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Biomechanics of Orthodontic
     Tooth Movement




         Dr. Nabil Al-Zubair
Objectives
•   Define the term “biomechanical principles” with
    respect to various methods of orthodontic
    therapy.
•   Evaluate various force systems used for
    orthodontic tooth movement and orthopedic
    application.
•   Describe the biology of orthodontic tooth
    movement and discuss the histologic changes
    that occur with various force systems.
Physiologic tooth movement
                            • Include :
•   Definition: naturally
    occurring tooth         1. Tooth eruption
    movement that take      2. Migration or drift of teeth
    place during & after    3. Changes in tooth position
    tooth eruption.            during mastication
Tooth eruption
• Definition: the axial movement of the tooth
  from its developmental position in the jaw to
  its final position.
Theories of tooth eruption
        1     The root elongation theory
2    The hydrostatic theory (vascular theory)

    3       The alveolar bone growth theory
               4   The pulp theory

    5       The periodontal ligament theory
Migration or drift of teeth
• Refers to the minor changes in tooth position observed after eruption of teeth

                             The human dentition




         Shows a natural tendency to move in a mesial & occlusal direction

              • • howevertrue lower jaw show certain variation)
                   largely the in case of maxillary dentition
Migration or drift of teeth
Tooth migration is usually as a result of
                                              Proximal & occlusal wear of teeth




  Teeth undergo proximal & occlusal wear


                  Move in a mesial & occlusal direction

                                  to maintain inter-proximal & occlusal contact.
Tooth movement during mastication

                                       Slight movement within its socket

Force absorbed by bone bending

                                        Return to its original position as
                                          soon as the load is removed


                 The teeth & periodontal structures

                                  1-50 Kg based on type of food

                          Intermittent heavy forces
Short duration
                       Cycles of one second or less
Tooth movement during mastication

  1-2 secs – PDL fluid displaced
                                                        Pain
2-3 secs – PDL tissues compressed




                   The teeth & periodontal structures



  Long duration             1-50Kg / continuous
Histological basis of tooth movement
• Single point force application to crown of tooth   Tilting




     Center of Rotation
Histological basis of tooth movement


                                 Pressure side




                 + --
Tension side     +     -
                 +      -
                 +
                 +        +
                          +
                   -       +              Tension side
                   -        +
                    -       +
                    -        +
                     -
                     -
 Pressure side
Histological basis of tooth movement
           Continuous optimal force-


        Direct bone resorption
                                                 Pressure side

                                 -
                                     -        Cell proliferation
                                         -
                                          -

                          -                   Osteoclasts
                          -
                           -
                           -
                            -
Pressure side               -
Histological basis of tooth movement
                 Continuous optimal force-



                              Osteoid
                                                mineralised
                              +
  Tension side                +
                              +                PL fibers arebone
                                                     Woven stretched
                              +         +
                              +         +
                                         +                    Tension side
                                          +
Fibroblasts and osteoblasts               +
                                           +




                                                 Mature lamella bone.
Histological basis of tooth movement
•If force exceeds capillary blood pressure

           Reduces blood flow

                                                    Pressure side
  Will not produce optimal tooth movement.


                                    + --
       Tension side                 +     -
                                    +      -
                                    +
                                    +        +
                                             +
                                      -       +              Tension side
                                      -        +
                                       -       +
                                       -        +
                                        -
                                        -
         Pressure side


Tooth movement occurs with a force duration for only 6 hrs/day
Excessive force

      1. No direct resorption of bone
      2. Compression of blood vessels



This results in sterile necrosis of cells (known as hyalinization because
   of the structureless appearance under the microscope.


No tooth movement initially.                                      Pressure side

Delay of 2-3 weeks then there is
   undermining resorption outwards
   from the marrow spaces of the
   adjacent alveolar bone.


