Malocclusion

Malocclusion
Malocclusion definition
• Malocclusion is a condition in which there is

a departure from the normal relation of teeth
to the other teeth in the same arch and/or to
the teeth in the opposing arch
(White TC, Gardiner JH and LeightonB).
Definition of classification in
orthodontics
• Classification in orthodontics is concerned with the
recognition of deviation from a quantitative and qualitative
biological norm.
• Classification is also defined as the orderly reduction of the
database to a list of the patient’s problem (William R Proffit).
• Classification employs various diagnostic criteria like clinical
examination, facial photographs, radiographs and diagnostic
casts.
Need/purpose/uses of classification
There are various purposes/uses of classification:

• Classification is used for grouping of orthodontic problems into a category.
• Such grouping helps in ease of reference.
• Useful in locating the problems which have to be treated.
• Classification helps in diagnosis and treatment plan.
• Classification is done for the purpose of comparison of different types of
malocclusions.
• Classification is used for self-communication.
• Useful for documentation of the problem.
• Used for studying in the prevalence and severity of malocclusion in
population groups. Used for epidemiological studies.
• Training of orthodontist.
• To assess treatment effects of orthodontic appliances.
Methods of recording and measuring
malocclusion/various methods of
classification of malocclusion
• Methods of classification can be broadly divided into two types:
(i)quantitative and qualitative types of classification
(ii) intra-arch and inter-arch problems.
• Classification of malocclusion:
• quantitative methods
• qualitative methods
• Classification based on intra-arch and inter-arch problems
• Classification based on intra-arch and inter-arch
problems
• Malocclusion can also be classified depending upon the
problems present in the same arch (intra-arch) and the
problems present between maxillary and mandibular arches
(inter-arch
• Malposition of an individual tooth or groups of teeth in the same
arch/intraarch problems
• Malrelationship between upper and lower arches or interarch
problems
• Malposition of an individual tooth or groups of teeth in the same
arch/intraarch problems
• Sagittal problems (Labioversion ,Linguoversion, Mesioversion and Distoversion)
• Transverse problems(Crowding, Spacing, Buccoversion and Linguoversion)
• Vertical problems (Supraversion and Infraversion)
• Rotated teeth
• Transposition of teeth
Malrelationship between upper and lower arches or interarch problems
• Sagittal
• Class II malocclusion
• Class III malocclusion
• Transverse
• Crossbites, scissor bite
• Midline shift
• Vertical
• Deep bite
• Open bite
Angle’s classification of malocclusion
Introduction
• Angle’s system of classification is based on the anteroposterior
relationship of the teeth with each other.
• Edward Hartley Angle introduced this classification with the concept
of key of occlusion and line of occlusion.
• Maxillary first permanent molar is considered to be the key of
occlusion and Angle stated that the position of the maxillary first
permanent molar is relatively constant.
Angle’s classification
• Angle described three classes of malocclusion
• The three classes of malocclusion are based on the permanent first molar
relationship.
• Class II malocclusion has got two types, namely division 1 and 2.
Angle’s class I malocclusion(neutraloclusion
• Molar relation: The mesiobuccal cusp of the upper first molar occludes
with the mesiobuccal groove of the lower first molar.
• Canine relation: The mesial incline of the upper canine occludes with
the distal incline of the lower canine whereas the distal incline of the
upper canine occludes with mesial incline of lower first premolar.
Angle’s class I malocclusion(neutraloclusion
• Line of occlusion: Line of occlusion will be altered in the maxillary
and mandibular arches:
• Individual tooth irregularities, like crowding, spacing, rotations, absence of
tooth, will be seen.
• Interarch problems, like deep bite, open bite, proclination or increased
overjet, crossbite will be present.
Angle’s class II division 1 malocclusion (distoclusion)
Molar relation:
Lower dental arch is distally positioned in relation to upper arch.
• The distobuccal cusp of the upper first permanent molar occludes with the mesiobuccal groove of the
lower first permanent molar.
Class II canine relation:
• The distal incline of upper canine occludes with mesial incline of lower canine.
Line of occlusion:
• Altered; other features of class II division 1 are:
• V-shaped or constricted maxilla
• Proclined maxillary incisors
• Lip trap(incompetent lips)
• Exaggerated curve of Spee
• Deep bite
• Class II division 1 subdivision: Condition where the class II molar relationship is unilateral
or present only on one side with normal class I molar occlusion on the other side.
• Class II molar relation:
• Lower dental arch is distally positioned in relation to upper arch.
• The distobuccal cusp of the upper first molar occludes with the mesiobuccal
groove of the lower first molar
• Class II canine relation:
• The distal incline of the upper canine occludes with the mesial incline of the
lower canine.
• Line of occlusion: Altered.

