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Osteoclastogenesis in alveolar bone induced by compression stress triggers orthodontic tooth movement. Compression stress also stimulates angiogenesis, which is essential for osteoclastogenesis. However, the effects of osteoclastogenesis induced by compression on angiogenesis are poorly understood. In vivo, we found the markers of angiogenesis increased during orthodontic bone remodeling. In vitro, osteoclast-derived exosomes increased proliferation, migration, and tube formation of human umbilical vein endothelial cells (HUVECs), as well as expression of vascular endothelial growth factor and CD31. The promotive effects of exosomes derived from compressed osteoclasts were greater than those derived from osteoclasts without compression. Next, we analyzed changes in the microRNA transcriptome after compression stress and focused on microRNA146a-5p (miR-146a), which was significantly decreased by compression. Transfection of an inhibitor of miR-146a stimulated angiogenesis of HUVECs while miR-146a mimics repressed angiogenesis. Adiponectin (ADP) was confirmed to be a target of miR-146a by dual luciferase reporter assay. In HUVECs treated with exosomes, we detected increased ADP which promoted angiogenesis. Knockdown of ADP in HUVECs reduced the promotive effects of exosomes. Our results demonstrate that the decreased miR-146a observed in osteoclasts after compression promotes angiogenesis by targeting ADP, suggesting a novel method to interfere with bone remodeling induced by compression stress., (© 2021. Science China Press and Springer-Verlag GmbH Germany, part of Springer Nature.)

In the course of a lifetime the crowns of teeth wear off, cementum thickens and the pulp closes-in or may stiffen. Little is known about how these changes affect the tooth response to load. Using a series of finite element models of teeth attached to the jawbone, and by comparing these to a validated model of a 'young' pig 3-rooted tooth, the effects of these structural changes were studied. Models of altered teeth show a stiffer response to mastication even when material properties used are identical to those found in 'young' teeth. This stiffening response to occlusal loads is mostly caused by the thicker cementum found in 'old' teeth. Tensile stresses associated with bending of dentine in the roots fall into a narrower distribution range with lower peak values. It is speculated that this is a possible protective adaptation mechanism of the aging tooth to avoid fracture. The greatest reduction in lateral motion was seen in the bucco-lingual direction. We propose that greater tooth motion during mastication is typical for the young growing animal. This motion is reduced in adulthood, favoring less off-axis loading, possibly to counteract natural bone resorption and consequent compromised anchoring., (Copyright © 2021. Published by Elsevier Inc.)

Background and Objective: Over a century, an increased prevalence of gingival diseases associated with increasing plasma sex steroid hormone levels has been reported. These situations present unique challenges to the oral health-care professional. It is believed that hormonal fluctuations such as those associated with pregnancy, menstruation, and use of hormonal contraceptives lead to an increase in tooth mobility. However, this effect of female sex hormones on periodontal ligament and tooth-supporting alveolar bone has rarely been investigated. Hence, this study was conducted to understand the effect of hormonal changes during pregnancy on tooth mobility., Materials and Methods: Mobility of index teeth 16, 13, 21, 23, 24, 36, 33, 41, 43, and 44 was measured with periotest for fifty pregnant females at first trimester (12th week), second trimester (24th week), and third trimester (35th week). Simplified oral hygiene index, plaque index, Gingival index (GI), and probing depth were also evaluated during the three trimesters of pregnancy for each subject participating in the study., Statistical Analysis: The results of the study were subjected to statistical analysis. Data analysis was done by applying Z-test for comparing difference between two sample means., Results: A small but statistically significant influence on the periotest value was seen during the three trimesters of pregnancy. GI scores significantly increased throughout pregnancy despite no significant change in plaque levels., Conclusion: Pregnancy had a significant influence on tooth mobility. Highest value of tooth mobility was seen in the last month of pregnancy. The maximum severity of gingivitis was also seen during the third trimester of pregnancy.

Objective: To compare the percentage of force loss generated during canine sliding movements in newly introduced ceramic brackets with metal brackets., Materials and Methods: Two types of ceramic brackets, namely polycrystalline alumina (PCA) ceramic brackets (Clarity Advanced) and monocrystalline alumina (MCA) ceramic brackets (Inspire Ice) were compared with stainless steel (SS) brackets (Victory Series). All bracket groups (n = 5 each) were for the maxillary canines and had a 0.018-inch slot size. The brackets were mounted on an Orthodontic Measurement and Simulation System (OMSS) to simulate the canine retraction movement into the first premolar extraction space. Using elastic ligatures, 0.016 × 0.022″ (0.40 × 0.56 mm) stainless steel archwires were ligated onto the brackets. Retraction force was applied via a nickel-titanium coil spring with a nearly constant force of approximately 1 N. The OMSS measured the percentage of force loss over the retraction path by referring to the difference between the applied retraction force and actual force acting on each bracket. Between group comparisons were done with one-way analysis of variance., Results: The metal brackets revealed the lowest percentage of force loss due to friction, followed by the PCA and MCA ceramic bracket groups (67 ± 4, 68 ± 7, and 76 ± 3 %, respectively). There was no significant difference between SS and PCA brackets (p = 0.97), but we did observe significant differences between metal and MCA brackets (p = 0.03) and between PCA and MCA ceramic brackets (p = 0.04)., Conclusion: PCA ceramic brackets, whose slot surface is covered with an yttria-stabilized zirconia-based coating exhibited frictional properties similar to those of metal brackets. Frictional resistance resulted in an over 60 % loss of the applied force due to the use of elastic ligatures.

