Classification of the Face

Facial balance and harmony is a key goal in orthodontic treatment planning. It is not sufficient to simply align teeth without consideration of the impact proposed orthodontic treatment may have on facial esthetics. The relationship of the upper and lower jaws (maxilla and mandible, respectively) to other craniofacial structures must be taken into consideration. For a non-growing patient a treatment plan involving an interdisciplinary approach between the orthodontist and an oral surgeon may be the best means to achieving specific changes in facial esthetics in addition to alignment and functional fit of the teeth.

Class 1:

a) Maxillary-Mandibular Dental Protrusion
This is an example of a dental malocclusion where the upper and lower teeth protrude negatively impacting facial esthetics. This type of malocclusion may require the removal of teeth to achieve the optimal dental and facial esthetic result.

b) Maxillary-Mandibular Dental Retrusion
This is an example of a dental malocclusion upper and lower teeth are reclined. Treatment may involve expansion to accommodate room for all teeth rather than removing teeth.

Class 2:

a) Maxillary Dental Protrusion of the teeth:
This is an example where the upper teeth protrude over the lower teeth (“buck teeth”). This malocclusion may require the removal of teeth.

b) Mandibular Retrognathism (weak lower jaw)
The lower jawbone has not grown as much as the upper jaw. This is an example of a Class II malocclusion that may benefit from interceptive orthodontic treatment and growth guidance. As an adult this type of malocclusion may require adjunctive surgery to enhance the orthodontic result and facial esthetics.

Class 3:

a) Mandibular Dental Protrusion — teeth:
The lower teeth are too far in front of the upper teeth. This malocclusion is treated with orthodontic procedures and may require the extraction of teeth due to the dental protrusion.

b) Mandibular Prognathism — jaws:
The lower jawbone has outgrown the upper jaw. This malocclusion is more difficult to treat due to the skeletal disharmony and may require orthognathic surgery in conjunction with orthodontic treatment. A skeletal discrepancy may be detected early on in development by the General Dentist or Pediatric Dentist and may benefit from early interceptive orthodontic treatment.