Black, white, or gray: Finding commonality on how orthodontists describe the areas between Angle’s molar classifications

Introduction: Angle’s system for classifying molar relationships has been the standard in orthodontics for over a century. The purpose of this study was to determine what orthodontic students are being taught about the terminology of molar relationships and the use of Angle’s molar classification system. Methods: An e-mail survey was sent to the department chair or the program director of every orthodontic program in the United States, Canada, and Puerto Rico (n = 80). The survey included photos of models placed into 1/4 cusp, 1/2 cusp, and 3/4 cusp distal occlusions, and the participants were asked to classify them by selecting from a list of terms or writing 1 of their own. They were also asked whether they thought that the Angle molar classification was adequate for communication and diagnosis. Results: Forty surveys were completed and returned. The results showed that a variety of terminology is being taught, and most educators do not use Angle’s system as he defined it. About half of the respondents were dissatisfied with the Angle molar classification system. Conclusions: A modification of Angle’s system that is more descriptive is needed.