SlideShare a Scribd company logo
CLASSIFICATION OF
MALOCCLUSION
DR CHANDRIKA KATTI
Reader, Dept Of Orthodontics.
Navodaya Dental College, Raichur.
1
Introduction
 Malocclusion is defined as any deviation from
normal occlusion of teeth .
 Occlusion : Contact relationship between
maxillary and mandibular teeth in function and
parafunction.
 Classification of malocclusion is the
description of dentofacial deviations according
to a common characteristic or norm.
2
Advantages of Classification
1. Helps in diagnosis and treatment planning.
2. Helps in visualizing and understanding the
problem associated with malocclusion.
3. Helps in communicating the problem.
4. Helps in comparisons of various
malocclusions.
3
Types of Malocclusion
1. Intra-arch malocclusion
2. Inter-arch malocclusion
3. Skeletal malocclusion
4
1. Intra-arch malocclusion
Includes individual tooth position, variations and
malocclusions affecting a group of teeth within an
arch.
 Distal inclination
 Mesial inclination
 Lingual inclination
 Buccal inclination
 Mesial displacement
 Distal displacement
 Lingual displacement
 Buccal displacement
 Infra version
 Supra version
 Rotations
 Distolingual/Mesiobuccal
 Mesiolingual/Distobuccal
 Transposition 5
6
7
8
Mesial inclination Distal inclination Palatal inclination
Lingual inclination Labial inclination 9
Infraocclusion Supraocclusion
Supraocclusion Rotation
Mesiolingual or Distolabial
10
Rotation
Distolingual or Mesiolabial
Transposition
11
2. Inter-arch malocclusion
Malrelation of dental arches to one another upon
skeletal bony basis that may themselves be
normally related.
 Sagittal plane malocclusions
 Vertical plane malocclusions
 Transverse plane malocclusions
12
Sagittal plane malocclusions
 Pre-normal occlusion
Mandibular arch
anteriorly placed in
centric occlusion.
 Post-normal occlusion
Mandibular arch
posteriorly placed in
centric occlusion.
13
Vertical plane malocclusions
 Deep bite
Excessive vertical
overlap between
maxillary and
mandibular anteriors.
 Open bite
No vertical overlap.
- Anterior region
- Posterior region
Anterior open bite Posterior open bite
14
Transverse plane malocclusions
Includes various types of cross bites.
Lateral incisor in cross bite
Posterior segment in cross bite
15
3. Skeletal malocclusion
 Includes defects in underlying skeletal structure.
 Due to abnormalities in maxilla or mandible in size,
position or relationship between jaws.
 Sagittal abnormalities
 Prognathism
 Retrognathism
 Combinations
 Transverse abnormalities
 Narrowing and widening of jaws causes crossbites
 Vertical abnormalities
 Variation affects lower facial height.
16
17
18
Systems of Classification of
Malocclusion
1. Angle’s classification
2. Dewey’s modification of Angle’s classification
3. Lischer’s modification of Angle’s classification
4. Bennet’s classification
5. Simon’s classification
6. Ackermann-Profitt classification
7. Incisor classification
19
Angle’s classification
 It was introduced by Edward Angle in 1899.
 Based on mesiodistal relationship of teeth, dental arches and
jaws.
 Maxillary 1st molar is taken as key to occlusion.
Three classes :
 Class I
 Class II
 Class II division I
 Class II division II
 Class II subdivision
 Class II division I subdivision
 Class II division II subdivision
 Class III
 True Class III
 Pseudo Class III
 Class III subdivision 20
Class I
 Normal inter-arch molar relation
 Mesiobuccal cusp of maxillary 1st permanent molar occlude in
the buccal groove of mandibular 1st permanent molar.
 Dental irregularities
 Crowding
 Spacing
 Rotations
 Missing teeth
 Normal skeletal retaionships.
 Normal muscle function.
 Includes bimaxillary protrusion – normal Class I molar
relationship but the dentitions of both arches are forwardly
placed in relation to the facial profile.
21
22
Class II
 Distobuccal cusp of maxillary 1st permanent
molar occludes in the buccal groove of
mandibular 1st permanent molar.
Class II division I
 Characterized by proclined V-shaped upper
incisors.
 Therefore, increased overjet, lip trap, abnormal
muscle activity – hypotonic upper lip,
hypertonic mentalis and buccinator.
23
24
Class II division 2
 Characterized by lingually inclined upper incisors and
labially tipped upper lateral incisors overlapping the
centrals.
 Square shaped arch, peri-oral muscle activity normal.
Class II subdivision
 Class II molar relation exist on one side and Class I
molar relation on the other side.
 Class II division I subdivision
 Class II division II subdivision
25
26
Class III
 Mesiobuccal cusp of maxillary 1st permanent molar
occlude the interdental space between mandibular 1st
and 2nd molar.
 True Class III
 Pseudo Class III
 Class III subdivision
 True Class III – Skeletal Class III malocclusion of
genetic origin. Due to -
 Excessively large mandible
 Forwardly placed mandible
 Smaller than normal maxilla
 Combinations
27
 Pseudo Class III – Produced by forward
movement of mandible during jaw closure
 Also called postural/habitual Class III
 Due to
 Occlusal prematurities
 Premature loss of deciduous posteriors.
 Child with enlarged adenoids
 Class III subdivision – Class III molar relation
on one side and Class I on the other.
28
29
Advantages of Angle’s Classification
 First comprehensive classification – most
widely accepted.
 Simple
 Easy to use
 Conveys precisely what was conceived for ie,
relationship of mandibular teeth with respect to
maxillary 1st permanent molar.
30
Drawbacks of Angle’s Classification
 Considers malocclusion only in the anteroposterior
plane and not in transverse/ vertical planes.
 Considered 1st permanent molar as fixrd points in the
skull, not found to be so.
 Cannot be applied if 1st permanent molar is missing
or to deciduous dentition.
 Doesn’t distinguish between skeletal/dental
malocclusion.
 Doesn’t highlight etiology.
 Individual tooth positions aren’t considered.
31
Dewey’s modification of Angle’s
classification
Angle’s Class I
 Type I – Class I with crowded anteriors.
 Type II – Class I with protrusive maxillary
incisors.
 Type III – Class I with anterior cross bite.
 Type IV – Class I with posterior cross bite.
 Type V – Mesially drifted permanent molars
therefore early extraction of deciduous
predecessors.
32
Angle’s Class I with anterior crowding or Dewey’s Class I type 1
Angle’s Class I with anteriors proclined or Dewey’s Class I type 2
Dewey’s Class I type 3 malocclusion, molars in Angle’s Class I
with maxillary anteriors in crossbite
Dewey’s Class I type 4. Angle’s class I with posterior crossbite 33
Dewey’s Class I type 5
34
Angle’s Class III
 Type I – upper and lower arches are normally
aligned separately but show edge-to-edge bite/
incisor arrangement on occlusion.
 Type II – mandibular incisors crowded and in
lingual relation to maxillary incisors.
 Type III – maxillary incisors are crowded and
in cross bite with mandibular anteriors.
35
Dewey’s Class III type 1
Dewey’s Class III type 2
Dewey’s class III type 3
36
Lischer’s modification of Angle’s
classification
 Neutro-occlusion – Angle’s Class I
 Disto-occlusion – Angle’s Class II
 Mesio-occlusion – Angle’s Class III
 Mesioversion – mesial to normal position
 Distoversion – distal to normal position
 Linguoversion – lingual to normal position
 Labioversion – labial to normal position
 Infraversion – inferior or away from the line of occlusion
 Supraversion – superior or extended past the line of occlusion
 Axiversion – axial inclination is wrong, tipped
 Torsiversion – rotated on its long axis
 Transversion – transposed or changes in the sequence of
position 38
Mesioversion Distoversion of lateral incisor and canine
Torsiversion of 1st premolar rotated mesiobuccally
Linguoversion Labioversion 39
Axiversion Torsiversion
40
Bennet’s classification
Class I – abnormal position of one or more teeth due to
local causes.
Class II – abnormal formation of a part/ whole of either
arch due to developmental defect of bone.
Class III – abnormal relation between upper and lower
arches and between either arch and facial contour and
co-related abnormal formation of either arch.
41
Simon’s classification
It is a craniometric classification relating dental arches in
three planes i.e.,
 FH plane [Frankforts Horizontal plane]
 Orbital plane
 Mid-sagittal plane
FH plane
Attraction – closer than normal to FH
plane.
Abstraction – away from FH plane than
normal. 42
Orbital plane
Protraction – Farther from orbital
plane
Retraction – Closer/more posterior to
orbital plane.
Mid-sagittal plane
Distraction – away from mid sagittal
plane
Contraction – closer to mid sagittal
plane
43
Ackermann-Profitt classification
Based on five characteristics
1. Alignment
2. Profile
3. Transverse relationships
4. Class
5. Overbite
1
2
3
4
5
44
1. Alignment
 Interarch alignment and symmetry assessed when seen in
occlusal view.
 Dental arch is classified as ideal/crowded/spaced
2. Profile
 can be convex/straight/concave
 Includes assessment of facial divergence ie. Anterior or
posterior divergence.
3. Transverse relationships
 Include transverse skeletal and dental relationships.
 Buccal and palatal cross bites are noted.
 Further classified as unilateral or bilateral.
 Distinction made between skeletal and dental cross bites.
46
4. Class
 Sagittal relationship of teeth is assessed using Angle’s
classification as Class I / II / III.
 Distinction made between skeletal and dental
malocclusions.
5. Overbite
 Assessed in the vertical plane
 Described as anterior open bite / posterior open bite /
anterior deep bite / posterior collapsed bite.
 Distinction made between skeletal and dental
malocclusions.
47
Incisor classification
 Class I
 Class II
 Division I
 Division II
 Class III
Class II
div 1
Class I Class II
div 2
Class III
48
 Class I
Mandibular incisor edges occlude with or lie
immediately below the cingulum plateau of the
maxillary central incisors.
 Class II
Mandibular incisor edges lie posterior to the
cingulum plateau of the maxillary central
incisors.
 Division I
 Division II
49
Division I
Maxillary central incisors are proclined or of average
inclination and there is an increased overjet.
Division II
Maxillary central incisors are retro-clined; the overjet
is normally minimum, but maybe increased.
 Class III
Mandibular incisor edges lie anterior to the cingulum
plateau of the upper central incisors; the overjet is
reduced or reversed.
50
51

