Ortho- Class II Div 1 Treatment. Flashcards
Define Class II div1 incisor relationship
Lower incisor edges are located posterior to the cingulum of UI
Increased overjet
Upper central incisors are proclined or average angulation.
How does class II div 1 incisor relationship affect a patient’s dental health?
Patient is at risk of trauma.
Overjet >9mm 2x more likely to suffer from trauma.
Discuss the skeletal pattern associated with class II div 1 incisors?
Normally class II skeletal base. More likely retrognathic mandible (instead of maxillary protrusion)
Sometimes class I.
What can cause an overjet?
Tooth inclination
Skeletal pattern.
Combination.
Discuss the soft tissues normally associated with class II div 1 incsior relationship?
Patient normally has an incompetent lip due to incisor proclination or underlying skeletal pattern
How does a patient with incompetent lips achieve an anterior oral seal.
Mentalis muscle overactivity and protrusion of the maxilla. or
Lower lip drawn behind upper incisors and tongue placed forward between incisors to the lower lip.
List some dental factors assoicated with class II div 1 incisor relationship?
Overjet
Varied overbite
How can habitally parted lips affect the gingviae?
Gingivae are exposed to air so can dry up.
This also exacerbates any pre-existing gingivitis.
At what age would we be concerned about a patient’s sucking habits?
Age 9
How can we treat sucking habits?
Reinforcement
Removable habit breaker
Fixed habit breaker
List the treatment options for a Class II div 1 incisor relationship.
Accept
Growth modification Tipping teeth
Camoflauge
Orthognathic surgery.
What should be highlighted to any patients selecting to accept their class II div 1 relationship?
Treatment may be more difficult to complete in the future
What is growth modification?
This is trying to change the underlying skeletal base using functional appliances with the force of muscles correcting the malocclusion.
Maxillary growth is restrained and mandibular growth is encouraged.
Explain the dento-alveolar effects of growth modulation?
Distal movement of upper dentiton Mesial movement of lower dentition.
Upper incisors are retroclined.
Lower incisors are proclined.
List some growth modification options
Headgear (uncommon)
Removable appliance (Twin block)
Fixed appliance (Herbst)