This document provides an overview of different methods for classifying malocclusion. It describes Angle's classification system, which categorizes malocclusions based on the relationship between the upper and lower first molars. Class I has a normal molar relationship, Class II has distoclusion of the mandibular molars, and Class III has mesioclusion. It also discusses modifications to Angle's system by Dewey and Lischer, as well as Simon's craniometric classification approach. The document defines various types of individual tooth malpositions and interarch malocclusions. It notes limitations of Angle's system and provides illustrations to enhance understanding of the classification methods.

1. PROF (Dr.) SAIBEL FARISHTA
CLASSIFICATION OF MALOCCLUSION

2. THE ADVANTAGES OF CLASSIFYING MALOCCLUSION
IS AS FOLLOWS -
• CLASSIFICATION HELPS IN DIAGNOSIS AND TREATMENT
PLANNING FOR THE PATIENT
• IT HELPS IN VISUALIZING AND UNDERSTANDING THE
PROBLEM ASSOCIATED WITH THAT MALOCCLUSION
• CLASSIFICATION HELPS IN COMMUNICATING THE PROBLEM
• COMPARISON OF VARIOUS MALOCCLUSIONS IS MADE EASY
BY CLASSIFICATION

3. TYPES OF MALOCCLUSIONS
1. INDIVIDUAL TEETH MALPOSITIONS OR INTRA – ARCH
MALOCCLUSION
2. MAXILLO – MANDIBULAR MALOCCLUSIONS OR INTER – ARCH
MALOCCLUSION
1. INDIVIDUAL TEETH MALPOSITIONS
• DISTAL TIPPING/INCLINATION - CROWN OF THE TOOTH IS
TILTED/INCLINED DISTALLY
• MESIAL TIPPING/INCLINATION - CROWN OF THE TOOTH IS
TILTED/INCLINED MESIALLY
• LINGUAL TIPPING/INCLINATION – ABNORMAL
LINGUAL/PALATAL TILTING OF THE TOOTH. THIS IS ALSO
KNOWN AS RETROCLINATION

4. • BUCCAL TIPPING/INCLINATION – LABIAL/BUCCAL TILTING OF
THE TOOTH. THIS IS ALSO KNOWN AS PROCLINATION
• MESIAL DISPLACEMENT – A TOOTH WHICH MOVES BODILY IN
MESIAL DIRECTION TOWARDS THE MIDLINE
• DISTAL DISPLACEMENT – A TOOTH WHICH MOVES BODILY IN
DISTAL DIRECTION, AWAY FROM THE MIDLINE
• LINGUAL DISPLACEMENT – WHEN THE ENTIRE TOOTH IS
DISPLACED IN A LINGUAL DIRECTION
• BUCCAL DISPLACEMENT – WHEN THE ENTIRE TOOTH IS
DISPLACED BODILY IN A LABIAL/BUCCAL DIRECTION
• INFRAVERSION / INFRA-OCCLUSION – TOOTH THAT HAS NOT
ERUPTED ENOUGH, AS COMPARED TO THE OTHER TEETH IN
THE ARCH

5. • SUPRAVERSION/SUPRA-OCCLUSION – TOOTH THAT HAS
OVER-ERUPTED AS COMPARED TO OTHER TEETH IN THE
ARCH
• ROTATIONS – TOOTH MOVEMENTS AROUND IT’S LONG AXIS
• DISTO-LINGUAL OR MESIO-BUCCAL ROTATION – A TOOTH
WHICH HAS MOVED AROUND IT’S LONG AXIS, SO THAT THE
DISTAL ASPECT IS PLACED MORE LINGUALLY
• MESIO-LINGUAL OR DISTO-BUCCAL ROTATION – A TOOTH
WHICH HAS MOVED AROUND IT’S LONG AXIS, SO THAT THE
MESIAL ASPECT IS MORE LINGUALLY PLACED
• TRANSPOSITION – WHEN TWO TEETH HAVE EXCHANGED
PLACES

6. A = DISTAL TIPPING
B = MESIAL TIPPING
C = LINGUAL TIPPING
D = LABIAL TIPPING
E = MESIAL DISPLACEMENT
F = DISTAL DISPLACEMENT