More Related Content

What's hot

Modifications of angle`s classification
Modifications of angle`s classificationModifications of angle`s classification
Modifications of angle`s classification
Dr. Vishal Gohil
 
Classification & etiology of malocclusion
Classification & etiology of malocclusionClassification & etiology of malocclusion
Classification & etiology of malocclusion
Indian dental academy
 
Mouth breathing
Mouth breathingMouth breathing
Mouth breathing
Nursing Hi Nursing
 
Anchorage in Orthodontics
Anchorage in OrthodonticsAnchorage in Orthodontics
Anchorage in Orthodontics
IAU Dent
 
Development of the dentition
Development of the dentition Development of the dentition
Development of the dentition
Sharanya Majumdar
 
Essential diagnostic aids in orthodontics
Essential diagnostic aids in orthodonticsEssential diagnostic aids in orthodontics
Essential diagnostic aids in orthodontics
HariprasadL3
 
Etiology of Malocclusion I
Etiology of Malocclusion IEtiology of Malocclusion I
Etiology of Malocclusion I
IAU Dent
 
predentate period pedo
 predentate period pedo predentate period pedo
predentate period pedo
Parth Thakkar
 
Oral screen and mixed dentition appliance
Oral screen and mixed dentition applianceOral screen and mixed dentition appliance
Oral screen and mixed dentition appliance
A.K.M Mahbubar Rahman Ranga
 
