1) Short note on cortical plate, socket wall and cancellous bone

Cortical plate : compact bone on the facial and lingual surface of alveolus
Socket wall : A thin layer of compact bone, radiopaque in radiograph. In radiograph call as
lamina dura
Cancellous bone: consist of trabeculae. Also consist of haversian system and lamella, it
transport nutrient to the bone cell which is osteoblast and osteoclast




















2) Short note PDL structure and function



- Each tooth is attached to and separated from adjacent alveolar bone by PDL, a heavy
collageneous supporting structure.
- The major component of PDL is parallel collagenous fibers, inserting into cementum of the
root surface and lamina dura.
- Two major component of ligament that play an important role in normal function and
making orthodontic tooth movement possible:
a) the cellular elements: mesenchymal cells
b) tissue fluid

- Four main cell types that are considered to be cells of PDL:
1) Fibroblast: produce and degrade the extracelluler matrix
2) Cementoblast: produce of cementum
3) Osteoblast: for bone production and co-ordinating of bone deposition and resorption
4) Osteoclast: for bone resorption
- The tissue fluids provide resistance
- Thus allow normal mastication with force applications of 1 second or lessto occur without
pain
- PDL loses its adaptive capability as tissue is squeezed out of its confined area

Role of PDL

Cussion /Shock Absorber:
Provided by tissue fluid
Eruption Of The Teeth :
Metabolic events within PDL generate force that
produce tooth movement
Stabilization Of The Teeth
Metabolic events within the PDL generate force which
serve as active stabilization for teeth

3) Types of tooth movement

1) Tipping - Produced when single force applied against
crown of tooth

- PDL compressed near root apex ( same side
as force applied)

2) Bodily movement Two forces pplied simultaneously to the tooth crown

Root apex and crown move in same direction at same
amount

Force applied thru center of resisitance
3) Rotational
4) Extrusion Produce no compression, only produce tension
5) Intrusion
6) Torque
















4) Theories of tooth movement

1) Fluid dynamic theory 2) Blood flow theory by Bien
3) Tooth movement occurs as a result of
alterations in fluids dynamics in the
periodontal ligament.
4) When force is removed, the fluid is
replenished by diffusion from capillary
walls and recirculation of interstitial fluid.
5) When force is applied for short duration
eg mastication, fluid in periodontal space
is replenished when force is removed
6) If greater force and duration applied in
OTM, interstitial fluid is squeezed out
7) And moved towards the apex and cervical
margin and results in decrease in tooth
movement.
8) In compression area, blood vessel in pdl
get trapped and result in stenosis due to
reduced oxygen level.
9) This creates favourable environment for
resorption
2) Pressure tension hypothesis 1) Blood flow is decreased in
compressed area and increased in
tension area.
2) Alteration in blood flow create
changes in chemical environment. (eg
reduced oxygen level in compressed
area)
3) Chemical changes acting directly or
by stimulating the release of other
biologically active agents that would
stimulate cellular differentiation and
activity.
4) The process of initiation of tooth
movement has 3 stages:
5) - Alternation of blood flow associated
with pressure within the PDL
6) - The formation and release of
chemical messengers
7) - Activation of cells which causes
deposition and resorption of bone.
8) BONE RESORPTION (osteoclastic
activity) takes place at the side of the
PDL where there is PRESSURE
9) BONE FORMATION (osteoblastic
activity) takes place at the side where
there is TENSION


3) Piezoelectric force 1) Electric signal that initiate initial
tooth movement
2) The phenomenon observed in
crystalline materials
3) When a force is applied to a
crystalline structure (like bone or
collagen), a flow of current is
produced that quickly dies away
4) When the force is released, an
opposite current flow is observed
5) Deformation of the crystal
structure produces a flow of
electric current as electron are
displaced from one part of the
crystal lattice to another
6) The piezoelectric effect results
from migration of electrons
within the crystal lattice

4) Biomechanical response forces 1) Force applied on tooth
2) Cell membrane distort (cells
of supporting tissues)
3) Activation of phospholipase
A2
4) Initiate arachidonic acid
metabolism which cycl- and
lip- oxygenase pathway
(LT,HETE, PG)
5) Feed back to receptors on cell
membrane which stimulate
2nd messengers cascade
6) Cell response (resorption and
deposition)



5) Range of forces every type of tooth movement

Minimum pressure required for tooth to move is 20-25 gm/cm2






6) Pathological changes associated with tooth movement

Root resorption
Crestal bone resorption
Pulp damage
Loss of vitality







7) Tissue changes during tooth movement

Response to Normal Function
Teeth and periodontal structures are subjected to forces up to 50 kg during mastication
Force is transmitted to the alveolar bone which bends in response
Generation of piezoelectric currents
It acts as an important stimulus to regeneration and repair process resulting in adaptation of
bony architecture to functional demands

Response to Continuous Pressure
< 1 second: Fluid in the PDL is incompressible
1 2 seconds: PDL fluid expressed, Tooth moves within PDL space
3 5 seconds: PDL fluid squeezed out, Tissue compressed and immediate pain is felt if force is
heavy

Force for Orthodontic Tooth Movement
Forces that bring about orthodontic tooth movement are continuous and should have a
minimum magnitude (threshold)
Below this threshold limit, the PDL has the ability to stabilize the tooth by active metabolism
The minimum pressure required is 20 -25 gm/cm2