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[Results of measuring tooth mobility by a two-parameter periodontometer].

A new method for evaluating mobility of a tooth and area of its periodontium is suggested. The evaluation of elastic and viscous components of tooth mobility is based on theoretical estimations. Clinical evaluations of tooth mobility were carried out in patients with physiologically normal periodontium making use of a two-parametrical periodontometer. Experiments demonstrated that the ratio of elastic to viscous components of the tooth mobility is proportionate to periodontal area. Two-parameter periodontometer gives data on complete mobility of a tooth and periodontal area.

Diagnosis, Oral↗

Numerical analysis of tooth mobility: formulation of a non-linear constitutive law for the periodontal ligament.

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.

Compressive Strength↗

Effect of periodontal treatment on tooth mobility.

The purpose of this study was to compare tooth mobility at different time periods during periodontal treatment and to relate changes in mobility to each method of treatment. Ninety-three patients (2421 teeth) with moderate to severe periodontitis were scored: (1) at initial examination, (2) 1 month following scaling, root planing, instruction in oral hygiene and preliminary occlusal adjustment, (3) 1 month after treatment with pocket elimination or reduction, curettage, modified Widman flap or scaling and root planing by the periodontist, and (4) 1 and 2 years following completed periodontal treatment. After initial nonsurgical treatment there was a significant decrease in tooth mobility. Tooth mobility increased temporarily after pocket reduction surgery but was not altered following curettage, modified Widman flap or scaling and root planing. Two years post-treatment there was a trend toward further decrease in tooth mobility with professional tooth cleaning every 3 months.

Dental Scaling↗

Tooth mobility after periodontal surgery.

Changes in tooth mobility after surgical crown lengthening procedures were examined with a modern electro-mechanical instrument (Periotest) in a total of 37 teeth in 14 patients between the ages of 18 and 55 years. Seven teeth were incisors, three canines, thirteen pre-molars and fourteen were molars. Periotest values, probing depths, bleeding indices and plaque indices were recorded after the initial preparation stage of the periodontal treatment, and further Periotest values and plaque and bleeding indices were recorded at intervals up to 3 months after surgery. In each category of teeth there was a progressive increase in tooth mobility starting immediately after surgery and peaking about the seventh day. The mobility then declined steadily to approach the base line again at about 3 months. There were statistically significant differences in mobility after surgery between tooth types (p < 0.01). Gender and age did not significantly affect the values. The pattern of post-surgical tooth mobility can be closely correlated with the known biological events of post-surgical healing.

Adolescent↗

Clinical standardization of horizontal tooth mobility.

The clinical measurement of horizontal tooth mobility is discussed on the background of the current theories regarding the pathogenesis of periodontal disease. The common indices which have been designed to measure horizontal tooth mobility are discussed and critiqued. These indices are not sensitive in that they do not discriminate well between small increments in mobility. In addition, many of the indices cannot be utilized for individual teeth on a longitudinally reproducible basis. The preliminary testing of an in vitro model with mobile teeth which was designed to aid the clinician in assessing tooth mobility is described. Results indicate that the clinician may be capable of discriminating between mobilities that are in the 0.1 mm range, with the aid of the model.

Dental Instruments↗

Assessment of tooth mobility using small loads. II. Effect of oral hygiene procedures.

Tooth mobility at loads between 20 p and 80 p was studied in maxillary incisors and canines in eight subjects with moderate periodontal disease. The periodontal conditions of the investigated teeth exhibited clinical criteria of gingival inflammation and a moderate loss of attachment. None of the subjects showed subjective or clinical signs of occlusal disturbances. In all, 35 teeth were investigated over the 12-week period following periodontal hygiene treatment, including oral hygiene instructions and removal of supra- and subgingival plaque and calculus. During the course of the investigation, a gradual decrease of tooth mobility was observed amounting to a tooth mobility decrease of 65% (using the corrective formula described by Mühlemann 1960) at 50 p load. Tooth mobility curves within the 20--80 p loading area were transformed to lines of regression (Persson & Svensson 1980). Analyses of the lines showed significantly lower tooth mobility values 12 weeks after start of treatment.

Adult↗

Assessment of tooth mobility using small loads. IV. The effect of periodontal treatment including gingivectomy and flap procedures.

Tooth mobility at loads below 100 p, gingival fluid amounts and bone score heights were studied in five subjects. In all 28 maxillary anterior teeth were investigated during a period of 68 weeks. In order to enlarge upon a previous investigation of tooth mobility following periodontal surgery (Persson 1980), the effects on tooth mobility of gingivectomy and flap procedures were compared. A split-mouth technique was used for the two surgical procedures which were performed during one session. No preoperative differences of the investigated parameters were found. During the first weeks after surgery, an increase of tooth mobility was seen which amounted to +80% maximum (flap side) and +13.1% (gingivectomy side). The final tooth mobility changes were -60% on the flap side and -40% on the gingivectomy side. No significant differences of tooth mobility were found between the two surgical methods. The present findings of tooth mobility following surgery also indicated a considerable time lapse before any major decrease of tooth mobility took place.

