Classification-of-Malocclusion O.ppt

Classification-of-Malocclusion

1. CLASSIFICATION OF
MALOCCLUSION
DR CHANDRIKA KATTI
Reader, Dept Of Orthodontics.
Navodaya Dental College, Raichur.
1

2. Introduction
Malocclusionis defined as any deviation from
normal occlusion of teeth .
Occlusion : Contact relationship between
maxillary and mandibular teeth in function and
parafunction.
Classification of malocclusionis the
description of dentofacial deviations according
to a common characteristic or norm.
2

3. Advantages of Classification
1.Helps in diagnosis and treatment planning.
2.Helps in visualizing and understanding the
problem associated with malocclusion.
3.Helps in communicating the problem.
4.Helps in comparisons of various
malocclusions.
3

4. Types of Malocclusion
1. Intra-arch malocclusion
2. Inter-arch malocclusion
3. Skeletal malocclusion
4

5. 1. Intra-arch malocclusion
Includes individual tooth position, variations and
malocclusions affecting a group of teeth within an
arch.
Distal inclination
Mesial inclination
Lingual inclination
Buccal inclination
Mesial displacement
Distal displacement
Lingual displacement
Buccal displacement
Infra version
Supra version
Rotations
Distolingual/Mesiobuccal
Mesiolingual/Distobuccal
Transposition 5

6. 6

7. 7

8. 8

9. Mesial inclination Distal inclination Palatal inclination
Lingual inclination Labial inclination 9

10. Infraocclusion
Supraocclusion
Supraocclusion
Rotation
Mesiolingual or Distolabial
10

11. Rotation
Distolingual or Mesiolabial
Transposition
11

12. 2. Inter-arch malocclusion
Malrelationof dental arches to one another upon
skeletal bony basis that may themselves be
normally related.
Sagittalplane malocclusions
Vertical plane malocclusions
Transverse plane malocclusions
12

13. Sagittal plane malocclusions
Pre-normal occlusion
Mandibular arch
anteriorly placed in
centric occlusion.
Post-normal occlusion
Mandibular arch
posteriorly placed in
centric occlusion.
13

14. Vertical plane malocclusions
Deep bite
Excessive vertical
overlap between
maxillary and
mandibular anteriors.
Open bite
No vertical overlap.
-Anterior region
-Posterior region
Anterior open bite Posterior open bite
14

15. Transverse plane malocclusions
Includes various types of cross bites.
Lateral incisor in cross bitePosterior segment in cross bite
15

16. 3. Skeletal malocclusion
Includes defects in underlying skeletal structure.
Due to abnormalities in maxilla or mandible in size,
position or relationship between jaws.
Sagittalabnormalities
Prognathism
Retrognathism
Combinations
Transverse abnormalities
Narrowing and widening of jaws causes crossbites
Vertical abnormalities
Variation affects lower facial height.
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17. 17

18. 18

19. Systems of Classification of
Malocclusion
1.Angle’s classification
2.Dewey’s modification of Angle’s classification
3.Lischer’s modification of Angle’s classification
4.Bennet’s classification
5.Simon’s classification
6.Ackermann-Profitt classification
7.Incisor classification
19

20. Angle’s classification
It was introduced by Edward Angle in 1899.
Based on mesiodistal relationship of teeth, dental arches and
jaws.
Maxillary 1
st
molar is taken as key to occlusion.
Three classes :
Class I
Class II
Class II division I
Class II division II
Class II subdivision
Class II division I subdivision
Class II division II subdivision
Class III
True Class III
Pseudo Class III
Class III subdivision 20

21. Class I
Normal inter-arch molar relation
Mesiobuccalcusp of maxillary 1
st
permanent molar occlude in
the buccalgroove of mandibular1
st
permanent molar.
Dental irregularities
Crowding
Spacing
Rotations
Missing teeth
Normal skeletal retaionships.
Normal muscle function.
Includes bimaxillaryprotrusion –normal Class I molar
relationship but the dentitions of both arches are forwardly
placed in relation to the facial profile.
21

22. 22

23. Class II
Distobuccalcusp of maxillary 1
st
permanent
molar occludes in the buccalgroove of
mandibular1
st
permanent molar.
Class II division I
Characterized by proclinedV-shaped upper
incisors.
Therefore, increased overjet, lip trap, abnormal
muscle activity –hypotonic upper lip,
hypertonic mentalisand buccinator.
23

24. 24

25. Class II division 2
Characterized by linguallyinclined upper incisors and
labiallytipped upper lateral incisors overlapping the
centrals.
Square shaped arch, peri-oral muscle activity normal.
Class II subdivision
Class II molar relation exist on one side and Class I
molar relation on the other side.
Class II division I subdivision
Class II division II subdivision
25

26. 26

27. Class III
Mesiobuccalcusp of maxillary 1
st
permanent molar
occlude the interdentalspace between mandibular1
st
and 2
nd
molar.
True Class III
Pseudo Class III
Class III subdivision
True Class III –Skeletal Class III malocclusion of
genetic origin. Due to -
Excessively large mandible
Forwardly placed mandible
Smaller than normal maxilla
Combinations
27

28. Pseudo Class III–Produced by forward
movement of mandible during jaw closure
Also called postural/habitual Class III
Due to
Occlusalprematurities
Premature loss of deciduous posteriors.
Child with enlarged adenoids
Class III subdivision–Class III molar relation
on one side and Class I on the other.
28