7. G = LINGUAL DISPLACEMENT
H = LABIAL DISPLACEMENT
I = INFRAVERSION
J = SUPRAVERSION
K = ROTATION
L = TRANSPOSITION

8. 2. MAXILLO – MANDIBULAR MALOCCLUSIONS
THESE MALOCCLUSIONS ARE CHARACTERIZED BY ABNORMAL
RELATIONSHIP BETWEEN TWO TEETH OR GROUPS OF TEETH OF
ONE ARCH TO THE OTHER ARCH. THESE INTER-ARCH
MALOCCLUSIONS CAN OCCUR IN SAGITTAL, VERTICAL OR
TRANSVERSE PLANES OF SPACE.
• SAGITTAL PLANE MALOCCLUSIONS -
PRE NORMAL OCCLUSION – WHEN THE LOWER ARCH IS MORE
FORWARDLY PLACED WHEN THE PATIENT BITES IN CENTRIC
OCCLUSION
POST NORMAL OCCLUSION – WHEN THE LOWER ARCH IS
MORE DISTALLY PLACED WHEN THE PATIENT BITES IN
CENTRIC OCCLUSION

9. • VERTICAL PLANE MALOCCLUSIONS -
DEEP BITE OR INCREASED OVER BITE – WHEN THERE IS AN
EXCESSIVE VERTICAL OVERLAP BETWEEN THE UPPER AND
LOWER ANTERIOR TEETH
OPEN BITE – WHEN THERE IS AN NO VERTICAL OVERLAP
BETWEEN THE UPPER AND LOWER ANTERIOR TEETH. A SPACE
MAY EXIST BETWEEN UPPER AND LOWER TEETH, WHEN THE
PATIENT BITES IN CENTRIC OCCLUSION. THE OPEN BITE MAY
BE OF ANTERIOR OR POSTERIOR REGION
• TRANSVERSE PLANE MALOCCLUSIONS -
THE TRANSVERSE PLANE INTER – ARCH MALOCCLUSION
INCLUDES VARIOUS TYPES OF CROSS BITES
THE TERM CROSS BITE REFERS TO ABNORMAL TRANSVERSE
RELATIONSHIP BETWEEN THE UPPER AND LOWER ARCHES

10. DEEP BITE DEEP BITE
ANTERIOR OPEN BITE ANTERIOR OPEN BITE

11. ANTERIOR CROSS BITE ANTERIOR CROSS BITE
UNILATERAL CROSS BITE SINGLE TOOTH CROSS BITE

12. ANGLE’S SYSTEM OF CLASSIFICATION
‘EDWARD H. ANGLE’ IN 1899 INTRODUCED A SYSTEM OF
CLASSIFYING MALOCCLUSION
BASIS FOR ANGLE’S CLASSIFICATION -
1. IT IS BASED ON THE MESIO - DISTAL RELATIONSHIP OF TEETH,
DENTAL ARCHES AND THE JAWS
2. ACCORDING TO ANGLE, MAXILLARY FIRST PERMANENT MOLAR
IS THE KEY TO OCCLUSION. HE HAS CONSIDERED THIS TOOTH
AS FIXED ANATOMICAL POINT WITHIN THE JAWS
3. BASED ON THE RELATION OF THE LOWER FIRST PERMANENT
MOLAR TO THE UPPER FIRST PERMANENT MOLAR, HE HAS
CLASSIFIED MALOCCLUSIONS INTO THREE MAIN CLASSES,
DESIGNATED BY THE ROMAN NUMERALS I, II AND III

13. BASED ON THESE PRINCIPLES, ANGLE CLASSIFIED
MALOCCLUSION INTO THE FOLLOWING BROAD CATEGORIES
ANGLE’S CLASS I -
THIS TYPE OF MALOCCLUSION IS CHARACTERIZED BY THE
PRESENCE OF A NORMAL INTER – ARCH MOLAR RELATIONSHIP.
THE MESIO – BUCCAL CUSP OF THE MAX. FIRST PERMANENT
MOLAR OCCLUDES IN THE BUCCAL GROOVE OF MAN. FIRST
PERMANENT MOLAR. THE PATIENT MAY EXHIBIT DENTAL
IRREGULARITIES LIKE CROWDING, SPACING, ROTATIONS,
MISSING TOOTH ETC. THE PATIENTS HAVE NORMAL SKELETAL
PATTERN AND ALSO A NORMAL MUSCLE FUNCTION.
• CLASS I
• CLASS II
- DIVISION 1
- DIVISION 2
• CLASS III

14. ANOTHER TYPE OF MALOCCLUSION THAT IS MOST OFTEN
CATEGORIZED UNDER CLASS I IS BIMAXILLARY PROTRUSION, IN
WHICH PATIENTS EXHIBIT A NORMAL MOLAR RELATIONSHIP,
BUT THE ANTERIOR TEETH ARE FORWARDLY PLACED IN
RELATION TO THE FACIAL PROFILE.

