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BDS4 > Class 2 Div 1 > Flashcards

Class 2 Div 1 Flashcards

1
Q

Definition of class 2 div 1

A
  • lower incisor edge lies posterior to cingulum plateau of upper incisors
  • increased overjet
  • upper central incisors proclined or of average inclination
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2
Q

What % of malocclusion are class 1

A

67-72

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3
Q

What % of malocclusion are class 2 div 1

A

15-20

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4
Q

What % of malocclusion are class 2 div 2

A

10

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5
Q

What % of malocclusion are class 3

A

3

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6
Q

Why treat class 2 div 1?

A
  1. Aesthetics
  2. Dental health: trauma risk
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7
Q

What skeletal pattern are class 2 div 1 usually?

A

Class 2 due to retrognathic mandible- maxillary protrusion less common

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8
Q

Soft tissue features?

A
  • lips often incompetent due to prominence of incisors and/or underlying skeletal pattern
  • lower lip trap can be cause of increased overjet
  • if lip’s incompetent then special effort needed to achieve anterior oral seal
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9
Q

How to achieve anterior oral seal?

A

3 separate ways
1. Lip to lip seal by activity of circum-oral musculature- mandible postured to allow lips to meet
2. Lower lip drawn up behind upper incisors- tongue placed forwards between incisors to lower lip
3. Combination of these

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10
Q

Dental factors of class 2 div 1?

A
  • increased overjet
  • overbite varies
  • potentially good alignment, crowding or spacing
  • molar relationship
  • habitually parted lips may lead to drying of gingiva and exacerbation of any pre-existing gingivitis
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11
Q

What habit can cause class 2 div 1?

A

Sucking habit

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12
Q

Occlusal features of sucking habit?

A

Proclination of upper anteriors
Retroclination of lower anteriors
Localised AOB/ incomplete OB
Narrow upper arch +/- unilateral posterior crossbite

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13
Q

Management options of class 2 div 1

A
  1. Accept
  2. Attempt growth modification
  3. Simple tipping of teeth
  4. Canouflage
  5. Orthognathic surgery
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14
Q

What should u consider when thinking of accepting class 2 div 1

A
  • mildly increased overjet
  • significant overjet but patient not unhappy
  • will tx options be more difficult in future?
  • advice re mouthguard
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15
Q

2 ways in which u can attempt growth modification?

A
  1. Headgear- try and restrain growth of maxilla horizontally and/or vertically
  2. Functional appliance
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16
Q

How do functional appliances work?

A
  • FAs utilize, eliminate or guide forces of muscle function, tooth eruption and growth to correct malocclusion
  • mandible postured downwards and forwards
  • aim to restrain maxillary growth and promote mandibular growth
  • success depends on favourable growth and enthusiastic patient
  • used mostly for class 2 div 1, can use for 2 div 2, limited use for div 3
17
Q

Types of functional appliances?

A
  1. Removable:
    - Tooth borne e.g. twin block, activator/bionator
    - soft tissue borne- frankel
  2. Fixed- herbst
18
Q

When should functional appliances ideally be used?

A

Pubertal growth spurt
Can be used earlier - about 10 (2 phase tx)

19
Q

Potential disadvantage of early treatment with FA?

A
  • early skeletal effect from FA not maintained in long term
  • 2 phase tx, longer tx time- 1st phase early functional appliance plus retention- 2nd phase- fixed appliance in early permanent dentition
20
Q

Potential benefits of early Tx with FA

A
  • improve appearance earlier (psychological benefit)
  • reduced risk of trauma
  • better compliance
21
Q

How would u use a URA to tip teeth in class 2 div 1

A

Active: roberts retractor 0.5mm in tubing
Retention: Adams clasp 6/6 0.7mm HSSW
Anchorage: Mesial stops 3/3
Baseplate: FABP

22
Q

How can camouflage help with class 2 div 1

A
  • upper arch extraction to create space for OJ reduction
  • non extraction OJ reduction and molar correction
23
Q

Features of orthognathic surgery

A
  • when growth is complete
  • severe skeletal discrepancy in A/P and/or vertical direction
  • mostly mandibular surgery
  • fixed appliances required before, during and after surgery

BDS4 (50 decks)

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