Treatment of Class II Malocclusion Flashcards
Aetiology
- There is usually some degree of antero-posterior skeletal discrepancy (i.e. a class
II skeletal pattern)
- This will be the main limiting factor in successful treatment.
- In addition, there can be local/dental factors superimposed on the skeletal
discrepancy which also need to be planned for.
Tx options for class II
Accept a mild overjet - the patient’s appearance may well be quite acceptable.
Removable appliances – used far less nowadays.
Fixed appliances – cannot correct a skeletal discrepancy.
Functional appliances – either on their own or before fixed appliances.
Orthognathic surgery – for a severe Class II in a non-growing patient
Main limiting factor
Skeletal pattern
Assess face
Plan for local and dental factors
Class II Div 1 - growing patient - tx plan
Functional appliance
Orthodontic camouflage
Class II Div I - non-growing patient - tx plan
Orthodontic camouflage
Changing dental position without adapting skeletal pattern
Straight wire poor at reducing overjet
Functional appliance is excellent at reducing overjets
Activators
Used for
Deep overbite
Twin blocks
Anchorage
Planning considerations
Controls unwanted tooth movement loss of anchorage will result in lack of occlusion in buccal segments and residual overjet in a class II case
Lower arch crowding
molar and canine relationship
Mild class II - Ortho camouflage indications
for lower and upper crowding
No lower crowding
- class I molar
- 1/2 unit class II molars
- full unit class II molars
Lower crowding
- class I molars
- 1/2 unit class II
- full unit class II
No lower crowding - class I molars
Upper teeth displaced forward
- non extraction and anchorage reinforcement
head gear - worn for 12-14hrs a day
palatal arches
implants
class II elastics - runs from front to back
No lower crowding - half class II molars
Non-extraction distal movement with HEADGEAR
extraction upper 7s distal movement
extraction upper premolars –> full unit class II
distal movement of upper buccal segments
well aligned lower arch
compliant patient
Non-compliance appliance
Pendulum appliance
No lower crowding - full unit
extract UPPER premolar and use 6 as anchorage to move incisors back
Lower crowding - class I molars
Upper and lower extractions will be required
usually premolars
Lower crowding - half unit class II molars
Extract LOWER 5 AND UPPER 4/UPPER AND LOWER 4
Space for lower molar to move forward
