MANAGEMENT OF CLASS II

DIV 2
PREPARED BY
DR. RABIYA KHAN
RESIDENT, DEPT OF
ORTHODONTICS

AETIOLOGY
Skeletal
Genetic component

Soft tissue
Mediated by the skeletal pattern,
reduced lower facial height, lower lip
line higher relative to the crown of
the upper incisors causing retroclined
upper incisors

 Dental factors
Retroclination of the upper centrals
exacerbates crowding resulting in an arc of
smaller circumference. Retroclination of the
lower labial segment , resulting in trapping
of lower labial segment to the upper
Lack of effective occlusal stop to eruption of
the lower incisors may result in their
continued eruption giving rise to increased
overbite

EXTRAORAL FEATURES
Brachycepalic/
Euryprosopic
Hypodivergent
pattern
Saggital relationship
may vary
Well developed chin
Short lower anterior
facial height

INTRAORAL FEATURES
Retroclined upper
central incisors
Crowded upper
laterals or canines
Mesio labially
rotated upper
laterals
Deep bite and
possible lingual
crossbite

MANAGEMENT
The treatment approach will depend
upon the
Aetiology of the malocclusion
Patients profile
Presence and degree of crowding

Mx OF CLASS II DIV 2
Stable correction of a class II div 2
incisor relationship is difficult as it not
only requires reduction of the increased
overbite but also reduction of the
interincisal angle which is classically
increased, therefore the interincisal
angle needs to be reduced so that an
effective occlusal stop is created
The interincisal angle in div 2 can be
reduced in a number of ways

Mx IN CHILDREN
One way is with the The other way is to
use a functional
cervical headgear
appliance, (with or
i.e taking
without mandibular
advantage of the
advancement
extrusive tendency
depending on the
of extraoral force,
AP jaw relationship)
causing eruption of
that allows free
the molars and a
eruption of the
biteplane to open
posterior teeth
the bite

Mx IN ADULTS
Approaches to the
reduction of overbite
Intrusion of the
incisors
Eruption of the molars
Extrusion of the
molars
Proclination of the
lower incisors
And torqueing the
incisors lingually and
paltally

appliance

fixed
therapy

Mx IN ADULTS

SURGERY

Thank you!!