12/5/2020
OUTLINE
CLASSIFICATION AND
TERMINOLOGY OF MALOCCLUSION
Dr. Fe Jozemar Rigor-Salazar
WHAT IS A CLASSIFICATION
SYSTEM?
A grouping of clinical cases of similar
appearance for ease in handling and
discussion
Not a system of diagnosis, method for
determining prognosis, or a way of defining
treatment.
What is a classification system?
Purposes of classifying
Systems of classification and terminology
The Class I syndrome
The Class II syndrome
The Class III syndrome
Limitations of classification systems
PURPOSES OF CLASSIFYING
Traditional purposes
Ease of reference
Aids comparison
Self communication
 Identify problems of which we must be wary
 Recalling past difficulties with similar cases
 Alerting ourselves to possible strategies and
appliances that may be needed in treatment
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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
2 widely use system: Angle’s system
Angle system Simon system
Simon system Naming malpositions of individual teeth and
group of teeth
Etiologic classification: its effect on diagnosis
Ackermann-profit system

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
Angle’s system Angle’s system
Based in the anteroposterior relationships of Most traditional, most practical, most
the jaws with each other popular in use at present

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
Angle’s system Angle’s system
 Theory: the maxillary first permanent molar Class I
invariably was in correct position  AKA neutrocclusion
 Emphasis on the relationship of the first  Normal anteroposterior relationship between the
permanent molars ignores the facial skeleton maxilla and the mandible
itself  malfunction of muscles and problems
of growth of bones often were overlooked

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY
 Angle’s system
 Class I
 The triangular ridge of the mesiobuccal cusp of the
maxillary first permanent molar articulates in the buccal
groove of the mandibular first permanent molar
AND TERMINOLOGY
 Angle’s system
 Class I
 Bony base supporting the mandibular dentition is
directly beneath that of the maxillary, not too far
anterior or posterior in relation to the cranium

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Angle’s system  Angle’s system
 Class II  Class II
 AKA distocclusion  "distal" relationship of mandible to maxilla  Mesial groove of the mandibular first permanent molar articulates
 "distal" positioning of the mandible to the maxilla posteriorly to the mesiobuccal cusp of the maxillary first
 Maxilla is prognathic permanent molar

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
Angle’s system  Angle’s system
Class II  Class II
 Division I  Distoclusion in which the maxillary  Division II  maxillary
central incisors are near
incisors are typically in extreme labioversion normal anteroposteriorly
or slightly in
linguoversion, whereas
the maxillary lateral
incisors have tipped
labially and mesially

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Angle’s system  Angle’s system
 Class II  Class III
 Subdivisions  when the distoclusion occurs on one side  Mesiocclusion  mesial relationship of mandible to maxilla
of the dental arch only, the unilaterality is referred to as  Mesial groove of the mandibular first permanent molar articulates
anteriorly to the mesiobuccal cusp of the maxillary first
a subdivision of its division. permanent molar

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Martin Dewey’s modification of Angle’s I  Martin Dewey’s modification of Angle’s I
malocclusion malocclusion
 Type I – crowded anterior teeth  Type II – protrusive maxillary incisors

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Martin Dewey’s modification of Angle’s I  Martin Dewey’s modification of Angle’s I
malocclusion malocclusion
 Type III – anterior crossbite  Type I – posterior crossbite

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Martin Dewey’s modification of Angle’s I  Martin Dewey’s modification of Angle’s I
malocclusion malocclusion
 Type V – mesial drifting of permanent molar  Type V – mesial drifting of permanent molar

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY
 Martin Dewey’s modification of Angle’s III
malocclusion
 Type I – Viewed separately, arches are normal. In
occlusion – edge to edge incisor alignment suggestive of
forwardly moved mandibular arch.
AND TERMINOLOGY
 Martin Dewey’s modification of Angle’s III
malocclusion
 Type 2 – Crowding and lingual relation of mandibular
incisors to maxillary incisors.

