This document describes the features and treatment of Class II malocclusions. Key points: - Class II malocclusions are characterized by a protruded upper jaw or retruded lower jaw, resulting in a distanced molar relationship. Extraoral features include a convex profile and everted lower lip. - Causes may include heredity, drugs/radiation exposure during pregnancy, fetal hand position, trauma during birth, or habits/oral respiration post-birth. - Treatment objectives are to correct the skeletal discrepancy if present via growth modification or surgery, otherwise camouflage the issue by extracting teeth and closing gaps. Deep bites are addressed via removable plates or intruding incisors.

1. Class II Malocclusion

2.  EXTRA ORAL
 CONVEX PROFILE
 SHORT UPPER LIP
 INCOMPETENT LIPS
 EVERTED LOWER LIP
 DEEP MENTOLABIAL SULCUS
 HYPERACTIVE MENTALIS

3.  INTRAORAL FEATURES
 CLASSII MOLAR
 CLASSII CANINE
 PROCLINED UPPER ANTERIORS
 DEEPBITE
 V SHAPED UPPER ARCH
 DEEP PALATE

4. Prenatal factors
 Heredity -The size position and relationship of the jaws
are to a large extent the genes.
 Teratogenesis-Administration of certain drugs during
pregnancy can result in perverted or abnormal
development.
 Irradiation-Exposure of a pregnant woman to radiation
is another cause of altered development of the dento-
facial complex.
 Intrauterine fetal position.such as a hand across the face
is found to affect mandibular growth.

5. Natal factors
 Trauma can sometimes be induced by improper
forceps delivery.

6. Post natal factors
 Traumatic injury
 Long term irradiation therapy of the skeletal cranio-
facial region.
 Infectious conditions such as rheumatoid arthritis
can influence mandibular growth.
 Abnormal function such as oral
respiration,abnormal swallowing and habits such as
thumb sucking prevent normal muscle activity.

7. Treatment objectives
 Correction of skeletal abnormality if present.
 Reduction of overjet
 Reduction of overbite
 Correction of crowding and local irregularities
 Correction of molar relation
 Correction of posterior crossbites
 Normalizing the musculature.

8. Treatment of skeletal class II malocclusion
 Growth modification
 Camouflage
 Surgical correction.

9. Growth modification
 Class II,division 1 malocclusions are often
complicated by the presence of underlying skeletal
abnormalities. These are intercepted by functional
and orthopaedic appliances.

10. Camouflage
 In patients who are beyond growth, it is not possible
to undertake growth modification procedures. Thus
the underlying skeletal discrepancy can be
camouflaged by orthodontic tooth movement. This is
often done by extraction of certain teeth and moving
rest of the teeth into the space created.

11. Surgical correction
 In patients exhibiting severe skeletal
malrelationship,surgery may be the ideal treatment
modality. Based on the underlying skeletal pattern a
maxillary setback or a mandibular advancement is
undertaken after the completion of growth.

12.  Correction of deep bite.
 -use of removable anterior bite planes.
 -use of fixed appliances to intrude the upper and
lower anteriors.

13.  Crossbites are treated using appliances incorporating
screws or springs that expand the maxillary arch.

14. Features of class II division 2
 Molars Class II
 Retroclined central incisors and rarely of other
anteriors as well.
 Deep overbite
 Pleasing straight profile
 Broad square face
 Backward path of closure
 Deep mentolabial sulcus.
 Absence of abnormal muscle activity.

15. Treatment objectives
 Relief of gingival trauma
 Correction of incisor relationship
 Relief of crowding and local irregularities.
 Correction of buccal segement relationship.