Questions and Answers
When do you recommend a patient be referred to an orthodontist?
Age 7
When is extraction of teeth recommended?
When it is not a solution to compensate for skeletal discrepancies.
What characterizes Class II malocclusions?
The maxillary cusp of the first molar occluding mesial to the buccal groove of the mandibular first molar.
What defines Class II malocclusion Division 1?
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What defines Class II malocclusion Division 2?
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What is a subdivision in orthodontics?
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What is dental caused Class II malocclusion?
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What causes skeletal Class II malocclusion?
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What is the facial profile characteristic of Class II malocclusion?
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What is a 'Sunday bite'?
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What are some growth modification treatments for Class II malocclusion?
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What age range is targeted for growth modification treatments in Class II?
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What is a non-growth treatment for Class II malocclusion?
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What defines Class III malocclusion?
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Study Notes
Recommendations for Referral to Orthodontics
- Refer patients around age 7 for early interceptive treatment to prevent worsening of developing problems.
- Early intervention takes advantage of growth patterns and allows orthodontist to monitor facial growth.
Tooth Extraction Guidelines
- Extraction is not a solution for skeletal discrepancies; it may have negative impacts on form and function.
- Compromises in occlusion require an interdisciplinary treatment approach for better outcomes.
Class II Malocclusions
- Defined by the maxillary 1st molar's mesiobuccal cusp occluding mesial to the mandibular 1st molar's buccal groove.
- Typically associated with a retruded jaw position, presenting skeletal and dental issues.
- Indications include a visible maxilla positioned ahead of the mandible.
Class II Malocclusion Division 1
- Characterized by class II molars with protruded incisors, presenting a large overjet and minimal overbite.
- Maxillary incisors show anterior flare; untreated cases may lead to gingival recession and anterior teeth breakage.
Class II Malocclusion Division 2
- Presents with class II molars, lingually tipped maxillary incisors, and a deep overbite with minimal overjet.
- Similar lingering effects include periodontal problems and difficulties in restoring anterior teeth due to attrition.
Subdivisions of Class II and III
- Refers to the side that is not class I in patients who are class II or III on one side and class I on the other.
- Example: Class II division 1 subdivision indicates class II on one side and class I on the opposite side.
Dental Causes of Class II Malocclusion
- Occurs when jaws are proportionally sized, but dental protrusion exists due to habits such as thumb sucking or lip sucking.
Skeletal Causes of Class II Malocclusion
- Caused by an upper jaw larger than lower jaw, low positioning of the mandible, or backward rotation leading to lower dental retrusion.
Facial Profile Characteristics
- Class II malocclusion typically features a convex facial profile with the upper lip more anterior than the lower.
Sunday Bite
- Describes a situation in class II malocclusion where normal bite exists in centric relation, but a shift occurs during chewing, suggesting a balanced appearance.
Treatments for Class II Malocclusion
- Growth modifications involve functional appliances and headgear to correct positioning.
- Non-growth modifications may include camouflage extractions, distalization, and in extreme cases, extracting premolars.
Growth Modification Treatment for Class II
- Best evaluated around ages 10-13 for girls and 13-16 for boys, with an understanding that skeletal and dental ages may differ.
- Maxillary excess can be treated with headgear to restrain growth and allow downward mandibular development.
- For mandibular deficiency, functional appliances position the mandible forward, effective only if the patient is still growing.
Non-Growth Treatments for Class II Malocclusion
- Camouflage extraction of maxillary premolars and retraction of anterior teeth is common.
- Distalization requires temporary anchorage devices (TADs) for movement of anterior teeth.
- Extracting four premolars may be necessary for severe crowding, ensuring proper occlusion.
Class III Malocclusion
- Characterized by the mesiobuccal cusp of the maxillary 1st molar occluding distal to the buccal groove of the mandibular 1st molar, exceeding 6mm.
- Typically, treatment is not pursued as it often leads to incisor acceleration issues.
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This quiz provides essential flashcards on Class II and Class III malocclusions, focusing on important referral guidelines to orthodontics and extraction considerations. Ideal for dental students and professionals, the flashcards cover critical concepts related to early intervention and orthodontic treatment strategies.