Class II Div 2 Flashcards
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”
2) describe vertical skeletal pattern of it?
2)
- 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?
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?
1) Aesthetic concerns
Dental health concerns
- Traumatic overbite
- IOTN DHC 4f
2) what do treatment options depend on?
2) Severity of malocclusion
Age and motivation of patient
Dental health
Patients concerns
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?
modified twin block
what is this design of?
modified twin block
when to use camouflage as treatment option for class 2 div 2?
accept skeletal - goal make class 1 incisor
Mild to moderate Class II skeletal pattern
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
when to refer class 2 div 2?
Deep overbites best corrected when patient is growing
*Growth modification with functional appliance if AP discrepancy
*URA with FABP
Orthognathic/Orthodontics if significant skeletal component
*After growth completed
Remember link with other dental anomalies
how is stability and retention in class 2 div 2?
Difficult to treat
Future facial growth can affect stability
Rotated laterals and deep overbite can relapse
Long term bonded retention usually required
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
tx options for class II div 2
- accept - pt unconcerned, acceptable aesthetics, overbit no problem
- growth modification - growing, mild moderate skeletal 2, make div 2 to div 1
- camouflage - accepet skeletal base make class 1 incisor - mild moderate pattern
- orthognathic tx - too severe for ortho alone, non growing
