CLASSIFICATION OF

MALOCCLUSION

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 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.
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 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.

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Types of Malocclusion
1. Intra-arch malocclusion
2. Inter-arch malocclusion
3. Skeletal malocclusion

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 1. 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/Mesiobuccal
 Distal displacement
 Mesiolingual/Distobuccal
 Lingual displacement
 Transposition 5
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Mesial inclination Distal inclination Palatal inclination

Lingual inclination Labial inclination 9

Infraocclusion Supraocclusion

Supraocclusion Rotation 10
Mesiolingual or Distolabial
 Rotation Transposition
Distolingual or Mesiolabial

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 2. 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

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

 Post-normal occlusion
Mandibular arch
posteriorly placed in
centric occlusion.

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 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

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Transverse plane malocclusions
Includes various types of cross bites.

Posterior segment in cross bite Lateral incisor in cross bite

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 3. 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.
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 Systems of Classification of
Malocclusion
1. 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

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 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 20
 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.

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 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.
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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

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 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
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 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.

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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.

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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.
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 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.
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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 2

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 33

Dewey’s Class I type 5

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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.

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Dewey’s Class III type 1
Dewey’s class III type 3

Dewey’s Class III type 2 36

 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 of
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position
 Mesioversion Distoversion of lateral incisor and canine
Torsiversion of 1st premolar rotated mesiobuccally

Linguoversion Labioversion 39
Axiversion Torsiversion

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 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.
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 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. 42
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
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Ackermann-Profitt classification
Based on five characteristics
1. Alignment 1

2. Profile 3 2

3. Transverse relationships 4
4. Class 5
5. Overbite

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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.
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4. Class
 Sagittal relationship of teeth is assessed using Angle’s
classification as Class I / II / III.
 Distinction made between skeletal and dental
malocclusions.
5. 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.

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 Incisor classification
 Class I
 Class II
 Division I
 Division II
 Class III

Class I Class II Class II Class III

div 1 div 2
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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

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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.
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