}o/l"'(li of Oral Rehabilitation, t993. Volume 20.

pages 18Y- 202

Param eters of to oth mobility in cases of norm al

fun ction and functio na l disorders of th e

! masticatory system
W. N l E D E R M E l E R
University of Cologne. Gen nany
D epamncut ol J)ros(ltc'lic lJ" tll i.Hry . Sclloo l nl lJell w l Medicine .

Summa r)'
Too th mo bil ity was measur ed mcchano -clcct rouicall y wit h thc a id o f quasi- sta tic a nd
dynam ic met hods in 309 patie nts co mp rising 2650 teeth being pc riodo ntall y hea lth y.
Besides, clinica l and ro en tge nogra p hic lindi ngs were asce rtained 10 rela te fun ctio nal
features to each pe riod o ntiu m. In ge ne ra l the resu lt was tha I teeth lo aded e xce ssive ly
sho w increased mobilit y pa ram e te rs co m pa red to th o se lo ad ed normall y. H o we ve r,
the mobi lit y of teeth lo aded po o rly o r de ficientl y was e ve n gre a te r co m pa re d to tee t h
stress ed e xces sive ly. Mo reover , fo llow-up stud ies s ho wed th at toot h mobility decreas es
afte r remova l o f fun ctio nnl d iso rd er s o f the masti cator y sy~ t c m o r an imm oh ilisa t in n
of sp linted tee th . A n experi mental traum a o f the pcr iodontul ligam en t a lso b rings
o n an increased too th mo bi lity wh ich decreases to th e ori gina l values so me da ys a fte r
the trial.

Intr oduction
T he periodon tal ligam ent assu me s the fun cti on o f tran s mitt ing co mp res s ive s tre ng th
; ca used by m asti cat ion int o ten sile s tre ngt h actin g o n th e alveo lar bo ne . Bes ides . th e
per iod o nta l ligament is of great importan ce I'l l!' the co nt ro l o f ma sticat o ry force s. In
o rder to accomp lish t he two ta sks . a perfect fun ct io ning o f th e periodo n ta l tiss ue s is
requried . In this con nec tio n too th mobi lity is an impo rta n t parame ter for d e te rm in ing
the fun ction al co nd itio n o f thc per iodon ta l ligam e nt.
A n increased to oth mobilit y is cause d by a we ak e n ing o r destr uctio n o f th e pc rio -
dont alligam c nt (Muhlcrnann, Wartmun n & Mart haler. 1955: Fe rries. 19(16: Ho fma n n .
L967: Miihlemann. 1 967 ~ Rc ngg li & Muhlcm unn. 1l.J70: Ko nig et til.• IYSI ; Nied erme ie r.
~ 1988; N iede rme ie r. Dicpgc n & Pa iva . Il.JXlJ). severe occlusal discrepancies (Mu hlcrnann,
1954: Muhlemunn. Herzog & Vo gel , 1') 56 : E inrauc h-Hurn cckc r Kru ge r & Mausb c rg ,
1982: Niede rmeie r. IlJRX) or b ruxism ( H irt & Muhlc mn n n , 1955) . O n re mo val o f the
ca use o f an increa sed to o th mob ilit y a rc- co usu lida tio n o f th e too t h mo b ility usua lly
~ result s , u nless a p ro nou nced d es truc tio n o f the perio don tal tissu es ex ists . C o hc rc nc cs
betwee n mechanica l stress o f th e per iodont al ligam en t a nd to ot h mo b ility a rc CO I11-
) parat ive ly u nexp la ined . Therefo re e p ide m io logica l data o r sta tistica lly re pre se nt ati ve
fo llowwu p stud ies o f to ot h mo bi lity de pe nd ing o n me chani ca l s tress es a re no t known .
~ Th at is why the presen t study s ho uld cla rify th e p hysio logica l re act ion o f th e period-
o ntium whe n teet h 'a re stres se d d eficien tly o r excess ive ly co mp a red wit h norm al lo adi ng

Corrcspo ndc nce: Prutcsso n, O r \ V. Niede rmeier. Zahua rzrlichc l' rosthcu k. Kliuik Und Potikliui k .
Fur Zahn-. Mun d-U ud Kicfcr bcilkundc , Kc rpcn c r SIra:'l ie J2. :'iI KItI Kulll 4 1. Gcnn uuy.
IlJfl W. Niedermeier

