Classification of malocclusion
DEPARTMENT OF ORTHODONTICS SUBHARTI DENTAL COLLEGE
SWAMI VIVEKANAND SUBHARTI UNIVERSITY
Presented By: Dr Ashutosh Malocclusion – any deviation from the normal or ideal occlusion
Classification of malocclusion is the description of dentofacial deviation according to a common characterstics, or norm
Dr Ashutosh, Subharti Dental College, SVSU Types of malocclusion
Individual tooth malposition
Mal relation of the dental arches or dento alveolar segments
Skeletal malrelationships
Dr Ashutosh, Subharti Dental College, SVSU Individual tooth malpositions
Mesial inclination or tipping
Distal inclination or tipping
Lingual inclination or tipping
Dr Ashutosh, Subharti Dental College, SVSU Labial tipping
Infra occlusion
Supra occlusion
Dr Ashutosh, Subharti Dental College, SVSU
Rotations
Mesiolingual/distolabial
Distolingual/mesiolabial
Transposition
Dr Ashutosh, Subharti Dental College, SVSU Malrelation of dental arches
Sagittal plane malocclusion Pre normal occlusion- lower arch is more forwardly placed
Post normal occlusion- lower arch is more distally placed
Dr Ashutosh, Subharti Dental College, SVSU Vertical plane malocclusion
Deep bite Open bite
Dr Ashutosh, Subharti Dental College, SVSU Transeverse plane malocclusion
Various types of cross bites
Dr Ashutosh, Subharti Dental College, SVSU Skeletal mal occlusions
Caused due to the defect in the underlying skeletal structure
Defect can be in size, position or relationship between the jaws
Dr Ashutosh, Subharti Dental College, SVSU Angle’s classification of malocclusion
It was given by Edward Angle in 1899
Based on the mesio-distal relation of the teeth, dental arches and jaws
Maxillary 1st permanent molar- key to occlusion
Dr Ashutosh, Subharti Dental College, SVSU
Class I malocclusion
Class I molar relationship
Mesiobuccal cusp of the maxillary first molar occludes in the buccal groove of the mandibular 1st permanent molar
Dr Ashutosh, Subharti Dental College, SVSU Dr Ashutosh, Subharti Dental College, SVSU Dr Ashutosh, Subharti Dental College, SVSU Crowding, spacing, rotations missing tooth etc.
Normal skeletal and normal muscle relationship
Class I bimaxillary protrusion– normal class I relationship but dentition of both the arches are forwardly placed in relation to facial
profile Dr Ashutosh, Subharti Dental College, SVSU Angle’s class II malocclusion
Class II molar relationship- disto buccal cusp of the upper first permanent molar occludes in the buccal groove of the lower 1st molar It is sub classified into class II division 1 class II division 2 class II subdivision
Dr Ashutosh, Subharti Dental College, SVSU Class II div 1
Class II molar relation Proclined upper incisors –increased overjet Presence of abnormal muscle activity- characterstic feature Altered tongue positon- accentuates narrowing of upper arch Lip trap- lower lip cushions the palatal aspect of the upper teeth
Dr Ashutosh, Subharti Dental College, SVSU Dr Ashutosh, Subharti Dental College, SVSU Class II div 2
Class II molar relation
Lingually inclined upper central incisors
Labially tipped lateral incisors overlapping the centrals
Normal perioral muscle activity
Abnormal backward path of closure
Dr Ashutosh, Subharti Dental College, SVSU Dr Ashutosh, Subharti Dental College, SVSU Dr Ashutosh, Subharti Dental College, SVSU Class II subdivision
Class II molar relation on one side and class I on other
Dr Ashutosh, Subharti Dental College, SVSU Class III MALOCCLUSION CLASS III MOLAR RELATIONSHIP-
MESIOBUCCAL CUSP OF MAXILLARY FIRST MOLAR OCCLUDES IN THE INTERDENTAL SPACE BETWEEN THE DISTAL CUSP OF MANDIBULAR FIRST MOLAR AND SECOND MOLAR.
