Class II div 2

Question 1

What is the BSI definition of class 2 div 2 ?

Answer 1

• The lower incisors occlude posterior to the cingulum plateau of the upper incisors , the upper incisors are retroclined with reduced or increased overjet

Question 2

With which skeletal class is class 2 div 2 associated?

Answer 2

Usually with class 2 (mild or moderate)
Can also be Sk1 or Sk3

Question 3

Describe the vertical skeletal pattern associated with class 2 div 2?

Answer 3

• Reduced FMPA
• prominent chin
• forward rotational pattern of growth of the mandible

Question 4

3 soft tissue features associated with class 2 div 2?

Answer 4

• High resting lower lip
• Marked labio-mental fold
• High masseteric forces

Question 5

The high resting lower lip line is secondary to________?

Answer 5

Reduced lower face height

Question 6

High resting lower lip line in class 2 div 2 leads to ____?

Answer 6

Retroclination of upper incisors, but sometimes upper 2s escape this effect leading to a lower lip trap of the 2s

Question 7

What problems might be associated with increased masseteric forces in class 2 div 2?

Answer 7

Orthodontic space closure problems

Question 8

5 dental features of class 2 div 2?

Answer 8

• Retroclination of upper central incisors and lower incisors
• Deep overbite
• Usually reduced OJ
• Class II buccal segments
• Increased interincisal angle
• Thin upper laterals with poorly developed cingulum

Question 9

Describe how would the upper lateral incisors appear in class 2 div 2?

Answer 9

• Often crowded as mesio-labially rotated
• Poor cingulum and thin
• may be normal or proclined depending on their position relative to the lower lip

Question 10

2 developmental dental anomalies associated with class 2 div 2?

Answer 10

• Impacted canines
• Lateral incisor microdontia

Question 11

2 ways the lower incisors can occlude in class 2 div 2?

Answer 11

• with upper incisors or palatal mucosa

Question 12

IOTN of class 2 div 2 with a traumatic overbite?

Answer 12

4f

Question 13

Why would you treat class 2 div 2?

Answer 13

• Aesthetics
• Dental health - traumatic overbite

Question 14

What do ortho treatment options depend on ?

Answer 14

• Severity of malocclusion
• Age and motivation of patient
• Dental health
• Patient concerns

Question 15

4 treatment options for class 2 div 2?

Answer 15

• Accept
• Growth modification
• Camouflage
• Orthognathic surgery

Question 16

3 reasons why you would accept a class 2 div 2 malocclusion?

Answer 16

• Acceptable aesthetics
• Patient not concerned
• Overbite is not a significant problem

Question 17

In boys when is it suitable to attempt growth modification?

Answer 17

Age of 14 ±2

Question 18

In girl when is it suitable to attempt growth modification?

Answer 18

Age of 12±2

Question 19

2 indications of growth modification in Class II div 2 malocclusion?

Answer 19

• Growing patient
• Mild to moderate skeletal 2 pattern

Question 20

What would growth modification achieve in class 2 div 2 ?

Answer 20

• Convert class 2 div 2 into class 2 div 1 by proclination of upper incisors

Question 21

3 functional appliances that can be used for growth modification of class 2 div 2?

Answer 21

• Modified Twin block
• Springs or screws
• Upper sectional appliances

Question 22

Indications for camouflaging class 2 div 2

Answer 22

• Mild to moderate class 2 skeletal pattern
• Needs extractions
• Accepting the underlying skeletal base and aiming for class 1 incisor relationship

Question 23

To correct class 2 div 2 using functional appliances , What do you need to achieve?

Answer 23

• Reduction of overbite
• Reduction of inter-incisal angle

Question 24

What movements of functional appliance would correct the inter-incisal angle in class 2 div 2?

Answer 24

• Palatal root torque of upper incisors
• Proclination of lower incisors

Question 25

What would be the main risk in torquing upper incisors?

Answer 25

• Risk of root resorption , that is why you need adequate cancellous bone palatal to the upper incisors

Question 26

When would render to orthognathic surgery to correct class 2 div 2?

Answer 26

• Severe skeletal relationship in vertical or AP direction
• Non growing patients
• Profile concerns

Question 27

Which two features are more likely to relapse?

Answer 27

• rotated laterals
• Deep overbite

Question 28

2 ways to correct an overbite?

Answer 28

• Growth modification with functional appliance ( if AP descrepency)
• URA with FABP