1. Class II Malocclusion
Group 2

2. Outline
Definition
Types
Diagnosis
Epidemiology
Treatment
Cases
Future

3. Definition
Class II (or distocclusion) – In this classification, the maxillary first molar is even with, or anterior to, the mandibular first molar; the buccal groove of the mandibular first molar is distal to the mesiobuccal cusp of the maxillary first molar.  The distal surface of the mandibular canine is distal to the mesial surface of the maxillary canine by at least the width of a premolar.  The facial profile of both divisions is termed retrognathic.

4. Which one is class II?

5. Class II Division 1
Class II, Division 1 occurs when the permanent maxillary central incisors are either normal or slightly protruded out toward the lips.

6. Class II Division 2
Class II, Division 2 occurs when permanent maxillary central incisors are retruded and tilting inwards towards the tongue.

7. Cephalometric apperance

8. Diagnosis

9. Causes
Whatrole does genetics play in the etiology of Class II malocclusions? According to the study by Lundstrom
(1984), investigations published prior to that article have suggested that about 40%of commonanomalies in tooth position and in the relationship between maxil- lary and mandibular dental arches are due to genetic differences between individuals. Corruccini and Potter (1980), in studies of different dental and occlusal vari- ables, found the heritability of dental overjet wasre- duced to zero. Several syndromes have Class II maloc- clusions as a major finding. Of these syndromes, Treacher Collins, hemifacial microsomia, achondropla-
sia, and mobius syndromeare a few of the more widely known.
Inter-arch problems such as Class II and Class III malocclusions are genetic in nature,

10. Causes How do habits relate to Class II malocclusions? As
Was previously stated, the light continuous forces are muchmore detrimental to the oral complex than are heavy intermittent forces. Habits such as thumb suck- ing, when performed for fewer than 6 hr per day, have not been shownto be responsible for anterior open bites or Class II malocclusions. Forward positioning of the tongue (seen during swallowing in patients with ante- rior openbite) is morelikely to be an effect than a cause.
Timothy Shaughnessy, DDS, MS, Workshop Leader Lawrence H. Shire, DDS, Workshop Recorder

11. Diagnosis and Records History Clinical examination Radiographs
Mounted casts
Photographs

12. Epidemiology
study were to determine caries prevalence, oral hygiene and orthodontic status of Bedouin children in a desert around Al- Qasseem Region of Saudi Arabia. One hundred and fifty three children were examined for caries, oral hygiene and orthodontic status with mirror and explorer utilizing natural light.
One hundred and fifty one (98.6%) children had class I molar relation and 2 (1.4%) children had class II molar relation. Anterior open bite, anterior crossbite and posterior crossbite were found in one case (0.7%) each.
Caries prevalence, oral hygiene and orthodontic status of Saudi Bedouin children.
Wyne A1, al-Dlaigan Y, Khan N.

13. Treatment Treatment approaches Preadolescents Intra oral devices
Extra oral devices
Adult
surgical
camouflage

14. Preadolescence

15. Preadolecense *Functional appliance
Stimulates and enhances mandibular growth
Ex: activator, bionator, frankel, twin block

16. Preadolecense *Extra oral force (headgear) :
Retards the maxillary growth

17. Adults
*orthognathic surgeries

18. Adults
*Class II elastics:
Camouflage

19. Case 1 *21-year-old Saudi male was referred to the orthodontic clinic
*“Bothering anterior teeth.”

20. Treatment Pre surgical orthodontic treatment:
Upper and lower first premolars were extracted to get space for retracting the lower incisors, alleviation of lower arch crowding, uprighting the upper incisors, and severing dental class II relation.
Surgery:
Le Fort I osteotomy
bilateral sagittal split osteotomy

21. Post surgical

22. Post surgical orthodontic treatment
close minor spaces
final occlusal settling.
8 months

23. Results

24. Case Report
Surgical Orthodontic Treatment of Severe Skeletal Class II
Fahad F. Alsulaimani,1 Maisa O. Al- Sebaei,2 and Ahmed R. Afify1
1Orthodontic Division, Department of Preventive Dental Sciences, Faculty of Dentistry, King Abdul-Aziz University, Jeddah, Saudi Arabia2Oral and Maxillofacial Surgery Department, Faculty of Dentistry, King Abdul-Aziz University, Jeddah, Saudi Arabia

25. Class II treatment by cervical headgear

27. Thank you