Classification of malocclusion in orthodontics /certified fixed orthodontic courses by Indian dental academy

CLASSIFICATION OF
MALOCCLUSION

INDIAN DENTAL ACADEMY
www.indiandentalacademy.com

www.indiandentalacademy.co

CLASSIFICATION SYSTEM
• IS A GROUPING OF CLINICAL CASES
OF SIMILAR APPEARANCE FOR EASE
IN HANDLING AND DISCUSSION,IT IS
NOT A SYSTEM FOR DIAGNOSIS
,METHOD FOR DETERMINING
PROGNOSIS OR A WAY OF DEFINING
TREATMENT


OC UP
CLUSION CLOSING

“CLOSING UP”


DEFINITION

THE RELATIONSHIP OF THE MAXILLARY
AND MANDIBULAR TEETH WHEN THE JAWS
ARE CLOSED IN CENTRIC RELATION
WITHOUT STRAIN OF MUSCULATURE OR
DISPLACEMENT OF CONDYLES IN THEIR
FOSSAE.


NORMAL AND IDEAL OCCLUSION

“NORMAL” IMPLIES TO THE VARIATIONS
AROUND AN
AVERAGE OR MEAN VALUE.

“IDEAL” IS A HYPOTHETICAL CONCEPT OR A
STANDARDIZED GOAL.


SIX KEYS OF NORMAL OCCLUSION

1.MOLAR INTER-ARCHRELATIONSHIP

2.MESIODISTAL CROWN ANGULATION

3.LABIOLINGUAL CROWN INCLINATION

4.ABSENCE OF ROTATION

5.TIGHT CONTACTS

6.CURVE OF SPEE


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ANY DEVIATION IN NORMAL OCCLUSION.


WHY TO CLASSIFY?


REASONS FOR CLASSIFYING

TO GROUP CERTAIN MALOCCLUSIONS
TOGETHER WHICH MAY OR MAY NOT
HAVE THE SAME ETIOLOGY.

EASE OF REFERENCE, COMPARISON AND
COMMUNICATION.

THINKING OF THE POSSIBLE TREATMENT
MODALITIES THAT MAY BE NEEDED IN A
PARTICULAR CASE.

VARIOUS SYSTEMS OF CLASSIFICATION

ANGLE SYSTEM AND ITS MODIFICATIONS

SIMONS SYSTEM

AETIOLOGICAL CLASSIFICATION

BAUME CLASSIFICATION OF PRIMARY TEETH

ACKERMANN AND PROFITT CLASSIFICATION

BALLARDS CLASSIFICATION

WHO CLASSIFICATION

ANGLE SYSTEM
BY EDWARD HARTLEY
ANGLE

WAS CONSIDERED THE
FATHER OF MODERN
ORTHODONTICS

BASED ON THE ANTERO
POSTERIOR RELATIONSHIP
OF THE
JAWS WITH EACH OTHER

CONSIDERS MAXILLARY
FIRST PERMANENT MOLAR

CLASS II
DIVISION I
DIVISION II
TYPE A
TYPE B
TYPE C
CLASS II SUB DIV

TRUE
CLASS III
PSUEDO

CLASS III SUB DIV


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


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


• 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


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

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

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


Class II subdivision
» Class II molar relation on one side and class I on
other


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

Class III MALOCCLUSION


TRUE CLASS III
• Class III molar relation

• LOWER INCISORS LINGUALLY
INCLINED

• LOWER TONGUE POSTURE- NARROW
UPPER ARCH


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

CLASS III SUBDIVISION
• CLASS III MOLAR RELATION ON ONE
SIDE AND CLASS I RELATION ON THE
OTHER


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


SHORT COMINGS OF ANGLE’S
CLASSIFICATION
DOES NOT CONSIDER MALOCCLUSION IN VERTICAL
AND TRANSVERSE PLANE.
CANNOT BE APPLIED IF FIRST PERMANENT MOLARS
ARE MISSING.
CANNOT BE USED IN DECIDUOUS DENTITION.
DOES NOT INDICATE THE ETIOLOGY OF
MALOCCLUSION.
NO SKELETAL RELATIONSHIP IS CONSIDERED
MALFUNCTIONS OF MUSCLES AND BONES ARE
OVERLOOKED.
DOES NOT INDICATE THE COMPLEXITY OF THE
PROBLEM.


