Class 1 Malocclusion

Class I malocclusion
But, when there is any occlusal
abnormality or individual tooth
malocclusion in a case with normal arch
relationship in antero-posterior plane, we
call it Class I malocclusion.

e.g: Crowding, spacing, rotations,

bimaxillary proclination/retroclination,
crossbite, openbite
Occlusal abnormalities in CLASS I MO
Class I malocclusion may present one or more
occlusal abnormalities which are classified as
follows:
1. Abnormalities caused by local factors:
a. Medial, distal, buccal or lingual (palatal) tilts
or inclinations.
b. Medial, distal, buccal or lingual (palatal)
displacements.
c. Proclination (e.g. due to retained deciduous)
of the anterior teeth.
d. Supra-occlusion and infra-occlusion.
e. Localized spacing or diastema.
f. Rotations.
2. Abnormalities caused by tooth-arch (dento-
alveolar) disproportion.
a. Crowding- Outstanding, instanding,
imbrications, rotation etc.
b. Spacing, diastema.
3. Abnormalities caused by malrelationship of
arch in lateral plane :
a. Cross bite.
b. Centre-line shift.
4 . Abnormalities caused by malrelationship of
arch in vertical plane:
a. Excessive overbite.
b. Open bite- Anterior, lateral (posterior).
Occlusal features in CLASS I MO
Intraoral:
(1) Incisor & molar: class I relationship &
Angles class I molar relationship.
(2) SK patterns: usually class I sk. pattern. It
may however be possible to find mild class II or
class III SK pattern.
(3) Soft tissue morphology & behaviour: The
soft tissue form and activity are usually within
the normal range.
(4) Upper & lower incisors: Normal axial angle.
(5) Over jet: Generally normal. An individual
tooth may be proclined showing increased
overjet or may be retroclined and locked inside
the bite.
(6) Overbite: Usually normal & complete. But
may be “incomplete OB’ or even” an openbite”
(7) Cross bite: May be present.
(8) Dento Alveolar: Crowding is very frequent
showing disproportion imbrications,
displacement, rotation etc. in the incisor and
canine areas. Spacing and diastema may also be
present.
(9) FM plane Angle: Usually average.
(10) Mandibular posture of path of closure:
Endogenous posture. Path of closure is simple
hinge movement at condyles. But, premature
contact at path of closure may cause mandibular
displacement.
Extra Oral
(1)Straight profile.
(2)Competent / incompetent lips.
(3)Normal / deep / shallow mento
labial sulcus.
CROWDING
Definition – is the irregularities of teeth due to
inadequate space in the arch for normal
alignment.

Clinical features:
1. Imbrications
2. Displacement
3. Impaction
4. Rotation
5. Tilts.
6. Poor oral hygiene
7. Gingivitis & periodontitis may present
Types:
1.It may:-

(A) Localized
(B) Generalized.

2. According to severity:-

Crowding can be quantified as

A.mild (<4 mm),
B.moderate (4–8 mm) or
C. severe (≥8 mm).
AETIOLOGY
1. Large tooth size in relation to tooth length.
2. Prolong retention of deciduous teeth.
3. Premature lass of deciduous teeth.
4. Delayed eruption of permanent teeth.
5. Altered path of corruption.
6. Presence of supernumery teeth.
7. Trauma.
8. Localized abnormal size and shape of teeth.
9. Late horrizontal growth of mandible.
10. Mesial migration of buccal segment.
11.Gemination of tooth
Treatment
Preventive treatment
1. Clinical observation where family history
present.
2. Specially design nipple for feeding bottle to
prevent narrowness of the arch.
3. O.H. maintenance & fluoridation to prevent
deciduous caries.
4. Restoration of proximal caries to maintain the
arch length.
5.Surgical removal of high frenal att. [to prevent
localized spacing & crowding to the other place]
7. Space maintainer for early loss of Do teeth
[maintenance of lee way space]
8. Timely removal of retained on ankylosed
deciduous teeth.
9. Habit correction.
10. Early correction of --topically erupted
tooth.
11. Serial extraction where necessary
Treatment:
Corrective Treatment:
A. Gaining space for align tooth :

1.Increase arch length by–

(a) expansion of the arch
(b) Distalization of the molar.
(c) Proclination of anteriors tooth.

2.Decrease Tooth material by–

(a) proximal striping (Disking)
(b) Uprighting of the molars
(c) Derotation of post tooth.
(d) Extraction.
B. Alignment of malaligned tooth.
(a)Mild crowding – Aligned with removable
appliance(RA) such as labial bow, spring,
palatal finger spring, T spring, flapper
spring.
(b)Moderate crowding – Aligned with RA
or fixed appliance (FA).
(c)Severe crowding –
(i) Extraction usually premolars.
(ii) Retraction of canine.
(iii) Alignment of anteriors