The classification or description of malocclusion is an essential prerequisite for determining prevalence or severity of malocclusion

1. SUPERVISOR : DR .MAHER FOUDA
PREPARE : HAWA SHOAIB
Classification of malooclusion

2. THE CLASSIFICATION OR
DESCRIPTION OF MALOCCLUSION IS
AN ESSENTIAL PREREQUISITE FOR
DETERMINING PREVALENCE OR
SEVERITY OF MALOCCLUSION.

3. MALOCCLUSIONS CAN BE BROADLY CLASSIFIED
INTO FOLLOWING THREE TYPES (FLOW CHART 8.1):
 Intra-arch malocclusions: Malocclusion within the
same arch, i.e. either maxillary arch or mandibular arch
(Figs 8.1A and B).
 Interarch malocclusions: Malocclusions involving
both maxillary and mandibular arches (Figs 8.2 A and B).
 Skeletal malocclusions: Malocclusion involving
underlying skeletal structures (Figs 8.3).

8. INTRA-ARCH MALOCCLUSIONS (FLOW
CHART 8.2)
 Malalignment of individual tooth within the
same dental arch are referred as intra-arch
malocclusions. Intra-arch malocclusion may
be in the form of abnormal inclinations,
displacement, rotation, transposition or
abnormal position of a tooth.

11. INTRA-ARCH MALOCCLUSIONS CAN BE
CLASSIFIED INTO FOLLOWING TYPES:
 Abnormal Inclinations This condition involves an abnormal
tilting of a crown, with the root being in normal position. A tooth
may be abnormally inclined in any of the four directions.
 Buccal Inclination This refers to labial (in case of anteriors) or
buccal (in case of posteriors) tilting of the tooth crown (Fig. 8.4).

13.  Lingual Inclination This refers to palatal (maxillary teeth) or
lingual (mandibular teeth) tilting of the tooth crown (Fig. 8.5).

14.  Mesial Inclination : Refers to tilting of the tooth crown towards
the midline (Figs 8.6A and B).

15.  Distal Inclination This refers to tilting of the tooth crown away
from midline (Fig. 8.7).

16.  Displacement This involves bodily movement of the crown,
as well as the root of a tooth in the same direction to occupy an
abnormal location. A tooth can be displaced in any of the four
directions.
 Buccal Displacement This term refers to bodily movement of
the tooth in labial/buccal direction (Fig. 8.8).

17.  Lingual Displacement This term refers to bodily movement
of the tooth in a lingual direction (Fig. 8.9).

18.  Mesial Displacement This term refers to bodily
movement of tooth in a mesial direction towards the
midline (Fig. 8.10).

19.  Distal Displacement This term refers to the bodily
movement of the tooth in a distal direction away from
the midline (Fig. 8.11).

20.  Rotation This term refers to the movement of a tooth
around its long axis. A tooth may be rotated in two
directions:
 Mesiolingual (distolabial) or (Fig. 8.12A)
 Distolingual (mesiolabial) direction (Fig. 8.12B)

24.  Infra/Supraversion A tooth is said to be in
infra/supraversion, when it is not at the level of
occlusion as compared to other teeth in the arch
depending on its rate of eruption (Fig. 8.14).

25. INTERARCH MALOCCLUSIONS
 Such m alocclusions can occur in sagittal, vertical or
transverse planes of space (Flow chart 8.3).

26. SAGITTAL PLANE MALOCCLUSIONS
 This refers to conditions where the upper and lower
arches are abnormally related to each other in a sagittal
plane. Such malocclusions can be of two types:
 Prenornml occlusion: Where the lower arch is placed
more anteriorly w hen the teeth m eet in centric
occlusion (Fig. 8.15).
 Postnormal occlusion: Where the lower arch is placed
posteriorly when the teeth meet in centric occlusion (Fig.
8.16).

28. VERTICAL PLANE MALOCCLUSIONS
 Vertical plane malocclusions refer to conditions where
there is an abnormal vertical relationship between teeth of
upper and lower dental arches. They include deep bite and
open bite cases.
 Deep bite/increased overbite: Where there is excessive
vertical overlapping of upper anterior over the lower
anteriors when teeth are in central occlusion (Figs 8.17A
to C)
 Open bite: Where there is lack of vertical relationship
between upper and lower teeth. Open bite can be
presented in the anterior or posterior regions (Fig. 8.18).

31.  Anterior open bite: The term refers to conditions
where there is no vertical overlap of upper anterior over
the lower anterior when teeth are brought to centric
occlusion (Fig. 8.19).
 Posterior open bite: The term refers to a condition
where there is a lack of intercuspation between upper
and lower posterior teeth, when teeth are in centric
occlusion. Posterior open bite can be unilateral or
bilateral (Fig. 8.20).

34. TRANSVERSE PLANE MALOCCLUSIONS
 Transverse plane refers to conditions where there is an
abnormal transverse relationship between the upper and lower
arches. These include various types of crossbites and scissor bites.
 Crossbite: The term refers to a condition where one/ more
teeth may be abnormally malposed buccally, lingually or labially
with reference to the opposing tooth or teeth (Fig. 8.21).
 Scissors bite: The term applies to total maxillary buccal (or
mandibular lingual) crossbite with the mandibular dentition
completely contained in habitual occlusion (Fig. 8.22).

36. SKELETAL MALOCCLUSION
 Skeletal malocclusion can be caused by defects in
size, position or relationship between the upper and
lower jaws. The skeletal malocclusions can occur in
sagittal, vertical and transverse planes (Flow chart 8.4).

37. SKELETAL MALOCCLUSIONS IN SAGITTAL
PLANES
 These include conditions where the upper and lower jaws
are abnormally related to each other in a sagittal plane
 The term prognathism refers to forward placement of a
jaw and term retrognathism is used for backward
placement of a jaw.
 Sagittal plane malocclusion can occur in one or both the
jaws or as various combinations (Figs 8.23 A to C).

39. SKELETAL MALOCCLUSIONS IN
VERTICAL PLANE
 These malocclusions include open bite and deep
bite conditions (Fig. 8.24).

40. SKELETAL OCCLUSIONS IN TRANSVERSE
PLANE
 Narrowing or widening of the jaws may result in
an abnormal relationship between upper and lower jaws
in a transverse plane. These include skeletal crossbite and
scissor bite conditions, which may be unilateral/ bilateral
(Fig. 8.25).

41. CLASSIFICATION OF INCISOR
RELATIONSHIP
 British standard classification of incisor relationship
includes following three classes (Flow chart 8.5):

42. CLASS I INCISORS RELATIONSHIP
 Lower incisal edges occlude with or lie immediately below
the cingulum plateau of the upper incisors (Fig. 8.26A).

43. CLASS II INCISORS RELATIONSHIP
 The lower incisal edge lies posterior to the cingulum
plateau of the upper incisors.
 Class II Division 1 Incisor Relationship: The upper central
incisors are proclined or of average inclination. There is an increase
in overjet (Figs 8.26Bi and iii).
 Class II Division 2 Incisor Relationship: The upper central
incisors are retroclined. The overjet is usually minimal but may be
increased (Figs 8.26Bii and iv).

45. CLASS III INCISORS RELATIONSHIP
 The lower incisal edges lies anterior to the cingulum
plateau of the upper incisor (Fig. 8.26C).

47. FACTORS INFLUENCING INCISOR
RELATIONSHIP
 The overjet is determined partly by the skeletal pattern
and partly by the inclination of the incisors. The overbite
depends on the incisor classification. If the overjet is normal,
the depth of overbite will depend on the angle is about 135
degree. If the inter-incisal angle is much greater than this,
the overbite will be deep because the incisors can erupt
past one another. When the overjet is increased, the overbite
will be usually increased as well unless some other factors,
such as a thum bsucking habit, prevents full eruption of
incisors.

48. CANINE RELATIONSHIP

49. CANINE RELATIONSHIP
 Canine relationships are classified into following
three classes (Flow chart 8.6).

50. CLASS I CANINE RELATIONSHIP
 It means mesial inclination of the cusp of the
upper canine, which overlaps the distal incline of
the cusp of lower canine (Fig. 8.27A).

51. CLASS II CANINE RELATIONSHIP
 Distal incline of the cusp of upper canine, which
overlaps the mesial incline of the cusp of lower
canine are termed as class II canine relationship (Fig.
8.27B).

52. CLASS III CANINE RELATIONSHIP
 Lower canine is forwardly placed as compared to upper
canine. Hence, there is no relationship between upper
and lower canine that exist and is referred as class III
canine relationship (Fig. 8.27C).