Materials a nd meth ods diso rders ani

Ep ide mio logica l and fo llo w-up s tudi es were ca rr ied o ut in 2fl50 tee th of 309 patie nts teeth . Par an
co mprising 172 males an d 1:;7 fe males aged be twee n 17 a nd 69 . Ind ivid ual cha racteristics to tal of 256
an d data o f thc sam ple studie d a rc list ed in Ta ble I. T he su bjects we re ca re fully scree ned appliances 0
to e nsure pe riodo nta l a nd fun ct io na l cha rac te ristics . Deta iled cl inica l and rocn tgen cg, Tooth nu
raphic find ings o f £I II tee th we re asce rta ined in the co urse of which grea t impo rtance measur emc il
was att ached to changes co ntinge nt o n fun ctio na l d isorde rs o f the mast icatory syste m. teeth was f(
T he funct io na l findin gs which we re co nfirme d by a chec k-up or igina te d by K ro gh~ teeth ar c loa
Pou lse n ( llJ6R) a re listed in Table 2 . T hirt y-tw o pa tien ts sho wed cra nia -ma nd ibular or axialintn
reco rded 101

Table I . lndividual churu crc rist ics of the :-a l1l pll: slLl die d a
Numbe r of p.uicm s JOY
- fe males 1."'7
- mnk s 172
Mean age (yea r!.) ]1 ·3
uppe r lo we r
jaw

Tota l num be r or teeth 127X 1 ~ 72

Numb er of teeth c vuluntc d " 1016 1127
- incisors 2~.t 31X
- canines 174 196
pre molars JI I J50
- mola rs 2.t7 263

.. Selec ted by checking thc mobilit y pa ram e tc r:-, fo r

plau:-ihilil)'.

Tubl e 2. Findin gs of cruuio-nmudib ulur (eM) di:-nrd c Th of Ihe Ilw:-tical u r)' vysrcm b
Pe rsun:- withou t e M -lilllti llg.' 277 5• •
Puticn ts slwwiug C ~!I -( li"lf!.k rs 32
Positive findings: t
- T MJ ( Icr t o r right) 2h e- r ae
- m asse te ric mu scle
- tl.'l11 pll ralis muscle
22
I~
'C"'
Q
3 ••
E
- digusurc muscle
- late ral ptery goid m uscle
- mctl ial pt erygoid muscle
"
Ih
9
Q
>
0
E 2• •
(, s:

..
- lOngue
0
- rnyloh oid muscle
upper
• lower
2
,
juw

Tee t h sho wing clea r aurir icn s

ill patie nts with C M-diso rck rs 157 11 5
Teet h cvnluutcd" 1.t1J IOU
- inciso rs 36 :l2
21 Fig. I. 1;;1
- cani nes 30
prem olars 52 27 in till' 'C'
- molars 31 I~
showmg II
isodvnarm
afte r Ih..: •
* Mo bifiry para me ter s ch ecke d for plnu sibifiry.
 Parameters of loath m obility IYI

diso rders and prono un ced signs of a u nuo n of the incisa l or oc clusa l su rfaces in 272
19 pat ie nts teeth . Par am et ers of tooth mobi lity we re a lso o bse rve d in 5R pat ie nt s who had a
'acrcristics to ta l of 256 tee th loaded hypofuncrionally. c.g. tee th that were s plinte d by ex te nsive
~' scree ned a pp lia nces or showed no o cclusa l re lation a t a ll.
·c ntgcnog- T oo th mo bility was de te rm ine d by rn cchan o-ctcctroni c methods . In ge ne ra l mobi lity
nponaucc measure me nts were ta ke n between 3.0n and 5.00 p.m . Th e quasi-sta tic mob ility o f the
ry system . I teeth was re corded by Desmodontom et ry (N ied erm ei er & Proschel, 19R7) whe reby
J)' Krogh- teeth a re load ed isod ynam icall y using a force o f 1·5 N in th e ves tib ula-o ra l, o ro -vestib ula r
randibu ku o r ax ialintr usive d irec tion . In this case the me trica l amp litud e o f toot h move men t is
recorde d 100 ms af ter the process sta rts (Fig. I). In ad d itio n to this .th e pr imary ve locity
I
1

