Abstract
BackgroundTreatment planning the correction of a transverse maxillary occlusal plane cant often involves a degree of qualitative “eyeballing”, with the attendant possibility of error in the estimated judgement. A simple chair side technique permits quantification of the extent of asymmetry and thereby quantitative measurements for the correction of the occlusal plane cant.MethodsA measuring instrument may be constructed by soldering the edge of a stainless steel dental ruler at 90° to the flat surface of a similar ruler. With the patient either standing in natural head position, or alternatively seated upright in the dental chair, and a dental photographic retractor in situ, the flat under-surface of the horizontal part of this measuring instrument is placed on a unilateral segment of a bilateral structure, e.g. the higher maxillary canine orthodontic bracket hook. The vertical ruler is held next to the contralateral canine tooth, and the vertical distance measured directly from the canine bracket to the flat under-surface of the horizontal part of the measuring instrument.ResultsThis vertical distance quantifies the overall extent of movement required to level the maxillary occlusal plane.ConclusionsThis measuring instrument and simple chair side technique helps to quantify the overall extent of surgical levelling required and may be a useful additional technique in our clinical diagnostic armamentarium.
Highlights
Treatment planning the correction of a transverse maxillary occlusal plane cant often involves a degree of qualitative “eyeballing”, with the attendant possibility of error in the estimated judgement
Relative unilateral vertical over- or underdevelopment of the maxilla and maxillary dentoalveolus leads to a transverse cant of the maxillary occlusal plane [1]
The degree of unilateral superior versus contralateral inferior repositioning depends on the aesthetic parameters of maxillary incisor exposure in repose and overall maxillary dentogingival exposure on smiling [1, 2]
Summary
A measuring instrument may be constructed by soldering the edge of a double-sided stainless steel dental ruler at 90° to the flat surface of a similar ruler (Fig. 1). It is worth emphasising that the instrument may be held relative to a true vertical plumb line hanging from the ceiling if a patient has a severe craniofacial asymmetry and vertical orbital dystopia. This is usually not the case in orthognathic patients, and we suggest that when the interpupillary line is essentially parallel (i.e. the absence of vertical orbital dystopia), the horizontal part of the instrument may be help parallel to the interpupillary line
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