Biomechanical Basis Of

Orthodontic Tooth Movement

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INDIAN DENTAL
ACADEMY
Leader in continuing dental education
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Introduction
Components of P.D.L
P.D.L & Bone response to orthodontic force
Force Magnitude
Theories of tooth movement
Effects of force magnitude
Force Distribution & Types of tooth movement
Force Duration & Force Decay
Orthodontic & Orthopedic Force
Adverse Effect Of Orthodontic Force
Skeletal Effects Of Orthodontic Force
Biomechanics In Removable ,Fixed &Orthopedics

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INTRODUCTION
ORTHODONTIC TREATMENT IS
BASED ON THE PRINCPLE THAT IF
PROLONGED PRESSURE IS APPLIED
TO A TOOTH, TOOTH MOVEMENT
WILL OCCUR AS THE BONE AROUND
THE TOOTH REMODELS
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STRUCTURES INVOLVED IN
TOOTH MOVEMENT
PDL
ALVEOLAR BONE
TOOTH
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COMPONENTS OF PDL
CELLULAR ELEMENTS
UNDIFFERENTIATED MESENCHYMAL
CELLS- FIBROBLASTS AND
OSTEOBLASTS
TISSUE FLUID DERIVED FROM
VASCULAR SYSTEM
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ALVEOLAR BONE
CORTICAL PLATE


CANCELLOUS BONE
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TOOTH
CEMENTUM
FIBRES OF PERIODONTAL
LIGAMENT
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PDL AND BONE RESPONSE
TO SUSTAINED
ORTHODONTIC FORCE
HEAVY FORCE LEADS TO RAPIDLY
DEVELOPING PAIN, NECROSIS OF
CELLULAR ELEMENTS WITHIN THE
PDL
LIGHT FORCE COMPATIBLE WITH
SURVIVAL OF CELLS WITHIN PDL
AND A REMODELLING OF TOOTH
SOCKET
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THEORIES OF TOOTH
MOVEMENT
BIOELECTRIC THEORY TOOTH
MOVEMENT ATLEAST IN PART TO
CHANGES IN BONE METABOLISM
CONROLLED BY ELECTRIC SIGNAL THAT
ARE PRODUCED WHEN ALVEOLAR BONE
FLEXES AND BENDS
PIEZOELECTRICITY IS OBSERVED IN
CRYSTALLINE STRUCTURE PRODUCES A
FLOW OF ELECTRIC CURRENT AS
ELECTRON ARE DISPLACED FROM ONE
PART OF CRYSTAL LATTICE TO ANOTHER
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CHARACTERISTIC OF
PIEZOELECTRICITY- QUICK DECAY
RATE
PRODUCTION OF AN EQUIVALENT
SIGNAL OPPOSITE IN DIRECTION
WHEN FORCE IS RELEASED
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PRESSURE TENSION
THEORY
RELIES ON CHEMICAL
RATHER THAN
ELECTRICAL SIGNAL,
AS THE STIMULUS FOR
CELLULAR CHANGES

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FORCE APPLIED ON THE TOOTH

ALTERATION IN BLOOD FLOWE IN PDL

FORMATION AND RELEASE OF
CHEMICAL MESSENGER
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FORCE MAGNITUDE
FORCE IS DEFINED AS AN ACT UPON
A BODY THAT CHANGES OR TENDS
TO CHANGE THE STATE OF REST OR
THE MOTION OF THAT BODY
FORCE 3 COMPONENTS
MAGNITUDE
DIRECTION
SENSE
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FORCE MAGNITUDE
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EFFECTS OF FORCE
MAGNITUDE
HEAVY SUSTAINED PRESSURE

GREATER THE REDUCTUION IN BLOOD
FLOW THROUGH COMPRESSED AREAS OF
BLOOD FLOW

VESSELS ARE TOTATTLY COLAPSED

NO BLOOD FLOW


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LIGHT CONTINOUS FORCE APPLIED TO THE TOOTH

BLOOD FLOW TO THE PARTIALLY COMPRESSED PDL

DECREASES THE FLUID FROM PDL SPACE

AFTER FEW HOURS CHANGES IN CHEMICAL
ENVIROMENT

CHANGES IN CELLULAR ACTIVITY(INCREASED LEVEL
OF CYCLIC AMP SECOND MESSENGERS )

CELLULAR CHANGES AFTER 4HOURS OF SUSTAINED
PRESSURE
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RECENT STUDIES
PROSTAGLANDIN LEVEL INCREASES IN
PDL AFTER APPLICATION OF FORCE
PROSTAGLANDIN IS AN IMPOTANT
MEDIATOR FOR CELLULAR RESPONSE
PROSTOGLANDIN IS RELEASED WHEN
CELLS ARE DEFORMED FOR TOOTH
MOVEMENT
PLAY A MAJOR ROLE IN CELLULAR
DIFFERENTIATION OB, OC, FB, FC
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REMODELING OF BONE
FRONTAL OR DIRECT RESORPTION

UNDERMINING OR INDIRECT
RESORPTION
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TYPES OF TOOTH
MOVEMENT
TIPPING


TRANSLATION




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ROOT UPRIGHTING


ROTATION


EXTRUSION


INTRUSION



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Optimum force for orthodontic
tooth movement
Type of movement Force(g/cm
2
)
Tipping 35-60
Bodily movement 70-120
Root uprighting 50-100
Rotation 35-60
Extrusion 35-60
Intrusion 10-20








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Definitions
Force:
A load applied to an object that will tend to
move it to a different position in space.
Center of resistance:
A point at which resistance to movement can
be concentrated for mathematical analysis.
Moment:
A force acting at a distance to the center of
resistance. M=F x d
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Couple:
Two forces equal in magnitude and
opposite in direction
Center of rotation:
The point around which rotation
actually occurs when an object is being
moved

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Moment to Force ratio
During movement requires both a force
to move a tooth in desired direction, and a
couple to produce the necessary counter
balancing moment for control of root
position
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Effects of force duration and force decay
Continuous Force maintained at some
appreciable fraction of the original from one
patient visit to the next.
Interrupted Force level decline to zero between
activation
Intermittent Force level decreases to zero
intermittently, when the orthodontic appliance is
removed by the patient and returns to the original
level sometime later
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Adverse effects of the
orthodontic force
Mobility and pain related to orthodontic
treatment
Effects on the pulp
Effects on the root structure
Effects of treatment on the height of
alveolar bone
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