1. CLASSIFICATION OF
MALOCCLUSION
 UNDER THE GUIDANCE OF:
DR. D.K. JAIPURIA
DR. JAIDEEP Singh
DR. NEHA AGARWAL
 PRESENTEDBY:
MAUSAM TIWARI
BDS 4TH YR
(10-11) BATCH

2. SYNOPSIS:
 INTRODUCTION
 DEFINITIONS: OCCLUSION
IDEAL OCCLUSION
NORMAL OCCLUSION
MALOCCLUSION
 NEED OF CLASSIFICATION
 TYPES OF MALOCCLUSION
 CLASSIFICATION OF MALOCCLUSION

3. INTRODUCTION:
 In the specialty of orthodontics, the
classification of malocclusion plays an
important role.
 Classification aids in the diagnosis and
treatment planning of malocclusions by
orienting the clinician to the type and the
magnitude of the problems and possible
mechanical solutions to the problems.

4. TERMINOLOGIES:
1) Occlusion: The relation of maxillary and
mandibular teeth when the jaws are closed in
a centric relation without strain of
musculature or displacement of condyles in
their fossae.
2) Ideal occlusion: It is a pre- conceived theoretical
concept of occlusal structures and functional
relationships that include idealized principles
and characteristics that an occlusion should
have.

5. 3) NORMAL OCCLUSION: It is some deviation from
that of ideal but is aesthetically acceptable and
functionally stable for the individuals.
- The upper and lower teeth fit nicely and evenly
together with the least amount of destructive
interferences.

6. ANDREWS 6 KEYS TO NORMAL OCCLUSION:
 Andrews in 1970s put forward the six keys to
normal occlusion after studying models of 120
patients with ideal occlusion.
 The six keys to normal occlusion are
considered under following headings.

7. 1) Molar inter-arch relationship.
2) Mesio -distal crown relationship.
3) Labio -lingual crown inclination.
4) Absence of rotation.
5) Tight contacts.
6) Curve of spee.

10. 4) malocclusion: Defined as a condition where
there is departure from the normal relation of
the teeth to the other teeth in the same dental
arch or teeth in opposing arch.
 The term was coined by Edward H Angle, the
father of modern orthodontics.
 It is a condition that reflects an expression of
normal biologic variability in the way the
maxilla and mandible teeth occlude - Bishara.

11.  An occlusion in which there is a
malrelationship between the arches in any of
the planes of the spaces or in which there are
anomalies in tooth position beyond the limit of
normal- Walther and Huston.

12. NEED FOR CLASSIFICATION:
Acquire a better understanding of the many
deviates from normal occlusion.
1) Divide the wide range into small groups.
2) Describe the salient features.
3) Helps in diagnosing and planning treatment
for patient.
4) Helps in visualizing and understanding the
problem associated with that malocclusion.

13. 5) Helps in communicating the problem.
6) Comparison of the various malocclusions is
made easy by classification.
7) Unify the communications.

14. TYPES OF MALOCCLUSION:
1)Intra-arch malocclusion: It include variations in
individual tooth position or a group of teeth
within an arch.
2)Inter-arch malocclusions: It compromise of mal
relationship between two teeth or group of teeth
of one arch to another arch.
3)Skeletal malocclusions: It involves the apical
upper and lower bony bases.

15. INTRA-ARCH MALOCCLUSIONS:
It includes:
 Abnormal inclination.
 Abnormal displacement.
 Spacing and crowding within same arch.

16. ABNORMAL INCLINATIONS:
1)Mesial inclination: This is a condition where the
crown of tooth is tilted or inclined mesially.

17. 2) Distal inclination: Refers to a condition where
the crown is tilted or inclined distally.

18. 3)Lingual inclination(Retroclination): This is an
abnormal lingual or palatal tilting of tooth.

19. 4)Buccal inclination(Proclination): This refers to labial
or buccal inclination of tooth.

20. ABNORMAL DISPLACEMENT:
1) Mesial displacement: This refers to a tooth that is
bodily moved in a mesial direction towards the
midline.

21. 2) Distal displacement: This refers to a tooth that is
bodily moved in a distal direction away from the
midline.

22. 3) Lingual displacement: This is a condition where the
entire tooth is displaced in lingual direction.

23. 4) Buccal displacement: This is a condition where the
tooth is displaced bodily in labial or buccal
direction.

24. 5) extrusion(supra-version): this is a condition in
which a tooth that has over erupted as
compared to other teeth in the arch.
6) Intrusion(infra-version): Refers to a tooth that has
not erupted enough as compared to other teeth
in the arch.

25. 7)disto-lingual or mesio-buccal rotation: This describes a
tooth that has rotated around its long axis so
that the distal aspect is more lingually placed.
8)mesio-lingual or disto-buccal rotation: This is a
condition where the tooth has rotated around its
long axis so that the mesial aspect is more
lingually placed.

27. 9)Transposition: This term describes a condition
where two teeth have exchanged places.