Other features:
• Characteristic lingual inclination of upper central incisor alone or central and
lateral incisors together.
• Canine overlaps the retroclined incisors
• Closed bite will be present.
• Square-shaped arch.
• Exaggerated curve of Spee.
• Class II division 2 subdivision:
• Condition when the class II molar relation exists on only one side with normal
molar relation on the other side.
Typical class II division 2 maxillary incisor position

Angle’s class III malocclusion (mesiocclusion)
Class III molar relation:

• The lower dental arch is in anterior relation to the maxillary arch.
• Mesiobuccal cusp of the upper first permanent molar occludes with the
interdental space between the lower first and second permanent molars
• Class III canine relation:
• Upper canine occludes with the interdental space between the lower first and
second premolars.
Angle’s class III malocclusion (mesiocclusion
• Line of occlusion: May or may not be altered.

• Other features are:
• Reverse overjet or anterior crossbite
• Maxillary anterior crowding
• Posterior crossbite
• Class III subdivision:
• Condition in which class III molar relation is present only on one side with
normal molar relation on the other side
• True class III: This is a skeletal malocclusion. The

reasons for skeletal class III malocclusion are:
• Retrognathic maxilla
• Prognathic mandible
• Combination of both
• In this class III, molar relation exists both in centric
occlusion and rest position.
• Pseudo-class III/habitual class III:

• This is not a true class III malocclusion. Due to occlusal
prematurities, when the mandible moves from rest position to
occlusion, it slides forwards into a pseudo-class III position.
• These patients show normal molar relationship in rest position.
• In centric occlusion, they show class III relation.
• Cephalogram in both rest position and occlusion helps to
differentiate between true class III and pseudo-class III malocclusion
Merits and demerits of angle’s classification/validity of
angle’s classification
Merits
• Angle’s system of classification is the most traditional and oldest
• system still in use.
• Most practical and easy to comprehend method of classification.
• Most popular.
• Easy to communicate.
• Widely used for teaching purpose.
Merits and demerits of angle’s classification/validity of
angle’s classification
Demerits
• Disregarded the relationship of the teeth to the face.
• Malocclusion is a three-dimensional problem, but Angle considered only
sagittal dimension.
• The position of the maxillary first permanent molar is not stable as stated
by Angle.
• Muscle malfunction and growth of bones were overlooked. These factors
influence the molar position.
• Classification is not applicable when first permanent molars are missing.
Modifications of angle’s classification
• There are two modifications of Angle’s classification:

• Lischer’s modification
• Dewey’s modification
Lischer’s modifications
Lischer introduced the following names to Angle’s
classification.
• Neutroclusion – class I
• Distoclusion – class II
• Mesiocclusion – class III
Lischer’s modifications
Lischer also introduced nomenclature to describe malpositions of individual tooth.
• It consists of adding the suffix ‘version’ to the word. These indicate the
direction of deviation from the normal position.
• Mesioversion – mesial to the normal position.
• Distoversion – distal to the normal position.
• Linguoversion – lingual to the normal position.
• Labioversion/buccoversion – towards the lip or cheek
• Infraversion – away from the line of occlusion.
• Supraversion – crossing the line of occlusion.
• Axiversion – wrong axial inclination.
• Torsiversion – rotated on its long axis.
• Transversion – transposition – wrong position in the arch.
Dewey’s modification
• Martin Dewey divided Angle’s classes I and III into further types:
• Class I is divided into five types.
• Class III is divided into three types.
• Class II has no types.
Dewey’s modification Dewey’s modification

Class I
• Type 1: Crowded maxillary anterior teeth; canines
Class III
may be abnormally positioned; other individual tooth • Type1: Well-aligned teeth and dental
irregularities present.
• Type 2: Proclined or labioversion of maxillary incisors.
arches; edge–edge relationship exists.
• Type 3: Linguoversion of maxillary incisors; anterior • Type 2: Crowded mandibular incisors;
crossbite present.
normally placed lower incisors behind
• Type 4: Incisors and canines are normally positioned.
Molars and premolars are in buccoversion. Posterior the upper incisors.
crossbites are seen.
• Type 5: Mesioversion of molars; molars have moved
• Type 3: Crowded maxillary incisors;
mesially due to premature loss of teeth anterior to underdeveloped maxilla; anterior
molar crossbite present
Thank you

Malocclusion

Uploaded by

Copyright:

Available Formats

Malocclusion

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Malocclusion

Uploaded by

Copyright:

Available Formats

Malocclusion

• Malocclusion is a condition in which there is

There are various purposes/uses of classification:

• Line of occlusion: Altered.

Typical class II division 2 maxillary incisor position

Class III molar relation:

• Line of occlusion: May or may not be altered.

• True class III: This is a skeletal malocclusion. The

• Pseudo-class III/habitual class III:

• There are two modifications of Angle’s classification:

Dewey’s modification Dewey’s modification

You might also like