maloclusions

Malocclusions are misalignments of the teeth and bite, where the upper and lower teeth do not meet properly when the jaws close. They range from minor irregularities in tooth position to substantial bite discrepancies that can affect chewing, speech, and overall oral health. Malocclusions are commonly described using patterns of anteroposterior relationships, such as Class I, II, and III, with additional descriptors for crowding, spacing, open bites, deep bites, and crossbites. Class I denotes a normal molar relationship with potential misalignments elsewhere; Class II features a retrusive mandible or protrusive maxilla; Class III involves a protrusive mandible or retrusive maxilla. Skeletal and dental components may be involved, and multiple malocclusion patterns can coexist.

Causes of malocclusions are multifactorial and include genetic factors that influence tooth size and jaw shape, as well as environmental factors such as early loss of primary teeth, prolonged nonnutritive sucking, tongue thrust, mouth breathing, or trauma. Certain congenital conditions, such as cleft lip and palate, are associated with malocclusion as well.

Symptoms commonly include crooked or crowded teeth, improper bite, difficulty chewing or speaking, jaw discomfort, headaches, and increased risk of dental decay or gum disease due to challenging hygiene. Some individuals may have minimal functional impact but seek treatment for aesthetics.

Diagnosis involves clinical examination, dental impressions or digital scans, and radiographs (panoramic and cephalometric) to assess tooth position and jaw relationships. Treatment goals are to restore function, improve aesthetics, and maintain or improve orofacial health. Interventions may include braces or clear aligners, extractions when necessary, interceptive care in children, and orthognathic surgery for substantial skeletal discrepancies. Retention after treatment is typically required to preserve results.