Classification of malocclusion
DEPARTMENT OF ORTHODONTICS
SUBHARTI DENTAL COLLEGE
SWAMI VIVEKANAND SUBHARTI UNIVERSITY
Presented By: Dr Ashutosh
Malocclusion – any deviation from
the normal or ideal occlusion
Classification of malocclusion is the
description of dentofacial deviation according to a common characterstics, or norm
Dr Ashutosh, Subharti Dental College, SVSU
Types of malocclusion
Individual tooth malposition
Mal relation of the dental arches or dento alveolar segments
Skeletal malrelationships
Dr Ashutosh, Subharti Dental College, SVSU
Individual tooth malpositions
Mesial inclination or tipping
Distal inclination or tipping
Lingual inclination or tipping
Dr Ashutosh, Subharti Dental College, SVSU
Rotations
Mesiolingual/distolabial
Distolingual/mesiolabial
Transposition
Dr Ashutosh, Subharti Dental College, SVSU
Malrelation of dental arches
Sagittal plane malocclusion
Pre normal occlusion- lower arch is more forwardly placed
Post normal occlusion- lower arch is more distally placed
Dr Ashutosh, Subharti Dental College, SVSU
Transeverse plane malocclusion
Various types of cross bites
Dr Ashutosh, Subharti Dental College, SVSU
Skeletal mal occlusions
Caused due to the defect in the underlying skeletal structure
Defect can be in size, position or relationship between the jaws
Dr Ashutosh, Subharti Dental College, SVSU
Angle’s classification of
malocclusion
It was given by Edward Angle in 1899
Based on the mesio-distal relation of the teeth, dental arches and jaws
Maxillary 1st permanent molar- key to occlusion
Dr Ashutosh, Subharti Dental College, SVSU
Class I malocclusion
Class I molar relationship
Mesiobuccal cusp of the maxillary first
molar occludes in the buccal groove of
the mandibular 1st permanent molar
Dr Ashutosh, Subharti Dental College, SVSU
Crowding, spacing, rotations missing tooth etc.
Normal skeletal and normal muscle relationship
Class I bimaxillary protrusion– normal class I
relationship but dentition of both the arches are
forwardly placed in relation to facial profile Dr Ashutosh, Subharti Dental
College, SVSU
Angle’s class II malocclusion
Class II molar relationship- disto buccal cusp of the upper first permanent molar occludes in the buccal groove of the lower 1st molar
It is sub classified into
class II division 1
class II division 2
class II subdivision
Dr Ashutosh, Subharti Dental College, SVSU
Class II div 1
Class II molar relation
Proclined upper incisors –increased overjet
Presence of abnormal muscle activity- characterstic feature
Altered tongue positon- accentuates
narrowing of upper arch
Lip trap- lower lip cushions the palatal aspect of the upper teeth
Dr Ashutosh, Subharti Dental College, SVSU
Class II div 2
Class II molar relation
Lingually inclined upper central incisors
Labially tipped lateral incisors overlapping the centrals
Normal perioral muscle activity Abnormal backward path of closure
Dr Ashutosh, Subharti Dental College, SVSU
Class II subdivision
Class II molar relation on one side and class I on other
Dr Ashutosh, Subharti Dental College, SVSU
Class III MALOCCLUSION
CLASS III MOLAR RELATIONSHIP-
MESIOBUCCAL CUSP OF MAXILLARY FIRST MOLAR OCCLUDES IN THE INTERDENTAL SPACE BETWEEN THE DISTAL CUSP OF MANDIBULAR FIRST MOLAR AND SECOND MOLAR.
