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Biology of Tooth Movement
Biology of Tooth Movement
TOOTH ERUPTION:
Tooth eruption is the axial movement of tooth from its development position in the jaw to its final position in the oral cavity. The following are some theories which explains the eruption process a)Blood pressure theory: According to this theory, the tissue around the developing end of the root is highly vascular. This vascular pressure is believed to cause the axial movement of teeth. b)Root Growth: According to this theory,the apical growth of roots result in an axially directed force that brings about the eruption of teeth. This theory was rejected because: The tooth moves at a greater distance than the root length. Onset of root growth and eruption do not coincide. Teeth without roots also erupt. c)Hammock ligament theory: According to Sicher, a band of fibrous tissue exists below the root apex spanning from one side of alveolar wall to other.
This fibrous tissue appears to form a network below the developing root and is rich in fluid droplets.the developing root forces itself against this band of tissue, which in turn applies an occlusally directed force on tooth. d)Periodontal traction theory: This theory states that the periodontal ligament is rich in fibroblasts that contain contractile tissue.The contraction of these periodontal fibers (mainly the oblique group of fibers) results in axial movement of the tooth.
Changes on tension side: PDL stretched Distance between alveolar process & tooth is widened. Increased vascularity. Mobilization of fibroblasts & osteoblasts. Osteoid is laid down by osteoblast in PDL immediately adjacent to lamina dura. Lightly calcified bone mature to form woven bone. Secondary remodelling changes: Bony changes also takes place elsewhere to maintain the width or thickness of alveolar bone. These changes are called secondary remodeling changes. For eg: If a tooth is being moved in a lingual direction there is compensatory deposition of new bone on the outerside of the lingual alveolar bony plate and also a compensatory resorption on the labial side of the labial alveolar bone. This is to maintain the thickness of the supporting alveolar process .
On the tension side: Over stretched PDL . Tearing of blood vessels & ischaemia. Extreme forces applied net increase in osteoclastic activity and tooth loosened in socket.
Initial phase
Lag phase:
Little or no tooth movement occurs . Formation of hyalinized tissue . Extent upto 2-3 weeks .
Farrar in 1876, first noted deformation or bending of interseptal alveolar bones. suggest that bone bending may be a possible mechanism for bringing about tooth movement. Piezo-electricity is a phenomenon observed in many crystalline materials in which deformation of the crystal structure produces a flow of electric current as a result displacement of electrons from one part of the crystal lattice to the other.A small electric current is generated & bone is mechanically deformed. The possible source of electric current are :1. Collagen. 2. Hydroxyapetite. 3. Collagen hydroxyapetite interface. 4. Mucopolysaccharide. As long as the force is maintained ,The crystal structure is stable & no further electric effect is observed. When the force is released the crystals return to their original shape & reverse flow of electrons is observed. This rhythmic activity produces a constant interplay of electric signals .
Bone deposition:
On the tension side. Increase in number of osteoblasts . Osteoblasts are ovoid cells with basophilic cytoplasm and a oval nucleus. Osteoblast increase in number by proliferation of their precursor cells. The PDL fibers readapt to new position of the tooth by proliferation of intermediate zone.
Bone resorption:
By OSTEOCLASTS Multi-nucleated giant cells and may have 12 or more nuclei. They are irregularly and or club shaped with branching processes . They lie in bay like depressions called Howships lacunae. The part of osteoclast in contact with resorbing bone has a ruffled border. Osteoclasts derived from: Activation of previously present inactive cells. Migration from adjacent bones. Formation of new osteoclasts from local macrophages of PDL. Influx of monocytes from blood vessels. During bone resorption three processes occur: 1. 2. 3. Decalcification. Degradation of matrix. Transport of soluble products to the extracellular fluid or blood vascular system
IN SUMMARY
A dentist should thoroughly understand the biological factors and principles behind Orthodontic Tooth Movement. He should achieve the desired aesthetic and functional result using the optimum amount of force. He should also give consideration to the health of the periodontium and thus try to minimize the deleterious effects of the treatment.