Self correcting anomalies
Self correcting anomalies Self correcting anomalies
GROWTH AND DEVELOPMENT IN ORTHODONTICS
GROWTH AND DEVELOPMENT IN ORTHODONTICSGROWTH AND DEVELOPMENT IN ORTHODONTICS
GROWTH AND DEVELOPMENT IN ORTHODONTICS
kapil saroha
 
Interceptive orthodontics
Interceptive orthodonticsInterceptive orthodontics
Interceptive orthodontics
mahesh kumar
 
Non –pharmacological behavior management in children
Non –pharmacological behavior management in childrenNon –pharmacological behavior management in children
Non –pharmacological behavior management in children
Dr. Harsh Shah
 
Class II malocclusion
Class II malocclusionClass II malocclusion
Class II malocclusion
Cing Sian Dal
 
Treatment of crowding in permanent dentition
Treatment of crowding in permanent dentitionTreatment of crowding in permanent dentition
Treatment of crowding in permanent dentition
Cing Sian Dal
 
White spot lesions
White spot lesions White spot lesions
White spot lesions
Marwan Mouakeh
 
Functional appliances
Functional appliancesFunctional appliances
Functional appliances
Dr Shahzad Hussain
 
anchorage
anchorageanchorage
anchorage
Parth Thakkar
 
Posterior Crossbite
Posterior CrossbitePosterior Crossbite
Posterior Crossbite
Cing Sian Dal
 
Deep bite(1)
Deep bite(1)Deep bite(1)
Deep bite(1)
Saba Basit
 

What's hot (20)

Modifications of angle`s classification
Modifications of angle`s classificationModifications of angle`s classification
Modifications of angle`s classification
 
Classification & etiology of malocclusion
Classification & etiology of malocclusionClassification & etiology of malocclusion
Classification & etiology of malocclusion
 
Mouth breathing
Mouth breathingMouth breathing
Mouth breathing
 
Anchorage in Orthodontics
Anchorage in OrthodonticsAnchorage in Orthodontics
Anchorage in Orthodontics
 
Development of the dentition
Development of the dentition Development of the dentition
Development of the dentition
 
Essential diagnostic aids in orthodontics
Essential diagnostic aids in orthodonticsEssential diagnostic aids in orthodontics
Essential diagnostic aids in orthodontics
 
Etiology of Malocclusion I
Etiology of Malocclusion IEtiology of Malocclusion I
Etiology of Malocclusion I
 
predentate period pedo
 predentate period pedo predentate period pedo
predentate period pedo
 
Oral screen and mixed dentition appliance
Oral screen and mixed dentition applianceOral screen and mixed dentition appliance
Oral screen and mixed dentition appliance
 
Self correcting anomalies
Self correcting anomalies Self correcting anomalies
Self correcting anomalies
 
GROWTH AND DEVELOPMENT IN ORTHODONTICS
GROWTH AND DEVELOPMENT IN ORTHODONTICSGROWTH AND DEVELOPMENT IN ORTHODONTICS
GROWTH AND DEVELOPMENT IN ORTHODONTICS
 
Interceptive orthodontics
Interceptive orthodonticsInterceptive orthodontics
Interceptive orthodontics
 
Non –pharmacological behavior management in children
Non –pharmacological behavior management in childrenNon –pharmacological behavior management in children
Non –pharmacological behavior management in children
 
Class II malocclusion
Class II malocclusionClass II malocclusion
Class II malocclusion
 
Treatment of crowding in permanent dentition
Treatment of crowding in permanent dentitionTreatment of crowding in permanent dentition
Treatment of crowding in permanent dentition
 
White spot lesions
White spot lesions White spot lesions
White spot lesions
 
Functional appliances
Functional appliancesFunctional appliances
Functional appliances
 
anchorage
anchorageanchorage
anchorage
 
Posterior Crossbite
Posterior CrossbitePosterior Crossbite
Posterior Crossbite
 
Deep bite(1)
Deep bite(1)Deep bite(1)
Deep bite(1)
 

Similar to Classification-of-Malocclusion O.ppt

Classification ofmalocclusion
Classification ofmalocclusionClassification ofmalocclusion
Classification ofmalocclusion
MaherFouda1
 
classifcation of malocclusion
classifcation of malocclusionclassifcation of malocclusion
classifcation of malocclusion
nagi alawdi
 
Classification of malocclusion
Classification of malocclusionClassification of malocclusion
Classification of malocclusion
Rohan Vadsola
 
Classification of malocclusion1
Classification of malocclusion1 Classification of malocclusion1
Classification of malocclusion1
Indian dental academy
 
Classification Of Malocclusion
Classification Of MalocclusionClassification Of Malocclusion
Classification Of Malocclusion
Abhinav Mudaliar
 
Classification of malocclusion (4)
Classification of malocclusion (4)Classification of malocclusion (4)
Classification of malocclusion (4)
Indian dental academy
 
CLASSIFICATION OF NORMAL OCCLUSION AND MALOCCLUSION.
CLASSIFICATION  OF NORMAL OCCLUSION AND MALOCCLUSION.CLASSIFICATION  OF NORMAL OCCLUSION AND MALOCCLUSION.
CLASSIFICATION OF NORMAL OCCLUSION AND MALOCCLUSION.
Cing Sian Dal
 
CLASSIFICATION OF MAL OCCLUSION
CLASSIFICATION OF MAL OCCLUSIONCLASSIFICATION OF MAL OCCLUSION
CLASSIFICATION OF MAL OCCLUSION
Umair Karral
 
Malocclusion
MalocclusionMalocclusion
Malocclusion
Indian dental academy
 
Epidemiology of malocclusion
Epidemiology of malocclusionEpidemiology of malocclusion
Epidemiology of malocclusion
Preyas Joshi
 
Classification of malocclusion
Classification of malocclusionClassification of malocclusion
Classification of malocclusion
MaherFouda1
 
Classification of malocclusion
Classification of malocclusionClassification of malocclusion
Classification of malocclusion
Maher Fouda
 
Classification of malocclsion
Classification of malocclsionClassification of malocclsion
Classification of malocclsion
Mohanad Elsherif
 
