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Biology of Tooth Movement

  • Consistent Pressure: Clear aligners and metal braces move teeth the same way by applying consistent pressure. Consistent pressure is delivered by the aligner over the many areas where the aligner material contacts the tooth.

 

  • Osteoclastic Activity: Sustained pressure triggers the bone remodelling process causing the body to summon cells called osteoclasts. These cells break down the bone in the jaw.

 

  • Bone Removed, Space Created: After about two days of consistent light pressure, the tooth begins to move.

 

  • Root Moves, Space Created: Once the tooth is moved into the space created by osteoclasts, a vacant space is left on the opposite side of the tooth socket.

 

  • Osteoblastic Activity Rebuilds Bone:Periodontal ligament tension recruits bone-forming cells called osteoblasts to arrive at the site and begin to form new bone.

 

  • Rebuilt Bone: A rest period with no forces on the tooth allows for the osteoid (rebuilt bone) to mature into hardened and mineralized bone. It's important to allow for rest periods so this physiologic process can take place.

 

  • Osteoclastic and Osteoblastic Avtivity:A common misunderstanding is that aligners should always feel tight to be working. Although patients may report that aligners no longer feel tight, this is what is desired. Patients should be informed that there is a cycle of pressure followed by rest periods to allow for ideal tooth movement. Continual application of heavy forces may cause the paradoxical effect of bone hardening around the socket and being more resistant to osteoclastic resorption and thereby slowing down the rate of tooth movement, which is why the rest period is important.
Aligners-Module 7 >Biology of Tooth Movement
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