Increased tooth mobility after fixed orthodontic appliance treatment can be selectively utilized for case refinement via positioner therapy - a pilot study

L Keilig, J Goedecke, C Bourauel, N Daratsianos, C Dirk, A Jäger, A Konermann, L Keilig, J Goedecke, C Bourauel, N Daratsianos, C Dirk, A Jäger, A Konermann

Abstract

Background: Increased tooth mobility persists after fixed orthodontic appliance removal, which is therapeutically utilized for post-treatment finishing with positioners. As such a fine adjustment is only required for selected teeth, the aim of this pilot study was to investigate tooth mobility in vivo on corrected and uncorrected subgroups under positioner therapy.

Methods: Mobility was measured on upper teeth of 10 patients (mean age 16.8) by applying loadings for 0.1, 1.0 and 10.0 s with a novel device directly after multibracket appliance debonding as much as 2d, 1, 2 and 6 weeks later. Positioners were inserted at day 2. Specimens were divided into Group C (teeth corrected via positioner), Group N (uncorrected teeth adjacent to teeth from group C), and Group U (uncorrected teeth in an anchorage block). Untreated individuals served as controls (n = 10, mean age 22.4). Statistics were performed via Kolmogorov-Smirnov test and Welch's unequal variances t-test for comparisons between groups. P < 0.05 was considered statistically significant.

Results: After 1 week, tooth mobility in Group U almost resembled controls (13.0-15.7 N), and reached physiological values after 6 weeks (17.4 N vs. 17.3 N in controls). Group C (9.0-13.4 N) and Group N (9.2-14.7 N) maintained increased mobility after 6 weeks. Tooth mobility was generally higher by reason of long loading durations (10.0 s).

Conclusions: Positioner therapy can selectively utilized increased tooth mobility upon orthodontic fixed appliance treatment for case refinements. Here, uncorrected teeth in anchorage blocks are not entailed by unwanted side effects and recover after 6 weeks post treatment. Corrected teeth and their neighbors exhibit enhanced mobility even after 6 weeks, which represents a necessity for the proper correction of tooth position, and concurrently arouses the requirement for an adequate retention protocol.

Keywords: Case refinement; Orthodontic tooth movement; Positioner; Tooth mobility measurement.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Intraoral loading device (ILD). ILD for in vivo measurements of tooth mobility with splint for fixation of the device on the patient’s upper jaw
Fig. 2
Fig. 2
Maximum force values of tooth mobility measurements at 0.1 s loading duration. Mean maximum force values and standard deviations calculated from the tooth mobility measurements of the total patient collective (n = 10) at 0.1 s loading duration for all time points (T1-T5) investigated. Box plots represent the investigated subgroups and are compared to untreated controls. Group C - corrected teeth, whose position was actively modified with the positioner; Group N - uncorrected teeth adjacent to the ones of Group C; Group U - uncorrected teeth not adjacent to the ones from Group C. Statistically significant differences to controls were seen for Group C at T1 and T2, as much as for the teeth in Group N at T1 (P < 0.05)
Fig. 3
Fig. 3
Maximum force values of tooth mobility measurements at 1.0 s loading duration. Mean maximum force values and standard deviations calculated from the tooth mobility measurements of the total patient collective (n = 10) at 1.0 s loading duration for all time points (T1-T5) investigated. Box plots represent the investigated subgroups and are compared to untreated controls. Group C - corrected teeth, whose position was actively modified with the positioner; Group N - uncorrected teeth adjacent to the ones of Group C; Group U - uncorrected teeth not adjacent to the ones from Group C
Fig. 4
Fig. 4
Maximum force values of tooth mobility measurements at 10.0 s loading duration. Mean maximum force values and standard deviations calculated from the tooth mobility measurements of the total patient collective (n = 10) at 10.0 s loading duration for all time points (T1-T5) investigated. Box plots represent the investigated subgroups and are compared to untreated controls. Group C - corrected teeth, whose position was actively modified with the positioner; Group N - uncorrected teeth adjacent to the ones of Group C; Group U - uncorrected teeth not adjacent to the ones from Group C. Statistically significant differences to controls were seen for Group C at T1 (P < 0.05)

