Human tooth movement by continuous high and low stresses

Abstract

Objective: To compare three-dimensional tooth movements resulting from relatively higher and lower stresses in a split-mouth design. Materials and Methods: Eight volunteers whose maxillary first premolars were removed for orthodontic treatment participated. Each subject's maxillary canines were retracted by randomly assigned constant stresses of 78 kPa and 4 kPa via segmental mechanics. Dental casts depicting 8-10 visits per subject over 84 days and a three-axis microscope were used to measure movements serially. Descriptive statistics and mixed linear modeling were applied for data analyses (α = .05). Results: Teeth moved by 78 kPa had significantly faster (P = .0005) distal movement (0.066 ± 0.020 mm/day) compared to teeth moved by 4 kPa (0.031 ± 0.012 mm/day). Lateral movement and distopalatal rotation were also significantly faster (fourfold and 10-fold, respectively) with higher than with lower stress (P < .0001). Average extrusion-intrusion, crown torque, and tip were small (≤ |0.25| mm, |2.29|°, and |1.98|°, respectively), fluctuated, and not significantly different between high and low stresses. No lag phase of tooth movement was evident. Conclusions: Maxillary canines were retracted faster by 78 kPa than by 4 kPa. Controlled translation was possible with 4 kPa, but 78 kPa outstripped appliance constraints, causing distopalatal rotation. © 2014 by The EH Angle Education and Research Foundation, Inc.