;
I
I

sea
1
E '00
~
e
~
E '00
~
0
E
s: 2. . V 100
'0
)
!1 I
. 00

0 50 ' 00 .50 20 0

tim e (ms ]

) ~jg. 1. (a) handpiece of the Dcsmodoruomc try (DDM) de mon stra ted in the case o f a ll upper ca nine
111 the vcstib ulo-orul direction of measure men t [b] time-dependen t curve (If the Dcsmodontom ct ry
~howi ll!:\ the mo vem ent o f a slig ht ly mo vabl e (slilf!e I) up pe r premolar ca used by an imm edia te and
•• lsodyn arnic honz out ul lo ad 0 1" 1·5 N : the quasi-suui c mohilu y (am plitude o f toot h Il111VCI11 Cnt 100 ms
llunm
af te r the sta rt o f t he action ) in the vc stibulo-om l dir ection ( V 100 ) amoum s 10 (:IIT( lW) .
192 W. Niedermeier

o f to ot h mo vem e n t a nd d a ta of the veloc ity re la tive to th e 100 mscc-a mplitud c we re T he mob

det e rmin ed with the aid o f th e tim e-de pe nd ent d iagr a m o f the Ocsmodon tom cl ry fvJlowing
(D O M) ( Fig . 2) . A t th e sa me time measure men ts o f mo bil ity param eter s we re carr ied
o ut usi ng the Pcr iot cst-m c thod (K onig et nl . . I lJRI ) by wh ich teeth arc load ed pu lsative ly, type c
i.e .Ior a n interval less tha n I ms. T he Pcri o rest-rc adin gs ( PTW ) ran ging from - lO to funcii.
+ 50 s ho w no d imen s io n a nd a re a d yn amic e q u iva le n t to th e da mpi ng prope rti es o f
the tooth a nd irs perio don tiu m in th e vestibulo-oral di recti o n (Fig. 3) . In ge ne ral, Q uasi-st:l
excl usive ly vita l tee th we re selecte d for eva lua tio n wh ich d id no t sho w e ithe r approxima l were cor.
rest ora tio ns o r pat ho logica l findi ngs o f th e pe riodo n tiu m. i.c . a PI > I (Ru sse l. 1950) . :lccompli
ra ndom
Besid
co mp risi

e:;:
,. I
Ircatmcr
mobilit y
ill 12 pa
M oreovr
~
E
the peri,
~
> s..: parati
0
E s. asce rtai:
s:
'0 pe riod l
s , Results

Mo bi/it.
time (m s ) T he res
Tab le :
F ig . 2. Stan dardized DD lvl l:ur ....c {If th e ex ample show n ill Figu re I whe reby the V 100 is se t to IflO'J{, ;
fun ctioi
the g,r adit.: lll ;lll gic S l (If t he mea n prim a ry ve locity of rooth mov e ment be twee n I:' ami ~5 1l1 s a fte r
the start o f t he ;Il:l il li l is relat ed tl l :1 squa re enclose d by I ()( l lll ~ (a hsci:-''i;I) un d 111/ 1% (o rdin utc) or lJ7 ± 34
t he quu si-s uuic lll ohi l ity ( V 11 1/ )). aud amouut -, 10 h:''' .

PTW

l im e

p is Io n hil S tne
to otn s urface 5 ms
<,

Fig. -l
f iJ.:. 3. T imc-(k pe mk llt curv e o f the Porio n - a-method sho wing a damped os cilla t io n of the pisto n t ha t Po.: (\,'\
hi ll' the roo m pul sntivcl v: th e I'c not cst-vuluc ( PT W ) is ascert ain ed h y mea ns of the du ra t io n o r the l\l\\ \' r
f irs t ncg.u i....c peri od uf o scilln tiou .
 Pam m etel:\ of toot h mohilitv Ill 3

