Malocclusion/certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.


Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

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Malocclusion/certified fixed orthodontic courses by Indian dental academy

  1. 1. CLASSIFICATIONCLASSIFICATION OFOF MALOCCLUSIONMALOCCLUSION www.indiandentalacademy.com INDIAN DENTAL ACADEMYINDIAN DENTAL ACADEMY Leader in continuing dental educationLeader in continuing dental education www.indiandentalacademy.comwww.indiandentalacademy.com
  2. 2. IntroductionIntroduction Normality is the basis of classification inNormality is the basis of classification in orthodontics. It rests on what is known as biologicorthodontics. It rests on what is known as biologic continuity, i.e., the most frequently found relationshipcontinuity, i.e., the most frequently found relationship of the teeth and of the bones of the face in relation toof the teeth and of the bones of the face in relation to each other and to the skull as a whole.each other and to the skull as a whole. Malocclusion is any perversion of normalMalocclusion is any perversion of normal occlusion of the teeth. It is a condition where there isocclusion of the teeth. It is a condition where there is departure from the normal relation of the teeth todeparture from the normal relation of the teeth to other teeth in the same arch and to the teeth in theother teeth in the same arch and to the teeth in the opposing arch.opposing arch. www.indiandentalacademy.com
  3. 3. INTRODUCTIOINTRODUCTIO NN In order to acquire a better understanding of theIn order to acquire a better understanding of the many deviations from normal occlusion and to assistmany deviations from normal occlusion and to assist in diagnosis and treatment planning, it becomesin diagnosis and treatment planning, it becomes necessary to group the varieties of malocclusion intonecessary to group the varieties of malocclusion into order. This is difficult as occlusal anomalies are manyorder. This is difficult as occlusal anomalies are many and varied. Orthodontics has been described,and varied. Orthodontics has been described, admirably, as a ‘Science of Infinite Variations’.admirably, as a ‘Science of Infinite Variations’. www.indiandentalacademy.com
  4. 4. DEFINITIONDEFINITION Classification is a process of analyzing cases ofClassification is a process of analyzing cases of malocclusion for the purpose of segregating them intomalocclusion for the purpose of segregating them into a small number of groups, which groups area small number of groups, which groups are characterized by certain specific and fundamentalcharacterized by certain specific and fundamental variations from normal occlusion of the teeth.variations from normal occlusion of the teeth. www.indiandentalacademy.com
  5. 5. OBJECTIVESOBJECTIVES  Classification is an essential communication toolClassification is an essential communication tool between dental school professor and student, betweenbetween dental school professor and student, between practitioners, and between practitioner and insurancepractitioners, and between practitioner and insurance company or government bureaucracy. It is essentialcompany or government bureaucracy. It is essential that everyone "speak the same language."that everyone "speak the same language."  Classification aids in the diagnosis and treatmentClassification aids in the diagnosis and treatment planning of malocclusions by orienting the clinicianplanning of malocclusions by orienting the clinician to the type and the magnitude of the problems andto the type and the magnitude of the problems and possible mechanical solutions to the problems.possible mechanical solutions to the problems. www.indiandentalacademy.com
  6. 6. OBJECTIVESOBJECTIVES  Segregation of the countless number of cases ofSegregation of the countless number of cases of tooth malposition into a comparatively low number oftooth malposition into a comparatively low number of groups, each group containing only such cases as aregroups, each group containing only such cases as are characterized by a common factor or factors ofcharacterized by a common factor or factors of fundamental significance.fundamental significance.  Ease of reference i.e. giving name to a group ofEase of reference i.e. giving name to a group of symptoms making together a single problemsymptoms making together a single problem  Comparison of cases with other cases having sameComparison of cases with other cases having same problemproblem www.indiandentalacademy.com
  7. 7. GENERALGENERAL CLASSIFICATIOCLASSIFICATIO NN  Malocclusion can be broadly divided into-Malocclusion can be broadly divided into-  Individual tooth malposition or Intra arch malocclusionIndividual tooth malposition or Intra arch malocclusion  Maxillo-mandibular malocclusions or Inter archMaxillo-mandibular malocclusions or Inter arch malocclusionmalocclusion www.indiandentalacademy.com
  8. 8. GENERALGENERAL CLASSIFICATIOCLASSIFICATIO NN Individual tooth malposition or Intra archIndividual tooth malposition or Intra arch malocclusionmalocclusion  A tooth can be abnormally related to its neighboringA tooth can be abnormally related to its neighboring teeth, such abnormal variations are called individualteeth, such abnormal variations are called individual tooth malpositions or intra arch malpositions. Some oftooth malpositions or intra arch malpositions. Some of the commonly seen individual tooth malpositions arethe commonly seen individual tooth malpositions are  Distal inclination or distal tippingDistal inclination or distal tipping  Mesial inclination or mesial tippingMesial inclination or mesial tipping  Lingual inclination or lingual tippingLingual inclination or lingual tipping  Buccal inclination or buccal tippingBuccal inclination or buccal tipping www.indiandentalacademy.com
  9. 9. GENERALGENERAL CLASSIFICATIOCLASSIFICATIO NN Individual tooth malposition or Intra archIndividual tooth malposition or Intra arch malocclusionmalocclusion  Mesial displacementMesial displacement  Distal displacementDistal displacement  Lingual displacementLingual displacement  Buccal displacementBuccal displacement  Infraversion or infraocclusionInfraversion or infraocclusion  Supraversion or supra occlusionSupraversion or supra occlusion  Disto lingual or mesio buccal rotationDisto lingual or mesio buccal rotation  Mesio lingual or disto buccal rotationMesio lingual or disto buccal rotation  TranspositionTransposition www.indiandentalacademy.com
