This is normally a stable process in the growing patient, as it is accommodated by the increase in vertical facial height. However, in most average- to low-angle adult cases, distal tipping of posterior teeth is not stable, because it will be followed by intrusion of these teeth to the original vertical dimension. This may not occur during orthodontic treatment but will normally follow shortly after, and can be a source of post-orthodontic relapse of the deep bite. In the adult high-angle patient, the distal tipping of posterior teeth may lead to some permanent opening of the mandibular plane and is to be avoided. Sometimes the equilibration of posterior teeth after distal tipping is beneficial in these high-angle adult cases (Fig. 6.6).
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