DIAGNOSIS AND

TREATMENT STRATEGIES
OF CLASSII
MALOCCLUSION

OSAMA ABOSEN
ID:201341031
CLASS II MALOCCLUSION Class Il malocclusion can be divided into
two types:
1. CLASS II DIVISION 1
2. CLASS II DIVISION 2

CLASS II DIVISION 1
According to British Standards classification: "The lower incisor
edges lie posterior to the cingulum plateau of the
upper incisors, there is an increase in overjet and
the upper central incisors are usually proclined".

SKELETAL PATTERN:
 Prognathic maxilla.
 retrognathic mandible.
SOFT TISSUES :
 Incompetent lips.
 Lower lip trap behind upper incisors .
HABITS:
 Digit sucking habit
 Proclination of upper incisors
 Retroclination of lower incisors
 Cross bite
DENTAL FACTORS:
Crowding in upper incisors out of the arch labially result in
exacerbation of the overjet.
Features of Class II div 1:
 Class II molar, canine and incisor relations
 Proclined maxillary incisors
 Increased overjet
 Open bite, normal overbite or deep bite
CLASS II DIVISION 2 :
According to British Standards classification:
"The lower incisor edges lie posterior to the
cingulum of the upper incisors.
The upper central incisors are retroclined . Overjet is usually
minimal".

SKELETAL PATTERN :
 Mild skeletal class II pattern.
 Can also be present in association
with a class I relationship.
 Vertical dimension is typically reduced.

DENTAL FACTORS:
Pre-existing crowding is exacerbated because retroclination of
upper central incisors.

SOFT TISSUES:
 A high lower lip line will tend to retrocline the upper
incisors.
 It may also occur from upper & lower retroclination
caused by active muscular lips.
Features of class II division 2 malocclusion:
 Excessive lingual inclination of
maxillary central incisors
 U shaped or square palatal arch.
 Deep overbite
 profile is straight to convex.
DIAGNOSIS
 History.
 Intra & extra-oral examination.
 Study models.
 Orthodontic photographs: Radiographs. -
Cephalometrics.
TREATMENT OF CLASS II MALOCCLUSION
We have 3 options:

 Preadolescents:
- Growth modifications.
 Adult:
- Orthodontic camouflange.
- Surgical correction.

a. GROWTH MODIFICATIONS:
Can be achieved by:
 INTRA ORAL APPLIANCES: Can be done in pre-adolescent
children with Stimulation and enhancement of mandibular
growth through functional appliances:
1-REMOVABLE: used for:
- mild to moderate class II div1
- Proclined upper incisors

- Activator - Frankel
- Bionatar - Twin-Block

2- FIXED:
- Herbst appliance - Cemented Twin -block - Forsus
. appliance
  EXTRA ORAL APPLIANCES: redirection of maxillary growth
:
- Headgear.

2. ORTHODONTIC CAMOUFLAGE:
1- Non-extraction treatment with class II elastics:
retraction of upper teeth and more forward
movementof lower teeth comparatively without
tooth extractions.
2- Retraction of maxillary incisors into a premolar extraction
space.

3- Distal movement of upper teeth.

3. ORTHOGNATHIC SURGERY
REFERENCES:
 CONTEMPORARY ORTHODONTICS WILLIAM R.PROFFIT
(5TH EDITION)
 • AN INTRODUCTION TO ORTHODONTICS (3RD EDITION)