  10. 10. GENERALGENERAL CLASSIFICATIOCLASSIFICATIO NN MESIALMESIAL INCLINATIONINCLINATION DISTALDISTAL INCLINATIONINCLINATION LINGUAL AND LABIALLINGUAL AND LABIAL INCLINATIONINCLINATION MESIALMESIAL DISPLACEMENTDISPLACEMENT DISTALDISTAL DISPLACEMENTDISPLACEMENT www.indiandentalacademy.com
  11. 11. GENERALGENERAL CLASSIFICATIOCLASSIFICATIO NN INFRAVERSIONINFRAVERSION SUPRAVERSIONSUPRAVERSION LINGUAL AND LABIALLINGUAL AND LABIAL DISPLACEMENTDISPLACEMENT TORSIVERSIONTORSIVERSION TRANSPOSITIONTRANSPOSITION www.indiandentalacademy.com
  12. 12. GENERALGENERAL CLASSIFICATIOCLASSIFICATIO NN Inter arch malocclusionsInter arch malocclusions These malocclusions are characterized by abnormalThese malocclusions are characterized by abnormal relationships between two teeth or groups of teeth of onerelationships between two teeth or groups of teeth of one arch to the other arch. These inter arch malocclusion canarch to the other arch. These inter arch malocclusion can occur inoccur in  Sagital planeSagital plane  Vertical planeVertical plane  Transverse planeTransverse plane www.indiandentalacademy.com
  13. 13. GENERALGENERAL CLASSIFICATIOCLASSIFICATIO NN Sagital plane malocclusionsSagital plane malocclusions Pre-normal occlusion-Pre-normal occlusion- refers to a condition where therefers to a condition where the lower arch is more forwardly placed when the patientlower arch is more forwardly placed when the patient bites in centric occlusion.bites in centric occlusion. Post-normal occlusion-Post-normal occlusion- a condition where the lowera condition where the lower arch is more distally placed when the patient bites inarch is more distally placed when the patient bites in centric occlusion.centric occlusion. www.indiandentalacademy.com
  14. 14. GENERALGENERAL CLASSIFICATIOCLASSIFICATIO NN Vertical plane malocclusionsVertical plane malocclusions Deep bite or increased over biteDeep bite or increased over bite: this refers to a: this refers to a condition where there is an excessive vertical overlapcondition where there is an excessive vertical overlap between upper and lower anterior teeth.between upper and lower anterior teeth. Open biteOpen bite: is a condition where there is no vertical: is a condition where there is no vertical overlap between upper and lower teeth . Thus a spaceoverlap between upper and lower teeth . Thus a space exist between the upper and lower teeth when the patientexist between the upper and lower teeth when the patient bites in centric occlusion. Open bite can be inbites in centric occlusion. Open bite can be in anterioranterior oror posteriorposterior regionregion.. www.indiandentalacademy.com
  15. 15. GENERALGENERAL CLASSIFICATIOCLASSIFICATIO NN Transverse plane malocclusionsTransverse plane malocclusions Cross biteCross bite – refers to a condition in which mandibular– refers to a condition in which mandibular teeth overlap their maxillary antagonists. Cross bite canteeth overlap their maxillary antagonists. Cross bite can bebe anterioranterior oror posteriorposterior Buccal Non occlusion –Buccal Non occlusion – refers to a condition in whichrefers to a condition in which maxillary posteriors are completely buccally placed inmaxillary posteriors are completely buccally placed in relation to mandibular antagonists without occludingrelation to mandibular antagonists without occluding Palatal Non occlusionPalatal Non occlusion – refers to a condition in which– refers to a condition in which maxillary posteriors are completely palatally placed inmaxillary posteriors are completely palatally placed in relation to mandibular antagonists without occludingrelation to mandibular antagonists without occluding www.indiandentalacademy.com
  16. 16. ANGLE’SANGLE’S CLASSIFICATIOCLASSIFICATIO NN Angle believed that since biologic entities asAngle believed that since biologic entities as well as inanimate elements can be arranged intowell as inanimate elements can be arranged into well-defined classes, the same held also of thewell-defined classes, the same held also of the occlusion of the teeth and the shape of the face.occlusion of the teeth and the shape of the face. Angle based his classification of malocclusion onAngle based his classification of malocclusion on the normal mesiodistal relations of the mesiobuccalthe normal mesiodistal relations of the mesiobuccal cusps of the upper first molars in relation to thecusps of the upper first molars in relation to the mandibular first molars.mandibular first molars. www.indiandentalacademy.com
  17. 17. ANGLE’SANGLE’S CLASSIFICATIOCLASSIFICATIO NN Basis for Angle’s classificationBasis for Angle’s classification Most indicative irregularity of teeth found in antero-posteriorMost indicative irregularity of teeth found in antero-posterior relationship of the teeth and the jaws.relationship of the teeth and the jaws. There is a normal mesio distal or antero-posterior positionThere is a normal mesio distal or antero-posterior position for the body of the mandible with its superimposed mandibularfor the body of the mandible with its superimposed mandibular dental arch to occupy in the anatomy of the skull.dental arch to occupy in the anatomy of the skull. The maxillary dental arch being built upon a base that is aThe maxillary dental arch being built upon a base that is a fixed section of the skull anatomy, is more or less stable in itsfixed section of the skull anatomy, is more or less stable in its relationship to various landmarks on the head and consequentlyrelationship to various landmarks on the head and consequently the first molar teeth in this arch may be quite safely selected asthe first molar teeth in this arch may be quite safely selected as a key tooth from which to judge the relationship of mandibulara key tooth from which to judge the relationship of mandibular dental arch and intern to the body of mandible upon which it isdental arch and intern to the body of mandible upon which it is locatedlocated www.indiandentalacademy.com
  18. 18. ANGLE’SANGLE’S CLASSIFICATIOCLASSIFICATIO NN Basis for Angle’s classificationBasis for Angle’s classification If there is shifting of maxillary molars in theirIf there is shifting of maxillary molars in their relationship to the skull anatomy, this variation can berelationship to the skull anatomy, this variation can be detected by changes in the axial inclination of teeth indetected by changes in the axial inclination of teeth in the maxillary arch. The axial change is especiallythe maxillary arch. The axial change is especially manifested by canine teeth.manifested by canine teeth. Curvature and line of occlusion is unique to eachCurvature and line of occlusion is unique to each individualindividual.. www.indiandentalacademy.com
