Etiology of Malocclusion 2016

ETIOLOGY OF
MALOCCLUSION
Ahmad Syaukani
Lecturer of Orthodontics Department, YARSI University ,
Jakarta, Indonesia
1
Corresponding e-mail: ahmad.syaukani@yarsi.ac.id
ETIOLOGY OF MALOCCLUSION- CONTENTS
CONTENTS
INTRODUCTION
CLASSIFICATION OF ETIOLOGY OF
MALOCCLUSION
GRABERS CLASSIFICATION
CONCLUSION
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
ETIOLOGY OF MALOCCLUSION-INTRODUCTION
Etiology of malocclusion is the study of its causes.

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"
ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.
CLASSIFICATION OF ETIOLOGY
OF MALOCCLUSION
CLASSIFICATION OF ETIOLOGY OF
MALOCCLUSION
1.
2.
3.
4.
Moyers classification
White and Gardiners classification
Proffits Classification
Grabers classification
6
CLASSIFICATION OF ETIOLOGY
OF MALOCCLUSION
HEREDITY
TRAUMA
PHYSICAL AGENTS
HABITS
MOYERS
CLASSIFICATION
DISEASES
MALNUTRITION
DEVELOPMENTAL DEFECTS OF UNKNOWN ORIGIN
7
MOYERS CLASSIFICATION
HEREDITY
1. NEUROMUSCULAR
TRAUMA
2. BONE
1. PRENATAL TRAUMA AND

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

SUCKING
2. NATURE OF FOOD
2. TONGUE THRUSTING
3. LIP SUCKING AND LIP BITING
4. POSTURE
5. NAIL BITING
6. OTHER HABITS
DISEASES
MALNUTRITION
1. SYSTEMIC DISEASES
2. ENDOCRINE DISEASES
DEVELOPMENTAL DEFECTS OF
UNKNOWN ORIGIN
3. LOCAL DISEASES
i.
NASOPHARYNGEAL
DISEASES & DISTURBED
RESPIRATORY FUNCTION
ii.
iii.
GINGIVAL &PERIODONTAL
DISEASES
CARIES
iv.
TUMOURS
10
WHITE & GARDINERS

CLASSIFICATION
DENTAL BASE
ABNORMALITIES
ANTERO-POSTERIOR
MALRELATIONSHIP
VERTICAL MALRELATIONSHIP
LATERAL MALRELATIONSHIP
WHITE &
GARDINERS
CLASSIFICATION
PRE-ERUPTION
ABNORMALITIES
ABNORMALITIES IN POSITON OF
DEVELOPING TOOTH GERM
POST-ERUPTION
ABNORMALITIES
MUSCULAR
1. ACTIVE MUSCLE FORCE

MISSING TEETH
SUPERNUMERARY TEETH & TEETH
ABNORMAL IN FORM
2. REST POSITION OF MUSCULATURE

3. SUCKING HABITS
4. ABNORMALITIES IN PATH OF
CLOSURE
PROLONGED RETENTION OF DCIDUOUS TEETH

DISPROPORTION OF SIZE BETWEEN TEETH
& BASAL BONE
CONGENITAL ABNORMALITIES
PREMATURE LOST OF DECIDUOUS TEETH
LARGE LABIAL FRENUM

TRAUMATIC INJURY
EXTRACTION OF PERMANENT TEETH
11
PROFFITS CLASSIFICATION
PROFFITS
CLASSIFICATION
Genetic
Influences
12
SPECIFIC CAUSES1.Disturbances in embryologic

development.
2.Skeletal growth disturbances
a.Fetal molding & birth injuries.
b.Birth trauma to the mandible.
c.Childhood fracture of the jaw.
3.Muscle dysfunction.
4.Acromegaly & hemi-mandibular
hypertrophy.
5.Disturbances in dental development

a.Congenitally missing teeth.
b.Malformed teeth.
c.Supernumerary teeth.
d.Interference with eruption.
e.Ectopic eruption.
f.Early loss of primary teeth.
g.Traumatic displacement of teeth
13
GENETIC INFLUENCES
ENVIRONMENTAL INFLUENCES
Functional influences on Dentofacial developmenta. Masticatory function
b. Sucking & Other Habits
c. Tongue thrusting
d. Respiratory pattern
14
GRABERS
CLASSIFICATION
GENERAL
FACTORS
LOCAL FACTORS
15
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
16
GENERAL FACTORS
1. HEREDITY
3. ENVIRONMENT
a. PRE NATAL
b. POST NATAL
2. CONGENITAL
4. PRE-DISPOSING METABOLIC
CLIMATE & DISEASES
a. ENDOCRINE IMBALANCE
b. METABOLIC DISTURBANCES
c. INFECTIOUS DISEASES
17
GENERAL FACTORS
5. DIETARY PROBLEMS
7. POSTURE
8. TRAUMA AND ACCIDENT
6. ABNORMAL PRESSURE HABITS & FUNCTIONAL

ABERRATIONS
a. ABNORMAL SUCKING
b. THUMB & FINGER

SUCKING
c. TONGUE THRUST &

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

BRUXISM
18
LOCAL FACTORS
1. ANOMALIES OF NUMBER
3. ANOMALIES OF TOOTH SHAPE
5. PREMATURE LOST OF DECIDUOUS
TEETH
7. DELAYED ERUPTION OF PERMANENT
TEETH
9. ANKYLOSED
2. ANOMALIES OF TOOTH SIZE
4. ABNORMAL LABIAL FRENUM:

MUCOSAL BARRIERS
6. PROLONGED RETENTION OF
DECIDUOUS TEETH
8. ABNORMAL ERUPTIVE PATH
10. DENTAL CARIES
11. IMPROPER DENTAL RESTORATION
19
GRABERS CLASSIFICATIONGENERAL 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
20
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
21
HEREDITY
-Genuine Class II malocclusion
in three brothers
22
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
23
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
24
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
25
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
26
CONGENITAL DEFECTS
CLEFTS OF THE LIP AND PALATE

Cleft Palate can be defined as a furrow in the
palatal vault or Breach in continuity of
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.
27
CONGENITAL DEFECTS
CONGENITAL SYPHILIS
The child exhibits one or more of the
following features:
Hutchinsons incisors
Mulbery molars
Enamel def
Extensive dental decay
The maxilla may be smaller
in size relative the mandible
Anterior cross bite
MATERNAL RUBELLA INFECTIONS

Maternal rubella infections during
pregnancy show some features
Dental hypoplasia
Retarded eruption of
teeth
Extensive caries
28
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
29
CONGENITAL DEFECTS
CLEIDODOCRANIAL DYSOSTOSIS
30
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
31
Thalidomide gross congenital deformities including cleft
ENVIRONMENT
STICKLER SYNDROME
32
ENVIRONMENT
Teratogens affecting
dentofacial development
Contemporary Orthodontics: William R Proffit
33
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 deliveryTMJ damage
iii.
iv.
Ankylosis: develop ankylosis of TMJ, may be due to birth injury.

A high incidence of cross-bite is seen in a group of children who were born
with forceps delivery.
An increased asymmetric molar occlusion was observed with traumatic breech
v.
delivery.
34
ENVIRONMENT
vi.
vii.
viii.
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.
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.
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
35
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.
36
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.
37
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.
38
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.
39
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
40
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.
41
ACCIDENT OR TRAUMA
Undiscovered traumatic experiences- significant in malocclusion.

Eruptive abnormalities.
Abnormal resorption.
Loss of vitality.
Both prenatal trauma & postnatal injuries- Dentofacial deformity:
42
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.
43
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
44
permanent tooth bud teeth.
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.
45
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
46
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 incisorsPrevent 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 mesiodistal dimension of tooth
47
LOCAL FACTORS
4. FusionFused teeth arise through the
union of 2 normally separated
tooth germs.
5. GeminationResults from attempt at
division of single tooth germ
48
LOCAL FACTORS
6. Congenital syphilis
It is often associated with hypoplasia of maxillary and mandibular anteriors.
Characteristics of congenital syphilis are Hutchinsons incisors and mulberry
molars.
49
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.
50
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.
51
LOCAL FACTORS
ABNORMAL LABIAL FRENUM:
shows spacing between the maxillary central incisors due to presence of the
fibrous tissue ,labial frenum.
52
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.
53
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.
54
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
55
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.
56
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.
57
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.
58
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.
59
CONCLUSION
No longer can conscientious orthodontists look at a childs 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.
Knowledgeof 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.
60
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
61
promise.
62

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ETIOLOGY OF

ETIOLOGY OF MALOCCLUSION- CONTENTS

ETIOLOGY OF MALOCCLUSION- INTRODUCTION

Etiology of malocclusion is the study of its causes.

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

1. PRENATAL TRAUMA AND

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

1. TUMB SUCKING AND FINGER

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

WHITE & GARDINERS

1. ACTIVE MUSCLE FORCE

2. REST POSITION OF MUSCULATURE

PROLONGED RETENTION OF DCIDUOUS TEETH

PREMATURE LOST OF DECIDUOUS TEETH

LARGE LABIAL FRENUM

EXTRACTION OF PERMANENT TEETH

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

SPECIFIC CAUSES1.Disturbances in embryologic

5.Disturbances in dental development

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

4. PRE-DISPOSING METABOLIC CLIMATE & DISEASES

6. ABNORMAL PRESSURE HABITS & FUNCTIONAL ABERRATIONS

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

8. TRAUMA AND ACCIDENT

6. ABNORMAL PRESSURE HABITS & FUNCTIONAL

b. THUMB & FINGER

c. TONGUE THRUST &

d. LIP & NAIL BITING

h. TONSILS & ADENOIDS

i. PSYCHOGENIC TICS &

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

2. ANOMALIES OF TOOTH SIZE

4. ABNORMAL LABIAL FRENUM:

11. IMPROPER DENTAL RESTORATION

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

GRABERS CLASSIFICATIONGENERAL FACTORS

-Heredity has for long been attributed as one of

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

-They are malformations seen at the time of birth

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

CLEFTS OF THE LIP AND PALATE

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

MATERNAL RUBELLA INFECTIONS

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

Contemporary Orthodontics: William R Proffit

ETIOLOGY OF MALOCCLUSION-C. OF ETIO M/O.

Forceps deliveryTMJ damage

Ankylosis: develop ankylosis of TMJ, may be due to birth injury.