12/5/2020

OUTLINE
What is a classification system?
CLASSIFICATION AND Purposes of classifying
TERMINOLOGY OF MALOCCLUSION
Systems of classification and terminology
Dr. Fe Jozemar Rigor-Salazar The Class I syndrome
The Class II syndrome
The Class III syndrome
Limitations of classification systems

WHAT IS A CLASSIFICATION
PURPOSES OF CLASSIFYING
SYSTEM?
A grouping of clinical cases of similar Traditional purposes
appearance for ease in handling and Ease of reference
discussion
Aids comparison
Not a system of diagnosis, method for
determining prognosis, or a way of defining Self communication
treatment.  Identify problems of which we must be wary
 Recalling past difficulties with similar cases
 Alerting ourselves to possible strategies and
appliances that may be needed in treatment

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
2 widely use system: Angle’s system
Angle system Simon system
Simon system Naming malpositions of individual teeth and
group of teeth
Etiologic classification: its effect on diagnosis
Ackermann-profit system

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
Angle’s system Angle’s system
Based in the anteroposterior relationships of Most traditional, most practical, most
the jaws with each other popular in use at present

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
Angle’s system Angle’s system
 Theory: the maxillary first permanent molar Class I
invariably was in correct position  AKA neutrocclusion
 Emphasis on the relationship of the first  Normal anteroposterior relationship between the
permanent molars ignores the facial skeleton maxilla and the mandible
itself  malfunction of muscles and problems
of growth of bones often were overlooked

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Angle’s system  Angle’s system
 Class I  Class I
 The triangular ridge of the mesiobuccal cusp of the  Bony base supporting the mandibular dentition is
maxillary first permanent molar articulates in the buccal directly beneath that of the maxillary, not too far
groove of the mandibular first permanent molar anterior or posterior in relation to the cranium

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Angle’s system  Angle’s system
 Class II  Class II
 AKA distocclusion  "distal" relationship of mandible to maxilla  Mesial groove of the mandibular first permanent molar articulates
 "distal" positioning of the mandible to the maxilla posteriorly to the mesiobuccal cusp of the maxillary first
 Maxilla is prognathic permanent molar

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
Angle’s system  Angle’s system
Class II  Class II
 Division I  Distoclusion in which the maxillary  Division II  maxillary
central incisors are near
incisors are typically in extreme labioversion normal anteroposteriorly
or slightly in
linguoversion, whereas
the maxillary lateral
incisors have tipped
labially and mesially

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Angle’s system  Angle’s system
 Class II  Class III
 Subdivisions  when the distoclusion occurs on one side  Mesiocclusion  mesial relationship of mandible to maxilla
of the dental arch only, the unilaterality is referred to as  Mesial groove of the mandibular first permanent molar articulates
anteriorly to the mesiobuccal cusp of the maxillary first
a subdivision of its division. permanent molar

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Martin Dewey’s modification of Angle’s I  Martin Dewey’s modification of Angle’s I
malocclusion malocclusion
 Type I – crowded anterior teeth  Type II – protrusive maxillary incisors

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Martin Dewey’s modification of Angle’s I  Martin Dewey’s modification of Angle’s I
malocclusion malocclusion
 Type III – anterior crossbite  Type I – posterior crossbite

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Martin Dewey’s modification of Angle’s I  Martin Dewey’s modification of Angle’s I
malocclusion malocclusion
 Type V – mesial drifting of permanent molar  Type V – mesial drifting of permanent molar

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Martin Dewey’s modification of Angle’s III  Martin Dewey’s modification of Angle’s III
malocclusion malocclusion
 Type I – Viewed separately, arches are normal. In  Type 2 – Crowding and lingual relation of mandibular
occlusion – edge to edge incisor alignment suggestive of incisors to maxillary incisors.
forwardly moved mandibular arch.

