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ROOT MOVEMENT IN

ORTHODONTICS
INDIAN DENTAL ACADEMY

Leader in continuing dental education
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CONTENTS
Introduction
Need for axial corrections
Torque
Diagnosis & Evaluation for root correction
Biomechanical considerations
Root movement in Removable Appliances
Root movement in Beggs
Root movement in PEA
Root movement in segmental arch technique
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Root movement in Segmental Surgery
Cortical Anchorage
Complications
Conclusion
Bibliography

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INTRODUCTION
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Control of the axial inclinations of teeth during
orthodontic therapy is critical for achieving excellent
results and ensuring long term stability after
completion of treatment.
The careful evaluation of individual tooth axial
inclinations is often carried out as a second stage of
space closure in extraction therapy or before
completion of treatment in non-extraction therapy.
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Need For Axial
Corrections
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Good axial inclinations and
adequate root parallelism with
regular bone distribution
between teeth helps to obtain
and maintain a stable
treatment result.
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Raleigh William
The lower incisor roots, rather than their
crowns, should be divergent. If the roots
are left convergent, the crowns tend to
bunch together and cause relapse.
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STABLE UNSTABLE
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The evaluation of root axial inclinations
is also critical in patients with congenitally
missing teeth when the goal is to replace
these teeth with either implants or
bridges.

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CREATING SPACE FOR IMPLANTS
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Parallelism of the abutments roots as wells as adequate
bone distribution are important factors in the prognosis
and successful outcome of treatment.
Root correction, which may involve individual teeth or
groups of teeth is also instrumental in positioning teeth
over basal bone to achieve an ideal occlusal
relationship in the anterior and posterior portions of the
dental arches.

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Providing good Periodontal
Environment
Gingiva folded and bunched up
Plaque harboring pseudo
pocket
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TORQUE
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In terms of Engineering principles, it is defined as
a force causing twist in a structure, the resulting
twist of the mechanical part is called Torsion.
In terms of orthodontics it is defined as the
buccolingual or labiolingual root tipping in which
the movement of the crown is minimized and
movement of the root apex is maximized.
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Torque can be effectively employed in removable
appliance and in fixed appliances.
Torquing mechanics are more effective and widely
used in fixed mechanotherapy than in removable
appliances. In removable appliances springs are
used for torquing the tooth.
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Torque in the fixed appliance can be
employed in different ways.
By giving a twist in the arch wire commonly
used in Edgewise technique.
Torque exerted by the bracket itself e.g., PEA
By the use of Torquing auxiliaries widely used
in Begg technique and Edgewise technique.


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Diagnosis &
Evaluation for Root
Correction
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Root correction may be considered the second phase of
space closure and most often completion of space
closure is recommended before evaluating for the
potential need to correct root axial inclinations.
Clinical assessment of root positions during space
closure is often very useful and may be done by
monitoring the inclinations of the canine and anterior
brackets.
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Lateral cephalometric head films, IOPA taken at
45
0
and Panoramic radiographs are commonly
used to assess the need for not correction.
Lateral head films primarily assist in evaluating
the axial inclinations of the anterior teeth by
comparing a film taken before initiation of
treatment and one taken after completion of
space closure.

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Checking Lateral Ceph for Torque
Requirement
Finish with upper incisors parallel to the facial Axis
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Radiographs taken at 45
0
indicate the axial
inclinations of canines, premolars, and molars
and are helpful for assessing proper root
parallelism, adequate bone distribution and
bone levels.
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Despite the amount of deformation inherent in
panoramic radiographs routinely used to assess
the axial inclinations of the posterior teeth.
This is primarily because panoramic radiographs
are easily available and comparison with a
pretreatment panoramic radiograph is usually
possible.

