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Bio Mechanics

OF TOOTH MOVEMENT
Dental Bio Mechanics is the study and use of mechanical
devices and physical forces to effect desirable changes in
the oral structures.

Table of contents
1. Physiologic Tooth Movement.
2. Tooth eruption.
3. Tooth movement during mastication.
4. Histology of tooth movement.
5. Optimum Orthodontic force.
6. Hyalinization.
7. Phases of tooth movement.
8. Theories of tooth movement.
9. Biochemical reaction to orthodontic tooth movement.

1. Physiologic Tooth Movement
Physiologic Tooth Movement are naturally occurring tooth movements
that take place during and after tooth eruptions.
2. Tooth Eruption

It is the axial movement of tooth from its developmental position in the jaw to its final
position in the oral cavity

Theories of tooth eruption
BLOOD PRESSURE THEORY
According to this theory the
tissue around the developing
end of the root is highly vascular.
This vascular pressure cause the
axial movement of the tooth
ROOT GROWTH
The apical growth of roots results
in an axially directed force that
brings about the eruption of the
teeth
HAMMOCK LIGAMENT
According to Sicher, A band of
fibrous tissue exists below the root
apex spanning fromone side of
the alveolar wall to the other. This
fibrous tissue appears to forma a
network below the developing
root and is rich in fluid droplets.
PERIODONTAL LIGAMENT
TRACTION
The periodontal ligament is rich in
fibroblast that contain contractal
tissue. This leads to axial
movement of tooth.
Migration or drift of Teeth
Minor changes in tooth position observed after eruption of teeth.
The human dentition shows a natural tendency to move in a mesial and
occlusal direction.
3. Tooth movement during
Mastication
Slight movement within its socket.
Return to its original position as soon
as the loads is removed
1 50 kg based on type of food
Force absorbed by bone
bending
Teeth and periodontal structure
Intermittent heavy forces
Cycles of one second or less
SHORT DURATION
Tooth movement during mastication
1- 2 secs PDL fluid displaced
2 3 secs PDL tissues compressed
PAIN
1 50 kg/continuous
LONG DURATION
Teeth and periodontal structure
4. Histology of Tooth Movement
When force is applied on a tooth to bring about orthodontic movement , it
results in formation of areas of pressure and tension around the tooth. Areas of
pressure are formed in the direction of the tooth movement, while areas of
tension form in the opposite direction.
Bone surface subjected to pressure reacts by bone resorption while bone
subjected to tension exhibits deposition.

The histologic changes seen during
tooth movement vary according to
the amount and duration of force
applied.
The Histologic changes seen during tooth movement can be studied under two
headings as:

1). Changes following application of extreme force.
2). Changes following application of mild force.



Changes following APPLICATION OF EXTREME FORCES
Whenever extreme force are applied to teeth, it results in crushing or total
compression of the periodontal ligament.
On the pressure side, the root closely approximates the lamina dura,
compresses the periodontal ligament and leads to occlusion of the blood
vessels.
The ligament is hence deprived of its nutritional supply leading to regressive
changes called Hyalinization.
Changes following application of MILD FORCE
When a force is applied to a tooth, areas of pressure and tension are
produced
Changes on PRESSURE SIDE

- The periodontal ligament
in the direction of the tooth
movement gets
compressed to almost 1/3
rd

of its original thickness.

- A marked increase in the
vascularity of periodontal
ligament on this side is
observed due to increase in
blood supply which helps in
mobilization of cells such as
fibroblasts and osteoclasts.
Changes on TENSION
SIDE
- Its is the area of the
tooth opposite to the
direction of force


- On application of
orthodontic force, the
periodontal membrane
on the tension side gets
stretched, widening the
distance between the
alveolar process and
the tooth

SECONDARY REMODELLING
CHANGES
- whenever a force is
applied to move teeth, the
bone immediately adjacent
shows osteoclastic and
osteoblastic activity on the
pressure and tension side
respectively
bony changes also takes
place.
5. Optimum Orthodontic Force
Its is a force which moves teeth most rapidly in the
desired direction, with the least possible damage to
tissue and with minimum patient discomfort.

