Class II Div 2 Flashcards
what is definition of class II div 2
The lower incisor occludes posterior to the cingulum plateau of the upper incisor
The upper incisors are retroclined
The overjet is reduced but can also be increased
1) what skeletal pattern is class II div 2 usually associated with?
2) describe vertical skeletal pattern of it?
1) Usually associated with a mild or moderate Sk 2 base
- Can also be Sk 1 or Sk 3
2) Typically reduced
- Reduced FMPA
Often associated with a forward rotational pattern of growth of the mandible
Prominent chin
- “progenia”
1) describe soft tissue features of class II div 2?
High resting lower lip line
- Secondary to lower face height
- Retrocline upper incisors
Marked labio-mental fold
High masseteric forces
- Orthodontic space closure problems
Upper 2’s shorter clinical crown
- Escape the effect of the lower lip
- Trap lower lip
1) describe dental features of class 2 div 2?
1) Retroclination of the upper centrals.
Upper 2’s often crowded
- Mesio-labially rotated
- May be normal or proclined depending on their position relative to the lip line
Reduced arch length
- Exacerbates crowding
Lateral incisors
- Poor cingulum
increased overbite
Lower incisors may occlude with the upper incisors or palatal mucosa
(summary)
Retroclined upper and
lower incisors
Deep OB
OJ usually reduced
Class II buccal segments
increased inter-incisal angle
Upper laterals thin with
poorly developed
cingulum
1) why treat class 2 div 2 and dental health component number?
2) what do treatment options depend on?
3) what are ortho management options?
1) Aesthetic concerns
Dental health concerns
- Traumatic overbite
- IOTN DHC 4f
2) Severity of malocclusion
Age and motivation of patient
Dental health
Patients concerns
3) accept
growth modification
camouflage
orthognathic treatment
when is accept an option for class 2 div 2?
Acceptable aesthetics
Patient not concerned / not suitable
Overbite not a significant problem
when do you do growth modification for class 2 div 2?
Growing patient
- Adolescent growth spurt
- Boys 14 ± 2 years
- Girls 12 ± 2 years
Mild to moderate skeletal 2 pattern
Convert Class II div 2 into Class II div 1
Detail occlusion with fixed appliances
what do functional appliances do for class 2 div 2 and what types?
Proclination of upper incisors
- Modified Twin block
- Springs or screw
- Upper sectional fixed appliance
what is this?
what is this design of?
modified twin block
when to use camouflage as treatment option for class 2 div 2?
Accepting the underlying skeletal base relationship
and aiming to treat to class 1 incisor relationship
Mild to moderate Class II skeletal pattern
Careful extraction decision
- Space closure difficult in low angle cases
what does fixed appliances do in class 2 div 2?
- Stable correction of class II div 2 needs
*Overbite reduction
*Correction of inter- incisal angle (reduction) - Overbite will relapse if not corrected
how is inter-incisal angle corrected?
- Inter-incisal angle corrected by a combination of
*Palatal root torque upper incisors
*Proclination of lower incisors
when upper incisor torqueing what do you need and what is there risk of?
- Needs adequate cancellous bone palatal to upper incisors
- Risk of root resorption
when do you use orthognathic surgery for class 2 div 2?
Too severe a malocclusion for orthodontics alone *AP
*Vertical
Non growing patients
Profile concerns
