"Etiology of Malocclusion": Hemam Shankar Singh

“ETIOLOGY OF MALOCCLUSION”
Presented by—
Hemam Shankar Singh
1
ETIOLOGY OF MALOCCLUSION- CONTENTS
CONTENTS
INTRODUCTION
CLASSIFICATION OF ETIOLOGY OF MALOCCLUSION
GRABER’S CLASSIFICATION
CONCLUSION
2
ETIOLOGY OF MALOCCLUSION- INTRODUCTION
INTRODUCTION
FUNDAMENTAL TO UNDERSTANDING MALOCCLUSION IS THE

CONCEPT OF `NORMAL OCCLUSION`.
JOHN HUNTER
WAS THE FIRST TO DESCRIBE ABOUT NORMAL OCCLUSION.
3
ETIOLOGY OF MALOCCLUSION-INTRODUCTION
4
• Etiology of malocclusion is the study of its causes.
ETIOLOGY OF MALOCCLUSION-INTRODUCTION
• Recognition and elimination of the etiological factors is

important so that one can prevent and correct the
malocclusion and obtain a permanent result.
• Traditionally, any deviation from "ideal occlusion" has

represented what Guilford termed mal-occlusion. of
course, ideal occlusion rarely exists in nature and so perhaps it
is better to call this concept the "imaginary ideal"
5
ETIOLOGY OF MALOCCLUSION- INTRODUCTION
MALOCCLUSION
“An occlusion in which there is mal-relationship between the

arches in any of the planes of space or in which there are
anomalies in tooth position beyond the limits of normal”
Sameul S. Flitch was the first to classify malocclusion.
6
CLASSIFICATION OF ETIOLOGY
OF MALOCCLUSION
ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.
CLASSIFICATION OF ETIOLOGY OF
MALOCCLUSION
1. Moyer’s classification
2. White and Gardiner’s classification
3. Proffit’s Classification
4. Graber’s classification
7
CLASSIFICATION OF ETIOLOGY
OF MALOCCLUSION
HEREDITY
TRAUMA
PHYSICAL AGENTS
HABITS
DISEASES
MOYER’S
CLASSIFICATION MALNUTRITION
DEVELOPMENTAL DEFECTS OF UNKNOWN ORIGIN
8
MOYER’S CLASSIFICATION
HEREDITY TRAUMA
1. NEUROMUSCULAR 1. PRENATAL TRAUMA AND

2. BONE BIRTH INJURIES
3. TEETH 2. POSTNATAL TRAUMA
4. SOFT PARTS
9
PHYSICAL AGENTS HABITS
1. PREMATURE EXTRACTION OF 1. TUMB SUCKING AND FINGER

PRIMARY TEETH SUCKING
2. NATURE OF FOOD 2. TONGUE THRUSTING
3. LIP SUCKING AND LIP BITING
4. POSTURE
5. NAIL BITING
6. OTHER HABITS
10
DISEASES MALNUTRITION
1. SYSTEMIC DISEASES DEVELOPMENTAL DEFECTS OF

2. ENDOCRINE DISEASES UNKNOWN ORIGIN
3. LOCAL DISEASES
i. NASOPHARYNGEAL
DISEASES & DISTURBED
RESPIRATORY FUNCTION
ii. GINGIVAL &PERIODONTAL
DISEASES
iii. CARIES
iv. TUMOURS
11
ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O. WHITE & GARDINER’S
CLASSIFICATION
WHITE &
GARDINER’S
CLASSIFICATION
DENTAL BASE PRE-ERUPTION POST-ERUPTION

ABNORMALITIES ABNORMALITIES ABNORMALITIES
ANTERO-POSTERIOR ABNORMALITIES IN POSITON OF

DEVELOPING TOOTH GERM MUSCULAR
MALRELATIONSHIP
1. ACTIVE MUSCLE FORCE
MISSING TEETH 2. REST POSITION OF MUSCULATURE
VERTICAL MALRELATIONSHIP 3. SUCKING HABITS
SUPERNUMERARY TEETH & TEETH 4. ABNORMALITIES IN PATH OF
ABNORMAL IN FORM CLOSURE
LATERAL MALRELATIONSHIP
PROLONGED RETENTION OF DCIDUOUS TEETH

PREMATURE LOST OF DECIDUOUS TEETH
DISPROPORTION OF SIZE BETWEEN TEETH
& BASAL BONE LARGE LABIAL FRENUM
EXTRACTION OF PERMANENT TEETH

