Class II Div II

Question 1

What is BSI definition of CII div II

Answer 1

Lower incisors occlude posterior to Cingulum plateau of upper incisors

Upper incisors are retroclined

Overjet reduced but can be increased

Question 2

What soft tissues might someone with CII div II present with?

Answer 2

High resting lower lip line
Possible lip trap

Marked labial-mental fold

Question 3

How might the patients vertical dimension be in a CII div II? Why?

Answer 3

Typically reduced with reduced FMPA
- prominent chin

Forward rotational pattern of growth of mandible causing this?

Question 4

Give the main dental features of a CII div II

Answer 4

Retroclination of upper centrals,
- but laterals can procline as their high clinical crown can trap lower lip under them

50% have developmental dental abnormality, often impacted canine

Deep overbite

OJ usually reduced

Thin upper laterals with poorly developed cingulum

Question 5

What pt would be suitable for growth modification in CII div II?

Answer 5

Growing patient

Boys 14 girls 12

Mild / moderate class II d II

Question 6

What would the use of a functional appliance be for growth modification in a CII divII

Answer 6

Procline upper incisors

• modified twin block
• springs or screws
• sectional fixed appliance

Question 7

What pt would be suitable for camouflage of a CII div II?

Any considerations?

Answer 7

Mild / moderate class II SP

• pt who can be treated to get class 1 incisor relationship, and accept underlying skeletal malocclusion
• careful decision on extractions, as space closure is difficult in low FMPA angle cases

Question 8

What pt would benefit from orthognathic surgery for CII divII?

Answer 8

Where Otho isn’t suitable due to large discrepancy

Non growing patients around 18 years old

Question 9

When should i refer a CII divII?

Answer 9

IOTN 4 / 5

Orthognathic surgery indicated

Patient no longer growing