2. EXTRA ORAL
CONVEX PROFILE
SHORT UPPER LIP
INCOMPETENT LIPS
EVERTED LOWER LIP
DEEP MENTOLABIAL SULCUS
HYPERACTIVE MENTALIS
3. INTRAORAL FEATURES
CLASSII MOLAR
CLASSII CANINE
PROCLINED UPPER ANTERIORS
DEEPBITE
V SHAPED UPPER ARCH
DEEP PALATE
4. Prenatal factors
Heredity -The size position and relationship of the jaws
are to a large extent the genes.
Teratogenesis-Administration of certain drugs during
pregnancy can result in perverted or abnormal
development.
Irradiation-Exposure of a pregnant woman to radiation
is another cause of altered development of the dento-
facial complex.
Intrauterine fetal position.such as a hand across the face
is found to affect mandibular growth.
6. Post natal factors
Traumatic injury
Long term irradiation therapy of the skeletal cranio-
facial region.
Infectious conditions such as rheumatoid arthritis
can influence mandibular growth.
Abnormal function such as oral
respiration,abnormal swallowing and habits such as
thumb sucking prevent normal muscle activity.
7. Treatment objectives
Correction of skeletal abnormality if present.
Reduction of overjet
Reduction of overbite
Correction of crowding and local irregularities
Correction of molar relation
Correction of posterior crossbites
Normalizing the musculature.
8. Treatment of skeletal class II malocclusion
Growth modification
Camouflage
Surgical correction.
9. Growth modification
Class II,division 1 malocclusions are often
complicated by the presence of underlying skeletal
abnormalities. These are intercepted by functional
and orthopaedic appliances.
10. Camouflage
In patients who are beyond growth, it is not possible
to undertake growth modification procedures. Thus
the underlying skeletal discrepancy can be
camouflaged by orthodontic tooth movement. This is
often done by extraction of certain teeth and moving
rest of the teeth into the space created.
11. Surgical correction
In patients exhibiting severe skeletal
malrelationship,surgery may be the ideal treatment
modality. Based on the underlying skeletal pattern a
maxillary setback or a mandibular advancement is
undertaken after the completion of growth.
12. Correction of deep bite.
-use of removable anterior bite planes.
-use of fixed appliances to intrude the upper and
lower anteriors.
13. Crossbites are treated using appliances incorporating
screws or springs that expand the maxillary arch.
14. Features of class II division 2
Molars Class II
Retroclined central incisors and rarely of other
anteriors as well.
Deep overbite
Pleasing straight profile
Broad square face
Backward path of closure
Deep mentolabial sulcus.
Absence of abnormal muscle activity.
15. Treatment objectives
Relief of gingival trauma
Correction of incisor relationship
Relief of crowding and local irregularities.
Correction of buccal segement relationship.