ide we re Th e mo b ility pa ra met er s were ch ec ked for pla usibil ity. a nd di ffe re nt ia ted usin g the
1I10mc l ry followin g va riales:
t' ca rried
1' ,llively, typ e o f too th (inci sor. ca nine. posterior)
n - 10 to fun c tion of too th (no rmal . e xcess ive or d eficient )
Il'n ies of
gl.: ne ral, Qu asi.sta tic a nd d ynam ic mo bi lit y pa ra me ters o f tee th load ed e xcess ive ly or d efi cie n tly
prox imal wer e co mpa red with con tro ls th a t sho we d a no rm a l fun c tion . T he da ta a nal ys is was
.1. 1 ~5 6J . accom p lish ed using th e S PSS- prog ra m . Fo r s tat istica l tes ts te e th we re se lec ted at
rando m lO a vo id ina p ropri at e accu m ulat ion of da ta .
Besid es . fo llow -up stud ie s o n to ot h mo bility had bee n ca rrie d o u t in J:-i pa tients
I
com p rising t 9 J tee th loaded ex cessive ly befo re an d after 2. 4 a nd 6 wee ks fo llo win g
j treatm en t o f th e bruxis m with the a id o f pla s tic ste ms (E rkolo k, J.) nun}. Add itio na lly.
mobility pa rameter s o f 62 tee th sp linte d h y ex te nsive fixed app lian ces wer e rec orded
in 12 patien ts befo re and af ter 4 . Ra nd 12 week s foll u wi ng rem o va l of the b r idges .
Mor eo ver , in a gro up o f 23 pati ents mo bi lity pa ram et ers we re st ud ied in I X4 teeth
• the peri odo nta l liga men t o f wh ic h wa s tr au mati zed e xpe rime n ta lly using o rt ho do nt ic
separa tin g ru b be r rin gs (A la sric he a vy. U nitc k] (Fig . 4) . T he reby 100 th mobilit y wa s
l asce rta ined be fo re and imm edia tel y aft er remova l of th e rubbe r rin gs wo rn for a
pe riod o f 24 h . as we ll as 7 d a ys afte r th e tri a l.

• Result s

• Mobility parameters of teeth loaded nonnally

t T he result s concern ing the IfHJbilil y p a ram et er s o f teeth lo ad ed normal ly arc shown in
I to 100%: Tabl e 3. A m inimu m mo b ility was see n in teeth s tressed by a norm a l m ast ica to ry
:5 m' after 0 functi on. Th e ho ri zon tal mo bilit y ( H 100 = V 100 + 0 100) o f the DD M averag ed
rtin.uc ) or 97 ± 34 ~1I11 , the ax ia l-intrus ive (A 100) 40 :±: 14 u rn . T his resu lt was eq u iva le n t to a ll
0

) 1:-1(111 thm Fig: 4. Scparaling rubber rings ( Ala~tic heavy. Unitc k) au achcd til traum atize expe rime ntally the
ion o f the i~Od~tu al Iig:~lI1CIl I o r the ccn uu l upper riglu und lowe r left iuci-ur a ~ well as the up pe r left and
owe- n ght camn c For a per iod or 24 h .
I Y4 Y\l. N iede rme ier I

Table J . Mobi lity paramet er- a nd SO o f diftc rc ut typ es o f ICl'Ih lo aded norma lly: quasi-static DDM_ Ta hIr 5. M
pa rame te rs V ](II) , 0 100 . A 1110 and J-I Il KJ ( = s u m of V IOU a nd 0 100 ), dy nam ic DD M-pnfilm e tcrs sw t ic DDM
VS 1. as I. AS I a m i the sum o f the m (S I) . Pcriot cst-vuluc ( PT \ \ I) : suu istica l d iffere nce s rel a ting 10 pllramcl crs
H IfKl , S l and P'Tw nrc men tion ed in the tex t arc mcmio r

T ype of roorh

'....lcutod l ucisors Ca nines Poster ior

- par am ete r (1/ = 5 11) ( II = 2\)8 ) (II = 10 19)