Angles classification & its shortcoming 2 /certified fixed orthodontic course...
Angles classification & its shortcoming 2 /certified fixed orthodontic course...Angles classification & its shortcoming 2 /certified fixed orthodontic course...
Angles classification & its shortcoming 2 /certified fixed orthodontic course...
Indian dental academy
 
Classification of malocclusion by dr. golam
Classification of malocclusion by dr. golamClassification of malocclusion by dr. golam
Classification of malocclusion by dr. golam
Ishfaq Ahmad
 
Classification_of_malocclusion[1] [Read-Only].pptx
Classification_of_malocclusion[1] [Read-Only].pptxClassification_of_malocclusion[1] [Read-Only].pptx
Classification_of_malocclusion[1] [Read-Only].pptx
TiruvalliUttamkumar1
 
Malocclusion
MalocclusionMalocclusion
Malocclusion
docdentist1
 
klbvgtcvkij.pptx
klbvgtcvkij.pptxklbvgtcvkij.pptx
klbvgtcvkij.pptx
SPradhan10
 
Impaction.pptx
Impaction.pptxImpaction.pptx
Impaction.pptx
DentalYoutube
 
Malocclusion /certified fixed orthodontic courses by Indian dental academy
Malocclusion    /certified fixed orthodontic courses by Indian dental academy Malocclusion    /certified fixed orthodontic courses by Indian dental academy
Malocclusion /certified fixed orthodontic courses by Indian dental academy
Indian dental academy
 

Similar to Classification-of-Malocclusion O.ppt (20)

Classification ofmalocclusion
Classification ofmalocclusionClassification ofmalocclusion
Classification ofmalocclusion
 
classifcation of malocclusion
classifcation of malocclusionclassifcation of malocclusion
classifcation of malocclusion
 
Classification of malocclusion
Classification of malocclusionClassification of malocclusion
Classification of malocclusion
 
Classification of malocclusion1
Classification of malocclusion1 Classification of malocclusion1
Classification of malocclusion1
 
Classification Of Malocclusion
Classification Of MalocclusionClassification Of Malocclusion
Classification Of Malocclusion
 
Classification of malocclusion (4)
Classification of malocclusion (4)Classification of malocclusion (4)
Classification of malocclusion (4)
 
CLASSIFICATION OF NORMAL OCCLUSION AND MALOCCLUSION.
CLASSIFICATION  OF NORMAL OCCLUSION AND MALOCCLUSION.CLASSIFICATION  OF NORMAL OCCLUSION AND MALOCCLUSION.
CLASSIFICATION OF NORMAL OCCLUSION AND MALOCCLUSION.
 
CLASSIFICATION OF MAL OCCLUSION
CLASSIFICATION OF MAL OCCLUSIONCLASSIFICATION OF MAL OCCLUSION
CLASSIFICATION OF MAL OCCLUSION
 
Malocclusion
MalocclusionMalocclusion
Malocclusion
 
Epidemiology of malocclusion
Epidemiology of malocclusionEpidemiology of malocclusion
Epidemiology of malocclusion
 
Classification of malocclusion
Classification of malocclusionClassification of malocclusion
Classification of malocclusion
 
Classification of malocclusion
Classification of malocclusionClassification of malocclusion
Classification of malocclusion
 
Classification of malocclsion
Classification of malocclsionClassification of malocclsion
Classification of malocclsion
 
Angles classification & its shortcoming 2 /certified fixed orthodontic course...
Angles classification & its shortcoming 2 /certified fixed orthodontic course...Angles classification & its shortcoming 2 /certified fixed orthodontic course...
Angles classification & its shortcoming 2 /certified fixed orthodontic course...
 
Classification of malocclusion by dr. golam
Classification of malocclusion by dr. golamClassification of malocclusion by dr. golam
Classification of malocclusion by dr. golam
 
Classification_of_malocclusion[1] [Read-Only].pptx
Classification_of_malocclusion[1] [Read-Only].pptxClassification_of_malocclusion[1] [Read-Only].pptx
Classification_of_malocclusion[1] [Read-Only].pptx
 
Malocclusion
MalocclusionMalocclusion
Malocclusion
 
klbvgtcvkij.pptx
klbvgtcvkij.pptxklbvgtcvkij.pptx
klbvgtcvkij.pptx
 
Impaction.pptx
Impaction.pptxImpaction.pptx
Impaction.pptx
 
Malocclusion /certified fixed orthodontic courses by Indian dental academy
Malocclusion    /certified fixed orthodontic courses by Indian dental academy Malocclusion    /certified fixed orthodontic courses by Indian dental academy
Malocclusion /certified fixed orthodontic courses by Indian dental academy
 

More from DentalYoutube

Maxillary sinus.ppt
Maxillary sinus.pptMaxillary sinus.ppt
Maxillary sinus.ppt
DentalYoutube
 
Introduction to Dental Anatomy.ppt
Introduction to Dental Anatomy.pptIntroduction to Dental Anatomy.ppt
Introduction to Dental Anatomy.ppt
DentalYoutube
 
rationale of endodontic treatment.pptx
rationale of endodontic treatment.pptxrationale of endodontic treatment.pptx
rationale of endodontic treatment.pptx
DentalYoutube
 
diseasesofpulpandperiapicaltissues.pptx
diseasesofpulpandperiapicaltissues.pptxdiseasesofpulpandperiapicaltissues.pptx
diseasesofpulpandperiapicaltissues.pptx
DentalYoutube
 
cleaningandshaping.pptx
cleaningandshaping.pptxcleaningandshaping.pptx
cleaningandshaping.pptx
DentalYoutube
 
castrestorations-170210145741-converted.pptx
castrestorations-170210145741-converted.pptxcastrestorations-170210145741-converted.pptx
castrestorations-170210145741-converted.pptx
DentalYoutube
 
caseselectionfinal-170514163212.pptx
caseselectionfinal-170514163212.pptxcaseselectionfinal-170514163212.pptx
caseselectionfinal-170514163212.pptx
DentalYoutube
 
sealers.pptx
sealers.pptxsealers.pptx
sealers.pptx
DentalYoutube
 
MERCURY TOXICITY.pptx
MERCURY TOXICITY.pptxMERCURY TOXICITY.pptx
MERCURY TOXICITY.pptx
DentalYoutube
 
