Class II Div II Flashcards
Definition of Class II Div II
- Lower incisors lie posterior to cingulum plateau of upper incisors
- Upper incisors retroclined
- OJ reduced but can be increased
- Classic flaring of upper laterals
Define skeletal class II
Mandible more than 2-3mm behind maxilla
Soft tissue features of Class II Div II
- High resting lower lip line
- Marked labiomental fold
- High masseteric forces
- Upper 2s shorter clinical crown
Dental features of Class II Div II
- Upper 2s often crowded
- Reduced arch length
- Poor cingulum on lateral incisors
- Increased OB
- Retroclined incisors
- OJ usually reduced
- Class II buccal segments
What do tx options depend on?
- Severity of malocclusion
- Age + motivation of pt
- Dental health
- Pt concerns
Why do we tx Class II Div II
- Aesthetic concern
- Dental concern
(Traumatic OB)
Tx options for Class II Div II
- Accept
- Growth modification
- Camouflage
- Orthognathic tx
When would you consider doing nothing?
No ulceration of palatal mucosa/labial gingival stripping
Pt not concerned
OB not significant problem
Indications for growth modification
Growth modification window
Boys 14+/- 2yrs
Girls 12+/- 2yrs
Mild-moderate skeletal class 2 (severe wont work)
Examples of functional appliance to proline upper incisors in Class II Div II
Modified twin block
Springs/screws
Upper sectional fixed appliance
Indication for camouflage
Outwith growth window and relatively mild - moderate class II skeletal pattern
Define camouflage
Accepting the underlying skeletal base relationship and aiming to tx the malocclusion (incisor relationship)
What do we use to camouflage the malocclusion?
Fixed appliances
Outcomes required for stable correction of Class II Div II
OB reduction
Correction of inter-incisal angle
How is the interincisal angle corrected?
Combination of
Palatal root torque upper incisors
Proclination of lower incisors