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PRE RX
POST RX
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BIOMECHANICAL CONSIDERATIONS
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Moment-to-Force ratio
The ratio of counter-balancing moment
produced to net force that is applied to
a tooth.
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Uncontrolled Tipping
MOMENT : FORCE
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Controlled Tipping
MOMENT : FORCE
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TRANSLATION
MOMENT : FORCE
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ROOT MOVEMENT
MOMENT : FORCE
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PEA & Begg
Moment arm of
couple
Moment arm of couple
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ROOT MOVEMENT IN
REMOVABLE APPLIANCES
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Apron spring derive their main flexibility from
the twisting of the section and the length of
the torque bars.
These torque springs are flexible, easy to
construct, easily positioned and adjusted.
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Apron spring
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VERTICAL PLANE
SAGITAL PLANE
TRANSEVERSE PLANE
ROOT MOVEMENT IN BEGGS
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VERTICAL PLANE
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SAGITAL PLANE

LABIO-LINGUAL ROOT MOVEMENT
TORQUING
UPRIGHTING
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TORQUING AUXILLARIES
Two spur & Four spur
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Pre Wound Torquing Auxiliary
Base arch wire .020 Special Plus
Auxiliary .012, 014
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KITCHTON AUXILIARY
.014 Special Plus
Can be used with Beggs &
edgewise
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Auxiliary modified to apply labial root
torque to max laterals only.
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Reciprocal lateral Torquing Auxiliary
Situation where Central
incisors require palatal root
torque & Laterals require
labial root torque.
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Lower Reverse Torquing Auxiliary
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MAA Auxiliary
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Uprighting springs
Mini 0.5 mm diameter
Midi 0.9 mm diameter
Maxi 1.5 mm diameter
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Uprighting
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Reciprocal uprighting
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Transverse plane
Buccal root torque to molars
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Root Movement In PEA
Lawrence Andrew developed the straight
wire appliance which became widely
available in the mid 1970s.
Six keys to normal occlusion.
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Crown inclination:
Is defined as an angle between a line perpendicular
to the occlusal plane and a line that is parallel and
tangent to the FACC at its mid point (FApoint)
crown inclination is determined from the mesial and
distal perspectives.
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In PEA, torque or inclination of the tooth is
expressed by the bracket itself this because of the
bracket slot is cut at an angle.
The third key in the optimal occlusion is crown
inclination, most maxillary incisors have positive
inclination where as mandibular incisors have a
slightly negative inclination.
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The maxillary central incisors have a more
positive inclination than laterals where as
canines and premolars have a negative
inclination. Maxillary first and second molars
also have negative inclination.
Inclination of the mandibular teeth are
progressively more negative from the incisors
to the molar.


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Normally in PEA if we engage a full sized arch
wire into the slot it will automatically express the
torque which is incorporated in the bracket.
But in some situations it we need torque in the
individual or more number of teeth we have to
twist the arch wire to express the desired torque
(third order bend).
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Torque in Face V/s Torque in Base
Torque in Face Torque in Base
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First Generation Of PEA
Andrews appliance
5/7
9/3 11/-7 2/-7 2/-7 5/-9 5/-9
2/-1
2/-1 5/-11 2/-17 2/-22 2/-26 2/-35
UPPER
LOWER
Tip/torque in degrees
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Second Generation Of PEA
Roth appliance
5/12
9/8 13/-2 0/-7 0/-7 0/-14 0/-14
2/-1
2/-1 -1/-11 -1/-17 -1/-22 -1/-30 -1/-30
UPPER
LOWER
Tip/torque in degrees
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Third Generation Of PEA
MBT appliance
4/17
8/10 8/0 0/-7 0/-7 0/-14 0/-14
0/-6
0/-6 3/-6 2/-12 2/-17 0/-20 0/-10
UPPER
LOWER
Tip/torque in degrees
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EFFECT OF BUILT IN TIP
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BUCCAL ROOT TORQUE
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TORQUE +10
TORQUE -10
Blocked in Lateral incisor
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Root movement in
Segmental Arch Technique
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Root movement is generally divided into
two categories;
En masse root movement &
Individual root movement (as separate
canine root movement or separate incisor
root movement).
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En masse root movement is required when the
entire anterior segment must be moved as a unit,
commonly after en masse space retraction.
If the anterior segment has been retracted
through controlled tipping, all the roots are
retracted as a unit.