  19. 19. ANGLE’SANGLE’S CLASSIFICATIOCLASSIFICATIO NN Angle used the Roman numerals I, II and III toAngle used the Roman numerals I, II and III to designate the three main classes of mesiodistal archdesignate the three main classes of mesiodistal arch relationship viz., Class I or normal, Class II or distal andrelationship viz., Class I or normal, Class II or distal and Class III or mesial relationship of the cusps of theClass III or mesial relationship of the cusps of the mandibular first molars to the maxillary first molars.mandibular first molars to the maxillary first molars. He employed the Arabic numerals 1 and 2 toHe employed the Arabic numerals 1 and 2 to denote divisions of the classifications. Unilateraldenote divisions of the classifications. Unilateral deviations he termed subdivisions.deviations he termed subdivisions. www.indiandentalacademy.com
  20. 20. ANGLE’SANGLE’S CLASSIFICATIOCLASSIFICATIO NN Angle classified malocclusion as followsAngle classified malocclusion as follows Class IClass I Class IIClass II Division 1Division 1 Division IIDivision II SubdivisionSubdivision Class IIIClass III SubdivisionSubdivision www.indiandentalacademy.com
  21. 21. ANGLE’SANGLE’S CLASSIFICATIOCLASSIFICATIO NN Class I MalocclusionClass I Malocclusion The mandibular dental arch and the body of theThe mandibular dental arch and the body of the mandible are in normal relation to the maxillary archmandible are in normal relation to the maxillary arch indicated by the fact that mesiobuccal cusp of theindicated by the fact that mesiobuccal cusp of the maxillary first permanent molar occludes in the buccalmaxillary first permanent molar occludes in the buccal groove of the mandibular permanent first molar andgroove of the mandibular permanent first molar and the mesiolingual cusp of the maxillary first molarthe mesiolingual cusp of the maxillary first molar occludes with the occlusal fossa of the mandibular firstoccludes with the occlusal fossa of the mandibular first permanent molar when the jaws are in centricpermanent molar when the jaws are in centric occlusionocclusion www.indiandentalacademy.com
  22. 22. ANGLE’SANGLE’S CLASSIFICATIOCLASSIFICATIO NN www.indiandentalacademy.com
  23. 23. ANGLE’SANGLE’S CLASSIFICATIOCLASSIFICATIO NN Class II MalocclusionClass II Malocclusion The mandibular dental arch and the body of theThe mandibular dental arch and the body of the mandible are in distal relation to the maxillary arch bymandible are in distal relation to the maxillary arch by half the width of the maxillary first permanent molarhalf the width of the maxillary first permanent molar or mesioodistal width of a premolar indicated by theor mesioodistal width of a premolar indicated by the fact that mesiobuccal cusp of the maxillary firstfact that mesiobuccal cusp of the maxillary first permanent molar occludes in the space between thepermanent molar occludes in the space between the mesiobuccal cusp of the mandibular permanent firstmesiobuccal cusp of the mandibular permanent first molar and the buccal cusp of the second premolar.molar and the buccal cusp of the second premolar. www.indiandentalacademy.com
  24. 24. ANGLE’SANGLE’S CLASSIFICATIOCLASSIFICATIO NN Class II MalocclusionClass II Malocclusion The mesiolingual cusp of the maxillary first molarThe mesiolingual cusp of the maxillary first molar occludes mesial to the mesiolingual cusp of theoccludes mesial to the mesiolingual cusp of the mandibular first permanent molar when the jaws are inmandibular first permanent molar when the jaws are in centric occlusioncentric occlusion.. www.indiandentalacademy.com
  25. 25. ANGLE’SANGLE’S CLASSIFICATIOCLASSIFICATIO NN www.indiandentalacademy.com
  26. 26. ANGLE’SANGLE’S CLASSIFICATIOCLASSIFICATIO NN Class II MalocclusionClass II Malocclusion Division IDivision I A class II malocclusion in which maxilary incisorsA class II malocclusion in which maxilary incisors are in labioversionare in labioversion SubdivisionSubdivision A class II division I malocclusion occuring onA class II division I malocclusion occuring on only one sideonly one side www.indiandentalacademy.com
  27. 27. ANGLE’SANGLE’S CLASSIFICATIOCLASSIFICATIO NN Class II MalocclusionClass II Malocclusion Division IIDivision II A class II malocclusion in which maxilary incisorsA class II malocclusion in which maxilary incisors are not in labioversion rather they are retroclinedare not in labioversion rather they are retroclined with laterals overlapping centrals or canineswith laterals overlapping centrals or canines overlapping lateralsoverlapping laterals SubdivisionSubdivision A class II division I malocclusion occuring onA class II division I malocclusion occuring on only one sideonly one side www.indiandentalacademy.com
  28. 28. ANGLE’SANGLE’S CLASSIFICATIOCLASSIFICATIO NN Class III MalocclusionClass III Malocclusion The mandibular dental arch and the body of theThe mandibular dental arch and the body of the mandible are in mesial relationship to the maxillarymandible are in mesial relationship to the maxillary arch indicated by the fact that mesiobuccal cusp of thearch indicated by the fact that mesiobuccal cusp of the maxillary first permanent molar occludes in themaxillary first permanent molar occludes in the interdental space between the distal aspect of the distalinterdental space between the distal aspect of the distal cusp of the mandibular first permanent molar and thecusp of the mandibular first permanent molar and the mesial aspect of the mesial cusp of the secondmesial aspect of the mesial cusp of the second permanent molarpermanent molar www.indiandentalacademy.com
  29. 29. ANGLE’SANGLE’S CLASSIFICATIOCLASSIFICATIO NN www.indiandentalacademy.com
  30. 30. ANGLE’SANGLE’S CLASSIFICATIOCLASSIFICATIO NN Class III MalocclusionClass III Malocclusion SubdivisionSubdivision A class III malocclusion in which malocclusion isA class III malocclusion in which malocclusion is only unilaterallyonly unilaterally www.indiandentalacademy.com
