ANGLE’S CLASS II The distobuccal cusp of the upper 1st
permanent molar occludes in the buccal groove of the
lower 1st permanent molar.
CLASS II INCISOR RELATIONSHIP
The lower incisal edges lie posterior to the cingulum
plateaux of the upper incisors.
DIVISION 2 – The upper central incisors are
retroclined ; the overjet is minimal but may be
CLASS II, DIVISION 2 MALOCCLUSIONS
1) Occurs in about 10% of children.
2) In milder forms they may be
acceptable functionally, and the
facial appearance can be pleasing.
3) In severe cases the over bite is very deep, associated with
periodontal trauma palatal to upper, and labial to the
4) Class II, Div. 2 incisor relationship is generally the result
of dento-alveolar compensation for a class II skeletal
pattern by retroclination of the upper central incisors.
Molars in disto-occlusion.
The classic feature of the upper incisors.
Pleasing straight profile.
Broad square face.
Backward path of closure.
Deep mento-labial sulcus.
Absence of abnormal muscle activity.
The skeletal pattern may be Class I, but is
generally mild Class II, and the chin is well
developed so that the facial profile is good.
The lower anterior face height is often smaller
than average and characteristically the
maxillary-mandibular planes angle is low, with a
well-developed mandibular angle
In many class II, Div.2 patients, facial growth is
favourable, and there is an anterior mandibular
rotation, as might be expected from the
diminished anterior face height and the form of
The lips are almost always of adequate length to
meet without strain.
Frequently the lip line is high relative to the
upper incisor crown, and the higher the lip line
the more retroclined the upper incisors are liable
There is often a well-developed
MANAGEMENT OF CLASS II DIV 2
Three important factors to consider in the management are :
1. Nature of malocclusion.
2. Severity of malocclusion.
MANAGEMENT OF CLASS II DIV 2
Mandible is usually guided posteriorly due to
premature contact from the retroclined incisors and
thereby restricting its growth.
The treatment sequence remains the same except that
for any form of treatment modality to be instituted
the retroclined teeth have to be aligned in a proper
1. Mixed dentition phase – Use of functional
Results are good even after the eruption of
permanent teeth. The maxillary first premolars
are extracted generally to create space for
aligning crowded maxillary anterior segment.
2. After the cessation of growth – The need for
orthognathic surgery increases with the increase
in the severity of the problem.
The surgical procedures are also the same but
the use of presurgical orthodontics becomes
imperative to achieve stable results.
ORTHPAEDIC DEVICES USED IN
TREATMENT OF CLASS II
1. High pull H.G(parietal)
2. Medium pull H.G(occipital)
3. Low pull H.G(cervical)
4. Combee pull H.G
5. Reverse pull H.G
Functional appliances are designed to change the patients
Pattern of function,
Alter the jaw relationships,
Reprogram the neuromusculature,
thus altering the functional matrix of the face.
The Pendulum appliance
The K-loop appliance
The distal jet
Modified Nance Lingual appliance
Molar distalization with magnets
Use of Super elastic NiTi
NiTi Double Loop system
Mild to moderate
skeletal Class II
Treatment of malocclusion
with underlying mild or
alignment ( so that
moderate jaw discrepancies,
spaces can be
used for retraction
which can achieve a good
and not to relieve
dental occlusion, through
extraction of certain teeth, to
mask skeletal problem.
Good vertical facial
Surgical option should be
choosen in following cases:
1.Severe skeletal discrepancy or
extremely severe dento alveolar
3.Young patients with extremely
severe or progressive deformity.
4.Good general health status of