Background and Objectives: Anchorage is one of the most challenging sides in orthodontics. The use of biological modulators that inhibit osteoclasts could be a solution to address these problems and provide new adjunctive approaches. The aim of this study was to assess the effectiveness of recombinant osteoprotegerin fusion protein (OPG-Fc) in orthodontic anchorage., Materials and Methods: Two groups of male Sprague-Dawley rats were utilized. The animals in the experimental group received twice-weekly injections with high dose of OPG-Fc (5.0mg/kg) in mesial and distal mucosa of the first molars, and those in the control group received no drugs. Right first maxillary molars were mesialized using a calibrated nickel-titanium spring connected to an anterior mini-screw. Tooth movement was measured by two blinded observers using scanned and magnified stone casts. Receptor activator of nuclear factor κB (RANK), run-related transcription factor 2 (Runx2), type I collagen, vimentin, matrix metalloproteinases 2 and 9, S100 protein and the putative mechanoproteins acid-sensing ion channel (ASIC2) and transient receptor potential vainilloid 4 (TRPV4) were evaluated using immunohistochemistry., Results: OPG-Fc group showed an important decreased in mesial molar movement with only 52%, 31%, and 22% of the total mesial molar movement compared with control group at Days 7, 14, and 21, respectively (P < 0.001). RANK ligand and Runx2 positive cells were severely reduced after OPG-Fc treatment. Periodontal ligament architecture, cell arrangement, and immunohistochemical patter for vimentin, type I collagen and the mechanoproteins TRPV4 and ASIC2 were altered by tooth movement and all these parameters altered by the applied treatment., Conclusions: OPG-Fc effectively inhibits osteoclastogenesis resulting in improved bone quantity and orthodontic anchorage. Based on present results, OPG-Fc could have clinical utility in preventing undesired tooth movements., (© The Author 2015. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Evaluating periodontal tissue condition is an important diagnostic parameter in periodontal disease. Noncontact electromagnetic vibration device (NEVD) was previously developed to monitor this condition using mechanical parameters. However, this system requires accelerometer on the target tooth. This study assessed application of laser displacement sensor (LDS) to NEVD without accelerometer using experimental tooth models. Tooth models consisted of cylindrical rod, a tissue conditioner, and polyurethane or polyurethane foam to simulate tooth, periodontal ligament, and alveolar bone, respectively. Tissue conditioner was prepared by mixing various volumes of liquid with powder. Mechanical parameters (resonant frequency, elastic modulus, and coefficient of viscosity) were assessed using NEVD with the following methods: Group A, measurement with accelerometer; Group B, measurement with LDS in the presence of accelerometer; and Group C, measurement with LDS in the absence of accelerometer. Mechanical parameters significantly decreased with increasing liquid volume. Significant differences were also observed between the polyurethane and polyurethane foam models. Meanwhile, no statistically significant differences were observed between Groups A and B; however, most mechanical parameters in Group C were significantly larger and more distinguishable than those of Groups A and B. LDS could measure mechanical parameters more accurately and clearly distinguished the different periodontal ligament and alveolar bone conditions.

The main objective of treatment of an undeveloped tooth (immature) is to provide vital pulp therapy to allow continued development of root dentin. A case report is presented that demonstrates the use of calcium hydroxide (CaOH₂) as an indirect pulp-copping material for the purpose of continued maturogenesis of an early-erupted permanent tooth with severe mobility and almost-begun root formation. Seven-year radiographic and clinical follow-up demonstrated a vital pulp and physiologic root development without any endodontic failure clinically or radiographicaly.

Due to its significance in tooth movement, the stress/deformation field of periodontium and the alveolar bone remodeling process, periodontal ligament (PDL) cannot be excluded from the studies investigating dental biomechanics regarding its excessive deformability. Therefore, many analytical and numerical researches are carried out to simulate its response and to create a constitutive model via experiments intending to discover the material properties of PDL. The aim of this study is to formulate a user specified contact model that can be used in conjunction with finite element (FE) software and reflects PDL's influence on neighboring structures based on the currently available information, without requiring an actual volumetric finite element mesh of ligament. The results show good agreement with available experimental tooth mobility data. Smooth stress fields are obtained on the tooth root and alveolar bone, which is a significant aspect in bone-remodeling studies. The advantage of simulating PDL as a contact model at the interface of tooth root and the alveolar process instead of a solid-meshed FE model with poor geometric morphology and/or very dense mesh is expected to save pre/post-processing workforce, to increase the accuracy and to contribute to the smoothness of interface stress distributions., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

In this paper, a new method involving an experiment in vivo and hydro-mechanical coupling simulations was proposed to investigate the biomechanical property of human periodontal ligament (PDL). Teeth were loaded and their displacements were measured in vivo. The finite element model of the experiment was built and hydro-mechanical coupling simulations were conducted to test some PDL's constitutive models. In the simulations, the linear elastic model, the hyperfoam model, and the Ogden model were assumed for the solid phase of the PDL coupled with a model of the fluid phase of the PDL. The displacements of the teeth derived from the simulations were compared with the experimental data to validate these constitutive models. The study shows that a proposed constitutive model of the PDL can be reliably tested by this method. Furthermore, the influence of species, areas, and the fluid volume ratio on PDL's mechanical property should be considered in the modeling and simulation of the mechanical property of the PDL., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

The mechanism of orthodontic teeth movement is not entirely explained. The principal reaction on tissues at the cellular and molecular level is initiated by the force applied to the tooth crown and transferred in turn upon the periodontal ligament (PDL). It seems, therefore, that the PDL and particularly its properties play a key role in bone remodelling. One of the more commonly used methods, which is capable of analysis of a wide range of orthodontic movements or distribution of stress and strain within teeth and periodontium, is the finite element method (FEM). Aiming to achieve the FEM model as close as possible to in vivo conditions, it is necessary to account for accurate material properties. The aim of the present study is to compare particular studies and descriptions of material characteristics of the PDL. The analysis of available articles shows how imperfect modern descriptions of PDL material properties available today are, which in the precise method could allow the analysis of the occurrences within the in vivo processes in a non-destructive manner. The complicated anatomy and physiology of PDL, which incur significant parameter changes with age and disease susceptibility, make the accurate description of this material so difficult. The available study results show that those characteristics should be precise and complicated, which undoubtedly impedes the calculation processes but generates reliable results.

This study investigated the hypothetical contribution of biomechanical loading to the onset of equine odontoclastic tooth resorption and hypercementosis (EOTRH) and to elucidate the physiological age-related positional changes of the equine incisors. Based on high resolution micro-computed tomography (μCT) datasets, 3-dimensional models of entire incisor arcades and the canine teeth were constructed representing a young and an old incisor dentition. Special attention was paid to constructing an anatomically correct model of the periodontal ligament (PDL). Using previously determined Young's moduli for the equine incisor PDL, finite element (FE) analysis was performed. Resulting strains, stresses and strain energy densities (SEDs), as well as the resulting regions of tension and compression within the PDL and the surrounding bone were investigated during occlusion. The results showed a distinct distribution pattern of high stresses and corresponding SEDs in the PDL and bone. Due to the tooth movement, peaks of SEDs were obtained in the PDL as well as in the bone on the labial and palatal/lingual sides of the alveolar crest. At the root, highest SEDs were detected in the PDL on the palatal/lingual side slightly occlusal of the root tip. This distribution pattern of high SEDs within the PDL coincides with the position of initial resorptive lesions in EOTRH affected teeth. The position of high SEDs in the bone can explain the typical age-related alteration of shape and angulation of equine incisors., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Background and Objective: Once periodontitis has been completely resolved, one common follow-up method is to carry out orthodontic treatment to take advantage of the residual bone, i.e., via tooth intrusion. In this study, the biomechanical behavior of teeth in a reduced periodontium was studied by numerically simulating upper-incisor intrusion accomplished with various orthodontic mechanics., Materials and Methods: Using the finite element method, a patient-customized 3D model of a periodontally reduced dentition was generated in order to simulate tooth movement. The morphology of this upper-jaw model was derived from cone-beam computed tomography (CBCT) datasets of four patients. Material parameters were adopted from previous investigations, including teeth (E=20 GPa), periodontal ligament (PDL) (bilinear elastic; E1=0.05 MPa; E2=0.20 MPa; ε12=7%), and bone (homogeneous, isotropic; E=2 GPa). Two intrusion scenarios were used, the first drawing from Burstone's segmented-arch technique to intrude four splinted incisors at a time, and the second one using cantilevers to intrude single incisors. The aforementioned PDL material parameters were varied in several ways to simulate different biological and biomechanical states of PDL. All simulations were recalculated with an idealized, periodontally intact model to assess the effect of bone loss by way of comparison., Results: Single-tooth intrusion via cantilever mechanics was accompanied by less rotation than the segmented-arch approach. Both intrusion systems involved significantly greater degrees of tooth displacement and PDL load in the periodontally reduced model., Conclusion: Periodontally reduced dentitions are associated with an increased load on periodontal tissue. This can be counteracted by reducing orthodontic force levels and by selecting mechanics that do not harm the tissue. In so doing, the use of numerical methods may greatly facilitate individualized computer-aided treatment-planning strategies.

