Classification of malocclusion1 /certified fixed orthodontic courses by Indian dental academy

Classification of
Malocclusion

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INDIAN DENTAL ACADEMY
Leader in continuing dental education


INTRODUCTION
 Definition:

Malocclusion is defined as any
deviation from normal occlusion of teeth. The
teeth are in abnormal position in relationship
to the basalbone of the alveolar process, to
the adjacent teeth and/or opposing teeth.


INTRODUCTION
 The alignment and occlusion of the dentition are

extremely important in various oral functions. But
tooth positions are determined not by chance
but by numerous factors such as arch width and
tooth size. Any alteration in such factors can
give rise to malocclusion. As orthodontics is a
“science of infinite variations”(by jackson), it
becomes necessary to group the variety of
malocclusions into various groups for our better
understanding.

INTRODUCTION
 Classification involves the grouping together

of various malocclusion into simpler or
smaller groups. In order to have a system of
classification, standards should be set up that
represents normalcy. The deviations from the
accepted norms should also be grouped into
various smaller divisions or categories.


Advantages
 1. classification helps in diagnosis and

treatment planning.
 2. classification helps in visualizing and
understanding the problem associated with
that malocclusion.
 3. classification helps in communicating the
problem.
 4. comparison of various malocclusion
becomes easy.

TYPES OF MALOCCLUSIONS
 Malocclusion can be broadly divided into 1.Individual teeth malposition or intra-arch

malocclusion.
 2.Malrelation of dental arches to one another
upon bony bases which may themselves be
normally related.
 3.Skeletal malocclusions which involve the
underlying bony bases.


Individual Tooth Malpositions
 These are malposition of individual teeth in

respect to adjacent teeth with in the same
dental arch. Hence are called intra-arch
malocclusions.
Some of the commonly seen individual teeth
malpositions are:


MESIAL INCLINATION
OR TIPPING
 In this condition the tooth is tilted mesially, i.e.

the crown is mesial to the root.


DISTAL INCLINATION
OR TIPPING
 The tooth is tilted distally, i.e. the crown is

distal to the root.


LINGUAL INCLINATION
OR TIPPING
 The tooth is abnormally tilted towards the

palate {for the palate in the maxillary arch}.


LABIAL/BUCCAL INCLINATION
OR TIPPING
 The tooth is abnormally inclined towards the

lips/cheeks.


INFRA-OCCLUSION
 The tooth is below the occlusion plane as

compared to other teeth in the arch.


SUPRAOCCLUSION
 The tooth is above the occlusal plane as

compared to other teeth in the arch.


ROTATIONS
 This term refers to tooth movements around

the long axis of the tooth.
 Mesiolingual or Distolabial.
 Distolingual or mesiolabial.


MESIOLINGUAL OR
DISTOLABIAL ROTATION
 The mesial aspect of the tooth is inclined

lingually or in other words, the distal aspect of
crown is labially placed as compared to its
mesial aspect.


DISTOLINGUAL OR
MESIOLABIAL ROTATIONS
 The distal aspect of the tooth is inclined

lingually or the mesial aspect of the crown is
labially placed as compared to its distal
aspect.


TRANSPOSITION
 This term is used in case where two teeth

exchange places, e.g. a canine in place of the
lateral incisor.


MALRELATIONS OF DENTAL
ARCHES
 SAGITTAL PLANE MALOCCLUSION

TWO TYPES1.PRE NORMAL OCCLUSION
2.POST NORMAL OCCLUSION


PRE-NORMAL OCCLUSION
 Where the mandibular dental arch is placed

more anteriorly when the teeth meet in centric
occlusion.


POST-NORMAL OCCLUSION
 Where the mandibular dental arch is placed

more distally when the teeth meet in centric
occlusion.


VERTICAL PLANE
MALOCCLUSION
 TWO TYPES-

1. DEEP BITE-Here the vertical overlap
between the maxillary and mandibular teeth is
in excess.


2.OPEN BITE
 No overlap or a gap exists between the

maxillary and mandibular teeth when patient
bites in centric occlusion, can exist in the
anterior or posterior region.


