Skeletal classification /certified fixed orthodontic courses by Indian dental academy


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Skeletal classification /certified fixed orthodontic courses by Indian dental academy

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing dental education
  2. 2. SK ELETAL CLASSIFICATIO N Malocclusion may or may not be associated with facial dysplasia. Dental malocclusion may be present in an otherwise orthognathic face. However, normal occlusion may also be present in a face which is not orthognathic. Facial skeletal patterns are divided into Class 1, in which the profile is orthognathic, Class 2, where the mandible is retrognathic, and Class 3, in which the mandible is prognathic.
  3. 3. SK ELETAL CLASSIFICATIO N Classification of the facial skeletal pattern takes into consideration also the relationship of the teeth as follows: Skeletal Class 1: The bones of the face and the jaws are in harmony with one another and with the rest of the head. The maxilla is slightly ahead of the mandible. The profile is orthognathic. Division 1. Local malrelations of incisor, canine or premolar teeth. Division 2. Maxillary incisor protrusion. Division 3. Maxillary incisors in linguoversion. Division 4. Bimaxillary protrusion.
  4. 4. SK ELETAL CLASSIFICATIO N Skeletal Class 2: Subnormal distal mandibular development in relation to the maxilla. Division 1. Maxillary dental arch is narrower than mandibular and there is crowding in the canine region, crossbite and reduced vertical height. Protrusion of the maxillary anterior teeth. The profile is retrognathic. Division 2. Lingual inclination of the maxillary incisors. The lateral incisors may be normal or in labioversion.
  5. 5. SK ELETAL CLASSIFICATIO N Skeletal Class 3: Overgrowth of the mandible and obtuse mandibular angle. The profile is prognathic at the mandible.
  6. 6. ACK MAN – ER P OFFIT R CLASSIFICATION Ackerman and Proffit proposed a classification scheme for malocclusions in which five characteristics and their interrelationships are assessed. This system is a synthesis of two schemes, the Angle classification and the Venn diagram, both of which were proposed late in the nineteenth century by Angle and Venn. Venn proposed this representation in 1880, and it has become prominent in symbolic logic for computer use.
  7. 7. GROUP 1 GROUP 2 GROUP 4 GROUP 3 TRANSVERSE DEVIATION Gp6 Cross bites TRANSBuccal Palatal Unilateral Bilateral Class I Class II Div1 Class II Div 2 Class III SAGITTAL Skeletal Dental SAGITTAL DEVIATION Gp9 TRANSSAGITOVERTICAL VERTICOTRANSVERSE Gp8 PROFILE Skeletal Dental SAGITOVERTICAL Gp7 GROUP 5 VERTICAL DEVIATION Open Bite anterior Open bite posterior Deep bite anterior Collapsed bite posterior INTRA ARCH ALIGNMENT Skeletal Dental Anterior divergent Posterior divergent Convex Concave Straight IDEAL CROWDING SPACING
  8. 8. ACK MAN – ER P OFFIT R CLASSIFICATION Classification by groups Common to all dentitions is the degree of alignment and symmetry of the teeth within the dental arches. This is represented as the universe (Group 1). Many malocclusions affect the profile. For this reason, profile is represented as a major set (Group 2) within the universe. Lateral (transverse), anteroposterior (sagittal), and vertical deviations and their interrelationships (Groups 3 to 9) are represented by three interlocking subsets within the profile set.
  9. 9. ACK MAN – ER P OFFIT R CLASSIFICATION Step 1 in the classification procedure is an analysis of the alignment and symmetry of the teeth in the dental arches (interproximal contact relationships). Alignment is the key word of Group 1; among the possibilities are ideal, crowding (arch-length deficiency), spacing, and mutilated. Irregularities of individual teeth are described, if desired, by the method of Lischer, namely, the use of the suffix -version to describe the direction of individual tooth malalignments. Ideal occlusion, plus many (but by no means all) Angle Class I malocclusions, would fall into Group 1.
  10. 10. ACK MAN – ER P OFFIT R CLASSIFICATION In Step 2 one views the patient's profile. In the profile view, it should be noted whether the face is anteriorly divergent (mandible prominent) or posteriorly divergent (mandible recessive) and whether the lips are convex (prominent), straight, or concave relative to the nose and chin. The "divergence" is most often related to the facial skeleton; lip position is strongly influenced by the teeth. Lip and mouth posture should also be considered in the evaluation.
  11. 11. ACK MAN – ER P OFFIT R CLASSIFICATION In Step 3 the dental arches are viewed with regard to lateral dimensions (transverse plane), and the buccolingual relationships of the posterior teeth are noted. The term type is used to describe the various kinds of crossbite. A judgment is also made as to whether the problem is basically dentoalveolar or skeletal or due to a combination of the two. Buccal and palatal cross bites ( unilateral or bilateral) comes under this category
  12. 12. ACK MAN – ER P OFFIT R CLASSIFICATION In Step 4 the patient and dental arches are viewed in the anteroposterior dimension (sagittal plane). In this dimension, the Angle classification system is utilized and is merely supplemented by stating whether a deviation is skeletal, dentoalveolar, or a combination. This information can be derived from observing the patient or more accurately from a cephalometric head film.
  13. 13. ACK MAN – ER P OFFIT R CLASSIFICATION In Step 5 the patient and the dentition are viewed with regard to the vertical dimension. Bite depth is used to describe the vertical relationships. The possibilities are anterior open-bite, anterior deep-bite, posterior open-bite, or posterior collapsed bite. To determine whether this is on a skeletal, dentoalveolar, or combined basis, a cephalometric analysis may be particularly helpful.
  14. 14. ACK MAN – ER P OFFIT R CLASSIFICATION This approach defines nine groups of malocclusions. The complexity of the orthodontic problem increases with the group number. Thus, a Group 9 malocclusion is the most complex in that there is an alignment problem, a problem in profile, and problems in the lateral, vertical, and anteroposterior dimensions as well.
  15. 15. ACK MAN – ER P OFFIT R CLASSIFICATION Advantages of this classification  This method of classification based on five descriptive characteristics and defining nine groups of malocclusions overcomes the major weaknesses of the Angle system  Specifically, arch-length problems, with or without an influence on the profile, are recognized; the influence of the dentition on the profile is taken into account  All three planes of space, not just the sagittal plane, are taken into consideration  The differentiation between dental and skeletal problems is made at the appropriate level  Diagnosis is inherent in the classification
  16. 16. ETIOLOGIC CLASSIFICATIO N According to Moyers, Classification of malocclusion can be based on the origin of the problem. There are four classes depending on origin Skeletal or Osseous Dental Muscular Combination of above
  17. 17. CONCLUSION The goal of modern orthodontics can be summed up as the creation of the best possible occlusal relationships within the framework of acceptable facial aesthetics and stability of the occlusal result. The classification systems aid in diagnosis and treatment planning of malocclusions. There is a basic need for a system of classification of malocclusion that would be adequate for clinical, semantic and public health purpose and could be universally employed by those practicing the specialty throughout the world
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