Tooth impaction: these can cause resorption of adjacent teeth and other pathologies for example a dentigerous cyst formation. Psychosocial wellbeing: malocclusions of teeth with perceived poor aesthetics can have a significant effect on self-esteem. This is subjective in nature and will vary widely, being subject cultural and racial influences.Malocclusions may be coupled with skeletal disharmony of the face, where the relations between the upper and lower jaws are not appropriate. Such skeletal disharmonies often distort sufferers face shape, severely affect aesthetics of the face, and may be coupled with mastication or speech problems. Most skeletal malocclusions can only be treated by orthognathic surgery. Classification
Depending on the sagittal relations of teeth and jaws, malocclusions can be divided mainly into three types according to Angles classification system published 1899. However, there are also other conditions, e.g. crowding of teeth, not directly fitting into this classification. Many authors have tried to modify or replace Angles classification. This has resulted in many subtypes and new systems (see section below: Review of Angles system of classes). A deep bite (also known as a Type II Malocclusion) is a condition in which the upper teeth overlap the lower teeth, which can result in hard and soft tissue trauma, in addition to an effect on appearance. It has been found to occur in 15–20% of the US population.An open bite is a condition characterised by a complete lack of overlap and occlusion between the upper and lower incisors. In children, open bite can be caused by prolonged thumb sucking.
Treatment for adults include a combination of extractions, fixed appliances, intermaxillary elastics and orthognathic surgery. For children, orthodontics is usually used to compensate for continued growth. With children with mixed dentition, the malocclusion may resolve on its own as the permanent teeth erupt. Furthermore, should the malocclusion be caused by childhood habits such as digit, thumb or pacifier sucking, it may result in resolution as the habit is stopped. Habit deterrent appliances may be used to help in breaking digit and thumb sucking habits. Other treatment options for patients who are still growing include functional appliances and headgear appliances. Tooth size discrepancy
Identifying the presence of tooth size discrepancies between the maxillary and mandibular arches is an important component of correct orthodontic diagnosis and treatment planning. To establish appropriate alignment and occlusion, the size of upper and lower front teeth, or upper and lower teeth in general, needs to be proportional. Inter-arch tooth size discrepancy (ITSD) is defined as a disproportion in the mesio-distal dimensions of teeth of opposing dental arches. The prevalence is clinically significant among orthodontic patients and has been reported to range from 17% to 30%.Identifying inter-arch tooth size discrepancy (ITSD) before treatment begins allows the practitioner to develop the treatment plan in a way that will take ITSD into account. ITSD corrective treatment may entail demanding reduction (interproximal wear), increase (crowns and resins), or elimination (extractions) of dental mass prior to treatment finalization.Several methods have been used to determine ITSD. Of these methods the one most commonly used is the Bolton analysis.