CLASSIFIED INTO-
TRUE CLASS III PSEUDO CLASS III
Dr Ashutosh, Subharti Dental College, SVSU
TRUE CLASS III
Class III molar relation
LOWER INCISORS LINGUALLY
INCLINED
LOWER TONGUE POSTURE- NARROW UPPER ARCH
Dr Ashutosh, Subharti Dental College, SVSU
PSEUDO CLASS III
CAUSED BY FORWARD MOVEMENT OF THE MANDIBLE- POSTURAL OR HABITUAL CLASS III
CAUSES OF PSEUDO CLASS III:-
OCCLUSAL PREMATURITY
LOSS OF DECIDUOUS MOLARS
LARGE ADENOIDS
Dr Ashutosh, Subharti Dental
College, SVSU
CLASS III SUBDIVISION
CLASS III MOLAR RELATION ON ONE SIDE AND CLASS I RELATION ON THE OTHER
Dr Ashutosh, Subharti Dental College, SVSU
DRAWBACKS OF ANGLE’S
CLASSIFICATION
FIRST PERMANENT MOLAR NOT A FIXED POINT
CLASSIFICATION IS NOT POSSIBLE IF FIRST MOLARS ARE MISSING
MALOCCLUSION IS CONSIDERED ONLY IN A-P DIRECTION
INDIVIDUAL TOOTH MALOCCLUSION IS NOT CONSIDERED
Dr Ashutosh, Subharti Dental College, SVSU
NO DIFFERENTIATION BETWEEN SKELETAL AND DENTAL MALOCCLUSION
NO CLUE ABOUT ETIOLOGY
Dr Ashutosh, Subharti Dental College, SVSU
DEWEY’S MODIFICATION OF
ANGLES’S CLASSIFICATION
MODIFICATION OF ANGLE’S CLASS I
TYPE 1 – ANGLE CL I & CROWDING IN
MAXILLARY ANTERIORS
TYPE 2- ANGLE CL I & MAXILLARY INCISORS PROCLINED
TYPE 3 –ANGLE CLI & ANTERIOR CROSS BITE
Dr Ashutosh, Subharti Dental College, SVSU
Type 4 - Angle CL I with posterior cross bite
Type 5 - molars are in mesioversion due to early loss of teeth mesial to them
Dr Ashutosh, Subharti Dental College, SVSU
CLASS III MODIFICATION
TYPE 1- EDGE TO EDGE INCISOR ALIGNMENT
TYPE 2 - MANDIBULAR INCISORS ARE
CROWDED AND LINGUAL TO
INCISORS
TYPE 3 - MAXILLARY INCISORS ARE
CROWDED AND IN CROSS BITE WITH
RELATION TO MANDIBULA ANTERIORS
Dr Ashutosh, Subharti Dental College, SVSU
Lischer’s modification Of Angle’s
Classification
Lischer in 1933 modified Angle’s classification
by giving substitute names for angle’s
classification
Neutro-occlusion –Angle’s class I
Disto- occlusion -- Angle’s class II
Mesio- occlusion – Angle’s class III
Dr Ashutosh, Subharti Dental
College, SVSU
Lischer’s nomenclature for individual tooth
malposition involved the suffix “version” to
a word to indicate the deviation from the
normal position
1 Mesioversion- mesial to the normal position
2 Distoversion –distal to the normal position
3 Linguoversion – lingual to the normal position
Dr Ashutosh, Subharti Dental College, SVSU
4. Labioversion - labial to the normal position
5. Infraversion – inferior to the line of occlusion
6. Supraversion – superior to the line of occlusion
7.Axiversion- axial inclination is wrong
8. Torsiversion- rotated on the long axis
9. Transversion – transposed or change in the sequence of position
Dr Ashutosh, Subharti Dental College, SVSU
Benette’s classification of malocclusion
Benette classified the malocclusions based on their etiology-
Class I – Abnormal location of one or more teeth is due to local factors Class II – Abnormal formation of a part or a
whole of either arch due to development defects of bone
Class III –Abnormal relationship of upper and
lower arch and the either arch and facial contour due to developmental defects of bone Dr Ashutosh, Subharti Dental
College, SVSU
Simon’s classification of malocclusion
Simon in 1930 was the first to relate the dental arches to the face and cranium in the three plane of space i.e
Frankfort Horizontal Plane (vertically)
Orbital plane (anterio-posteriorly)
Raphe or Mid Sagital plane
(transversely)
Dr Ashutosh, Subharti Dental
College, SVSU
Frankfort horizontal plane
Formed by drawing
a straight line
through the bony
margins of the
orbit to the upper
margins of external
