Classification of malocclusion
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Transcript of Classification of malocclusion
PRESENTER: SAPEEDEH AFZAL.ROLL # 10GROUP : A
CLASSIFICATION OF MALOCCLUSION
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.
OCCLUSIONWHEN 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)
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)
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.
QUESTIONNAIRE, INTERVIEW
CLINICAL EXAMINATION
ANALYSIS OF DIAGNOSTIC
RECORDS
DATA BASE
PROBLEM LIST = DIAGNOSIS
CLASSIFICATION
METHODS OF CLASSIFICATION OF MALOCCLUSION
CAN BE BROADLY DIVIDED INTO TWO TYPES
QUANTITATIVE & QUALITATIVE
TYPES OF MALOCCLUSION
INTRA-ARCH & INTER- ARCH PROBLEMS
MALOCCLUSION: INTRA-ARCH & INTER-ARCH PROBLEMS
INTRA-ARCH PROBLEMS (INDIVIDUAL OR GROUPS OF TEETH)
MALOCCLUSION: INTRA-ARCH & INTER-ARCH PROBLEMS
INTER-ARCH PROBLEMS
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.
ANGLE’S CLASSIFICATION OF MALOCCLUSION
CLASS I MALOCCLUSION
CLASS II MALOCCLUSION
CLASS III MALOCCLUSION
DIVISION 1 DIVISION 2
CLASS III PSEUDO CLASS III
SUB-DIVISION
SUB-DIVISION
CLASS I MALOCCLUSIONTHE 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.
CLASS II MALOCLUSIONTHE MESIOBUCCAL CUSP OF THE LOWER FIRST PERMANENT
MOLAR OCCLUDES DISTAL TO THE CLASS I POSITION.
Condition when class II molar relationship is present with proclined upper central incisors.• There is an increase in overjet.
CLASS II DIVISION 1
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.
CLASS II DIVISION 2
CLASS II SUB-DIVISIONCondition when the class II molar relationship
exists on only one side with normal molar relationship on the other side.
CLASS III MALOCCLUSIONTHE MESIOBUCCAL CUSP OF THE LOWER FIST MOLAR
OCCLUDES MESIAL TO THE CLASS I POSITION.
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.
CLASS III SUB-DIVISIONCondition in which class III molar relationship is present only on one side with normal relation on
the other side.
MODIFICATIONS OF ANGLE’S CLASSIFICATION
There are two modifications of Angle’s classification
1.Lischer’s modification.2.Dewey’s modification.
LISCHER’S MODIFICATION• He introduced following names to the
Angle’s classification:
– Neutrocclusion- Class I.– Distocclusion- Class II.– Mesiocclusion- Class III
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.
– 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.
DEWEY’S MODIFICATION
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)
SKELETAL CLASSIFICATIONIt considered relationship
between maxilla & mandible, in antero-posterior direction.
• CLASS I:Maxilla & mandible
are in harmony with each other.
• CLASS II: Maxilla lies ahead
of mandible with refrence to anteroir cranial base. In other words maxilla is prgnated.
SKELETAL CLASSIFICATION
• CLASS III:Maxilla lies
posterior to mandible with reference to anterior cranial base. In other words maxilla is retrognathed.
SKELETAL CLASSIFICATION
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.
• 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.
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.
BRITISH STANDARD CLASSIFICATION OF INCISOR RELATIONSHIP
CANINE CLASSIFICATION• CLASS I :
When the mesial slope of upper canine coincides with the distal slope of lower canine.
• CLASS II : When the mesial slope of upper canine is ahead of
the distal slope of lower canine.
CANINE CLASSIFICATION
• Class III : When the mesial slope of the upper canine lies
behind the distal slope of the lower canine.
CANINE CLASSIFICATION
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.
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.
• 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.
SIMON’S CLASSIFICATION
• MID-SAGGITAL PLANE: - Helps to detect deviations
in the saggital plane. - Dental arch closer to mid-
saggital plane is called contraction and farther away is called distraction.
SIMON’S CLASSIFICATION
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.
FIVE MAJOR CHARACTERISTICS
ADDITION TO THE FIVE-CHARACTERISTICS CLASSIFICATION SYSTEM
• Two things particularly help this more thorough analysis:
1. Esthetic line of occlusion.2. Rotational axes.
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.
2. 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.
ROTATIONAL AXESPITCH:
•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 axes.
REFRENCES• CONTEMPORARY ORTHODONTICS, WILLIAM R.
PROFFIT (5TH. EDITION)• INTRODUCTION TO ORTHODONTICS, LAURA
MITCHELL (3RD. EDITION)• ORTHODONTICS, PREM KUMAR (2ND. EDITION)