CLASSIFICATION

OF MALOCCLUSION

 Presented by,
 Dr.dharampal Singh,
Dept. of Orthodontics.

Oct 14, 202 1

 Outline
 Introduction
 Purpose and need for classification
 Classification systems:
1.Angle’ classification
2.Modifications of Angle’s classification
4.Simon system
5.Ackerman-Proffit system
6.Salzmann’s classification
7.British standard Incisor classification
8.Bennet’s classification
9 moyers classification
epidemology trends
indian epidemology

Oct 14, 2020 2

 Introduction
 Orthodontics -“Science of Infinite
Variations” -Jackson
 Occlusion – “Normal relation of occlusal
inclined planes of the teeth when the jaws are
closed” -E.H.Angle

 Malocclusion – Any deviation from the normal

or ideal occlusion.
-Glossary of Orthodontic terms

Oct 14, 2020 3

 What is a classification system?

 A classification system is a grouping of clinical

cases of similar appearance for ease in
comparison, handling and discussion;
 it is not a system of diagnosis, method for
determining prognosis, or a way of defining
treatment.

Oct 14, 2020 4

 Purpose of classifying
 Conceptually, Classification can be viewed as an
orderly way to derive a list of the patient’s
problems from the database.

Oct 14, 2020 5

 Classification is needed for

 Ease of reference
 Comparison
 Communication

Oct 14, 2020 6

 Malocclusions can be broadly
categorized into-
 Dental dysplasias
 Skeletal dysplasias
 Skeletodental dysplasias

Oct 14, 2020 7

 Angle’s Classification

 Introduced by Edward
H.Angle in 1899.
 First and most important
universally used
classification.

E.H.Angle
Father of Modern
Orthodontics

Oct 14, 2020 8

 Principles of Angle’s classification-
 Maxillary first permanent molar- “key to
occlusion”
 Relationship of first molars
 Line of occlusion (Caternary curve)
 Anteroposterior relationship of dental
arches.

Oct 14, 2020 9

 Angle’s Classification has four
classes
 Normal occlusion
 Class I (neutroclusion)
 Class II (distoclusion)
 Class III (mesioclusion)

Oct 14, 2020 10

 Normal occlusion
 Angle’s concept of Normal occlusion is
essentially the description of an ideal occlusion.
 Normal molar relationship.
 Line of occlusion. (caternary curve)
 Normal anteroposterior relationship between
maxillary and mandibular dental arches.

Oct 14, 2020 11

 Normal Class I molar relationship:
1.The mesiobuccal cusp of the mandibular first
molar occludes in the embrasure area between the
maxillary second premolar and first molar.
2.The mesiobuccal cusp
of the maxillary first molar
is aligned directly over the
buccal groove of the
mandibular first molar.

3.The ML cusp of the maxillary first molar is

situated in the central fossa area of mandibular first
molar.
Oct 14, 2020 12
 Line of occlusion (catenary curve)
Line of occlusion is a
smooth curve passing
through the central fossa of
each upper molar and across
the cingulum of the upper
canine and incisor teeth. The
same line runs along the
buccal cusps and incisal
edges of the lower teeth.

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In original classification by Angle-
 All teeth except lower centrals and upper third
molars have two antagonists.
 Also the upper first molar has a mesial tilt that
allows the distal incline of distal cusp of upper
first molar to occlude with mesial incline of
mesial cusp of the lower second molar. (Angle, later
Strang, Stoller and Andrews)

Oct 14, 2020 14

 Angle’s Class I Malocclusion:
 Normal anteroposterior
relationship between maxilla and
mandible.
 Normal class I molar relation.
 Normal muscle function.
 Line of occlusion is incorrect
because of malposed teeth,
rotations or other causes.

Oct 14, 2020 15

 Bimaxillary protrusion
 Occasionally, with
normal anteroposterior
jaw relationship, the
teeth are forward on their
respective bases termed
as Bimaxillary
protrusion.
 Angle considered
Bimaxillary protrusions
in class I category.