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Separate canine root movement may be necessary
following separate canine retraction.
When an anterior segment with flared incisors is
retracted by controlled tipping, the incisors may
assume normal axial inclinations while the canine
develops a distal axial inclination, hence only the
canines need separate root correction.
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En masse root movement, or root retraction
(rotation around a point on the crown of the
tooth), forms a second phase of space closure
after tipping movement.
It is accomplished by using a mechanism that
places moments on the teeth with centers of
rotation located at the level of the brackets. The
mechanism which delivers these moments is
known as a root spring.
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HORIZONTAL PLANE
ANTERIOR ROOT SPRING
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HELICAL SPRING FOR
ENMASSE ROOT MOVEMENT
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Cantilever for En Masse Root
Correction
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CANINE ROOT UPRIGHTING
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T-Looped spring in 17x25 SS to upright molar
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VERTICAL PLANE
INTRUSION UTILITY
ARCHES
INTRUSION & PROTRACTION
UTILITY ARCHES
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BURSTONE INTRUSION
ARCH
3 PIECE INTRUSION
ARCH
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ROOT MOVEMENT IN SEGMENTAL SURGERY
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CORTICAL
ANCHORAGE
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The cortical bone is characterized by being more
dense and laminated, with a very limited blood
supply.
The blood supply in the bone is the key factor in
tooth movement, since it carries the cellular
elements that resorb away bone and also the
cellular elements that build up new bone.
In cortical bone, where the blood supply is
limited, the physiological process is delayed and
tooth movement is slower,
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Tooth movement can be further delayed where
excess force against the cortical bone can press
out the blood supply and limit the physiology
and the tooth movement.
Bio-progressive Therapy applies this principle of
cortical bone anchorage in stabilizing the teeth
in those areas where it desires to limit their
movement.
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Lower molar anchorage is enhanced by
expanding the molar roots into the dense cortical
bone on their buccal surface.
Excessive buccal root torque and expansion is
placed in the archwires to locate the roots into
the cortical bone.

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COMPLICATIONS
ANCHOR LOSS
ROOT RESORPTION
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ANCHOR LOSS

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ROOT RESORPTION
Fixed versus Removable: only one study
compared root resorption resulting from fixed
and removable appliances, concluding that the
use of fixed appliances is more detrimental to
the roots.
Ketcham claimed that normal function is
disturbed by the splingting effect of orthodontic
fixed appliances over a long period that can
cause root resorption.
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Stuteville on the other hand, suggested
that the juggling forces caused by
removable appliances are more harmful
to the roots.

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It is often stated that the light wire Begg
technique causes less root resorption
than Edgewise, although maxillary
incisor root resorption during the Begg
third stage has been documented.

Begg versus Edgewise

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Intermaxillary elastics:
Lee & Lange found significantly more root
resorption on the side where elastics were
used and suggested that jiggling forces
due to elastics are responsible for root
resorption.
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Orthodontic Movement Type
It seems that there is no safe tooth
movement.
Intrusion is probably the most
detrimental to the roots involved, but
tipping, torque, bodily movement, and
palatal expansion can also be implicated.
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Orthodontic Force
They concluded that higher stress causes
more root resorption.
According to Schwartz Applied force
exceeding the optimal level of 20 to 25
gm/Sq.cm causes periodontal ischemia,
which can lead to root resorption.
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Continuous versus Intermittent Forces:
The pause in treatment with intermittent forces
allows the resorbed cementum to heal and
prevents further resorption.

Treatment Duration.
Most studies report that the severity of root
resorption is directly related to treatment
duration.
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Root correction is a critical step of
orthodontic treatment before finishing.
Proper root alignment and axial
inclinations are key factors for the
attainment of a functional, stable and
esthetically pleasing occlusion.
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Adequate root parallelism and bone
distribution will also be beneficial to long
term periodontal health and are therefore
important to ensure a good prognosis for
treatment.
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BIBLIOGRAPHY
The design construction and use of Removable
orthodontic Appliances By: Philip Adams
Robert J. Nikolai Bio Engineering Analysis of
orthodontic Mechanics
Orthodontic management of the Dentition with the
pre adjusted
Bennett & Richard P. Mclaughlin 2nd Edition
Edgewise Orthodontics By: Raymon C. Thurow
Contemporary Orthodontics By: William R. Profit
Roth RH Treatment mechanics for the straight
wire Appliance ;Graber T.M & Vanarsadall R.R

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The straight wire Appliance 17 years later J.C.O Vol
21; 1987; 632-642
Andrews six keys to normal occlusal Am J Orhod
1972; vol 62: 296 309
Begg Orthodontic Theory & Technique By: P.R. Begg
& Kesling
The Begg Appliance & Technique By: G.G.T. Fletcher
Barry Mollen hauer Aust Orthodontic J 11 Oct 1990
T.P Orthodontics catalouge
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