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Martin Dewey’s modification of Angle’s III  Simon system
malocclusion  Related the dental
 Type 3 – Crowding and cross bite relation of maxillary arches to three
incisors to mandibular incisors. anthropologic planes
based on
craniallandmarks
 Frankfurt
 Orbital
 Midsagittal

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Simon system  Simon system
 Principal contribution:  Anteroposterior relationships (orbital plane)
emphasis on the  Protraction  When the dental arch, or part of it, is
orientation of the more anteriorly placed than normal with respect to the
dental arches to the orbital plane
facial skeleton  Retraction  When the dental arch, or part of it, is more
anteriorly placed than normal with respect to the orbital
 Separates problems in plane
malpositions of teeth
from osseous dysplasia

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY
 Simon system
 Mediolateral relationships (midsagittal plane)
 Contraction  when the dental arch, or part of it, is
nearer to the midsagittal plane than the normal position
 Distraction  when the dental arch, or part of it, is
farther away from the midsagittal plane than the normal
position
AND TERMINOLOGY
 Simon system
 Vertical relationships (Frankfurt plane)
 Attraction
 When the dental arch, or part of it, is nearer to the
Frankfurt plane than the normal position
 Intrusion of maxillary teeth
 Extrusion of mandibular teeth
 Abstraction  When the dental arch, or part of it, is farther
away from the Frankfurt plane than the normal position

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY
 Naming malpositions of individual teeth
 Lischer’s nomenclature
 Involves adding the suffix "-version" to a word to
indicate the direction from the normal position
AND TERMINOLOGY
 Naming malpositions of individual teeth
 Mesioversion  mesial to the normal position.

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Naming malpositions of individual teeth  Naming malpositions of individual teeth
 Distoversion  distal to the normal position  Linguoversion  lingual to the normal position

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Naming malpositions of individual teeth  Naming malpositions of individual teeth
 Labioversion or buccoversion  toward the lip or  Infraversion  away from the line of occlusion
cheek.

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Naming malpositions of individual teeth  Naming malpositions of individual teeth
 Supraversion  extended past the line of occlusion  Axiversion  tipped; the wrong axial inclination
(below in the maxilla and above in the mandible.)

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Naming malpositions of individual teeth  Naming malpositions of individual teeth
 Torsiversion  rotated on its long axis  Transversion (transposition)  wrong order in the
arch

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY
 Naming vertical variations of groups of teeth
 Deep overbite
 Excessive vertical overlap of the incisors  soft tissue of
the palate is impinged or the health of the supporting
structures is endangered
AND TERMINOLOGY
 Naming vertical variations of groups of teeth
 Open bite
 Localized absence of occlusion while the remaining
teeth are in occlusion
 Seen most frequently in the anterior part of the mouth
 posterior open bites are also encountered

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY
 Naming transverse variations of groups of teeth
 Crossbite
 Indicate an abnormal buccolingual (Iabiolingual)
relationship of the teeth
 Most commo:buccal cusps of some of the maxillary
posterior teeth occlude lingually to the buccal cusps of the
lower teeth.
AND TERMINOLOGY
 Naming transverse variations of groups of teeth
 Crossbite
 Lingual crossbite  when one or more maxillary teeth
are in crossbite toward the midline
 Buccal crossbite  when the lingual cusps of upper
posterior teeth occlude completely buccally of the buccal
cusps of the lower teeth,

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY
Etiologic classification: its effect on diagnosis
 Several primary tissue sites in which
orthodontic problems may originate 
osseous, muscular and dental
AND TERMINOLOGY
Etiologic classification: its effect on diagnosis
 Osseous
 Includes problems in abnormal growth, size, shape, or
proportion of any of the bones of the craniofacial
complex.
 When any bone of the face develops in a perverted,
delayed, advanced, or otherwise asynchronous manner,
the aberration may be reflected in an orthodontic
problem

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY
Etiologic classification: its effect on diagnosis
 Osseous
 Ex:
 Class III cases may be due to mandibular hypertrophy
 Class II cases may be due to mandibular inadequacy.
AND TERMINOLOGY
Etiologic classification: its effect on diagnosis
 Muscular
 Any persistent alteration in the normal synchrony of the
mandibular movements or muscle contra.ctions may
result in distorted growth of the facial bones or
abnormal positions of teeth.

