Understanding Malocclusion: Causes, Classification, and Etiology

Understanding Occlusion and Malocclusion

Occlusion: The manner in which the maxillary and mandibular teeth articulate.

Malocclusion: Normal biological variation in how jaws are articulated with the mandibular teeth. Not all malocclusions require orthopedic or orthodontic treatment; only those that have the capacity to generate changes at a psychological, social, growth, and developmental level, or affect other oral structures, require intervention.

Etiology of Malocclusion

Time is a critical etiological factor that intervenes in several ways:

• Age of Onset: The age at which an alteration appears can lead to poor positioning. If left untreated, the malocclusion may become more severe and sometimes incorrigible.
• Duration: The length of time the etiologic entity is present affects the severity of the malocclusion.
• Frequency: The frequency of the etiological factor—referring to the number of times a habit is repeated—can also influence the severity and complexity of the condition.

Classification of Etiological Factors

Malocclusion develops slowly as the individual grows, providing many opportunities for various influences to take effect. Therefore, malocclusions are considered to be of multifactorial origin.

General Factors

• Evolution: Multiple evolutionary processes have changed the facial morphology of modern humans, impacting the masticatory system:
  • Human verticalization of the dorsal column and a more central position of the foramen magnum, leading to a less protruded face.
  • Increased brain size, which has altered cephalic morphology and achieved a more upright profile.
  • The appearance and perfection of language.
  • Changes in the size of the jaws, depth of the palate, and palatal projection.
  • Dietary changes reflected in the size of the jaws and the number of teeth.
• Inheritance: Malocclusions can be inherited for two primary reasons:
  • Disproportion between the teeth and jaws, which could lead to crowding or spacing.
  • Disproportion between the size and shape of the jaws, which could generate inadequate occlusal relations.
• Acquired Defects: Anomalies established during management or at birth. Abnormalities in embryonic development can occur, which may be purely genetic or the result of environmental actions, such as teratogens.