CLASSIFICATION OF MALOCCLUSION

INDIAN DENTAL ACADEMY
Leader in continuing dental education
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CONTENTS
•
•
•
•

DEFINITIONS
PURPOSE OF CLASSIFYING
SYSTEMS OF CLASSIFICATIONS
LIMITATIONS OF CLASSIFICATION SYSTEMS

• A...
Definitions
Occlusion:
The changing interrelationship of the opposing
surfaces of max & mand.teeth occuring during
movemen...
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ANGLES PROTOTYPE IDEAL OCCLUSION

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Definitions
Occlusion:
The changing interrelationship of the opposing
surfaces of max & mand.teeth occuring during
movemen...
Three factors
1.Occlusal inclined planes of cusps
2.Support given by harmonious size of both arches
3. Influence of muscle...
Malocclusion: An arrangement of teeth in a
dentition &/or relation in the jaws to each other
which is not according to the...
Purposes of classification
•
•
•
•
•

Ease of reference
Self communication
For comparison
For traditional reasons
Imp tool...
QUESTIONNAIRE,
INTERVIEW

CLINICAL
EXAMINATION

DATA
BASE

CLASSIFICATION

PROBLEM =DIAGNOSIS
LIST

ANALYSIS OF
DIAGNOSTIC...
WHEN TO CLASSIFY

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Malocclusions are morphologic abnormality
morphology
Malocclusions involve 4 tissue systems
Dental dysplasias
Skeletal
Ske...
Classification systems
 Angle’s system
Modifications
Lischers modification
Deways modification







Simons classi...
Angle’s system
E.H Angle -1899
Most uni. Used.
BASIS: Relationship of 1st per.molar teeth &
alignment of teeth to line of ...
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Normal occlusion: normal molar relationship , teeth in line of occlusion
Class I normal molar relation but teeth not in li...
Class I malocclusion
• AP relationship of max & mand molars
correct
• Normal AP relationship between max &
mand
• Usually ...
Class II malocclusion
• Relative MD relations of dental arches abnormal with all lower teeth occluding distal to
normal
Mo...
Class II Div I
Mand denture may r may not be normal with respect to
individual teeh
Protrusion of max incisors
Over erupti...
Typical max incisor inclination in class I , II div I & cl. III

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Typical lip postures in cl II div 1

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Class II Div 2
Mand molars & mand arch ---post. Position with
respect to max I molars & max arch
Mand arch may or may not ...
Characteristic milalignments of upper ant teeth in class II div2

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Perioral muscle function - normal
Abnormal path of closure due to combination of
lingually inclined max incisors & infraoc...
Class III malocclusion
• All the lower teeth occlude mesial to normal the
width of 1 bicuspid tooth or more
• mand # large...
Facial profile & molar relationship

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Pseudo class III

• Postural , habitual class III
• Lingually inclined max incisors gliding
down lingual surfaces of mand ...
Limitations of angle classification
• Discrepancies in vertical & transverse plane
• Inconsistency or gray areas which are...
Lischers modifications

• Neutrocclusion or class I
• Distocclusion or class II
• Mesiocclusion or class III
Buccocclusion...
Some malpositions of individual teeth
“Version” to classify malpositions of teeth in
relation to line of occlusion
Transve...
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Deways modification
• Martin Deway
class I
5 types
class III
3 types
Type 1:crowding of max. ant
canines #labio axio or in...
Modifications angles class III
Type 1: Individually arches are well formed
Teeth in normal alignment
Edge to edge bite in ...
Simons classification
• Paul simon
• A 3D classification
• Related denture to face & cranium in 3 planes
1.FH plane vertic...
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Deviations
• In Orbital plane
Protractions
Retractions
In FH plane
Attraction
Abstraction
In Mid Sagittal plane
Contractio...
Demerits
• Cumbersome
• Confusing at times
eg .intrusion of max teeth
extrusion of mand teeth
• Little used

www.indianden...
Ackermann proffit system
• 1960 s by informal additions to angles system by
identifying 5 major characteristics
• Overcome...
Set is defined on the basis of morphologic
deviations from ideal
Degree of alignment & symmetry are common to all
dentitio...
www.indiandentalacademy.com
advantages
• Differentiation is made betw. Ske. & dental
problems
• Teaches a perspective about complexities of
malocclusi...
Bennet ‘s classification
• Based on etiology
• 3 classes
• Class I
abnormal position of 1 or more
teeth due to local cause...
Skeletal classification
• Class I , class II , class III
• takes relationship of teeth also into consideration