The aim of this study was biomechanical rationale for splinting mobile teeth with periodontitis according to the height and slope of teeth crowns, their degree of mobility, and type of occlusion. The research studied the effect of axial vertical and horizontal loads on the functioning of the proposed method of splinting. Set clear indications and contraindications for the use of the method of splinting. Biomechanically proven unreasonableness includes teeth with III degree of mobility in the splinted construction. Clinical variant of splinting is only possible at the height of the anatomical crowns of the teeth of at least 7 mm, otherwise the preferred laboratory methods for the manufacture of tires.

BACKGROUND.  Hypophosphatasia (HP) is characterized by defective mineralization of bone and teeth because of deficient alkaline phosphatase activity. There are generally six recognized clinical forms, of which the most severe is often lethal prenatally or early in life. In milder forms, such as odontohypophosphatasia (OHP), premature exfoliation of primary teeth may be the only clinical manifestation. CASE REPORT.  A 20-month-old girl was referred to the Specialist Paediatric Salaried Dental Service within the Harrogate and District NHS Foundation Trust with mobility of tooth numbers 71 and 81. Clinical examination revealed grade III mobile 71 and 81, with minimal gingival inflammation and plaque deposits. There were no other dental findings and no significant medical history. Tooth numbers 71 and 81 exfoliated prematurely with no evidence of root resorption, shortly after presentation. Haematological and urinary investigations showed no abnormalities. Histological examination showed a complete absence of cementum. A diagnosis of OHP was made. After 10 months of dental follow-up, no further teeth have increased mobility. CONCLUSION.  Odontohypophosphatasia should be included as a differential diagnosis in children presenting with early loss of primary teeth. The dentist may be the first health care professional to whom the patient presents., (© 2012 John Wiley & Sons Ltd, BSPD and IAPD.)

Background: This study evaluates the effect of periodontitis on masticatory performance and quality of life index., Methods: Patients (n = 24; 23 to 76 years of age) with periodontal conditions ranging from healthy to generalized disease categorized by the alveolar bone height-to-tooth length (AB/T) ratio were separated into the following two groups: control (AB/T >50%) and test (AB/T <50%). The masticatory performance was evaluated through continuous mastication of a special device called a biocapsule. The Brazilian Oral Health Impact Profile (OHIP-14Br) questionnaire was used to assess the oral health-related quality of life. The Student t test was applied for independent samples (P <0.05) to evaluate the masticatory performance, and the Mann-Whitney U test was used to determine quality of life (P <0.05)., Results: There was a statistically significant difference in masticatory efficiency between groups (P = 0.006). Statistically significant differences were also observed in the following parameters: 1) physical pain (P = 0.003); 2) psychologic discomfort (P = 0.008); 3) physical disability (P = 0.033); and 4) OHIP-14Br total score (P = 0.001). The control group achieved the best indicators. Both the masticatory performance and quality of life indicators showed significant correlation with the alveolar bone height., Conclusion: The loss of periodontal supporting structures has negative effects on the masticatory performance and quality of life.

Aim: To identify early clinical variables that are most predictive of treatment outcome and to develop a model that will allow prediction of treatment outcomes based on these variables., Study Design and Methods: A dental trauma database was used to randomly identify patients who had received treatment for avulsed teeth between 1998 and 2007. A data extraction form was designed and completed for each tooth. Demographic, diagnostic and treatment information recorded in the patient's records, in addition to radiographs, were viewed retrospectively., Statistics: The significance and the predictive power for each early clinical variable were assessed using a univariate logistic regression model. Only significant variables (p<0.05) were considered eligible for the prediction model and a c-index was then constructed for their respective predictive power (0.5 = no predictive power, 1.0 = perfect prediction)., Results: Of the original sample of 213 patients who had received treatment for avulsed teeth between 1998-2007 only 105 fulfilled the criteria for evaluation. Two models ('At first visit' and 'at initial treatment visits') were produced with a total of five variables that were significant and holding the greatest predictive power (high c-index): patient age (p=0.001, c=0.80); stage of root formation (p=0.001, c=0.76); storage medium (p=0.047, c=0.58); tooth mobility after dressing (p=0.001, c=0.70); and tooth mobility after splinting (p=0.003, c=0.70). These variables underwent multi-variate analysis and the final models had good predictive abilities (c-index of 0.80 and 0.74)., Conclusion: These predictive models based on patient age, stage of root formation, storage medium, tooth mobility after dressing and tooth mobility after splinting were shown to have high predictive value and will enable a clinician to estimate the long term prognosis of avulsed and replanted teeth. It will enable planning for further treatment with a realistic view of outcome at an early stage.

Objectives: Inlay-retained fixed partial dentures are conservative prosthetic restorations. Their failure resistance is influenced by the stress distribution that depends on the material properties as well as the loading conditions. Finite element analysis provides the ability to estimate the loading capacity by simulating the stress distribution in all-ceramic dental restorations. The null-hypothesis of this study was that tooth mobility or tooth bearing condition significantly influences the stress distribution and therefore the failure resistance of all-ceramic inlay-retained fixed dental prostheses. Therefore, the stress distribution under different loading and bearing conditions of the teeth was analyzed using the finite element method., Methods: Three different bearing conditions, one fixed and two flexible were chosen to simulate tooth mobility. The flexible models were constrained with spring elements to a virtual center of rotation. In addition, loading conditions were varied., Results: The influence of tooth mobility on the stress distribution depended on the degree of modeled tooth mobility, as well as the loading conditions. The maximum first principal stresses differed significantly in magnitude and location depending on the modeled bearing condition and the simulated load case. The maximum difference between fixed and flexible model was more than 100%., Significance: Tooth mobility and occlusal loading conditions have to be considered in finite element analyses as the simulated stress distribution is strongly influenced by these factors., (Copyright © 2011 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

The periodontal condition was investigated by means of tooth natural frequency assessment. The correlation between tooth natural frequency and mobility was found out. The comparative estimation of percussion and spectral methods for natural frequency assessment revealed the percussion method to be more complicates because the initial acoustic signal is disturbed by external noises and hammer sound. The spectral method allows receiving reliable and reproducible results when using modified two-parametrical periodontometer.

