Ortho Lec 2 Outline by Falcasantos, Kriszia Carro D.

CLASSIFICATIONS OF MALOCCLUSION - Space available for the tongue is usually more. Thus, the
tongue occupies a lower position resulting in a narrow upper
Angle’s Classification of Malocclusion (1899) arch
- based on the mesio-distal relation of the teeth, dental arches Pseudo Class III
and the jaw - Produced by a forward movement of the mandible during
- According to Angle, the maxillary first molar is the key to jaw closure
occlusion. He considers these teeth as fixed anatomical - Called ‘postural’ or ‘habitual’ class III malocclusion
points within the jaw. - CAUSES:
- Angle classified malocclusions into three main classes based a. Presence of occlusal prematurity may deflect the
on the relation of the lower first permanent molar to the mandible forward
upper first permanent molar b. In case of premature loss of deciduous posteriors, the
child tends to move the mandible forward to establish
contact in the anterior region
c. A child with enlarged adenoids tends to move the
mandible forward in an attempt to prevent the tongue
from contacting the adenoids

Class III, Subdivision

- Characterized by a Class III molar relation on one side and a
CLASS I Class I relation on the other side
- characterized by the presence of
normal inter-arch molar relation MODIFICATIONS TO ANGLE’S CLASSIFICATION OF MALOCCLUSION
- the mesio-buccal cusp of the maxillary
first permanent molar occludes in the Dewey’s Modifications
buccal groove of mandibular first permanent molar - He divided Angle’s Class I into five types and Class III into
- patient exhibits dental irregularities such as crowding, three types
spacing, rotations and missing tooth
- patient also exhibit normal skeletal function and show Class I
normal muscle function 1. Type 1 – Class I with bunched or crowded anterior teeth
- Bimaxillary protrusion 2. Type 2 – Class I with protrusive maxillary incisors
3. Type 3 – Class I with anterior crossbite
CLASS II, Division 1 4. Type 4 – Class I molar relation with posterior crossbite
- referred as the ‘lip trap’ 5. Type 5 – permanent molar has drifted mesially due to early
- characterized by proclined upper extraction of second deciduous molar or second premolar
incisors with a resultant increase in overjet with presence of
abnormal muscle activity Class III
- V-shape arch 1. Type 1 – the upper & lower arches when viewed separately
- associated with lowered tongue posture are in normal alignment. But when the arches are made to
and therefore unrestricted buccal muscle occlude shows an edge-to-edge incisor alignment,
activity causing constriction of the upper suggestive of a forwardly moved mandibular dental arch
arch 2. Type 2 – the mandibular incisors are crowded and are in
lingual relation to the maxillary incisors
CLASS II, Division 2 3. Type 3 – the maxillary incisors are crowded and are in
- has presence of lingually inclined crossbite in relation to the mandibular anteriors
upper central incisors and labially
tipped upper lateral incisors Lischer’s Modifications
overlapping the central incisors Lischer substituted the Angle’s Class I, II and III with the terms:
- Patient exhibits a deep anterior overbite and a normal
a. Neutrocclusion – synonymous with Angle’s Class I malocclusion
perioral muscle
b. Distocclusion – synonymous with Angle’s Class II malocclusion
- Squarish arch shape c. Mesiocclusion – synonymous with Angle’s Class III malocclusion
d. Buccocclusion – buccal placement of a tooth or a group of teeth
e. Linguocclusion – lingual placement of a tooth or a group of teeth
f. Supraocclusion –tooth/group teeth erupted beyond normal level
g. Infraocclusion – tooth/group teeth not erupted to normal level
h. Mesioversion – mesial to the normal position
i. Distoversion – distal to the normal position
j. Transversion – transposition of two teeth
k. Axiversion – abnormal axial inclination of a tooth
l. Torsiversion – rotation of a tooth around its long axis

CANINE CLASSIFICATION

CLASS II, Subdivision

- When a Class II molar relation exist on one side and a Class I
relation on the other

CLASS III
True Class III Simon’s Classification
- mesio-buccal cusp of the maxillary first permanent molar - Simon had put forward a craniometric classification of
occluding in the interdental space between the mandibular malocclusion that related the dental arches in all these three
first and second molars planes.
- Occurs due to the following causes: - His classification of malocclusion was based on abnormal
a. Excessively large mandible deviations of the dental arches from their normal position in
b. Forwardly placed mandible relation to these three planes:
c. Smaller than normal maxilla 1. Frankfort Horizontal Plane
d. Retropositioned maxilla 2. Orbital Plane
e. Combination of the above causes 3. Mid-sagittal Plane
- Patient present with a normal overjet
- Edge to edge incisor relation Frankfort Horizontal Plane
- Anterior crossbite - This plane connects the upper margin
of the external auditory meatus to the
 Ortho Lec 2 Outline by Falcasantos, Kriszia Carro D.

infra-orbital margin. It is used to classify malocclusions in a Step 5: Bite depth – malocclusions in the vertical plane are noted.
vertical plane. They are described as anterior or posterior open bite, anterior
- When the dental arch or a part of it is closer than the normal deep bite or posterior collapsed bite. A mention is made whether
to the Frankfort plane, it is called attraction the malocclusion is skeletal or dental.
- When the dental arch or a part of it is farther away from the
Frankfort plane, it is called abstraction

Orbital Plane
- This plane is used to describe malocclusion
in a sagittal or antero-posterior direction
- When the dental arch or a part of it is
farther from the orbital plane, it is called
protraction
- When the arch or a part of it is closer or more posteriorly
placed in relation to this plane, it is called retraction

Mid-sagittal Plane
- This plane is used to describe malocclusion in
a transverse direction
- When a part or whole of the arch is away
from the mid-sagittal plane, it is called
distraction
- When the arch or part of it is closer to the
mid-sagittal plane, it is called contraction

Bennet’s Classification
Norman Bennet classified malocclusion based on its etiology
- Class I – abnormal position of one or more teeth due to local
causes
- Class II – abnormal formation of a part of or a whole of either
arch due to developmental defects of the bone
- Class III – abnormal relationship between upper and lower
arches, and between either arch and facial contour and
correlated abnormal formation of either arch

Ackerman-Proffit System
Ackerman and Proffit proposed a diagrammatic classification of
malocclusion in 1960 which overcome the limitations of the
Angle’s classification
- Transverse as well as vertical
discrepancies can be
considered in addition to
antero-posterior
malrelations
- Crowding and arch
asymmetry can be evaluated
- Incisor protrusion is taken
into account

This system identifies five major characteristics to be considered

and described in the classification.
Step 1: Alignment – involves assessment of the alignment and
symmetry of the dental arch. It is classified as ideal, crowded,
spaced.

Step 2: Profile – involves consideration of profile. It is described

as convex, straight, concave. The facial divergence is also
considered anterior or posterior divergence.

Step 3: Type – the transverse skeletal and dental relationship is

evaluated. The buccal and palatal crossbites if any are noted. The
crossbite is further sub-classified as unilateral or bilateral.
Differentiation is made between skeletal and dental crossbite.

Step 4: Class – involves assessment of the sagittal relationship. It

is classified as Angle’s Class I/ II/ III malocclusion. Differentiation
is made between skeletal and dental malocclusion.