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 st the mandibular 1 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