Classification of malocclusion

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Classification of malocclusion

  1. 1. CLASSIFICATION OF MALOCCLUSION PRESENTER: SAPEEDEH AFZAL. ROLL # 10 GROUP : A
  2. 2. ROAD MAP • WHAT IS MALOCCLUSION? • NEED OR USES FOR CLASSIFICATION. • SYSTEMS OF CLASSIFICATION & TERMINOLOGIES. – ANGLE’S CLASSIFICATION. • MODIFICATIONS OF ANGLE’S CLASSIFICATION. – ANDREW’S SIX KEYS. – SKELETAL CLASSIFICATION. – BRITISH STANDARD CLASSIFICATION OF INCISOR RELATIONSHIP. – CANINE CLASSIFICATION. – SIMON’S CLASSIFICATION. – ACKERMAN & PROFFIT CLASSIFICATION.
  3. 3. OCCLUSION WHEN THE TEETH IN THE MANDIBULAR ARCH COME INTO CONTACT WITH THOSE IN THE MAXILLARY ARCH IN ANY FUNCTIONAL RELATION, ARE SAID TO BE IN OCCLUSION. (WHEELER’S)
  4. 4. WHAT IS MALOCCLUSION..?? A CONDITION IN WHICH THERE IS A DEFLECTION FROM THE NORMAL RELATION OF THE TEETH TO OTHER TEETH IN THE SAME ARCH AND/OR TO TEETH IN THE OPPOSING ARCH. (GARDINER, WHITE & LEIGHTON)
  5. 5. NEED FOR CLASSIFICATION • • • • • • • • Grouping of orthodontic problems. Location of problems to be treated. Diagnosis & treatment plan. Comparison of different types of malocclusion. For self-communication. Documentation of problems. Used for epidemiological studies. Assessment of treatment effects of orthodontic appliances.
  6. 6. QUESTIONNAIRE, INTERVIEW CLASSIFICATION CLINICAL EXAMINATION ANALYSIS OF DIAGNOSTIC RECORDS DATA BASE PROBLEM LIST = DIAGNOSIS
  7. 7. METHODS OF CLASSIFICATION OF MALOCCLUSION CAN BE BROADLY DIVIDED INTO TWO TYPES QUANTITATIVE & QUALITATIVE TYPES OF MALOCCLUSION INTRA-ARCH & INTER- ARCH PROBLEMS
  8. 8. MALOCCLUSION: INTRA-ARCH & INTER-ARCH PROBLEMS INTRA-ARCH PROBLEMS (INDIVIDUAL OR GROUPS OF TEETH)
  9. 9. MALOCCLUSION: INTRA-ARCH & INTER-ARCH PROBLEMS INTER-ARCH PROBLEMS
  10. 10. ANGLE’S CLASSIFICATION OF MALOCCLUSION • In 1899 Edward H. Angle published the first classification of malocclusion. • The classifications are based on the relationship of the mesiobuccal cusp of the maxillary first molar and the buccal groove of the mandibular first molar.
  11. 11. ANGLE’S CLASSIFICATION OF MALOCCLUSION CLASS I MALOCCLUSION DIVISION 1 CLASS II MALOCCLUSION DIVISION 2 CLASS III MALOCCLUSION SUB-DIVISION CLASS III PSEUDO CLASS III SUB-DIVISION
  12. 12. CLASS I MALOCCLUSION THE MESIOBUCCAL CUSP OF THE UPPER FIRST PERMANENT MOLAR OCCLUDES WITH THE MESIOBUCCAL GROOVE OF THE LOWER FIRST MOLAR, BUT LINE OF OCCLUSION IS INCORRECT BECAUSE OF MALPOSED TEETH, ROTATIONS OR OTHER DISCREPANCIES.
  13. 13. CLASS II MALOCLUSION THE MESIOBUCCAL CUSP OF THE LOWER FIRST PERMANENT MOLAR OCCLUDES DISTAL TO THE CLASS I POSITION.
  14. 14. CLASS II DIVISION 1 Condition when class II molar relationship is present with proclined upper central incisors. • There is an increase in overjet.
  15. 15. CLASS II DIVISION 2 Condition when class II molar relationship is present with retroclined upper central incisors, upper lateral incisors may be proclined or normally inclined. • Overjet is usually minimal or may be increased.
  16. 16. CLASS II SUB-DIVISION Condition when the class II molar relationship exists on only one side with normal molar relationship on the other side.
  17. 17. CLASS III MALOCCLUSION THE MESIOBUCCAL CUSP OF THE LOWER FIST MOLAR OCCLUDES MESIAL TO THE CLASS I POSITION.
  18. 18. PSEUDO CLASS III MALOCCLUSION Due to occlusal prematurity, when the mandible moves from rest position to occlusion, it slides forward into a pseudo class III position. It’s also known as postural class III.
  19. 19. CLASS III SUB-DIVISION Condition in which class III molar relationship is present only on one side with normal relation on the other side.
  20. 20. MODIFICATIONS OF ANGLE’S CLASSIFICATION There are two modifications of Angle’s classification 1.Lischer’s modification. 2.Dewey’s modification.
  21. 21. LISCHER’S MODIFICATION • He introduced following names to the Angle’s classification: – Neutrocclusion- Class I. – Distocclusion- Class II. – Mesiocclusion- Class III
  22. 22. DEWEY’S MODIFICATION (1915) • Martin Dewey divided Angle’s class I & III into further types: – CLASS I: • Type 1: Crowded maxillary anterior teeth. Canines may be abnormally positioned. • Type 2: Proclined or labioversion of maxillary incisors. • Type 3: Anterior cross bite present. • Type 4: Posterior cross bite present. • Type 5: Mesioversion of molars.
  23. 23. DEWEY’S MODIFICATION – CLASS III: • Type 1: Well aligned teeth & dental arches. Edge-edge relationship. • Type 2: Crowded mandibular incisors. • Type 3: Crowded maxillary incisors, underdeveloped maxilla. Anterior cross bite present.
  24. 24. ANDREW’S SIX KEYS (1970) Andrew extended Angle’s classification: 1. Correct molar relationship. 2. Correct crown angulations. 3. Correct crown inclination i.e. Class I incisor relationship. 4. No rotation present. 5. Teeth in tight contact with no spacing. 6. Occlusal plane/ curve of spee should be flat i.e. it should not be deeper than 1.5mm. 7. No tooth size discrepancies. (Bannet & McLanghlan’s)
