SYED SOHAIB DAUD GILANI FINAL YEAR BDS ROLL#303

MALOCCLUSION. 
A malocclusion is a  misalignment of teeth  incorrect relation between the teeth of the two dental arches.  The term was coined byEdward Angle, the byEdward Angle, "father of modern orthodontics", as a derivative of occlusion, which refers to the manner in occlusion, which opposing teeth meet.

WHAT IS MALOCCLUSION? 
Malocclusion is not a disease, but a spectrum representing biological variability/diversity  When the deviation from the normal reaches a certain degree of severity (threshold), then it is (threshold), termed malocclusion  What is of relevance is ³clinically significant´ deviation from normal occlusion

35% 5% 20% 20% 20%

WHY ETIOLOGY?     Better understanding of the condition Prevention Prediction Management .

ETIOLOGY OF MALOCCLUSION  The various classifications proposed are: are: ‡ White and Gardiner's classification ‡ Salzmann's classification ‡ Moyer's classification ‡ Graber's classification. . classification.

malocclusion. factors. .  It tried to make a distinction between the skeletal and dental etiologic factors.  It also tried to distinguish between pre-eruptive and prepostpost-eruptive causes. causes.White and Gardiner's classification  This was one of the first attempts to classify malocclusion.

Antero-posterior mal relationship Antero2.DENTAL BASE ABNORMALITIES      1. Congenital abnormalities. . Lateral mal relationship 4. Disproportion of size between teeth and basal bone 5. Vertical mal relationship 3.

Abnormalities in position of developing tooth germ 2.PRE·ERUPTION ABNORMALITIES       1. Traumatic injury. . Missing teeth 3. Supernumerary teeth and teeth abnormal in form 4. Large labial frenum 6. Prolonged retention of deciduous teeth 5.

Abnormalities in path of closure  2. Extraction of permanent teeth. Active muscle force b. . Sucking habits d. Premature loss of deciduous teeth  3. Rest position of musculature c. Muscular a.POST·ERUPTION ABNORMALITIES  1.

the division of the etiologic factors into prenatal. .  Since different factors effect these different stages hence. The fetal environment  3. acquired. functional and environmental or acquired.SALZMANN'S CLASSIFICATION Salzmann defined three definite stages in which malocclusions are likely to manifest: manifest:  1. environment. The genotypic  2. postnatal. The postnatal environment.

can be hereditary or acquired but existing at birth. Local-effect the face. Can be subdivided into: stage. engrafted in the body in the prefunctional embryonic developmental stage. General-effect the body as a whole Generalb.  3. as: a. Congenital . General or constitutional b. Genetic . Local or dentofacial. where the dentofacial anomalies may or may not be in evidence at birth. Can be subdivided as: birth. Differentiative . .included malocclusions transmitted by genes.malocclusions that are inborn.PRENATAL  1. dentofacial. jaws and teeth only.  2. into: a. birth. Localonly.

. Endocrine disturbances which may modify the growth pattern and eventually affect dentofacial growth e. Nutritional disturbances f.POSTNATAL  Developmental  A. Radiation. Radiation.or hypertonicity of muscles which may eventually Hypoaffect the dentofacial development and function d. General a. Childhood diseases that affect the growth pattern g. Birth injuries b. Hypo. Abnormalities of relative rate of growth in different body organs c.

Abnormal frenal attachments  5. . Abnormalities of tooth development: development:  1. b. face and jaws  2. Abnormalities of the dentofacial complex: complex:  1. teeth. Birth injuries of the head. Facial hemiatrophy. Aplasia of teeth. Delayed or premature eruption of the deciduous or permanent teeth  2. Delayed or premature shedding of deciduous teeth  3.or macrognathia Micro 3. hemiatrophy. Ectopic eruption  4. Local a. Micro.or macroglossia Micro 4. Micro. B. Impacted teeth  5.

General  1. Neurotrophic disturbances  4. Endocrine disturbances  3. Nutritional deficiencies  5. Respiratory disturbances (mouth breathing). . Postural defects  6.FUNCTIONAL A.or hypotonicity hyper 2. Muscular hyper.

Faulty masticatory functions. Local  1. . disturbances. Temporomandibular articulation disturbances. Trauma from occlusion  7. Loss of forces caused by failure of proximaI contact between teeth  3.  4. condition. Masticatory and facial muscular hypo.B. Malfunction of forces exerted by the inclined planes of the cusps of the teeth  2. Compromised periodontal condition.or hypohyperactivity  5. especially during the tooth eruption period  6.