TRANSVERSE PLANE
MALOCCLUSIONS
 The transverse plane inter-arch malocclusion

includes various types of cross bites. The
term cross bite refers to abnormal transverse
relationship between upper and lower arches.


SKELETAL MALOCCLUSION
 These malocclusion are caused due to the

defect in the underlying skeletal structure
itself. The defect can be in size, position or
relationship between the jaw bones.


OCCLUSAL RELATIONSHIP OF
POSTERIOR TEETH
 In 1899, Edward Angle classified

malocclusion based on the mesial-distal
relation of the teeth, dental arches and jaws.
He considered the maxillary first permanent
molar as a fixed anatomical point in the jaws
and the key to occlusion.
 Angle’s classified malocclusion into three
broad categories.


CLASS-I MALOCCLUSION
 1.The mesiobuccal cusp of the mandibular

first molar occludes in the embrasure area
between the maxillary second premolar and
first molar.
 2.The mesiobuccal cusp of the maxillary first
molar is aligned directly over the buccal
groove of the mandibular first molar.
 3.The ML cusp of the maxillary first molar is
situated in the central fossa area of
mandibular first molar.

 In this relationship each mandibular tooth

occludes with its counterpart and the adjacent
mesial tooth.


CLASS-II MALOCCLUSION

first molar occludes in the central fossa area
of the maxillary first molar.
first molar is aligned with the buccal groove of
the maxillary first molar.
 3.The DL cusp of the maxillary first molar
occludes in the central fossa area of the
mandibular first molar.

 When compared with class-I, each occlusal

contact pair is situated to the distal
approximately the MD width of premolar.


CLASS II-DIVISON I
 Along with the molar relation as seen in

typical class II malocclusion the maxillary
incisor teeth in are in labio-version.


CLASS II DIVISON 2
 Along with typical class II molar relationship,

the maxillary incisor are near normal
anteroposteriorly or slightly in linguoversion
where as the maxillary lateral incisor are
tipped labially.


CLASS II-SUBDIVISION
 When the class II molar relationship occurs

on one side of the dental arch only, the
malocclusion is referred to as a subdivision of
its division.


CLASS-III MALOCCLUSION
 The distobuccal cusp of the mandibular first

molar is situated in the embrasure between
the maxillary second premolar and first molar.
 The MB cusp of the maxillary first molar is
situated over the embrasure between the
mandibular first and second molar.


 The ML cusp of the maxillary first molar is

situated in the mesial pit of the mandibular
second molar.


PSEUDO CLASS III
MALOCCLUSION
 This is not a true class III malocclusion but

the presentation is similar. Here the mandible
shifts anteriorly in the glenoid fossa due to a
premature contact of the teeth or some other
reason when jaws are brought together in
centric occlusion.


DRAWBACK OF ANGLES
CLASSIFICATION
 Angle presumed the first molars as fixed

points within the jaws, which definitely is not
so.
 The classification is not possible , if the first
molars are missing.
 Classification is not applicable in deciduous
dentition.
 Individual tooth malocclusion are not
considered.

 Malocclusion are considered only in the

anteroposterior plane.
 There is no differentiation between skeletal
and dental malocclusion.
 Etiology of the malocclusions has not been
elaborated upon.


INCISOR CLASSIFICATION
 It was adopted by the British standards’

institute in 1983 and is based upon the
relationship of the lower incisor edges and
the cingulum plateau of the maxillary central
incisors.


VARIATIONS IN ANTERIOR
TOOTH RELATIONSHIP


VARIATIONS IN ANTERIOR
TOOTH RELATIONSHIPS.


CANINE RELATIONSHIP
 CLASS I RELATION: Mesial incline of the

upper canine overlaps the distal incline of the
lower canine.
 CLASS II RELATION: In this canine

relationship upper canine is placed forward ,
i.e. distal incline of upper canine contacts the
mesial incline of lower canine.


 CLASS III RELATION: The lower canine is

placed forward to the upper canine and there
is no overlapping.


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Classification of malocclusion1 /certified fixed orthodontic courses by Indian dental academy

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