O /HI

- V IUD ( [\ 111) 4 1" 20 35 ± 12 50 :!: II}

- 0 100 (urn } ss ~ 2:1 45 ± 14 52 ± 23
- 1-\ 1(10 (Jim) -\·I :!: IJ ·12:!: 12 37 ± IH
- H 1IH l (l Ull) IN ::!: 37 XO::t 26 I02 :!: 32
VSI n 6 1·X:!: 1·(, fl l ·X:!:: 2 ·7 fJ2·H:t 0 ·4
OS I (0) 6.'\ ·2 :!: 3·7 fl} ·Y :!: 2·0 6J·() ± 2·3
AS I (0) 6O·1' ::t 1· ) () I '(l :!:: 2·t) 6:\·4 =.2 ·2
Sli m o f S I ( 0) I ~n · s ::!:: 2' (1 I H 7<~ :!: J · -l 1:51) ·8 =. 2·\)
Pcriot cst
- PT W s ·() :.'.: -l·2 D· ] 1: 3·9 3·.'1 =. fl · I
t

mo bility parameters reco rded bo th by the DDM and the Perio test-rnct hod. T he canines teet h loa
showed a minimum ho rizon tal mo bility. the posterior teeth a minimu m axia l-intrusive increaser
one . whe reby the incisor s loo k an in term ed iat e range be twee n the canines a nd (he normal 1
premo lars o r molars. T he differe nces o f the ho rizont al mob ility of ca nines on the one the same
ha nd and inciso rs o r poste rio r teeth o n the o ther proved to be signifi cant ( P < 0·0 1). the mast
Besides. inciso rs an d ca ni nes sho wed it significantly ( P « H II) g re a te r axial-int rusive c utiated
mo bility than prem o lars and mol ars. in the C~
T he 5 1-d ata. i .c . th c standard ized pr imary velocity o f the tooth movement relative and the
to the quasi-static to oth mobility re co rded at 100 ms , a mo un ted 10 an avera ge of ~l J H.I mol
IR8·9 ± 3. 10 which was the sum of the single S l-valu es of the three directions (V'S l , T ht: incr
a s 1 and AS 1) o f DDM -mcasuremc nt. A signifi cant ( P < 0·0 1) d iffe rence was obse rved ht:ing III
betwee n the mean S f -value o f inciso rs and canines on the o ne hand and (hat o f p o s ~ of the L
terio r teeth on (he o ther. T he PT W showed minimum da ta in the case o f the canines mcchani
(0 ,1 ± 3'9) a nd maximum in th at o f the incisor s (5· 0 ::!: 4·2). T he differ ences of the assoc iati
PTW bet ween the several types of teeth also proved to be significant ( P < O·Ol ).
M ohi/il.\
Mob ility oj teeth loaded tvyperfunaionalty Teeth v.
T he result was th at teeth loaded hyperfuncti on all y showed a significantly increased mobility
mo bility in all dir ections o f measu re ment (Tables 4 and 5) . T he DD M-param etcrs of o r an e:
amount,
Tab le 4. Nu mbe r o f te et h lo aded no rm ally o r d ysf wu.:lio lla !ly rnarely
deficien
No rma l E xces sive Def icient
Type fuuc tiou load lo ad
nearly 1
mobilit -
Inciso rs 5 11 68 23 those s!
Canines 29X 52 211 without
Po ster io r 10[1) 129 23 he quit,
 Param eters o] tooth m obility 19:'

rc DD ~\'I­ 'j'nblc S. Mobili ty para me ters a nd SD o f teet h load ed no rma lly: excessively ami dc ficic nuy: qun si-
rram ct crs
l al in ~ 10 , sialic DDM -pa ra mc tcrs V IlKJ. 0 l OCI, A lOll a nd 1-1 lOll ( = s um o f V 100 a nd 0 100 ) . d ynam ic DD M-
ammet er s VSI. 051. A SI and the s um of them (5 1). Pc rio rcs t-valu cs (I'TW ): stare-ne al differen ce s
~rc mcntion ed in the te xt or s ho wn ill Figs 5-g
t M echa n ica l lo ad

Me tho d No rmal Excessive Deficient

- paramet e r (n = IH20) (11 = 24lJ) (II = (16 )

t DOM

\ - V 1110 (! lIn ) 45 ± IS 72 ± 2X l.J5 ± 52

- 0 100 (I " n) 52 ± 20 X5 ± 32 132 ± N7
- A 100 (11m ) 40 " 14 70 ± IlJ 04 " 3 1
- 1-1 100 ( juu} 1.)7 =: J-l 157 ± 4lJ 227 ± 126
VS I (") (,2'4 =: 1·6 6~ · 5 ± 2 ·7 6-1 ·4 ± 2· ll
OS I ('j (H· I =: J.:! 65 ·11 ± 2 ·X (,(" ..J =: 2 ·X
AS I (' ) (12·..J c 2·3 M, (, ± 2·..J 63 ·9 =: )·2
j Sum er s : (oJ 1 ~ ·l) .!: 3 · l 19-1 · 1 ± J. l) 1') -1 ·7 =: ..J ....
Pcri ot cs r
- pn v ~ ...J ~ 5· 11 ..J .I) =: 5· 1 IIJ.(I =: I) . ...