Oct 14, 2020 16

 Angle’s class I is a range, rather than
an ideal point…….!
 In 1900, Angle made class II a full premolar-
width distocclusion and class III a full premolar-
width mesiocclusion, resulting in a class I range
of 14 mm(7+7).

Oct 14, 2020 17

In 1907, Angle revised definition of class I from
a full premolar width in either direction to one
half of a cusp in either direction, reducing the
range of class I to 7 mm(3.5+3.5).

This refinement brought more malocclusions into

the class II and class III categories.
Oct 14, 2020 18
 Angle’s Class II Malocclusion:
 Lower dental arch is in a DISTAL relation to the
upper dental arch.
 Class II molar relation.
 Line of occlusion not specified.
 There are 2 divisions in class II malocclusions

Oct 14, 2020 19

 Class II molar relation:
 The mesiobuccal cusp of the mandibular first
molar occludes in the central fossa area of the
maxillary first molar.
 The mesiobuccal cusp of
the mandibular first molar
is aligned with the buccal
groove of the maxillary
first molar.
 The DL cusp of the maxillary first molar occludes
in the central fossa area of the mandibular first
molar.
Oct 14, 2020 20
 Division 1
 Class II molar relation.
 Proclined upper incisors.
 ‘V’ shaped maxillary arch.
 Supraversion of the lower
anteriors.
 Abnormal muscle activity.

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 Division 2
 Class II molar relation.
 Lingually inclined upper centrals
and labially tipped upper lateral
incisors.
 Wide maxillary arch.
 Exaggerated curve of spee.
 Closed bite.

Oct 14, 2020 22

Division 2 (contd.)
 Supraversion of mandibular
incisors.
 Perioral musculature usually
normal.
 Excessive interocclusal
clearance.
 Forced retrusion of the
mandible.

Oct 14, 2020 23

 Class II subdivision
 When the class II molar relationship occurs on
one side of the dental arch only, the
malocclusion is referred to as a subdivision of
its division.
It can be-
 Class II div.1 subdivision
 Class II div.2 subdivision

Oct 14, 2020 24

 Subdivision…….??
Refers to which side(class II or class I)?
 Majority – Subdivision refers to Class II side.
(AAO glossary, moyers, proffit, salzman….)
 65% refered subdivision as affected side
 35% refered subdivision as non affected side
 The most accurate depiction would be to specify
which side is class II and which is class I.
e.g Class II div 1, Subdivision; R class II, L class I.
Siegel, M.A. : A matter of Class: Interpreting
subdivision in a malocclusion. AJO 2002;122;582-6.

Oct 14, 2020 25

 Angle’s Class III Malocclusion
 Mandibular dental arch in MESIAL relation to
the maxillary dental arch.
 Class III molar relation.
 Line of occlusion not
specified.

Oct 14, 2020 26

 Class III molar relation:
 The distobuccal cusp of the mandibular first
molar is situated in the embrasure between the
maxillary second premolar and first molar.
 The MB cusp of the
maxillary first molar is
situated over the
embrasure between the
mandibular first and
second molar.
 The ML cusp of the maxillary first molar is
situated in the mesial pit of the mandibular
second molar.
Oct 14, 2020 27
 Class III (contd.)
 Mandibular incisors – cross bite, inclined
lingually.
 Maxillary arch constricted.

Oct 14, 2020 28

 Pseudo Class III
 This is not a true class III malocclusion but the
presentation is similar. Here the mandible shifts
anteriorly in the glenoid fossa due to a premature
contact of the teeth or some other reason when
jaws are brought together in centric occlusion.
 Lingually inclined maxillary incisors leads to
anterior displacement of the mandible.
 Can be due to premature loss of deciduous
posteriors.
 It can also be due to occlusal prematurities or
enlarged adenoids.
Oct 14, 2020 29
 Class III subdivision
 Class III molar relation on one side & Class I
on the other.

Oct 14, 2020 30

 Advantages
 Simplicity.
 It is the most traditional, most practical and
Universally accepted method of classification.
 It was the first to define normal occlusion in
natural dentition.
 Foundation for future classifications.