From a clinical point of view. From a histologic point of view.
a. Produces rapid tooth
movement
b. Minimal patient discomfort
c. The lag phase of tooth
movement is minimal
d. No marked mobility of the teeth
being moved
a. The vitality of the tooth and
supporting periodontal
ligament is maintained
b. Initiates maximum cellular
response
c. Produces direct or frontal
resorption
Characteristics of Optimum
Orthodontic Force
6. Hyalinization
Its a form of tissue degeneration characterized by formation of clear, eosinophilic
homogenous substance.
It can occur in organs such as lungs, kidney, etc..
Conventional pathologic process of hyalinization is irreversible and hyalinization of
periodontal ligament is reversible process.
Observed changes during the formation of Hyalinised zones
1. Gradual shrinking of periodontal ligament fibers
2. Distinct cellular structure. Disappearance of some nuclei.
3. Breakdown of blood vessel walls leading to spilling of their
contents
4. Osteoclasts are formed in marrow spaces and adjacent areas of
inner bone surface after 20-30 hours
The elimination of hyalinised occurs by two mechanism.
1) Reabsorption of the alveolar bone by osteoclasts.
2) Invasion of cells and blood vessels from the periphery of the
compressed zone by which the necrotic tissue is removed.
7. Phases of Tooth Movement
Burstone categories the tooth movement into three
stages as:
1. INITIAL PHASE
3. POST LAG PHASE
2. LAG PHASE
Very rapid movement is
observed over a short
distance which then stops
Represents displacement
of the tooth in the
periodontal membrane
space and probably
bending of aveolar bone.
Tooth movement between
0.4 to 0.9 mm in a weeks
time
Little or no tooth
movement occurs.
Formation of
hyalinised tissue in the
periodontal ligament
With light force small
hyalinization and
heavy force large
hyalinization occurs
Lag phase 2-3 week or
till 10 weeks
Tooth movement
progresses rapidly.
Hyalinised zone is
removed.
Bone undergoes
resorption.
Osteoclasts are found over
a large surface area.
8. Theories of Tooth Movement
.

Pressure
tension
theory
.

Fluid
Dynamic
Theory
.

Bone
bending and
piezoelectric
theories of
tooth
movement
1. PRESSURE TENSION THEORY
Oppenheim (1911) first person to study the tissue changes in the bone
incident to orthodontic tooth movement
Schwarz (1932) author of pressure tension theory
According to Schwarz the areas of pressure show bone resorption while
areas of tension show bone deposition.
2. FLUID DYNAMIC THEORY
According to this theory, tooth movement occurs as a result of
alterations in fluid dynamics in the periodontal ligaments.
This theory proposed by Bien, also called it as blood flow theory
Bien suggested that there is an alteration in the chemical environment
at the site of the vascular stenosis due to a decreased oxygen level in
the compressed areas as compared to the tension side.
3. BONE BENDING AND PEIZOELECTRIC THEORY OF TOOTH MOVEMENT
Farrar (1876) was the fist to suggest that bone bending maybe a
possible mechanism for bringing about tooth movement.
A small electric current is generated when bone is mechanically
deformed.
The possible sources of the electric current are:
a. Collagen: it exist in crystallised state, could be a source of
piezoelectricity when deformed.
b. Hydroxyapatite: crystalline in form, can produce electricity when
deformed.
c. Collagen-Hydroxyapatite: the junction between the collagen and
hydroxyapatite crystals when bent can be a source of electricity.
d. Mucopolysaccharide fraction a non crystalline sometimes
generate electricity when deformed.
9. Biochemical Reaction to
Orthodontic tooth movement.
When a force is applied onto a tooth, it results into periodontal ligament,
bone deformation and tissue injury called a biophysical event. Here
orthodontic force is converted into a cellular response.
Bone deformation and compression of the periodontal ligament leads
to the release of some extra cellular signalling molecules called first
messengers, which includes hormones (PTH), neurotransmitters and
vasoactive intestinal polypeptides.
Formation of osteoclasts and osteoblast takes place which are
responsible for bone remodelling.

BIO-PHYSICAL REACTIONS
Bone deformation,
compression of predontal ligament
Tissue Injury
PRODUCTION OF FIRST MESSENGERS
Hormones (eg PTH)
Prostaglandins
Neurotransmitters
PRODUCTION OF SECOND MESSENGERS
C amp
C gmp
Ca++
+VE increase in Cells of Resorption
-VE Increase in Cells of Desposition
Bone Remodelling
SUMMARY OF
BIOCHEMICAL
REACTIONS
Orthodontic force
Orthodontic Tooth Movement
Piezoelectric response
inflammation
Activation of Collagenase