Orthodontic class 2 div 2

CLASS II
ANGLE’S CLASS II The distobuccal cusp of the upper 1st
permanent molar occludes in the buccal groove of the
lower 1st permanent molar.

CLASS II INCISOR RELATIONSHIP

The lower incisal edges lie posterior to the cingulum
plateaux of the upper incisors.
DIVISION 2 – The upper central incisors are

retroclined ; the overjet is minimal but may be
increased.

CLASS II, DIVISION 2 MALOCCLUSIONS
1) Occurs in about 10% of children.

2) In milder forms they may be

acceptable functionally, and the
facial appearance can be pleasing.

3) In severe cases the over bite is very deep, associated with
periodontal trauma palatal to upper, and labial to the
lower incisors.
4) Class II, Div. 2 incisor relationship is generally the result
of dento-alveolar compensation for a class II skeletal
pattern by retroclination of the upper central incisors.

FEATURES
1)

Molars in disto-occlusion.

2)

The classic feature of the upper incisors.

3)

Deep overbite.

4)

Pleasing straight profile.

5)

Broad square face.

6)

Backward path of closure.

7)

Deep mento-labial sulcus.

8)

Absence of abnormal muscle activity.

SKELETAL RELATIONSHIPS
1)

The skeletal pattern may be Class I, but is
generally mild Class II, and the chin is well
developed so that the facial profile is good.

2)

The lower anterior face height is often smaller
than average and characteristically the
maxillary-mandibular planes angle is low, with a
well-developed mandibular angle

FACIAL GROWTH

In many class II, Div.2 patients, facial growth is
favourable, and there is an anterior mandibular
rotation, as might be expected from the
diminished anterior face height and the form of
the chin.

SOFT TISSUES
1)

The lips are almost always of adequate length to
meet without strain.

2)

Frequently the lip line is high relative to the
upper incisor crown, and the higher the lip line
the more retroclined the upper incisors are liable
to be.
There is often a well-developed
labiomental fold.

MANAGEMENT OF CLASS II DIV 2
Three important factors to consider in the management are :
1. Nature of malocclusion.
1.Skeletal.
2.Dentoalveolar.
3.Functional.
4.Combination.
2. Severity of malocclusion.
1.Mild.
2.Moderate.
3.Severe
3. Age.
1.Growth left.
2.After growth

MANAGEMENT OF CLASS II DIV 2
Mandible is usually guided posteriorly due to

premature contact from the retroclined incisors and
thereby restricting its growth.
The treatment sequence remains the same except that
for any form of treatment modality to be instituted
the retroclined teeth have to be aligned in a proper

labiolingual direction.

1. Mixed dentition phase – Use of functional

appliances

after

proclining

the

maxillary

anteriors.
Results are good even after the eruption of
permanent teeth. The maxillary first premolars
are extracted generally to create space for

aligning crowded maxillary anterior segment.

2. After the cessation of growth – The need for

orthognathic surgery increases with the increase
in the severity of the problem.

The surgical procedures are also the same but
the use of presurgical orthodontics becomes

imperative to achieve stable results.

ORTHPAEDIC DEVICES USED IN
TREATMENT OF CLASS II

1. High pull H.G(parietal)
2. Medium pull H.G(occipital)
3. Low pull H.G(cervical)
4. Combee pull H.G
5. Reverse pull H.G

Functional Appliances
Functional appliances are designed to change the patients
1)

Pattern of function,

2)

Alter the jaw relationships,

3)

Reprogram the neuromusculature,

thus altering the functional matrix of the face.

ACTIVATOR

TWIN BLOCK APPLIANCE

BIONATOR

FIXED FUNCTIONAL APPLIANCES
1)
2)
3)
4)

Herbst appliance
Jasper Jumper
Universal bite jumper
Mandibular corrector

…………………..etc

MOLAR DISTALIZATION
1)

The Pendulum appliance

2)

The K-loop appliance

3)

The distal jet

4)

Modified Nance Lingual appliance

5)

Molar distalization with magnets

6)

Use of Super elastic NiTi

7)

NiTi Double Loop system

1)

Mild to moderate
skeletal Class II
Jaw

Treatment of malocclusion
2) Reasonably
good
with underlying mild or
alignment ( so that
moderate jaw discrepancies,
Xn
spaces can be
used for retraction
which can achieve a good
and not to relieve
dental occlusion, through
crowding)
extraction of certain teeth, to
mask skeletal problem.
3)

Good vertical facial

proportions,
neither

extreme

Surgical option should be
choosen in following cases:
1.Severe skeletal discrepancy or
extremely severe dento alveolar
problem.

2.Adult patients.
3.Young patients with extremely
severe or progressive deformity.
4.Good general health status of
patient.

DISTRACTION
OSTEOGENESIS

Orthodontic class 2 div 2

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Orthodontic class 2 div 2