Oct 14, 2020 31

 Disadvantages of Angle’s
Classification
 Considered Anteroposterior relationship, not
vertical & transverse.
 First permanent molars are not fixed
points.
 Cannot be applied if first molars missing.
 Cannot be applied to deciduous dentition.
 No differentiation between skeletal & dental
malocclusion.
 Classification does not highlight etiology.
Oct 14, 2020 32
 Martin Dewey’s modification of
Angle’s Malocclusion(1915)
Dewey modified Class I malocclusion
with-
Type I: Crowded anterior teeth.
Type II: Protrusive maxillary incisors.
Type III: Anterior crossbite.
Type IV: Posterior crossbite.
Type V: Mesial drifting of permanent molar.
Oct 14, 2020 33
 Type I: Crowded anterior teeth.

Type II: Protrusive maxillary incisors.

Oct 14, 2020 34

 Type III: Anterior crossbite.

Type IV: Posterior crossbite.

Oct 14, 2020 35

 Type V: Mesial drifting of permanent molar.

Oct 14, 2020 36

Dewey modified class III malocclusion
with-
 Type 1: Viewed separately, archs are normal, In
occlusion – edge to edge incisor alignment
suggestive of forwardly moved mandibular arch.

Oct 14, 2020 37

 Type 2: Crowding and lingual relation of
mandibular incisors to maxillary incisors.

Oct 14, 2020 38

 Type 3: Crowding and cross bite relation of
maxillary incisors to mandibular incisors.

Oct 14, 2020 39

 Lischer’s modification of Angle’s
Classification(1933)
 Lischer substituted Angle’s classes by-
 “Neutrocclusion” - Angle’s class I
 “Distocclusion” - Angle’s class II
 “Mesiocclusion” - Angle’s class III

Oct 14, 2020 40

 In addition, Lischer described nomenclature for
individual tooth malpositions by adding suffix
“version” to a word indicating deviation from
normal position

1.Mesioversion:

2.Distoversion:

Oct 14, 2020 41

3.Lingoversion:

4.Labioversion

Oct 14, 2020 42

5.Infraversion:

6.Supraversion:

Oct 14, 2020 43

7.Axioversion:

8.Transversion:

Oct 14, 2020 44

 9.Torsiversion:
(rotation)

Mesiolabial or Mesiolingual
distolingual or distolabial
rotation rotation

Oct 14, 2020 45

Van der Linden classification of Class
II Div 2
Depending on the spatial conditions in the
maxillary dental arch.
Type A- The upper central and lateral
incisors are retroclined.
It is of less severe in nature.

Oct 14, 2020 46

 Type B- The central incisors
are retroclined and overlapped
by the lateral incisors.

Type C- The central and

lateral incisors are retroclined
and overlapped by the canines.
Oct 14, 2020 47
 A MODIFIED ANGLE
CLASSIFICATION
A goal-directed classification
(Morton I. Katz, AJO,1992)

 Angle in his classification of malocclusions,

appears to have made class I a range of
abnormality, not a point of ideal occlusion.
 Current goals of orthodontic treatment however,
strive for the designation “class I occlusion” to be
synonymous with the point of ideal intermeshing
and not a broad range.
Oct 14, 2020 48
 If contemporary orthodontists are to continue to
use class I as a goal, then it is appropriate that
angle’s century old classification, be modified to
be more precise.
 In this modification, angle’s prototype ideal
occlusion has been retained.
 The larger 7 mm range of class I has been
discarded.

Oct 14, 2020 49

 Premolar derived Classification
 Class I : The most anterior upper premolar fits
exactly into the embrasure created by the distal
contact of the most anterior lower premolar.
 When this relationship is achieved, the canines
will also relate correctly, as will the incisors.
 But, molar relation is not considered.