  31. 31. ANGLE’SANGLE’S CLASSIFICATIOCLASSIFICATIO NN Pseudo-Class III MalocclusionPseudo-Class III Malocclusion In this condition the mandible is protruded a little duringIn this condition the mandible is protruded a little during the final stages of closure in order to avoid a prematurethe final stages of closure in order to avoid a premature contact of incisors or caninescontact of incisors or canines This is most likely to arise in cases where theThis is most likely to arise in cases where the relationship of the incisors is edge-to-edge, and may berelationship of the incisors is edge-to-edge, and may be caused by a mildly prenormal relationship of the dentalcaused by a mildly prenormal relationship of the dental basesbases Such pseudo – or postural Class III cases may tend, ifSuch pseudo – or postural Class III cases may tend, if left untreated, to become established by a furtherleft untreated, to become established by a further development of the whole occlusion in Class III relation.development of the whole occlusion in Class III relation. www.indiandentalacademy.com
  32. 32. Features True Class III Pseudo Class III 1 Profile Concave Straight to concave 2 Etiology Hereditary Habitual/developmental 3 Premature contacts Absent Present 4 Path of closure Forward Deviated 5 Gonial angle Increased/decreased Normal 6 Retrusion of mandible further Not possible Possible 7 Treatment Orthopedic or surgical Elimination of prematurities, replacement of lost posterior teeth 8 Left untreated No further changes Becomes established into true class III Differences between true and pseudo class III malocclusionDifferences between true and pseudo class III malocclusion www.indiandentalacademy.com
  33. 33. ANGLE’SANGLE’S CLASSIFICATIOCLASSIFICATIO NN Drawbacks of Angle’s ClassificationDrawbacks of Angle’s Classification The Angle classification was readily acceptedThe Angle classification was readily accepted by the dental profession, since it brought order out ofby the dental profession, since it brought order out of what previously had been confusion regarding dentalwhat previously had been confusion regarding dental relationships. It was recognized almost immediately,relationships. It was recognized almost immediately, however, that there were deficiencies in the Anglehowever, that there were deficiencies in the Angle system.system. www.indiandentalacademy.com
  34. 34. ANGLE’SANGLE’S CLASSIFICATIOCLASSIFICATIO NN Drawbacks of Angle’s ClassificationDrawbacks of Angle’s Classification Angle considered malocclusion only in antero-posteriorAngle considered malocclusion only in antero-posterior planeplane Angle considered maxillary first permanent molar as aAngle considered maxillary first permanent molar as a fixed point but it was not found sofixed point but it was not found so The classification cannot be applied if first permanentThe classification cannot be applied if first permanent molars are missing or extractedmolars are missing or extracted The classification cannot be applied in the deciduousThe classification cannot be applied in the deciduous dentitiondentition www.indiandentalacademy.com
  35. 35. ANGLE’SANGLE’S CLASSIFICATIOCLASSIFICATIO NN Drawbacks of Angle’s ClassificationDrawbacks of Angle’s Classification The classification does not differentiates betweenThe classification does not differentiates between skeletal and dental malocclusionsskeletal and dental malocclusions The classification does not highlight the etiology of theThe classification does not highlight the etiology of the malocclusionmalocclusion Individual tooth malpositions have not been consideredIndividual tooth malpositions have not been considered in the classificationin the classification www.indiandentalacademy.com
  36. 36. LISCHER’SLISCHER’S CLASSIFICATIOCLASSIFICATIO NN Lischer introduced the following terms which areLischer introduced the following terms which are widely used to describe the varieties of malocclusion. Hewidely used to describe the varieties of malocclusion. He substituted the term Class I, Class II, Class III given bysubstituted the term Class I, Class II, Class III given by angle with the terms Neurtro-occlusion, Disto-occlusion andangle with the terms Neurtro-occlusion, Disto-occlusion and Mesio-occlusionMesio-occlusion.. www.indiandentalacademy.com
  37. 37. LISCHER’SLISCHER’S CLASSIFICATIOCLASSIFICATIO NN Neutro-occlusion: Normal relation of dentalNeutro-occlusion: Normal relation of dental arches. It is synonymous with Angle’s Class Iarches. It is synonymous with Angle’s Class I malocclusion.malocclusion. Disto-occlusion: Synonymous with Angle’s ClassDisto-occlusion: Synonymous with Angle’s Class II, used to describe all cases of post-normalII, used to describe all cases of post-normal occlusion.occlusion. Mesio-occlusion: Synonymous with Angle’sMesio-occlusion: Synonymous with Angle’s Class III and describes all cases of prenormalClass III and describes all cases of prenormal occlusion.occlusion. www.indiandentalacademy.com
  38. 38. LISCHER’SLISCHER’S CLASSIFICATIOCLASSIFICATIO NN He gave the suffix “version” to describe theHe gave the suffix “version” to describe the wrong position of individual teeth as follows:wrong position of individual teeth as follows: Linguo version—Lingual placementLinguo version—Lingual placement Labio version—Labial placementLabio version—Labial placement Mesio version—Mesial placementMesio version—Mesial placement Disto version—Distal placementDisto version—Distal placement Infra version—Intrusion of teethInfra version—Intrusion of teeth Supra version—Extrusion of teethSupra version—Extrusion of teeth Torsiversion—RotationTorsiversion—Rotation Perversion—Impacted toothPerversion—Impacted tooth www.indiandentalacademy.com
  39. 39. Dewey’s Modification ofDewey’s Modification of Angle’s ClassificationAngle’s Classification Dewey proposed a modification of theDewey proposed a modification of the Angle’s classification of malocclusion. HeAngle’s classification of malocclusion. He divided the Angle’s class I into five types anddivided the Angle’s class I into five types and Angle’s Class III into three types. There were noAngle’s Class III into three types. There were no modifications for Class II. He considered themodifications for Class II. He considered the same molar relationship as in Angle’ssame molar relationship as in Angle’s classificationclassification www.indiandentalacademy.com
