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    Add as FriendClass II malocculusion

    by: bilal

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    1 :
    2 : BILAL AHMED CLASSII MALOCCLUSION NIDA MOIN
    3 : OCCLUSION “The static contact of upper and lower teeth”
    4 : MALOCCLUSION “MALOCCLUSION IS DEFINED AS ANY DEVIATION FROM NORMAL OCCLUSION OF TEETH” THE TEETH ARE IN ABNORMAL POSITION TO BASALBONE OF THE ALVEOLAR PROCESS OR TO THE ADJACENT TEETH/OR OPPOSING TEETH
    5 : Occlusion is the end result of the interaction of three systems: DENTURE SYSTEM SKELETAL SYSTEM NEURO-MUSCULAR SYSTEM
    6 : ANGLE’S CLASSIFICATION CLASS I(NEUTROCCLUSION) CLASSII(DISTOCCLUSION) CLASSII DIVISION 1 CLASSIIDIVISION 2 CLASSIII(MESIOCCLUSION)
    7 : CLASSII “THE DISTOBUCCAL CUSP OF UPPER FIRST PERMANENT MOLAR OCCLUDES WITH THE MESIOBUCCAL GROOVE OF THE LOWER FIRST PERMANENT MOLAR”.
    8 : CLASSII DIVISION 1 “ALL THE UPPER INCISORS ARE PROCLINED”.
    9 : CLASSII DIVISION 2 “THE UPPER CENTRAL INCISORS SHOW LINGUAL INCLINATION AND THE LATERAL INCISORS OVERLAP THE CENTRAL INCISORS”.
    10 : CLASS II SUBDIVISION WHEN THE CLASS II MOLAR RELATIONSHIP IS PRESENT ON ONE SIDE ONLY AND CLASS I MOLAR RELATIONSHIP IS PRESENT ON OTHERSIDE IT IS CALLED AS CLASSIISUBDIVISION.BASED ON THE INCISOR POSITION AS IN CLASS II MALOCCLUSION IT CAN FURTHER DIVIDED INTO CLASSII SUBDIVISION,DIVISION 1 CLASSII SUBDIVISION,DIVISION2
    11 : ETIOLOGY OF MALOCCLUSION GRABERS CLASSIFICATION GRABERS DIVIDES THE CAUSES INTO TWO MAJOR FACTORS GENERAL FACTORS LOCAL FACTORS
    12 : GENERAL FACTORS HEREDITY CONGENITAL DEFECTS ENVIRONMENTAL A)PRENATAL:TRAUMA,MATERNAL DIET,MATERNAL METABOLISM,ETC B)POSTNATAL:BIRTH INJURY,CEREBRAL PALSY,TMJ INJURIES,ETC.
    13 : PREDISPOSING FACTORS ENDOCRINE IMBALANCE METABOLIC DISTURBANCE INFECTIOUS DISEASES DIETARY PROBLEM S(NUTRITIONAL DEFICIENCY) ABNORMAL PRESSURE HABITS AND FUNCTIONAL ABERRATIONS ABNORMAL SUCKLING THUMB AND FINGER SUCKING TONGUE THRUST Mouth breathing
    14 : LIP AND NAIL BITING SPEECH DEFECTS ABNORMAL SWALLOING HABITS RESPIRATORY ABNORMALITIES ADENOIDS BRUXISM POSTURE TRAUMA AND ACCIDENTS
    15 : LOCAL FACTORS ANOMALIES OF NUMBER A)SUPERNUMERARY TEETH B)MISSING TEETH ANOMALIES OF TOOTH SIZE ANOMALIES OF TOOTH SHAPE ABNORMAL LABIAL FRENUM PREMATURE LOSS OF DECIDUOUS TEETH PROLONGED RETENTATION ANKYLOSIS DENTAL CARIES
    16 : HEREDITY In a homogeneous racial groping the incidence of malocclusion is low as compared to mixture of racial groups.
    17 : Significant role in Tooth size Crowding and spacing
    18 : Palate height Soft tissue
    19 : Cleft lip and palate
    20 : Oligodontia Diastema Deep bite
    21 : Mandibular retrusion
    22 : Endocrine imbalancethyroid Hypothyroidism: Retardation of tooth eruption Narrowing of dental arches Bone formation decreases
    23 : Hyperthyroidism: Increase in elimination of phosphorus and calcium Retardation of skeletal growth Early closure of epiphyseal growth in children In adults produce osteoprosis
    24 : Parathyroid glands Parathyroid gland:regulates the level of blood calcium and phosphorus metabolism Hypoparathyroidism: Does not affect the teeth that have been previously formed Affect enamel and dentine when tooth is formed
    25 : Hyperparathyroidism: The dentin shows hypocalcification Marked resorption of alveolar bone Teeth become loose due to lack of alveolar support
    26 : Pituitary gland Hypopituitarism: Retard tooth eruption Reduce arch length Size of jaws are reduced both anteroposteriorly and vertically
    27 : Hyperpituitarism: Its hyperfunction leads to gigantism in early life and acromegaly in adult life. Accelerate tooth eruption paranasal sinuses are overdeveloped Enlargement of tongue Spacing of teeth(overgrowth of alveolar process)
    28 : Etiology of class II division 1 malocclussion A)Hereditary B)Habits C)unknown/idiopathic
    29 : Etiology of classII division 2 malocclusion Low tongue posture. High lip line.
    30 : Causes of deep bite It is a combination of: a)skeletal factor b)dental factor c)soft tissue factor
    31 : Skeletal factor Decrease lower facial height Increase ramal height Low maxillomandibular plane angle
    32 : Dental factor Increase interincisal angle Supra eruption of anterior teeth Under eruption of posteriors
    33 : Soft tissue factors High lip line Tongue posture interference with normal eruption of posterior teeth and anterior Teeth.
    34 : Features of Class II division 1 malocclusion: Extraoral: Convex profile Short upperlip Incompetent lips
    35 : Everted lowerlip Deep mentolabial sulcus Hyperactive mentalis