TRAUMATIC INJURY
CONGENITAL ABNORMALITIES
12
ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O. PROFFIT’S CLASSIFICATION
PROFFIT’S
CLASSIFICATION
Genetic
Influences
13
SPECIFIC CAUSES-
5.Disturbances in dental development.
1.Disturbances in embryologic
development. a.Congenitally missing teeth.
2.Skeletal growth disturbances b.Malformed teeth.
a.Fetal molding & birth injuries. c.Supernumerary teeth.
b.Birth trauma to the mandible. d.Interference with eruption.
c.Childhood fracture of the jaw. e.Ectopic eruption.
3.Muscle dysfunction. f.Early loss of primary teeth.
4.Acromegaly & hemi-mandibular g.Traumatic displacement of teeth
hypertrophy.
14
• GENETIC INFLUENCES
• ENVIRONMENTAL INFLUENCES
Functional influences on Dentofacial development-
a. Masticatory function
b. Sucking & Other Habits
c. Tongue thrusting
d. Respiratory pattern
15
ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O. GRABER’S CLASSIFICATION
GRABER’S
CLASSIFICATION
GENERAL
LOCAL FACTORS
FACTORS
16
GENERAL FACTORS
1. HEREDITY
2. CONGENITAL
3. ENVIRONMENTAL
4. PRE-DISPOSING METABOLIC CLIMATE & DISEASES
5. DIETARY PROBLEMS
6. ABNORMAL PRESSURE HABITS & FUNCTIONAL ABERRATIONS
7. POSTURE
8. TRAUMA AND ACCIDENT

17
GENERAL FACTORS
1. HEREDITY 2. CONGENITAL
4. PRE-DISPOSING METABOLIC
3. ENVIRONMENT
CLIMATE & DISEASES
a. PRE NATAL a. ENDOCRINE IMBALANCE
b. POST NATAL b. METABOLIC DISTURBANCES
c. INFECTIOUS DISEASES
18
GENERAL FACTORS
6. ABNORMAL PRESSURE HABITS & FUNCTIONAL
5. DIETARY PROBLEMS ABERRATIONS
b. THUMB & FINGER
a. ABNORMAL SUCKING
7. POSTURE SUCKING
c. TONGUE THRUST &

d. LIP & NAIL BITING
8. TRAUMA AND ACCIDENT TONGUE SUCKING
e. ABNORMAL
SWALLOWING HABITS f. SPEECH DEFECT
g. RESPIRATORY DEFECT h. TONSILS & ADENOIDS
i. PSYCHOGENIC TICS &

BRUXISM 19
LOCAL FACTORS
1. ANOMALIES OF NUMBER
2. ANOMALIES OF TOOTH SIZE
3. ANOMALIES OF TOOTH SHAPE 4. ABNORMAL LABIAL FRENUM:
MUCOSAL BARRIERS
5. PREMATURE LOST OF DECIDUOUS
TEETH 6. PROLONGED RETENTION OF
DECIDUOUS TEETH
7. DELAYED ERUPTION OF PERMANENT
TEETH
8. ABNORMAL ERUPTIVE PATH
9. ANKYLOSED
10. DENTAL CARIES
11. IMPROPER DENTAL RESTORATION
20
GRABER’S CLASSIFICATION-
GENERAL FACTORS
HEREDITY
-Heredity has for long been attributed as one of
the causes of malocclusion
- Another reason attributed for genetically
determined malocclusion is the
-Racial, ethical & regional inter-mixture
21
HEREDITY
-Number of human traits that are influenced by the genes include

(according to Lundstrom):
i. Tooth size
ii. Arch dimension
iii. crowding/spacing
iv. Abnormalities of tooth shape
v. Abnormalities of tooth number
vi. Overjet
vii. Inter-arch variations
viii. Frenum
22
HEREDITY
-Genuine Class II malocclusion

in three brothers
23
CONGENITAL DEFECTS
-They are malformations seen at the time of birth

