Tx Class II Malocclusion

Question 1

Definition class II incisors?

Answer 1

Lower incisor tip occludes behind cingulum plateau of upper incisor
Div I - upper incisors normal or proclined
Div II- upper incisors retroclined

Question 2

What do you tend to see with class II div I?

Answer 2

Generally see increased overjet

Question 3

What is limitation for tx of class II cases?

Answer 3

Skeletal pattern

Question 4

Tx options for class II div I?

Answer 4

1. Accept mild overjet- pt appearance may be acceptable
2. Removable appliance - used less
3. Fixed appliance - can’t correct skeletal discrepancies
4. Functional appliance
5. Orthoganathic surgery - only severe class II in non-growing pt

FOR FA

Question 5

Difference tx in growing vs non-growing pt?

Answer 5

Growing - functional appliance and orthodontic camouflage

Non-growing - orthodontic camouflage/ surgery if severe

Question 6

Best tx for overjet?

Answer 6

SAW - poor at reducing

Functional appliance - excellent reducing

Question 7

Tx moderate- severe class II?

Answer 7

1. Change skeletal pattern
2. Functional appliance - if growing
3. Surgery -non-growing

Question 8

Tx mild class II?

Answer 8

1. Accept
2. Removable appliance
3. Fixed appliance

Question 9

How can orthodontic camouflage be undertaken?

Answer 9

Use anchorage - control unwanted tooth movement
Need careful planning
Loss anchorage - lack of occlusion in buccal segment/ residual overjet

Question 10

Tx if no lower arch crowding and class I molars?

Answer 10

Non-extraction

Anchorage reinforcement

Question 11

Tx if no lower arch crowding but 1/2 class II molars

Answer 11

Distal movement of buccal segments

Consider upper extractions (premolars)

Question 12

Tx if no lower arch crowding but class II molars

Answer 12

Upper premolar XLA

Question 13

Tx if lower arch crowding and class I molars?

Answer 13

Upper and lower XLA

Question 14

Tx if lower arch crowding and 1/2 unit class II molars

Answer 14

Upper and lower XLA - correct molar relationship –> allow lower molars to drift forwards

Question 15

Tx if lower arch crowding and class II molars

Answer 15

Difficult case - avoid in general practice

If growing can use functional appliance

Question 16

Tx of class II div II?

Answer 16

Have increased overbite and retroclination of incisors
Convert to class II div I then tx as class II div I