Management of class ii division 1 malocclusion

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Management of class ii division 1 malocclusion
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Management of class ii division 1 malocclusion

  1. 2. Aetiology <ul><li>Skeletal: </li></ul><ul><ul><li>Genetic component: </li></ul></ul><ul><ul><ul><li>Prognathic maxilla </li></ul></ul></ul><ul><ul><ul><li>Retrognathic mandible </li></ul></ul></ul><ul><ul><ul><li>Combination of both </li></ul></ul></ul>
  2. 3. Aetiology <ul><li>Soft tissues: </li></ul><ul><li>Incompetent lips </li></ul><ul><ul><li>Proclined upper incisor </li></ul></ul><ul><li>Lower lip trap behind upper incisors </li></ul><ul><ul><li>Proclination of upper incisors </li></ul></ul><ul><ul><li>Retroclination of lower incisors </li></ul></ul><ul><li>Tongue thrust </li></ul>
  3. 4. Aetiology <ul><li>Habits: </li></ul><ul><li>Digit sucking habit </li></ul><ul><ul><li>Proclination of upper incisors </li></ul></ul><ul><ul><li>Retroclination of lower incisors </li></ul></ul><ul><ul><li>AOB or in less severe forms incomplete OB </li></ul></ul><ul><ul><li>Cross bite </li></ul></ul><ul><ul><li>Incresed LFH </li></ul></ul>
  4. 5. Features of Class II div 1 <ul><li>Skeletal features: </li></ul><ul><ul><li>Usually class II relation ranging from mild to sever (Large ANB angle) </li></ul></ul><ul><ul><li>Open bite, normal or deep (MM angle) </li></ul></ul>
  5. 7. Features of Class II div 1
  6. 8. Features of Class II div 1 <ul><li>Dental features: </li></ul><ul><ul><li>Class II molar, canine and incisor relations </li></ul></ul><ul><ul><li>Proclined maxillary incisors or normally inclined </li></ul></ul><ul><ul><li>Increased overjet </li></ul></ul><ul><ul><li>Open bite, normal overbite </li></ul></ul><ul><ul><li>or deep bite </li></ul></ul>
  7. 9. Treatment modalities <ul><li>Growth modification: </li></ul><ul><ul><li>Head gear (High pull, low pull, medium pull) </li></ul></ul><ul><ul><li>Functional appliances </li></ul></ul><ul><li>Fixed appliances (with Class II elastics) </li></ul><ul><li>Removable appliances </li></ul><ul><li>Surgery </li></ul>
  8. 11. Functional appliances <ul><li>For growth modification in </li></ul><ul><li>a growing patients : </li></ul>1- Mild to moderate Class II div. 1 2- Proclined upper incisors 3- N o lower and upper arch crowding 4- Deep overbite 5- Average or reduced LFH.
  9. 12. Effect of functional appliances
  10. 13. Class II division I malocclusion <ul><li>Removable appliances </li></ul><ul><li>Robert retractors </li></ul><ul><li>-Proclined upper incisors </li></ul><ul><li>-Spaced upper incisor </li></ul><ul><li>-Normal or reduced overbite </li></ul>
  11. 14. Fixed appliances <ul><li>Used for most complicated tooth movements which involve bodily tooth movement, intrusion, extrusion. </li></ul>
  12. 15. Treatment modalities <ul><li>Non growing patients: </li></ul><ul><ul><li>Removable appliances: </li></ul></ul><ul><ul><li>e.g Robert’s retractor </li></ul></ul><ul><ul><li>Fixed appliances </li></ul></ul><ul><ul><li>Surgery </li></ul></ul>
  13. 16. Patient’s assessment and RX planning <ul><li>Rx depends on: </li></ul><ul><ul><li>Patient’s age (Grower or not) </li></ul></ul><ul><ul><ul><li>Growth modification with or with out fixed appliances </li></ul></ul></ul><ul><ul><li>The severity of malocclusion </li></ul></ul><ul><ul><li>Patients facial profile </li></ul></ul>
  14. 17. Retention and stability <ul><li>For OJ reduction to be stable, anterior lip seal should be achieved </li></ul><ul><li>Lower lip contact the upper incisors </li></ul>
  15. 18. Retention
  16. 19. ORTHOGNATHIC SURGERY
  17. 22. FIXED APPLIANCES
  18. 26. GROWTH MODIFICATION

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