Oct 14, 2020 50

 Class II when the most anterior upper
premolar is occluding mesial to the
embrasure created by the distal contact of
the most anterior lower premolar

 Class III when the most anterior upper

premolar is occluding distal to the
embrasure created by the distal contact of
the most anterior lower premolar

Oct 14, 20 51
 Deciduous and mixed dentition
classification
 Class I : The center axis of the upper first
deciduous molar should split the embrasure
between both lower deciduous molars.
 If upper first deciduous molar is lost permaturely
lost, a line drawn through the center axis of the
edentulous space should bisect the embrasure
between the two lower deciduous molars.

Oct 14, 2020 52

 Quantifying the classification:

Modified classification designates-

 Ideal cusp-embrasure occlusion (0)
(as described by angle)
 Class II (+)
 Class III (-)
 Right side is evaluated first, then the left side.
 Ideal occlusion on both sides (0,0)

Oct 14, 2020 53

 Ideal relation on right, 2mm class II tendency on left side = (0, +2)

Half cusp class II on right side, full cusp class II on left side = (+4,+8)
Oct 14, 2020 54
 1.5mm class II on right side, 3.5mm class III on left side = (+1.5,-3.5)
Note traditional angle can not classify a patient with both class II and
class III sides.

Oct 14, 2020 55

 Advantages:
 This new system establishes a treatment goal that
is a specific cusp-embrasure point rather than a
range.
 Quantifies the degree of occlusal error of a
malocclusion precisely in mm and for each side
separately.
 Covers even the rare malocclusions. (class II on
one side and class III on other side)
 Classifies deciduous and mixed dentition.
 Can be computerized.
Oct 14, 2020 56
 Disadvantages
 Does not consider malocclusions in transverse
and vertical planes.
 Does not consider etiology.
 Doesn't include dental or skeletal malocclusion.

Oct 14, 2020 57

 Simon’s Classification:
 Introduced in 1930s
 First to Related the
teeth to the rest of the
face & cranium in all
three dimensions.
 Related dental arches
to 3 anthropologic
planes-
1. The Frankfurt
horizontal plane.
2. The orbital plane.
3. The midsagittal plane.
58
 The vertical relationship (Frankfurt’s plane)-
1. Plane is from porion to orbitale.
2. Closer the dental arch to this plane – attraction.
3. Away from this plane – abstraction.

 The Anteroposterior relationship (Orbital plane)-

1. Perpendicular to the Frankfurt plane.
2. Passes through distal third of upper canine –
‘Simon’s law of the canine’.
3. Further from this plane- Protraction.
4. Closer to this plane – Retraction.

59
 The mediolateral relationship (Midsagittal plane):
1. It is in the transverse direction.
2. Away from this plane – Distraction.
3. Close to this plane – Contraction.

Advantages of Simon’s classification-

1. Orients the dental arches to the facial skeleton.
2. Malpositions of teeth & osseous dysplasia are
separated.

Disadvantages-Cumbersome & confusing.

Was not as popular as Angle’s classification.

60
Ackermann - Proffit Classification

 Developed in 1960s.
 Combination of two schemes – the Angle
classification & the Venn diagram.
 The Venn diagram offers visual
demonstration to the complex interrelated
variables.

61
62
 Classification by groups-

Group 1 – Alignment & symmetry.

Group 2 – Profile.
Group 3 – Lateral or transverse deviations.
Group 4 – Sagittal or anteroposterior
deviations.
Group 5 – Vertical deviations.
Group 6, 7, 8 & 9 from interlocking subsets.

63
 Method of application of the classification-
Diagnostic information required.
Step I – Analysis of alignment & symmetry.
 Possibilities are – ideal, crowding, spacing, mutilated.

Step II – Analysis of profile.

 Anterior or posterior divergence
 – convex, straight, concave.

Step III – Analysis of transverse plane.

 Can be dentoalveolar or skeletal.

 Maxillary or mandibular used to indicate the jaw
involved.

64
Step IV – Analysis of sagittal plane.
 Class – 1,II,III
 Angle’s classification applied.
 Can be dentoalveolar or skeletal.

Step V – Analysis of vertical dimension.

