DEPARTMENT OF ORTHODONTICS SUBHARTI DENTAL...

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


Individual tooth malpositions

Mesial inclination or tipping

Distal inclination or tipping

Lingual inclination or tipping


Labial tipping

Infra occlusion Supra occlusion


Rotations

Mesiolingual/distolabial

Distolingual/mesiolabial

Transposition


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


Vertical plane malocclusion

Deep bite Open bite


Transeverse plane malocclusion

Various types of cross bites


Skeletal mal occlusions

Caused due to the defect in the underlying skeletal structure

Defect can be in size, position or relationship between the jaws


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


Class I malocclusion

Class I molar relationship

Mesiobuccal cusp of the maxillary first

molar occludes in the buccal groove of

the mandibular 1st permanent molar


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


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


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


Class II subdivision

Class II molar relation on one side and class I on other


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 III


Class III MALOCCLUSION


TRUE CLASS III

Class III molar relation

LOWER INCISORS LINGUALLY

INCLINED

LOWER TONGUE POSTURE- NARROW UPPER ARCH


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


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


NO DIFFERENTIATION BETWEEN SKELETAL AND DENTAL MALOCCLUSION

NO CLUE ABOUT ETIOLOGY


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


Type 4 - Angle CL I with posterior cross bite

Type 5 - molars are in mesioversion due to early loss of teeth mesial to them


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


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


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


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


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)


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


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


Orbital plane

Perpendicular to the

FHP

Simon’s law of

canine- “this plane

should pass through

the distal third of the canine”


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


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

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


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 relationship is assessed. Dr Ashutosh, Subharti 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


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


5. overbite malocclusion are assessed in the vertical plane

Openbite - Anterior or Posterior

Deep bite - Anterior or Posterior

Skeletal or dental


INCISOR CLASSIFICATION

1. Class I: The lower incisor edges occlude with or lie directly below the

cingulum plateau of the upper central incisors. If the overbite is

incomplete the lower incisors are repositioned along their long axis until

they meet the upper incisors.

2. Class II: The lower incisor edges lie posterior to the cingulum plateau of

the upper central incisors. There are two divisions of Class II:

Division 1: the upper central incisors are of average inclination or are

proclined. The overjet is thus increased.

Division 2: the upper central incisors are retroclined; the overjet is

usually within normal limits but the overbite is often increased.

Class III: The lower incisor edges lie anterior to the cingulum plateau of the upper central incisors

CANINE CLASSIFICATION

1. Class I canine relationship – the upper permanent canine

occludes in the embrasure between the lower permanent

canine and first premolar.

2. Class II canine relationship – the upper canine occludes a

whole tooth width further anteriorly and lies in the

embrasure between the lower canine and lateral incisor.

3. Class III canine relationship – the upper canine occlude a

whole tooth width further posteriorly than normal and

occludes in the embrasure between the lower first and

second premolars.

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