Adult↗

Tooth mobility and periodontal disease.

Tooth mobility (TM) is an important feature of periodontal disease. This is evidenced by the large number of devices and methods of TM assessment that have been developed and tested. TM had been considered and investigated as an indirect measure of the functional condition of the periodontium as well as possible aggravating co-factor for periodontal disease.

Disease Progression↗

[Value and significance of tooth mobility measurements].

1. The measurement of tooth mobility by manual and instrumental techniques is necessary for establishing a diagnosis, since it is of considerable importance for decisions in the framework of prophylaxis and therapy. 2. The significance of the measurement of tooth mobility depends upon the respective problem and the sensitivity of the measuring technique used. 3. The specifications for the precision of the measuring technique will be determined by the specific objective of the examination. 4. The instrumental measuring techniques are reproducible and, therefore, imperative in scientific studies.

Humans↗

An evaluation of clinical tooth mobility measurements.

This study evaluated the reliability and reproducibility of the modified Miller Index of horizontal tooth mobility. Each of three periodontists utilizing the modified Miller Index assessed the horizontal tooth mobility of 50 teeth in five subjects. The same teeth were also evaluated by the periodontometer. The results of these two methods were then compared. It was found that: (1) there were a high positive correlation between the periodontists' (pooled) assessment of clinical tooth mobility and the measurements of the periodontometer, (2) in any given patient the three periodontists (pooled) were highly accurate in their ability to rank teeth in order of their mobility as determined by the periodontometer, and (3) the periodontists (individually) were not as consistent when comparing teeth with the Miller Index across different subjects. The periodontists did not accurately utilize the Miller Index as it was originally described. It appears that the periodontists either ignored the reference to 1 mm in the description of the Miller Index, or they were unable to estimate what constitutes 1 mm of movemnet in the mouth. The periodontists all consistently scored as a 2 degrees mobility a tooth that moved approximately 0.5 mm not 1.0 mm as described by Miller. It is suggested that the modified Miller Index as described here provides an efficacious system for evaluating horizontal tooth mobility. It provides accurate, reproducible mobility scores in clinical studies requiring an estimation of this parameter. However, for individual teeth, when the clinician or researcher is trying to evaluate the effects of therapy on the periodontium and relatively few evaluation are made, the modified Miller Index may not provide the required degree of sensitively.

Adult↗

Assessment of tooth mobility using small loads. III. Effect of periodontal treatment including a gingivectomy procedure.

The effect on tooth mobility of periodontal treatment utilizing a gingivectomy procedure was studied during a period of 26 weeks in 25 maxillary anterior teeth of six subjects with moderate to advanced periodontal disease. The gingival conditions were evaluated by gingival fluid measurement and the loss of marginal bone as seen on radiographs. Tooth mobility was measured in a bucco-lingual direction using forces between 20 p and 80 p. The results show a decrease of gingival fluid throughout the study. Tooth mobility was already reduced in the majority of teeth 2 weeks after surgery. An average reduction of tooth mobility amounting to 43.7% (using the corrective formula of Mühlemann 1960) was observed after 4 weeks. No additional reduction took place during the remaining experimental period.

Adult↗

Longitudinal measurements of tooth mobility during orthodontic treatment using a periotest.

The present study was designed to investigate the alteration of tooth mobility through orthodontic treatment using a Periotest. Eighty-three crowding cases without severe skeletal discrepancies were used as subjects. For each subject, the mobility of the central and lateral incisors on both arches (U1, U2, L1, and L2) was measured immediately before and after orthodontic treatment (T1 and T2 stages) and after retention (T3 stage) by use of a Periotest. No significant differences of all the measurements were found between the left and right sides. At T1 stage, the mean values were 10.8, 10.4, 9.3, and 7.4 for U1, U2, L1, and L2, respectively. At T2 stage, the Periotest values for all the teeth increased in comparison with those at T1 stage, and significantly decreased at T3 stage compared with those at T2 stage. Negative correlations were found between the Periotest value and age, which imply that tooth mobility decreases with age. The durations of treatment and retention had low correlation with the change of tooth mobility for all the teeth. It is suggested that the tooth mobility before treatment and after retention may be one of the useful indicators for determination of the retention period.

Adolescent↗

Tooth mobility and periodontal therapy.