References

    1. Tanaka E, Ueki K, Kikuzaki M, Yamada E, Takeuchi M, Dalla-Bona D, et al. Longitudinal measurements of tooth mobility during orthodontic treatment using a periotest. Angle Orthod. 2005;75:101–105.
    1. Tanne K, Inoue Y, Sakuda M. Biomechanical behavior of the periodontium before and after orthodontic tooth movement. Angle Orthod. 1995;65:123–128.
    1. Konermann A, Al-Malat R, Skupin J, Keilig L, Dirk C, Karanis R, et al. In vivo determination of tooth mobility after fixed orthodontic appliance therapy with a novel intraoral measurement device. Clin Oral Investig. 2017;21:1283–1289. doi: 10.1007/s00784-016-1881-5.
    1. Lew KK. The orthodontic tooth positioner--an appraisal. Br J Orthod. 1989;16:113–116. doi: 10.1179/bjo.16.2.113.
    1. Pravindevaprasad A, Therese BA. Tooth positioners and their effects on treatment outcome. J Nat Sci Biol Med. 2013;4:298–301. doi: 10.4103/0976-9668.116975.
    1. Pedersen E, Andersen K, Melsen B. Tooth displacement analysed on human autopsy material by means of a strain gauge technique. Eur J Orthod. 1991;13:65–74. doi: 10.1093/ejo/13.1.65.
    1. Hinterkausen M, Bourauel C, Siebers G, Haase A, Drescher D, Nellen B. In vitro analysis of the initial tooth mobility in a novel optomechanical set-up. Med Eng Phys. 1998;20:40–49. doi: 10.1016/S1350-4533(97)00042-8.
    1. Kawarizadeh A, Bourauel C, Jäger A. Experimental and numerical determination of initial tooth mobility and material properties of the periodontal ligament in rat molar specimens. Eur J Orthod. 2003;25:569–578. doi: 10.1093/ejo/25.6.569.
    1. Burstone CJ, Pryputniewicz RJ, Bowley WW. Holographic measurement of tooth mobility in three dimensions. J Periodontal Res. 1978;13:283–294. doi: 10.1111/j.1600-0765.1978.tb00182.x.
    1. Yoshida N, Koga Y, Kobayashi K, Yamada Y, Yoneda T. A new method for qualitative and quantitative evaluation of tooth displacement under the application of orthodontic forces using magnetic sensors. Med Eng Phys. 2000;22:293–300. doi: 10.1016/S1350-4533(00)00044-8.
    1. Meirelles L, Siqueira R, Garaicoa-Pazmino C, Yu SH, Chan HL, Wang HL. Quantitative tooth mobility evaluation based on intraoral scanner measurements. J Periodontol. 2019. 10.1002/JPER.19-0282.
    1. Wucher T, Dippenaar AM, Wucher M. In-vivo determination of critical force levels using an intraoral electromechanical device to measure nonpathologic tooth mobility. Am J Orthod Dentofac Orthop. 2017;152:592–600. doi: 10.1016/j.ajodo.2017.02.016.
    1. Naumann M, von Stein-Lausnitz M, Rosentritt M, Walter C, Meyer-Lückel H, Sterzenbach G. Impact of simulated reduced alveolar bone support, increased tooth mobility, and distal post-supported, root-treated abutment tooth on load capability of all-ceramic zirconia-supported cantilever FDP. Clin Oral Investig. 2018;22:2799–807. doi: 10.1007/s00784-018-2366-5.
    1. Dorow C, Krstin N, Sander FG. Experimental model of tooth mobility in the human "in vivo". Biomed Tech (Berl) 2002;47:20–25. doi: 10.1515/bmte.2002.47.1-2.20.
    1. Drolshagen M, Keilig L, Hasan I, Reimann S, Deschner J, Brinkmann KT, et al. Development of a novel intraoral measurement device to deter-mine the biomechanical characteristics of the human periodontal ligament. J Biomech. 2011;44:2136–2143. doi: 10.1016/j.jbiomech.2011.05.025.
    1. Göllner M, Holst A, Berthold C, Schmitt J, Wichmann M, Holst S. Noncontact intraoral measurement of force-related tooth mobility. Clin Oral Investig. 2010;14:551–557. doi: 10.1007/s00784-009-0344-7.
    1. Kenkre JS, Bassett J. The bone remodelling cycle. Ann Clin Biochem. 2018;55:308–327. doi: 10.1177/0004563218759371.
    1. Eriksen EF. Cellular mechanisms of bone remodeling. Rev Endocr Metab Disord. 2010;11:219–227. doi: 10.1007/s11154-010-9153-1.
    1. Wei Z, Yu X, Xu X, Chen X. Experiment and hydro-mechanical coupling simulation study on the human periodontal ligament. Comput Methods Prog Biomed. 2014;113:749–756. doi: 10.1016/j.cmpb.2013.12.011.

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit