TOOTH MOVEMENT

IN
ORTHODONTICS
Dr.Krishna Kanth Reddy

 Orthodontic

tooth movement is achieved

with the application of force on the teeth
using certain appliances.
Tooth
movement in response to these forces is
governed by certain laws of physics.
Biomechanics deals with these laws.

clear knowledge of these

concepts is essential for the proper
understanding
of
the
tooth
movement and how we can
optimize orthodontic treatment to
achieve best results

Flas h Player Movie

CENTRE OF GRAVITY
Every

object or a free body has one point

on which it can be perfectly balanced.
This point is known as the Centre of
gravity.

The

movement of a free body depends

upon the relationship of the line of action
of the force to the centre of gravity.

Center of Gravity:

 The

center of gravity of the tooth is located

more towards the crown of the tooth as the
mass of the tooth is concentrated more
coronally

Center of Resistance
It

is a point at which resistance to tooth

movement is concentrated.
It is at the approximate midpoint of the
embedded portion of the root.

Center of Resistance

Center of Resistance

Center of Gravity

 Since

the kind of reaction to an applied

force system is so strongly dependent on
the site of the center of resistance, it is of
paramount importance to estimate where
its location will be.

FORCE
It

is a load applied to an object that

will move it to a different position in
space. Though defined in units of
Newtons, it is usually measured in
units of grams or ounces

MOMENT
If

the line of action of an applied force

does not pass through the Centre of
resistance, the force will produce some
rotation. The potential for rotation is
measured as MOMENT.
Is defined as a tendency to rotate
Flas h Player Movie

TiP

Flas h Player Movie

Tran

COUPLE
Two

Flas h Player Movie

equal and opposite, non-collinear

forces

PHYSIOLOGIC TOOTH
MOVEMENT

Means the slight tipping movement of the

functioning tooth in its socket and the changes
in tooth position which occurs in young
persons during and after tooth eruption.

ORTHODONTIC TOOTH
MOVEMENT
Basically

there is no difference
between the tissue reactions
observed in physiologic tooth
movement and orthodontic tooth
movement.

 However, the

more rapidly teeth are

moved during treatment, the tissue
changes elicited by orthodontic
forces are consequently more
marked and extensive.

TISSUE RESPONSE AND TOOTH

MOVEMENT DEPENDS ON
Force

Magnitude
Direction of Force
Duration and Type of Force.

Effects of force magnitude

Ideal

orthodontic force = 26gms/cm 2

Lighter the force, the better is the tissue
response.

TYPES OF TOOTH MOVEMENT

TIPPING
CONTROLLED
UNCONTROLLED

TORQUING
BODILY
INTRUSION
EXTRUSION

ROTATION

TIPPING MOVEMENT

Simplest

form of orthodontic movement

Requires force of very low magnitude
Crown movement is more than the root
movement.

 Tipping

movements are produced when a

single force (for instance, a spring
extending from a removable appliance) is
applied against the crown of a tooth. When
this is done, the tooth rotates around its
centre of resistance, a point located about
halfway down the root

 When

the tooth moves in this fashion, the

periodontal ligament is compressed near the
root apex on the same side as the spring,
and at the crest of the alveolar bone
Maximum
pressure in the periodontal
ligament is created at the alveolar crest and
at the root apex. Progressively less pressure
is created as the Cres is approached.

UNCONTROLLED TIPPING

Flas h Player Movie

When

the force is applied,

the crown moves in one
direction and the root
moves in the opposite
direction. Here the centre
of rotation lies somewhere
near
the
centre
of
resistance of the tooth.
This is referred to as
Uncontrolled tipping.

Flas h Player Movie

CONTROLLED TIPPING
The

centre of rotation
lies near or close to
the apex. Here the
crown moves in one
direction but the root
position remains the
same
or
gets
minimally displaced.

Flas h Player Movie

TORQUING MOVEMENT

Root

movement is more than the crown

movement.
Requires force of high magnitude (2-3
times greater than tipping).

Flas h Player Movie

BODILY MOVEMENT
Crown

movement = Root movement.

If two forces are applied simultaneously to the
crown of a tooth, the tooth can be moved bodily
(translated) i.e., the root apex and crown move
in the same direction the same amount.
In this case, the total periodontal ligament area
is loaded uniformly.
The centre of rotation lies at infinity.

EXTRUSION
Extrusion

is the bodily displacement of

a tooth along its long axis in an occlusal
direction.
Extrusion movements ideally would
produce no areas of compression within
the periodontal ligament, only tension.

INTRUSION
Intrusion

is the bodily displacement of a

tooth along its long axis in an apical
direction.
Light force is required for intrusion
because the force will be concentrated in
a small area at the root apex.
Only if the force is kept very light can
intrusion be expected.

ROTATION
TWO

FORCES
OF
EQUAL
MAGNITUDE ACTING OPPOSITE IN
DIRECTION PRODUCES ROTATION.

OPTIMUM ORTHODONTIC FORCE

Optimum

orthodontic force is one which

moves teeth most rapidly in the desired
direction, with the least possible
damage to tissues and with minimum
patient discomfort.
OOF is equivalent to the capillary blood
pressure which is 20-26 gms/sq cm. of
root surface area.

OPTIMUM FORCES FOR

ORTHODONTIC TOOTH MOVEMENT
TIPPING
TRANSLATION
TORQUING
ROTATION
EXTRUSION
INTRUSION

50-75 gms force

100-150 gms force
75-125 gms force
50-75 gms force
50-75 gms force
15-25 gms force

EFFECTS OF FORCE DURATION AND

FORCE DECAY
The

key to producing orthodontic tooth

movement is the application of sustained
force.
A minimum of 4-6 hours of continuous
force is necessary to initiate tooth
movement.
Continuous force, 24 hours/day, produces
the most efficient tooth movement.

CLINICAL EXPERIENCE SUGGESTS THAT

THERE IS A THRESHOLD FOR FORCE
DURATION IN HUMANS, PROBABLY AT
ABOUT
6
HOURS,
AND
THAT
INCREASINGLY
EFFECTIVE
TOOTH
MOVEMENT IS PRODUCED IF FORCE IS
MAINTAINED FOR LONGER DURATION

ORTHODONTIC FORCES
With

many orthodontic devices, the force may

drop all the way to zero. From this perspective,
orthodontic force duration is classified by the
rate of decay as:

CONTINUOUS
INTERRUPED
INTERMITTENT

OHP

CONTINUOUS FORCE
Force

maintained at some appreciable

fraction of the original from one patient visit
to the next
Ex: An ideal spring would maintain the
same amount of force regardless of the
distance a tooth had moved. Forces that
are maintained between the activations of
an orthodontic appliance, even though the
force declines.

INTERRUPTED FORCE
Force

levels drop to zero between

activation
Both continuous and interrupted forces
can be produced by fixed appliances
that are constantly present.

INTERMITTENT FORCE
Force

levels decline abruptly to zero

intermittently , when the orthodontic
appliance is removed by the patient.
Intermittent forces are produced by all
patient activated appliances, such as
removable
plates, head gear and
elastics.

RATE OF TOOTH MOVEMENT

About

1mm/month may be regarded as an

acceptable rate of tooth movement.

VARIOUS FACTORS AFFECT THE RATE OF TOOTH

MOVEMENT:

Force applied: Both light and heavy force will result

in orthodontic tooth movement. However, it is
generally felt that if light forces are used, minimizing
hyalinization of the periodontal ligament, the rate of
tooth movement will be greater.

AGE: In the adult, the periodontal ligament is

much cellular than in the child. In addition, the
alveolar bone in children is less dense than in
older patients. This means that, in general,
tooth movement in the adult will be slower.
INDIVIDUAL VARIATION: There is individual
variation in the response to orthodontic forces.
This is at least part dependent on the density of
the alveolar bone.

THEORIES OF TOOTH
MOVEMENT
PRESSURE

TENSION THEORY
FLUID DYNAMICS THEORY
PIEZO ELECTRIC THEORY

PRESSURE TENSION THEORY

Briefly

this indicates that when a tooth is

pressed from one side the periodontal
fibers on the side are tensed, or
straightened.
The fibers on the
opposite side are compressed.
Schwartz felt that pressures should be
limited to capillay

FLUID DYNAMIC THEORY

is

a relatively recent one

The
contents of the periodontal
ligament acts like a colloidal solution to
mechanical pressure.
Pressure on a tooth elicits several
reactions which are typical of viscous
fluids, according to Bein.

 If

a viscous fluids is compressed

between two flat bearings, it tends to
move to the periphery.
Intrusive pressure on a tooth tends to
move the interstitial fluid toward the
apex and the gingival margin. This acts
to slow down the intrusive movement.
This is the squeeze film effect.

PIEZO ELECTRIC THEORY

OR BONE BENDING
THEORY

Piezoelectricity

is a phenomenon observed in
many crystalline materials in which a
deformation of the crystal structure produces
a flow of current as electrons are displaced
from one part of the crystal lattice to another .
Stipulates that the bone is deformed in
response to pressure on the tooth, and
reforms to adjust to the new position of the
tooth.

 Mechanical

stress initiated by orthodontic

force or alveolar bone deflection induced
an electric polarization referred to as
PIEZOELECTRIC RESPONSE.
In electronegative regions, bone formation
occurs,
whereas
bone
resorption
predominates in electropositive areas.

HISTOLOGICAL ASPECT OF
TOOTH MOVEMENT

Swhartz

felt that pressures should be

limited to capillary blood pressure;
otherwise he felt there would be tissue
necrosis in the periodontal ligament.