15. ANGLE’S CLASS II -
IN THIS TYPE OF MALOCCLUSION, THE MOLAR HAS A CLASS II
RELATIONSHIP, WHERE THE DISTO – BUCCAL CUSP OF THE
UPPER FIRST PERMANENT MOLAR, OCCLUDES IN THE BUCCAL
GROOVE OF THE LOWER FIRST PERMANENT MOLAR. ANGLE
HAS SUBDIVIDED CLASS II MALOCCLUSIONS INTO TWO
DIVISIONS -
• ANGLE’S CLASS II DIVISION 1
THIS TYPE OF MALOCCLUSION IS CHARACTERIZED BY
PROCLINED UPPER INCISORS, WITH A RESULTANT INCREASE IN
OVERJET. A DEEP ANTERIOR OVERBITE CAN OCCUR. THERE IS AN
ABNORMAL MUSCLE ACTIVITY. THE UPPER LIP IS USUALLY
HYPOTONIC, SHORT AND FAILS TO FORM A LIP SEAL. LOWER LIP
CUSHIONS THE PALATAL ASPECT OF THE UPPER TEETH [ALSO
REFERRED TO AS LIP TRAP]. THE MUSCLE IMBALANCE IS
PRODUCED BY HYPERACTIVE BUCCINATOR AND MENTALIS
MUSCLES AND AN ALTERED TONGUE POSITION, THAT
ACCENTUATES THE NARROWING OF THE DENTAL ARCH.

16. • ANGLE’S CLASS II DIVISION 2
IN THIS TYPE OF MALOCCLUSION, THE MOLAR HAS A CLASS II
RELATIONSHIP. THE UPPER CENTRAL INCISORS ARE
LINGUALLY INCLINED WITH THE LATERAL INCISORS BEING
LABIALLY PLACED AND OVERLAPPING CENTRAL INCISORS.
VARIATIONS MAY OCCUR WITH THE CENTRALS AND LATERALS
BEING LINGUALLY INCLINED AND CANINES LABIALLY TIPPED.
THERE IS A DEEP ANTERIOR OVERBITE. THE PERIORAL
MUSCLE ACTIVITY IS NORMAL.
CLASS II SUBDIVISION -
WHEN A CLASS II MOLAR RELATIONSHIP EXISTS ON ONE SIDE
AND A CLASS I ON THE OTHER, IT IS CALLED AS CLASS II
SUBDIVISION. BASED ON WHETHER IT IS A DIVISION 1 OR 2, IT
CAN BE CALLED AS CLASS II, DIV 1, SUBDIVISION OR CLASS II,
DIV 2, SUBDIVISION.

18. ANGLE’S CLASS III -
THIS MALOCCLUSION EXHIBITS A CLASS III MOLAR
RELATION, WITH THE MESIO – BUCCAL CUSP OF THE
MAXILLARY PERMANENT FIRST MOLAR OCCLUDING IN THE
INTERDENTAL SPACE BETWEEN THE MANDIBULAR FIRST
AND SECOND MOLARS. IT HAS FURTHER BEEN CLASSIFIED
INTO TRUE CLASS III AND PSEUDO CLASS III
• TRUE CLASS III MALOCCLUSION
THIS IS A SKELETAL CLASS III MALOCCLUSION OF GENETIC
ORIGIN THAT CAN OCCUR DUE TO AN EXCESSIVE LARGE
MANDIBLE, FORWARD PLACED MANDIBLE, SMALL MAXILLA,
RETROPOSITIONED MAXILLA OR COMBINATION OF THE
ABOVE CAUSES.
THE LOWER INCISORS ARE LINGUALLY INCLINED. A NORMAL
OVERJET, EDGE – EDGE INCISOR RELATION OR AN ANTERIOR
CROSS BITE MAY BE PRESENT. THE SPACE AVAILABLE FOR
TONGUE IS LESS, THEREFORE TONGUE OCCUPIES A LOWER
POSITION, RESULTING IN A NARROW UPPER ARCH.

