Optimum Force: Undermining Resorption vs. Frontal Resorption
How Fast Can You Move Teeth During Braces?
An important concept in orthodontic tooth movement is the use an optimum force to allow efficient and timely treatment without causing any detrimental problems to surrounding hard or soft tissues.
If an applied force is in excess of physiological limits, there is a risk of developing areas of sterile necrosis; as total occlusion of blood vessel under a threshold of force may result in areas of avascular blood supply . This is an unwanted consequence of the application of heavy forces in orthodontics; as a process of hyalinization (histological appearance, as cells disappear in associated avasuclar areas) ensues . It then takes several days for cellular elements to invade and remodel the necrotic areas, a process known as undermining resorption . This is an unwanted effect through the application of heavy forces in orthodontics, as it results in significant delay in tooth movement.
The more ideal method of tooth movement is to avoid undermining resorption via heavy forces, and apply lighter and continuous forces to allow for continual frontal resorption, a process which allows for steady remodelling of the lamina dura; resulting in a smooth and continuous tooth movement . Furthermore, the use of light and continuous forces is ideal, as with frontal resportion there is a smaller degree of clinical symptoms of pain associated with tooth movement . Finally, although it is ideal to allow for frontal resportion, it has been shown that even under light continuous forces necrotic areas may still develop .
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