canines teeth loaded hypc rfu nctic nall y and s ho wing signs o f at tri tion at the same time we re
ntrusive t incre ased significa ntly (P « ).(J( ll) by abo ut 6n- 75% co mpa red 10 th ose sho wing u
and the normal funcito n, while th e mean PT\V was increa sed no t mo re tha n a bou t 10 1~~ in
the o ne o the same cases. T he mean sum o f S l -dai a of the teeth stressed by hypcrfu ncr iun o f
< (j·1J 1). the masticat or y syste m was also significa ntly ( P < I)·HOI ) incr ea sed . Th e resul ts d iffe r-
mrusive e ntiated by the type o f tee th showed tha t the mobili ty paramet ers we re stillt he smalles t
in the case of ca nines loaded hypcrfun cti onall y. Ho we ver. the incre ase of thc H 100
re lat ive and the PTW co mpa red to teet h leaded no rma II)' was lo wer in the case o f premo lars,
'rage of and mo lars, as was th at o f th e A 100 in the case o f inciso rs a nd ca nines (Fig:-. 5 - R).
s (VSI , o T he incr ease of the S l-valucs ca used by hypcrfuuction wa s al ways significa nt (P < 0 .0(1 ) .
bser ved bein g most pron ou nce d in the case o f incisor s , less in tha t of poste rior te e th . III sp ite
of pos- of the fact that neither the dim en sion an d d irectio n nor the durati on o f the e nhance d
can ines mechanical stress we re asce rtai ned q uantitati ve ly, the results still show it nar ro w
j of the
associati on betwee n hyperfu ncrion nl loads a nd a ll incr ea sed mob ility o f teeth .
( 1).
Mobility of teeth loaded hypojunctionallv
Te eth with a hypofunction , i.e. those which a rc loaded by ve ry poo r forces , sho we d
icrcased ~ mobili ty pa ra mete rs th at we re e ve n mo re increased co m pa red to teeth with a no rma l
etcrs of or an excessive stress (sec a lso T ables 4 a nd 5). T he ave rage incre ase o f Ihc H Ion
• amou nted to ab o ut 45% , that o f th e A 100 to abo ut 20% , the mea n PTV\' was a pprox i-
mately twice as high co mpared to te e th s tressed hypc rfun cti on a lly. Te et h loa de d
• deficie nt ly sho wed D OM -valu es e ve n mo re than twice as high a nd Pf'w-rcadi ngs
nearly thr ee times as high as th ose with a no rma l functio n . T he d iffe re nces of th e
~ mobilit y para me te rs bet ween teeth load ed hypo functio nally 0 11 th e o ne hand a nd
th.o se Showing a normal o r a n e xcessive load o n th e o ther were significa nt ( P < I H Hl l )
• without exceptio n. T he mean 5 1-da ta o f teet h loaded hypofunctionall y appe a red to
be q uite similar to that o f tee th un der excessive s tress .
1% W. Niedermeier ~
pm
PTW
400
25
350
20
300

250 15

J I
200 10

150
\ r! 5
100

50
r T
-5
0
t
0
incisor s ca nines po ste rior - 10

• norma lly
• ollc ossivo ly t de fici en tly loa ded

Fig. 5. A ve rage values a nd S O o f the q uusi- suu ic bo rizoru al mobility ( 1-1 H10). i.c . th e sum of V 1IJO
:11 ](10 100 of the Dcsmodon to mc try dif'lcrcur i.u ccl by the typ e a nd the masti cator y load o f the te et h : Fig. 7.
t he number o f teet h is sho wn ill T a ble -l: s tatistical diffe rences o f th e ave rag e value s using the r-rc st I he mas'
nrc marked hy menu s of '~ (I ; < I H I."i ) . * ~ ( p < n · I JI ) a nd H ~ ( P< O · U0 1 ) . rhc ave r.
0
pm
dogr66s
140
210
120