28. INTER-ARCH MALOCCLUSIONS:
These inter-arch malocclusions can occur in the:
 Sagittal plane
 Vertical plane
 Transverse plane of space.

30. SAGITTAL PLANE MALOCCLUSIONS:
This includes condition where the upper and lower
arches are abnormally related to each other in a
sagittal plane.
1)pre-normal occlusions: This is a condition where the
lower arch is more forwardly placed when the
patient bites in centric occlusion.
2)Post-normal occlusions: This is a condition where the
lower arch is more distally placed when the patients
bite in centric occlusion.

31. VERTICAL PLANE MALOCCLUSIONS:
These malocclusions include deep bite and open
bite where an abnormal vertical relation exists
between the teeth of upper and lower arch.
1)Deep bite or increased overbite: It is a condition where
there is excessive vertical overlap between the
upper and lower anterior.
2)Open bite: This is a condition where there is no
vertical overlap between upper and lower teeth.
-thus a space may appear between the upper
and lower arch when the patient bites in centric
occlusion.
-it can either be in anterior or posterior region.

33. TRANSVERSE PLANE MALOCCLUSIONS:
It includes various types of crossbites i.e. the
abnormal transverse relationship between the
upper and lower arches.

34. SKELETAL MALOCCLUSIONS:
-They are the malrelations of apical bases of
upper and lower arch.
-It is due to:
 Abnormal size
 Abnormal shape
 Abnormal relation to the skull
 Abnormal relation to each other

35. SAGITTAL PLANE MALOCCLUSION:
The forward placement of a jaw is called as
prognathism while more backward placement of
jaw is called as retrognathism.
Vertical plane malocclusions:
The abnormal variations in vertical
measurement of jaws can affect the lower facial
height.
Transverse plane malocclusion:
It is a result of narrowing or widening of jaws.
-can be described as narrow maxilla, wide
mandible etc.

36. CLASSIFICATIONS:
 Angle classification
 Dewey's modification of Angles classification
 Lischer's modification of Angles’ classification
 Simon’s classification
 Bennett's classification
 Ackerman-Profit system of classification
 Ballard's incisor classification
 Katz premolar classification
 Newly proposed system

37. ANGLE’S CLASSIFICATION:
-It was introduced by Edward H Angle in 1899.
-based on mesio-distal relation of the teeth,
dental arches and the jaws.
-According to him, the maxillary 1st permanent
molar is the key to occlusion and considered
these as fixed anatomical points within jaws.
-classified into 3 classes-class I, class II, class III.

39. ANGLE’S CLASS I:
-The mesio-buccal cusp of maxillary 1st molar
occludes in buccal groove of mandibular 1st
molar.
-malocclusion could be crowding, spacing,
rotations, missing tooth etc.
-another malocclusion that is most often
categorized under class I is bimaxillary
protrusion where the patient exhibit normal
class I molar relationship but the dentition of
both the upper and lower arches are forwardly
placed in relation to facial plane.

41. ANGLE’S CLASS II:
-Here the distobuccal cusp of the maxillary 1st
molar lies within the buccal groove of
mandibular 1st molar.
-Divided into:
Division 1: - proclined upper incisors with a resultant
increase in overjet.
- A deep incisor overbite can occur in anterior
region.
- Presence of abnormal muscle activity.

42. -The upper lip is usually hypotonic, short and
fails to form a lip seal.
-The lower lip cushions the palatal surface of
upper teeth called as “lip trap”.
-the muscle imbalance is produced by a
hyperactive buccianator and mentalis and an
altered tongue that accentuates the narrowing
of upper dental arch(V shape).
DIVISION 2:- presence of lingually inclined upper
central incisors and labially tipped lateral
incisors overlapping the central incisors.

43. Division 1
Division 2
Lip trap

44. CLASS II SUBDIVISION: -
When a class II molar relationship exists on one
side and a class I relationship on other side it is
referred as class II subdivision.

45. ANGLE’S CLASS III:
-In this the mesiobuccal cusp of maxillary 1st
molar occludes the interdental space between
mandibular 1st and 2nd molars.
-Classified into: 1) True class III(skeletal)
2) Pseudo class III(false or
postural).

46. True class III: It is of genetic origin and is due to:
 Excessively large mandible
 Forwardly placed mandible
 Smaller than normal maxilla
 Retro positioned maxilla
 Combination of above causes
- The lower incisor tend to be lingually inclined.

47. Pseudo class III: - It is produced by forward movement
of mandible during jaw closure; thus it is also
called postural or habitual class III malocclusion.
- It is due to:
 Presence of occlusal prematurities may
deflect the mandible forward.
 In case of premature loss of deciduous
posteriors.
 A child with enlarged adenoids.

48. Class III subdivision: This is a condition characterized
by a class III molar relationship on one side ad
class I on other.

49. DRAWBACKS OF ANGLE’S CLASSIFICATION:
1) Angle considered malocclusion only in antero-
posterior plane not in transverse and vertical
plane.
2) He considered the 1st permanent molars as
fixed points in skull which was not found so.
3) The classification cannot be applied if 1st
permanent molars are extracted or missing.
4) The classification cant be applied to
deciduous dentition.

