Classification of

Malocclusion

SMEET M.SANARIA
3rd YEAR
MGM DENTAL
COLLAGE
Classification of
Malocclusion

SMEET
SANARIA
 Introduction
 Malocclusion is defined as any
deviation from normal occlusion of
teeth .
 Occlusion : Contact relationship
between maxillary and mandibular
teeth in function and parafunction.
 Classification of malocclusion is the
description of dentofacial deviations
according to a common characteristic
or norm.
 Advantages of
Classification
1. Helps in diagnosis and
treatment planning.
2. Helps in visualizing and
understanding the problem
associated with malocclusion.
3. Helps in communicating the
problem.
4. Helps in comparisons of various
malocclusions.
 Types of
Malocclusion
1.Intra-arch malocclusion
2.Inter-arch malocclusion

3.Skeletal malocclusion
 Intra-arch
malocclusion
Includes individual tooth position, variations
and malocclusions affecting a group of teeth
within an arch.
 Distal inclination  Buccal displacement
 Mesial inclination  Infra version
 Lingual inclination  Supra version
 Buccal inclination  Rotations
 Mesial displacement  Distolingual/Mesio
 Distal displacement buccal
 Lingual displacement  Mesiolingual/Disto
buccal
 Transposition
Mesial inclination Distal inclination Palatal inclination

Lingual inclination Labial inclination

Infraocclusion Supraocclusion

Supraocclusion Rotation
Mesiolingual or Distolabial
 Rotation Transposition
Distolingual or Mesiolabial
 Inter-arch
malocclusion
Malrelation of dental arches to one
another upon skeletal bony basis
that may themselves be normally
related.

 Sagittal plane malocclusions

 Vertical plane malocclusions
 Transverse plane malocclusions
 Sagittal plane
malocclusions
 Pre-normal occlusion
Mandibular arch
anteriorly placed in
centric occlusion.

 Post-normal occlusion
Mandibular arch
posteriorly placed in
centric occlusion.
 Vertical plane
malocclusions
 Deep bite
Excessive vertical
overlap between
maxillary and
mandibular
anteriors.

 Open bite
No vertical overlap.
- Anterior region
- Posterior region
Anterior open bite Posterior open bite
 Transverse plane
malocclusions
Includes various types of cross bites.

Posterior segment in cross bite Lateral incisor in cross bite

 Skeletal malocclusion
 Includes defects in underlying skeletal
structure.
 Due to abnormalities in maxilla or mandible in
size, position or relationship between jaws.
 Sagittal abnormalities

 Prognathism

 Retrognathism

 Combinations

 Transverse abnormalities

 Narrowing and widening of jaws causes

crossbites
 Vertical abnormalities

 Variation affects lower facial height.

 Systems of
Classification of
1.
Malocclusion
Angle’s classification
2. Dewey’s modification of Angle’s
classification
3. Lischer’s modification of
Angle’s classification
4. Bennet’s classification
5. Simon’s classification
6. Ackermann-Profitt classification
7. Incisor classification
 Angle’s

classification
It was introduced by Edward Angle in 1899.
 Based on mesiodistal relationship of teeth, dental
arches and jaws.
 Maxillary 1st molar is taken as key to occlusion.

Three classes :
 Class I

 Class II
 Class II division I
 Class II division II
 Class II subdivision
 Class II division I subdivision
 Class II division II subdivision
 Class III
 True Class III
 Pseudo Class III
 Class III subdivision
 Class I
 Normal inter-arch molar relation
 Mesiobuccal cusp of maxillary 1st permanent molar
occlude in the buccal groove of mandibular 1st
permanent molar.
 Dental irregularities
 Crowding
 Spacing
 Rotations
 Missing teeth
 Normal skeletal retaionships.
 Normal muscle function.
 Includes bimaxillary protrusion – normal Class I
molar relationship but the dentitions of both arches
are forwardly placed in relation to the facial profile.
 Class II
 Distobuccal cusp of maxillary 1st
permanent molar occludes in the buccal
groove of mandibular 1st permanent molar.
Class II division I
 Characterized by proclined V-shaped

upper incisors.
 Therefore, increased overjet, lip trap,

abnormal muscle activity – hypotonic

upper lip, hypertonic mentalis and
buccinator.
Class II division II
 Characterized by lingually inclined upper

incisors and labially tipped upper lateral

incisors overlapping the centrals.
 Square shaped arch, peri-oral muscle

activity normal.

Class II subdivision
 Class II molar relation exist on one side

and Class I molar relation on the other

side.
 Class II division I subdivision
 Class II division II subdivision
Angle’s Class I malocclusion

Angle’s Class II division 1

Angle’s Class II division 2

 Class III
 Mesiobuccal cusp of maxillary 1st
permanent molar occlude the interdental
space between mandibular 1st and 2nd
molar.
 True Class III
 Pseudo Class III

 Class III subdivision

 True Class III – Skeletal Class III

malocclusion of genetic origin.
Due to -
 Excessively large mandible
 Forwardly placed mandible
 Smaller than normal maxilla
 Combinations
 Pseudo Class III – Produced by forward
movement of mandible during jaw closure
 Also called postural/habitual Class III
 Due to
 Occlusal prematurities

 Premature loss of deciduous posteriors.