53. Molar Relationship

54. MOLAR RELATIONSHIP
 There are 12 permanent molars— six upper and six
lower. The six permanent molar in each arch are the first,
second, and third molars on either side of the arch. The
permanent molars play a major role in the mastication of
food (chewing and grinding to pulverize) and are the most
important in maintaining the vertical dimension of the
face (preventing a closing of the bite or vertical
dimension, appearance).
They are also important in maintaining continuity within
the dental arches, thus keeping other teeth into proper
alignm ent. Molar relationships are classified into
following three classes (Flow chart 8.7).

56. CLASS I MOLAR RELATIONSHIP
 Mesiobuccal cusp of the permanent maxillary first molar
occludes in mesiobuccal developmental groove of first
permanent mandibular molar, referred as Class I molar
relationship (Fig. 8.28A).

57. CLASS II MOLAR RELATIONSHIP
 Distobuccal cusp of the maxillary first permanent
molar occludes in the mesiobuccal development
groove of first permanent mandibular molar, termed
as class II molar relationship (Fig. 8.28B).

58. CLASS III MOLAR RELATIONSHIP
 Mesiobuccal cusp of maxillary first permanent molar
occludes interdentally between first and second
mandibular molar are said to be class III molar
relationship (Fig. 8.28C).

59. Angle's Classification of Malocclusion

60.  Angle classified malocclusion based on the
anteroposterior relationship of the teeth in the year
1898. He used Roman numerical I, II, III to designate the
main classes, whereas Arabic numerical, 1, 2, denote the
divisions of the classification. Unilateral deviations were
termed as subdivisions
 Angle's classes o f malocclusion are given as
follows:
 Angle's class I malocclusion
 Angle's class II malocclusion
 Angle's class III malocclusion

61.  Angle's class II malocclusion is further
subdivided into the following two types:
 Angle's class II division 1 malocclusion
 Angle's class II division 2 malocclusion
 Angle's class II is classified into folloiving types, based
on subdivisions:
 Angle's class II subdivision division 1 malocclusion
 Angle's class II subdivision division 2 malocclusion
 Angle's class III is classified into following two
types:
 True class III malocclusion
 Pseudo class III malocclusion
 Angle's class III is classified based on subdivisions: Angle's class
III subdivision

62. ANGLE'S CLASS I MALOCCLUSION
 Angle's class I malocclusion, where the
mesiobuccal cusp of the maxillary permanent first
molar occludes with the mesiobuccal groove of
the mandibular first permanent molar (Fig. 8.29).

64.  Extraoral features of Angle's class I malocclusion are
listed in Table 8.1.
 Intraoral features of Angle's class I malocclusion are
listed in Table 8.2.

66. ANGLE CLASS II MALOCCLUSION
 Angle class II malocclusion is characterized by class
II molar relation, where the distobuccal cusp of the
maxillary permanent first molar occludes with the
buccal groove of the mandibular first permanent
molar (Fig. 8.30).

67.  Angle's class II malocclusion has been sub-
classified into the following divisions:
 Angle class II division 1 malocclusion
 Angle class II division 2 malocclusion

68. ANGLE'S CLASS II DIVISION 1 MALOCCLUSION
 Angle's class II division 1 malocclusion is
characterized by class II molar relation on either side
with proclined maxillary anteriors (Figs 8.31A to C).

69. ANGLE'S CLASS II DIVISION 2 MALOCCLUSION
 Angle's class II division 2 malocclusion is
characterized by class II molar relation with
retroclined maxillary anteriors (Figs 8.32A and
B).

70.  Extraoral features Angle class II division 1 m
alocclusion are listed in Table 8.3.
 Intraoral features Angle class II division 1
malocclusion are listed in Table 8.4

73.  Extra and intraoral features of Angle's class II
division 2 malocclusion are listed in Tables 8.5
and 8.6.

76. ANGLE'S CLASS II SUBDIVISION
 Angle's class II subdivision may be:
 Angle's class II subdivision division 1
malocclusion
 Angle's class II subdivision division 2
malocclusion

77. ANGLE'S CLASS II SUBDIVISION
DIVISION 1 MALOCCLUSION
 If the class II molar relation on one side of the
arch and class I molar relation on the other side
of the dental arch with proclined maxillary
anteriors, it is termed as Angle's class II
subdivision division 1 malocclusion.

