All you do is open up the chaincase, and see how much extra slack you have when you back out your chain tightener. Adding 1 tooth to the top sprocket is roughly equivalent to using a 2 fewer teeth on the bottom sprocket.
I would guess that it wouldn't, I would have to check for sure but I think I am running 19/43 with a 74p chain and there is just a tiny bit of slack in it I don't think i am even running the tensioner
I for sure have the 19t / 43t and I am using the tensioner...a 21T will not go with the bottom 43t...but I thought a 20t might...but not sure...wanted to gear up alittle from the 2.26. I assumed I had a 74P chain.....