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BDS4 Ortho > Class II Div 2 > Flashcards

Class II Div 2 Flashcards

1
Q

What is the definition of Class II div 2 malocclusion?

A
  • Edge of Lower incisor occludes posterior to the cingulum plateau of the upper inicisor
  • Upper incisors are retroclined
  • Overjet is reduced and can also be increased
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2
Q

What is the incidence of Class II div2 malocclusion?

A
  • 5-18%
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3
Q

What AP skeletal pattern is Class II div 2 usually associated with?

A
  • Mild or mod sk 2 base
  • Can also be sk 1 or sk3
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4
Q

What is the typical vertical skeletal pattern of Class II div 2 malocclusion? What pattern of growth is it associated with?

A
  • Typically reduced (reduced FMPA)
  • Often associated with forward rotational pattern of growth of mandible
  • Gives prominent chin (Progenia)
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5
Q

What soft tissue associations are there for Class II div 2 malocclusion?

A
  • High resting lower lip line which is secondary to decreased lower face height and gives Retroclination of upper incisors
  • Marked labio-mental fold
  • High masseteric forces (give orthodontic space closure problems)
  • Upper 2’s have shorter clinical crown which escape the effect of the lower lip and trap lower lip
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6
Q

What are the 6 dental features of Class II div 2 malocclusion?

A
  • Retroclined upper and
    lower incisors
  • Deep OB (can be traumatic or non traumatic)
  • OJ usually reduced
  • Class II buccal segments
  • Increased inter-incisal angle
  • Upper laterals thin with
    poorly developed
    cingulum
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7
Q

What is the percentage of Class ii div 2 malocclusion that have a dental anomaly?

A
  • Approx 50% have congenital dental anomaly
  • 33% with impacted canine
  • 55% >1 developmental dental anomaly with 20% impacted canine and 15% lateral incisor microdontia
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8
Q

Why treat a Class II div 2 malocclusion?

A
  • Aesthetic concerns
  • Dental health concerns (Traumatic OB with IOTN DHC 4f)
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9
Q

What 4 factors does txt options depend on?

A
  • Severity of malocclusion
  • Age and motivation of pt
  • Dental health
  • Pts concerns
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10
Q

What are the 4 options of txt for Class II div 2 malocclusion?

A
  • Accept and monitor
  • Growth modification
  • Camouflage
  • Orthognathic txt
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11
Q

When would you chose to Accept the Class II div 2 malocclusion?

A
  • Acceptable aesthetics
  • Patient not concerned
    / not suitable
  • Overbite not a
    significant problem
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12
Q

When would you choose the Growth modification txt option for Class II div 2?

A
  • Growing pt during their adolescent growth spurt i.e. Boy 14+-2yrs and Girl 12+-2 years
  • Mild to mod Sk 2 pattern
  • Convert Class II div 2 into Class II div 1
  • Detail occlusion with fixed appliance
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13
Q

What functional appliance can you use for procline the upper incisors?

A
  • Modified Twin block
  • Springs or screw
  • Upper sectional fixed appliance
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14
Q

What do we mean when attempting to camouflage a Class ii div 2?

A
  • Accept underlying skeletal base relationship
  • Aim to treat to class 1 incisor relationship
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15
Q

When can we opt for camouflage for Class II div 2 ?

A
  • Mild to mod Class II skeletal pattern
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16
Q

When choosing to camouflage a Class II div 2 you have to be careful when extracting teeth why?

A
  • Space closure is difficult in low angle cases
  • May never close the gap
17
Q

In order to get a stable correction of Class ii div 2 what do you need to correct ?

A
  • Overbite reduction (will relapse if not corrected)
  • Correction of inter-incisal angle (reduction)
18
Q

How is a inter-incisal angle corrected?

A
  • Palatal root torque upper incisors
  • Proclination of lower incisors
19
Q

What is a risk of Upper incisor torqueing and what do you need to do it correctly?

A
  • Needs adequate cancellous bone palatal to upper incisors
  • Risk of root resorption
20
Q

When would you opt for orthognathic surgery in Class II div 2 maloclussion?

A
  • When AP or Vertical sk pattern is too sever a malocclusion for orthodontics alone
  • Non growing pts
  • Profile concerns
21
Q

What two things are the most likely things to relapse after txt?

A
  • Rotated lateral
  • Deep overbite
  • Long term retention usually required
22
Q

When is a deep overbite best to correct?

A
  • When pt still growing
  • Use growth mod with functional appliance if AP discrepancy
  • URA with FABP
23
Q
A

BDS4 Ortho (9 decks)

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