78. ANGLE'S CLASS II SUBDIVISION
DIVISION 2 MALOCCLUSION
 If the class II molar relation on one side of the
arch and class I molar relation on the other side of
the dental arch with retroclined m axillary
anteriors, it is termed as Angle's class II
subdivision division 2 malocclusion.

79. ANGLE'S CLASS III MALOCCLUSION
 Angle's class III malocclusion is characterized by
class III molar relationship where the mesobuccal
cusp of the permanent maxillary first molar
occludes into the interdental space between
mandibular first and second perm anent molar.
True class III is due to the malrelationship of
either the dental arches or skeletal structure of the
m axillary retrognathism that is the prognathism
of the mandible (Figs 8.33A and B).

81. PSEUDO CLASS III MALOCCLUSION
 Angle's class III pseudo malocclusion is
characterized by class III molar relationship,
which is mainly due to habit. It is also called as
habitual or postural malocclusion.

83.  Extra and intraoral features of A ngle's class III
malocclusion are listed in the Tables 8.7 and 8.8.

85. CLASS III SUBDIVISION
 Class III molar relationship on one side and class
I on the other side of the dental arch is termed as
class III subdivision (Figs 8.34A and B).

86. LIMITATION OF ANGLE'S CLASSIFICATION

87. Dewey's Classification
DEWEY'S MODIFICATION FOR ANGLE'S
CLASSIFICATION (FLOW CHART 8.8)

89.  Dewey's modified the A n gle's classificatio n of
malocclusions with modifications in Angle's class
I and class III malocclusions. He divided Angle's
class I malocclusion into five types and class III
into three types. Since Angle's class II
malocclusion was already well defined, Dewey
did not give any modification for it.

98. LISCHER'S CLASSIFICATION FOR
MODIFICATION OF ANGLE'S CLASSIFICATION
(FLOW CHART 8.9)

100.  Lischer's replaced the terms class I, II, III in
Angle's classification of malocclusion, with the
terms neutroocclusion , disto -occlusion and
Mesio-occlusion (Fig. 8.43), respectively. In
addition, he described other possible malpositions
of a tooth or a group of teeth as listed below (Figs
8.44A to C).

103. Neutron-Occlusion Neutron-occlusion is the
normal retention step of dental arches.
Disto-Occlusion Disto-occlusion is the
postnormal occlusion.
Mesio-Occlusion Mesio-occlusion is the
prenormal occlusion.

104.  For Individual Teeth :
 Labioverison of tooth— Movement of tooth/teeth
towards the lip or cheek.
 Linguoversion of teeth—Lingual to normal position
 Mesioversion-—Mesial to the normal position
 Distoversion—Distal to normal position
 Supraversion of tooth—Crossing the line of
occlusion .
 Infraversion of tooth—Away from the line of
occlusion °
 Transversion—Transposition-Wrong position in the
arch
 Torsi version— Rotated on its long axis

105. SIMON'S CLASSIFICATION (FLOW CHART 8.10)

106.  Simon's classification is based on anterior posterior,
transverse and vertical plane relationships of the
dental arches. Simon's system of classification made
use of three anthropometric, which are:
 I. Frankfort horizontal plane (FH plane)
 II. Orbital plane
 III. Midsagittal plane.
 Simon's classification of malocclusion is based on
abnormal relationship of the dental arches from their
normal position in relation to anteroposterior,
transverse and vertical planes.

111. BALLARD'S CLASSIFICATION

112.  Ballard's classification of m alocclusion is based on
skeletal relationship on the jaws (Flow chart 8.11).

116. BENNETT'S CLASSIFICATION OF
MALOCCLUSION

117.  Sir Norman Bennett's classification of malocclusion
is based on its etiology. B ennett's classification of
malocclusion is as follows (Flow chart 8.12):

119. ACKERMAN-PROFIT SYSTEM OF
CLASSIFICATION

120.  Ackerman and Profit is the most recent of all
the classifications. It is based on Venn-Diagrams.
It has got 9 groups as shown in the Figure 8.49.
Ackerman and Profit gave an all-inclusive
method of diagramming and categorizing
malocclusions to overcome the limitations of the
Angle's classification system in which five
characteristics and their interrelationships are
assessed, using a modified Venn diagram.