Objectives: The aim of this in vitro study was to investigate a dynamic and static tooth mobility assessment method in terms of reproducibility and correlation., Materials and Methods: A custom-made artificial model was used. The central incisors simulated 'injured' teeth with increased mobility, and the lateral incisors served as 'uninjured' teeth with physiological mobility. To assess tooth mobility, three consecutively repeated measurements were taken, in the vertical and horizontal dimensions before and after splinting, using the Periotest method as well as the Zwick universal testing machine. Reproducibility of the measurements was tested using anova and the Bonferroni post hoc test (α = 0.05). Correlation was analysed using Spearman's rank correlation (α = 0.05)., Results: No significant differences were found when comparing the three consecutively taken Periotest values and the vertical Zwick values (P > 0.05). In the horizontal dimension, the first Zwick values differed from the second and third values (P < 0.05). Only a few random correlations (P < 0.05) were found when comparing the two assessment methods. Horizontal and vertical measurements within one method did not correlate (P > 0.05)., Conclusions: The Periotest and vertical Zwick values are highly reproducible. The measurements of the two methods do not correlate; therefore, a conversion of Periotest values into metric displacement data is not feasible. The two methods provide different valuable information about tooth mobility. The Periotest method describes the damping characteristics of the periodontal ligament while the Zwick method reveals quantitative metric values., (© 2011 John Wiley & Sons A/S.)

Objectives: To evaluate the influence of wire dimension and wire length on the splint rigidity of wire-composite splints in vitro., Materials and Methods: A custom-made artificial model was used. The central incisors simulated 'injured' teeth with increased mobility, and the lateral incisors and canines served as 'uninjured' teeth with physiological mobility. To assess horizontal and vertical tooth mobility before and after splinting, the Periotest and Zwick methods were applied. Teeth 13-23 were splinted using wire-composite splint 1 (WCS1; Dentaflex 0.45 mm) and wire-composite splint 2 (WCS2; Strengtheners 0.8 × 1.8 mm). Splint length was varied by successively shortening the wire. The influence of wire dimension was tested using t-test and Wilcoxon-Mann-Whitney test with the Bonferroni-Holm procedure (α = 0.05). To test the influence of wire length, anova and Kruskal-Wallis tests as well as Tukey range and Wilcoxon test with Bonferroni-Holm procedure were applied (α = 0.05)., Results: Wire dimension significantly influenced splint rigidity (P < 0.05). The wire length significantly influenced the splint rigidity of WCS1 in the horizontal dimension and WCS2 in the horizontal and vertical dimensions (P < 0.05). Splint rigidity was significantly reduced when splinting only 'injured' teeth compared with splints including 'uninjured' adjacent teeth (P < 0.05). No differences were found between splints including one or two 'uninjured' teeth on each side (P > 0.05)., Conclusion: WCS1 is flexible compared with the more rigid WCS2. The wire length influences the rigidity. To ensure adequate fixation and reduce the risk of enamel damage during splint removal, the splint should include only one 'uninjured' tooth bilaterally., (© 2011 John Wiley & Sons A/S.)

Objective: Simulation of tooth mobility in vitro with or without reduced bone support is an aspect of particular interest from the clinical perspective. To elucidate adequate simulation of the periodontal ligament in terms of tooth mobility, three materials were investigated., Methods: Human lower sound premolars were selected and randomly assigned to six groups (n = 5) and stored at 37°C in a 0.5%-chloramine solution. For tooth mobility simulation, roots were covered with a thin layer of three types of material: (i) polyurethane elastomeric material, (ii) polyether impression material and (iii) A-polysiloxane soft cushion material. Teeth were embedded in an acrylic resin block simulating no and 50% bone loss, respectively. Specimens were statically subjected up to a maximum load of 30 N perpendicular to tooth axis (crosshead speed = 1 mm/min) in a universal material testing machine. Load-deflexion curves and periotest values were recorded. Statistical analysis was performed using 2-way Anova and post-hoc Bonferroni Test (p = 0.05). The Pearson's correlation coefficient between deflexion and periotest values was calculated., Results: Median horizontal deflexion values (μm) of specimen crowns with no bone loss were significant higher for polysiloxane (210) compared to polyurethan (24) (p < 0.001). The tooth deflexion, e.g. tooth mobility, increased significantly as the bone level decreased only when specimens were embedded in polysiloxane (iii) (1150) (p = 0.045). All specimens with reduced bone support layered with polyether were dislocated. Deflexion was significantly positive correlated with periotest values (p = 0.01)., Conclusion: Using A-polysiloxane soft cushion material combined with autopolymerizing acrylic resin may be suitable to simulate increased tooth mobility in vitro.

Purpose: The influence of resilient support of abutment teeth on the fracture resistance of all-ceramic three-unit fixed partial dentures (FPDs) was tested in this study., Materials and Methods: Three groups (n = 8) of glass-infiltrated, alumina-based, all-ceramic FPDs that were adhesively bonded to human molar teeth were investigated. In control group A, teeth that were rigidly inserted in polymethyl methacrylate (PMMA) resin were used for thermocycling and mechanical loading (TCML), as well as for fracture testing. In group B, TCML was conducted on teeth that had their roots covered with a polyether layer. After TCML, the polyether layer was removed entirely, and the teeth were rigidly fixed in PMMA for fracture testing. In group C, teeth roots remained covered with a polyether layer during TCML as well as during fracture testing. Using a resilient attachment, tooth mobility was determined in axial, buccal, and oral directions., Results: Mean tooth mobility was 76 ± 4 Μm in the axial direction, 278 ± 41 Μm in the buccal direction, and 128 ± 17 Μm in the oral direction. Group C showed the lowest mean fracture strength (polyether during both TCML and fracture testing) of 523 N. For group B (polyether during TCML but not during fracture testing), a fracture strength of 676 N was found, and for control group A (rigidly embedded teeth), it was 919 N., Conclusion: These results confirmed the influence of resilient attachments on the aging process and fracture strength testing of FPDs. Fracture resistance was significantly reduced when this particular interface was used in both TCML and fracture testing.