-Its causes can be broadly classify as
1. General congenital factors
2. Local congenital factors
24
CONGENITAL DEFECTS
-General congenital factors

a. Abnormal state of mother during pregnancy
b. Malnutrition
c. Endocrinopathies
d. Infectious disease
e. Metabolic and nutritional disturbances
f. Accidents during pregnancy and child birth
g. Intra-uterine pressure
h. Accidental traumatization of the fetus by external forces
25
CONGENITAL DEFECTS
-Local congenital factors

a. Abnormalities of jaw development due to intra-uterine
position
b. Clefts of the face and palate
c. Macro and microglossia
d. Cleidocranial dysostosis
26
CONGENITAL DEFECTS
-The following are some of the congenital conditions frequently

encountered by orthodontist
a. Clefts of the lip and palate
b. Congenital syphilis
c. Maternal rubella infections
d. Cleidocranial dysostosis
e. Cerebral palsy
27
ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O. GRABER’S CLASSIFICATION CLEFTS OF THE LIP AND PALATE
Cleft Palate can be defined as a furrow in the
palatal vault or Breach in continuity of
CONGENITAL DEFECTS palate.
Most commonly seen congenital deformity at
the time of birth.
Both dental & skeletal components affected
Such patients exhibit following
 Missing
 Mobile teeth
 Rotations
 Cross bite
 Impacted teeth
 Supernumerary teeth, etc.
28
CONGENITAL DEFECTS
CONGENITAL SYPHILIS MATERNAL RUBELLA INFECTIONS

The child exhibits one or more of the Maternal rubella infections during
following features: pregnancy show some features
 Hutchinson’s incisors • Dental hypoplasia
 Mulbery molars • Retarded eruption of
 Enamel def teeth
 Extensive dental decay • Extensive caries
 The maxilla may be smaller
in size relative the mandible
 Anterior cross bite
29
CONGENITAL DEFECTS
CLEIDODOCRANIAL DYSOSTOSIS
This is a congenital condition characterized
by unilateral or bilateral, partial or
complete absence of the clavicle
The patient may exhibit the following features
• Maxillary retrusion & possible Mandibular protrusion
• Over retained deciduous teeth & retarded eruption of
permanent teeth
• Presence of supernumerary teeth
• Presence of short & thin roots
30
CLEIDODOCRANIAL DYSOSTOSIS
CONGENITAL DEFECTS
31
ENVIRONMENT
1. PRE-NATAL FACTORS
• Fetus is well protected against injuries & nutritional def during pregnancy
• But there are certain factors, presence of which can result in abnormal
growth of oro-facial region thereby predisposing to malocclusion
Pressure against rapidly growing areas leads to distortion
Arm pressed against the face- maxillary deficiency
Head flexed against the chest- Mandibular deficiency.
Decreased amniotic fluid- small mandible
Cleft palate results due to upward displacement of tongue.
Growth catches-up when pressure is released except when cartilage
is affected- Stickler syndrome
Thalidomide – gross congenital deformities including cleft 32
ENVIRONMENT
STICKLER SYNDROME
33
ENVIRONMENT
Teratogens affecting
dentofacial development
Contemporary Orthodontics: William R Proffit 34

ENVIRONMENT
2. POST-NATAL FACTORS
 Birth injuries
i. Trauma to mandible
Most mandibular deformities-due to congenital anomalies-but thought to be
due to birth trauma.
ii. Forceps delivery–TMJ damage .

iii. Ankylosis: develop ankylosis of TMJ, may be due to birth injury.
iv. A high incidence of cross-bite is seen in a group of children who were born
with forceps delivery.
v. An increased asymmetric molar occlusion was observed with traumatic breech
delivery.
35
ENVIRONMENT
vi. A tendency for abnormal dental arch dimension, larger height of the maxilla
and greater length of the mandibular arch was observed to occur as a result of
forceps delivery.
vii. Palatal grooves and cleft formation:
A prolonged oro-tracheal intubation of pre term infants is seen to be
associated with airway damage, palatal groove formation, defective primary
incisors and an acquired cleft palate.
viii. Delayed eruption of primary teeth:
Viscardi (1994) found that first primary teeth eruption at the usual chronologic
age in healthy premature infants, but eruption may be delayed in premature
infants who require a prolonged mechanical ventilation for neonatal illness/or
who experience inadequate nutrition
36
PREDISPOSING METABOLIC
CLIMATE & DISEASE
Hypopituitarism:
Dwarf
Delayed eruption of permanent teeth and delayed shedding of primary
teeth.
Crowding due to smaller arch size.
Mandibular growth more affected than maxilla.
37
CLIMATE & DISEASE
Hyperpituitarism:
Gigantism- large teeth and jaws.
Acromegaly- occurs after growth and
ossification is complete.
Lips thick, tongue enlarged, shows
scalloping.
Accelerated condylar growth-large
mandible.
Teeth tipped buccally due to large
tongue.
38
CLIMATE & DISEASE
Hypothyroidism:
• Delayed eruption.
• Abnormal resorption pattern.
• Retained deciduous teeth.
• Malposed teeth-deflected from eruption path.
• Gingival disturbances.
Hyperthyroidism:
• Early shedding and eruption
• Atrophy of alveolar bone.
39
DIETARY PROBLEMS
NUTRITIONAL DEFICIENCY
• Disturbances in the developmental timetable.
• Rickets, scurvy and beri-beri can produce severe malocclusions.
• Premature loss of teeth/Prolonged retention.
• Abnormal eruptive path.
• Poor tissue health
• Poor absorption-hormonal/enzymatic deficiency.
• Decreased fluoride intake-loss of teeth due to caries-malocclusion.
40
ABNORMAL PRESSURE HABITS AND