 Bite depth analysed
 Can be dentoalveolar or skeletal.
 The possibilities are – Anterior openbite,
anterior deep bite, posterior openbite,
posterior collapsed bite.
65
Advantages-
1. Very comprehensive.
2. Both skeletal & dental aspects
considered.
3. Adaptable to computer processing.

Disadvantages-
1. Etiology not taken into consideration.
2. Analysis is essentially static.

66
E.g. of the clinical application of this
classification – Group 9 indicates –
Alignment – both arches crowded.
Profile – Posterior divergent/convex.
Type – Maxillary palatal crossbite,
bilaterally, skeletal & dental.
Class - Class I, excessive overjet, Class II
skeletal.
Bite – Openbite, skeletal.

67
 Bennet’s Classification
Based on etiology –
Class I – Abnormal position of one or more
teeth due to local causes.
Class II – Abnormal formation of either arch
due to developmental defects.
Class III – Abnormal relationship between
U/L arches
- Between either arches and facial contour.
- Correlated abnormal formation of either
arch.
68
 British Standard Classification
 Incisor classification – Ballard & Wayman (1964).
 Forms the basis of British standard classification.
Class I – Lower incisor edges preclude with or lie immediately below the
cingulum of the upper central incisors.
Class II – Incisor edges lie posterior to the cingulum.
Div 1 – Increase in overjet & proclination of upper central incisors.
Div 2 – Upper central incisors are retroclined.
Class III – Incisor edges lie anterior to cingulum.

69
 Skeletal Classification(Salzmann)
 Skeletal Class I –
Profile is orthognathic.

Div 1 – Local malpositions of incisors,

canines and premolars.
Div 2 – Maxillary incisor protrusion.
Div 3 – Maxillary incisors in
linguoversion.
Div 4 – Bimaxillary protrusion.
70
 Skeletal Class II –

Mandible in distal relation to maxilla-

Div 1 – Maxillary dental arch narrower
than the mandibular.
Crowding in canine region.
Crossbite.
Reduced vertical height & protrusion of
maxillary anterior teeth.
71
 Div 2 – lingual inclination of maxillary
incisors.
Lateral incisors normal or in labioversion.
Profile: Retrognathic.

Skeletal Class III –

Mandible in mesial relation to maxilla.
Obtuse gonion angle.
Profile: Prognathic.

72
Moyers etiological classification
 Classification based on tissue origin-
Osseous –
 Problems in growth, size, shape or proportions of the
bones are considered.
 Orthodontic problem results when the bones of the
craniofacial complex develop in an abnormal manner.
 Cephalometric analysis provides best means of studying
these variations.
 Treatment is to correct the osseous dysplasia

Oct 14, 2020 73

 Muscular
 Malfunction of dentofacial musculature.
 Most of these neuromuscular pattern of
behaviour are habits.
 Treatment of original reflexes or habit if detected
early – easy.
 In case of skeletal manifestations – Not easily
reversible.

 Dental
 1. Involves the teeth & supporting structures.
 2. Precise dental abnormality to be determined.
Oct 14, 2020 74
 3. Primary or secondary to be determined
 This category includes –
 Malpositions of teeth.
 Abnormal number of teeth.
 Abnormal size of teeth.
 Abnormal conformation of teeth.

 Primary etiological tissue needs to be

identified to determine the final treatment
plan.

Oct 14, 2020 75

Epidemology of
malocclusion
 Malocclusion is one of the most prevalent oral pathologies,
next only to dental caries and periodontal disease and usually
ranked third among worldwide public health dental disease
priorities
 Developing countries like India are struggling to eradicate
many medical and dental diseases.
 The main reason behind this is an inadequate implementation
of preventive oral health care programmes which need a
sound base of epidemiological data.

Oct 14, 2020 77

 Epidemiological studies on occlusion and
malocclusion not only help in orthodontic
treatment planning and evaluation of dental
health services but also offer a valid research
tool for ascertaining the operation of distinct
environmental and genetic factors in the
aetiology of malocclusion
 Facial appearance has a long lasting implication
on an individual.
Oct 14, 2020 78
 Need ?
 Epidemology is important for planning health
programmes for polpulation and to know what
are health care need in a polulation
 They are also important in evaluating efficacy
of the preventive and thereputic measures
 earlier surveys on dental diseases were mainly
focused on dental caries and periodontal
disease while malocclusion received
comparatively much less attention.
 The reasons could be a lack of the uniform criteria
in recording the malocclusion which is not a
disease but a variation of the normal morphology
 large spectrum of its presentation in several traits
and difficulties in assessment of the REAL
treatment needs superimposed with the social and
ethnic curtains.
 However lately, much information on
malocclusion and treatment needs is being made
available from around the world
Facial appearance ---low self esteem -----
negative self image-----career advancement and
peer-group acceptance.
In order to prevent a wide-spread impact on
their psychological development
children having very severe or handicapping
malocclusion should be identified and corrective
measures should be instituted at the earliest
 Angle was first to conduct epidemological
surveyd on malocclusion
 Screen 1000 students in school of mossurie
 Class 1 69
 Class 2 19
 Class 3 3.4
 Drawback of angles system

 Angles system is most commonly used in

epidemological surveys
 it does not reveal the severity of the
malocclusion
 not consider the patient’s profile and also the
skeletal relationship.
 Inter examiner differences are high
 Still used in most epidemological surveys
 Methods of measuring
malocclusion
 Angle stallard
 Mc calls
 Sclare
 Fisk
 Bjork et al
 Proffit and ackerman
 WHO FDI
 Kinaan and bruke
 Bjork et al criteria
 Did objective registration of malocclusions
based on detailed definitions and computer
analysed data is used
 3 parts
 1 anomalies in dentition
 Occlusal anomalies …. Between jaws segital,
vertical, transverse
 Space problems……crowding, spacing
 WHO/FDI 1979
 This method was based on byork method.,
 Many amendments and corrections were done by FDI and
WHO groups
 Dentofacial anomalies assesment form was made and was used
In 1979 oral health survey
 Acessing tools were symplified and detailed .
Dental exam…..missing teeth, malformed teeth ,
supernumerary, trauma , extn
Inter arch examination…….molar relation, post crossbite, ant
cross bite , overjet, overbite , open bite deep bite
Intra arch…………crowding , spacing, midline diestema, etc
 Reason for large variation in
prevalence
 Lack of uniform criteria
 Faulty technique
 Error in examination and data recording
 Not proper sample size which represent the
population….specially in children
 In child occlusion is constantly changing with growth so late
mixed dentition or early permanent dentition time should be
considered 10..12 years of age
 Ethnic variation
 Sex differences
 Intra examiner variation
 Inter examiner errors
 Criteria to record proper
malocclusion
 Age 10 plus…..late mixed or early
permanent
 Proper sample size which should represent
the target population
 Specify area/location
 Specify survayor
 Specify criteria and method of registration
 Sample size

 It should represent its parent population

 n= 4pq/l
p ..prevalence from previous
studies
q..100-p
l.. allowable error
n ….required sample
 Ethnic trends in malocclusion
 Whites 34 > black 18
 Urban > rural

 Race factor
negros……………………………class 1 bimax
causcasians USA…………….class 2
Mangoloid of japan china
Korea,taiwan …………………………class 3

Class 2 malocclusion
danish child……….31%
johansberg 8%
kenya……………………..11%
saudi arab…………………….16%
delhi………………………………14%
 Prevelence around the world
 America and canada proffit

national health and nutrition estimates survey 3 (1989 )

14000 subjects
8 to 50 yrs. subjects
8..17 yrs. 70% had malocclusion
50 to 55…..class 1
15% class 2
1% class 3
more than 50% children had crowding in max/ mandible or both

Division of health examination statistics 1977

25 states 40 location 7514 school children examined
nutrocclusion 54% w 62% black
distocclusion 34% w 18% black
mesiocclusion 14%

crossbite…………..12%
highky desirable treatment 12%

mandatory treatment 16%

 Canada
payette and plante
quebec school children
TPI ( orthodontic treatment priority index
1201 child
32 % has class 2….18% .5mm overjet
13 % treatment mandatory