29. 29

30. Advantages of Angle’s Classification
First comprehensive classification –most
widely accepted.
Simple
Easy to use
Conveys precisely what was conceived for ie,
relationship of mandibular teeth with respect to
maxillary 1
st
permanent molar.
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31. Drawbacks of Angle’s Classification
Considers malocclusion only in the anteroposterior
plane and not in transverse/ vertical planes.
Considered 1
st
permanent molar as fixrd points in the
skull, not found to be so.
Cannot be applied if 1
st
permanent molar is missing
or to deciduous dentition.
Doesn’t distinguish between skeletal/dental
malocclusion.
Doesn’t highlight etiology.
Individual tooth positions aren’t considered.
31

32. Dewey’s modification of Angle’s
classification
Angle’s Class I
Type I –Class I with crowded anteriors.
Type II –Class I with protrusive maxillary
incisors.
Type III –Class I with anterior cross bite.
Type IV –Class I with posterior cross bite.
Type V –Mesially drifted permanent molars
therefore early extraction of deciduous
predecessors.
32

33. Angle’s Class I with anterior crowding or Dewey’s Class I type 1
Angle’s Class I with anteriors proclined or Dewey’s Class I type 2
Dewey’s Class I type 3 malocclusion, molars in Angle’s Class I
with maxillary anteriors in crossbite
Dewey’s Class I type 4. Angle’s class I with posterior crossbite
33

34. Dewey’s Class I type 5
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35. Angle’s Class III
Type I –upper and lower arches are normally
aligned separately but show edge-to-edge bite/
incisor arrangement on occlusion.
Type II –mandibular incisors crowded and in
lingual relation to maxillary incisors.
Type III –maxillary incisors are crowded and
in cross bite with mandibular anteriors.
35

36. Dewey’s Class III type 1
Dewey’s Class III type 2
Dewey’s class III type 3
36

38. Lischer’s modification of Angle’s
classification
Neutro-occlusion –Angle’s Class I
Disto-occlusion –Angle’s Class II
Mesio-occlusion –Angle’s Class III
Mesioversion –mesial to normal position
Distoversion –distal to normal position
Linguoversion –lingual to normal position
Labioversion –labial to normal position
Infraversion –inferior or away from the line of occlusion
Supraversion –superior or extended past the line of occlusion
Axiversion –axial inclination is wrong, tipped
Torsiversion –rotated on its long axis
Transversion –transposed or changes in the sequence of
position
38

39. Mesioversion
Distoversion of lateral incisor and canine
Torsiversion of 1
st
premolar rotated mesiobuccally
Linguoversion Labioversion
39

40. Axiversion
Torsiversion
40

41. Bennet’s classification
Class I–abnormal position of one or more teeth due to
local causes.
Class II–abnormal formation of a part/ whole of either
arch due to developmental defect of bone.
Class III–abnormal relation between upper and lower
arches and between either arch and facial contour and
co-related abnormal formation of either arch.
41

42. Simon’s classification
It is a craniometric classification relating dental arches in
three planes i.e.,
FH plane [Frankforts Horizontal plane]
Orbital plane
Mid-sagittal plane
FH plane
Attraction –closer than normal to FH
plane.
Abstraction –away from FH plane than
normal. 42

43. Orbital plane
Protraction –Farther from orbital
plane
Retraction –Closer/more posterior to
orbital plane.
Mid-sagittal plane
Distraction –away from mid sagittal
plane
Contraction –closer to mid sagittal
plane
43

44. Ackermann-Profitt classification
Based on five characteristics
1.Alignment
2.Profile
3.Transverse relationships
4.Class
5.Overbite
1
2
3
4
5
44

46. 1.Alignment
Interarch alignment and symmetry assessed when seen in
occlusal view.
Dental arch is classified as ideal/crowded/spaced
2.Profile
can be convex/straight/concave
Includes assessment of facial divergence ie. Anterior or
posterior divergence.
3.Transverse relationships
Include transverse skeletal and dental relationships.
Buccal and palatal cross bites are noted.
Further classified as unilateral or bilateral.
Distinction made between skeletal and dental cross bites.
46

47. 4.Class
Sagittal relationship of teeth is assessed using Angle’s
classification as Class I / II / III.
Distinction made between skeletal and dental
malocclusions.
5.Overbite
Assessed in the vertical plane
Described as anterior open bite / posterior open bite /
anterior deep bite / posterior collapsed bite.
Distinction made between skeletal and dental
malocclusions.
47

48. Incisor classification
Class I
Class II
Division I
Division II
Class III
Class II
div 1
Class I
Class II
div 2
Class III
48

49. Class I
Mandibular incisor edges occlude with or lie
immediately below the cingulum plateau of the
maxillary central incisors.
Class II
Mandibular incisor edges lie posterior to the
cingulum plateau of the maxillary central
incisors.
Division I
Division II
49

50. Division I
Maxillary central incisors are proclined or of average
inclination and there is an increased overjet.
Division II
Maxillary central incisors are retro-clined; the overjet
is normally minimum, but maybe increased.
Class III
Mandibular incisor edges lie anterior to the cingulum
plateau of the upper central incisors; the overjet is
reduced or reversed.
50

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