CLASSIFICATION OF

MALOCCLUSION

PRESENTED BY
BENIYA E S
FIRST YEAR POSTGRADUATE
DEPT OF ORTHODONTICS AND DENTOFACIAL
ORTHOPEDICS
 NUTS AND BOLTS…..
INTRODUCTION
What is Classification???
What is Malocclusion???
What is the need for the Classification???
ROOTS
History
Ideal occlusion
Normal occlusion
Line of occlusion
Andrews 6 keys to normal occlusion
CORE
Recording Malocclusion
Types of Malocclusion Let’s start
CLASSIFICATIONS OF MALOCCLUSION

CONCLUSION

BIBLIOGRAPHY
 INTRODUCTION
WHAT IS CLASSIFICATION?

Classifying means distributing a topic into different classes or groups

according to a given classification method or system

( Ferreira 1986)

The act of classifying can render a given subject or pursuit more

Objective ,Understandable, Consistent even if studied or analyzed by different people

(Moyers 1991)

(Int.J.odontostomatology, 2010,vol 4)
WHAT IS MALOCCLUSION?

The term IRREGULARITIES OF TEETH often doesn’t properly express the full meaning of
deformities.

Term MALOCCLUSION was coined by Edward H Angle

( THE DENTAL COSMOS)

A malocclusion doesn’t in itself represent a disease state, but rather a variation from what is
considered ideal.

(Martyn D Cobourn, Andrews T Dbiase

Handbook of orthodontics)
WHAT IS NEED FOR THE CLASSIFICATION ??

 Time saving device

 Contribution to orderly thinking

 Grouping various malocclusions

 Diagnosis

 Treatment planning

 Comparison

 Easy Communication

Online Reference
 HISTORY
2010
Newly proposed system,
1992 Miguel& much
Katz premolar classification
1983
British Standard's Institute Classification
1969
Ackermann and Proffit classification
1933
Lischer-----Modification of Angles classification
1930
Paul W Simon-----Simon’s classification of malocclusion
1915
Martin Deway-----Modification of Angles classification
1899
Edward.H.Angle----Angles classification of malocclusion
1880
Kingsley-------Classified based on etiology
1836
Kneisel ----Attempted first classification of malocclusion
 IDEAL OCCLUSION

If the teeth are perfectly arranged in both arches

by definition ideal occlusion will occur when the

mesiolingual cusps of maxillary first molar, rest in the

central fossae of the mandibular first molar

provided the curve of spee are harmonious and

there is no tooth size discrepancy.

This, of course, is the original Angle concept

GRABER,VANARSDALL,VIG,XUBAIR
ORTHODONTICS CURRENT PRINCIPLES AND TECHNIQUE
5TH EDITION:23PG)
 NORMAL OCCLUSION
Normal occlusion can be defined from two characteristics :

 Alignment of teeth within each arch along the line of occlusion

through the central fossa of maxillary teeth

and along the cusp tips of mandibular teeth.

 Occlusion, with the mesiobuccal cusp of maxillary first molar occluding with the mesiobuccal
groove of lower first molar.

With the teeth aligned along the line of occlusion, this would produce normal occlusion.

(GRABER,VANARSDALL,VIG,HUANG
ORTHODONTICS CURRENT PRINCIPLES AND TECHNIQUE 6TH EDITION:209PG)
L Marginal ridge of incisors -1/3rd from cutting edge
I
N Lingual ridge of
cuspid
E Parabolic curve

Varies with Sulcus between buccal

O Race and lingual cusp
F Type
Temperament
O
C
C
L Mesial and distal inclined
planes of buccal cusps
U
S
I
O Cutting edge
N
Proffit and The Dental cosmos
 ANDREWS 6 KEYS TO NORMAL

OCCLUSION

The six keys to normal occlusion,Lawrance.F.Andrews (AJO-DO 1972) Sept

 TYPES OF MALOCCLUSION

INTRAARCH INTERARCH SKELETAL

INTRAARCH INTERARCH SKELETAL

Sagittal plane Sagittal

INCLINATION D/M/B/L
prognatism
retrognatism
DISPLACEMENT M/D/B/L prenormal post normal
Vertical
ML/DB/MB/DL ROTATION Vertical plane ↑facial height
↓facial height
TRANSPOSITION Open bite Deep bite

INFRA /SUPRA OCCLUSION

Transverse Plane Transverse
Wide arch
Buccal rotn Lingual rotn Narrow arch

Textbook of orthodontics Gurkeerat Singh

 RECORDING THE MALOCCLUSION

QUALITATIVE QUANTITATIVE

Angles classification
PAR INDEX
British standards institute
incisor classification
IOTN
Canine classification
Kartz premolar
classification
Simons classification
Ackerman proffit
classification

Bennet's classification

Newly proposed system

An introduction to orthodontics :Laura mitchell
ANGLE’S CLASSIFICATION OF MALOCCLUSION

Angle described three classes of malocclusion, based on the occlusal relationship of first
molars

Class І Malocclusion

Normal relationship of molars but line of occlusion is incorrect because of malposed

teeth, rotations, or other causes

Contemporary orthodontics :William R proffit,Henry W Fields

Class ІІ Malocclusion

Lower molar is distally positioned relative to upper molar ,line of occlusion is not specified.