Harris and davis

61% of british colombia children had malocclusion

South america
survey of 4724 child 5 to 17 yrs
dental health services bagota colombia
TON indes and byork method used
88% had some form of dental anomaly

3% urgent need
20% great need
35 % moderate need
30 % little need
 Europe
80% childern had some form of occlusal
anomaly
Class 2 prevelence higher in europe
 danish childs…..31%
 hungary childs …..47 %
europeans has higher class 2 than arabia
africa and india
 Africa
More of class 1 malocclusion types found
72%
Kenya nigeria tanzania
Class 2 ……8%
class 2 is very less as compared to
europeans

china
67 % prevelence
Higher class 3 tendency than europeans
50% showed crowding
 Prevelence in india
 Prevelence 20 to 43 %
 Urban >rural
 Female > male
 Class1 >class 2> class 3
 Class 2 more in north ( delhi haryana 10-15 %) less in south india
( bangalore ,trivendram 5%)
 Class 1 bimax is more in south india han north

 Class 1
66.7% rajasthan ,, 49% bangalore

Class 2
1.9% rajasthan
4-6% bangalore
14% delhi

Class 3
1-4% rajasthan
0.3 to 6% bangalore
 Tiruvanant puram prevelence 49% 12.15 yrs
class 1….44%
class 2…..4.7%
class 3…..0.3%
Phaphe at al…bangalore 12-14 yrs
class 1……17%
class 2……30.1 %
class 3…..1.6%
Prabhakar et al chennai
class 1…….21.8%
class 2 div 1…..27.7%
div 2….9.5%
class 3 …..4.5
Kharbanda delhi 10to 13
class 1…….26
class2……..15
class 3…….3.5
haryana total prevelance 55%
 Malocclusion in tribes

 Mandu village tribe study in central india

study
 Show 85% child free from malocclusion
 Prevelence of only 14%
 10.5% had only mild malocclusion
 3% moderate to severe malocclusion
 0.2% only needed treatment
 Quantification of malocclusion
 Indices are developed and assessed by experts

 Byork et al
 HMAR…..handicaping malocclusion assessment records
 Swe NBH swedish national board of health
 IOTN index of orthodontic treatment needs uk
 NorHS norweign health service
 MSI malocclusion severity index
 DAI dental aesthetics index
 ICON index of complexity outcome and needs
 Six studies assessed orthodontic treatment
needs in india
 2 used IOTN
 4 used DAI
 Chauhan…..hillystates….12.5
 Damle …..haryana….23.6% anomaly
15,5,3.4
Sandhya et al udaipur 33% need
 References:
 Robert E. Moyers- Handbook of Orthodontics- 4 th ed
 William R. Proffit- Contemporary Orthodontics- 3 rd ed
 T. M. Graber- Orthodontics- Principles and practice
 Graber T.M, Vanarsdall R.L –Orthodontics-current
principles and techniques-3rd ed
 T. C. White, J. H. Gardiner, B. C. Leighton- Orthodontics
for dental students.
 Samir E.Bishara- Text book of Orthodontics- 3 rd ed
 Rakosi T, Joans I, Graber T.M – Orthodontic-Diagnosis –
1st ed
 Van der Linden- Development of the dentition.
 Daskalogiannakis J- Glossary of orthodontic terms.

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 Katz M.I- Angle classification revisited 1: Is current use
reliable? AJO 1992;102;173-9.
 Katz M.I- Angle classification revisited 2: A modified
angle classification. AJO 1992;102;277-84.
 Siegel, M.A. : A matter of Class: Interpreting subdivision
in a malocclusion. AJO 2002;122;582-6.
 Brin I, Weinberger T, Ben-chorin E- Classification of
occlusion reconsidered. EJO 21(1991)169-174.
 James c. Ackerman, Williams R. Proffit- The
characteristics of malocclusion: A modern approach to
classification and diagnosis. Am J Orthod. 1969; vol-56,
no-5.

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thankyou

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