This document describes the Ackerman-Proffit analysis system for orthodontic malocclusions. It evaluates malocclusions based on Angle's classification plus five additional characteristics: transverse and vertical discrepancies, crowding, asymmetry, and incisor protrusion. It also assesses the dental arch, profile, lip posture, incisor display, and presence of crossbites or open bites. Rotational deviations around transverse, antero-posterior, and vertical axes (pitch, roll, yaw) are also evaluated. Scoring is done on a scale of 0 to 5 based on severity of the malocclusion characteristics.

1. DR. ALI WAQAR HASAN
FCPS-II TRAINEE ORTHODONTICS
UCMD LAHORE
SUPERVISED BY : DR. SAAD ASAD
ASSOCIATE PROFESSOR OF ORTHODONTICS
UCMD LAHORE

2. INTRODUCTION
 Ackerman and Profitt presented
their system in 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

3. SALIENT FEATURES
 Transverse and vertical
discrepancies can be considered in
addition to antero-posterior
malrelations
 Crowding and Arch asymmetry can
be evaluated
 Incisor protrusion is taken into
account

5. DENTOFACIAL APPEARANCE
 PROFILE : concave, straight,
convex
 LIPS : protrusive, normal,
retrusive
 INCISOR DISPLAY : Excessive,
normal, Inadequate

6. TEETH / ARCH FORM
 Involves assessment of alignment and symmetry of
dental arch
 Classified as IDEAL / CROWDED / SPACED

7. TRANSVERSE
 The transverse skeletal and
dental relationship is
evaluated
 Buccal and palatal crossbites
are noted
 CROSS BITE : unilateral /
bilateral
 Skeletal or Dental cross bite ?

8. SAGITTAL (A-P)
 Involves assessment of
sagittal relationship
 Angle’s Class- I / II /
III
 Differention between
skeletal and dental
malocclusion

9. VERTICAL
 Malocclusions in vertical
plane are noted
 Anterior or posterior open
bite
 Anterior deep bite
 Posterior collapsed bite
 Skeletal / Dental ??

10. ADDITIONAL CHARACTERISTICS
Two things particularly help this more thorough
analysis:
 Esthetic line of occlusion.
 Rotational axes.

11. 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.

12. ROTATIONAL AXES
 In addition to relationship in the transverse, antero-
posterior 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

13. PITCH
 The vertical relationship of the teeth to the lips
& cheeks can be conventionally described as up-
down deviations around the antero-posterior
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 axis.

15. METHOD OF SCORING
0- Ideal
1- Slight
2- Slight to Moderate
3- Moderate
4- Moderate to Severe
5- Severe