Data collected as part of an 8-year longitudinal study on periodontal therapy involving 82 patients and 1974 teeth were analyzed to determine if tooth mobility influenced the result of treatment. For each patient, pocket depth, attachment level and tooth mobility were scored clinically at the initial appointment, and once a year for 8 years following periodontal therapy. The treatment consisted of scaling, oral hygiene instruction, occlusal adjustment, periodontal surgery (curettage, modified Widman or pocket elimination), followed by recall prophylaxes every 3 months. Tooth mobility data on a scale of 0--3 were related to changes in attachment levels for three grades of severity of periodontal disease, based on initial pocket depth (1--3 mm, 4--6 mm, and 7 + mm). Mean patient attachment changes were calculated from teeth in the same severity category for each patient. The data were analyzed by one-way analysis of variance and Scheffe's multiple comparison procedure to test the hypothesis of equal effects of tooth mobility on the results of the treatment for the three severity groups over 8 years. The results indicate that there is a statistically significant relationship between original tooth mobility and the change in level of attachment following treatment. Pockets of clinically mobile teeth do not respond as well to periodontal treatment as do those of firm teeth exhibiting the same initial disease severity.

Humans↗

Parameters of tooth mobility in cases of normal function and functional disorders of the masticatory system.

Tooth mobility was measured mechano-electronically with the aid of quasi-static and dynamic methods in 309 patients comprising 2650 teeth being periodontally healthy. Besides, clinical and roentgenographic findings were ascertained to relate functional features to each periodontium. In general the result was that teeth loaded excessively show increased mobility parameters compared to those loaded normally. However, the mobility of teeth loaded poorly or deficiently was even greater compared to teeth stressed excessively. Moreover, follow-up studies showed that tooth mobility decreases after removal of functional disorders of the masticatory system or an immobilisation of splinted teeth. An experimental trauma of the periodontal ligament also brings on an increased tooth mobility which decreases to the original values some days after the trial.

Adolescent↗

The effect of splinting on tooth mobility. (2) After osseous surgery.

The purpose of this study was to determine if fixed splinting of teeth with intraoral wire and acrylic splints had advantages with respect to tooth mobility, bone level and attachment level over unsplinted teeth following osseous surgery. Ten patients were chosen who exhibited bilaterally similar chronic destructive periodontitis and mobile teeth. One maxillary sextant was splinted, while the other was unsplinted. Both sextants functioned against an unsplinted mandibular arch. Following initial therapy, osseous surgery was performed in both maxillary sextants on the same day. Tooth mobility data was collected 1 week before and at 3, 6, 12, and 24 weeks following surgery. Levels of gingival attachment and bone were recorded before and 24 weeks after surgery. Splints were removed before measurements, then replaced, and the occlusion refined. Prophylaxes and oral hygiene instruction were repeated every 3 weeks throughout the study. For all categories of teeth and mobility examined, tooth mobility increased initially after surgery and subsequently decreased by 24 weeks to about presurgical values. The splinted and unsplinted segments reacted similarly throughout the study; splinting did not significantly reduce the mobility of individual teeth. Pre- and postsurgical bone and gingival attachment levels were also similar for the splinted and unsplinted segments.

Adult↗

Interrelationship of inflammation and tooth mobility (trauma) in pathogenesis of periodontal disease.

A series of studies has investigated interactions between periodontal trauma and marginal periodontitis in relation to the initiation, progression and treatment of periodontal disease. Lesions of trauma in the periodontal ligament consequent to either single or jiggling displacing forces result in morphologic alterations in the ligament and alveolar bone. These changes do not initiate the loss of connective tissue attachment characteristic of marginal periodontitis. Studies conducted in squirrel monkeys and beagle dogs in which jiggling forces have been produced subjacent to an established marginal periodontitis reported increased loss of alveolar bone, but the accelerated loss of attachment which occurred in the dog model did not occur in the monkey model. To clarify the relative importance of inflammation and tooth mobility in the treatment of advanced periodontal disease, periodontal response was evaluated after removing traumatic and/or inflammatory components. Elimination of trauma in the presence of existing marginal inflammation did not reduce tooth mobility or increase bone volume. Osseous regeneration and decreased tooth mobility occurred after resolving both components, however, similar findings occurred after resolving inflammation in the presence of continued tooth mobility. Resolution of marginal inflammation is of prime importance in the management of periodontal disease. After resolution of inflammation, bone regeneration may occur around mobile teeth and, furthermore, any residual tooth mobility does not result in increased loss of connective tissue attachment.

Animals↗

Tooth mobility.

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Dentistry↗

Impression pressures against teeth in a partially edentulous model with a mobile tooth: influence of impression tray design.

The purpose of the present study was to examine the effect of custom tray designs on local pressures against teeth during the impression procedure. In a previous study, a partially edentulous simulation model with a mobile tooth was used, and the effect of custom tray designs on the displacement of the mobile tooth was examined during the impression procedure. Based on that study's results, we have assumed that the differences in impression pressures between the labial and the lingual sides of a mobile tooth could either cause or affect displacement. The present study was undertaken to determine the local impression pressures against each side of three anterior teeth, including one mobile tooth, using the same simulation model and the same custom trays as in the previous study. It was found that the local pressures exerted against teeth during the impression procedure were affected by the custom tray designs and varied according to the coronal shape, axis inclination and location of the teeth.

Analysis of Variance↗