100 200

II
80

60

40

20
~ ... \ \I 190

180

0
inciso rs ca nines pos terior
1:
+ nor mally
• oxcossively t do ficiontly loadod

F i ~. 6. A ve rage va lues ami S D o f the quu si-sruric ax ial-int r usive mobilit y (A 100 ) o f the D csmo-
dontomc try di ffe renti a ted hy the type an d the mastica to ry lo ad o f the tee th : the num be r o f tee th is Fig. 8. I

sho wn in T a ble -k sta tis tica l dif fe ren ces o f the ave rage va lues us ing the t-Il:st a rc mar ked hy me a ns of lllL"'h'ldJ
*( /-'< 0 ·05), **'( P< O·OI ) ami u* ( P < O·OlJl ). III Tallie
' ( / ' <. !.

T he result o f th e .\ IA NO VA was that the type o f the teet h a lso exe rts a n influen ce
0 11the mob ility para me ters recor ded . However , the diffe re nces appe rta ining to these Fol/ol l'
pa rame te rs we re less re mar kable due to t he poor co nsiste ncy of the sample (see a lso T re'-ltn
Figs 5-8) . Neve rthe less. the mean H 100 o f inciso rs and ca nine s stresse d hypofun c- dc crcu
tionally was rem ar kab ly ( P < O·05) increa sed co mpa red to t ha t of poster ior tee th. corned
T he ave rage A 100 of cani nes was significant ly ( P < 0· 01) gre at e r tha n tha t of the After
o the r teeth defic ie ntly loaded . Howe ver . the d iffe ren ces o f the mea n PTW betw ee n llL'a rly
the vario us types o f tee th d id not a ppea r to be re le va nt in the case o f hypofunction . li nd in£
5 1-data aga in showe d a ma ximum ave ra ge va lue in inciso rs lo ad ed de fi cie ntly. dccrca
 ?

III (If \ II)£)

If me rc...t h: Fig. 7. Ave rage values am i 51) o f th e dynamic l' criot cst-valuc s ( PTW) di ffe re ntia te d by th e type and
19. the t-tcs r the masticato ry lo ad o f th e teet h: th e numbe r of te et h i:- shown ill Table :.I : sta tistical di ffe re nce s o f
th e avera ge values usi ng the r-rcst a rc ma rked by m c an ~ of "'( /' < (H 15 I. •n ( P < O·{II ) a mi • • >1- ( / ' < IH KI I ) .

degrees

21 0

200

t \
190
f t·" ! t t ! t
180

inciso rs ca nines ocetcrtcr

I
+normall y • exce ssively t derid enUy loaded
the Dcsmo -
r of tee th is: Fig. H. A verage val ues and SI) uf th e sum o f S I ( -= VS 1 + OS I + AS 1) of th e 10011i mo vem en t ( DD M-
by mean s o f

• met hod ) diffe re ntiated b)' the type and t he mas ricut ury lo ad of the teeth : t he numhe r o f tee th is sho wn
in Table .~: :-ta t i~t ica l niff c rcn cc-, o f till' average values usin g the I-test ar c ma rk ed h y menus of -t-( P < (HI5) .
U (P < O·OI) and u*(/'< O·IIO I ).
,
1 influence
Ig to these ~ f Follo l\l·up studies
e (sec also Treatme nt of brux ism with the a id of it plastic ste ms res ulte d in a significan t ( P < O·OI)
hypofun c- b decrease of all mobility para me ters reco rd ed . T he reby th e mob ility of th e teet h co n-
rior teet h . cern ed ca me dow n to data co mpa rable to those loaded normally (F ig. 1.) . T ab le 6).
.hat of [he Afte r re moval o f the splinting o f te et h a red uction of the mo bility par am e ters to
}J between
ne arl y nor mal data was see n. pro vided that the y d id not sho w fu rt her pat hologica l
sofunction. find ings of the pe riod o nti um (Fig. 10 , T able 7). No t on ly the DDM -dat a a nd I'TW
nl/y. decreased by abo ut 311 - 50% o f the o rigina l d ata within a fe w months but a lso the
I ~X W. Niederme ier

a a
pm
pm
25 0
400

350

-----
200
300
' 50 250

100
• • 200

' 50
50 e 100

50
0
0 2 4
o
6
weeks afte r inse rtion
b
pm b
90 pm
0

-----
80 120
70
100
60
50 • • 80
40
60
30
20 40
10
20
0
0 2 4 6 0
week s afte r inse rtion
~