Sk. Class ...
Skeletal class 2 :
sub normal distal mand development in relation to
maxilla
Max. arch narrower than mand
Div 1
Crowding i...
Malpositions
•
•
•

Individual teeth
Groups of teeth
sagittal # labioversion with spacing
without spacing
linguoversion # ...
Transverse occlusal deviations of post. segments

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3 categories of crowding [ in mixed dentition ]
I degree crowding
II degree crowding
III degree crowding
On etiology
Prima...
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Apical base dental arch width
Normal
relationship

Coronal crowding

Apical
crowding

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Canine relationships
• Class I The distal surface of the mand canine is
with in 1 premolar’s width of the mesial surface
o...
Incisor relationship
• Class I Incisor margins of mand incisors
occlude directly below the middle of the lingual
surfaces ...
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Leader in continuing dental education

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Classification of malocclusion /certified fixed orthodontic courses by Indian dental academy

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Classification of malocclusion /certified fixed orthodontic courses by Indian dental academy

  1. 1. CLASSIFICATION OF MALOCCLUSION INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. CONTENTS • • • • DEFINITIONS PURPOSE OF CLASSIFYING SYSTEMS OF CLASSIFICATIONS LIMITATIONS OF CLASSIFICATION SYSTEMS • ANGLE CLASSIFICATION REVISITED www.indiandentalacademy.com
  3. 3. Definitions Occlusion: The changing interrelationship of the opposing surfaces of max & mand.teeth occuring during movements of mand & the terminal full contact of max. & mand arches. Not a static condition Normal occlusion [angle]: evenly placed rows of teeth arranged in graceful curve with harmony between upper & lower arches www.indiandentalacademy.com
  4. 4. www.indiandentalacademy.com
  5. 5. ANGLES PROTOTYPE IDEAL OCCLUSION www.indiandentalacademy.com
  6. 6. Definitions Occlusion: The changing interrelationship of the opposing surfaces of max & mand.teeth occuring during movements of mand & the terminal full contact of max. & mand arches. Not a static condition Normal occlusion [angle]: evenly placed rows of teeth arranged in graceful curve with harmony between upper & lower arches www.indiandentalacademy.com
  7. 7. Three factors 1.Occlusal inclined planes of cusps 2.Support given by harmonious size of both arches 3. Influence of muscles Characteristics of normal occlusion 1. Correct axial position of teeth 2. Normal over jet overbite 3. Normal relationship of individual teeth 4. Normal relationship of dental arches to each other & to face & cranium www.indiandentalacademy.com
  8. 8. Malocclusion: An arrangement of teeth in a dentition &/or relation in the jaws to each other which is not according to the accepted morphologic configuration of human maxillodentofacial complex. Classification: it’s a grouping of clinical cases of similar appearance for ease in comparison , handling & discussion www.indiandentalacademy.com
  9. 9. Purposes of classification • • • • • Ease of reference Self communication For comparison For traditional reasons Imp tool in diagnosis –treatment planning In our concept of diagnosis it can be viewed as orderly reduction of data base to a list of pt s problems www.indiandentalacademy.com
  10. 10. QUESTIONNAIRE, INTERVIEW CLINICAL EXAMINATION DATA BASE CLASSIFICATION PROBLEM =DIAGNOSIS LIST ANALYSIS OF DIAGNOSTIC RECORDS ORDERLY REDUCTION OF DATABASE TO LIST OF PROBLEMS www.indiandentalacademy.com
  11. 11. WHEN TO CLASSIFY www.indiandentalacademy.com
  12. 12. Malocclusions are morphologic abnormality morphology Malocclusions involve 4 tissue systems Dental dysplasias Skeletal Skeletodental www.indiandentalacademy.com
  13. 13. Classification systems  Angle’s system Modifications Lischers modification Deways modification       Simons classification Ackerman proffit classification Malpositions Bennet classification Skeletal classification Modified Angles classification www.indiandentalacademy.com
  14. 14. Angle’s system E.H Angle -1899 Most uni. Used. BASIS: Relationship of 1st per.molar teeth & alignment of teeth to line of occlusion Key to occlusion _ max 1st molar Basically describes the AP relationship It has 4 groups Normal occlusion Class I malocclusion Class II malocclusion www.indiandentalacademy.com Class III malocclusion
  15. 15. www.indiandentalacademy.com
