Questions and Answers
What is a Class II division 2 malocclusion?
The lower incisor edges lie posterior to the cingulum plateau of the upper incisors, with the upper central incisors retroclined and a usually minimal overjet.
What are Class II indefinite malocclusions?
Where the lower incisor tip occludes posterior to the cingulum plateau of the upper incisors but where one incisor is proclined and the other is upright or retroclined.
What are Class II intermediate malocclusions?
Where the lower incisors tip occlude posterior to the cingulum plateau of the upper incisors and where the upper incisors are either upright with an overjet of 5-7 mm.
What are the three aetiological factors of Class II division 2 malocclusion?
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What is the anterior-posterior skeletal pattern of Class II division 2 malocclusion?
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What is the vertical skeletal pattern of Class II division 2 malocclusion?
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What are the dental factors that cause Class II division 2 malocclusion?
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What are the dental features of Class II division 2 malocclusions?
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Why is the overbite increased in Class II division 2 malocclusion?
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What does overbite cause?
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What are the traumatic cases that an overbite can cause?
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What are the soft tissue factors that cause Class II division 2 malocclusion?
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Why treat Class II division 2 malocclusions?
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What are the four main ways of treating Class II division 2 malocclusions?
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When should the patient accept Class II division 2 malocclusions?
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Who can undergo growth modification treatment?
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What are the steps of growth modification treatment?
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What are the functional appliances used in growth modification of Class II division 2 malocclusion?
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How does ELSAA appliance work?
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How can camouflage be used for Class II division 2 malocclusion?
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What is the stability of a Class II division 2 correction dependent upon?
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Who is suitable for orthognathic treatment of Class II division 2 malocclusion?
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What is the prognosis of Class II division 2 correction?
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Study Notes
Class II Division 2 Malocclusion
- Characterized by lower incisors positioned behind the cingulum plateau of upper incisors.
- Upper central incisors are typically retroclined.
- Often presents with minimal overjet, which can sometimes increase.
Types of Class II Division 2 Malocclusion
- Indefinite Malocclusion: Lower incisors occlude behind the upper incisors with one upper incisor proclined and another upright or retroclined.
- Intermediate Malocclusion: Lower incisors occlude behind upper incisors; upper incisors upright with overjet of 5-7mm but not proclined.
Aetiological Factors
- Skeletal Factors: Commonly associated with mild to moderate skeletal Class II, but may also be present in Class I or mild Class III.
- Vertical Skeletal Pattern: Reduced vertical dimension (V.D) with a lower anterior face height smaller than upper. Forward growth pattern of the mandible can increase overbite.
- Dental Factors: Includes acute crown-root angles, thin labio-palatal thickness, and retrusion of both maxilla and mandible.
Dental Features
- Often results in retroclination of upper central incisors leading to increased inter-incisal angle (IIA).
- Frequent crowding exacerbated by retroclination reduces arch length.
Increased Overbite
- Caused by retroclination and reduced V.D, leading to lack of occlusal stop for lower incisors which further increases overbite.
Trauma from Overbite
- Potential soft tissue damage to palatal mucosa and labial gingiva due to lower incisors occluding with upper incisors.
Soft Tissue Factors
- Influence of soft tissues impacted by skeletal pattern, particularly in cases of reduced lower facial height which raises the lower lip line.
Treatment Justification
- Treatment is recommended due to aesthetic concerns, potential dental health issues such as traumatic overbite, and crowding.
Treatment Approaches
- Main options include acceptance, growth modification, camouflage, and orthognathic treatment.
Growth Modification
- Suitable for growing patients with mild to moderate skeletal Class II patterns.
- Aims to convert to Class II div 1 through proclination of upper incisors using functional appliances like Twin Block.
Camouflage Options
- Can include tooth extractions or non-extraction treatments to create space by proclining incisors, which enhances arch length.
Stability of Correction
- Stability relies on reducing overbite and correcting inter-incisal angle to prevent relapse due to lack of an occlusal stop.
Orthognathic Treatment
- Recommended for adults with complete growth exhibiting severe skeletal issues and poor facial aesthetics.
- Often entails mandibular advancement and fixed appliances used before, during, and after surgery.
Prognosis
- Class II division 2 malocclusion can be challenging to treat; prognosis varies based on facial growth patterns.
- High likelihood of relapse due to rotated laterals and deep bite necessitates long-term retention strategies.
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Description
Explore the characteristics, types, and aetiological factors related to Class II Division 2 Malocclusion. This quiz covers the unique features of lower and upper incisors, as well as the skeletal and dental factors involved. Test your knowledge and understand this orthodontic condition better.