MODIFICATIONS

LISCHERS

DEWEYS

HOWARDS

TAYALORS


LISHERS MODIFICATION

 NEUTROCCLUSION
 DISTOCCLUSION
 MESIOCCLUSION
 BUCCOCCLUSION
 LINGUOCCLUSION
 SUPRAOCCLUSION
 INFRAOCCLUSION
 MESIOVERSION
 DISTOVERSION
 TRANSVERSION
 AXIVERSION
 TORSIVERSION

DEWEYS MODIFICA TION

ANGLES CLASS I

TYPE I CROWDED ANTERIORS

TYPE 2 MAXILLARY INCISORS ARE PROCLINED AND
SPACED

TYPE 3 ANTERIOR CROSS BITE

TYPE 4 POSTERIOR CROSSBITE

TYPE 5 IS SIMILAR TO TYPE 1 BUT IS DUE TO DRIFTING
OF TEETH

ANGLES CLASS II

NO MODIFICATIONS

ANGLES CLASS III

TYPE I OVERLAPED BY MAXILLARY MANDIBULAR
INCISORS ARE CROWDED AND INCISORS

TYPE II UPPER AND LOWER ANTERIORS ARE IN
EDGE TO EDGE RELATION

TYPE III ANTERIOR CROSS BITE


HOWARDS MODIFICATION

ANGLES CLASS II GROWTH PROBLEM

ANGLES CLASS I NON GROWTH PROBLEM

TAYLORS MODIFICATION

BIMAXILLARY PROTRUSION CLASS IV


SIMON CLASSIFICATION

ATTRACTION
FRANKFORT HORIZONTAL
PLANE ABTRACTION

PROTRACTION
ORBITAL PLANE

RETRACTION

CONTRACTION
MID SAGITAL
PLANE
DISTRACTION

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)


Frankfort horizontal plane
Formed by drawing
a straight line
through the bony
margins of the
orbit to the upper
margins of external
auditory meatus


• 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


Orbital plane
• Perpendicular to the
FHP
• Simon’s law of
canine- “this plane
should pass through
the distal third of the
canine”


• 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
closed or more posteriorly placed


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

• 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


ADVANTAGES

1 . 3 DIMENSIONAL - MORE PRECISE

2. LAYS EMPHASIS ON THE ORIENTATION
OF DENTAL ARCHES TO THE FACIAL
SKELETON

DISADVANTAGES
IT IS TIME CONSUMING AND CUMBERSOME


BAUME CLASSIFICATION OF PRIMARY TEETH

CLASS I
STRAIGHT OR FLUSH OR
TERMINAL PLANE CLASS II

CLASS I
MESIAL STEP OR
CLASS III

DISTAL CLASS II
STEP


BAUME
CLASSIFICATION


ETIOLOGICAL
CLASSIFICATION
BY MOYER'S

OSSEOUS

MUSCULAR

DENTAL


BALLARD'S CLASSIFICATION-
Incisor Classification

CLASS I CLASS II CLASS III

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.

VENN DIAGRAM

ACKERMAN AND PROFIT CLASSIFICATION
DIAGRAMATIC CLASSIFICATION OF MALOCCLUSION IN 1960

ALIGNMENT IDEAL
STEP 1 AND CROWDING
SYMMETRY SPACING

STRAIGHT (ORTHOGNATHIC)
PROFILE CONVEX
CONCAVE
STEP 2 AND
STRAIGHT
ANTERIOR
DIVERGENCE
POSTERIOR

BUCCO LINGUAL
STEP 3 TRANSVERSE PLANE RELATIONSHIP OF
POST TEETH

STEP 4 SAGITAL PLANE ANGLES CLASS I
ANGLES CLASS II
ANGLES CLASS III

STEP 5 VERTICAL PLANE BITE DEPTH

OPEN BITE SKELETAL
DEEP BITE DENTAL


THANK YOU


Classification of malocclusion in orthodontics /certified fixed orthodontic courses by Indian dental academy

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