Class II Division 2 Malocclusion: Features, Causes, And Treatment
Briefly describe class 2, division 2 malocclusion. Write the probable cause for its development.
Answer. Class 2, division 2 is a condition characterized by a class 2 molar relationship with retroclined upper centrals that are overlapped by the lateral incisor.
Features of Class 2 Division 2
It should be studied under the following headings:
Skeletal Features
- Pattern can be class 1 or 2
- In the vertical dimensions height of the lower anterior face is small.
- Frankfort horizontal plane is low.
- Severe to moderate deep bite is present.
- From transverse view maxillary arch is broader as compared to mandibular arch.
Soft Tissue Features
- Level of lower lip is high when compared to crown of maxillary incisor.
- Retroclined maxillary incisors because of high lower lip.
- Lower lip is hyperactive
- Mentolabial fold lies deep
- Profile can be straight due to chin prominence
- Lips are competent
- Musculature is strong
- Palatal gingiva gets traumatized because of close bite of lower incisor.
Occlusal Features
- Presence of Angle’s class 2 molar relationship
- Presence of class 2 division 2 incisor relationship
- Presence of class 2 canine relationship
- Mandibular anterior teeth are retroclined
- Presence of excessive deep overbite.
- Curve of Spee is increased
- Freeway space is increased
- Presence of mandibular anterior teeth crowding.
Functional Features
Mandible is posteriorly displaced because of overclosure, i.e. functional retrusion of mandible.
Path of closure of mandible lies upward and backward.
Treatment
- Correction of incisor relationship and buccal segment relationship
- Relief of the gingival trauma
- Relief of crowding and local irregularities
- Correction of buccal segment relationship
- Role of the extraction in treatment as well as correction of buccal segment relationship is same as for class 2 division 1 malocclusion.
- Deep anterior overbite and retroclination are characteristic of Class 2 division 2 malocclusion which is treated by reduction in incisal overbite and alteration in incisal inclination.
- Deep overbite is decreased by use of the anterior bite plane or fixed appliances incorporating anchor bands or reverse curve of Spee.
- Incisor inclination is treated by the use of torquing springs to move maxillary incisor roots lingually and crown buccally.
- During the mixed dentition period, it is possible to procline the maxillary incisors by converting class 2 division 2 in malocclusion which resembles class 2 division 1. This is done by the use of functional appliances.
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