Periodontal diseases like gingivitis and periodontitis have damaging effects on the periodontium and commonly affect the mechanical properties of the periodontal ligament (PDL), which in the end might lead to loss of teeth. Monitoring tooth mobility and changes of the material properties of the PDL might help in early diagnosis of periodontal diseases and improve their prognosis. It was the aim of this study to develop a novel intraoral device to determine the biomechanical characteristics of the periodontal ligament. This includes the measurement of applied forces and resulting tooth displacement in order to investigate the biomechanical behaviour of the periodontium with varying loading protocols with respect to velocity and tooth displacement. The developed device uses a piezoelectric actuator to apply a displacement to a tooth's crown, and the resulting force is measured by an integrated force sensor. To measure the tooth displacement independently and non-invasively, two magnets are fixed on the teeth. The change in the magnetic field caused by the movement of the magnets is measured by a total of 16 Hall sensors. The displacement of the tooth is calculated from the movement of the magnets. The device was tested in vitro on premolars of four porcine mandibular segments and in vivo on two volunteers. The teeth were loaded with varying activation curves. Comparing the force progression of different activation velocities, the forces decreased with decreasing velocity. Intensive testing demonstrated that the device fulfils all requirements. After acceptance of the ethical committee, further testing in clinical measurements is planned., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Purpose: Clinically, we have observed the phenomenon of postoperatively accelerated orthodontic tooth movement in patients who had orthognathic surgery. This phenomenon lasts for a period of 3 to 4 months. However, the underlying mechanisms of this phenomenon have not been well studied yet. The purpose of this prospective clinical pilot study was to study the postoperative changes in bone physiology and metabolism and the corresponding responses in the dentoalveolus, such as the changes in tooth mobility., Materials and Methods: Twenty-two consecutive adult patients who had 2-jaw orthognathic surgery were included in this study. The levels of serum alkaline phosphatase and C-terminal telopeptide of type I collagen (ICTP), as well as the tooth mobility of the maxillary and mandibular incisors based on the Periotest method (Siemens AG, Bensheim, Germany), were examined preoperatively and 1 week, 1 month, 2 months, 3 months, and 4 months postoperatively. The data were analyzed statistically., Results: Both tooth mobility of the maxillary and mandibular incisors and ICTP significantly increased from 1 week to 3 months postoperatively and then decreased to their preoperative levels in the fourth month postoperatively. The changes in tooth mobility were significantly in correspondence with the changes in ICTP. The alkaline phosphatase level significantly increased from the first to fourth month postoperatively, but it was not significantly correlated to the changes in tooth mobility., Conclusion: The orthognathic surgery triggers a 3- to 4-month period of higher osteoclastic activities and metabolic changes in the dentoalveolus postoperatively, which possibly accelerates postoperative orthodontic tooth movement., (Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Objectives: The testing of new materials under simulation of oral conditions is essential in medicine. For simulation of fracture strength different simulation devices are used for test set-up. The results of these in vitro tests differ because there is no standardization of tooth mobility in simulation devices. The aim of this study is to develop a simulation device that depicts the tooth mobility curve as accurately as possible and creates reproducible and scalable mobility curves., Materials and Methods: With the aid of published literature and with the help of dentists, average forms of tooth classes were generated. Based on these tooth data, different abutment tooth shapes and different simulation devices were designed with a CAD system and were generated with a Rapid Prototyping system. Then, for all simulation devices the displacement curves were created with a universal testing machine and compared with the tooth mobility curve. With this new information, an improved adapted simulation device was constructed., Results: A simulations device that is able to simulate the mobility curve of natural teeth with high accuracy and where mobility is reproducible and scalable was developed.

Tooth movement occurs as a consequence of periodontal tissue remodeling. The goal of every orthodontist is to investigate better approaches to accelerate tooth movement. Estrogen, by binding with its receptors in periodontal tissue, regulates the remodeling of alveolar bones, promotes bone formation, and inhibits bone resorption. Estrogen secretion in vivo is characterized by a nearly lunar rhythm. The estrogen expression level is low during menstruation and the luteal phase, and reaches the highest at 1-2days before ovulation. Estrogen physiological fluctuations can cause physiological fluctuations in the serum markers of bone turnover. Therefore, orthodontic therapy should be planned according to the menstrual cycle since tooth movement, under the application of force, is faster during low estrogen levels. In this paper, we propose a hypothesis that application of orthodontic force after each ovulation may promote tooth movement, thereby shortening the course of orthodontic treatment., (Copyright 2010 Elsevier Ltd. All rights reserved.)

The aim of this pilot study was to measure force-related tooth mobility. Vertical and horizontal anterior tooth mobility in 31 healthy periodontal subjects was measured by a noncontact optical measurement technique. The subjects continuously increased the force on each tooth by biting on a load cell. An automated software program recorded tooth displacement at 9-N intervals. Vertical and horizontal displacements were subsequently measured. The vector of tooth mobility in the buccal direction was calculated using the Pythagorean theorem. The average displacements over all subjects for each tooth were determined. Global differences were assessed with the Wilcoxon test. There were no significant differences between contralateral teeth overall load stages. There were no significant differences in tooth mobility between the central and lateral incisors except for in the horizontal direction. However, there were significant differences between central incisor and canine and lateral incisor and canine teeth.

The aim of this study was to evaluate the occurence of compensation in mesiodistal axial inclinations of canines in skeletal malocclusions patients. The sample consisted of 25 Angle Class II, division 1 malocclusion (group 1) and 19 Angle Class III malocclusion patients (group 2). After measurement of dental angulations through a method that associates plaster model photography and AutoCad software, comparisons between the groups were performed by T-test for independent samples. Results showed that there was no statistically significant difference (p < 0.05) between groups, when maxillary canine angulations were compared. Regarding the mandibular canines, there was a statistically significant difference in dental angulation, expressed by 3.2 degrees for group 1 and 0.15 degrees for group 2. An upright position tendency for mandibular canines was observed in the Angle Class III sample. This configures a pattern of compensatory coronary positioning, since the angulation of these teeth makes them occupy less space in the dental arch and consequently mandibular incisors can be in a more retracted position in the sagittal plane.

Background: Limited evidence exists on the significance of residual probing pocket depth (PPD) as a predictive parameter for periodontal disease progression and tooth loss., Aim: The aim of this study was to investigate the influence of residual PPD >or=5 mm and bleeding on probing (BOP) after active periodontal therapy (APT) on the progression of periodontitis and tooth loss., Material and Methods: In this retrospective cohort, 172 patients were examined after APT and supportive periodontal therapy (SPT) for 3-27 years (mean 11.3 years). Analyses were conducted using information at site, tooth and patient levels. The association of risk factors with tooth loss and progression of periodontitis was investigated using multilevel logistic regression analysis., Results: The number of residual PPD increased during SPT. Compared with PPDor=7 mm 37.9 and 64.2, respectively. At patient level, heavy smoking, initial diagnosis, duration of SPT and PPD>or=6 mm were risk factors for disease progression, while PPD>or=6 mm and BOP>or=30% represented a risk for tooth loss., Conclusion: Residual PPD>or=6 mm represent an incomplete periodontal treatment outcome and require further therapy.