FUNCTIONAL ABERRATION
EQUILIBRIUM THEORY
• If an object is acted upon by a set of forces but remains in the same
position, then the forces must be in balance.
• Dentition is in equilibrium.
• Movement occurs when equilibrium is disturbed.
4 PRIMARY FACTORS IN EQUILIBRIUM:

1.Intrinsic forces of tongue and lips.
2.Extrinsic forces- habits & orthodontic appliances.
3.Forces from dental occlusion.
4.Forces from periodontal membrane 41
POSTURE
 Frequently suggested that poor posture can lead to malocclusion.
 Stooping with chin on the chest- mandibular retrusion.
 Child resting head on hand or sleeping on arm or fist- possible
development of malocclusion.
 May accentuate existing malocclusion.
 Role as primary etiological factor to be proved conclusively.
42
ACCIDENT OR TRAUMA
• Undiscovered traumatic experiences- significant in malocclusion.

 Eruptive abnormalities.
 Abnormal resorption.
 Loss of vitality.
• Both prenatal trauma & postnatal injuries- Dentofacial deformity:
43
LOCAL FACTORS
ANOMALIES IN NUMBER OF TEETH:
In order to achieve good occlusion, normal number of teeth should be

present. Presence of extra teeth or absence of one or more teeth
predisposes to malocclusion.
Heredity plays a strong part in anomalies in number of teeth.
44
LOCAL FACTORS
SUPERNUMERARY TEETH:
 Teeth that are extra to the normal
complement are termed supernumerary teeth.
 These teeth have abnormal morphology and do not resemble normal teeth.
Extra teeth that resemble normal teeth are called supplemental
They result from disturbances during the initiation and proliferation stages of
dental development.
no definitive time when supernumerary teeth may develop.
may form prior to birth or as late as 10- 12 years of age.
usually develop from a 3rd tooth bud arising from the dental lamina near the
permanent tooth bud teeth. 45
LOCAL FACTORS
Supernumerary teeth can cause:

1. Non-eruption of adjacent teeth
2. Delay the eruption of adjacent teeth
3. Deflect the erupting teeth into abnormal locations
4. Crowding in the dental arches.
46
LOCAL FACTORS
ANOMALIES OF TOOTH SIZE:

 There should be harmony between the tooth size and the arch
length, and also between the maxillary and mandibular tooth size, in order to
have normal occlusion.
An increase in size of teeth results in crowding while, smaller sized teeth
predispose to spacing.
 Anomalies of size of teeth can be of 2 types:
1.Microdontia
2. Macrodontia
47
LOCAL FACTORS
ANOMALIES OF TOOTH SHAPE:

Anomalies of tooth size and shape are often interrelated. Abnormally shaped
teeth predispose to malocclusion.
Anomalies of tooth shape include:
1. The presence of peg shaped maxillary lateral incisors is often accompanied
by spacing and migration of teeth.
2. Abnormally large cingulum on maxillary incisors-
Prevent establishment of normal overbite and Overjet. The involved tooth is
usually in labio-version due to the forces of occlusion.
3. Additional lingual cusp of mandibular 2nd premolars-Increase the mesio-
distal dimension of tooth
48
LOCAL FACTORS
4. Fusion-
Fused teeth arise through the
union of 2 normally separated
tooth germs.
5. Gemination-
Results from attempt at division
of single tooth germ
49
LOCAL FACTORS
6. Congenital syphilis –
It is often associated with hypoplasia of maxillary and mandibular anteriors.
Characteristics of congenital syphilis are “Hutchinson’s incisors” and “mulberry
molars”.
50
LOCAL FACTORS
7. Dilaceration –
Dilacerated tooth often fails to erupt to
proper level and can thus interfere with
normal occlusion. They may also
complicate extraction of teeth and may
interfere with tooth movement and
alignment.
51
LOCAL FACTORS
8. Dens evaginatus –
A developmental condition that appears
clinically as an accessory cusp or a globule of
enamel on the occlusal surface between the
buccal and lingual cusps mainly of premolars.
It may result in incomplete
eruption, displacement of teeth and may
interfere with normal occlusion.
52
LOCAL FACTORS
ABNORMAL LABIAL FRENUM:

shows spacing between the maxillary central incisors due to presence of the
fibrous tissue ,labial frenum.
53
LOCAL FACTORS
PREMATURE LOSS OF DECIDUOUS TEETH:
Specifically, it refers to the stage of development of the permanent tooth that will succeed
the lost primary tooth.
Premature loss can occur due to:
1. Caries
2. Trauma
3. Endocrinal disturbances like hyperthyroidism
4. Metabolic disturbances like hypophosphotasia
When a primary tooth is lost before the permanent successor has started to erupt, bone may
reform atop the permanent tooth, delaying its eruption. When its eruption is
delayed, more time is available for other teeth to drift into space that would have been
occupied by the permanent tooth. 54
LOCAL FACTORS
PROLONGED RETENTION OF DECIDUOUS TEETH
Can occur because of :-
1. Absence of underlying permanent teeth
2. Endocrinal disturbances such as hypothyroidism and hypopituitarism
3. Ankylosed deciduous teeth that fail to resorb
4. Malposition of erupting permanent teeth
Prolonged retention of deciduous anteriors usually results in lingual or palatal
eruption of their permanent successor
Prolonged retention of buccal teeth results in eruption of the permanent teeth
either buccally or lingually or may remain impacted within the jaws.
55
LOCAL FACTORS
DELAYED ERUPTION OF PERMANENT TEETH
Probable causes for delayed eruption of permanent teeth :-
1. Early loss of a primary tooth might cause formation of a bony crypt over the
succedaneous tooth.
2. Presence of supernumerary tooth can block the eruption of permanent tooth.
3. Presence of a heavy mucosal barrier can prevent the permanent tooth from
emerging into the oral cavity.
4. Presence of odontomas or other cysts and tumors might prevent the permanent
tooth from erupting.
5. Presence of deciduous root fragments that have not resorbed may block the
erupting permanent tooth.
6. Presence of ankylosed deciduous teeth may cause delay in eruption of permanent
teeth.
7. Congenital absence of permanent teeth 56
LOCAL FACTORS
ABNORMAL ERUPTIVE PATH:
This is usually a secondary manifestation of a primary disturbance.
Some causes of abnormal eruptive pathway are:
1. In cases of arch length deficiency, deflection of the erupting tooth may be merely an
adaptive response to the condition present.
2. Presence of supernumerary teeth, retained deciduous teeth, root fragments, bony
barrier or mucosal barrier may result in abnormal eruptive pathway.
3. Traumatic displacement of tooth buds–
A deciduous tooth may be driven into the alveolar process, and though it may
erupt later, it may displace the developing successor in an abnormal direction.
4. 1st and 2nd permanent molars are occasionally impacted; 3rd are frequently impacted by
an abnormal path of eruption.
5. Coronal cysts can also cause abnormal eruptive paths.
57
LOCAL FACTORS
ANKYLOSIS:
Ankylosis is encountered relatively frequently during the 6 –12 year age period. It may
result due to an injury of some sort as a result of which a part of the periodontal membrane
is perforated and a bony “bridge” forms joining the lamina dura and cementum. The
“bridge” need not be large to stop the
normal eruptive force of a tooth. The
most commonly affected tooth is
mandibular 2nd deciduous molar.
Accidents or trauma, infections, certain
congenital disorders like cleidocranial
dysostosis predispose to ankylosis of
teeth.
58
LOCAL FACTORS
DENTAL CARIES:
Caries can lead to premature loss of deciduous
or permanent teeth thereby causing migration of
contiguous teeth, abnormal axial inclination and
supra-eruption of opposing teeth.
Proximal caries that has not been restored can
cause migration of adjacent teeth into the space
leading to a reduction in arch length.
A substantial reduction in arch length can be
expected if several adjacent teeth involved by
proximal caries are left un-restored.
59
LOCAL FACTORS
IMPROPER DENTAL RESTORATIONS:
Malocclusion can be caused due to improper dental restorations.
Undercontoured proximal restorations result in loss of arch length due to drifting
of adjacent teeth to occupy the space.
Overcontoured proximal restorations might bulge into the space to be occupied
by a succedaneous tooth and result in a reduction in this space.
Overhang or poor proximal contacts may predispose to periodontal breakdown
around these teeth.
Premature contacts on an overcontoured occlusal restoration can cause a
functional shift of the mandible during jaw closure, whereas, undercontoured
occlusal restorations can lead to the supra-eruption of the opposing teeth.
60
ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O. CONCLUSION
No longer can conscientious orthodontists look at a child’s