CLASSIFIED INTO-
TRUE CLASS III
PSEUDO CLASS DrIII Ashutosh, Subharti Dental College, SVSU Class III MALOCCLUSION
Dr Ashutosh, Subharti Dental College, SVSU Dr Ashutosh, Subharti Dental College, SVSU TRUE CLASS III
Class III molar relation
LOWER INCISORS LINGUALLY INCLINED
LOWER TONGUE POSTURE- NARROW UPPER ARCH
Dr Ashutosh, Subharti Dental College, SVSU PSEUDO CLASS III
CAUSED BY FORWARD MOVEMENT OF THE MANDIBLE- POSTURAL OR HABITUAL CLASS III
CAUSES OF PSEUDO CLASS III:-
OCCLUSAL PREMATURITY LOSS OF DECIDUOUS MOLARS LARGE ADENOIDS
Dr Ashutosh, Subharti Dental College, SVSU CLASS III SUBDIVISION
CLASS III MOLAR RELATION ON ONE SIDE AND CLASS I RELATION ON THE OTHER
Dr Ashutosh, Subharti Dental College, SVSU DRAWBACKS OF ANGLE’S CLASSIFICATION
FIRST PERMANENT MOLAR NOT A FIXED POINT CLASSIFICATION IS NOT POSSIBLE IF FIRST MOLARS ARE MISSING MALOCCLUSION IS CONSIDERED ONLY IN A-P DIRECTION INDIVIDUAL TOOTH MALOCCLUSION IS NOT CONSIDERED
Dr Ashutosh, Subharti Dental College, SVSU NO DIFFERENTIATION BETWEEN SKELETAL AND DENTAL MALOCCLUSION
NO CLUE ABOUT ETIOLOGY
Dr Ashutosh, Subharti Dental College, SVSU DEWEY’S MODIFICATION OF ANGLES’S CLASSIFICATION
MODIFICATION OF ANGLE’S CLASS I
TYPE 1 – ANGLE CL I & CROWDING IN MAXILLARY ANTERIORS
TYPE 2- ANGLE CL I & MAXILLARY INCISORS PROCLINED
TYPE 3 –ANGLE CLI & ANTERIOR CROSS BITE
Dr Ashutosh, Subharti Dental College, SVSU Type 4 - Angle CL I with posterior cross bite
Type 5 - molars are in mesioversion due to early loss of teeth mesial to them
Dr Ashutosh, Subharti Dental College, SVSU CLASS III MODIFICATION
TYPE 1- EDGE TO EDGE INCISOR ALIGNMENT
TYPE 2 - MANDIBULAR INCISORS ARE CROWDED AND LINGUAL TO INCISORS
TYPE 3 - MAXILLARY INCISORS ARE CROWDED AND IN CROSS BITE WITH RELATION TO MANDIBULA ANTERIORS
Dr Ashutosh, Subharti Dental College, SVSU Lischer’s modification Of Angle’s Classification
Lischer in 1933 modified Angle’s classification by giving substitute names for angle’s classification
Neutro-occlusion –Angle’s class I
Disto- occlusion -- Angle’s class II
Mesio- occlusion – Angle’s class III
Dr Ashutosh, Subharti Dental College, SVSU Lischer’s nomenclature for individual tooth malposition involved the suffix “version” to a word to indicate the deviation from the normal position
1 Mesioversion- mesial to the normal position
2 Distoversion –distal to the normal position
3 Linguoversion – lingual to the normal position
Dr Ashutosh, Subharti Dental College, SVSU 4. Labioversion - labial to the normal position
5. Infraversion – inferior to the line of occlusion
6. Supraversion – superior to the line of occlusion
7.Axiversion- axial inclination is wrong
8. Torsiversion- rotated on the long axis
9. Transversion – transposed or change in the sequence of position
Dr Ashutosh, Subharti Dental College, SVSU Benette’s classification of malocclusion
Benette classified the malocclusions based on their etiology-
Class I – Abnormal location of one or more teeth is due to local factors
Class II – Abnormal formation of a part or a whole of either arch due to development defects of bone
Class III –Abnormal relationship of upper and lower arch and the either arch and facial contour due to developmental defects of bone Dr Ashutosh, Subharti Dental College, SVSU Simon’s classification of malocclusion
Simon in 1930 was the first to relate the dental arches to the face and cranium in the three plane of space i.e Frankfort Horizontal Plane (vertically) Orbital plane (anterio-posteriorly) Raphe or Mid Sagital plane (transversely) Dr Ashutosh, Subharti Dental College, SVSU Frankfort horizontal plane
Formed by drawing a straight line through the bony margins of the orbit to the upper margins of external auditory meatus
