Class II malocclusions include anomalies where the mesiobuccal cusp of the maxillary first permanent molar occludes mesial to the lower first permanent molar, with variations including Class II Division 1 and Division 2 based on incisor inclination. Class II Division 1 is characterized by proclined upper incisors, prominent overjet, and potential dental anomalies, while Class II Division 2 features retroclined upper incisors, deep overbite, and possible crossbites. Both divisions exhibit distinct skeletal relations, facial growth patterns, and mandibular positioning affecting treatment approaches in orthodontics.

1. Class II malocclusions
Class II division 1
Class II division2

2. Class II malocclusion
• Class II malocclusion includes those anomalies where
the mesiobuccal cusp of maxillary first permanent molar
occludes mesial to the buccal developmental groove of
the lower first permanent molar.
• This may or may not associated with alignment ,
dentitional and spaced problems.
• Class II malocclusion usually occurs on the skeletal II
dental base, but may also occur on skeletal I base

3. Class II malocclusion is divided into
Class II, division 1 - if the incisors are proclined
Class II, division 2 - if the incisors are retroclined.

4. Class II, div 1 malocclusion
Class II, div 2 malocclusion

5. Class II division 1 malocclusion
 Most common type of malocclusion demanding
orthodontic treatment because of the prominence of the
upper incisors affecting facial aesthetics.

6. Occlusal features
Incisal relation
 Class II incisor relation with increased overjet.
 The upper incisors are usually proclined or of
average inclination if the underlying cause is
maxillary skeletal protrusion.
 The overbite is usually deep and complete.
 Incomplete overbite may be associated with
abnormal swallowing or soft tissue behavior.

11. Buccal segment relation.
 First permanent molar relation is usually class II ,
reflecting the underlying skeletal pattern II.
 The molar relation may be class I if the skeletal pattern
is class I or if associated with early loss of primary
molars leading to mesial drift of the lower molars.
 Crowding , spacings , rotations , crossbites , openbites
and other dental anomalies may be associated with
class II division 1 malocclusions.

12. Skeletal relation
Anteroposterior relation
 The skeletal pattern is generally class II.
 In which case the anteroposterior arch discrepancy
(overjet) reflects the severity of the underlying skeletal
discrepancy.
 The skeletal pattern may be class I, in which case, the
anteroposterior arch discrepancy is caused by finger
sucking habit or alveolar dental protrusion.

13. Vertical
 There is wide variation of vertical relationship.
 Anterior facial height may be average or reduced.
 In some cases there may be increased lower facial height
with high mandibular plane angle.
 The lower incisors may be proclined to compensate the
severity of the underlying skeletal discrepancy.

14. Facial growth
 Associated with varying patterns of facial growth.
 Anteriorly directed mandibular growth with signs of
anterior mandibular growth rotation.
 This growth direction is usually favourable as the
continuing facial growth improves the facial profile.

15.  Vertically directed mandibular growth with signs of
posterior growth rotation.
 This growth direction is usually unfavourable as the
continuing facial growth further exacerbate the
overjet and anterior facial height.
 Lips are grossly incompetent and does not improve
with treatment.
 Such growth direction can be predicted by :
- mandibular plane angle,
- gonial angle and

16. Soft tissues
 The level and action of lips and adaptation of the tongue
is determined by the severity of the anteroposterior and
vertical skeletal dysplasia.
 In mild skeletal discrepancy, the lips are usually
competent or potentially competent and can obtain an
anterior oral seal without undue effort.

17.  In severe skeletal discrepancy, the lips are grossly
incompetent and the tongue has to move forward
to reach the lower lip and obtain an anterior oral
seal.
 Thus the eruption of the lower incisors will be
impeded resulting in incomplete overbite.

19. Path of mandibular closure and mandibular position
 In moderately severe class II division 1 cases , the
mandible is usually positioned forward in an attempt to
achieve anterior oral seal without undue effort and to
improve the facial esthetics.(habitual rest position)
 In this position the mandibular condyle is not in centric
relation position.
 During closure from the habitual rest position to centric
occlusion position the mandible has to move upward and
backward into centric relation position.

20.  This mandibular deviation during closure from rest
to centric relation position should be detected
clinically to correctly diagnose the severity of both
skeletal and occlusal discrepancy.
 In patients with small or narrow maxilla , the
mandible may be displaced laterally, due to
premature occlusal contact.

21. Class II division 2 malocclusion
• The clinical features of class II division 2 malocclusion is
characterized by the interaction of both the
anteroposterior and vertical dimensions of the skeletal
bases .

22. Occlusal features
Incisal relation
 Class II incisal relation – the lower incisor edge occludes
posterior to the cingulum plateau of the upper incisor.
 The angulation of upper incisors are retroclined.

23.  In crowded arch , the lateral incisors are usually proclined ,
mesiolabially rotated and overlap the centrals.
 The overbite is usually deep and complete.
 In some cases traumatic to the labial or palatal gingiva or
with gingiva recession.
 The severe the discrepancy in anteroposterior relation of
incisors, the greater the depth of the overbite

24. Buccal segment relation
Molar relation
 Full unit class II molar relation is rare.
 Mild class II molar relation is common.
 May be class I cases in cases with bimaxillary
retroclination.
 Transversely, there may be a crossbite which is usually
confined to premolar region.

25. Skeletal relation
Anteroposterior relation
 The skeletal pattern is usually mild class II but could be
class I.

26. Vertical relation
 The lower facial height is often reduced.
 Low mandibular plane angle, maxillomandibular plane angle
and the gonial angle is acute and well developed.
 Forward growth rotation of the mandible resulting in well
developed chin and pleasing facial profile.
 In extremely low angle class II division 1 cases, forward
growth rotation of mandible could result in protrusive chin.

27. Transverse relation
 The maxillary basal bone is usually broad and well
developed relative to mandibular basal bone.
 In severe transverse discrepancy, there may be crossbite
usually in premolar region.
 In mild to moderate discrepancy, the upper molars and
premolars may be lingually inclined to compensate
transverse skeletal discrepancy.

28. Soft tissues
 The lips are usually competent and relax.
 The lip line is high relative to upper incisor crowns.
 The greater the retroclination of incisors, the higher the
lip line.
 The labiomental fold is usually deep with prominent chin.

29. Path of mandibular closure and mandibular position
 In cases with deep overbite, protruding lip and prominent
chin , the patient may adopt the habitual mandibular
posture in a slightly forward and opened position.
 This may lead to mandibular backward deviation during
closure from rest to centric position.
 There may be limitations in mandibular lateral movement in
cases with deep overbite and mandibular backward
deviation.