                            Pressure side
• The optimum force for tooth movement is 25 g/cm2 of
  root surface area.
• The size of force is determined by surface area of the
  root and the type of movement i.e tipping < force than
  bodily movement.
Force – 50-75g




Force –100-150g




                                                      Force –50-100g




                  Tooth movement


                  Force –15-25g


                                  Force –50g
Excessive forces results in:-



–   delay in tooth movement
–   discomfort to patient
–   tooth mobility
–   root resorption
–   excessive force dispersed over anchor teeth, threshold
    exceeded
Timing of treatment
Usually the early permanent dentition 10-14 yrs.
  Reasons

      • Bone remodelling in response to orthodontic forces
        are more rapid in children.
      • Patient co-operation best around early teens.
      • Active tooth movement cannot begin until after
        eruption.
      • Growth can be used for overbite reduction,
        anteroposteior arch correction and spontaneous
        tooth movement.
Biomechanics
Free bodies :
their mass is concentrated at a single point.

                          This point is called the mass center
• If, e.g., a free body
  is found in space
  and a force is
  applied at a
  specific point on it,
  then all body
  points will follow
  the same course.
The tooth not a free body

       The periodontal ligament   Restrict its movement
       The alveolar bone.




The point that corresponds to the mass center of a free
  body is the center of resistance of the tooth.
The center of resistance

     The point where tooth resistance to a movement may be
                            concentrated;

                     Center of Rotation (CR)        M
                                   CR

 in other words, when a force is
  applied through this point, tooth
                                                             D
        translation ensues.


Forces applied at a distance from the CR also                F
    create a moment that tends to rotate the
                      tooth.
           Moment = Force x Distance
Moment = Force x Distance
                                              M

Moment magnitude depends on
1. force magnitude
2. distance of the force vector from the CR
                                                  D




                                                  F
Moment / force ratio
• When the orthodontist knows the location of a tooth’s CR,
Moment / force ratio for every tooth movement may be calculated;

       thus, tooth movement may be controlled

                                 M




                                                 D

  Distance = Moment / Force


                                                 F
Moment / Force = Distance
• Translation • Torque
• Controlled tipping
            Moment to force ratio is between 1 and 7
      Moment to force ratio is between higher 10 10
             Moment to force ratio is 8 and than
Moment / force ratio

    • If, e.g., tooth translation is to be achieved

                                                       M



• An opposite moment
  counteracting the first
  one                                                      D


                                • a force applied
                                  through the center
                                                           F
                                  of resistance



          • Should be incorporated into the system.
M




                                                       D



• If, e.g., tooth translation is to be achieved
                                                       F



• An opposite moment counteracting the first one
Dr. Nabil Al-Zubair

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Biomechanics of Orthodontic Tooth Movement _2 - Dr. Nabil Al-Zubair