19. • PSEUDO CLASS III MALOCCLUSION
THIS TYPE OF MALOCCLUSION IS PRODUCED BY A
FORWARD MOVEMENT OF THE MANDIBLE DURING JAW
CLOSURE, THEREFORE IT IS ALSO CALLED AS POSTURAL
OR HABITUAL CLASS III MALOCCLUSION. THE ETIOLOGY OF
PSEUDO CLASS III MALOCCLUSION ARE –
• PRESENCE OF OCCLUSAL PREMATURITIES MAY DEFLECT
THE MANDIBLE FORWARD.
• IN CASE OF PREMATURE LOSS OF DECIDUOUS
POSTERIORS, THE CHILD TENDS TO MOVE THE MANDIBLE
FORWARD, FOR ESTABLISHING CONTACT IN THE
ANTERIOR REGION.
• A CHILD WITH LARGE ADENOIDS, TEND TO MOVE THE
MANDIBLE FORWARD, IN AN ATTEMPT TO PREVENT THE
TONGUE FROM CONTACTING THE ADENOIDS.

20. CLASS III SUBDIVISION -
CLASS III MOLAR RELATIONSHIP ON ONE SIDE AND CLASS I
ON THE OTHER.

21. G H
A = CLASS I BIMAXILLARY
PROTRUSION
B = CLASS II, DIVISION 1
C = CLASS II, DIVISION 2
D = MIDLINE DIASTEMA
E = ANTERIOR OPEN BITE
F = ANTERIOR DEEP BITE
G = ANTERIOR CROSS BITE
H = SPACING

22. DRAWBACKS OF ANGLE’S CLASSIFICATION
1. ANGLE CONSIDERED MALOCCLUSION ONLY IN THE ANTERO -
POSTERIOR PLANE. HE HAS NOT CONSIDERED TRANSVERSE
AND VERTICAL PLANE MALOCCLUSIONS
2. ANGLE HAS CONSIDERED THE FIRST PERMANENT MOLARS TO
BE THE FIXED POINTS IN THE SKULL
3. IF THE FIRST PERMANENT MOLARS ARE EXTRACTED OR ARE
MISSING, THE CLASSIFICATION CANNOT BE APPLIED
4. THE CLASSIFICATION CANNOT BE APPLIED TO THE DECIDUOUS
DENTITION
5. THE CLASSIFICATION DOESN’T DIFFERENTIATE BETWEEN
SKELETAL AND DENTAL MALOCCLUSIONS
6. IT DOES NOT HIGHLIGHT THE ETIOLOGY OF MALOCCLUSIONS
7. IT HAS NOT CONSIDERED INDIVIDUAL TOOTH MALPOSITIONS

23. CLASS I MODIFICATIONS OF DEWEY
DEWEY DIVIDED ANGLE’S CLASS I INTO FIVE TYPES AND ANGLE’S
CLASS III INTO THREE TYPES -
DEWEY’S MODIFICATIONS OF ANGLE’S MALOCCLUSION
TYPE 1 : CLASS I MALOCCLUSION WITH CROWDED ANTERIOR TEETH
TYPE 2 : CLASS I WITH PROTRUSIVE MAXILLARY INCISORS
TYPE 3 : CLASS I MALOCCLUSION WITH ANTERIOR CROSS BITE
TYPE 4 : CLASS I MOLAR RELATION WITH POSTERIOR CROSS BITE
TYPE 5 : THE PERMANENT MOLAR HAS DRIFTED MESIALLY DUE TO
EARLY EXTRACTION OF SECOND DECIDUOUS MOLAR OR
SECOND PREMOLAR.