Division 1 :Along with molar relation typical as class ІІ malocclusion the maxillary incisors are
proclined

Division 2: along with molar relation is typical as class ІІ maxillary central incisors are inclined to
lingual and lateral incisors are tipped labially or mesially

Subdivision : class 2 molar relation ship occur in one side of dental arch and other side is class 1
Class ІІІ Malocclusion

Lower molar is mesially positioned relative to upper molar, line of occlusion is not specified

Pseudo class 3

This is not true class 3 but presentation is similar. here mandible shifts anteriorly in glenoid
fossa due to premature contact of teeth or some other reason when the jaws are brought
together in centric occlusion

Subdivision
Class 3 on one side of arch and class 1 on other side
DRAWBACKS OF ANGLES CLASSIFICATION

 Maxillary permanent molar is not a fixed anatomic point (key ridge)

 Cannot classify for mesially drifted, impacted, missing/extracted max1st molars

 Didn’t consider single tooth malposition

 Cannot classify primary teeth

 Didn't classify skeletal relationship

 Didn’t predict etiological factors

CLASSIFICATION OF SKELETAL AND DENTAL REVISITED

Stomatology education journal: Mageet A.O,2016
 DEWEY’S MODIFICATION
1915 Dewey’s modified Angle’s Class I and III malocclusion by segregating malposition of
anterior and posterior segments

Type 1 Crowding of Max anterior teeth

Type 2 Proclined Max incisors
CLASS І Type 3 Max incisors are in cross bite
Type 4 Posterior cross-bite
Type 5 Mesial drift of molars

CLASS II no modifications

Type 1 Edge to edge bite

CLASS ІІІ Type 2 Crowded Mandibular incisors
Type 3 Underdeveloped crowded Maxillary arch and a well
developed Mandibular arch.

CLASSIFICATION OF SKELETAL AND DENTAL REVISITED

Stomatology education journal : Mageet A.O,2016
 LISCHER ‘S MODIFICATION
Lischer in 1933 further modified Angle’s classification
by giving substitute names

CLASS I Neutrocclusion
CLASS II Distocclusion
CLASS III Mesiocclusion

Also proposed terms to designate individual tooth malposition,

Mesio-version Mesial to normal position

Disto-version Distal to normal position
Linguo-version Cross bite
Labio-version Increased overjet
Infra-version Submerged tooth
Supra-version Supra-erupted
Axio-version Tipped tooth
Torsiversion Rotated tooth
Trans-version Transposed tooth

CLASSIFICATION OF SKELETAL AND DENTAL REVISITED

Stomatology education journal : Mageet A.O,2016
 BRITISH STANDARD’S INSTITUTE
CLASSIFICATION
CLASS 1:
The lower incisor edges occlude with or lie immediately below the
cingulum plateau of the upper incisor

CLASS 2 :
The lower incisor edges lie posterior to the cingulum plateau of upper incisors

DIVISION 1 –The upper central incisors are proclined or of average inclination &
there is an increase in overjet

DIVISION 2 –The upper central incisors are retroclined.The overjet is usually

minimal

CLASS 3
The lower incisor edge lies anterior to the cingulum plateau of upper incisors.
The overjet is reduced or reversed

(Bellard’s and Wayman’s classification forms the basis of BSI classification)

An introduction to orthodontics :Laura mitchell

 CANINE CLASSIFICATION
The canine relationship also provides a useful anteroposterior occlusal classification

Class I
The maxillary permanent canine should occlude directly in the
embrasure between mandibular canine and first premolar.

Class II
The maxillary permanent canine occludes in front of the
embrasure between mandibular canine and first premolar.