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
Etiologic classification: its effect on diagnosis Etiologic classification: its effect on diagnosis
 Muscular  Muscular
 Includes:  Ex:
 Functional "slides into occlusion" due to occlusal  Lip-sucking habit may give rise to a Class II dentiton and
int~rferences . profile
 Detrimental sucking habits (e,g., thumb, finger, lip)  Thumb-sucking  contraction of the maxillary arch 
 Abnormal patterns of mandibular closure. mandibular retraction
 Incompetent normal reflexes (e.g., lip posture)
 Abnormal muscular contractions (e.g., tongue-thrusting
during swallowing, mouth breathing, etc).

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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
Etiologic classification: its effect on diagnosis Etiologic classification: its effect on diagnosis
 Dental  Dental
 Teeth and their supporting structures.  Teeth and their supporting structures.
 Includes:  Treatment is aimed at:
 Malpositions of teeth  Moving the teeth to their normal positions
 Abnormal numbers of teeth  Replacing lost teeth
 Abnormal size of teeth  Ffitting the dentition's abnormalities to the facial skeleton
 Abnormal conformation or texture of teeth and its musculature

SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Ackerman-Proffit System  Ackerman-Proffit System
 Scheme which  Step 1: alignment
embodies the Angle  Involves assessment of
classification and five the alignment and
characteristics of symmetry of the dental
malocclusion within a arch when seen in the
occlusal view
Venn diagram
 Ideal/crowded/spaced

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SYSTEMS OF CLASSIFICATION
AND TERMINOLOGY
 Ackerman-Proffit System
 Step 2: profile and facial
divergence
 Convex, straight, concave
 Anterior or posterior
divergence
SYSTEMS OF CLASSIFICATION
AND TERMINOLOGY
 Ackerman-Proffit System
 Step 4: class
 Assessment of the
sagittal relationship
 Classified as Angle’s Class
I, II, III
 Differentiation is made
between skeletal and
dental malocclusions
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SYSTEMS OF CLASSIFICATION
AND TERMINOLOGY
 Ackerman-Proffit System
 Step 3: type
 The transverse skeletal
and dental relationship is
evaluated
 Crossbites
 Unilateral or bilateral
 Skeletal or dental
SYSTEMS OF CLASSIFICATION
AND TERMINOLOGY
 Ackerman-Proffit System
 Step 5: bite depth
 Malocclusons in the
vertical plane are noted
 Described as :
 Anterior or posterior
crossbite
 Deep bite
 Posterior collapsed bite
 Skeletal or dental
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SYSTEMS OF CLASSIFICATION SYSTEMS OF CLASSIFICATION

AND TERMINOLOGY AND TERMINOLOGY
 Ackerman-Proffit System  Ackerman-Proffit System
 Advantages:
 Teaches a perspective about  Advantages:
the complexities of  Leads one to the
malocclusion.
 All three planes of space and diagnosis and to
the influence of the differential treatment
dentition on profile are
considered. planning
 Differentiation between
skeletal and dental problems
is made at the appropriate
level
 Arch length problems with
or without an influence on
the profile are recognized

CLASS I SYNDROME CLASS II SYNDROME

Characterized by a normal molar and skeletal Most frequently encountered severe
relationship. malocclusion.
Skeletal profile: straight Malrelationship may be due to a basic osseous
Problem usually is dental in origin dysplasia or to forward movement of the
 Large teeth maxillary dental arch and alveolar processes or
 Open bite
a combination of skeletal and dental factors
 Deep bite

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LIMITATIONS OF
CLASS III SYNDROME CLASSIFICATION SYSTEMS
 Deep-seated skeletal dysplasia None are truly inclusive
 Most classification schemes omit entire regions
which are now known to be an indigenous and
integral part of the malocclusion
 Most omit dimensions
 Most omit entire syndromes or malocclusion
types

LIMITATIONS OF
CLASSIFICATION SYSTEMS
All are static in concept.
 Malocclusions adapt and change through time, yet
most classification schemes do not encourage us
to think in terms of such changes.
LIMITATIONS OF
CLASSIFICATION SYSTEMS
Most are narrow in focus and perspective
 Difficult to fit new findings or ideas into a
classification scheme or framework.
 Simplicity of the classification leads to emphasis
on one aspect of the total malocclusion
syndrome
 There is a tradition of misuse and
misapplication

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