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Orthodontics > Malocclusion Class 2 Div 1 > Flashcards

Malocclusion Class 2 Div 1 Flashcards

1
Q

Class 2 div 1

A

-Lower incisors lies above cingulum plateau of upper central incisors.
- upper central incisors are at normal inclination or proclined
- increased Overjet

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2
Q

Incidence

A

20%

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3
Q

Aetiology of class 2 div 1

A
  • Skeletal factors
  • soft tissue factors
  • Dento alveolar factors
  • habits
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4
Q

Skeletal pattern class 2 div 1

A
  • sk Class 2 div 1 76%
  • sk Class 2 div 2 15%
  • sk class 1 Less than 30%
  • sk class 3 less than 5 %
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5
Q

Sk Factor - AP

A
  • large maxilla
  • small mandible
  • posterior articulation of mandible with glenoid fossa
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6
Q

Sk Factors vertical and lateral.

A

-All types ( Average, increased , reduced face height)
- facial asymmetry possible

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7
Q

Soft tissues factors

A

-lip morphology - length or tone

  • lip competence definition : ( lower lip resting height)- short upper lip or low lower lip
  • anterior oral seal
  • tongue
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8
Q

Lip competency definition

A

Lips together at rest without muscular activity

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9
Q

Lip competency describe?

A

-Resting height of lower lip should ideally cover Incisal third upper 21-12
- lip competence seems to improve with age due to growth and social acceptability.

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10
Q

Habitual competency

A

Contraction of mentalis muscle alllow lips to meet.

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11
Q

Why do lips matter in tx?

A
  • Markedly incompetent lips may cause Relapse of overjet
  • Ditto a low lower lip line.
  • short upper lip may give an un attractive smile.
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12
Q

Anterior oral seal

A
  • Tongue to lower lip
  • lower lip to palate
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13
Q

Why do we need AOS?

A

Swallowing

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14
Q

Dento alveolar factors
Crowding

A

Does not cause CLASS 2 div 1

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15
Q

Habit

A

Digit sucking

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16
Q

Treatment why?

A
  • Asthetic considerations
  • functional considerations
  • dental health considerations
  • To reduce the risk trauma to upper incisors in children > 10 years
17
Q

Incidence of incisors trauma

A

Greater than 9 mm 50%

18
Q

Treatment consideration

A
  • dental Camouflage
  • Growth Modification (restrained maxillary growth and more mandibular growth)
  • correction of underlying sk problem

Pt should be fully informed and involved in decision making process

19
Q

Treatment Aims

A
  • Relieve crowding
  • Align the teeth
    -Reduce overbite
  • Reduce overjet
  • close spacing
  • co ordinate upper and lower arch
20
Q

Treatment methods

A

-Upper removable appliance
- Functional appliance
- Fixed appliance
- Joint orthodontic / orthodonathic (surgical approach)

21
Q

Favourable feature for orthodontic treatment

A
  • small ANB
  • no dental compensation
  • growing pt
  • cessation of habit if present
  • greater component of OJ being proclination of ULS
22
Q

Upper removable appliance
Clinical indication

A

-Overjet less than 8mm
- Proclined upper labial segment
- mesially angulated 3s’

23
Q

Removable appliance for which cases?

A
  • Class 2 div 1 incisor relationship
  • upper incisor crowding
  • canine mesially angulted
  • lower incisor lie anterior to upper root centroid
    -OJ less than 8mm
    -Proclined upper labial segment
24
Q

Removable appliance Aim

A
  • Relief of crowding
  • overbite reduction
  • Overjet reduction
25
Q

Functional appliance:

A
  • one stage treatment
  • Two stage treatment folllowed by fixed appliance therapy with or without XTs.
26
Q

When do we use Functional Appliance ? One stage

A

-One stage treatment
- Overjet more than 8mm
- well aligned arches
- class 2 molar relationship
-prepubertal

27
Q

Functional appliance:
Clinical indication ?

A
  • Overjet more than 8mm
  • crowding
  • class 2 molar relationship
28
Q

Stage two Fixed appliances
Clinical indications

A
  • Multiple tooth movement
  • bodily movement of upper labial segment
  • correction of rotations
  • space closure
  • Arch co ordination
29
Q

Orthognathic treatment when?

A
  • Severe Class 2 sk pattern
  • tooth movement alone unable to achieve aims in terms of aesthetic, functions and stability
  • non growing pt
30
Q

General feature of SK

A
  • 76% SK 2 base , If SK1 incisors relationship due to habit
  • cranial base angle high - mandibular rethrognathia
  • longer cranial base - prognathic Maxilla
  • may have small or large maxilla
  • average lower facial height.

Normal cranial base angle 120-125

31
Q

General feature of Soft tissue

A

Incompetent lips
Lower Lip trap
Short upper lips

32
Q

General dental features

A
  • class 2 incisor relationship
  • increased Overjet
  • OB deep incomplete
  • buccal segment can be class 2 or 1
  • mandibular position : ensure pt not habitually posturing, treat to centric
  • facial growth - variable, usually favourable growth
33
Q

Which component of upper removable appliance reduce over jet?

A
  • Robert’s retractor

Orthodontics (45 decks)

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