50. 5) The classification does not differentiate
between skeletal and dental malocclusions.
6) The classifications does not highlight the
etiology of malocclusion.
7) Individual tooth malpositions have not been
considered by Angle.

51. DEWEY’S MODIFICATION OF ANGLE’S
CLASSIFICATION:
- Divided class I into 5 subtypes and class III into 3
subtypes.
- Class I modification:-
Type 1: - class I malocclusion with bunched or
crowded anterior teeth.
Type 2:- class I with protrusive maxillary incisors.
Type 3: -class I malocclusion with anterior
crossbite.
Type 4: class I molar relation with posterior
crossbite.

52. Type 5: - The permanent molar has drifted mesially
due to early extraction of second deciduous
molar or second premolar.
Class III modification:
Type 1:- The upper and lower dental arches when
viewed separately are in normal alignment. But
when the arches are made to occlude the
patient shows an edge to edge incisor alignment
,suggestive of forward movement of mandible.

53. Type 2:- The mandibular incisors are crowded and
are in lingual relation to the maxillary incisors.
Type 3:- The maxillary incisors are crowded and are
in cross bite in relation to mandibular anteriors.

54. LISCHER’S MODIFICATION OF ANGLE’S
CLASSIFICATION:
Neutrocclusion: Angle’s class I malocclusion.
Distocclusion: Angle’s class II malocclusion.
Mesiocclusion: Angle’s class III malocclusion.
Buccocclusion: Buccal placement of a tooth or group of
teeth.
Linguocclusion: lingual placement of tooth or group of
teeth.
Supraocclusion: When a tooth or group of teeth have
erupted beyond the normal level.

55. Infraocclusion: when a tooth or group of teeth have
erupted below the normal level.
Mesioversion: mesial to normal position.
Distoversion: Distal to normal position.
Transversion: transposition of two teeth.
Axiversion: Abnormal axial inclination of a tooth.
Torsiversion: Rotation of a tooth around its long
axis.

56. BENNET’S CLASSIFICATION:
-Based on etiology.
-Class I:- Abnormal position of one or more teeth
due to local causes.
-Class II:- Abnormal formation of a part of or
whole of either arch due to developmental
defects of bone.
-Class III:- Abnormal relationship between upper
and lower arches, and between either arch and
facial contour and correlated abnormal
formation of either arch.

57. SIMMON’S CLASSIFICATION:
-It is a craniometric classification.
-made use of anthropometric planes i.e. the
Frankfort horizontal plane, the orbital plane, the
midsagittal plane.
- Classification was based on abnormal
deviations of dental arches form their normal
position in relation to these three planes.

58. FRANKFORT HORIZONTAL PLANE: -
-It connects the margin of the external auditory
meatus to the infra-orbital margin.
-This plane is used to classify malocclusions in
vertical plane.
- When the dental arch or part of it is closer than
normal to Frankfort plane, it is called attraction.
- When the dental arch or part of it is farther
away from the Frankfort plane, it is called
abstraction.

59. Orbital plane:-This plane is perpendicular to the
Frankfort plane, dropped down from the bony
orbital margins directly under the pupil of the
eye.
-According to Simon, this plane should pass
through the distal third of upper canine called as
Simon’s law of canine.
-This plane is used to describe malocclusion in
sagittal or antero-posterior direction.
-When the dental arch or part of it is away from
orbital plane, it is called as protraction.
-When the dental arch is closer or placed more
posteriorly to this plane, it is called as retraction.

60. Mid sagittal plane:-
-it is used to describe malocclusion in transverse
direction.
-When a part or whole of arch is away from the
this plane, it is called as distraction.
- When the dental arch is near to this plane, it is
called as contraction.

62. ACKERMAN-PROFITT SYSTEM OF CLASSIFICATION:
-Based on 5 characteristics:
 Alignment
 Profile
 Transverse relationship
 Class
 Bite depth
-considered transverse and vertical
discrepancies.
-evaluated crowded and arch asymmetry.
-incisor protrusion.
-influence of dentition on profile.

63. Venn symbolic diagram

64. BALLARD’S CLASSIFICATION:
-Incisor classification.
-A classification of malocclusion based on
incisor.
-As treatment is often primarily aimed at
correcting this relationship.
-Three classes: class I incisor
class II incisor
class III incisor

66. KATZ PREMOLAR RELATIONSHIP:
Premolar class I- most anterior upper premolar fits
exactly into the embrasure created by distal
contact of most anterior lower premolar.
Premolar class II:- the most anterior premolar is
occluding mesial embrasure created by distal
contact of most anterior lower premolar.
Premolar class III:-the most anterior premolar is
occluding distal of the embrasure created by
the most anterior lower premolar.

67. BIBLIOGRAPHY:
1) Balajhi – book of orthodontics
2) Wikipedia

68. THANKYOU