  25. 25. SKELETAL CLASSIFICATION It considered relationship between maxilla & mandible, in anteroposterior direction. • CLASS I: Maxilla & mandible are in harmony with each other.
  26. 26. SKELETAL CLASSIFICATION • CLASS II: Maxilla lies ahead of mandible with refrence to anteroir cranial base. In other words maxilla is prgnated.
  27. 27. SKELETAL CLASSIFICATION • CLASS III: Maxilla lies posterior to mandible with reference to anterior cranial base. In other words maxilla is retrognathed.
  28. 28. BRITISH STANDARD CLASSIFICATION OF INCISOR RELATIONSHIP (1983) Based upon incisor relationship, proposed in 1983. Do not consider molar relationship in some cases. • CLASS I: The lower incisor edges occlude with or lie immediately below the cingulum plateau of upper central incisors.
  29. 29. BRITISH STANDARD CLASSIFICATION OF INCISOR RELATIONSHIP • CLASS II: The lower incisor edges lie posterior to the cingulum plateau of the upper incisors. There are two sub-divisions: – DIVISION 1: The upper central incisors are proclined or of average inclination & there is an increase in overjet. – DIVISION 2: The upper central incisors are retroclined. The overjet is usually minimal or may be increased.
  30. 30. BRITISH STANDARD CLASSIFICATION OF INCISOR RELATIONSHIP • CLASS III: The lower incisor edges lies anterior to the cingulum plateau of the upper incisors. The overjet is reduced or reversed.
  31. 31. CANINE CLASSIFICATION • CLASS I : When the mesial slope of upper canine coincides with the distal slope of lower canine.
  32. 32. CANINE CLASSIFICATION • CLASS II : When the mesial slope of upper canine is ahead of the distal slope of lower canine.
  33. 33. CANINE CLASSIFICATION • Class III : When the mesial slope of the upper canine lies behind the distal slope of the lower canine.
  34. 34. SIMON’S CLASSIFICATION (1926) • In Simon’s classification system, the dental arches are related to three anthropologic planes. • PLANES USED: – Frankfort horizontal plane or eye-ear-plane. – Orbital plane. – Raphe median plane or mid-saggital plane.
  35. 35. SIMON’S CLASSIFICATION • FRANKFORT HORIZONTAL PLANE: -Helps detect deviations in the vertical plane. -Dental arch closer to the plane is called attraction and farther away is called abstraction.
  36. 36. SIMON’S CLASSIFICATION • ORBITAL PLANE: -Helps to detect deviations in the transverse plane. -Dental arch more anteriorly placed is called protraction and posteriorly placed dental arch is called retraction.
  37. 37. SIMON’S CLASSIFICATION • MID-SAGGITAL PLANE: - Helps to detect deviations in the saggital plane. - Dental arch closer to midsaggital plane is called contraction and farther away is called distraction.
  38. 38. ACKERMAN & PROFFIT CLASSIFICATION (1960) • It was proposed to overcome the drawbacks of Angle’s classification. • This system includes Angle’s classification & five characteristics of malocclusion within a Venn diagram.
  39. 39. FIVE MAJOR CHARACTERISTICS
  40. 40. ADDITION TO THE FIVE-CHARACTERISTICS CLASSIFICATION SYSTEM • Two things particularly help this more thorough analysis: 1. Esthetic line of occlusion. 2. Rotational axes.
  41. 41. 1. ESTHETIC LINE OF OCCLUSION • In modern analysis, another curved line characterizing the appearance of the dentition is important. – Esthetic line of occlusion, follows the facial edges of the maxillary anterior and posterior teeth.
  42. 42. 2. ROTATIONAL AXES • In addition to relationship in the transverse, anteroposterior and vertical planes of space used in traditional 3-D analysis, rotations around axes perpendicular to three planes also must be evaluated. • It’s a useful way to evaluate the relationship of the teeth to the soft tissues that frame their display. – Pitch. – Roll. – Yaw.
  43. 43. ROTATIONAL AXES PITCH: •The vertical relationship of the teeth to the lips & cheeks can be conventionally described as up-down deviations around the anteroposterior axes. •Evaluated clinically & from cephalometric radiographs. ROLL: •Roll describes the vertical position of the teeth when this is different on the right & left sides. •Viewed as up-down deviations around the transverse axes. •It’s seen with lips relaxed and more clearly on smile, in both frontal and oblique views. •YAW: •Rotation of the jaw or dentition to one side or the other, around a vertical axes, produces a skeletal or dental midline discrepancy. •Viewed as left-right deviations around the vertical axes.
  44. 44. REFRENCES • CONTEMPORARY ORTHODONTICS, WILLIAM R. PROFFIT (5TH. EDITION) • INTRODUCTION TO ORTHODONTICS, LAURA MITCHELL (3RD. EDITION) • ORTHODONTICS, PREM KUMAR (2ND. EDITION)

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