Treatment of CLII malocclusion

CLII can be classified into CLII div 1 CLII div 2

What we mean by CLII

Some times Molar CLI & canine CLII Molar CLII & canine CLI Dental CLII on skeletal CLI or CLIII due to habits ?

T. Wallen

Etiology of class II 1. skeletal

2. Soft tissue Over jet & over bite

3. Dental factor In case of large teeth size so we either have

In association with skeletal relationship the muscles of the lips and tongue govern the inclination and degree of vertical development of the incisors, and thus govern the incisal overjet and overbite.

Treatment objectives in CLII div1 Relief of crowding Reduction of over bite Reduction of over jet Correction of CLII of buccal segment teeth

Treatment of class II division 1: There are many factors that must be taken in Mind during treatment: I- Age of the patient. 2-severity of the cases. 3- Patient's cooperation.

If the patient is growing start with CLII correction. But CLII should be due to antero posterior. But if it was due to vertical problem so further growth of the mandible will lead to posterior rotation of the mandible and in competent lips.

Types of treatments Young growing

adult Removable fixed

Sever CLII 1 Combination of orthodontic treatment and surgery

Treatment by removable appliance CLII div 1 Skeletal CLI or mild sk. CLII Canine mesially angulated Cooperative patient

always correct the overbite- before NOTE: always correct the overbite- before the overjet correction

Treatment by removable appliance Stage 1 Exo. Up. 4 Adam 56 Finger spring or BCR on 3 Fitted labial arch Acrylic base plate Ant. Bite plane (flat or inclined)

Stage 2 Double Adam clasp 56 Stoppers C clasp 3 Ant bite plane Robert retractor 2112

Stage 3 Retainer Adam 6 Hawly Acrylic base plate

Treatment by fixed appliance Canine vertically or distally angulated Upper incisors not proclined 90 degree rotation Moderate – sever CLII Residual space Increased over bite

Surgical correction Adult Vertical maxillary excess Gummy smile Retruded mandible

وجــــــهان للحق غير الله ما عبدا          وجه منير ووجـــــه يستطير هدى هـما الجواد وموسى فاعتصم بهما          فــــــفيهما الفوز دنيا والنجاة غدا هــــــما العماد لمن طاحت به عمد          هما الســـــــناد لظـهر يبتغي سندا

The crown of lower third molar is suspected to be completed in age of ------- 6-9 years 18-24 years 10-14 years 12-16 years