The Control of the Palatal Plane in the Treatment of Malocclusion
Is it important to try to control the inclination of the palatal plane in the treatment of malocclusion? To what extent is it possible to control the inclination of the palatal plane in treatment?.
Our literature contains reference to the fact that the palatal plane changes its inclination independently. In June 1999 there was published an article in the Angle Orthodontist, entitled "Evaluation of Differential Growth and Orthodontic Treatment Outcome by Regional Cephalometric Superimpositions.".
The stated aim of the article was to evaluate the effects of regional superimposition (cranial versus maxillary) on interpreting mandibular displacement. According to the authors, since the palatal plane is subject to rotational changes, it must be measured from the palatal plane. It is misleading to infer that we have a choice between superimposition on the palatal plane and on the cranial base (cranial versus maxillary) - that they are equal in value.
In Article 84 of the Schudy Chronicles it is shown that the palatal plane rotates forward when upper anterior vertical facial growth is predominant. Also it was shown that the palatal plane rotates backward when vertical condylar growth is predominant.
It is known that we can, in many cases, vary the inclination of the palatal plane by treatment procedures. Knowing this, we should make every effort to cause it to tip in the right direction. I would estimate that in the "run of the mill" treatment that it is allowed to tip downward most of the time. This allows the biting force to be primarily on the anterior portion of the jaws, whereas the biting force should be primarily on the posterior teeth. When the biting force is on the anterior portion of the dentures there is sure to be some bite closure.
The members of the Tweed Foundation as well as many proficient orthodontists do not allow the anterior end of the palatal plane to tip downward, in most cases. This enhances aesthetics, improves function, and improves stability of the treated result.
When we have the courage to insist that our patients wear a headgear applying force in an upward and backward direction, we can prevent the downward tipping of the palatal plane, and produce thereby stability of the treated result.
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