auditory meatus
Dr Ashutosh, Subharti Dental College, SVSU
This plane is used to classify malocclusion in vertical direction
1. Attraction: when the dental arch or part
of it is closed to FHP
2. Abstraction: when a dental arch or a
part of it is away from FHP
Dr Ashutosh, Subharti Dental College, SVSU
Orbital plane
Perpendicular to the
FHP
Simon’s law of
canine- “this plane
should pass through
the distal third of the canine”
Dr Ashutosh, Subharti Dental College, SVSU
This plane is used to describe malocclusion in saggital or anterio posterior plane
Protraction – when the dental arch or part of it is away from this plane
Retraction - when the arch or part of it is close or more posteriorly places
Dr Ashutosh, Subharti Dental College, SVSU
Mid sagittal plane
This plane is formed
by points apprx 1.5
cm apart on the
median raphe of the
palate
This plane passes at
right angle to FHP
Dr Ashutosh, Subharti Dental College, SVSU
It classifies malocclusion according to Transeverse deviation from MSP
Contraction : A part or all of the dental arch is contracted towards MSP
Distraction : A part or all of the dental arch is wider or placed at a distance which is normal
Dr Ashutosh, Subharti Dental College, SVSU
Ackermann-profitt system of
classification
This classification includes description of malocclusion in all the three spaces
It gives indication towards the severity of malocclusion
The classification is illustrated using venn symbolic logic diagram
It considers five characteristics and their inter relationship is assessed. Dr Ashutosh, Subharti Dental
College, SVSU
1. Alignment - Intra arch alignment and
asymmetry is assessed, a dental arch is
classified as- Ideal
Crowded
Spaced
2. Profile - Concave
Convex
Straight
Anterior or posterior divergent
Dr Ashutosh, Subharti Dental College, SVSU
3 Transeverse relationship - Transeverse
skeletal and dental relationship is assessed
Buccal or Palatal Cross bite
Unilateral or Bilateral
Skeletal and Dental
4. Class - Sagittal relationship is assessed using Angle’s classification of malocclusion
Skeletal or dental
Dr Ashutosh, Subharti Dental College, SVSU
5. overbite malocclusion are assessed in the vertical plane
Openbite - Anterior or Posterior
Deep bite - Anterior or Posterior
Skeletal or dental
Dr Ashutosh, Subharti Dental College, SVSU
INCISOR CLASSIFICATION
1. Class I: The lower incisor edges occlude with or lie directly below the
cingulum plateau of the upper central incisors. If the overbite is
incomplete the lower incisors are repositioned along their long axis until
they meet the upper incisors.
2. Class II: The lower incisor edges lie posterior to the cingulum plateau of
the upper central incisors. There are two divisions of Class II:
Division 1: the upper central incisors are of average inclination or are
proclined. The overjet is thus increased.
Division 2: the upper central incisors are retroclined; the overjet is
usually within normal limits but the overbite is often increased.
Class III: The lower incisor edges lie anterior to the cingulum plateau of the upper central incisors
CANINE CLASSIFICATION
1. Class I canine relationship – the upper permanent canine
occludes in the embrasure between the lower permanent
canine and first premolar.
2. Class II canine relationship – the upper canine occludes a
whole tooth width further anteriorly and lies in the
embrasure between the lower canine and lateral incisor.
3. Class III canine relationship – the upper canine occlude a
whole tooth width further posteriorly than normal and
occludes in the embrasure between the lower first and
second premolars.