The document outlines Dr. Ahmed Safwat's presentation on the management of Class II malocclusions. It begins with Dr. Safwat's introduction and credentials. It then provides an outline of the presentation topics which include definitions, classifications, etiological factors, clinical features, and management. The bulk of the document describes in detail the classification, clinical features, and treatment modalities for managing Class II malocclusions during the mixed dentition period, with a focus on management involving maxillary restriction using headgear for cases involving maxillary prognathism.

1. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
1
ORTHODONTICS MANAGEMENT OF
CLASS II MALOCCLUSIONS
A
H
M
E
D
S
A
F
W
A
T
EVENT SPEAKER:
DR. AHMED SAFWAT
BDS, DDS, MSC ORTHODONTICS, EOS AAO.

2. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
2
1.
Definitions:
2.
Classification:
3. Etiological
Factors:
4. Clinical
Features:
5.
Management:
O
U
T
L
I
N
E
S
ANTRO-POSTERIOR MALOCCLUSIONS
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS,

3. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
3
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
ANTRO-POSTERIOR MALOCCLUSIONS
Class 2 Malocclusions
Maxillary
Prognathism
Mandibular
Retrognathism
Combinations
Class 3 Malocclusions
Maxillary
Retrognathism
Mandibular
Prognathism
Combinations
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
CLASSIFCATIONS

4. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
4
Class II
MALOCCLUSIONS
Young Age
Growth
Modification
Adults
Camouflage
Class III
MALOCCLUSIONS
Young Age
Growth
Modification
Adults
Camouflage
ORTHODONTICS MANAGEMENT OF
SKELETAL ANTRO-POSTERIOR MALOCCLUSIONS
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
T
R
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A
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M
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N
T
M
O
D
A
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Antero-Posterior
Malocclusions,
Ahmed
Safwat
5
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS

6. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
6
I. Classification of Angle's Class II Malocclusion
 Based On Angle's Classification
Malocclusions Are Classified Into Two Types:
 Angle's Class II Division 1 Malocclusion;
The molar relationship is class ll with the upper
anteriors proclined.
 Angle's Class II Division 2 Malocclusion;
The molar relationship is class ll and the upper
incisors are retroclined
 Angle's Class ll Subdivision Malocclusion;
The molar relationship is class ll only in one side and
the other side has class l molar relationship.
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS

7. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
7
I. Classification of Angle's Class II Malocclusion
 Based On Angle's Classification
Malocclusions Are Classified Into Two Types:
1. Angle's Class II Division 1 Malocclusion;
The molar relationship is class ll with the upper
anteriors proclined.
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS

8. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
8
I. Classification of Angle's Class II Malocclusion
 Based On Angle's Classification
Malocclusions Are Classified Into Two Types:
2. Angle's Class II Division 2 Malocclusion;
The molar relationship is class ll and the upper
incisors are retroclined
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS

9. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
9
I. Classification of Angle's Class II Malocclusion
 Based On Angle's Classification
Malocclusions Are Classified Into Two Types:
3. Angle's Class ll Subdivision Malocclusion;
The molar relationship is class ll only in one side and
the other side has class l molar relationship.
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS

10. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
10
 When buccal groove of
first mandibular molar
occlude distal to mesio
buccal cusp of the first
maxillary molar with
retroclination of
maxillary central
incisors.
 It represent 5 to 10 %
of all malocclusion, by
Sassouni 1971.
II. Class II division II malocclusion
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
II. Von-der-lindon Classification Of Angle's Class II Malocclusion
Based On Severity Of Incisor Relationship
II. Class II division II malocclusion

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Malocclusions,
Ahmed
Safwat
11
II. Class II Division II Malocclusion Sub-division
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
- TYPE A:
Maxillary central and lateral incisors are retroclined.
Degree of retroclination is less severe in nature.
II.
Von-der-lindon
Classification
Of
Angle's
Class
II
Malocclusion
Based
On
Severity
Of
Incisor
Relationship

12. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
12
II. Class II Division II Malocclusion Sub-division
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
- TYPE B:
Maxillary lateral incisors are overlapping the
retroclined maxillary central incisors.
II.
Von-der-lindon
Classification
Of
Angle's
Class
II
Malocclusion
Based
On
Severity
Of
Incisor
Relationship

13. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
13
II. Class II Division II Malocclusion Sub-division
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
- TYPE C:
Maxillary central and lateral incisors are retroclined
and are overlapped by the maxillary canines.
II.
Von-der-lindon
Classification
Of
Angle's
Class
II
Malocclusion
Based
On
Severity
Of
Incisor
Relationship

14. 9/9/2021
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Malocclusions,
Ahmed
Safwat
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Pre-natal Factors
• Genetic and
congenital:
• Teratogenesis
• Irradiation
• Intrauterine fetal
posture
Natal Factors
• Improper forceps
application during
delivery can lead to
condylar damage
/fracture causing internal
hemorrhage into the
joint area. TMJ can get
ankylosed or fibrosed
later, leading to
underdevelopment of
the mandible
Post-natal Factors
• Traumatic injuries
• Oral habits such as
thumb sucking
• Congenitally missing
teeth
Etiological Factors of Class II Malocclusion
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS

15. 9/9/2021
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Malocclusions,
Ahmed
Safwat
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Clinical Features of Class II Division I Malocclusion
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Extra-oral
Features
Shape Of The Head: Mesocephalic or Dolichocephalic Facial Form: Mesoprosopic or Euryprosopic.
Facial Divergence: Posterior facial divergence.
Lips: Incompetent lips.
Mentolabial Sulcus: Deep .
Nasolabial Angle: Decreased .
Mentalis: Hyperactive.
Lower Facial Height: Decreased.
Profile: Convex facial profile

16. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
16
Clinical Features of Class II Division I Malocclusion
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Radiographic Features

17. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
17
Clinical Features of Class II Division I Malocclusion
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Intra-oral Features • Maxillary Anteriors:
Proclination of maxillary
anterior .
• Molar Relationship: Class II
molar relationship
• Incisor Relationship: Class II
division I incisor relationship.
• Over Jet: Increased .
• Over Bite: Increased .
• Shape Of The Maxillary Arch:
V shaped arch .
• Curve Of Spee: Exaggerated .
• Anterior Open Bite: May or
may not be present, Depends
on the persistence of
deleterious oral habits.
• Posterior Cross-bite & Scissor-
Bite: Presence depends on
persistence of habit.

18. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
18
Clinical Features of Class II Division I Malocclusion
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Extra-oral
Features
FEATURES CLASS II DIV 2
Shape Of The Head: Brachycephalic head
Profile Strait to mild convex
Upper Lip
Lower lip
Competency
Normal
Normal or everted
Competent
Mentolabial sulcus Maybe deep or normal
LFH Low

19. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
19
Clinical Features of Class II Division I Malocclusion
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Intra-oral
Features
Molar and canine
relationship
Class II molar and
canine relationship
Incisors
Centrals retroclined,
laterals proclined
Overjet decreased
Overbite Closed bite
Arch form Square U shaped
Palate shallow
Curve of spee deep
Path of closure Backward

20. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
20
Clinical Features of Class II Division I Malocclusion
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Radiograhic Features
1. SNA: Normal
2. SNB: Decreased
3. ANB: Increased
4. Flat mandibular plane.
5. Increased posterior
facial height(s-go).
6. Short lower anterior
facial height

21. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
21
Clinical Features of Class II Division I Malocclusion
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
 Result from discrepancy in
Maxillo-mandibular
relationship, which May
be due to;
 Mandibular deficiency.
 Maxillary excess,
 or combinations
Difference Between Dental & Skeletal Class II
Skeletal Class II
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS

22. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
22
Clinical Features of Class II Division I Malocclusion
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Difference Between Dental & Skeletal Class II
 Normal maxillo-mandibular relationship.
 Mainly due to mesial drift of upper 6 as a result of:
• Premature extraction of upper E.
• Congenitally missed of upper E.
 Discrepancy at inter arch tooth size;
• Small or congenitally missed upper Permenant premolar (u5) lead
to class II molar relationship.
• Impacted or missed upper canine or 2nd premolar lead to
inadequate space and then class II relationship.
Dental Class II

23. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
23
Management of Class II Division I Malocclusion
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Age At Which
The Patient
Is Seem
Nature &
Severity of
The
Problem
Treatment Principles Depends On Three Important Factors:

24. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
24
Class II
MALOCCLUSIONS
Young Age
Growth
Modification
Adults
Camouflage
Class III
MALOCCLUSIONS
Young Age
Growth
Modification
Adults
Camouflage
ORTHODONTICS MANAGEMENT OF
SKELETAL ANTRO-POSTERIOR MALOCCLUSIONS
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
T
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M
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N
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M
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A
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Antero-Posterior
Malocclusions,
Ahmed
Safwat
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Management of Class II Division I Malocclusion
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS

26. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
26
Management of Class II Division I Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Maxillary Prognathism
With
Normal Mandible:
Normal Maxilla With
Mandibular Deficiency

27. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
27
Management of Class II Division I Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Maxillary
Prognathism
&
Normal
Mandible:
• Restrict The Excessively Growing
Maxilla (Distalization)
• Extraoral Force Using Headgear
(The Most Effective Approach)
Main
Treatment
Objectives

28. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
28
Management of Class II Division I Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Maxillary
Prognathism
&
Normal
Mandible:
Face bow therapy is the best treatment to restrict max.
growth.
Face bow applay a distal extra-oral force on the maxillary
dentition and the maxilla in the magnitude of 400-600 gm
perside, intermittently for a duration of 12 to 14 hours a
day to bring about the desired skeletal effects.
More dental movement occurs if the face bow is worn more
than 16 hrs. per day at force level 300 gm or less.
Patients are advised to wear the appliance in the evening
and throughout the night.
Headgear age of treatment is usually given at 8.5 to 10.5
years in females and 9.5 to 11.5 years in males

29. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
29
Management of Class II Division I Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Maxillary
Prognathism
&
Normal
Mandible:
 Components Of Headgear:
1. Force Delivering Unit:
 Face Bow.
 'J'hook.
2. Force Generating Unit:
 Coil Spring (Safety Module).
3. Anchor Unit:
 Head Cap Or,
 Neck Strap.

30. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
30
Management of Class II Division I Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Maxillary
Prognathism
&
Normal
Mandible:

31. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
31
Management of Class II Division I Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Maxillary
Prognathism
&
Normal
Mandible:

32. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
32
Management of Class II Division I Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Maxillary
Prognathism
&
Normal
Mandible:
• Shape Of The Head: Mesocephalic or Dolichocephalic
• Facial Form: Mesoprosopic or Euryprosopic.
• Lips: Incompetent lips.
• Mentolabial Sulcus: Deep .
• Nasolabial Angle: Decreased .
• Mentalis: Hyperactive.
• Profile: Convex facial profile
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Extra-oral
Records:

33. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
33
Management of Class II Division I Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Maxillary
Prognathism
&
Normal
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Intra-oral Records:

34. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
34
Management of Class II Division I Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Maxillary
Prognathism
&
Normal
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Radiographic
Records:

35. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
35
Management of Class II Division I Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Maxillary
Prognathism
&
Normal
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Radiograhic Features
1. SNA: Increased.
2. SNB: Normal.
3. ANB: Increased.
4. FMA: Increased.
5. Decreased
posterior facial
height(s-go).
6. Long lower anterior
facial height

36. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
36
Management of Class II Division I Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Maxillary
Prognathism
&
Normal
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Treatment Objectives:
 Restrict the maxillary forward downward growth.
 Correct the increased dental over-jet.
Treatment Steps:
 Two Stage Treatment Protocols Were Followed:
 1st Removable Stage: High-pull headgear with
removable acrylic maxillary splint for 9 months for
maxillary distalization.
 2nd Fixed Stage: SWA reinforced with High-pull
headgear for anchorage

37. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
37
Management of Class II Division I Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Maxillary
Prognathism
&
Normal
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS

38. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
38
Management of Class II Division I Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Maxillary
Prognathism
&
Normal
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Intra-oral Records:

39. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
39
Management of Class II Division I Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Maxillary
Prognathism
&
Normal
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Extra-oral
Records:
• Shape Of The Head: Mesocephalic or Dolichocephalic
• Lips: Competent lips.
• Mentolabial Sulcus: Normal .
• Nasolabial Angle: Increased .
• Mentalis: Normal.
• Profile: Straight to Convex facial profile
Extra-oral
Records:

40. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
40
Management of Class II Division I Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Maxillary
Prognathism
&
Normal
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Intra-oral Records:

41. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
41
Management of Class II Division I Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Management
Of
Class
ΙΙ
Div
I
With
Maxillary
Prognathism
&
Normal
Mandible:
Radiographic Records:
1. SNA: Decreased.
2. SNB: Normal.
3. ANB: Decreased.

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Antero-Posterior
Malocclusions,
Ahmed
Safwat
42
Management of Class II Division II Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
II
With
Normal
Maxilla
&
Deficient
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Case Report:
• Egyptian male with 10
years old.
• Chief complaint of bad
smile & improper occlusion
functions.
• Extra-oral records show
deficient mandible with
decreased anterior lower
facial height &
incompetent lips.
• Intra-oral records show
increased over-jet with
crowded & extruded lower
anterior teeth.

43. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
43
Management of Class II Division II Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
II
With
Normal
Maxilla
&
Deficient
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
• Shape Of The Head: Mesocephalic or Dolichocephalic
• Lips: Incompetent lips.
• Mentolabial Sulcus: Deep .
• Nasolabial Angle: Decreased .
• Mentalis: Hyperactive.
• Profile: Convex facial profile
Extra-oral
Records:

44. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
44
Management of Class II Division II Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
II
With
Normal
Maxilla
&
Deficient
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Intra-oral Records:

45. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
45
Management of Class II Division II Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
II
With
Normal
Maxilla
&
Deficient
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Radiographic
Records:
1. SNA: Increased.
2. SNB: Decreased.
3. ANB: Increased.

46. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
46
Management of Class II Division II Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Treatment Objectives:
 Activate the mandible forward downward growth.
 Correct the increased dental over-jet.
Treatment Steps:
 Two Stage Treatment Protocols Were Followed:
 1st Removable Stage: Twin-block removable apliance
for 9 months for mandible forward downward growth
activation.
 2nd Fixed Stage: SWA reinforced with fixed
functional appliance for anchorage & continue
mandible forward downward movement.
Management
Of
Class
ΙΙ
Div
II
With
Normal
Maxilla
&
Deficient
Mandible:

47. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
47
Management of Class II Division II Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
II
With
Normal
Maxilla
&
Deficient
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
 The primary goal is to
enhance the mandibular
growth using functional
appliances like activator,
frankel, herbest and various
bite jumping devices.
 They work by unloading the
mandibular condyle from the
glenoid fossa to a more
forward position inducing
altered muscular activity.
 This tend to enhance the
growth in the condyle region.

48. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
48
Management of Class II Division II Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
II
With
Normal
Maxilla
&
Deficient
Mandible:
Twin-Block Appliance
 Twin-block appliance is
composed of maxillary and
mandibular acrylic retainers
that fit tightly against the
teeth, alveolus and adjacent
supporting structures.
 Delta clasps are used bilaterally
to anchor the maxillary
appliance to the first permanent
molars and 0.030 inch
 Ball clasps are placed in the
interproximal areas anteriorly
REMOVABLE FUNCTIONAL APPLIANCES THERAPY

49. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
49
Management of Class II Division II Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
II
With
Normal
Maxilla
&
Deficient
Mandible:
Twin-Block Appliance
REMOVABLE FUNCTIONAL APPLIANCES THERAPY

50. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
50
Management of Class II Division II Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
II
With
Normal
Maxilla
&
Deficient
Mandible:
REMOVABLE FUNCTIONAL APPLIANCES THERAPY
Twin-Block Appliance

51. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
51
Management of Class II Division II Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
II
With
Normal
Maxilla
&
Deficient
Mandible:
Twin-Block Appliance
 Anchorage: The precise clasp configuration depends on
the type of deciduous or permanent teeth and number of
teeth present at the time of appliance construction.
 Bio-mechanics: It produce increase in mandibular length,
incisor proclination and variations in lower anterior facial
height.
 The posterior bite blocks of the twin block appliance can
be trimmed to facilitate the eruption of the lower
posterior teeth in patient with a deep bite and an
accentuated curve of Spee.
 The blocks also can be left untouched to prevent the
eruption of the posterior teeth in patients with a
tendency toward an anterior open bite.
REMOVABLE FUNCTIONAL APPLIANCES THERAPY

52. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
52
Management of Class II Division II Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
II
With
Normal
Maxilla
&
Deficient
Mandible:
Twin-Block Appliance
REMOVABLE FUNCTIONAL APPLIANCES THERAPY

53. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
53
Management of Class II Division II Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
II
With
Normal
Maxilla
&
Deficient
Mandible:
FIXED FUNCTIONAL APPLIANCES THERAPY
HERBST DESIGN
The Herbst appliance is a fixed functional
orthopedic appliance having passive tube and
plunger system with the exact length of the
tube determining the amount of anterior
mandibular development.
The tube is attached to a maxillary posterior
root, whereas the plunger is fixed anteriorly
to the mandibular dentition and slides through
the tube during opening and closing movements.
HERBST APPLIANCE

54. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
54
Management of Class II Division II Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
II
With
Normal
Maxilla
&
Deficient
Mandible:
FIXED FUNCTIONAL APPLIANCES THERAPY
HERBST APPLIANCE

55. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
55
Management of Class II Division II Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
II
With
Normal
Maxilla
&
Deficient
Mandible:
FIXED FUNCTIONAL APPLIANCES THERAPY
HERBST APPLIANCE
Indications:
• 1. Dental class II
malocclusion.
• 2. Deep bite with
retroclined
mandibular incisors.
• 3. Skeletal class II
mandibular
deficiency
Contraindication:
• 1. Dental and
skeletal open bites.
• 2. Cases prone to
root resorption.
Disadvantages:
• 1. High cost.
• 2. Herbst appliance
associated with
more chances of
breakage.
• 3. Less patient
acceptance

56. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
56
Management of Class II Division II Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
II
With
Normal
Maxilla
&
Deficient
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
• Shape Of The Head: Mesocephalic or Dolichocephalic
• Lips: Competent lips.
• Mentolabial Sulcus: Normal .
• Nasolabial Angle: Increased .
• Mentalis: Normal function.
• Profile: Straight to Convex facial profile
Extra-oral
Records:

57. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
57
Management of Class II Division II Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
II
With
Normal
Maxilla
&
Deficient
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Radiographic
Records:
1. SNA: Decreased.
2. SNB: Increased.
3. ANB: Decreased.

58. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
58
Management of Class II Division II Malocclusion
During Mixed Dentition Period (Growing Period)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
II
With
Normal
Maxilla
&
Deficient
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Intra-oral Records:

59. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
59
Management of Dento-alveolar Class II Malocclusion
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Management
Of
Dento-alveolar
Class
ΙΙ

60. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
60
Management of Dento-alveolar Class II Malocclusion
With Normal Skeletal Relationship (Growing Period).
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Dento-alveolar
Class
ΙΙ
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Management Is Based Mainly On The
Etiological Factors:
2-In prematurely
extracted cases where
mesial drift has occurred,
space regaining device are
to be used
1-Avoid premature
extraction and if necessary
space should maintained to
prevent mesial drift in the
molar.

61. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
61
Management of Dento-alveolar Class II Malocclusion
With Normal Skeletal Relationship (Growing Period).
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
THEY FALL UNDER TWO CATEGORY:
B- Extra-oral appliances
for distalization can be
done using headgear
A- Intra-oral appliances
for distalization , include
pendulum, distal slide
appliance or springs.
Management
Of
Dento-alveolar
Class
ΙΙ

62. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
62
Management of Dento-alveolar Class II Malocclusion
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Management
Of
Dento-alveolar
Class
ΙΙ
 Premature Tooth Loss With Adequate Space: Space
Maintenance :
 Band-and-Loop Space Maintainers.

63. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
63
Management of Dento-alveolar Class II Malocclusion
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Early
loss of
primary teeth

64. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
64
Management of Dento-alveolar Class II Malocclusion
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Management
Of
Dento-alveolar
Class
ΙΙ

65. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
65
Class II
MALOCCLUSIONS
Young Age
Growth
Modification
Adults
Camouflage
Class III
MALOCCLUSIONS
Young Age
Growth
Modification
Adults
Camouflage
ORTHODONTICS MANAGEMENT OF
SKELETAL ANTRO-POSTERIOR MALOCCLUSIONS
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
T
R
E
A
T
M
E
N
T
M
O
D
A
L
I
T
I
E
S

66. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
66
Management of Class II Division I Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Maxillary
Prognathism
&
Normal
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Class II Division I Malocclusion In Adult Patients
Maxillary
Prognathism
Mandibular
Retrognathism
Combinations
CLASSIFCATIONS

67. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
67
Management of Class II Division I Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Maxillary
Prognathism
&
Normal
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Non Accepted Smile
Display Due To
Maxillary
Prognathism
Two Treatment Protocols
Available:
Retraction Of Anterior
Segment Into Premolars
Extraction Spaces
Distalization Of The
Whole Maxillary
Segment
A- Maxillary Prognathism

68. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
68
Management of Class II Division I Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Maxillary
Prognathism
&
Normal
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Extra-oral
Features
Shape Of The Head: Mesocephalic or Dolichocephalic
Facial Profile: Convexdivergence.
Lips: Incompetent lips.
Mentolabial Sulcus: Deep .
Nasolabial Angle: Decreased .

69. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
69
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Intra-oral Features
• Maxillary Anteriors:
Proclination of maxillary
anterior .
• Molar Relationship: Class II
molar relationship
• Incisor Relationship: Class II
division I incisor relationship.
• Over Jet: Increased .
• Over Bite: Increased .
• Shape Of The Maxillary Arch:
V shaped arch .
• Curve Of Spee: Exaggerated .
Management of Class II Division I Malocclusion
In Permanent Dentition (Adult Patients)
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS

70. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
70
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management of Class II Division I Malocclusion
In Permanent Dentition (Adult Patients)
Radiographic Features
1. SNA: Increased.
2. SNB: Normal.
3. ANB: Increased.
4. FMA: Increased.
5. Decreased posterior facial
height(s-go).
6. Long lower anterior facial
height

71. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
71
Management of Class II Division I Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Maxillary
Prognathism
&
Normal
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Treatment Objectives:
 Retract the maxilla.
 Correct the increased
dental over-jet.
Treatment Steps:
 Extraction of 1st premolars.
 Retraction Of Anterior Segment Into Premolars
Extraction Spaces

72. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
72
Management of Class II Division I Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Maxillary
Prognathism
&
Normal
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Treatment
Progress:

73. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
73
Management of Class II Division I Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Maxillary
Prognathism
&
Normal
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Treatment Progress:

74. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
74
Management of Class II Division I Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Maxillary
Prognathism
&
Normal
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Treatment Progress:

75. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
75
Management of Class II Division I Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Maxillary
Prognathism
&
Normal
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Treatment Progress:

76. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
76
Management of Class II Division I Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Two Treatment Protocols
Available:
Retraction Of Anterior
Segment Into Premolars
Extraction Spaces
Distalization Of The
Whole Maxillary
Segment
B- Mandibular Retrusion
Management
Of
Class
ΙΙ
Div
I
With
Normal
Maxilla
&
Retruded
Mandible:

77. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
77
Management of Class II Division I Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Normal
Maxilla
&
Retruded
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Maxillary
Distalization
MEAW
Bio-mechanics

78. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
78
Management of Class II Division I Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Normal
Maxilla
&
Retruded
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
MEAW
Bio-mechanics
Maxillary
Distalization

79. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
79
Management of Class II Division I Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Normal
Maxilla
&
Retruded
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Maxillary
Distalization
TADs
Bio-mechanics

80. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
80
Management of Class II Division I Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
I
With
Maxillary
Prognathism
&
Normal
Mandible:
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Class II Division I Malocclusion In Adult Patients
Maxillary
Prognathism
Mandibular
Retrognathism
Combinations
CLASSIFCATIONS

81. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
81
Management of Class II Division I Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
In Case Of A Combinations Of Increased Maxilla & Mandible

82. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
82
Management of Class II Division I Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
I
n
C
a
s
e
O
f
A
C
o
m
b
i
n
a
t
i
o
n
s
O
f
I
n
c
r
e
a
s
e
d
M
a
x
i
l
l
a
&
M
a
n
d
i
b
l
e
Two Treatment Objecties:
Retraction Of Maxillary
Anterior Segment
Retraction Of
Mandibular Anterior
Segment
C- Maxillary & Mandibular
Excess

83. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
83
Management of Class II Division I Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
I
n
C
a
s
e
O
f
A
C
o
m
b
i
n
a
t
i
o
n
s
O
f
I
n
c
r
e
a
s
e
d
M
a
x
i
l
l
a
&
M
a
n
d
i
b
l
e
• Shape Of The Head:
Dolichocephalic
• Facial Profile: Convex divergence.
• Lips: Incompetent lips.
• Mentolabial Sulcus: Deep .
• Nasolabial Angle: Decreased .
Extra-oral
Features

84. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
84
Management of Class II Division I Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
I
n
C
a
s
e
O
f
A
C
o
m
b
i
n
a
t
i
o
n
s
O
f
I
n
c
r
e
a
s
e
d
M
a
x
i
l
l
a
&
M
a
n
d
i
b
l
e
• Shape Of The Head:
Dolichocephalic
• Facial Profile: Convex divergence.
• Lips: Incompetent lips.
• Mentolabial Sulcus: Deep .
• Nasolabial Angle: Decreased .
Extra-oral
Features

85. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
85
Management of Class II Division I Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
I
n
C
a
s
e
O
f
A
C
o
m
b
i
n
a
t
i
o
n
s
O
f
I
n
c
r
e
a
s
e
d
M
a
x
i
l
l
a
&
M
a
n
d
i
b
l
e
Radiographic Features
1. SNA: Increased.
2. SNB: Increased.
3. ANB: Increased.
4. FMA: Increased.
5. Decreased posterior
facial height(s-go).
6. Long lower anterior
facial height

86. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
86
Management of Class II Division I Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
I
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M
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Intra-oral Records

87. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
87
Management of Class II Division I Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
I
n
C
a
s
e
O
f
A
C
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m
b
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a
t
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s
O
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I
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c
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e
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M
a
x
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a
&
M
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n
d
i
b
l
e
Treatment
Progress:

88. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
88
Management of Class II Division II Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Management
Of
Class
ΙΙ
Div
II
In
Permanent
Dentition
(Adult
Patients):
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS

89. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
89
Management of Class II Division II Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Treatment
Objectives
Correct Molar & Canine Relationships
Relief The Crowded Dentition
Correct Anterior Teeth Torque
Management
Of
Class
ΙΙ
Div
II
In
Permanent
Dentition
(Adult
Patients):

90. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
90
Extra-oral
Features
FEATURES CLASS II DIV 2
Shape Of The Head: Brachycephalic head
Profile Strait to mild convex
Upper Lip
Lower lip
Competency
Normal
Normal or everted
Competent
Mentolabial sulcus Maybe deep or normal
LFH Low
Management
Of
Class
ΙΙ
Div
II
In
Permanent
Dentition
(Adult
Patients):
Management of Class II Division II Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS

91. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
91
Clinical Features of Class II Division I Malocclusion
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Radiographic Features
1. SNA: Normal
2. SNB: Decreased
3. ANB: Increased
4. Flat mandibular plane.
5. Increased posterior
facial height(s-go).
6. Short lower anterior
facial height

92. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
92
Management of Class II Division II Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Radiographic Records:
Management
Of
Class
ΙΙ
Div
II
In
Permanent
Dentition
(Adult
Patients):

93. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
93
Management of Class II Division II Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Intra-oral Records:
Management
Of
Class
ΙΙ
Div
II
In
Permanent
Dentition
(Adult
Patients):

94. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
94
Clinical Features of Class II Division I Malocclusion
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
Intra-oral
Features
Molar and canine
relationship
Class II molar and
canine relationship
Incisors
Centrals retroclined,
laterals proclined
Overjet decreased
Overbite Closed bite
Arch form Square U shaped
Palate shallow
Curve of spee deep
Path of closure Backward

95. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
95
Management of Class II Division II Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Management
Of
Class
ΙΙ
Div
II
In
Permanent
Dentition
(Adult
Patients):
Treatment
Progress:

96. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
96
Management of Class II Division II Malocclusion
In Permanent Dentition (Adult Patients)
ORTHODONTICS MANAGEMENT OF
ANTRO-POSTERIOR MALOCCLUSIONS
BY, DR. AHMED SAFWAT ORTHODONTIC CENTERS
Treatment
Progress:
Management
Of
Class
ΙΙ
Div
II
In
Permanent
Dentition
(Adult
Patients):

97. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
97
ORTHODONTICS MANAGEMENT OF
CLASS II MALOCCLUSIONS
A
H
M
E
D
S
A
F
W
A
T
EVENT SPEAKER:
DR. AHMED SAFWAT
BDS, DDS, MSC ORTHODONTICS, EOS AAO.
• Orthodontics contemporary ( William R.
Proffit).
• Hand book of Orthodontics (Robert
Moyers).
• ORTHODONTICS Principles and Practice(
Basavaraj Subhashchandra Phulari).
• FLAVIO URIBE, RAVINDRA NANDA,
Treatment of Class II, Division 2
Malocclusion in Adults: Biomechanical
Considerations 2003 JCO.
• Paulo Renato Carvalho Ribeiro, Angle
Class II, Division 2, malocclusion with
deep overbite, Dental Press J. Orthod.
132-143, Jan./Feb. 2010.
• Hande Görücü Coşkuner, İlken
Kocadereli, Non extraction Treatment OF An
Adult With CLASS II DIVISION 2 Malocclusion,
CLINICAL DENTISTRY AND RESEARCH 2013; 37(3): 49-
56
References:

98. 9/9/2021
Antero-Posterior
Malocclusions,
Ahmed
Safwat
98
ORTHODONTICS MANAGEMENT OF
CLASS II MALOCCLUSIONS
A
H
M
E
D
S
A
F
W
A
T
EVENT SPEAKER:
DR. AHMED SAFWAT
BDS, DDS, MSC ORTHODONTICS, EOS AAO.