    36 : Intraoral Class II molar relation(disto occlussion) Class II canine relation(upper canine place forward i.e distal incline of upper canine contacts the mesial incline of lower canine) Proclination of upper anteriors
    37 : Deep bite Crowding and spacing of teeth Deep curve of spee Deep palate
    38 : Features of Class II division 2 malocclussion: Extra-oral: Straight profile Competent lips
    39 : Intra-oral: Class II molar relation classII canine relation Retrusion of upper incisors Overjet is decreased
    40 : Deep curve of spee Broad and u shape arch Sometime buccal crossbite is present
    41 : Management of classII division 1 malocclusion: Diagnosis: History Clinical examination Study models Radiographs:lateral cephalogram
    42 : Lateral cephalogram is an important diagnostic tool. The important readings in lateral cephalograms are SNA,SNB,ANB and IMPA
    43 : normal value for classII SNA 81+/- 3 increase SNB 78+/-3 decrease ANB 3+/-2 increase IMPA 90+/- 5 usually dec Inter incisalangle 125-135 IMPA=incisor mandibular plane angle
    44 : Factors influencing the treatment plan: 1)degree of antero posterior relation 2)degree of crowding of teeth 3)degree of overjet and overbite
    45 : Treatment objectives: Improvement in aesthetic Correction of overjet Correction of deepbite Alignment of anterior crowding teeth Correction of deep curve of spee
    46 : There are three basic approaches to the treatment of class II Div 1 malocclusion. 1.Growthmodification(myofunctional appliances) 2.camouflage(extraction and tooth movement) 3. Surgical correction
    47 : In deciduous dentition: Control on oral habits Thumb sucking Finger sucking Arm sucking
    48 : Adhesive Bandage Habit crib
    49 : In mixed dentition: Use of myofunctional appliances: Frankel appliance Cybernator Propulsor Bionator
    50 : Jasper jumper Stockli type activator
    51 : In maxillary prognathism: Cervical pull headgear
    52 : In case of combined maxillary prognathism and mandibular retrognathism: Activator along with headgear therapy
    53 : Combination pull Cervical pull
    54 : In late mixed dentition: Herbst appliance Bonded herbst Twin block
    55 : In permanent dentition: If there is discrepency of more than 5mm in both arches,extraction of all first premolars should be done. If discrepency is more than 5mm in only upper arch,then extraction of upper first premolars should be done.
    56 : If discrepancy of more than 5mm in upper and 2.5 to 5mm in lower then extraction of upper first and lower second premolar should be undertaken. Extractions are not indicated in spacing and proclination of upper anterior teeth. Use of removable and fixed appliance indicated
    57 : Permanent dentition in which active growth is completed: For maxillary prognathism:osteotomy of the bone corresponding to the space of first premolars following extractions is carried,through the palate.the anterior segment is then retracted and wired to posterior segment.splint should be cemented,left for 6 weeks.
    58 : Successful treatment of class II malocclusion:
    59 : When mandibular retrognathism is present Mandibular advancement surgery can be advised. For recessive chin,genioplasty is Indicated.
    60 :
    61 : Management of classII division 2 malocculusion: Types of class II division 2 malocculusion: Type A:central incisors are retroclined And laterals are proclined Type B:where centeral and lateral incisors are retroclined and canines are buccally placed. Type C:All anteriors are retroclined.
    62 : Treatment: Diagnosis: History Clinical examination Study models Radiographs
    63 : Treatment: Treatment for deciduous dentition: classII division 2 malocclusion is usually not seen in deciduous dentition.if present no need for orthodontic treatment.
    64 : In mixed dentition: Correction by bite plane therapy. By aligning the anteriors and latter putting the patient on frankel II or activator to correct class II relation. When discrepency is of 2-3mms,the case can be manage by distilization of upper first molars to gain space for alingment of anteriors.
    65 : In permanent dentition: usually extractions are not indicated. Aligning the anteriors can be manage by expansion and proximal stripping. Anteriors are aligned by combination of cantilever spring and labial bow
    66 : In severe crowding in upper arch,upper first premolars are extracted to gain space for alingment of upper anteriors. If there is crowding in both arches extraction of first/second premolars in both arches is carried out to gain space for aligning the anteriors.
    67 : Retension is also given.usually by soft tissue control..
    68 :

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