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BDS3 CLINICAL Ortho > Physiology of Tooth Movement > Flashcards

Physiology of Tooth Movement Flashcards

1
Q

What are the types of tooth movement

A

physiological

orthodontic

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2
Q

What are the physiological tooth movements

A

tooth eruption

mesial drift

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3
Q

How is orthodontic movement done

A

through externally generated forces

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4
Q

What are the different movements in tooth eruption

A 
pre-eruptive tooth movement
intra-osseous eruption 
mucosal penetration
pre-occlusal eruption 
post-occlusal eruption
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5
Q

What is the speed of pre-eruptive tooth movement

A

small and random

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6
Q

What is the speed of intra-osseous eruption

A

occurs after crown forms
slow
1mm takes around 3-24 months

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7
Q

What is the speed of mucosal penetration

A

fast

1mm takes about 2 weeks

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8
Q

What is the speed of pre occlusal eruption

A

slow

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9
Q

What is the speed of post occlusal eruption

A

very slow

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10
Q

What are the different tooth eruption theories

A

pulpal pressure
pulpal growth
fibroblast traction
blood vessel thrust

main 3:
root elongation
alveolar bone remodel
PDL formation

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11
Q

What is the process of tooth eruption

A

the dental follicle is the mediator for bone resorption
the bone and the deciduous root has to be resorbed for the tooth to come through
apical blood flow is important
collagen fibre cross linking is only important after eruption
parathyroid hormone receptor gene (PTHR1 and PPE)

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12
Q

How can orthodontics utilize tooth eruption

A

to minimize impact of a developing malocclusion

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13
Q

How can an ectopic upper permanent canine be treated

A

by interceptive extraction of the deciduous canine (10-13yrs)

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14
Q

How can permanent teeth be encouraged to erupt

A

if deciduous tooth is extracted at correct stage

1/3-2/3 of root development

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15
Q

What is the physiological basis of orthodontics

A

if an external force is applied to a tooth, the tooth will move as the bone around it remodels

if a tooth has no PLD or it is ankylosed it will not move

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16
Q

What is the bony remodeling seen in orthodontics mediated by

A

periodontal ligament

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17
Q

Why does bone resorb and cementum not in tooth movement

A

cementum is more resistant to resorption than bone

although some degree of root resorption after ortho should be expected

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18
Q

What does an orthodontist do

A

manages the growth and development of the teeth face and jaws

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19
Q

What are the 3 theories for orthodontic tooth movement

A

differential pressure theory
piezo electric theory
mechano-chemical theory

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20
Q

What is the differential pressure theory

A

The side of pressure’s PDL is under tension while the other is compressed
on the tension side there is bone deposition and the compression side there is bone resorption

21
Q

What is the piezoelectric pressure theory

A

Piezoelectric currents are generated when crystalline structures, such as bone, are deformed

these currents have been suggested as the prime mechanism by which tooth movement is modulated

22
Q

What is the mechano-chemical pressure theory

A

mechanical stress –> release of neuropeptides from nerve endings –> stimulate fibroblasts, endothelial cells and alveolar bone –> fibroblasts also communicate with osteoblasts and osteoclasts –> alveolar bone and PDL remodeling –> tooth movement

23
Q

What are the types of ortho appliances

A

URA (removable)
functionals
fixed

24
Q

What are upper removable appliances

A

made of acrylic and wire

can tip teeth

25
Q

What is a functional appliance

A

growth modification device
twin block
good for class 2 division 1

26
Q

What are the types of tooth movement

A 
tipping
bodily movement
intrusion
extrusion
rotation
torque
27
Q

What is the ideal force for tipping

A

35-60 grams

28
Q

What is tipping

A

the centre of rotation is around the middle of the tooth and as it tips it moves up

29
Q

How do functional appliances work

A

mandible is postured away from usual rest position
facial musculature is stretched which generates forces transmitted to the teeth and alveolus
may be effect on facial growth

30
Q

What is the mode of action of functionals

A

skeletal change (30%), growth of mandible, restraint of maxilla

dent-alveolar change (70%) retroclination of upper teeth, proclamation of lower teeth

mesial migration of the lower teeth

distal migration of the upper teeth

combination of the above achieves class I

31
Q

What is the ideal force of bodily movement

A

150-200 grams

32
Q

What is bodily movement

A

there is coordinated bone remodeling response leading and trailing the moving tooth

this mechanism allows a tooth to move relative to basilar bone while maintaining a normal functional relationship with its periodontist

33
Q

What is the ideal force for intrusion

A

10-20 grams

34
Q

What is intrusion

A

pressure on supporting structures is evenly distributed and bone resorption is necessary, particularly at the apical area and at the alveolar crest

35
Q

What is the ideal force for extrusion

A

35-60

36
Q

What is extrusion

A

tension is induced in the supporting structures and bone deposition is necessary to maintain tooth support

37
Q

What is the ideal force of rotation

A

35–60 g

38
Q

How is rotation achieved

A

two forces going in opposite directions

have stretched elastic module

stretched elastic chain on other side

39
Q

What is apical root torque

A

root uprighting

40
Q

What is the ideal force for apical root torque

A

50-100g

41
Q

What happens with light force

A

hyperemia within the PDl
appearance of osteoclasts and osteoblasts
resorption of lamina dura from the pressure side via osteoclasts
apposition of osteoid on tension side via osteoblasts
remodeling of socket in frontal resorption
periodontal fibres reorganise
gingival fibres appear not to become reorganized but remain distorted

42
Q

What happens with moderate force

A

occlusion of vessels of PDL on pressure side
hyperemia of vessels of PDL on tension side
cell free areas on pressure side (called hyalinization)
period of stasis
increased endosteal vascularity (undermining resorption)
relatively rapid movement of tooth with bone deposition on tension side - tooth may become slightly loose
healing of PDL - reorganization and remodeling

43
Q

What happens with excessive force

A 
necrsos
undermining resorption
resorption of root surfaces
pain
permanent change
44
Q

What is the histological effects of excessive force

A

extensive lateral root resorption (RR) and undermining resorption (UR), just to the left of an area of PDL necrosis (N) is associated with the lag phase of tooth movement

45
Q

What are factors affecting the respone to ortho force

A

magnitude
duration
age
anatomy

46
Q

What anatomy can effect response to force

A

no bone - wasting/cleft

soft tissue mid palatal suture

47
Q

What is the deleterious effects of ortho force

A 
pain and mobility
pulpal changes
root resoprtion
loss of alveolar bone support
relapse
48
Q

How much tooth movement per month is ideal

A

1mm

49
Q

What is the treatment time for fixed appliances

A

24m

BDS3 CLINICAL Ortho (11 decks)

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