24. CLASS III MODIFICATIONS OF DEWEY
TYPE 1 : THE UPPER AND LOWER DENTAL ARCHES, WHEN VIEWED
SEPARATELY ARE IN NORMAL ALIGNMENT. BUT WHEN THE
ARCHES ARE MADE TO OCCLUDE, THE PATIENT SHOWS AN
EDGE TO EDGE INCISOR ALIGNMENT, SUGGESTIVE OF A
FORWARDLY MOVED MANDIBULAR DENTAL ARCH
TYPE 2 : THE MANDIBULAR INCISORS ARE CROWDED AND ARE IN
LINGUAL RELATION TO THE MAXILLARY INCISORS
TYPE 3 : THE MAXILLARY INCISORS ARE CROWDED AND ARE IN
CROSS BITE WITH RELATION TO THE MANDIBULAR
ANTERIORS

25. LISCHER’S MODIFICATIONS OF ANGLE’S CLASSIFICATION
LISCHER SUBSTITUTED THE TERM CLASS I, II AND III GIVEN BY
ANGLE, WITH THE TERMS NEUTROCCLUSION, DISTOCCLUSION
AND MESIOCCLUSION.
NEUTROCCLUSION : SYNONYMOUS WITH ANGLE’S CLASS I
MALOCCLUSION
DISTOCCLUSION : SYNONYMOUS WITH ANGLE’S CLASS II
MALOCCLUSION
MESIOCCLUSION : SYNONYMOUS WITH ANGLE’S CLASS III
MALOCCLUSION
BUCCOCCLUSION : BUCCAL PLACEMENT OF A TOOTH / TEETH
LINGUOCCLUSION : LINGUAL PLACEMENT OF A TOOTH / TEETH

26. SUPRAOCCLUSION : WHEN A TOOTH / TEETH HAVE ERUPTED
BEYOND NORMAL LEVEL
INFRAOCCLUSION : WHEN A TOOTH / TEETH HAVE NOT ERUPTED
TO NORMAL LEVEL
MESIOVERSION : MESIAL TO THE NORMAL POSITION
DISTOVERSION : DISTAL TO THE NORMAL POSITION
TRANSVERSION : TRANSPOSITION OF TWO TEETH
AXIVERSION : ABNORMAL AXIAL INCLINATION OF A TOOTH
TORSIVERSION : ROTATION OF A TOOTH ALONG IT’S LONG
AXIS

27. SIMON’S CLASSIFICATION
AS MALOCCLUSION CAN OCCUR IN ANTERIO – POSTERIOR,
TRANSVERSE AND IN THE VERTICAL PLANES, ‘SIMON’ HAD PUT
FORWARD A CRANIOMETRIC CLASSIFICATION OF MALOCCLUSION
THAT RELATED THE DENTAL ARCHES IN ALL THESE THREE
PLANES. THE THREE ANTHROPOMETRIC PLANES ARE – 1. THE
FRANKFORT HORIZONTAL PLANE 2. THE ORBITAL PLANE 3. THE
MID – SAGITTAL PLANE
1. THE FRANKFORT HORIZONTAL PLANE
THIS IS THE PLANE THAT CONNECTS THE UPPER MARGIN OF THE
AUDITORY MEATUS TO THE INFRA – ORBITAL MARGIN. THIS
PLANE IS USED TO CLASSIFY MALOCCLUSIONS IN A VERTICAL
PLANE. WHEN THE DENTAL ARCH OR PART, IS CLOSER THAN
NORMAL TO THE FH PLANE, IT IS CALLED ATTRACTION. WHEN
THE DENTAL ARCH IS AWAY, IT IS CALLED AS ABSTRACTION.

28. 2. THE ORBITAL PLANE
THIS PLANE IS PERPENDICULAR TO THE FH PLANE, DROPPED
DOWN FROM THE BONY ORBITAL MARGIN, DIRECTLY UNDER THE
PUPIL OF THE EYE. ACCORDING TO ‘SIMON’, THIS PLANE SHOULD
PASS THROUGH THE DISTAL THIRD OF THE CANINE, THIS IS
CALLED SIMON’S LAW OF CANINE. THIS PLANE IS USED TO
DESCRIBE MALOCCLUSIONS IN A SAGITTAL OR ANTERO –
POSTERIOR PLANE. WHEN THE DENTAL ARCH OR PART IS
CLOSER TO THE ORBITAL PLANE, IT IS CALLED RETRACTION AND
WHEN IT IS AWAY, IT IS CALLED PROTRACTION.
3. THE MID – SAGITTAL PLANE
THIS PLANE IS USED TO DESCRIBE MALOCCLUSION IN A
TRANSVERSE DIRECTION. WHEN A PART OR WHOLE ARCH IS
CLOSER TO THE MID – SAGITTAL PLANE, IT IS CALLED AS
CONTRACTION, AND WHEN IT IS AWAY, IT IS CALLED AS
DISTRACTION.

