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Orthodontics > Class II Malocclusion > Flashcards

Class II Malocclusion Flashcards

1
Q

Angle’s Class II Definition

A

Lower first permanent molar is distal to the upper first permanent molar by at least the width of half a cusp

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2
Q

How is Class II subdivided

A

Based on maxillary incisor inclination

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3
Q

Class II Div 1

A

Max anteriors are proclined and a large OJ is present

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4
Q

Class II Div 2

A

Max anteriors are retroclined and a deep OB is present

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5
Q

Prevalence of Class II Div 1 and 2 malocclusion

A

Div 1: 1 in 4 in asian males
Div 2: Very little

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6
Q

Aetiology of Malocclusions

A

Genetic + Environmental factors

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7
Q

Genetic predisposing factor of Class II

A

Inherited growth patterns of mandible that causes the chin to grow downwards and backwards

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8
Q

Environmental predisposing factor of Class II
1

A
  1. Digit sucking/Persistent non-nutritive sucking beyond the age of 4
  2. Imbalance of forces from oral soft tissues (eg. tongues and lips)
  3. Early loss of maxillary second deciduous molars - mesial migration, rotation and tipping of permanent maxillary first molars
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9
Q

General characteristics of Class II (skeletal + dental)

A
  1. Maxillary skeletal excess (Size)
  2. Maxillary dental excess (Proclination)
  3. Mandibular skeletal deficiency (Size)
  4. Mandibular dental deficiency (Retroclination)
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10
Q

Class II Div 1 Soft Tissue profile
4

A
  • Convex
  • Lower lip trap
  • Shorter upper lip - failure in lip closure
  • Acute nasolabial angle
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11
Q

Class II Div 1 Skeletal features

A
  • Protrusive Max
  • Retrognathic Man
  • Shorter Man length
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12
Q

What does skeletal involvement indicate about the case

A

Increase in degree of difficulty and less favourable prognosis

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13
Q

Class II Div 1 Dental Features
6

A
  • Protrusive Max Dentoalveolus
  • Retrusive Man Dentoalveolus
  • Class II Molar relationship
  • Increased OJ
  • Deep OB
  • V-shaped upper arch (narrow at canines and broad at molars)
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14
Q

Class II Div 1 Lat Ceph

A

Various combinations of:
- Maxilla and teeth are anterior in relation to cranium
- Max teeth are anterior in normally positioned max
- Man is normal size but posteriorly position
- Man is underdeveloped
- Man teeth are posteriorly placed in a mandible that is in a normal position

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15
Q

Class II Div 2 Soft Tissue profile
9

A
  • Straight to slightly convex
  • Hypodivergent
  • Short lower face height
  • Prominent chin point
  • Flat mandibular plane
  • Deep bite
  • Deep labiomental fold
  • Well-developed and active orbicularis oris and mentalis muscle –> lingually inclined upper centrals
  • Lower lip curl –> deep bite causing upper incisors to sit behind the lower lip
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16
Q

Class II Div 2 Dental features
6

A
  • Max centrals lingually inclined and overlapped on the labial by max laterals
  • Deep OB
  • Minimal OJ
  • Broad upper arch (usually)
  • Inverted Max occlusal plane (2 occlusal planes): Overerupted anteriors and infraoccluded posteriors
  • Exaggerated curve of Spee with extrusion of mandibular incisors
17
Q

Class II Div 2 Lat Ceph

A
  • Acute gonial and mandibular plane angles
  • Short LAFH
  • Excessive OB
  • Lingual axial inclination of maxillary central incisors
18
Q

What is a unilateral class II molar r/s called

A

subdivision

19
Q

What components make up an orthodontic diagnostic statement

A

Dental + Skeletal + Cause/Aetiology + Growth Component

Eg. Class II Div 1 Malocclusion on a Class II skeletal base due to retrognathic mandible in an adolescent patient

20
Q

What makes children at risk of suffering trauma to their upper incisors

A

Children with incompetent lips and an increased overjet greater than 7-8mm

21
Q

What are the objectives of the first stage of Class II Management

A

Early correction of incisor flaring, molar relationship and crossbite
+ Retention

22
Q

Why is early correction important in the management of class II patients

A
  • Simplifies treatment in the second stage
  • Maxillary incisor retraction minimises danger of traumatic injury and improves abnormal lip position
23
Q

What is DAC used for

A

To mask underlying AP skeletal discrepancies

24
Q

What happens prior to dental surgery in DAC patients

A

Dental Decompensation must be done first

25
Q

Timing of Class II referral

A

7-8 years old during eruption of permanent incisors

26
Q

Types of Class II treatment modalities

A
  • Growth modification (interceptive treatment on growing patients) eg. Twin block functional appliance
  • Comprehensive ortho
  • Orthodontic-Orthognathic surgery - after halt of growth

Orthodontics (18 decks)

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