how teeth move

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bobby9ez@hotmail.com - 13 Mar 2007 16:16 GMT

Hi,

I'm thinking of having ortho treatment done to my crowded teeth. But
I'm curious about how teeth move.
If there's space on one side of a tooth, and crowded on another, does
that tooth literally move sideways over time to make use of the space?
Or does it just get pushed by its neighbor to lean to the spacious
side, with its root still in the same place?

Thanks,
Bob

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Mark & Steven Bornfeld - 13 Mar 2007 17:17 GMT

> Hi,
>
[quoted text clipped - 7 lines]
> Thanks,
> Bob

    This is a complex subject, and a quick google search for information
led me only to abstracts of scholarly articles for purchase.
    Teeth move through the bone; in order to do this there is a net
resorption of bone in advance of the moving tooth, and net deposition of
bone in its wake. It is not efficient to try to push teeth out of the
way by exerting force on the neighbor; usually force is applied to the
individual tooth to get it to move.
    Often the roots don't move horizontally in the bone, but are tipped,
then tipped again, and "walked" through the bone. If there is not
enough room for movement into the desired location, there are a variety
of techniques to achieve that space.

Steve

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Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

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bobby9ez@hotmail.com - 14 Mar 2007 05:38 GMT

On Mar 13, 12:17 pm, Mark & Steven Bornfeld
<bornfeldm...@dentaltwins.com> wrote:

> bobby...@hotmail.com wrote:
> > Hi,
[quoted text clipped - 26 lines]
> Mark & Steven Bornfeld DDShttp://www.dentaltwins.com
> Brooklyn, NY718-258-5001

I have seen cases where after the treatment, their teeth are perfectly
straight. But in some cases their teeth all seem to point inward. I
wonder whether that happened by choice, or was it less than perfect
work by the orthodontist? Is there a way to prevent an inward-pointing
result?

Bob

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Steven Bornfeld - 14 Mar 2007 14:06 GMT

> On Mar 13, 12:17 pm, Mark & Steven Bornfeld
> <bornfeldm...@dentaltwins.com> wrote:
[quoted text clipped - 33 lines]
>
> Bob

I'm sure it was someone's choice, but probably not the patient's.
There is a reason for this, but I'm off to work and will try to answer
this later. Maybe carabelli (our resident orthodontist) will show up
and answer with more authority.

Steve

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Mark & Steven Bornfeld - 14 Mar 2007 16:43 GMT

>> On Mar 13, 12:17 pm, Mark & Steven Bornfeld
>> <bornfeldm...@dentaltwins.com> wrote:
[quoted text clipped - 38 lines]
>
> Steve

There are various different "styles" and techniques used in orthodontic
tooth movement. When I was in school the best known were the "edgewise"
technique and "Begg orthodontics" (some of the big names got their names
hung on their particular flavor of ortho).
I wouldn't swear to this, but I think it was Begg that had 3 stages; in
the second stage the incisors were tipped in; that was supposed to be
followed by a contrary movement accomplished by torquing the roots in.
This last stage may be more difficult to accomplish, or maybe the
orthodontist is rushed. In any case, failure to complete the third
stage of this particular style of orthodontic treatment left the
incisors in what was referred to as "rabbited inward" position. Again,
this is the detritus of my mediocre memory from over 30 years ago; I
don't know if something akin to Begg is still used. But it's definitely
true that some orthodontic patients (for whatever reason) have been left
with their incisor teeth with this inward-tipped position.

Steve
(Dan, help me out if you're there)

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Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

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carabelli - 14 Mar 2007 19:15 GMT

"Mark & Steven Bornfeld" <bornfeldmung@dentaltwins.com> wrote in
......................

> There are various different "styles" and techniques used in orthodontic
> tooth movement. When I was in school the best known were the "edgewise"
[quoted text clipped - 14 lines]
> Steve
> (Dan, help me out if you're there)

Yeah, that was kind of how Begg orthodontics worked - we were fortunate to
have a couple faculty that used it. There are some aspects of that
technique that can be used with any fixed appliance system. It's been
forever since I've seen that appliance though. I don't think hardly anyone
uses it anymore. It was all round wires with auxilliaries for tipping and
torquing.

