classification of malocclusion

Classification of Malocclusion, A mixture of online presentations

1. CLASSIFICATION OF MALOCCLUSION

2. OC CLUSION oc clusion CLOSING UP CLOSING UP

3. MAL OCCLUSION MAL OCCLUSION BITE BAD BAD BITE

4. OCCULSION IDEAL OCCLUSION NORMAL OCCLUSION MALOCCLUSION

5. OCCLUSION DEFINITION The relation of the Maxillary and Mandibular teeth when the jaws are - Closed in centric relation - Without strain of musculature or displacement of condyles in their fossae

6. IDEAL & NORMAL OCCLUSION “ IDEAL” is a hypothetical concept or a standardized goal “Normal” implies to the variations around an average mean value The Perfect Occlusion

7. IDEAL OCCLUSION: It is a theoretical concept based on the ideal teeth position and arches relationships. It is rarely , , if ever, found in nature. However, it provides a standard by which all other occlusions may be judged .

8. Ideal occlusion Normal occlusion A coincident mid-line No (crowding/spacing/rotations ) Over-jet = 2-3mm Correct crown angulation and inclination Class I molar & canine relationship A flat or slightly upwards curve of Spee - Is one which shows: some deviation from that of the ideal but is aesthetically acceptable and functionally stable for the individual - the upper and lower teeth fit nicely and evenly together with the least amount of destructive interferences

9. Andrews 6 KEYS of Normal Occlusion ( 1972 ) Correct crown inclination No spaces Flat to slight curve of spee No rotation Correct crown angulation Class I molar relationship

10. Definition: Malocclusion may be defined as ―A condition where there is departure from the normal relation of the teeth to - other teeth in the same dental arch and/or to - teeth in the opposing arch The term was coined by Edward H Angle , the " father of modern orthodontics.” MALOCCLUSION

11. MALOCCLUSION: An occlusion In which there is a malrelationship between the arches in any of the planes of the spaces or in which there are anomalies in tooth position beyond the limit of normal . ( Walther & Huston)

12. Occlusion and malocclusion

13. The World Health Organization ( 1987 ), had included malocclusion under the heading of Handicapping Dento Facial Anomaly , defined as an anomaly which causes disfigurement or which impedes function, and requiring treatment “if the disfigurement or functional defect was likely to be an obstacle to the patient’s physical or emotional well-being”

14. What is a classification system ??

15. A classification system is a grouping of clinical cases of similar appearance for ease in handling and discussion; it is not a system of diagnosis , method for determining prognosis ,or a way of defining treatment Robert E.Moyers

16. Why we need a Classification for malocclusion ???

17. Acquire a better understanding of the many deviations from normal occlusion 1) divide the wide range into small groups. 2) describe the salient features. 3) provide a verbal and mental picture. 4) simplify the documentations 5) unify the communications. 7) give clue about the etiology. 8) help to select treatment modality. Thinking of possible treatment modalities that may be needed in a particular case

18. TYPES OF MALOCCULSION INTER ARCH SKELETAL INTRA ARCH

19. INTRA ARCH Includes variation in individual tooth position & a group of teeth within in a arch Abnormal inclination Abnormal Displacements Spacing and crowding within the same arch

20. Distal inclination Mesial inclination Buccal inclination Lingual inclination ABNORMAL INCLINATION

21. Labioversion Lingoversion ABNORMAL DISPLACEMENTS

22. Palatoversion Buccoversion

23. Supraversion Infraversion

24. Torsiversion

25. INTERARCH PROBLEMS Types Abnormal relationship between two teeth or group of teeth of one arch to the other Sagittal plane malocclusions Vertical plane malocclusions Transverse plane malocclusions

26. SAGITTAL DIRECTION Either : - Abnormal overjet - Anterior cross-bite Anteriorly Class II malocclusion Class III malocclusion Posteriorly O R

27. Vertical plane malocclusions Normal overbite Deep overbite Open bite

28. Transverse plane malocclusions Either : DEVIATIONS OF THE MIDLINE Anteriorly POSTERIOR CROSS BITE: Posteriorly OR

29. Skeletal malocclusions Malrelation of the apical bases: Malrelation of the upper and lower apical bases is due to : a. Abnormal size; b. Abnormal shape; c. Abnormal relation to skull d. Abnormal relation to each other.

30. QUESTIONS?

31. VARIOUS SYSTEMS OF CLASSIFICATION ANGLE CLASSIFICATION LISCHER’S MODIFICATION OF ANGLES CLASSIFICATION SIMONS SYSTEM ACKERMANN AND PROFITT CLASSIFICATION BALLARDS CLASSIFICATION

32. ANGLE CLASSIFICATION It was introduced by Edward H. Angle ( 1889) • B ased on the mesiodistal relationship of teeth, dental arches and jaws M axillary first molar is taken as the key of occlusion Three classes

33. Class I Class II Class II div 1 Class II div 2 Class II Subdivision Class III True Class III Pseudo Class III THREE CLASSES Class III Subdivision

34. NORMAL LINE OF OCCLUSION

35. Angle Class І malocclusion Neutroclusion Molar relationship Canine relationship Line of occlusion: ALTERED in the max. & mand . Arches : • individual tooth irregularities (crowding/spacing /….) • Inter-arch problems (deep bite/open bite/ increased overjet /…)

36. Angle Class ІІ malocclusion C anine relationship: - the distal incline of upper canine anterior to the mesial incline of lower first premolar Distoclusion Molar relationship: There are two divisions of class ІІ designated, division 1 and division 2