Dr Ashutosh, Subharti Dental College, SVSU This plane is used to classify malocclusion in vertical direction
1. Attraction: when the dental arch or part of it is closed to FHP
2. Abstraction: when a dental arch or a part of it is away from FHP
Dr Ashutosh, Subharti Dental College, SVSU Orbital plane
Perpendicular to the FHP Simon’s law of canine- “this plane should pass through the distal third of the canine”
Dr Ashutosh, Subharti Dental College, SVSU This plane is used to describe malocclusion in saggital or anterio posterior plane
Protraction – when the dental arch or part of it is away from this plane
Retraction - when the arch or part of it is close or more posteriorly places
Dr Ashutosh, Subharti Dental College, SVSU Mid sagittal plane
This plane is formed by points apprx 1.5 cm apart on the median raphe of the palate
This plane passes at Dr Ashutosh, Subharti Dental College, SVSU right angle to FHP It classifies malocclusion according to Transeverse deviation from MSP
Contraction : A part or all of the dental arch is contracted towards MSP
Distraction : A part or all of the dental arch is wider or placed at a distance which is normal
Dr Ashutosh, Subharti Dental College, SVSU Ackermann-profitt system of classification
This classification includes description of malocclusion in all the three spaces
It gives indication towards the severity of malocclusion
The classification is illustrated using venn symbolic logic diagram
It considers five characteristics and their inter relationshipDr Ashutosh, is Subhartiassessed. Dental College, SVSU 1. Alignment - Intra arch alignment and asymmetry is assessed, a dental arch is classified as- Ideal Crowded Spaced
2. Profile - Concave Convex Straight Anterior or posterior divergent
Dr Ashutosh, Subharti Dental College, SVSU 3 Transeverse relationship - Transeverse skeletal and dental relationship is assessed Buccal or Palatal Cross bite Unilateral or Bilateral Skeletal and Dental
4. Class - Sagittal relationship is assessed using Angle’s classification of malocclusion Skeletal or dental
Dr Ashutosh, Subharti Dental College, SVSU 5. overbite malocclusion are assessed in the vertical plane Openbite - Anterior or Posterior
Deep bite - Anterior or Posterior
Skeletal or dental
Dr Ashutosh, Subharti Dental College, SVSU Dr Ashutosh, Subharti Dental College, SVSU
INCISOR CLASSIFICATION
1. Class I: The lower incisor edges occlude with or lie directly below the cingulum plateau of the upper central incisors. If the overbite is incomplete the lower incisors are repositioned along their long axis until they meet the upper incisors.
2. Class II: The lower incisor edges lie posterior to the cingulum plateau of the upper central incisors. There are two divisions of Class II:
Division 1: the upper central incisors are of average inclination or are proclined. The overjet is thus increased.
Division 2: the upper central incisors are retroclined; the overjet is usually within normal limits but the overbite is often increased. Class III: The lower incisor edges lie anterior to the cingulum plateau of the upper central incisors
CANINE CLASSIFICATION
1. Class I canine relationship – the upper permanent canine occludes in the embrasure between the lower permanent canine and first premolar.
2. Class II canine relationship – the upper canine occludes a whole tooth width further anteriorly and lies in the embrasure between the lower canine and lateral incisor.
3. Class III canine relationship – the upper canine occlude a whole tooth width further posteriorly than normal and occludes in the embrasure between the lower first and second premolars.