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Martin Dewey’s modification of Angle’s III  Simon system
malocclusion  Related the dental
 Type 3 – Crowding and cross bite relation of maxillary arches to three
incisors to mandibular incisors. anthropologic planes
based on
craniallandmarks
 Frankfurt
 Orbital
 Midsagittal

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Simon system  Simon system
 Principal contribution:  Anteroposterior relationships (orbital plane)
emphasis on the  Protraction  When the dental arch, or part of it, is
orientation of the more anteriorly placed than normal with respect to the
dental arches to the orbital plane
facial skeleton  Retraction  When the dental arch, or part of it, is more
anteriorly placed than normal with respect to the orbital
 Separates problems in plane
malpositions of teeth
from osseous dysplasia

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Simon system  Simon system
 Mediolateral relationships (midsagittal plane)  Vertical relationships (Frankfurt plane)
 Contraction  when the dental arch, or part of it, is  Attraction
nearer to the midsagittal plane than the normal position  When the dental arch, or part of it, is nearer to the
 Distraction  when the dental arch, or part of it, is Frankfurt plane than the normal position
farther away from the midsagittal plane than the normal  Intrusion of maxillary teeth
position  Extrusion of mandibular teeth
 Abstraction  When the dental arch, or part of it, is farther
away from the Frankfurt plane than the normal position

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Naming malpositions of individual teeth  Naming malpositions of individual teeth
 Lischer’s nomenclature  Mesioversion  mesial to the normal position.
 Involves adding the suffix "-version" to a word to
indicate the direction from the normal position

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Naming malpositions of individual teeth  Naming malpositions of individual teeth
 Distoversion  distal to the normal position  Linguoversion  lingual to the normal position

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Naming malpositions of individual teeth  Naming malpositions of individual teeth
 Labioversion or buccoversion  toward the lip or  Infraversion  away from the line of occlusion
cheek.

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Naming malpositions of individual teeth  Naming malpositions of individual teeth
 Supraversion  extended past the line of occlusion  Axiversion  tipped; the wrong axial inclination
(below in the maxilla and above in the mandible.)

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Naming malpositions of individual teeth  Naming malpositions of individual teeth
 Torsiversion  rotated on its long axis  Transversion (transposition)  wrong order in the
arch

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Naming vertical variations of groups of teeth  Naming vertical variations of groups of teeth
 Deep overbite  Open bite
 Excessive vertical overlap of the incisors  soft tissue of  Localized absence of occlusion while the remaining
the palate is impinged or the health of the supporting teeth are in occlusion
structures is endangered  Seen most frequently in the anterior part of the mouth
 posterior open bites are also encountered

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Naming transverse variations of groups of teeth  Naming transverse variations of groups of teeth
 Crossbite  Crossbite
 Indicate an abnormal buccolingual (Iabiolingual)  Lingual crossbite  when one or more maxillary teeth
relationship of the teeth are in crossbite toward the midline
 Most commo:buccal cusps of some of the maxillary  Buccal crossbite  when the lingual cusps of upper
posterior teeth occlude lingually to the buccal cusps of the posterior teeth occlude completely buccally of the buccal
lower teeth. cusps of the lower teeth,

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
Etiologic classification: its effect on diagnosis Etiologic classification: its effect on diagnosis
 Several primary tissue sites in which  Osseous
orthodontic problems may originate   Includes problems in abnormal growth, size, shape, or
osseous, muscular and dental proportion of any of the bones of the craniofacial
complex.
 When any bone of the face develops in a perverted,
delayed, advanced, or otherwise asynchronous manner,
the aberration may be reflected in an orthodontic
problem

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
Etiologic classification: its effect on diagnosis Etiologic classification: its effect on diagnosis
 Osseous  Muscular
 Ex:  Any persistent alteration in the normal synchrony of the
 Class III cases may be due to mandibular hypertrophy mandibular movements or muscle contra.ctions may
 Class II cases may be due to mandibular inadequacy. result in distorted growth of the facial bones or
abnormal positions of teeth.