The aim of this study was to test natural teeth stability under various simulated types and degrees of alveolar vertical bone loss, as well as to assess the role that the surrounding bone played for maintaining tooth stability. A three-dimensional finite element model of the human maxillary central incisor with surrounding tissue, including periodontal ligament, enamel, dentin, pulp, and alveolar bone, was established. One side and multiple vertical bone loss were simulated by means of decreasing the surrounding bone level apically from the cemento-enamel junction in 1 mm steps incrementally downward for 10 mm. Natural frequency values of the incisor model with various types and degrees of bone loss were then calculated. The results showed that, with one-sided bone resorption, the model with labial bone loss had the lowest natural frequency decreasing rates (8.2 per cent). On the other hand, in cases of multiple bone loss, vertical bone resorption at the mesial and distal sides had more negative effects on tooth stability compared to vertical bone losses on facial and lingual sides. These findings suggest that the natural frequency method may be a useful, auxiliary clinical tool for diagnosis of vertical periodontal diseases.

Purpose: Tooth positional changes following posterior tooth loss may alter arch forms and occlusal planes. This may result in the development of occlusal interferences. The purpose of this study was to determine clinical parameters associated with the presence of retruded contact position (RCP) contacts and occlusal interferences associated with posterior tooth loss., Materials and Methods: Diagnostic casts of 100 patients with at least one unopposed posterior tooth and 100 control patients were scanned and analyzed to record clinical parameters described in the earlier publications in this series. Clinical examinations identified the presence of RCP contacts and occlusal interferences. Five generalized linear models were developed to investigate the parameters associated with presence of RCP contacts, protrusive interferences, working side interferences, and nonworking side interferences., Results: RCP contacts were associated with the degree of supraeruption of the unopposed tooth and the presence of other types of interferences. Protrusive interferences were associated with the presence and position of a tooth distal to the extraction site and the presence of other types of interference. Working side interferences were associated with tipping of the tooth mesial to the extraction site and the presence of other interferences. Nonworking side interferences were associated with the presence of other types of interference only., Conclusion: Unopposed posterior teeth are more likely to be involved in RCP contacts or interferences than their matched controls. Many teeth were involved in multiple interferences, and there appears to be a number of interrelationships between these. Initial RCP contacts have associations with the extent of supraeruption of the unopposed teeth. The presence and position of the teeth distal to extraction sites was significant when modeling protrusive interferences. Protrusive interferences are more prevalent where the site of tooth loss was bounded. Mesial tipping of the teeth distal to extraction sites reduced this effect. Working side interferences were associated with tipping of teeth mesial to the site of tooth loss. No associations between patient or tooth factors were found for nonworking side interferences, and the only association found for these interferences were with protrusive interferences at the sites.

Background: Orthodontic tooth movements are based on the ability of bone reaction to mechanical stimulus with the deposition and resorption of alveolar bone. The numerical simulation of tooth movement could be helpful for the treatment strategy. However, at present, few calculations have been carried out on the tooth movement simulation., Methods: Finite element (FE) models were developed to simulate an orthodontic treatment of mandibular canine tipping movement during a therapy period with decayed loads. The tooth movement was based on the surface bone remodeling method, and the normal strain of periodontal ligament was assumed as the key mechanical stimulus for alveolar bone remodeling. Changes in the tooth position and the geometry of the tooth supporting structures were taken into account., Findings: The highest normal strain in the periodontal ligament was observed at the cervix or apex and the lowest normal strain was observed near the middle of the root. The tipping degrees of the simulation were similar to the observed in clinical studies., Interpretation: It was acceptable to simulate clinical tooth tipping movements by finite element method based on these mechanical assumptions. Such a numerical simulation would be used to predict clinical tooth movements and help the planning of the therapy.

Prosthodontics should be one of the means of establishing conditions for the maintenance of periodontal health. The forces applied to the abutment teeth and their effects are very important considerations in the design and construction of the removable partial dentures. This 6-month follow-up clinical study evaluated the degree of mobility of abutment teeth of distal extension and tooth supported removable partial dentures by using Periotest. Two types of clasp design were selected for evaluation. In cases with unilateral and bilateral distal-extension, a clasp design including a T clasp of Roach retentive arm, a rigid reciprocal arm and a mesial rest were used. For the abutments of tooth-supported removable partial dentures, a second clasp design with a cast circumferential buccal retentive arm, a rigid reciprocal clasp arm and a rest adjacent to the edentulous ridges was selected. A total of 68 abutment teeth was analysed. Periotest values were made at the time of denture placement (control) and at 1, 3 and 6 months after the denture placement. The statistical analysis was performed using Friedman test. All analysis was performed at a 0.05 level of significance. The results revelled that no significant changes in tooth mobility were observed during the 6-months follow-up (P > 0.05). In conclusion, our findings suggest that adequate oral hygiene instructions, careful prosthetic treatment planning and regular recall appointments play an important role in preventing changes in abutment tooth mobility caused by removable partial denture placement.

There is little quantitative information concerning the number and distribution of bone-matrix resorbing osteoclasts (BMRO) within the adjacent alveolar bone coincident to tooth movement. We moved the right first maxillary molar tooth anteriorly in 40 female rats (E), the left side was untreated, serving as an internal control (IC). Forty female age and weight matched rats were untreated, serving as external controls (EC). BMRO were identified on periosteal and endosteal surfaces of the interdental septum from 1-5 days after initial force application using the MTB-322 antibody. The number of BMRO at periosteal surfaces of E was greater in IC and EC from 2-5 days (P < 0.001). Similarly, the number of BMRO at endosteal surfaces was greater from 1-5 days (P < 0.001). The number of BMRO at periosteal and endosteal surfaces was greater within E than within EC from 1-5 days (P < 0.001). Outcome data from IC were often significantly different from EC. Our data suggest that relatively low forces increase the number of BMRO, which are not uniformly distributed onto both periosteal and endosteal surfaces. Thus, the interdental septum resorbs at the alveolar wall and within spaces between the trabeculae, which, taken together, results in net removal of bone from areas of compression. These data also suggest that experimental tooth movement produces significant differences in the number and distribution of BMRO within IC and EC. Thus, EC groups should be included in studies of tooth movement., (c 2006 Wiley-Liss, Inc.)

The influence of alveolar bone support on the functional capability of a tooth remains unclear. It was hypothesized that a reduction in alveolar support causes an increase of maximum stress in the periodontal structures. Mathematical models of the maxillary incisor to simulate in vivo tooth movement were constructed with periodontium of normal or reduced bone height, and normal or widened periodontal ligament (PDL) space. Under simulated bite force, the maximum tensile stress at the lingual cervical region in the PDL increased with bone height reduction, but decreased with PDL widening. The compressive stress at the cervical region in the cortical bone was no more than 22% of the yield strength of bone, and did not increase by the height reduction with widened PDL. The result suggests that the height reduction potentially causes mechanical damage to the PDL, but, of itself, is not likely to have a negative effect on the bone.