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  17. 17. Normal occlusion: normal molar relationship , teeth in line of occlusion Class I normal molar relation but teeth not in line of occlusion Class II a full premolar width disto-occlusion line of occlusion not specified Class III a full premolar width mesio-occlusion (resulting in a Class I range of 14 mm) Class II a full premolar width disto-occlusion and Class III a full premolar width mesio-occlusion (resulting in a Class I range of 14 mm) Class I from a full premolar width in either direction to one half of a cusp in either direction (reducing the range of Class I to 7 mm) www.indiandentalacademy.com
  18. 18. Class I malocclusion • AP relationship of max & mand molars correct • Normal AP relationship between max & mand • Usually Normal muscle function • Bimax protrusion • Diff between normal occlusion & class I www.indiandentalacademy.com
  19. 19. Class II malocclusion • Relative MD relations of dental arches abnormal with all lower teeth occluding distal to normal Molar relation Consists of 2 divisions Same molar relation www.indiandentalacademy.com
  20. 20. Class II Div I Mand denture may r may not be normal with respect to individual teeh Protrusion of max incisors Over eruption of incisors Narrow max arch V shape Abnormal muscle function Lower lip cushions upper teeth Accentuation of max arch Depending on tongue lower ant may / may not over erupt Class II Div I sub division www.indiandentalacademy.com
  21. 21. Typical max incisor inclination in class I , II div I & cl. III www.indiandentalacademy.com
  22. 22. Typical lip postures in cl II div 1 www.indiandentalacademy.com
  23. 23. Class II Div 2 Mand molars & mand arch ---post. Position with respect to max I molars & max arch Mand arch may or may not show individual irregularities An exaggerated COS Supraversion of incisors Mand labial gingiva traumatized Max arch –sometimes wider than normal Lingual inclination of max centrals , labial inclination of laterals Variations www.indiandentalacademy.com
  24. 24. Characteristic milalignments of upper ant teeth in class II div2 www.indiandentalacademy.com
  25. 25. Perioral muscle function - normal Abnormal path of closure due to combination of lingually inclined max incisors & infraocclusion of post teeth Class II Div 2 sub div www.indiandentalacademy.com
  26. 26. Class III malocclusion • All the lower teeth occlude mesial to normal the width of 1 bicuspid tooth or more • mand # large bodily or situated mesially to an abnormal degree • Mand incisors in total cross bite • Lower ant. # excessively inclined lingually# lip pressure • Individual tooth irregularities • Constricted max arch deficient arch length • Tongue # floor of the mouth • Max incisors # more lingually inclined • constricted max arch www.indiandentalacademy.com
  27. 27. Facial profile & molar relationship www.indiandentalacademy.com
  28. 28. Pseudo class III • Postural , habitual class III • Lingually inclined max incisors gliding down lingual surfaces of mand incisors on closure • Mand guided ant displacement • Causes: occlusal prematurities Premature loss of pri. Posteriors Enlarged adenoids www.indiandentalacademy.com
  29. 29. Limitations of angle classification • Discrepancies in vertical & transverse plane • Inconsistency or gray areas which are not fully class II or class III • Cant be applied if I molars are ext’d or missing • Max molar may vary in AP relationship • Individual tooth malpositions # overlooked • Mixed dentition ? • Malfunctions of muscles & problems of growth of bones were overlooked • Etiology ? www.indiandentalacademy.com
  30. 30. Lischers modifications • Neutrocclusion or class I • Distocclusion or class II • Mesiocclusion or class III Buccocclusion Linguocclusion Supraocclusion Infraocclusion www.indiandentalacademy.com
  31. 31. Some malpositions of individual teeth “Version” to classify malpositions of teeth in relation to line of occlusion Transversion Linguoversion Labioversion Mesioversion Distoversion Torsiversion Axiversion www.indiandentalacademy.com
  32. 32. www.indiandentalacademy.com
  33. 33. www.indiandentalacademy.com
  34. 34. Deways modification • Martin Deway class I 5 types class III 3 types Type 1:crowding of max. ant canines #labio axio or infaversion Type 2 :max incisors labioversion Type 3 :max incisors in linguoversion to mand incisors Type 4 :molars +/-premolars in bucco/ linguoversion Type 5:molars in mesioversion due to shifting www.indiandentalacademy.com
  35. 35. Modifications angles class III Type 1: Individually arches are well formed Teeth in normal alignment Edge to edge bite in occlusion bodily movement of mand arch Type 2: mand incisors – crowded lingual relation to max incisors Type 3 :underdeveloped max arch crowded max incisors Cross bite Well developed mand arch , mand teeth normally aligned www.indiandentalacademy.com