 Child with enlarged adenoids

 Class III subdivision – Class III molar

relation on one side and Class I on the
other.
 Angle’s Class II subdivision

Angle’s Class III malocclusion

Pseudo Class III malocclusion

 Advantages of Angle’s
Classification
 First comprehensive classification –
most widely accepted.
 Simple
 Easy to use
 Conveys precisely what was
conceived for ie, relationship of
mandibular teeth with respect to
maxillary 1st permanent molar.
 Drawbacks of Angle’s
Classification
 Considers malocclusion only in the
anteroposterior plane and not in transverse/
vertical planes.
 Considered 1st permanent molar as fixrd
points in the skull, not found to be so.
 Cannot be applied if 1st permanent molar is
missing or to deciduous dentition.
 Doesn’t distinguish between skeletal/dental
malocclusion.
 Doesn’t highlight etiology.
 Individual tooth positions aren’t considered.
 Dewey’s modification of
Angle’s classification
Angle’s Class I
 Type I – Class I with crowded anteriors.

 Type II – Class I with protrusive maxillary

incisors.
 Type III – Class I with anterior cross bite.

 Type IV – Class I with posterior cross bite.

 Type V – Mesially drifted permanent

molars therefore early extraction of

deciduous predecessors.
Angle’s Class I with anterior crowding or Dewey’s Class I type 1

Angle’s Class I with anteriors proclined or Dewey’s Class I type

Dewey’s Class I type 3 malocclusion, molars in Angle’s Class I

with maxillary anteriors in crossbite

Dewey’s Class I type 4. Angle’s class I with posterior crossbite

Dewey’s Class I type 5
Angle’s Class III
 Type I – upper and lower arches are

normally aligned separately but show

edge-to-edge bite/ incisor
arrangement on occlusion.
 Type II – mandibular incisors crowded

and in lingual relation to maxillary

incisors.
 Type III – maxillary incisors are

crowded and in cross bite with

mandibular anteriors.
Dewey’s Class III type 1
Dewey’s class III type 3

Dewey’s Class III type 2

 Lischer’s modification of
Angle’s classification
 Neutro-occlusion – Angle’s Class I
 Disto-occlusion – Angle’s Class II
 Mesio-occlusion – Angle’s Class III

 Mesioversion – mesial to normal position

 Distoversion – distal to normal position
 Linguoversion – lingual to normal position
 Labioversion – labial to normal position
 Infraversion – inferior or away from the line of
occlusion
 Supraversion – superior or extended past the line of
occlusion
 Axiversion – axial inclination is wrong, tipped
 Torsiversion – rotated on its long axis
 Transversion – transposed or changes in the sequence
Mesioversio Distoversion of lateral incisor and canine
n Torsiversion of 1st premolar rotated mesiobuccally

Linguoversion Labioversion
Axiversion Torsiversion
 Bennet’s classification
Class I – abnormal position of one or more
teeth due to local causes.

Class II – abnormal formation of a part/ whole

of either arch due to developmental defect of
bone.

Class III – abnormal relation between upper

and lower arches and between either arch
and facial contour and co-related abnormal
formation of either arch.
 Simon’s classification
It is a craniometric classification relating
dental arches in three planes i.e.,
 FH plane [Frankforts Horizontal plane]

 Orbital plane

 Mid-sagittal plane

FH plane
Attraction – closer than normal
to FH plane.
Abstraction – away from FH
plane than normal.
Orbital plane
Protraction – Farther from orbital plane
Retraction – Closer/more posterior to
orbital plane.

Mid-sagittal plane
Distraction – away from mid sagittal
plane
Contraction – closer to mid sagittal
plane
 Ackermann-Profit
classification
Based on 5 characteristics
2. Alignment 1
3. Profile 3 2

4. Transverse 4
relationships
5
5. Class
6. Overbite
1. Alignment
 Interarch alignment and symmetry assessed
when seen in occlusal view.
 Dental arch is classified as ideal/crowded/spaced
2. Profile
 can be convex/straight/concave
 Includes assessment of facial divergence ie.
Anterior or posterior divergence.
3. Transverse relationships
 Include transverse skeletal and dental
relationships.
 Buccal and palatal cross bites are noted.
 Further classified as unilateral or bilateral.
 Distinction made between skeletal and dental
cross bites.
1. Class
 Sagittal relationship of teeth is assessed
using Angle’s classification as Class I / II /
III.
 Distinction made between skeletal and
dental malocclusions.
2. Overbite
 Assessed in the vertical plane
 Described as anterior open bite /
posterior open bite / anterior deep bite /
posterior collapsed bite.
 Distinction made between skeletal and
dental malocclusions.
 Incisor classification

 Class I
 Class II
 Division I
 Division II

 Class III

Class I Class II Class II Class III

div 1 div 2
Class I
Mandibular incisor edges occlude with or
lie immediately below the cingulum
plateau of the maxillary central
incisors.

Class II
Mandibular incisor edges lie posterior to
the cingulum plateau of the maxillary
central incisors.
 Division I
 Division II
Division I
Maxillary central incisors are proclined or of
average inclination and there is an increased
overjet.
Division II
Maxillary central incisors are retro-clined; the
overjet is normally minimum, but maybe
increased.

 Class III
Mandibular incisor edges lie anterior to the
cingulum plateau of the upper central
incisors; the overjet is reduced or reversed.