Objectives: This study investigated the mechanical interactions of implant-teeth splinting systems under different periodontal supports and number of splinted teeth with rigid and non-rigid connectors using non-linear finite element (FE) approach., Methods: Two FE models with normal and compromised periodontal supports containing a Frialit-2 implant splinted to the first and second premolars were constructed. Non-linear contact elements were used to simulate a realistic interface fixation within the implant system and the sliding function of the non-rigid connector. ANOVA was used to test for relative importance of the investigated factors and main effects for each level of the three investigated factors (periodontal supports, teeth splinting and connector designs) in terms of the stress values were performed., Results: The simulated results indicated that the cross-interaction of the periodontal support and the splinting situation was a major factor affecting the stress value in alveolar bone. An additional splinting decreased the stress values of bone significantly for a compromised periodontal support. The individual factor of periodontal support also influenced the stress found in the alveolar bone (28%) and implant (72%), and the stress values increased when the periodontal support was reduced. Using different connectors affected the stresses found in bone (15%), implant (21%) and prosthesis (99%). The stress values of the implant and prosthesis increased, but were decreased in bone when the splinting system used non-rigid connectors. The mobility of natural teeth and the implant system between non-rigid and rigid connections showed only small differences., Conclusions: A non-rigid connector should be used with caution since it breaks the stress transfer and increases the unfavorable stress values in the implant system and prosthesis. The tooth/implant-supported system with an additional splinting is more efficient in compromised periodontal supports.

Background: Tooth mobility resulting from the loss of periodontal support or trauma induced by periodontal surgery may change the amount of bite force (BF) and bite pressure (BP) and number of occlusal contact areas (OCAs). The aim of the authors' study was to compare BF, BP and OCA of teeth with periodontal disease before and after periodontal surgery with similar values of healthy teeth., Methods: The authors performed quantitative analysis of BF, BP and OCA using a pressure measurement film. Ten patients with periodontitis who needed periodontal surgery served as the test group. The authors took measurements of BF, BP, OCA and mobility (using Miller's Mobility Index) just before surgery and at one, four and 12 weeks after surgery. They also measured clinical attachment levels (CAL) before surgery and 12 weeks after surgery. Ten subjects without periodontitis served as the control group., Results: Although BF and OCA increased the first week after periodontal surgery, analysis of variance (ANOVA) showed no statistically significant differences at a 95 percent confidence interval. There were statistically significant differences between first-week mobility and that at four and 12 weeks (P = .001). A factorial ANOVA showed significant interaction between BF and mobility (P < .05)., Conclusions: The authors' findings suggest that changes in BF, BP and OCA were not affected by periodontal surgery. However, mean mobility values and BF are correlated. Further investigations of this measurement method involving larger study populations and a longer follow-up period are needed., Clinical Implications: It seems to be helpful to follow occlusal changes after periodontal surgery using a pressure measurement film. It also may be suggested that this measurement method could be used to evaluate the treatment prognosis.

This study evaluated the relationship between occlusal force and tooth displacement in function. The three-dimensional tooth displacement transducer Type M-3 was used to measure the tooth displacement path and a three-dimensional small occlusal force sensor was developed to detect the occlusal force. Subjects' teeth were the upper and lower first molars. The three-dimensional tooth displacement and occlusal force of the upper and lower first molars were measured at the same time during light and heavy clenching in vivo. The direction of the tooth displacement and that of the occlusal force of the upper first molar almost coincided and they were along the palato-apical direction. However, in the lower first molar, the direction of occlusal force was in the apical direction, and the tooth displacement path was along the lingual direction. There was no relationship between the direction of occlusal force and clenching intensity at the upper and lower first molars and no relationship was observed between the direction of tooth displacement and occlusal force at the lower first molar. However, the upper molars showed a tendency to move more in the palatal direction as the force increased. In the case of the upper first molar, the energy of force seemed to change with the distortion of the alveolar bone especially around the root surface. However, in the case of the lower first molar, the energy of this occlusal force might be absorbed by the deformation of the mandible.

A new method of measuring mandibular alveolar bone mineral density (BMD) was applied to 40 postmenopausal Japanese women aged 50-69 years exhibiting minimal to mild periodontal diseases. Lumbar spine BMD was measured by dual X-ray absorptiometry (DXA) and calcaneus speed of sound (SOS) by quantitative ultrasound (QUS). There were age-related decreases of alveolar BMD, calcaneus SOS and vertebral BMD. There were significant correlations between two of the respective bone mass values. Correlations between clinical dental findings and bone mass data including alveolar BMD, SOS and lumbar spine BMD were investigated. Significant correlations were demonstrated between alveolar BMD and calcaneus SOS or vertebral BMD. Alveolar BMD showed significant correlation with clinical dental findings including periodontal pocket depth and mobility as well as calcaneus SOS and lumbar spine BMD. Using multivariate analysis combinations of univariate predictors, including deoxypyridinoline (DPD), significantly predicted attachment levels. The SOS value was useful combined with other predictors for predicting attachment level. It was concluded that the new method of evaluating alveolar BMD is useful to predict systemic bone mass and strength as well as dental clinical findings.

Purpose: The purpose of this study was to clarify the influence of changes of occlusal contacts on adjacent tooth displacement during articulation., Materials and Methods: The amount and direction of displacement of the maxillary left first molar and adjacent teeth were measured using a displacement transducer, Type M-3. Seven subjects were included in this study. On the maxillary left first molar, 8 experimental occlusal contact points were established using platinum foil and these were divided into 2 groups, the buccal and lingual groups, which corresponded to the buccal and lingual cusps, respectively., Results: During clenching, the buccal group showed differences in the direction of the tooth displacement paths among the 3 teeth (second premolar, first and second molar), but there was no difference in the lingual group and the direction of displacement of these 3 teeth was similar to the natural teeth., Conclusion: It is necessary to make at least one lingual occlusal contact point to obtain displacement of not only the abutment tooth but also the adjacent teeth.

The effects of design parameters on crack growth along the adhesive layer in a resin-bonded first incisor/canine bridge are analysed using a finite element (FE) model in which allowance is made for tooth mobility by including elastic supports for the abutment teeth. The energy release rate, G, for incipient cracks in the adhesive layer are calculated for various crack lengths, metal frame configurations, frame thicknesses and tooth mobilities. Energy release rates for bridge frame designs with and without wrap round, denoted by G(w), and G(o), respectively, decrease as the metal frame thickness increases. The difference deltaG = G(o) - G(w), reaches a maximum with respect to the crack length, a, in the range 0.3 < a < 0.6mm, depending on the frame thickness. The effect of tooth mobility becomes increasingly important in the FE model as the overall stiffness of the bridge increases. Critical lengths for incipient cracks in the adhesive layer are estimated for a range of factors of safety against the onset of unstable crack propagation.

