Class II Div II

Question 1

What dental factors could lead to a class II div II malocclusion?

Answer 1

Acute crown-root angle
Thin labio-palatal thickness of teeth
Retrusive dentoalveolar processes of the maxilla & mandible

Question 2

Comment on lower anterior face height (LAFH) and Frankfurt Mandibular Plane Angle (FMPA) for class II div II pts

Answer 2

LAFH and FMPA reduced with FMPA meeting after occiput

Question 3

Define class II molar relationship

Answer 3

Buccal groove of the mandibular first permanent molar occludes posterior to the mesio-buccal cusp of the maxillary first molar

Question 4

What is a common rotation of upper laterals if there is a class II div II malocclusion?

Answer 4

Mesio-labially rotated

Due to the presence of crowding

Question 5

What does the red dot highlight in this image?

Answer 5

Prominent chin (progenia)
Asscociated with Class II Div II

Question 6

How may a very high lower lip affect a patients teeth?

(Reduced LAFH)

Answer 6

A high lower lip will retrocline all upper incisors

Question 7

What is the aim of growth modification on class II div II patients?
How do we acheive this?

Answer 7

Convert malocclusion into a Class II div 1 by:
- Proclination of upper incisors
- Increase overjet
- Functional appliance (e.g. Twin block) to correct OverJet
- Usually finished with fixed appliances

Question 8

Describe the growth of the mandible in a class II div II pt

Answer 8

Often associated with forward rotational growth pattern of the growing mandible

Question 9

Define class II div II incisor relationship

Answer 9

Lower incisor edges occlude or lie posterior to the cingulum plateau of the upper central incisors with the upper central incisors are retroclined. The overjet is usually minimal but may be increased

Question 10

What skeletal class is class II div II normally associated with?

Answer 10

Mild or moderate class II

Question 11

Why do we treat class II div II pts?

Answer 11

Aesthetic concerns
Traumatic overbite
Crowding concerns

Question 12

What are the treatment options for class II div II pts?

Answer 12

1. No treatment
2. Growth modification
3. Camouflage
4. Orthgnathic surgery

Question 13

What teeth need to be removed for camouflage tx of patients with class II div II malocclusion?

For upper and lower

Answer 13

UPPER = extraction of 4s
LOWER= extraction of 5s (preferably non extraction)

Question 14

How can the lips cause a class II div II malocclusion?

Answer 14

The lower anterior face height is reduced the lower lip will act higher on the upper incisors retroclining them. If the laterals are much shorter they may escape this action and be proclined (see pic)

Retroclined = Pushed towards palate Proclined = Pushed away from palate

Question 15

What would you expect to see clinically in a class II div II pt?

Answer 15

1. Retroclined upper central incisors
2. Upper lateral incisors are often crowded,mesio-labially rotated, normal or proclined
3. Crowding is exacerbated by incisor retroclination (due to reduced arch length)
4. Increased overbite
5. Trauma: Lower incisors may occlude with upper incisors (damage to labial gingiva of lowers) or palate (damage to palatal mucosa)