Orthodontic

tooth
movement

Abdurrahman Mosaad
Orthodontics department
Armed forces medical complex – Kobry
al Qubba
In the name of Allah , most
gracious , most merciful
# What is orthodontics :

= Orthodontics is the specialty of dentistry concerned

with the management and treatment
of malocclusion.

=In the majority of cases, a malocclusion does not in

itself represent a disease state, but rather a variation
from what is considered ideal
- Andrew’s keys for ideal occlusion
- The nature of orthodontic tooth movement :

= it has a bio – mechanic nature.

= solely based upon stress- strain occurs in the

PDL
environment

= the orthodontic tooth movement results from

forces delivered to the teeth
= the forces are delivered via orthodontic app.
Either fixed or removable

= PDL undergoes biological respond upon the

mechanical application of a force i.e to
achieve a
precise biological respond the mechanical
forces to be delivered should be precise
 = Knowledge of the mechanical principles
governing forces is necessary for the
control of orthodontic treatment

 = The proper application of biomechanics

principles increases treatment efficiency
through improved planning and delivery of
care
= Knowledge of the mechanical principles
governing forces is necessary for the control
of
orthodontic treatment

= The proper application of biomechanics

principles increases treatment efficiency
through improved planning and delivery of
care
1 = center of
resistance.
- All objects have a
center of mass.
- This is the point
through which an applied
force must pass for a
free object to move
linearly without any
rotation,
- i.e., the center of mass
is an object’s “balance
point.”
analytic studies have
determined that the
center of resistance for
single-rooted teeth
with normal alveolar
bone levels is about
1/4 to 1/3 the distance
from the
cementoenamel
junction (CEJ) to the
root apex.
 Location of the center of resistance depends on the alveolar
bone height and root length . = Location of the center of
resistance with
alveolar bone loss
= with a shortened root
2 - Forces

= they are actions applied to

bodies

= they equals ( mass X

acceleration) F =ma

= in clinical orthodontics its

unit is Grams
= forces has the
characteristics of vectors i.e
magnitude & direction
Note : the diagram shows that the
force vectors characteristics –
magnitude , point of origin &
direction
= 2 vectors could added by
placing one vector at the
head of the another i.e sum
of them called resultant

= a vector could be
resolved into components
along x , y & z axes
= Clinically the determination of the horizontal,
vertical, and transverse components of a force
improves the understanding of the direction of
tooth movement

= An important point of view that the orthodontic

tooth movement is not applied on the center of
rotation of the tooth as it is usually delivered
through the tooth crown
= as the orthodontic forces
are delivered through the
tooth crown they will not
produce a pure linear
movement ,, some rotational
movement will be present ,,
those rotational movements
are called Moment of the
force
= The moment of the force
is the tendency for a force to
produce rotation.
= Its direction is found by
following the line of action
around the center of resistance
toward the point of origin

=It is determined by multiplying

the magnitude of the force by
the perpendicular distance of
the line of action to the center of
resistance
= The importance of the moment of a force
is often not recognized in clinical
orthodontics, but awareness of it is needed
to develop effective and efficient appliance
designs
Clinical examples of moments of the forces
3 – Couple

- A couple is

two parallel forces of equal

magnitude acting in opposite
directions and separated by a
distance (i.e. different lines of
action)

- The magnitude of a couple is

calculated by multiplying the
magnitude of force(s) by the
distance between them
Couples result in pure rotational
movement about the center of
resistance
clinical examples of couples
4 – Torque

= Torque is a common synonym for moment

(both moments of forces and of couples)

= Torque is erroneously described in terms of

degrees by many orthodontists.
= The appropriate unit for the applied torque is
gram/millimeters (force × distance). It is the
description of the moments that more accurately
describes the rotational components of a force
system and appliance design
Orthodontic wire bends

-1st order

-- 2nd order

-- 3rd order
# Anchorage
-Anchorage is the site
of delivery from which
force is exerted

- degree of resistance
to displacement
offered by an anatomic
unit for the purpose of
tooth movement.
# Classification of ortho. Anchorage
-acc. to manner of force application :
* simple * stationary * reciprocal

- according to jaws involved :

* intermaxillary * intramaxillary

- according to site :
* intraoral * extaraoral * muscular

- according to anchorage units :

* primary * compound *reinforced (multiple)
# anchorage planning :
-Increasing no. of teeth to be move requires
more anchorage
- teeth having more surface area requires more
anchorage
- bodly movement requires more anchorage
- prolonged tx. Plan requires more anchorage
- vertical growth pattern requires more
anchorage due to the less tonicity of muscles
- N.B. Good occlusion = Good anchorage
# Anchorage loss :
-Its is the unwanted tooth movements during
orthodontics that cause space loss
-Maximum anch.
* anch. Demand is very high
*not more than ¼ of ext space should be lost
* augmentation of anchor units is usually done

