from imbalances between tooth size and available space in the jaw. Early detection through methods like Cone-beam computed tomography (CBCT) or traditional radiography allows for timely intervention and better long-term dental health outcomes for children.

How does Cone-beam computed tomography (CBCT) compare to traditional methods like Moyers' Analysis and the Tanaka-Johnston Formula for assessing tooth size?

A study compared CBCT to methods such as Moyers' Analysis and Tanaka-Johnston Formula. The study found a high level of agreement between CBCT and traditional radiographic methods like 45-degree oblique radiographs. However, there was low agreement between CBCT and the Moyers' table and Tanaka-Johnston’s formula. This suggests that while CBCT offers a similar assessment to radiographic techniques, it may provide different insights compared to prediction-based methods that rely on formulas and measurements of erupted teeth to estimate the size of unerupted teeth.

What are the advantages of using CBCT in mixed dentition analysis?

CBCT offers several advantages. It allows for the observation and measurement of unerupted teeth individually without the superimposition of anatomical structures, providing a more detailed view of tooth development. It also enables viewing teeth from multiple perspectives, leading to a comprehensive assessment. This can be particularly helpful in diagnosing potential issues early and planning appropriate orthodontic interventions.

Can you explain the methods of Moyers' Analysis and the Tanaka-Johnston Formula in more detail?

Both Moyers' Analysis and Tanaka-Johnston Formula are traditional methods used to estimate the size of unerupted permanent teeth. Moyers' Analysis uses tables to predict the size of unerupted canines and premolars based on the measurements of erupted lower incisors. The Tanaka-Johnston Formula is also a formula-based approach that relies on the measurements of erupted lower incisors to estimate the size of unerupted teeth. These methods are used in mixed dentition analysis to predict future space needs in the dental arch.

What factors should parents and orthodontists consider when deciding between CBCT and traditional methods for mixed dentition analysis?

When deciding between CBCT and traditional methods like 45-degree oblique radiographs, Moyers' Analysis, or the Tanaka-Johnston Formula, several factors should be considered. The availability and cost of CBCT technology are important practical considerations. While CBCT offers advanced imaging capabilities, traditional methods can still provide valuable insights. A combination of clinical expertise, thorough evaluation, and appropriate imaging techniques will lead to the best possible outcomes for patients. The decision should be based on individual patient needs, the specific diagnostic question, and the resources available.