Nutritional disturbances especially during the tooth formation stage. jaws. Metabolic disturbances  5. .ENVIRONMENTAL OR ACQUIRED A. accidental injuries Trauma. Trauma.  6. Tumours. Radiation.  3. Disease can affect the dentofacial tissues directly or by affecting other parts of the body indirectly disturb the teeth and jaws. Acquired endocrine disturbances that are not present at birth  4. General  1.  7. Radiation. Tumours. stage.  2.

Prolonged retention of deciduous teeth  4. Pressure habits  10. Temporomandibular articulation disturbances  8. bones. bones. Delayed eruption of permanent teeth  5. . Early loss of deciduous teeth  3. Traumatic injuries including fractures of the jaw 10.B. Loss of permanent teeth  6. Infections of the oral cavity  9. Periodontal diseases  7. Local  1. Disturbed forces of occlusion  2.

from where the sites. system. included: included: A)the A)the craniofacial skeleton. more often in groups rather than individually.MOyER'S CLASSIFICATION  Moyer identified etiologic sites. individually. . B)the B)the dentition. variations were expected to arise. These sites arise. C)the C)the orofacial musculature. He based his classification on the premise that various factors may contribute to cause variations at these sites. and D)other D)other 'soft tissues' of the masticatory system.

Lip sucking and lip biting  d. Developmental defects of unknown origin  3. Heredity  2. Prenatal trauma and birth injuries b. Physical agents: agents: a. Other habits . Trauma: Trauma: a. Nature of food  5. Thumb sucking and finger sucking b. Nail biting  f. Postnatal trauma  4. Tongue thrusting c. 1. Posture  e. Premature extraction of primary teeth b. Habits: Habits: a.

Early loss of permanent teeth  7. Endocrine disorders c.Premature loss of deciduous teeth . Diseases: Diseases: a. . Malnutrition. Systemic diseases b. 6. Local diseases: diseases:  ‡ Nasopharyngeal diseases and disturbed respiratory function  ‡ Gingival and periodontal disease  ‡ Tumours  ‡ Caries: Caries: .Disturbances in sequence of eruption of permanent teeth . Malnutrition.

classification. factors. .  This helped in clubbing together of factors which make it easier to understand and associate a malocclusion with the etiologic factors.GRABER'S CLASSIFICATION  Graber divided the etiologic factors as general or local factors and presented a very comprehensive classification.

Heredity  2. Prenatal (trauma. cerebral palsy. etc). Endocrine imbalance b. TMJ injury)  4. Postnatal (birth injury. etc). b. Predisposing metabolic climate and disease: disease: a. . etc). Infectious diseases (poliomyelitis. etc). Metabolic disturbances c. German measles.GENERAL FACTORS  1. Congenital  3. Environment: Environment: a. material maternal metabolism. maternal diet.

. Lip and nail biting e. Tonsils and adenoids i.) h. Abnormal pressure habits and functional aberrations: a. 5. Abnormal swallowing habits (improper deglutition) f. etc. Dietary problems (nutritional deficiency)  6. Trauma and accidents. Abnormal sucking b. Thumb and finger sucking c. Respiratory abnormalities (mouth breathing. Psychogenetics and bruxism  7. Speech defects g. Posture  8. Tongue thrust and tongue sucking d.

 2. Prolonged retention . Anomalies of number: number: a. caries. Missing teeth (congenital absence or loss due to accidents. Supernumerary teeth b. LOCAL FACTORS  1. Premature loss  6. Anomalies of tooth size  3. etc. Anomalies of tooth shape  4. Abnormal labial frenum: mucosal barriers frenum:  5.). etc.

. Delayed eruption of permanent teeth 8. restorations. Dental caries 11. 10.     7. Abnormal eruptive path 9. 11. Ankylosis 10. Improper dental restorations.

.

.

.

Infectious diseases .

.

DIETARY PROBLEMS (NUTRITIONAL DEFICIENCY) .

.

.

.

.

.

.

.

.

.

.

RESPIRATORY PATTERN ADENOID FACIES ± THRESHOLD?? .

DIGIT SUCKING HABIT Threshold ± 6 hrs .

TONGUE THRUSTING .

.

ETIOLOGY IN CONTEMPORARY PERSPECTIVE  Etiology of most malocclusions are unknown  Role of genetic and environmental influences  Skeletal traits have greater genetic influence  Dental traits have relatively greater environmental influence .

THANK YOU .

Sign up to vote on this title
UsefulNot useful