  40. 40. Dewey’s Modification ofDewey’s Modification of Angle’s ClassificationAngle’s Classification Modification of Angle’s Class IModification of Angle’s Class I  Type 1Type 1. Bunched or crowded maxillary anterior teeth.. Bunched or crowded maxillary anterior teeth. The canines may be in labioversion or infraversion. AllThe canines may be in labioversion or infraversion. All other versions of individual teeth may be presentother versions of individual teeth may be present  Type 2.Type 2. Maxillary incisors in labioversionMaxillary incisors in labioversion  Type 3Type 3. The maxillary incisor teeth are in linguoversion. The maxillary incisor teeth are in linguoversion to the mandibular incisorsto the mandibular incisors  Type 4Type 4. The molars, occasionally also premolars are in. The molars, occasionally also premolars are in linuoversion or labiobversion but canines and incisorslinuoversion or labiobversion but canines and incisors are in normal relationare in normal relation  Type 5Type 5. The molars are in mesioversion due to shifting. The molars are in mesioversion due to shifting following loss of teeth anterior to molarsfollowing loss of teeth anterior to molars www.indiandentalacademy.com
  41. 41. Dewey’s Modification ofDewey’s Modification of Angle’s ClassificationAngle’s Classification Modification of Angle’s Class IIIModification of Angle’s Class III  Type 1Type 1. The dental arches are well formed and the teeth. The dental arches are well formed and the teeth are in normal alignment when viewed individually butare in normal alignment when viewed individually but there is edge-to-edge bite in anterior regionthere is edge-to-edge bite in anterior region  Type 2.Type 2. The mandibular incisors are crowded and inThe mandibular incisors are crowded and in lingual relation to the maxillary incisorslingual relation to the maxillary incisors  Type 3Type 3. The maxillary arch is underdeveloped. The. The maxillary arch is underdeveloped. The maxillary incisor are crowded. The mandibular arch ismaxillary incisor are crowded. The mandibular arch is well developed and the mandibular teeth are in normalwell developed and the mandibular teeth are in normal aligmentaligment www.indiandentalacademy.com
  42. 42. BENNET’SBENNET’S CLASSIFICATIOCLASSIFICATIO NN Sir Norman Bennett introduced a classification ofSir Norman Bennett introduced a classification of abnormalities of occlusion which was based on their etiology.abnormalities of occlusion which was based on their etiology. Briefly the classification is as follows:Briefly the classification is as follows:  Class I - Abnormal position of one or more teeth due to localClass I - Abnormal position of one or more teeth due to local causes.causes.  Class II - Abnormal formation of a part or whole of either archClass II - Abnormal formation of a part or whole of either arch due to developmental defects of bone.due to developmental defects of bone.  Class III- Abnormal relationship between upper and lowerClass III- Abnormal relationship between upper and lower arches, and between either arch and facial contour andarches, and between either arch and facial contour and correlated abnormal formation of either arch.correlated abnormal formation of either arch. www.indiandentalacademy.com
  43. 43. SIMON’SSIMON’S CLASSIFICATIOCLASSIFICATIO NN Since growth of the face and jaws occurs in the threeSince growth of the face and jaws occurs in the three planes of space-height, width and depth, abnormalities alsoplanes of space-height, width and depth, abnormalities also occur in any one or more of the foregoing planes.occur in any one or more of the foregoing planes. Simon’s craniometric classification relates the denture toSimon’s craniometric classification relates the denture to the face and cranium in the three planes of space,the face and cranium in the three planes of space, (1) The Frankfort horizontal(1) The Frankfort horizontal (2) The Orbital plane and(2) The Orbital plane and (3) The raphe or median sagittal plane.(3) The raphe or median sagittal plane. www.indiandentalacademy.com
  44. 44. SIMON’SSIMON’S CLASSIFICATIOCLASSIFICATIO NN The Frankfort horizontal planeThe Frankfort horizontal plane The Frankfort horizontal plane or the eye-ear planeThe Frankfort horizontal plane or the eye-ear plane is determined by drawing a straight line through the margin ofis determined by drawing a straight line through the margin of the bony orbit directly under the pupil of the eye, to the upperthe bony orbit directly under the pupil of the eye, to the upper margin of the auditory meatus (the notch above the tragus ofmargin of the auditory meatus (the notch above the tragus of the ear). This plane is used to determine deviations in the heightthe ear). This plane is used to determine deviations in the height of the dental arches and teeth in relation to the face andof the dental arches and teeth in relation to the face and cranium.cranium. www.indiandentalacademy.com
  45. 45. SIMON’SSIMON’S CLASSIFICATIOCLASSIFICATIO NN The Frankfort horizontal planeThe Frankfort horizontal plane www.indiandentalacademy.com
  46. 46. SIMON’SSIMON’S CLASSIFICATIOCLASSIFICATIO NN The Orbital planeThe Orbital plane The orbital plane is a perpendicular at right anglesThe orbital plane is a perpendicular at right angles to the eye-ear plane at the margin of the bony orbit directlyto the eye-ear plane at the margin of the bony orbit directly under the pupil of the eye. This plane is used to determineunder the pupil of the eye. This plane is used to determine sagittal deviations of the dental arches and the axial inclinationsagittal deviations of the dental arches and the axial inclination of the teeth to the face and the cranium.of the teeth to the face and the cranium. www.indiandentalacademy.com
  47. 47. SIMON’SSIMON’S CLASSIFICATIOCLASSIFICATIO NN The Orbital planeThe Orbital plane www.indiandentalacademy.com
  48. 48. SIMON’SSIMON’S CLASSIFICATIOCLASSIFICATIO NN The Raphe or Median Sagittal planeThe Raphe or Median Sagittal plane The Raphe or Median Sagittal plane is determinedThe Raphe or Median Sagittal plane is determined by points approximately 1.5 cm apart on the median raphe ofby points approximately 1.5 cm apart on the median raphe of the palate. The raphe median plane passes through these twothe palate. The raphe median plane passes through these two points at right angles to the Frankfort horizontal plane. Thispoints at right angles to the Frankfort horizontal plane. This plane is used to determine the deviations in the general formplane is used to determine the deviations in the general form and width of the dental arches and the axial inclination of theand width of the dental arches and the axial inclination of the teeth in relation to the midline of the palate and the headteeth in relation to the midline of the palate and the head www.indiandentalacademy.com
