53. Class II malocclusion. Prevention and treatment Flashcards
(23 cards)
Class II malocclusion. Prevention and treatment
Treatment approaches to dental class II malocclusion
- Without Extraction => Distalisation of Maxillary Teeth=>if class II dental relationship results from mesial drift of maxillary permanent molars=>
- Premature loss or small maxillary primary molars=>
- Maxillary permanent molars moved distally to achieve a normal class I relationship
- With Extraction => Unilateral or Bilateral Extraction of Teeth=>
- Extraction of maxillary first or second premolars to correct malocclusion
Class II malocclusion. Prevention and treatment
Current treatment approaches to skeletal class II malocclusion division 1
- Growth Modification=>
- Extraoral Appliances
- Functional Appliances
- Interarch Elastic Traction
- Orthodontic Camouflage=>
- w/extraction
- w/out extraction
- Orthognathic surgery
Class II malocclusion. Prevention and treatment
Growth modification in class II malocclusion treatment
- Alter skeletal relationship=>modify facial growth w/ orthodontic appliances
- Extraoral Appliances=>
- Headgear=>during growth periods=>
- Intercept or correct skeletal malocclusions and distalize maxillary dentition or maxilla itself
- Restricts maxillary growth while allowing mandible forward growth
- Functional Appliances=>
- Position mandible downward and forward to stimulate mandibular growth=>
- Removable Tooth-Borne Appliances=>
- Activator, bionator, twin block
- Removable Tissue-Borne Appliances=> Fränkel II
- Fixed Tooth-Borne Appliance=> Herbst appliance
- Interarch Elastic Traction=>
- Class II elastics deliver anterior force to mandibular teeth and posterior force to maxillary teeth=>
- Protraction of mandibular teeth and retraction of maxillary teeth=>
- w/ some extrusion of mandibular molars and maxillary incisors
Class II malocclusion. Prevention and treatment
Orthodontic Camouflage in class II malocclusion
- Disguises unacceptable skeletal relationship by repositioning teeth in jaws
- With Extraction=>
- If space is needed=>Extraction of maxillary first premolar if crowding or protrusion
- Without Extraction=>
- If enough space in dental arches=>
- Retract maxillary dentition and protract mandibular dentition
Class II malocclusion. Prevention and treatment
Orthognathic Surgery in class II malocclusion treatment
- Severe cases and divided into five categories=>
- Mandibular Advancement=>intraoral ramus osteotomy or sagittal split=>advance mandible
- Mandibular Total Subapical Advancement=>
- Advances mandibular dentoalveolus
- Maxillary Impaction=>vertical maxillary excess
- Anterior Maxillary Subapical Setback=>if maxillary excess limited to sagittal dimension
- Combined Surgery=>maxillary and mandibular surgeries to address malocclusion
Class II malocclusion. Prevention and treatment
Treatment objectives for skeletal class II division 2 malocclusion
- Relief of gingival trauma
- Correction of incisor relationship
- Relief of crowding and local irregularities
- Correction of buccal segment relationship
- Role of extraction in treating class II division 2 malocclusion similar to class II division 1 malocclusion
Class II malocclusion. Prevention and treatment
Treatment methods for class II division 2 malocclusion
- Reduction in Incisal Overbite=>Anterior bite plane or fixed appliances
- Alteration of Incisal Inclination=> Torqueing springs used to move upper incisors’ roots lingually and crowns buccally
- Functional Appliances=>mixed dentition period=>
- Procline maxillary incisors=>class II division 2=>malocclusion resembling class II division 1=>
- Followed by use of functional appliances as described for class II division 1 malocclusion
Class II malocclusion. Prevention and treatment
What is a treatment approach for Class II malocclusion without extraction?
- Distalisation of maxillary teeth=>
- If Class II relationship results from mesial drift of maxillary permanent molars.
Class II malocclusion. Prevention and treatment
Cause of mesial drift of maxillary permanent molars
Premature loss or small maxillary primary molars can cause mesial drift
Class II malocclusion. Prevention and treatment
Goal of distalisation in Class II malocclusion treatment
Move maxillary permanent molars distally to achieve a normal Class I relationship.
Class II malocclusion. Prevention and treatment
Treatment approach for Class II malocclusion with extraction
- Unilateral or bilateral extraction of teeth=>
- Specifically maxillary first or second premolars, is performed to correct malocclusion.
Class II malocclusion. Prevention and treatment
Goal of growth modification in class II malocclusion treatment
Alter skeletal relationship to modify facial growth with orthodontic appliances.
Class II malocclusion. Prevention and treatment
What are extraoral appliances used for?
Intercept or correct skeletal malocclusions and distalize maxillary dentition or the maxilla itself.
Class II malocclusion. Prevention and treatment
Effect of headgear during growth periods
- Restricts maxillary growth
While allowing forward growth of mandible.
Class II malocclusion. Prevention and treatment
Functional appliances function
Position mandible downward and forward to stimulate mandibular growth.
Class II malocclusion. Prevention and treatment
Examples of removable tooth-borne appliances
- Activator
Bionator
Twin block
Class II malocclusion. Prevention and treatment
Example of a removable tissue-borne appliance
Fränkel II.
Class II malocclusion. Prevention and treatment
Example of a fixed tooth-borne appliance
Herbst appliance.
Class II malocclusion. Prevention and treatment
Purpose of interarch elastic traction
- Class II elastics deliver anterior force to mandibular teeth
- and posterior force to maxillary teeth
Class II malocclusion. Prevention and treatment
Effects of interarch elastic traction
- Protraction of mandibular teeth and retraction of maxillary teeth=>
- w/ some extrusion of mandibular molars and maxillary incisors
Class II malocclusion. Prevention and treatment
What is orthodontic camouflage in class II malocclusion?
It disguises unacceptable skeletal relationships by repositioning teeth in jaws.
Class II malocclusion. Prevention and treatment
Approach when extraction ineeded in orthodontic camouflage
Extraction of maxillary first premolar if crowding or protrusion is present.
Class II malocclusion. Prevention and treatment
Approach when no extraction is needed in orthodontic camouflage
- If there is enough space in dental arches=>
- Retract maxillary dentition and protract mandibular dentition.