Background: The objective of this clinical trial was to assess the relative contribution of patient-, tooth-, and site-associated variables on changes in probing depths (PD) following delivery of a standard non-surgical phase of periodontal therapy., Methods: Ninety-four (94) systemically healthy subjects with severe generalized periodontitis were included in this 6-month prospective longitudinal study. Medical, periodontal, and microbiological parameters were collected at baseline and 2 and 6 months after completion of oral hygiene instructions, motivation, and subgingival debridement using a piezoelectric instrument. The relative contribution of patient-, tooth-, and site-associated variables was evaluated with a hierarchical multilevel analysis., Results: Eighty percent (80%) of variability in PD reductions was attributed to site level parameters, while 12% was at the tooth level and 8% at the patient level. The multilevel analysis associated PD reductions with patient factors (cigarette smoking status and carriage of the rare allele of a specific polymorphism for the interleukin-6 [IL-6] gene), tooth factors (tooth mobility and tooth type), and site factors (mesial and distal location). Cigarette smoking and carriage of the rare allele of the IL- 6-174 G/C polymorphism were associated with less PD reduction. Incisors and canines responded better than premolars and molars. A dose-dependent effect of mobility was observed: teeth with higher baseline mobility resulted in significantly greater decreases in PD. At the site level, greater reductions were observed at interdental sites (compared to facial or oral), and at deeper sites (1.2 mm for 4 to 5 mm pockets and 2.4 mm for pockets > or =6 mm)., Conclusion: These data provided an estimation of the relative contribution of site-, tooth-, and patient-associated variables in terms of PD reductions following a standard course of machine-driven subgingival debridement.

A finite helical axis (FHA) analysis can provide precise three-dimensional information on orthodontic tooth movement compared to an analysis based on a rectangular coordinate system. The FHA has already been applied in an analysis of orthodontic tooth movement. Interestingly, the position of the FHA changes dramatically in different stages of treatment; however, no previous report has provided detailed information of its basic behavior for clinicians. The purpose of this study was to clarify the basic behavior of the FHA in simple tooth movement, which could promote a better understanding of the 3-D orientation of and rotation about the FHA during tooth movement. Parameters of the FHA were calculated from a simulation of canine retraction. As the tipping angle of the canine was increased from 5 degrees to 30 degrees , the orientation vector of the FHA approached the most affected axis of rotation (on a rectangular coordinate system) in a non-linear manner. The angle of rotation about the FHA also increased in a non-linear manner. This non-linear problem was solved analytically. The basic behavior of the orientation vector of the FHA and the non-linear characteristics of the FHA parameters clarified in this study should be important for the future analysis of actual tooth movement based on the FHA. However, we must be aware that the non-linearity of the FHA itself may affect the analysis of the mechanical properties of the periodontal tissue.

Objective: The aim of the present work is the analysis of mobility of human dentition under the action of physiological short-term loading by using a numerical approach. The mobility of tooth is mainly attributed to the deformation of the periodontal ligament, hence particular attention is focused on the definition of a suitable constitutive model for this soft tissue., Methods: A numerical model of human upper incisor and periodontum is proposed by means of the finite element method. The mechanical response of the most deformable constituent, i.e. the periodontal ligament, is described by using a hyperelastic constitutive model., Results: Numerical analyses show an effective correspondence with in vivo experimental tests, in literature, on tooth mobility caused by the application of intrusive loads. The model proves to offer valid results, leading to a general, reliable and efficient numerical approach., Significance: The hyperelastic approach allows the description of the mechanical response of the periodontum under short lasting loads, according to the characteristic non-linear behavior of the PDL. This approach overcomes the approximation caused by the adoption of simplified models, widely reported in literature, and leads to a valid definition of tooth movement by means of an effective numerical procedure.

Objective: The mechanism of action of vasoactive drugs on tooth movement is unknown. The purpose of the present study was to measure simultaneously the axial movement of the mandibular incisor, regional blood flow at the base of the incisor, and systemic arterial blood pressure in angiotensin II-induced hypertensive rats to determine the possible cause of tooth displacement., Design: The measurements were made under artificial respiration with halothane anaesthesia. In the experimental animals, 2.5 microg of angiotensin II in 1 ml of Ringer's solution was infused at 0.83 ml/h for 12 h from the femoral vein. In the control animals, only Ringer's solution was infused., Results: Angiotensin II caused an increase of the mean arterial blood pressure from 86 to 119 mm Hg, and decreases of the eruption rate from 667 to 494 microm/24 h and the regional blood flow from 262 to 214 mV. There was a positive correlation between the eruption rate and regional blood flow, and a negative correlation between the blood pressure and regional blood flow., Conclusion: These results suggest that angiotensin II caused constriction of the peripheral vascular smooth muscle resulting in an increase of arterial blood pressure and a decrease of regional blood flow, followed by a decrease of fluid volume and then a reduction of either the pressure within the socket or of the eruptive force. We assume that the regional vascular pressure within the socket plays an important role in determining the position of the rat incisor.

Laser Doppler flowmetry (LDF) is a non-invasive method to assess pulpal blood flow (PBF). Dental injury has been associated with losses of pulpal sensibility. The purpose of this study was to assess whether LDF could be used to detect short- and long-term changes of PBF values of luxated permanent maxillary central incisors after repositioning and splinting. In 18 trauma patients, a single maxillary incisor treated by repositioning and splinting, and the respective contralateral homologous tooth were investigated by LDF to assess local PBF values. Perfusion units (PU) were taken in four sessions: on the day of splint removal, and 12, 24, and 36 weeks after splint removal. Analysis of the luxation type-related PBF measurements revealed intrusion type-related PBF values to be associated with a significant decrease in PBF values (P < 0.05), while lateral luxation and extrusion type-related PBF values showed no significant difference between the session-related values (P > 0.05). PBF measurements did not change over time for the contralateral incisors (P > 0.05). Teeth affected by an intrusion-type luxation injury remained unresponsive to sensitivity testing at follow up, while 3 (60%) developed grey discoloration of the crown. LDF may become useful in the detection of ischemic episodes of luxated maxillary central incisors after repositioning and splinting. Further studies are warranted to assess the validity of post-traumatic 'ischemic episodes' by comparing it to histological tooth pulp changes.

The focus of the article is on a generic approach to prediction of a healing process based on automatic measurement and modelling of mechanical disease indicators. As a specific example the healing process after treatment of advanced periodontitis is characterised and predicted based on measurement of tooth mobility (TM). For the measurement a new mechatronic instrument was developed that includes a pneumatically driven probe with incorporated sensors of tooth displacement and loading force. TM is measured by a computer controlled data acquisition system and predicted by a non-parametric regression. Similarly as in the characterisation of technical processes, a measured sample is described by TM time series detected on a particular patient, while the regression is determined by a set of samples obtained from a group of patients following periodontal therapy. The influence of surgical access therapy and systemic administration of metronidazole as an adjunct to the mechanical treatment is demonstrated. For this purpose the average changes of tooth mobility are determined on variously treated subgroups. A new method of healing process prediction is demonstrated and its performance is described by a prediction quality.