-Moderate anch.
* ¼ - ½ of ext space should be lost

- Minimum anch.
* more than ½ ext space could be lost
Maximum anch.
Moderate anch.
Minimum anch.
# Equivalent Force systems
= A useful method for
predicting the type of tooth
movement that will occur with
appliance activation is to
determine the equivalent force
system at the tooth’s center of
resistance

= The force system at the

center of resistance accurately
reflects the type of movement
 eg. Intrusion arch force system
# Types of tooth movement :

1 – tipping ( controlled & uncontrolled)

2 – translation ( bodily )
3 – root movement
4 - rotation
5 - intrusion & extrusion
-The relationship between the applied force
system and the type of movement can be
described by the moment/force ratio

-The movement that occurs is dependent on the

(moment/force ) ratio #and# the quality of the
periodontal Support
1- Tipping :

* simplest orthodontic movement

* controlled occurs about the tooth apex

*uncontrolled occurs about CER

* Force needed is about 50 – 75 gm.

Controlled tipping
Uncontrolled tipping
2- Translation :

* all PDL is uniformly loaded with the force

* Force needed is about 100 – 150 gm.

3 – Rotation :

* needs high force

* occurs around the CER
* Force needed is about 50 – 100 gm.
4 – Extrusion :

* needs to produce tension in the PDL

ligaments

* Force needed is about 50 gm.

5 – Intrusion :

* forces are nearly at the apex

* needs minimum force application
* Force needed is about 15 – 25 gm.
6- Root movement :
* usually expressed as torque
* the crown is held stationary and the root
moves
* CER is the bracket itself
* done by increasing the Moment/Force
ratio
Moment / Force ratios needed for different kinds of
tooth movement :

1 – tipping
* controlled 5:1
* uncontrolled 7 : 1

2 – translation 10 : 1

3 – root movement 12 : 1
Types of orthodontic forces acc. to Duration

- continuous

- interrupted

- intermitted
* Threshold --- 6 hrs per day.

* No tooth movement if forces are applied less

than
6 hrs/d.

* From 6 to 24 hrs/d, the longer the force is

applied, the more the teeth will move.
- Continuous force :

* achievable via fixed orthodontics

*Never declines to zero.

- Interrupted force :

* force starts heavy then decline to optimal

after that may reach zero .

*achievable via removable appliance.

* produces some kind of undermining

resorption .

* reactivated every specific time .

-Intermittent forces :

* declines to zero
* very high force 250 – 500 gm.( anch – dist )

* achievable via extraoral appliance

* needs at least 12 hrs/day to be effective

* 14 hrs/day is optimal
-Force level :

* Light, continuous forces are currently

considered to be most effective in inducing
tooth movement.
*Heavy forces cause damages and fail to move
the teeth.
N.B. Optimal force : “High enough to stimulate
cellular activity without completely occluding blood
vessels in the PDL”
Heavy Forces

* B.V of PDL is totally occluded ---

then
* causes cellular necrosis within the bone ---
then
* hyalinization i.e undermining resorption
Tooth movement (mm)
occur

Phase 3
Phase 2
Phase 1

Time (Arbitrary Unit)

Light, continuous forces

Tooth mov.
Phase 3

• Osteoclasts formed
Phase 2
• *Removing lamina dura.
*Tooth movement begins
*This process is called Time
“FRONTAL RESORPTION”.
( remodeling process )
-Phases of orthodontic tooth movement :-

* Displacement - no clinical movement

- instantaneous
* Delay – no clinical movement
- short ( partial B.Vs occ. ) or long
1-2
weeks ( more B.Vs occ. )
* Acceleration – rapid tooth displacement
- differs among individuals
Tooth movement (mm)

Phase 3
Phase 2
Phase 1

Time (Arbitrary Unit)

Orthodontic tooth movement adverse
effects :
* Pulp - transient inf. response , can cause
loss of vitality
- in cases of compromised tooth ,,
heavy
force ,, wrong mech.
* Root - usually repaired by cementum
during
rest periods
- resorption may occur up to 2 mm.
in
permanent cases
- At risk : thin roots ,, heavy force ,,
Material considerations :

1 – orthodontic wires
*material of the wire
* effect of increasing wire diameter

2 – orthodontic brackets
* edgewise vs pre-adjusted (roth)
* self ligating brackets
* size of slots
* interbracket distance
* torque of the brackets
force

deflection
Modulus of elasticity of the wire
 14’’ 50gm
 16’’ 85gm 71% increase
 18’’ 137gm 173% increase
100% 200% 300% 400%
Percentage increase in
stiffness

14’’ 16’’ 18’’ 20’’ 22’’

Wire diameter
Effect of increasing wire diameter
Torque selection of lower teeth brackets
Torque selection of upper teeth brackets
Finally :

Optimal force
is the lightest force that will move a
tooth to a desired position in the shortest
possible time without iatrogenic effects

So ,,, we should think optimal ,, it is

orthodontics so we ( work smarter not
harder ) 
Thank You 