mouth, observe a space deficiency and then attribute it to the premature loss of
teeth or prolonged retention of teeth. In the past, local “causes” were stressed but
today we know the importance of general factors in etiology of malocclusion along
with the local causes.
Knowledge·of the contribution of genetic and environmental causes of
malocclusion obligates clinicians to differentiate between patients whose
malocclusions are primarily of genetic origin from patients whose malocclusions
are primarily of environmental origin.
Abnormal morphologic structures in the face and dentition that have a
high degree of heritability require different treatment approaches from those
structures that are influenced primarily by environmental factors.
61
ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O. CONCLUSION
For most patients the differentiation between genetic and local

environmental factors is of great importance when choosing the appropriate
treatment and retention plans.
Retention of a treated malocclusion is a challenge because the genetic
and environmental etiologic factors responsible for the malocclusion may continue
to draw the treated teeth back into malocclusion.(AJO 81,82,83,84,85)
Stability of treated malocclusions appears to be similar in growing and
adult patients.(AJO 94)
Addressing known etiologic factors during treatment can produce more
stable occlusions after treatment.
Prevention of genetic causes for malocclusion is not possible at this time.
In contrast, the prevention of environmental causes holds much promise.
62
63

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“ETIOLOGY OF MALOCCLUSION”

CLASSIFICATION OF ETIOLOGY OF MALOCCLUSION

FUNDAMENTAL TO UNDERSTANDING MALOCCLUSION IS THE

• Recognition and elimination of the etiological factors is

• Traditionally, any deviation from "ideal occlusion" has

“An occlusion in which there is mal-relationship between the

Sameul S. Flitch was the first to classify malocclusion.

DEVELOPMENTAL DEFECTS OF UNKNOWN ORIGIN

1. NEUROMUSCULAR 1. PRENATAL TRAUMA AND

PHYSICAL AGENTS HABITS

1. PREMATURE EXTRACTION OF 1. TUMB SUCKING AND FINGER

1. SYSTEMIC DISEASES DEVELOPMENTAL DEFECTS OF

DENTAL BASE PRE-ERUPTION POST-ERUPTION

ANTERO-POSTERIOR ABNORMALITIES IN POSITON OF

PROLONGED RETENTION OF DCIDUOUS TEETH

EXTRACTION OF PERMANENT TEETH

4. PRE-DISPOSING METABOLIC CLIMATE & DISEASES

6. ABNORMAL PRESSURE HABITS & FUNCTIONAL ABERRATIONS

8. TRAUMA AND ACCIDENT

a. PRE NATAL a. ENDOCRINE IMBALANCE

b. POST NATAL b. METABOLIC DISTURBANCES

c. TONGUE THRUST &

g. RESPIRATORY DEFECT h. TONSILS & ADENOIDS

i. PSYCHOGENIC TICS &

-Number of human traits that are influenced by the genes include

-Genuine Class II malocclusion

-They are malformations seen at the time of birth

-General congenital factors

-Local congenital factors

-The following are some of the congenital conditions frequently

CONGENITAL SYPHILIS MATERNAL RUBELLA INFECTIONS

Contemporary Orthodontics: William R Proffit 34

ii. Forceps delivery–TMJ damage .

ABNORMAL PRESSURE HABITS AND

4 PRIMARY FACTORS IN EQUILIBRIUM:

• Undiscovered traumatic experiences- significant in malocclusion.

ANOMALIES IN NUMBER OF TEETH:

In order to achieve good occlusion, normal number of teeth should be

Heredity plays a strong part in anomalies in number of teeth.

Supernumerary teeth can cause:

ANOMALIES OF TOOTH SIZE:

ANOMALIES OF TOOTH SHAPE:

ABNORMAL LABIAL FRENUM:

No longer can conscientious orthodontists look at a child’s

For most patients the differentiation between genetic and local

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