5. class2 division1


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5. class2 division1

  1. 1. Class2 division1 <ul><li>This classification according to british standards institute classification:- </li></ul><ul><li>This class based upon incisor relationship and is the most widely used descriptive classification . </li></ul><ul><li>Classified as:- </li></ul><ul><li>Class1-the lower incisor edges occlude with or lie immediately below the cingulum plateau of the upper central incisors. </li></ul>
  2. 2. <ul><li>Class2-the lower incisor edges lie posterior to the cingulum plateau of the upper incisors. There are two subdivisions of this category: </li></ul><ul><li>Division1-the upper central incisors are proclined or of average inclination and there is an increase in overjet. </li></ul><ul><li>Division2-the upper central incisors are retroclined. The overjet is usually minimal or may be increased. </li></ul><ul><li>Class3-the lower incisor edges lie anterior to the cingulum plateau of the upper incisors. The overjet is reduced or reversed. </li></ul>
  3. 3. Class2 division1 <ul><li>Definition </li></ul><ul><li>Aetiology </li></ul><ul><li>Occlusion Feature </li></ul><ul><li>Out line of management </li></ul>
  4. 4. <ul><li>Definition :- </li></ul><ul><li>The British Standards classification defines a Class2 division1 incisor relationship as follows: the lower incisor edges lie posterior to the cingulum plateau of the upper incisors, there is an increase in overjet and the upper central incisors are usually proclined. </li></ul><ul><li>In a Caucasian population the incidence of Class2 division1 incisor relationship is approximately 15-20 per cent. </li></ul>
  5. 5. <ul><li>Prominent upper incisors, particularly when the lips are incompetent, are at increased risk of being traumatized. It has been shown that children with an overjet greater than 9 mm are twice as likely to have suffered trauma involving their upper incisor teeth as are those with normal or reduced overjets. </li></ul>
  6. 7. <ul><li>AETIOLOGY :- </li></ul><ul><li>1-Skeletal pattern. </li></ul><ul><li>2-Soft tissues. </li></ul><ul><li>3-Dental factors. </li></ul><ul><li>4-Habits. </li></ul>
  7. 8. Occlusal features <ul><li>The overjet is increased. </li></ul><ul><li>The upper incisors may be proclined. </li></ul><ul><li>Perhaps as the result of a habit or an adaptive swallow; or upright, with the increased overjet reflecting the skeletal pattern. </li></ul><ul><li>The overbite is often increased, but may be incomplete as a result of an adaptive tongue-forward sward swallow, a habit or increased vertical skeletal proportion. </li></ul><ul><li>The latter two factors are marked, an anterior open bite may result. </li></ul>
  8. 9. <ul><li>If the lips are grossly incompetent and are habitually apart at rest, drying of the gingivae may lead to an exacerbation of any pre-existing gingivitis . </li></ul><ul><li>The molar relationship usually reflects the skeletal pattern unless early deciduous tooth loss has resulted in mesial drift of the first permanent molars </li></ul>
  9. 10. Assessment of, and treatment planning <ul><li>Factor should be considered before deciding upon a treatment plan: </li></ul><ul><li>1-The patient’s age. </li></ul><ul><li>2-The difficulty of treatment. </li></ul><ul><li>3-The likely stability of reduction. </li></ul><ul><li>4-The patient’s facial appearance. </li></ul>
  10. 11. Practical Treatment planning <ul><li>In general class2 division1 malocclusions are commonly </li></ul><ul><li>associated </li></ul><ul><li>with increased overbite, which must be reduced before the overjet </li></ul><ul><li>can be reduced. </li></ul><ul><li>Overbite reduction requires space (about 1-2 mm for an averagely </li></ul><ul><li>increased overbite). </li></ul><ul><li>Significantly increased overbites will require more space and fixed </li></ul><ul><li>appliances, or even surgery. </li></ul>
  11. 12. <ul><li>If extraction are required in the lower arch, both spontaneous and </li></ul><ul><li>active tooth movement are facilitated by removal of the </li></ul><ul><li>corresponding </li></ul><ul><li>tooth in the upper arch. </li></ul><ul><li>The actual choice of extraction site will depend upon the presence </li></ul><ul><li>of </li></ul><ul><li>crowding, the tooth movements planned, and their anchorage </li></ul><ul><li>requirements. </li></ul>
  12. 13. In a Moderate to Severe Class2 skeletal pattern: <ul><li>1-Growth modification. </li></ul><ul><li>2-Orthodontic camouflage using fixed appliances. </li></ul><ul><li>3-Surgcalcorrection. </li></ul>
  13. 14. <ul><li>Thank You </li></ul>