  49. 49. SIMON’SSIMON’S CLASSIFICATIOCLASSIFICATIO NN The Raphe or Median Sagittal planeThe Raphe or Median Sagittal plane www.indiandentalacademy.com
  50. 50. SIMON’SSIMON’S CLASSIFICATIOCLASSIFICATIO NN The Law of the CanineThe Law of the Canine In normal arch relationship, according to Simon,In normal arch relationship, according to Simon, the orbital plane passes through the distal axial aspect of thethe orbital plane passes through the distal axial aspect of the canine. This is known as “The law of the canine”.canine. This is known as “The law of the canine”. www.indiandentalacademy.com
  51. 51. SIMON’SSIMON’S CLASSIFICATIOCLASSIFICATIO NN Deviation from the raphe or median sagittal planeDeviation from the raphe or median sagittal plane .. Arch form and inclination of tooth axisArch form and inclination of tooth axis are determinedare determined from this plane.from this plane. ContractionContraction: A part or all of the dental arch is contracted: A part or all of the dental arch is contracted toward the raphe median plane. The abnormality may betoward the raphe median plane. The abnormality may be mandibular, alveolar, dental, anterior, posterior, unilateralmandibular, alveolar, dental, anterior, posterior, unilateral or bilateral.or bilateral. DistractionDistraction: A part or all of the dental arch is wider than: A part or all of the dental arch is wider than usual from the raphe median planeusual from the raphe median plane www.indiandentalacademy.com
  52. 52. SIMON’SSIMON’S CLASSIFICATIOCLASSIFICATIO NN Deviations from the Frankfort horizontal planeDeviations from the Frankfort horizontal plane:: The angle between the Frankfort horizontal and theThe angle between the Frankfort horizontal and the occlusal plane, the form of the occlusal curve, and theocclusal plane, the form of the occlusal curve, and the inclination of the teeth axesinclination of the teeth axes are determined from this plane.are determined from this plane. AttractionAttraction: The distance between the occlusal plane and: The distance between the occlusal plane and the FH Plane is comparatively shorter than normal. Thisthe FH Plane is comparatively shorter than normal. This distance is as a rule normally shorter in the young than indistance is as a rule normally shorter in the young than in older persons and in some ethnic groups.older persons and in some ethnic groups. AbstractionAbstraction: The distance between the occlusal plane and: The distance between the occlusal plane and the FH plane is comparatively longer than normal.the FH plane is comparatively longer than normal. www.indiandentalacademy.com
  53. 53. SIMON’SSIMON’S CLASSIFICATIOCLASSIFICATIO NN Deviations from the Orbital planeDeviations from the Orbital plane:: Sagittal symmetry and inclination of the axes of the teethSagittal symmetry and inclination of the axes of the teeth are determined from this plane.are determined from this plane. ProtractionProtraction: The teeth, one or both dental arches, and or: The teeth, one or both dental arches, and or jaws are too far forward. Normally the orbital plane passesjaws are too far forward. Normally the orbital plane passes through the distal incline of the canine.through the distal incline of the canine. RetractionRetraction: The teeth, one or both dental arches and or: The teeth, one or both dental arches and or jaws are too far retruded. The orbital plane passes too farjaws are too far retruded. The orbital plane passes too far anteriorly to the canines.anteriorly to the canines. www.indiandentalacademy.com
  54. 54. SIMON’SSIMON’S CLASSIFICATIOCLASSIFICATIO NN Deviations of the dental arches in relation to the orbital plane,Deviations of the dental arches in relation to the orbital plane, according to Simon, may occur as follows:according to Simon, may occur as follows: Both the jaws in normal relation to each otherBoth the jaws in normal relation to each other Upper jaw normal, lower jaw distalUpper jaw normal, lower jaw distal Upper jaw normal, lower jaw mesialUpper jaw normal, lower jaw mesial Lower jaw normal, upper jaw mesialLower jaw normal, upper jaw mesial Lower jaw normal, upper jaw distalLower jaw normal, upper jaw distal Upper jaw mesial, lower jaw distalUpper jaw mesial, lower jaw distal Upper jaw distal, lower jaw mesialUpper jaw distal, lower jaw mesial www.indiandentalacademy.com
  55. 55. SKELETALSKELETAL CLASSIFICATIOCLASSIFICATIO NN Malocclusion may or may not be associated with facialMalocclusion may or may not be associated with facial dysplasia. Dental malocclusion may be present in an otherwisedysplasia. Dental malocclusion may be present in an otherwise orthognathic face. However, normal occlusion may also beorthognathic face. However, normal occlusion may also be present in a face which is not orthognathic. Facial skeletalpresent in a face which is not orthognathic. Facial skeletal patterns are divided intopatterns are divided into Class 1, in which the profile is orthognathic,Class 1, in which the profile is orthognathic, Class 2, where the mandible is retrognathic, andClass 2, where the mandible is retrognathic, and Class 3, in which the mandible is prognathic.Class 3, in which the mandible is prognathic. www.indiandentalacademy.com
  56. 56. SKELETALSKELETAL CLASSIFICATIOCLASSIFICATIO NN Classification of the facial skeletal pattern takes intoClassification of the facial skeletal pattern takes into consideration also the relationship of the teeth as follows:consideration also the relationship of the teeth as follows: Skeletal Class 1Skeletal Class 1: The bones of the face and the jaws are in: The bones of the face and the jaws are in harmony with one another and with the rest of the head. Theharmony with one another and with the rest of the head. The maxilla is slightly ahead of the mandible. The profile ismaxilla is slightly ahead of the mandible. The profile is orthognathic.orthognathic. Division 1. Local malrelations of incisor, canine orDivision 1. Local malrelations of incisor, canine or premolar teeth.premolar teeth. Division 2. Maxillary incisor protrusion.Division 2. Maxillary incisor protrusion. Division 3. Maxillary incisors in linguoversion.Division 3. Maxillary incisors in linguoversion. Division 4. Bimaxillary protrusion.Division 4. Bimaxillary protrusion. www.indiandentalacademy.com