DFG.pptx
DFG.pptxDFG.pptx
DFG.pptx
DentalYoutube
 
contactsandcontours.pptx
contactsandcontours.pptxcontactsandcontours.pptx
contactsandcontours.pptx
DentalYoutube
 
resorption-160714175024.pptx
resorption-160714175024.pptxresorption-160714175024.pptx
resorption-160714175024.pptx
DentalYoutube
 
pulpirritants.pptx
pulpirritants.pptxpulpirritants.pptx
pulpirritants.pptx
DentalYoutube
 
pulp responses.pptx
pulp responses.pptxpulp responses.pptx
pulp responses.pptx
DentalYoutube
 
NON CARIOUS LESIONS AND MANAGEMENT.pptx
NON CARIOUS LESIONS AND MANAGEMENT.pptxNON CARIOUS LESIONS AND MANAGEMENT.pptx
NON CARIOUS LESIONS AND MANAGEMENT.pptx
DentalYoutube
 
introduction-ENDODONTICS.pptx
introduction-ENDODONTICS.pptxintroduction-ENDODONTICS.pptx
introduction-ENDODONTICS.pptx
DentalYoutube
 
Intracanal Medicaments.pptx
Intracanal Medicaments.pptxIntracanal Medicaments.pptx
Intracanal Medicaments.pptx
DentalYoutube
 
cavity designs.pptx
cavity designs.pptxcavity designs.pptx
cavity designs.pptx
DentalYoutube
 
airabrasion.pptx
airabrasion.pptxairabrasion.pptx
airabrasion.pptx
DentalYoutube
 
PAIN CONTROL in operative dentistry.pptx
PAIN CONTROL in operative dentistry.pptxPAIN CONTROL in operative dentistry.pptx
PAIN CONTROL in operative dentistry.pptx
DentalYoutube
 

More from DentalYoutube (20)

Maxillary sinus.ppt
Maxillary sinus.pptMaxillary sinus.ppt
Maxillary sinus.ppt
 
Introduction to Dental Anatomy.ppt
Introduction to Dental Anatomy.pptIntroduction to Dental Anatomy.ppt
Introduction to Dental Anatomy.ppt
 
rationale of endodontic treatment.pptx
rationale of endodontic treatment.pptxrationale of endodontic treatment.pptx
rationale of endodontic treatment.pptx
 
diseasesofpulpandperiapicaltissues.pptx
diseasesofpulpandperiapicaltissues.pptxdiseasesofpulpandperiapicaltissues.pptx
diseasesofpulpandperiapicaltissues.pptx
 
cleaningandshaping.pptx
cleaningandshaping.pptxcleaningandshaping.pptx
cleaningandshaping.pptx
 
castrestorations-170210145741-converted.pptx
castrestorations-170210145741-converted.pptxcastrestorations-170210145741-converted.pptx
castrestorations-170210145741-converted.pptx
 
caseselectionfinal-170514163212.pptx
caseselectionfinal-170514163212.pptxcaseselectionfinal-170514163212.pptx
caseselectionfinal-170514163212.pptx
 
sealers.pptx
sealers.pptxsealers.pptx
sealers.pptx
 
MERCURY TOXICITY.pptx
MERCURY TOXICITY.pptxMERCURY TOXICITY.pptx
MERCURY TOXICITY.pptx
 
DFG.pptx
DFG.pptxDFG.pptx
DFG.pptx
 
contactsandcontours.pptx
contactsandcontours.pptxcontactsandcontours.pptx
contactsandcontours.pptx
 
resorption-160714175024.pptx
resorption-160714175024.pptxresorption-160714175024.pptx
resorption-160714175024.pptx
 
pulpirritants.pptx
pulpirritants.pptxpulpirritants.pptx
pulpirritants.pptx
 
pulp responses.pptx
pulp responses.pptxpulp responses.pptx
pulp responses.pptx
 
NON CARIOUS LESIONS AND MANAGEMENT.pptx
NON CARIOUS LESIONS AND MANAGEMENT.pptxNON CARIOUS LESIONS AND MANAGEMENT.pptx
NON CARIOUS LESIONS AND MANAGEMENT.pptx
 
introduction-ENDODONTICS.pptx
introduction-ENDODONTICS.pptxintroduction-ENDODONTICS.pptx
introduction-ENDODONTICS.pptx
 
Intracanal Medicaments.pptx
Intracanal Medicaments.pptxIntracanal Medicaments.pptx
Intracanal Medicaments.pptx
 
cavity designs.pptx
cavity designs.pptxcavity designs.pptx
cavity designs.pptx
 
airabrasion.pptx
airabrasion.pptxairabrasion.pptx
airabrasion.pptx
 
PAIN CONTROL in operative dentistry.pptx
PAIN CONTROL in operative dentistry.pptxPAIN CONTROL in operative dentistry.pptx
PAIN CONTROL in operative dentistry.pptx
 

Recently uploaded

Journal Article Review on Rasamanikya
Journal Article Review on RasamanikyaJournal Article Review on Rasamanikya
Journal Article Review on Rasamanikya
Dr. Jyothirmai Paindla
 
Role of Mukta Pishti in the Management of Hyperthyroidism
Role of Mukta Pishti in the Management of HyperthyroidismRole of Mukta Pishti in the Management of Hyperthyroidism
Role of Mukta Pishti in the Management of Hyperthyroidism
Dr. Jyothirmai Paindla
 
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxDoes Over-Masturbation Contribute to Chronic Prostatitis.pptx
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
walterHu5
 
Osteoporosis - Definition , Evaluation and Management .pdf
Osteoporosis - Definition , Evaluation and Management .pdfOsteoporosis - Definition , Evaluation and Management .pdf
Osteoporosis - Definition , Evaluation and Management .pdf
Jim Jacob Roy
 