29. A. THE FRANKFORT HORIZONTAL PLANE [Attraction/Abstraction]
B. THE ORBITAL PLANE [Retraction/Protraction]
C. THE MID – SAGITTAL PLANE [Contraction/Distraction]

30. BENNET’S CLASSIFICATION
‘NORMAN BENNET’ CLASSIFIED MALOCCLUSION ACCORDING TO
IT’S ETIOLOGY -
CLASS I : ABNORMAL POSITION OF ONE OR MORE TEETH DUE TO
LOCAL CAUSES
CLASS II : ABNORMAL FORMATION OF A PART OR WHOLE OF
EITHER ARCH, DUE TO DEVELOPMENTAL DEFECTS OF
BONE
CLASS III : ABNORMAL RELATIONSHIP BETWEEN UPPER AND
LOWER ARCHES & BETWEEN EITHER ARCH AND FACIAL
CONTOUR AND CORRELATED ABNORMAL FORMATION
OF EITHER ARCH

31. ACKERMAN – PROFFIT SYSTEM OF CLASSIFICATION
‘ACKERMAN AND PROFITT’ IN 1960 PROPOSED A DIAGRAMMATIC
CLASSIFICATION OF MALOCCLUSION TO OVERCOME THE
LIMITATIONS OF ANGLE’S CLASSIFICATION. IT’S SALIENT
FEATURES ARE -
• TRANSVERSE AS WELL AS VERTICAL DISCREPANCIES CAN BE
CONSIDERED IN ADDITION TO THE ANTERO - POSTERIOR
MALRELATIONS
• CROWDING AND ARCH SYMMETRY CAN BE EVALUATED, AND
• INCISOR PROTRUSION CAN BE TAKEN INTO ACCOUNT
THE CLASSIFICATION IS BASED ON ‘VENN SYMBOLIC DIAGRAM’
THAT IDENTIFIES FIVE MAJOR CHARACTERISTICS TO BE
CONSIDERED AND DESCRIBED IN THE CLASSIFICATION -

32. STEP 1 [ALIGNMENT]: IT INVOLVES ASSESSMENT OF THE
ALIGNMENT AND SYMMETRY OF THE DENTAL
ARCH. IT IS CLASSIFIED AS IDEAL / CROWDED /
SPACED
STEP 2 [PROFILE] : IT INVOLVES CONSIDERATION OF THE
PROFILE. THE PROFILE IS DESCRIBED AS
CONVEX / STRAIGHT / CONCAVE. THE FACIAL
DIVERGENCE IS ALSO CONSIDERED –
ANTERIOR OR POSTERIOR
STEP 3 [TYPE] : THE TRANSVERSE SKELETAL AND DENTAL
RELATIONSHIP IS EVALUATED. BUCCAL AND
PALATAL CROSSBITES [IF ANY] ARE NOTED.
THE CROSSBITE IS FURTHER SUB –
CLASSIFIED AS UNILATERAL OR BILATERAL
AND SKELETAL OR DENTAL

33. STEP 4 [CLASS] : IT INVOLVES THE ASSESSMENT OF SAGITTAL
RELATIONSHIP. IT IS CLASSIFIED AS ANGLE’S
CLASS I, II OR III. DIFFERENTIATION IS MADE
BETWEEN SKELETAL AND DENTAL
MALOCCLUSION
STEP 5 [BITE DEPTH] : MALOCCLUSIONS IN VERTICAL PLANE ARE
NOTED. THEY ARE DESCRIBED AS ANTERIOR
OR POSTERIOR OPEN BITE, ANTERIOR DEEP
BITE OR POSTERIOR COLLAPSED BITE.
SKELETAL AND DENTAL DIFFERENTIATION IS
ALSO DONE

34. INTRA-ARCH ALIGNMENT
ACKERMAN –
PROFFIT
CLASSIFICATION
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35. THANK YOU