  57. 57. SKELETALSKELETAL CLASSIFICATIOCLASSIFICATIO NN Skeletal Class 2Skeletal Class 2: Subnormal distal mandibular: Subnormal distal mandibular development in relation to the maxilla.development in relation to the maxilla. Division 1. Maxillary dental arch is narrower thanDivision 1. Maxillary dental arch is narrower than mandibular and there is crowding in the caninemandibular and there is crowding in the canine region, crossbite and reduced vertical height.region, crossbite and reduced vertical height. Protrusion of the maxillary anterior teeth. TheProtrusion of the maxillary anterior teeth. The profile is retrognathic.profile is retrognathic. Division 2. Lingual inclination of the maxillary incisors.Division 2. Lingual inclination of the maxillary incisors. The lateral incisors may be normal or inThe lateral incisors may be normal or in labioversion.labioversion. www.indiandentalacademy.com
  58. 58. SKELETALSKELETAL CLASSIFICATIOCLASSIFICATIO NN Skeletal Class 3Skeletal Class 3: Overgrowth of the mandible and obtuse: Overgrowth of the mandible and obtuse mandibular angle. The profile is prognathic at the mandible.mandibular angle. The profile is prognathic at the mandible. www.indiandentalacademy.com
  59. 59. ACKERMAN –ACKERMAN – PROFFITPROFFIT CLASSIFICATIONCLASSIFICATION Ackerman and Proffit proposed a classification scheme forAckerman and Proffit proposed a classification scheme for malocclusions in which five characteristics and theirmalocclusions in which five characteristics and their interrelationships are assessed.interrelationships are assessed. This system is a synthesis of two schemes, the AngleThis system is a synthesis of two schemes, the Angle classification and the Venn diagram, both of which wereclassification and the Venn diagram, both of which were proposed late in the nineteenth century by Angle and Venn.proposed late in the nineteenth century by Angle and Venn. Venn proposed this representation in 1880, and it hasVenn proposed this representation in 1880, and it has become prominent in symbolic logic for computer use.become prominent in symbolic logic for computer use. www.indiandentalacademy.com
  60. 60. INTRA ARCHINTRA ARCH ALIGNMENTALIGNMENT IDEALIDEAL CROWDINGCROWDING SPACINGSPACING PROFILEPROFILE GROUP 1GROUP 1 GROUP 2GROUP 2 GROUP 3GROUP 3 GROUP 4GROUP 4 GROUP 5GROUP 5 Gp6Gp6 Gp7Gp7 Gp8Gp8 Gp9Gp9 VERTICAL DEVIATIONVERTICAL DEVIATION Open Bite anteriorOpen Bite anterior Open bite posteriorOpen bite posterior Deep bite anteriorDeep bite anterior Collapsed bite posteriorCollapsed bite posterior SkeletalSkeletal DentalDental AnteriorAnterior divergentdivergent PosteriorPosterior divergentdivergent ConvexConvex ConcaveConcave StraightStraight TRANSVERSETRANSVERSE DEVIATIONDEVIATION Cross bitesCross bites BuccalBuccal PalatalPalatal UnilateralUnilateral BilateralBilateral SkeletalSkeletal DentalDental SAGITTALSAGITTAL DEVIATIONDEVIATION Class IClass I Class II Div1Class II Div1 Class II Div 2Class II Div 2 Class IIIClass III SkeletalSkeletal DentalDental TRANS-TRANS- SAGITTALSAGITTAL SAGITO-SAGITO- VERTICALVERTICAL VERTICO-VERTICO- TRANSVERSETRANSVERSE TRANS-TRANS- SAGITO-SAGITO- VERTICALVERTICAL www.indiandentalacademy.com
  61. 61. ACKERMAN –ACKERMAN – PROFFITPROFFIT CLASSIFICATIONCLASSIFICATION Classification by groupsClassification by groups Common to all dentitions is the degree of alignment andCommon to all dentitions is the degree of alignment and symmetry of the teeth within the dental arches. This issymmetry of the teeth within the dental arches. This is represented as the universerepresented as the universe (Group 1).(Group 1). Many malocclusions affect the profile. For this reason,Many malocclusions affect the profile. For this reason, profile is represented as a major setprofile is represented as a major set (Group 2)(Group 2) within thewithin the universe.universe. Lateral (transverse), anteroposterior (sagittal), and verticalLateral (transverse), anteroposterior (sagittal), and vertical deviations and their interrelationshipsdeviations and their interrelationships (Groups 3 to 9)(Groups 3 to 9) areare represented by three interlocking subsets within the profile set.represented by three interlocking subsets within the profile set. www.indiandentalacademy.com
  62. 62. ACKERMAN –ACKERMAN – PROFFITPROFFIT CLASSIFICATIONCLASSIFICATION Step 1Step 1 in the classification procedure is an analysis of thein the classification procedure is an analysis of the alignment and symmetry of the teeth in the dental archesalignment and symmetry of the teeth in the dental arches (interproximal contact relationships).(interproximal contact relationships). Alignment is the key word of Group 1; among theAlignment is the key word of Group 1; among the possibilities arepossibilities are idealideal,, crowding (arch-length deficiencycrowding (arch-length deficiency),), spacingspacing, and, and mutilatedmutilated. Irregularities of individual teeth. Irregularities of individual teeth are described, if desired, by the method of Lischer, namely,are described, if desired, by the method of Lischer, namely, the use of the suffix -version to describe the direction ofthe use of the suffix -version to describe the direction of individual tooth malalignments.individual tooth malalignments. Ideal occlusion, plus many (but by no means all) AngleIdeal occlusion, plus many (but by no means all) Angle Class I malocclusions, would fall into Group 1.Class I malocclusions, would fall into Group 1. www.indiandentalacademy.com
  63. 63. ACKERMAN –ACKERMAN – PROFFITPROFFIT CLASSIFICATIONCLASSIFICATION InIn Step 2Step 2 one views the patient's profile.one views the patient's profile. In the profile view, it should be noted whether the face isIn the profile view, it should be noted whether the face is anteriorly divergentanteriorly divergent (mandible prominent) or(mandible prominent) or posteriorlyposteriorly divergentdivergent (mandible recessive) and whether the lips are(mandible recessive) and whether the lips are convexconvex (prominent),(prominent), straightstraight, or, or concaveconcave relative to therelative to the nose and chin. The "divergence" is most often related to thenose and chin. The "divergence" is most often related to the facial skeleton; lip position is strongly influenced by thefacial skeleton; lip position is strongly influenced by the teeth. Lip and mouth posture should also be considered inteeth. Lip and mouth posture should also be considered in the evaluation.the evaluation. www.indiandentalacademy.com