  • 1. Biomechanics of Orthodontic Tooth Movement Dr. Nabil Al-Zubair
  • 2. Objectives • Define the term “biomechanical principles” with respect to various methods of orthodontic therapy. • Evaluate various force systems used for orthodontic tooth movement and orthopedic application. • Describe the biology of orthodontic tooth movement and discuss the histologic changes that occur with various force systems.
  • 3. Physiologic tooth movement • Include : • Definition: naturally occurring tooth 1. Tooth eruption movement that take 2. Migration or drift of teeth place during & after 3. Changes in tooth position tooth eruption. during mastication
  • 4. Tooth eruption • Definition: the axial movement of the tooth from its developmental position in the jaw to its final position.
  • 5. Theories of tooth eruption 1 The root elongation theory 2 The hydrostatic theory (vascular theory) 3 The alveolar bone growth theory 4 The pulp theory 5 The periodontal ligament theory
  • 6. Migration or drift of teeth • Refers to the minor changes in tooth position observed after eruption of teeth The human dentition Shows a natural tendency to move in a mesial & occlusal direction • • howevertrue lower jaw show certain variation) largely the in case of maxillary dentition
  • 7. Migration or drift of teeth Tooth migration is usually as a result of Proximal & occlusal wear of teeth Teeth undergo proximal & occlusal wear Move in a mesial & occlusal direction to maintain inter-proximal & occlusal contact.
  • 8. Tooth movement during mastication Slight movement within its socket Force absorbed by bone bending Return to its original position as soon as the load is removed The teeth & periodontal structures 1-50 Kg based on type of food Intermittent heavy forces Short duration Cycles of one second or less
  • 9. Tooth movement during mastication 1-2 secs – PDL fluid displaced Pain 2-3 secs – PDL tissues compressed The teeth & periodontal structures Long duration 1-50Kg / continuous
  • 10. Histological basis of tooth movement • Single point force application to crown of tooth Tilting Center of Rotation
  • 11. Histological basis of tooth movement Pressure side + -- Tension side + - + - + + + + - + Tension side - + - + - + - - Pressure side
  • 12. Histological basis of tooth movement Continuous optimal force- Direct bone resorption Pressure side - - Cell proliferation - - - Osteoclasts - - - - Pressure side -
  • 13. Histological basis of tooth movement Continuous optimal force- Osteoid mineralised + Tension side + + PL fibers arebone Woven stretched + + + + + Tension side + Fibroblasts and osteoblasts + + Mature lamella bone.
  • 14. Histological basis of tooth movement •If force exceeds capillary blood pressure Reduces blood flow Pressure side Will not produce optimal tooth movement. + -- Tension side + - + - + + + + - + Tension side - + - + - + - - Pressure side Tooth movement occurs with a force duration for only 6 hrs/day
  • 15. Excessive force 1. No direct resorption of bone 2. Compression of blood vessels This results in sterile necrosis of cells (known as hyalinization because of the structureless appearance under the microscope. No tooth movement initially. Pressure side Delay of 2-3 weeks then there is undermining resorption outwards from the marrow spaces of the adjacent alveolar bone. Pressure side
  • 16. • The optimum force for tooth movement is 25 g/cm2 of root surface area. • The size of force is determined by surface area of the root and the type of movement i.e tipping < force than bodily movement.
  • 17. Force – 50-75g Force –100-150g Force –50-100g Tooth movement Force –15-25g Force –50g
  • 18. Excessive forces results in:- – delay in tooth movement – discomfort to patient – tooth mobility – root resorption – excessive force dispersed over anchor teeth, threshold exceeded
  • 19. Timing of treatment Usually the early permanent dentition 10-14 yrs. Reasons • Bone remodelling in response to orthodontic forces are more rapid in children. • Patient co-operation best around early teens. • Active tooth movement cannot begin until after eruption. • Growth can be used for overbite reduction, anteroposteior arch correction and spontaneous tooth movement.
  • 20. Biomechanics Free bodies : their mass is concentrated at a single point. This point is called the mass center • If, e.g., a free body is found in space and a force is applied at a specific point on it, then all body points will follow the same course.
  • 21. The tooth not a free body The periodontal ligament Restrict its movement The alveolar bone. The point that corresponds to the mass center of a free body is the center of resistance of the tooth.
  • 22. The center of resistance The point where tooth resistance to a movement may be concentrated; Center of Rotation (CR) M CR in other words, when a force is applied through this point, tooth D translation ensues. Forces applied at a distance from the CR also F create a moment that tends to rotate the tooth. Moment = Force x Distance
  • 23. Moment = Force x Distance M Moment magnitude depends on 1. force magnitude 2. distance of the force vector from the CR D F
  • 24. Moment / force ratio • When the orthodontist knows the location of a tooth’s CR, Moment / force ratio for every tooth movement may be calculated; thus, tooth movement may be controlled M D Distance = Moment / Force F
  • 25. Moment / Force = Distance • Translation • Torque • Controlled tipping Moment to force ratio is between 1 and 7 Moment to force ratio is between higher 10 10 Moment to force ratio is 8 and than
  • 26. Moment / force ratio • If, e.g., tooth translation is to be achieved M • An opposite moment counteracting the first one D • a force applied through the center F of resistance • Should be incorporated into the system.
  • 27. M D • If, e.g., tooth translation is to be achieved F • An opposite moment counteracting the first one