Top 10 Best Ayurvedic Kidney Stone Syrups in India
Top 10 Best Ayurvedic Kidney Stone Syrups in IndiaTop 10 Best Ayurvedic Kidney Stone Syrups in India
Top 10 Best Ayurvedic Kidney Stone Syrups in India
Swastik Ayurveda
 
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
Holistified Wellness
 
Artificial Intelligence Symposium (THAIS)
Artificial Intelligence Symposium (THAIS)Artificial Intelligence Symposium (THAIS)
Artificial Intelligence Symposium (THAIS)
Josep Vidal-Alaball
 
Top Effective Soaps for Fungal Skin Infections in India
Top Effective Soaps for Fungal Skin Infections in IndiaTop Effective Soaps for Fungal Skin Infections in India
Top Effective Soaps for Fungal Skin Infections in India
SwisschemDerma
 
Abortion PG Seminar Power point presentation
Abortion PG Seminar Power point presentationAbortion PG Seminar Power point presentation
Abortion PG Seminar Power point presentation
AksshayaRajanbabu
 
Best Ayurvedic medicine for Gas and Indigestion
Best Ayurvedic medicine for Gas and IndigestionBest Ayurvedic medicine for Gas and Indigestion
Best Ayurvedic medicine for Gas and Indigestion
Swastik Ayurveda
 
share - Lions, tigers, AI and health misinformation, oh my!.pptx
share - Lions, tigers, AI and health misinformation, oh my!.pptxshare - Lions, tigers, AI and health misinformation, oh my!.pptx
share - Lions, tigers, AI and health misinformation, oh my!.pptx
Tina Purnat
 
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Oleg Kshivets
 
CHEMOTHERAPY_RDP_CHAPTER 4_ANTI VIRAL DRUGS.pdf
CHEMOTHERAPY_RDP_CHAPTER 4_ANTI VIRAL DRUGS.pdfCHEMOTHERAPY_RDP_CHAPTER 4_ANTI VIRAL DRUGS.pdf
CHEMOTHERAPY_RDP_CHAPTER 4_ANTI VIRAL DRUGS.pdf
rishi2789
 
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.GawadHemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
NephroTube - Dr.Gawad
 
A Classical Text Review on Basavarajeeyam
A Classical Text Review on BasavarajeeyamA Classical Text Review on Basavarajeeyam
A Classical Text Review on Basavarajeeyam
Dr. Jyothirmai Paindla
 
CHEMOTHERAPY_RDP_CHAPTER 3_ANTIFUNGAL AGENT.pdf
CHEMOTHERAPY_RDP_CHAPTER 3_ANTIFUNGAL AGENT.pdfCHEMOTHERAPY_RDP_CHAPTER 3_ANTIFUNGAL AGENT.pdf
CHEMOTHERAPY_RDP_CHAPTER 3_ANTIFUNGAL AGENT.pdf
rishi2789
 
Histololgy of Female Reproductive System.pptx
Histololgy of Female Reproductive System.pptxHistololgy of Female Reproductive System.pptx
Histololgy of Female Reproductive System.pptx
AyeshaZaid1
 
Cell Therapy Expansion and Challenges in Autoimmune Disease
Cell Therapy Expansion and Challenges in Autoimmune DiseaseCell Therapy Expansion and Challenges in Autoimmune Disease
Cell Therapy Expansion and Challenges in Autoimmune Disease
Health Advances
 
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
Donc Test
 
The Electrocardiogram - Physiologic Principles
The Electrocardiogram - Physiologic PrinciplesThe Electrocardiogram - Physiologic Principles
The Electrocardiogram - Physiologic Principles
MedicoseAcademics
 

Recently uploaded (20)

Journal Article Review on Rasamanikya
Journal Article Review on RasamanikyaJournal Article Review on Rasamanikya
Journal Article Review on Rasamanikya
 
Role of Mukta Pishti in the Management of Hyperthyroidism
Role of Mukta Pishti in the Management of HyperthyroidismRole of Mukta Pishti in the Management of Hyperthyroidism
Role of Mukta Pishti in the Management of Hyperthyroidism
 
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxDoes Over-Masturbation Contribute to Chronic Prostatitis.pptx
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
 
Osteoporosis - Definition , Evaluation and Management .pdf
Osteoporosis - Definition , Evaluation and Management .pdfOsteoporosis - Definition , Evaluation and Management .pdf
Osteoporosis - Definition , Evaluation and Management .pdf
 
Top 10 Best Ayurvedic Kidney Stone Syrups in India
Top 10 Best Ayurvedic Kidney Stone Syrups in IndiaTop 10 Best Ayurvedic Kidney Stone Syrups in India
Top 10 Best Ayurvedic Kidney Stone Syrups in India
 
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
 
Artificial Intelligence Symposium (THAIS)
Artificial Intelligence Symposium (THAIS)Artificial Intelligence Symposium (THAIS)
Artificial Intelligence Symposium (THAIS)
 
Top Effective Soaps for Fungal Skin Infections in India
Top Effective Soaps for Fungal Skin Infections in IndiaTop Effective Soaps for Fungal Skin Infections in India
Top Effective Soaps for Fungal Skin Infections in India
 
Abortion PG Seminar Power point presentation
Abortion PG Seminar Power point presentationAbortion PG Seminar Power point presentation
Abortion PG Seminar Power point presentation
 
Best Ayurvedic medicine for Gas and Indigestion
Best Ayurvedic medicine for Gas and IndigestionBest Ayurvedic medicine for Gas and Indigestion
Best Ayurvedic medicine for Gas and Indigestion
 
share - Lions, tigers, AI and health misinformation, oh my!.pptx
share - Lions, tigers, AI and health misinformation, oh my!.pptxshare - Lions, tigers, AI and health misinformation, oh my!.pptx
share - Lions, tigers, AI and health misinformation, oh my!.pptx
 
