Class II malocclusion
Class II malocclusion is a bite in which the lower teeth, the lower jaw or both sit back relative to the upper teeth or jaw, and the American Association of Orthodontists’ glossary adds that the upper front teeth protrude forward.
The lower teeth or jaw behind the upper: Class II in two definitions
Class II malocclusion has an entry in the Glossary of Orthodontic Terms of the American Association of Orthodontists (AAO), printed this way: “A malocclusion the lower teeth and/or jaw is positioned back relative to the upper teeth and/or jaw. This results the upper front teeth protruding forward.”
The American Academy of Pediatric Dentistry (AAPD) gives the clinical name in its guideline on the developing dentition: “Class II malocclusion (distocclusion) may be unilateral or bilateral and involves a distal relationship of the mandible to the maxilla or the mandibular teeth to maxillary teeth.” In plain terms, the lower jaw or the lower teeth sit behind the upper, on one side of the mouth or on both.
Prominent upper front teeth: the plain words, and where they stop
Prominent upper front teeth are the plain words a 2018 Cochrane review puts beside Class II in its title: “Orthodontic treatment for prominent upper front teeth (Class II malocclusion) in children and adolescents.” The AAO’s own entry ends on the same picture, the upper front teeth protruding forward.
Those plain words do not fit every Class II bite: a second 2018 Cochrane review, on deep bite in children, says a Class II division 2 malocclusion has “upper front teeth that are retroclined (tilted toward the roof of the mouth) and an increased overbite (deep overbite).”
Where Class II comes up: the cause behind the bite
Class II comes up in treatment planning as a question of cause, and the AAPD lists the possibilities: the relationship “may result from dental (malposition of the teeth in the arches), skeletal (mandibular retrusion and/or maxillary protrusion), or a combination of dental and skeletal factors.” Put simply, the teeth may be out of position, the lower jaw set back or the upper jaw set forward, or the causes may combine.
Sorting out which cause applies to a particular bite is the orthodontist’s job at the examination. Whether an overbite is a Class II bite, and how an overbite is treated, are answered on the page about overbite. The bite problems the glossary defines also take in Class III, the opposite arrangement.
Sources
- American Association of Orthodontists, Orthodontic Glossary: Braces & Dental Terms Defined
- American Academy of Pediatric Dentistry, Management of the Developing Dentition and Occlusion in Pediatric Dentistry
- Batista and colleagues, Cochrane Database of Systematic Reviews, 2018, Orthodontic treatment for prominent upper front teeth (Class II malocclusion) in children and adolescents, abstract
- Millett and colleagues, Cochrane Database of Systematic Reviews, 2018 (PubMed record), Orthodontic treatment for deep bite and retroclined upper front teeth in children
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