  36. 36. Simons classification • Paul simon • A 3D classification • Related denture to face & cranium in 3 planes 1.FH plane vertical relationships deviations in ht of arch & teeth irt face cranium 2. orbital plane Sagittal deviations in AP relation of arch , axial inclination of teeth to face & cranium Law of canine 3. Median Sagittal plane or raphe for deviations in gen form & width of arches & axial inclination of teeth www.indiandentalacademy.com irt midline of palate & head
  37. 37. www.indiandentalacademy.com
  38. 38. Deviations • In Orbital plane Protractions Retractions In FH plane Attraction Abstraction In Mid Sagittal plane Contractions Distractions www.indiandentalacademy.com
  39. 39. Demerits • Cumbersome • Confusing at times eg .intrusion of max teeth extrusion of mand teeth • Little used www.indiandentalacademy.com attraction
  40. 40. Ackermann proffit system • 1960 s by informal additions to angles system by identifying 5 major characteristics • Overcomes the major weakness of angle system incorporated evaluation of crowding & asymmetry • Recognizes relationship between protrusion & crowding • Includes transverse AP vertical planes • Incorporates information about skeletal jaw proportions • Used venn symbolic diagram or set theory www.indiandentalacademy.com
  41. 41. Set is defined on the basis of morphologic deviations from ideal Degree of alignment & symmetry are common to all dentitions outer envelope /universe [group I] Profile affected by many malocclusions # major set in the universe [ group 2] Deviations in 3 planes of space # represented by 3 to 9 group, which also includes overlapping sub sets www.indiandentalacademy.com
  42. 42. www.indiandentalacademy.com
  43. 43. advantages • Differentiation is made betw. Ske. & dental problems • Teaches a perspective about complexities of malocclusions • Readily adaptable to compute processing • Demerits • etiology ? • Analysis is static , a functional analysis must still be made www.indiandentalacademy.com
  44. 44. Bennet ‘s classification • Based on etiology • 3 classes • Class I abnormal position of 1 or more teeth due to local causes Class II Class III abnormal formation of part / whole arch due to developmental defects abnormal relationship of arches arch & facial contour abnormal formation of arch www.indiandentalacademy.com
  45. 45. Skeletal classification • Class I , class II , class III • takes relationship of teeth also into consideration Sk. Class I • Bones of face & jaws , harmony , & with head • Profile orthognathic 4 divisions Div 1. local malrelations of incisors , canine premolars Div 2 : max incisor protrusion Div 3: retroclined max incisors Div 4: bimax protrusion www.indiandentalacademy.com
  46. 46. Skeletal class 2 : sub normal distal mand development in relation to maxilla Max. arch narrower than mand Div 1 Crowding in canine region Cross bite Vertical ht Protrusion of max ant teeth Retrognathic profile Div 2 : lingual inclined max incisors laterals normal / labioversion Sk. Class 3 Overgrowth of mand, obtuse mand plane ang Prognathic mand www.indiandentalacademy.com
  47. 47. Malpositions • • • Individual teeth Groups of teeth sagittal # labioversion with spacing without spacing linguoversion # deep bite , class II div 2 mesioversion , distoversion • Transverse # buccoversion , linguoversion crowding ,spacing • vertical # supraversion infraversion www.indiandentalacademy.com
  48. 48. Transverse occlusal deviations of post. segments www.indiandentalacademy.com
  49. 49. 3 categories of crowding [ in mixed dentition ] I degree crowding II degree crowding III degree crowding On etiology Primary hereditary Secondary mesial drift of post teeth Tertiary assoc with 3 rd molar eruption By taking inclination of teeth coronal crowding www.indiandentalacademy.com apical crowding
  50. 50. www.indiandentalacademy.com
  51. 51. Apical base dental arch width Normal relationship Coronal crowding Apical crowding www.indiandentalacademy.com
  52. 52. Canine relationships • Class I The distal surface of the mand canine is with in 1 premolar’s width of the mesial surface of max canine • Class II The distal surface of the mand canine is distal to the mesial surface of max canine by at least a width of 1 premolar • Class III The distal surface of the mand canine is mesial to the mesial surface of max canine by atleast a width of 1 premolar www.indiandentalacademy.com
  53. 53. Incisor relationship • Class I Incisor margins of mand incisors occlude directly below the middle of the lingual surfaces of the max incisors • Class II Incisor margins of mand incisors lie behind the middle part of lingual surfaces of max incisors • Class III Incisor margins of mand incisors lie in front of the middle part of lingual surfaces of max incisors www.indiandentalacademy.com
  54. 54. www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com

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