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
 
CHEMOTHERAPY_RDP_CHAPTER 4_ANTI VIRAL DRUGS.pdf
CHEMOTHERAPY_RDP_CHAPTER 4_ANTI VIRAL DRUGS.pdfCHEMOTHERAPY_RDP_CHAPTER 4_ANTI VIRAL DRUGS.pdf
CHEMOTHERAPY_RDP_CHAPTER 4_ANTI VIRAL DRUGS.pdf
 
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.GawadHemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
 
A Classical Text Review on Basavarajeeyam
A Classical Text Review on BasavarajeeyamA Classical Text Review on Basavarajeeyam
A Classical Text Review on Basavarajeeyam
 
CHEMOTHERAPY_RDP_CHAPTER 3_ANTIFUNGAL AGENT.pdf
CHEMOTHERAPY_RDP_CHAPTER 3_ANTIFUNGAL AGENT.pdfCHEMOTHERAPY_RDP_CHAPTER 3_ANTIFUNGAL AGENT.pdf
CHEMOTHERAPY_RDP_CHAPTER 3_ANTIFUNGAL AGENT.pdf
 
Histololgy of Female Reproductive System.pptx
Histololgy of Female Reproductive System.pptxHistololgy of Female Reproductive System.pptx
Histololgy of Female Reproductive System.pptx
 
Cell Therapy Expansion and Challenges in Autoimmune Disease
Cell Therapy Expansion and Challenges in Autoimmune DiseaseCell Therapy Expansion and Challenges in Autoimmune Disease
Cell Therapy Expansion and Challenges in Autoimmune Disease
 
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
 
The Electrocardiogram - Physiologic Principles
The Electrocardiogram - Physiologic PrinciplesThe Electrocardiogram - Physiologic Principles
The Electrocardiogram - Physiologic Principles
 