Upper incisors can be left with inadequate torque and appear to be tipped
inwards towards the inside of the mouth. Judicious use of extractions and
proper use of the edgewise hybrids that are out there now should prevent
results such as this. Occasionally I will see a high, vaulted palate that
simply won't allow bodily retraction of the upper incisors because of the
lingual and palatal cortical plate. Not a good time to consider extractions
to reduce overjet unless you are willing to accept a result such as this.

carabelli

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Mark & Steven Bornfeld - 14 Mar 2007 20:44 GMT

> "Mark & Steven Bornfeld" <bornfeldmung@dentaltwins.com> wrote in
> ......................
[quoted text clipped - 33 lines]
>
> carabelli

Thanks Dan!

Best,
Steve

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Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

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carabelli - 14 Mar 2007 21:04 GMT

>> "Mark & Steven Bornfeld" <bornfeldmung@dentaltwins.com> wrote in
>> ......................
[quoted text clipped - 39 lines]
> Best,
> Steve

Funny, I forgot about this one. We had a typhodont setup to practice with
the Begg appliance. I dug out some old Universal Appliance archwires we had
there. (This was the appliance before edgewise - the archwire had a larger
incisal/gingival dimension than labial/lingual). Ugly looking thing - anyway
I was able to make if fit in the Begg brackets. I got called on the carpet
for typhodont abuse ;)

carabelli

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Mark & Steven Bornfeld - 14 Mar 2007 23:03 GMT

>>> "Mark & Steven Bornfeld" <bornfeldmung@dentaltwins.com> wrote in
>>> ......................
[quoted text clipped - 47 lines]
>
> carabelli

We had Typodonts--was yours sick?

Steve

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Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

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Newbie - 15 Mar 2007 20:18 GMT

>> Funny, I forgot about this one. We had a typhodont setup to practice with
>> the Begg appliance. I dug out some old Universal Appliance archwires we had
[quoted text clipped - 8 lines]
>
>Steve

No they just called him Mary.

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bobby9ez@hotmail.com - 14 Mar 2007 21:28 GMT

On Mar 14, 12:44 pm, Mark & Steven Bornfeld
<bornfeldm...@dentaltwins.com> wrote:

> > "Mark & Steven Bornfeld" <bornfeldm...@dentaltwins.com> wrote in
> > ......................
[quoted text clipped - 49 lines]
> Brooklyn, NY
> 718-258-5001

Thanks for all the info. I think I got most of it, except the last
paragraph by Carabelli.
Can you put it more in laymen's words: what's lingual, palatal
cortical plate?

Carabelli said that Begg's method is hardly used any more. What's the
most common method nowadays and how does it work? What's the biggest
advantage of the new method?

Bob

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carabelli - 14 Mar 2007 21:52 GMT

<bobby9ez@hotmail.com> wrote i............>

> Thanks for all the info. I think I got most of it, except the last
> paragraph by Carabelli.
[quoted text clipped - 6 lines]
>
> Bob

I was referring to the outer layer of hard dense bone immediately under the
gum tissue on the roof of your mouth. The roots of the teeth can literally
bump into it when they are being moved if the anatomy of the individual is a
little out of the ordinary. One end result can be the appearance referred
to earlier.

Most common now is a variant of the original edgewise appliance. The
original was a wire with a rectangular cross section is inserted into a
milled rectangular slot. That way forces to move the teeth can be applied
in all three dimensions. Originally the slots had no adjustment for these
three dimensions. Most now have this built into the bracket - there are
lots of different prescibed individual brackets. This means when the
original edgewise appliance came out the orthodontist had to be skilled in
bending the wires to provide the proper torque, tip and insets in the wire
to ensure proper final position of the teeth. Less wire bending is needed
now with these preadjusted brackets. The down side is most orthodontists
aren't as experienced in these type of wire adjustments now when they are
necessary compared to the orthodontist practicing 40 years ago..

carabelli

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bobby9ez@hotmail.com - 15 Mar 2007 05:37 GMT

> <bobby...@hotmail.com> wrote i............>> Thanks for all the info. I think I got most of it, except the last
> > paragraph by Carabelli.
[quoted text clipped - 27 lines]
>
> carabelli

So for the braces to work, it must be 'anchored' to the molars(?) in
order to exert force to pull the incisors and canines in? If so, just
like a tug of war, do the molars also move forward as a result?
Say there's 5mm space on each side, I guess the front row won't be
able to move in and take up all that 5mm gap?

I also read that adult teeth have more 'filaments' in the teeth, will
it have any effect on the treatment outcome?

Bob

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