Class II Division 2
1/Definition:
It is a basal anomaly of the antero-posterior direction characterized by an upper maxilla too far forward in relation to the mandible, associated with a dental anomaly of very pronounced lingual version of the upper incisors.
2/Etiopathogenesis:
-Anomaly with hereditary mode of transmission.
– Favoring morphological and eruptive factors:
< Mesial situation of the lateral sectors
< Decrease in the height of the alveolar processes.
-Dental factors:
A negative angulation between the crowns and roots of the upper central incisors
Low coronal height at the lateral sectors.
3/Clinical forms:
Bassigny described 3 clinical forms:
– Form 1: (the most frequent) linguoversion of the 2 upper central incisors and apparent vestibuloversion of the lateral incisors (DECK-Biss).
-Form 2 : Linguoversion of the 3 or 4 upper incisors, vestibular or included ectopic canines and overbite.
-Form 3: Box lid occlusion (most severe case), with linguoversion of the incisor-canine group and supraposition of the canines.
4/POSITIVE DIAGNOSIS:
4-1/Facial signs:
On examination of the face, no aesthetic facial repercussions are observed, except in certain severe cases which present a significant reduction in the lower part of the face and an accentuated concavity of the profile.
a-Face examination: the face is usually short face type, the face is sometimes square.
b-Profile examination: the profile is frequently concave, depending on a chin symphysis and a nose of larger than average dimensions:
-The goniac angle appears closed.
-Relative procheilia of the upper lip compared to the lower lip.
4-2/Occlusal signs:
-Intra-arcade layout:
a-Maxillary:
-deep palatine vault at the anterior level
-linguoversion of the two central incisors and vestibuloversion of the lateral incisors.
-the free edge of the upper central incisors is located lower than the occlusal plane.
b-Mandible:
-little or no incisal crowding
-incisor overbite
-abrasion facets sometimes visible at the free edges of the incisors.
-Inter-arcade relationship:
a-Statics:
-Anteroposterior direction: molar and canine Class II relationship with reduced incisal overjet.
-Vertical direction: excessive incisal overlap.
-Transverse direction: normoclusion from the canines
b- In the resting position the free space of exclusion is increased
4-3/Tele-radiographic signs:
FMA
ANB
I/F
ENA-Me
5/The muscular environment and functions:
a-Tongue: Normal size, high and posterior posture; no dental support.
b-Lips: Significant lip tone, gummy smile quite unsightly if the upper lip is short.
c-The masticatory muscles: predominance of the posterior fibers, the temporal and masseter muscles.
d-Functions: Swallowing and normal breathing.
Class II Division 2
Early cavities in children need to be treated promptly.
Dental veneers cover imperfections such as stains or cracks.
Misaligned teeth can cause difficulty chewing.
Dental implants provide a stable solution to replace missing teeth.
Antiseptic mouthwashes reduce bacteria that cause bad breath.
Decayed baby teeth can affect the health of permanent teeth.
A soft-bristled toothbrush preserves enamel and gums.