Class II div II

Question 1

What is the best time for growth modification?

Answer 1

Adolescent growth spurt
Boys: 14 +/- 2 years
Girls: 12 +/- 2 years

Question 2

What is the BSI definition of a class II div II?

Answer 2

Lower incisal edges occlude posterior to the cingulum plateau of the upper incisors.
Upper incisors are retroclined
OJ is reduced - can also be increased

Question 3

What is the AP skeletal aetiology of a class II div II?

Answer 3

Usually associated with a mild or moderate Sk 2 base
CAN BE 1or 3 but uncommon

Question 4

What is the FMPA angle for a class II div II?

Answer 4

Reduced FMPA

Question 5

What pattern of growth rotation is associated with class II div II malocclusion?

Answer 5

FORWARD growth rotation

Question 6

What are the soft tissue characteristics of a class II div II and how do they contribute to aetiology of this malocclusion?

Answer 6

Marked labio-mental fold
HIGH lower lip line - pushes on upper incisors and retroclines them

Question 7

What can happen if short clinical crown length of lateral incisors of class II div II?

Answer 7

They can escape the retroclining effect of the lower lip, and get caught in a lip trap.

Question 8

What are the dental features of a class II div II?

Answer 8

HAVE TO HAVE - Retronclined upper and lower incisors
Deep OB
OJ USUALLY reduced
Class II molar relationship
Increased inter-incisal angle
Upper laterals thin with poorly developed cingulum

Question 9

What iotn dhc score would be common and indicative of treatment in a class II div II?

Answer 9

4f - traumatic overbite with gingival or palatal trauma

Question 10

Why would you treat a class II div II malocclusion?

Answer 10

Aesthetic concerns
Dental health concerns - traumatic over bite?

Question 11

What factors influence available treatment options?

Answer 11

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

Question 12

What can be used to reduce an OB in a URA?

Answer 12

FABP

Question 13

When would you accept a class II div II malocclusion?

Answer 13

Acceptable aesthetics
Non-traumatic OB
Patient unconcerned

Question 14

What are the criteria for growth modification in class II div II malocclusions?

Answer 14

Growing patient - patient in pubertal growth spurt
Mild to moderate Sk II

Question 15

What is the aim of growth modification in class II div II patients?

Answer 15

Convert them to class II div I - detail occlusion with fixed appliances

Question 16

What type of functional appliance would be used for a class II div II and what is the purpose of it?

Answer 16

Modified twin block - proclination of the upper incisors

Question 17

When should a class II div II patient be referred?

Answer 17

Deep OB best corrected DURING GROWTH
Orthognathic surgery/ orthodontics is significant skeletal component - AFTER GROWTH

Question 18

What will happen in a class II div II case if the inter-incisal angle is not reduced?

Answer 18

The overbite will relapse

Question 19

What are the tx options for a class II div II patient?

Answer 19

Accept
Growth modification
Camouflage - accept underlying sk bas and treat incisor relationship with orthodontics
Orthognathic surgery