Causes and Factors of Malocclusion
- Malocclusion is multifactorial, with genetic and environmental influences.
- Skeletal factors, such as the size and position of the upper and lower jaws, can contribute to malocclusion.
- Muscle factors, including habits like finger sucking and tongue thrusting, can impact the alignment of teeth.
- Dental factors, such as tooth size and abnormal eruption, can also cause malocclusion.
- Oral habits and pressure can play a role in the development of malocclusion.
- Habits like mouth breathing, finger sucking, and nail biting can influence the development of the face and dental arches.
- Pacifier sucking habits are correlated with otitis media.
- Dental caries, periapical inflammation, and tooth loss in primary dentition can affect the eruption of permanent teeth.
- Abnormal posture, deglutition disorders, and other habits can also impact dental development.
- Malocclusion can be influenced by oral habits and pressure.
Types and Classification of Malocclusion
- Malocclusions can be classified based on the sagittal relations of teeth and jaws.
- Angle's classification system is commonly used, but there are also other conditions that do not fit directly into this classification.
- Types of malocclusion include deep bite, open bite, and overbite.
- A deep bite occurs when the upper teeth overlap the lower teeth, affecting appearance and causing tissue trauma.
- An open bite is characterised by a lack of overlap and occlusion between the upper and lower incisors.
- Edward Angle is considered the father of modern orthodontics.
- Angle classified malocclusion based on the position of the maxillary first molar.
- Class I (Neutrocclusion) is when the molar relationship is normal but other teeth have problems.
- Class II (Distocclusion) is when the upper first molar is anterior to the lower first molar.
- Class III (Mesiocclusion) is when the upper molars are placed posteriorly to the lower molars.
- Modifications to Angle's classification have been suggested by Martin Dewey and Benno Lischer.
- Alternative systems have been proposed by Simon, Jacob A. Salzmann, and James L. Ackerman and William R. Proffit.
- Angles classification remains popular due to its simplicity and clarity.
- Besides the molar relationship, malocclusion is also classified based on incisor relationship.
- Class I is when the lower incisors occlude with or lie immediately below the upper central incisors.
- Class II has two divisions: Division 1 with proclined upper central incisors and increased overjet, and Division 2 with retroclined upper central incisors.
- Class III is when the lower incisors lie anterior to the upper incisors and the overjet is reduced or reversed.
- Class I is when the mesial slope of the upper canine coincides with the distal slope of the lower canine.
- Class II is when the mesial slope of the upper canine is ahead of the distal slope of the lower canine.
- Class III is when the mesial slope of the upper canine is behind the distal slope of the lower canine.
Signs, Symptoms, and Treatment of Malocclusion
- Malocclusion is a common finding, but not always serious enough to require treatment.
- Severe malocclusions may require orthodontic or surgical treatment to correct craniofacial anomalies.
- Symptoms of malocclusion can include tooth decay, periodontal disease, trauma to anterior teeth, difficulty with mastication, speech impairment, tooth impaction, and psychosocial wellbeing issues.
- Malocclusions may be coupled with skeletal disharmony, affecting face shape, aesthetics, and function.
- Orthognathic surgery may be necessary for treating skeletal malocclusions.
- Treated with orthodontics, tooth extraction, clear aligners, dental braces, or jaw surgery.
- Surgery may be required in rare cases.
- Wires, plates, or screws may be used to secure the jawbone.
- Most people have minor crowding that doesn't require treatment.
- Crowding can be an indication for intervention in severe cases.
- Corrective treatments include fixed or removable appliances.
- No robust evidence for treatment success.
- May or may not require surgical intervention.
- Open bite difficult to treat due to multifactorial causes.
- Thorough initial assessment crucial for diagnosis and treatment plan.
- Treatment includes behavior changes, appliances, and surgery.
- Orthodontics used for children to compensate for continued growth.
- Malocclusion may resolve on its own or with habit deterrent appliances.
- ITSD is a common issue among orthodontic patients, with a prevalence ranging from 17% to 30%.
- Identifying ITSD before treatment allows for a treatment plan that considers the tooth size discrepancy.
- ITSD corrective treatment options include interproximal wear, crowns and resins, or extractions.
- The Bolton analysis is the most commonly used method to determine ITSD.
- According to Bolton's formula, a correct occlusion requires adequate proportionality of tooth sizes.
- Severe malocclusions may require corrective jaw surgery or orthognathic surgery.
- Approximately 5% of the general population undergoes corrective jaw surgery as part of their treatment.
- Corrective jaw surgery aims to improve the alignment of the jaws and correct skeletal discrepancies.
- Orthognathic surgery can improve both functional and aesthetic aspects of malocclusions.
- The decision to undergo corrective jaw surgery is made based on the severity and impact of the malocclusion.
Primary and Secondary Dentition
- Malocclusion can occur in both primary and secondary dentition.
- In primary dentition, malocclusion can be caused by underdevelopment or overdevelopment of dentoalveolar tissue, cleft lip and palate, overcrowding, and abnormal tooth growth.
- In secondary dentition, malocclusion can be caused by periodontal disease, overeruption of teeth, and premature or congenital loss of
In orthodontics, a malocclusion is a misalignment or incorrect relation between the teeth of the upper and lower dental arches when they approach each other as the jaws close. The English-language term dates from 1864; Edward Angle (1855-1930), the "father of modern orthodontics",[need quotation to verify] popularised it. The word "malocclusion" derives from occlusion, and refers to the manner in which opposing teeth meet (mal- + occlusion = "incorrect closure").
| Malocclusion | |
|---|---|
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| Malocclusion in 10-year-old girl | |
| Specialty | Dentistry  |
The malocclusion classification is based on the relationship of the mesiobuccal cusp of the maxillary first molar and the buccal groove of the mandibular first molar. If this molar relationship exists, then the teeth can align into normal occlusion. According to Angle, malocclusion is any deviation of the occlusion from the ideal. However, assessment for malocclusion should also take into account aesthetics and the impact on functionality. If these aspects are acceptable to the patient despite meeting the formal definition of malocclusion, then treatment may not be necessary. It is estimated that nearly 30% of the population have malocclusions that are categorised as severe and definitely benefit from orthodontic treatment.
First attested in 1888. Formed as mal- (“wrong”, “improper(ly)”: ultimately from the Classical Latin male, “badly”, “wrongly”; from malus, “bad”; compare the ben- element in benocclusion) + occlusion (“alignment of the teeth in closed jaws”).
