Brachyfacial Orthodontics: Van der Linden Classification Quiz and Flashcards

Study Notes

Class II, Division 2 Malocclusion

Characterized by an inverted or decreased axial inclination of upper teeth, also known as root proclined or axial protrusion
Leads to retroclined Class II, Division 2

Etiology

Eruption pattern of the upper incisors is very vertical, genetically conditioned
Characteristic morphology of the incisor with a greater corono-root angle and smaller buccopalatal width

Classification

Van der Linden (1983) classification:
- Type A: Excess of upper space, no crowding, retroclination of all 4 upper incisors
- Type B: Mild upper crowding, retroclination of the central incisors, and proclination of the lateral incisors
- Type C: Severe upper crowding, retroclination of all upper incisors, and ectopic buccal canines
Canut (1986) classification:
- Based on the skeletal class and position of the lower incisor
- Type I: Class I molar, Class I skeletal, brachyfacial pattern, retrusion of the lower incisors, and moderate-severe lower crowding
- Type II: Class II molar, Class II skeletal mandibular, normal position of lower incisors, and no lower crowding
- Type III: Class II molar, retrusion of lower incisors, skeletal class I, brachyfacial, and crowding varies in the lower arch
- Type IV: Class II molar, retroclination of upper central incisors, dolicofacial pattern, normal position of lower incisors, and no lower crowding

Definition

Defined by Angle (1907) as "When the buccal groove of the first mandibular molar occludes distal to the mesiobuccal cusp of the first maxillary molar, with retroclination of the maxillary central incisor"

History

Case 1921: "Upper apical protrusion"
Hellman 1922: "Upper dentoalveolar malocclusion"
Lundstrom 1925: "Upper apical mesialisation"
Mayrhofer: "deep bite" with increased overbite and retrusion of the upper central incisors

Cephalometric Characteristics

Skeletal class I (Swann, Hedges, Renfroe...)
Skeletal mandibular class II (Raga, Godiawala)
Skeletal maxillary class II (Logan)
Brachyfacial pattern with decreased lower facial height and goniac angle (Hellman, Renfroe, Hedges etc...)

Prevalence

3-4% of the general population
2-9% of the malocclusive population
Female predominance (3:1)

Extraoral Analysis

Frontal:
- Reduced lower third
- Increased bigonial distance
- Correct lip sealing
- Thick, hypertonic lower lip
- Marked labiomental fold
- Variable gingival smile
Lateral:
- Reduced lower third
- Convex/straight profile
- Labial retrusion varies
- Harmonious lip sealing
- Lower lip prolapse

Dental Arches Analysis

U-shaped upper arch with anterior group retrusion
Variable lower arch (U or V shape)

Description

This quiz covers the classification and etiology of Class II, Division 2 malocclusion, including the characteristics of the upper incisors and eruption patterns. Test your knowledge of orthodontic classifications and their causes.