Class III
The maxillary permanent canine occludes behind the
embrasure between mandibular canine and first premolar

(Martyn D Cobourn, Andrews T Dbiase :Handbook of orthodontics)

KATZ CLASSIFICATION OF MALOCCLUSION
According to Katz

Class І

Exact fit between the mid cusp of the most anterior upper premolar and
the embrasure created by distal contact of most anterior lower premolar.
this ideal relationship has been designed by Katz as 0

Class ІІ

Mid cusp of most anterior upper premolar is ahead of

Embrasure created by distal contact of most anterior lower premolar
Plus sign

Class ІІІ

Mid cusp of most anterior upper premolar is behind the

embrasure created by distal contact of most anterior lower premolar
Minus sign
Classification of occlusion reconsidered: Brin,Weinberger (euro.jour.ortho 1999)
 SIMONS CLASSIFICATION
In 1930 Simon was the first to relate the dental arches to the face and cranium in
three planes of face

Attraction

Frankfurt horizontal plane Vertical

(OR-PO)
Abstraction

protraction
Orbital plane anteroposterior
(perpendicular to FH plane)
at the margin of bony orbit
Retraction

contraction

Median sagittal plane transverse

(1.5cm apart of median Distraction
Textbook of orthodontics Gurkeerat Singh
 ACKERMANN PROFFIT CLASSIFICATION
STEP 1 :EVALUATION OF DENTOFACIAL ARRANGEMENT

PROFILE :Dolicofacial :Anterior open bite

Brachyfacial :Deepbite
Mesofacial

STEP 2: ANALYSIS OF DENTAL ALIGNMENT AND INTRAARCH SYMMETRY

ALIGNMENT : Ideal
Crowded : Arch length deficiency
Spaced

STEP 3 : LATERAL DIMENSIONS

TRANSVERSE PLANE OF FACE : Crossbites

Maxillary palatal crossbite : narrow max arch
mandibular buccal crossbite : excess mand width

STEP 4 : ANTEROPOSTERIOR DIMENSION

SAGITTAL PLANE OF FACE : Angles classification

STEP 5 : VERTICAL DIMENSION

VERTICAL PLANE OF SPACE : Bite depth :steep mandibular plane : open bite tendency
 BENNET’S CLASSIFICATION

CLASS І

Abnormal location of one or more teeth is due to local factors.

CLASS ІІ

Abnormal formation of a part or a whole of either arch

due to developments defects of bone.

CLASS ІІІ

Abnormal relationship between the upper and lower arches

and between either arch and
the facial contour due to developmental defects of bone.

Textbook of orthodontics Gurkeerat Singh

 NEWLY PROPOSED SYSTEM OF CLASSIFICATION
Proposed by
Miguel Neto- Nelson Mucha

Anatomic structure used as reference

Distobuccal cusp of upper first molar relative to the
occlusal embrasure between the first and second lower molar

CLASS І
When the tip of the distobuccal cusp pointed towards the
occlusal embrasure between the first and second lower molar

CLASS ІІ
Any deviations of 1mm and above from CLASS І

CLASS ІІІ
whenever the upper arch was positioned towards distal 1mm and
above or the lower arch towards mesial.

Int.j.odontostomat:2010 :Agreement evaluation of newly proposed system of malocclusion classification, migual &mucha
 CONCLUSION
 Classification of malocclusion is a time saving device and a contribution to orderly
thinking.

 For any classification to use it needs to be simple, objective and reliable.

 Simon said that must have very positive aim and purpose.

 Classification has a significant effect on the patient treatment.

 Once the patient is classified the practitioner will tend to apply treatment
mechanics appropriate to that classification.

 The angles classification of malocclusion is most useful and effective mechanism

when application is restricted to tooth and dental arch relationship

 The classification of Simon is most precise description of dentofacial deformities

 BIBLIOGRAPHY
1) Angle .E.H Classification of malocclusion ,The Dental cosmos 1899

2) International journal of Odontostomatology, 2010

3) Harold J Noyes-Angle Orthodontist(classification of malocclusion-1942

4) Andrews.L.F –The six keys to normal occlusion- AJODO-1972

5)Miguel Neto, A B Nishio, Mucha J N –Agreement evaluation of newly proposed system of

malocclusion classification—Int.J.Odontostomatology 2010

6)Devanshi Yadav, M S Rani, A M Shailaja—The journal of Indian orthodontic society- 2014

7)Brin, T Weinberger, E.Benchorin-classification of occlusion reconsidered –European journal of

orthodontics 1999

8)Mageet A O-Classification of skeletal and dental malocclusion revisited-Stoma ed J 2016

9)Morton.I.kartz, Jeanne C Sinkford, Charles F Sanders,Jr –quintessence international,

vol21,1990
9) Graber, Vanersdall, Vig, Huang –Orthodontics Current principles and techniques

10) William.R.Proffit, Henry W fields-Contemporary Orthodontics

11)Laura Mitchell-An introduction to orthodontics

12)Gurkeerath Singh--Textbook of orthodontics

13)Martyn D Cobourne, Andrew T Dibiase –Handbook of orthodontics

14)Robert.N.Staley--Essentials of Orthodontics Diagnosis and treatment

 HAHA

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