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
Etiologic classification: its effect on diagnosis Etiologic classification: its effect on diagnosis
 Muscular  Muscular
 Includes:  Ex:
 Functional "slides into occlusion" due to occlusal  Lip-sucking habit may give rise to a Class II dentiton and
int~rferences . profile
 Detrimental sucking habits (e,g., thumb, finger, lip)  Thumb-sucking  contraction of the maxillary arch 
 Abnormal patterns of mandibular closure. mandibular retraction
 Incompetent normal reflexes (e.g., lip posture)
 Abnormal muscular contractions (e.g., tongue-thrusting
during swallowing, mouth breathing, etc).

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
Etiologic classification: its effect on diagnosis Etiologic classification: its effect on diagnosis
 Dental  Dental
 Teeth and their supporting structures.  Teeth and their supporting structures.
 Includes:  Treatment is aimed at:
 Malpositions of teeth  Moving the teeth to their normal positions
 Abnormal numbers of teeth  Replacing lost teeth
 Abnormal size of teeth  Ffitting the dentition's abnormalities to the facial skeleton
 Abnormal conformation or texture of teeth and its musculature

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Ackerman-Proffit System  Ackerman-Proffit System
 Scheme which  Step 1: alignment
embodies the Angle  Involves assessment of
classification and five the alignment and
characteristics of symmetry of the dental
malocclusion within a arch when seen in the
occlusal view
Venn diagram
 Ideal/crowded/spaced

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Ackerman-Proffit System  Ackerman-Proffit System
 Step 2: profile and facial  Step 3: type
divergence  The transverse skeletal
 Convex, straight, concave and dental relationship is
 Anterior or posterior evaluated
divergence  Crossbites
 Unilateral or bilateral
 Skeletal or dental

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Ackerman-Proffit System  Ackerman-Proffit System
 Step 4: class  Step 5: bite depth
 Assessment of the  Malocclusons in the
sagittal relationship vertical plane are noted
 Classified as Angle’s Class  Described as :
I, II, III  Anterior or posterior
 Differentiation is made crossbite
between skeletal and  Deep bite
dental malocclusions  Posterior collapsed bite
 Skeletal or dental

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Ackerman-Proffit System  Ackerman-Proffit System
 Advantages:
 Teaches a perspective about  Advantages:
the complexities of  Leads one to the
malocclusion.
 All three planes of space and diagnosis and to
the influence of the differential treatment
dentition on profile are
considered. planning
 Differentiation between
skeletal and dental problems
is made at the appropriate
level
 Arch length problems with
or without an influence on
the profile are recognized

CLASS I SYNDROME CLASS II SYNDROME

Characterized by a normal molar and skeletal Most frequently encountered severe
relationship. malocclusion.
Skeletal profile: straight Malrelationship may be due to a basic osseous
Problem usually is dental in origin dysplasia or to forward movement of the
 Large teeth maxillary dental arch and alveolar processes or
 Open bite
a combination of skeletal and dental factors
 Deep bite

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LIMITATIONS OF
CLASS III SYNDROME CLASSIFICATION SYSTEMS
 Deep-seated skeletal dysplasia None are truly inclusive
 Most classification schemes omit entire regions
which are now known to be an indigenous and
integral part of the malocclusion
 Most omit dimensions
 Most omit entire syndromes or malocclusion
types

LIMITATIONS OF LIMITATIONS OF
CLASSIFICATION SYSTEMS CLASSIFICATION SYSTEMS
All are static in concept. Most are narrow in focus and perspective
 Malocclusions adapt and change through time, yet  Difficult to fit new findings or ideas into a
most classification schemes do not encourage us classification scheme or framework.
to think in terms of such changes.  Simplicity of the classification leads to emphasis
on one aspect of the total malocclusion
syndrome
 There is a tradition of misuse and
misapplication

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