  64. 64. ACKERMAN –ACKERMAN – PROFFITPROFFIT CLASSIFICATIONCLASSIFICATION InIn Step 3Step 3 the dental arches are viewed with regard to lateralthe dental arches are viewed with regard to lateral dimensions (transverse plane), and the buccolingualdimensions (transverse plane), and the buccolingual relationships of the posterior teeth are noted.relationships of the posterior teeth are noted. The term type is used to describe the various kinds of cross-The term type is used to describe the various kinds of cross- bite. A judgment is also made as to whether the problem isbite. A judgment is also made as to whether the problem is basically dentoalveolar or skeletal or due to a combinationbasically dentoalveolar or skeletal or due to a combination of the two.of the two. Buccal and palatal cross bites ( unilateral or bilateral)Buccal and palatal cross bites ( unilateral or bilateral) comes under this categorycomes under this category www.indiandentalacademy.com
  65. 65. ACKERMAN –ACKERMAN – PROFFITPROFFIT CLASSIFICATIONCLASSIFICATION InIn Step 4Step 4 the patient and dental arches are viewed in thethe patient and dental arches are viewed in the anteroposterior dimension (sagittal plane).anteroposterior dimension (sagittal plane). In this dimension, the Angle classification system is utilizedIn this dimension, the Angle classification system is utilized and is merely supplemented by stating whether a deviationand is merely supplemented by stating whether a deviation is skeletal, dentoalveolar, or a combination. Thisis skeletal, dentoalveolar, or a combination. This information can be derived from observing the patient orinformation can be derived from observing the patient or more accurately from a cephalometric head film.more accurately from a cephalometric head film. www.indiandentalacademy.com
  66. 66. ACKERMAN –ACKERMAN – PROFFITPROFFIT CLASSIFICATIONCLASSIFICATION InIn Step 5Step 5 the patient and the dentition are viewed with regard tothe patient and the dentition are viewed with regard to the vertical dimension.the vertical dimension. Bite depth is used to describe the vertical relationships. TheBite depth is used to describe the vertical relationships. The possibilities arepossibilities are anterior open-bite, anterior deep-bite,anterior open-bite, anterior deep-bite, posterior open-bite, or posterior collapsed biteposterior open-bite, or posterior collapsed bite. To. To determine whether this is on adetermine whether this is on a skeletal,skeletal, dentoalveolardentoalveolar, or, or combinedcombined basis, a cephalometric analysis may bebasis, a cephalometric analysis may be particularly helpful.particularly helpful. www.indiandentalacademy.com
  67. 67. ACKERMAN –ACKERMAN – PROFFITPROFFIT CLASSIFICATIONCLASSIFICATION This approach defines nine groups of malocclusions. TheThis approach defines nine groups of malocclusions. The complexity of the orthodontic problem increases with the groupcomplexity of the orthodontic problem increases with the group number. Thus, a Group 9 malocclusion is the most complex innumber. Thus, a Group 9 malocclusion is the most complex in that there is an alignment problem, a problem in profile, andthat there is an alignment problem, a problem in profile, and problems in the lateral, vertical, and anteroposterior dimensionsproblems in the lateral, vertical, and anteroposterior dimensions as well.as well. www.indiandentalacademy.com
  68. 68. ACKERMAN –ACKERMAN – PROFFITPROFFIT CLASSIFICATIONCLASSIFICATION Advantages of this classificationAdvantages of this classification  This method of classification based on five descriptive characteristicsThis method of classification based on five descriptive characteristics and defining nine groups of malocclusions overcomes the majorand defining nine groups of malocclusions overcomes the major weaknesses of the Angle systemweaknesses of the Angle system  Specifically, arch-length problems, with or without an influence on theSpecifically, arch-length problems, with or without an influence on the profile, are recognized; the influence of the dentition on the profile isprofile, are recognized; the influence of the dentition on the profile is taken into accounttaken into account  All three planes of space, not just the sagittal plane, are taken intoAll three planes of space, not just the sagittal plane, are taken into considerationconsideration  The differentiation between dental and skeletal problems is made at theThe differentiation between dental and skeletal problems is made at the appropriate levelappropriate level  Diagnosis is inherent in the classificationDiagnosis is inherent in the classification www.indiandentalacademy.com
  69. 69. ETIOLOGICETIOLOGIC CLASSIFICATIOCLASSIFICATIO NN According to Moyers, Classification ofAccording to Moyers, Classification of malocclusion can be based on the origin of themalocclusion can be based on the origin of the problem. There are four classes depending on originproblem. There are four classes depending on origin Skeletal or OsseousSkeletal or Osseous DentalDental MuscularMuscular Combination of aboveCombination of above www.indiandentalacademy.com
  70. 70. CONCLUSIONCONCLUSION The goal of modern orthodontics can be summed up as theThe goal of modern orthodontics can be summed up as the creation of the best possible occlusal relationships within thecreation of the best possible occlusal relationships within the framework of acceptable facial aesthetics and stability of theframework of acceptable facial aesthetics and stability of the occlusal result. The classification systems aid in diagnosis andocclusal result. The classification systems aid in diagnosis and treatment planning of malocclusions. There is a basic need for atreatment planning of malocclusions. There is a basic need for a system of classification of malocclusion that would be adequate forsystem of classification of malocclusion that would be adequate for clinical, semantic and public health purpose and could beclinical, semantic and public health purpose and could be universally employed by those practicing the specialty throughoutuniversally employed by those practicing the specialty throughout the worldthe world www.indiandentalacademy.com
  71. 71. THANK YOU Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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