37. Angle Class ІІ malocclusion division 1

38. Angle Class ІІ malocclusion division 2

39. Angle Class ІІ malocclusion division I I Mandible is retruded and one or more maxillary incisors are retruded Class ІІ Division 2 : Class II molar relation Lingually tipped upper central incisors Labially tipped lateral incisors Normal muscle activity

40. class I molar class ІІ molar Class ІІ malocclusion subdivision

41. Angle Class III malocclusion True class III Genetic in origin Excessively large mandible Smaller than normal maxilla Retropositioned maxilla Class ІІІ malocclusion: 2 types - True class ІІІ malocclusion (Skeletal) - Pseudo class ІІІ (FALSE or postural) Pseudo class ІІІ Forward movement of mandible during jaw closure Occlusal prematurities Premature loss of deciduous posteriors Enlarged adenoids

42. Advantages of ANGLE classification First comprehensive classification- most widely accepted Simple Easy to use Most POPULAR Easy to Communicate

43. DEMERTIS OF ANGLE CLASSIFICATION Considers malocculsion only in antroposterior plane not in transeverse /vertical Considered 1 st molar as fixed point – skull Deciduous dentition 1 st molar extracted Doesn't distinguish between skeletal and dental malocclusion Doesn’t highlight etiology Individual tooth positions

44. Lischer’s modification ( 1933 )

45. Neutroclusion : Angles class I malocclusion Distoclusion : Angles class II malocclsion Mesioclusion : Angles class III malocclsion Buccocclusion : Buccal placement of a tooth or a group of teeth Linguocclusion : lingual placement of a tooth or a group of a tooth or a group of teeth Supraocclusion : when a tooth or group of teeth have erupted beyound normal level Infraocclsion : when a tooth or group of teeth have not erupted to normal level Mesioversion : mesial to the normal position Distoversion : distal to the normal position Transversion : transposition of two teeth Axiversion : Abnormal axial inclination of a tooth Torsiversion : Rotation of a tooth around its long axis

46. SIMONS CLASSIFICATION ( 1926 )

47. It is craniometric classification Based on abnormal deviations of dental arches from their normal position in relation to these 3 planes VERTICAL PLANE ANTERO-POSRTERIOR TRANSVERSE PLANE ‘ GNATHODYNAMOMETER ’

48. ATTRACTION ABSTRACTION FH PLANE This plane help to detect devotions in the VERTICAL DIRECTION

49. ORBITAL PLANE Perpendicular to the FHP Simon’s law of canine- “this plane should pass through the distal third of the canine” This plane used to describe malocclusion in ANTERIO-POSTERIOR direction Protraction Retraction

50. THIS plane passes at right angle to FHP MID SAGITTAL PLANE It classifies malocclusion according to TRANSVERSE DEVIATION from MSP CONTRACTION DISTRACTION

51. ACKERMAN-PROFIT SYSTEM ( 1960 )

52. DENTOFACIAL APPEARANCE PROFILE : concave, straight, convex LIPS : protrusive, normal, retrusive INCISOR DISPLAY : Excessive, normal, Inadequate

53. TEETH / ARCH FORM Involves assessment of alignment and symmetry of dental arch Classified as IDEAL / CROWDED / SPACED

54. TRANSVERSE The transverse skeletal and dental relationship is evaluated Buccal and palatal crossbites are noted CROSS BITE : unilateral / bilateral Skeletal or Dental cross bite ?

55. SAGITTAL (A-P) Involves assessment of sagittal relationship Angle’s Class- I / II / III Differention between skeletal and dental malocclusion

56. VERTICAL Malocclusions in vertical plane are noted Anterior or posterior open bite Anterior deep bite Posterior collapsed bite Skeletal / Dental ??

57. ADDITIONAL CHARACTERISTICS Two things particularly help this more thorough analysis: Esthetic line of occlusion. Rotational axes.

58. ESTHETIC LINE OF OCCLUSION In modern analysis, another curved line characterizing the appearance of the dentition is important Esthetic line of occlusion, follows the facial edges of the maxillary anterior and posterior teeth.

59. ROTATIONAL AXES In addition to relationship in the transverse, antero -posterior and vertical planes of space used in traditional 3-D analysis, rotations around axes perpendicular to three planes also must be evaluated It’s a useful way to evaluate the relationship of the teeth to the soft tissues that frame their display Pitch Roll Yaw

60. Roll – Anteroposterior Axis ROLL Roll describes the vertical position of the teeth when this is different on the right & left sides. It’s seen with lips relaxed and more clearly on smile, in both frontal and oblique views.

61. Pitch – Transverse Axis The vertical relationship of the teeth to the lips & cheeks can be conventionally described as up-down deviations around the antero -posterior axes.

62. Pitch – Transverse Axis The vertical relationship of the teeth to the lips & cheeks can be conventionally described as up-down deviations around the antero -posterior axes.

63. Yaw – Vertical Axis Rotation of the jaw or dentition to one side or the other, around a vertical axes, produces a skeletal or dental midline discrepancy. Viewed as left-right deviations around the vertical axis .

64. BALLARDS CLASSIFICATION

65. Incisor classification ( 1965 ) A classification of malocclusion based on incisor As treatment is often primarily aimed at correcting this relationship Three CLASSES Class I incisor Class II incisor Class III incisor

66. Class I incisor Class II incisor Div 1

67. Class III incisor

68. Thanks