Class II Division 2 Malocclusion Overview
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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?

<p>Skeletal, soft tissues, and dental.</p> Signup and view all the answers

What is the anterior-posterior skeletal pattern of Class II division 2 malocclusion?

<p>Commonly associated with a mild or moderate skeletal Class II.</p> Signup and view all the answers

What is the vertical skeletal pattern of Class II division 2 malocclusion?

<p>Typically reduced vertical dimension (V.D) with Frankfort mandibular plane angle (FMPA) reduced and often involves a forward rotational pattern of growth of the mandible.</p> Signup and view all the answers

What are the dental factors that cause Class II division 2 malocclusion?

<p>Acute crown-root angle, thin labio-palatal thickness, and both dentoalveolar processes of the maxilla and mandible being retrusive.</p> Signup and view all the answers

What are the dental features of Class II division 2 malocclusions?

<p>Retroclination of the upper centrals, crowding of upper 2's, and increased overbite.</p> Signup and view all the answers

Why is the overbite increased in Class II division 2 malocclusion?

<p>Retroclination of incisors leads to increased inter-incisal angle and reduced vertical dimension, resulting in absence of an occlusal stop.</p> Signup and view all the answers

What does overbite cause?

<p>Lower incisors may occlude with the upper incisors or palatal mucosa, potentially causing soft tissue damage.</p> Signup and view all the answers

What are the traumatic cases that an overbite can cause?

<p>Soft tissue damage to palatal mucosa and labial gingiva of lower incisors.</p> Signup and view all the answers

What are the soft tissue factors that cause Class II division 2 malocclusion?

<p>Influence of soft tissues mediated by skeletal pattern, high resting lower lip line, and increased mentalis activity.</p> Signup and view all the answers

Why treat Class II division 2 malocclusions?

<p>Concerns regarding aesthetics and dental health like traumatic overbite and crowding.</p> Signup and view all the answers

What are the four main ways of treating Class II division 2 malocclusions?

<p>Accept, growth modification, camouflage, and orthognathic treatment.</p> Signup and view all the answers

When should the patient accept Class II division 2 malocclusions?

<p>When aesthetics are acceptable, the patient is not concerned, and overbite is not a significant problem.</p> Signup and view all the answers

Who can undergo growth modification treatment?

<p>Growing patients with a mild to moderate skeletal II pattern.</p> Signup and view all the answers

What are the steps of growth modification treatment?

<p>Proclination of upper incisors, increasing overjet, then correcting with functional appliance and fixed appliances.</p> Signup and view all the answers

What are the functional appliances used in growth modification of Class II division 2 malocclusion?

<p>Upper removable appliance (URA), Twin-block with proclining spring, and sectional fixed appliance.</p> Signup and view all the answers

How does ELSAA appliance work?

<p>It works by discluding the posterior teeth allowing lower teeth to erupt and increasing the vertical dimension.</p> Signup and view all the answers

How can camouflage be used for Class II division 2 malocclusion?

<p>By extraction of teeth or proclination to create space and improve dental relationships.</p> Signup and view all the answers

What is the stability of a Class II division 2 correction dependent upon?

<p>Overbite reduction and correction of inter-incisal angle.</p> Signup and view all the answers

Who is suitable for orthognathic treatment of Class II division 2 malocclusion?

<p>Adults with complete growth, severe skeletal A/P or V.D, and poor facial appearance.</p> Signup and view all the answers

What is the prognosis of Class II division 2 correction?

<p>Class II division 2 can be difficult to treat, with prognosis depending on facial growth and a high tendency for relapse.</p> Signup and view all the answers

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.

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