Classification-of-Malocclusion O.ppt

  • 1. CLASSIFICATION OF MALOCCLUSION DR CHANDRIKA KATTI Reader, Dept Of Orthodontics. Navodaya Dental College, Raichur. 1
  • 2. Introduction  Malocclusion is defined as any deviation from normal occlusion of teeth .  Occlusion : Contact relationship between maxillary and mandibular teeth in function and parafunction.  Classification of malocclusion is the description of dentofacial deviations according to a common characteristic or norm. 2
  • 3. Advantages of Classification 1. Helps in diagnosis and treatment planning. 2. Helps in visualizing and understanding the problem associated with malocclusion. 3. Helps in communicating the problem. 4. Helps in comparisons of various malocclusions. 3
  • 4. Types of Malocclusion 1. Intra-arch malocclusion 2. Inter-arch malocclusion 3. Skeletal malocclusion 4
  • 5. 1. Intra-arch malocclusion Includes individual tooth position, variations and malocclusions affecting a group of teeth within an arch.  Distal inclination  Mesial inclination  Lingual inclination  Buccal inclination  Mesial displacement  Distal displacement  Lingual displacement  Buccal displacement  Infra version  Supra version  Rotations  Distolingual/Mesiobuccal  Mesiolingual/Distobuccal  Transposition 5
  • 6. 6
  • 7. 7
  • 8. 8
  • 9. Mesial inclination Distal inclination Palatal inclination Lingual inclination Labial inclination 9
  • 12. 2. Inter-arch malocclusion Malrelation of dental arches to one another upon skeletal bony basis that may themselves be normally related.  Sagittal plane malocclusions  Vertical plane malocclusions  Transverse plane malocclusions 12
  • 13. Sagittal plane malocclusions  Pre-normal occlusion Mandibular arch anteriorly placed in centric occlusion.  Post-normal occlusion Mandibular arch posteriorly placed in centric occlusion. 13
  • 14. Vertical plane malocclusions  Deep bite Excessive vertical overlap between maxillary and mandibular anteriors.  Open bite No vertical overlap. - Anterior region - Posterior region Anterior open bite Posterior open bite 14
  • 15. Transverse plane malocclusions Includes various types of cross bites. Lateral incisor in cross bite Posterior segment in cross bite 15
  • 16. 3. Skeletal malocclusion  Includes defects in underlying skeletal structure.  Due to abnormalities in maxilla or mandible in size, position or relationship between jaws.  Sagittal abnormalities  Prognathism  Retrognathism  Combinations  Transverse abnormalities  Narrowing and widening of jaws causes crossbites  Vertical abnormalities  Variation affects lower facial height. 16
  • 17. 17
  • 18. 18
  • 19. Systems of Classification of Malocclusion 1. Angle’s classification 2. Dewey’s modification of Angle’s classification 3. Lischer’s modification of Angle’s classification 4. Bennet’s classification 5. Simon’s classification 6. Ackermann-Profitt classification 7. Incisor classification 19
  • 20. Angle’s classification  It was introduced by Edward Angle in 1899.  Based on mesiodistal relationship of teeth, dental arches and jaws.  Maxillary 1st molar is taken as key to occlusion. Three classes :  Class I  Class II  Class II division I  Class II division II  Class II subdivision  Class II division I subdivision  Class II division II subdivision  Class III  True Class III  Pseudo Class III  Class III subdivision 20
  • 21. Class I  Normal inter-arch molar relation  Mesiobuccal cusp of maxillary 1st permanent molar occlude in the buccal groove of mandibular 1st permanent molar.  Dental irregularities  Crowding  Spacing  Rotations  Missing teeth  Normal skeletal retaionships.  Normal muscle function.  Includes bimaxillary protrusion – normal Class I molar relationship but the dentitions of both arches are forwardly placed in relation to the facial profile. 21
  • 22. 22
  • 23. Class II  Distobuccal cusp of maxillary 1st permanent molar occludes in the buccal groove of mandibular 1st permanent molar. Class II division I  Characterized by proclined V-shaped upper incisors.  Therefore, increased overjet, lip trap, abnormal muscle activity – hypotonic upper lip, hypertonic mentalis and buccinator. 23
  • 24. 24
  • 25. Class II division 2  Characterized by lingually inclined upper incisors and labially tipped upper lateral incisors overlapping the centrals.  Square shaped arch, peri-oral muscle activity normal. Class II subdivision  Class II molar relation exist on one side and Class I molar relation on the other side.  Class II division I subdivision  Class II division II subdivision 25
  • 26. 26
  • 27. Class III  Mesiobuccal cusp of maxillary 1st permanent molar occlude the interdental space between mandibular 1st and 2nd molar.  True Class III  Pseudo Class III  Class III subdivision  True Class III – Skeletal Class III malocclusion of genetic origin. Due to -  Excessively large mandible  Forwardly placed mandible  Smaller than normal maxilla  Combinations 27
  • 28.  Pseudo Class III – Produced by forward movement of mandible during jaw closure  Also called postural/habitual Class III  Due to  Occlusal prematurities  Premature loss of deciduous posteriors.  Child with enlarged adenoids  Class III subdivision – Class III molar relation on one side and Class I on the other. 28
  • 29. 29
  • 30. Advantages of Angle’s Classification  First comprehensive classification – most widely accepted.  Simple  Easy to use  Conveys precisely what was conceived for ie, relationship of mandibular teeth with respect to maxillary 1st permanent molar. 30
  • 31. Drawbacks of Angle’s Classification  Considers malocclusion only in the anteroposterior plane and not in transverse/ vertical planes.  Considered 1st permanent molar as fixrd points in the skull, not found to be so.  Cannot be applied if 1st permanent molar is missing or to deciduous dentition.  Doesn’t distinguish between skeletal/dental malocclusion.  Doesn’t highlight etiology.  Individual tooth positions aren’t considered. 31
  • 32. Dewey’s modification of Angle’s classification Angle’s Class I  Type I – Class I with crowded anteriors.  Type II – Class I with protrusive maxillary incisors.  Type III – Class I with anterior cross bite.  Type IV – Class I with posterior cross bite.  Type V – Mesially drifted permanent molars therefore early extraction of deciduous predecessors. 32
  • 33. Angle’s Class I with anterior crowding or Dewey’s Class I type 1 Angle’s Class I with anteriors proclined or Dewey’s Class I type 2 Dewey’s Class I type 3 malocclusion, molars in Angle’s Class I with maxillary anteriors in crossbite Dewey’s Class I type 4. Angle’s class I with posterior crossbite 33
  • 34. Dewey’s Class I type 5 34
  • 35. Angle’s Class III  Type I – upper and lower arches are normally aligned separately but show edge-to-edge bite/ incisor arrangement on occlusion.  Type II – mandibular incisors crowded and in lingual relation to maxillary incisors.  Type III – maxillary incisors are crowded and in cross bite with mandibular anteriors. 35
  • 36. Dewey’s Class III type 1 Dewey’s Class III type 2 Dewey’s class III type 3 36
  • 37.
  • 38. Lischer’s modification of Angle’s classification  Neutro-occlusion – Angle’s Class I  Disto-occlusion – Angle’s Class II  Mesio-occlusion – Angle’s Class III  Mesioversion – mesial to normal position  Distoversion – distal to normal position  Linguoversion – lingual to normal position  Labioversion – labial to normal position  Infraversion – inferior or away from the line of occlusion  Supraversion – superior or extended past the line of occlusion  Axiversion – axial inclination is wrong, tipped  Torsiversion – rotated on its long axis  Transversion – transposed or changes in the sequence of position 38
  • 39. Mesioversion Distoversion of lateral incisor and canine Torsiversion of 1st premolar rotated mesiobuccally Linguoversion Labioversion 39
  • 41. Bennet’s classification Class I – abnormal position of one or more teeth due to local causes. Class II – abnormal formation of a part/ whole of either arch due to developmental defect of bone. Class III – abnormal relation between upper and lower arches and between either arch and facial contour and co-related abnormal formation of either arch. 41
  • 42. Simon’s classification It is a craniometric classification relating dental arches in three planes i.e.,  FH plane [Frankforts Horizontal plane]  Orbital plane  Mid-sagittal plane FH plane Attraction – closer than normal to FH plane. Abstraction – away from FH plane than normal. 42
  • 43. Orbital plane Protraction – Farther from orbital plane Retraction – Closer/more posterior to orbital plane. Mid-sagittal plane Distraction – away from mid sagittal plane Contraction – closer to mid sagittal plane 43
  • 44. Ackermann-Profitt classification Based on five characteristics 1. Alignment 2. Profile 3. Transverse relationships 4. Class 5. Overbite 1 2 3 4 5 44
  • 45.
  • 46. 1. Alignment  Interarch alignment and symmetry assessed when seen in occlusal view.  Dental arch is classified as ideal/crowded/spaced 2. Profile  can be convex/straight/concave  Includes assessment of facial divergence ie. Anterior or posterior divergence. 3. Transverse relationships  Include transverse skeletal and dental relationships.  Buccal and palatal cross bites are noted.  Further classified as unilateral or bilateral.  Distinction made between skeletal and dental cross bites. 46
  • 47. 4. Class  Sagittal relationship of teeth is assessed using Angle’s classification as Class I / II / III.  Distinction made between skeletal and dental malocclusions. 5. Overbite  Assessed in the vertical plane  Described as anterior open bite / posterior open bite / anterior deep bite / posterior collapsed bite.  Distinction made between skeletal and dental malocclusions. 47
  • 48. Incisor classification  Class I  Class II  Division I  Division II  Class III Class II div 1 Class I Class II div 2 Class III 48
  • 49.  Class I Mandibular incisor edges occlude with or lie immediately below the cingulum plateau of the maxillary central incisors.  Class II Mandibular incisor edges lie posterior to the cingulum plateau of the maxillary central incisors.  Division I  Division II 49
  • 50. Division I Maxillary central incisors are proclined or of average inclination and there is an increased overjet. Division II Maxillary central incisors are retro-clined; the overjet is normally minimum, but maybe increased.  Class III Mandibular incisor edges lie anterior to the cingulum plateau of the upper central incisors; the overjet is reduced or reversed. 50
  • 51. 51