F i ~ . ~ . Ave rage val ues nud S I) elf (he lj ua:-i-:>la ,ic toot h mobilit y {D D M] dependen t 0 11 the lime afte r
insertion o f; I re mo vable plastic -acut-, in cases of bru xism: (a) horizionml mob ility (H ]( ~ ) , : (b) axial- FiJ.:. IU.
intrusi ve mo bility ( A HH I): dynamic mo bilit y parnm c tcrx a rc sh own Tab le (1, rvm oc .r!
1.-\ 1lIi11:

Table II. Dynamic mobi lit y para mcl cr s and S I) o f altoge ther 191 teeth lo aded e xcess ively by bruxism Tahh- 7.
before am i af ter 2. ... and 6 week s fo llow ing inse rt io n o f a plastic ste ms in o rde r to trent the function al .lllt·r t )-
diso rd e rs: 1I1e:l l1 Pcrior cxt-valuc (pn...t ) and su m o f S! (DDM) : diffe rences (0 the starl ing values arc :tI1d vum
ma rked hy 1( 1-' < 0·05 ). n U'< O·UI). -t'l'>t ( P < lI·(lfJI I t1'

Ti me a fte r inse rtion Sum otS !

( weeks ) PTW (d egrees)

o 5 ·6 ::!: S·3 19-1·6 =-1 ·2

2 4 ·2 ~ 6· ~ I(.HI ·-I ::!: -I·OU •

4 J. -I ::!: 5· 0 "'" 1 l'.)9 · 2 ~ 3 · I) "' u

(> .1·2 =j .....l "$ 1 ~·7 = J·n.l"U
 Param eters of tooth mobility I l)l)

, a
pm

400
350
300

• 250
200
150
100
50
-------- • •
0
o 4 B 12
weeks after removal

b
pm
120

100

o 80

o 60

40
..
20

o+--_-~-_-~- ~-_-~

o 4 8 12
wee ks aft er rem ova l
. lime afte r
: (b) axial- Fig. 10. Ave ra ge values a nd SO of the qua.. . i-suui c toot h lll ohilll ~ ( D U i\'1) dependent Ul! rhc rime aft e r
re moval of an e xten sive splinting uf teeth : (a l hori zomulmobilu y ( 1-1 IlN)J : (h I a xial-intrusive mobilit y
• (A 100): dynam ic mobilit y param eter- a rc ~ how n in Tul -le 7.

!:I~bruxism Ta ble 7. Dynamic mo bility paramet er . . and SO o f alt ogether 6~ rc crh loaded defi cie ntl y before and
functiona l after 4. 8 and 12 wee ks followi ng rem oval o f all e xten si ve splinlinp: mean P•.-riot c sr-vnluc ( I:JTW )
\ '" h ICS arc and Slim of SI (O O M): dif feren ces «I th e slarling val ue.. . arc mar ked h\ *( I' < (1-1 )5 1. **( ,.. <c' CHII) .

• .U( P < O{)OI ) .

Ti me afte r remova l SUllI lIf S I

(wee ks] 1'1' \\' (d l:!!rcl"". 1

o I t .t ::!: 10·11 1" ·I · \) ~ :'i · 1I

4 7· 2 :t 1'\ ' 4"' 11) 1·6 ± 4 ·IlU ,j

8 4 'X ~ h ·:t"'" l tl ll·] .:.!: J ' x~ u

12 =
:t ' 1l :, . l) ' ~ " IXl) ·,:\ ± ~, x u .!
S f-va lues we re red uce d to a no rrn al mag nitu d c . T his result ma kes clear o nce mo re that cuhies. th ose ~ t
the re mo val o f fuucriunal immobilisation which brin gs o n it gre ate r mcchanicul stress were d istinct rn
of th e pcr iodnu tnlli gamcm . results in .111 adaptati on of the tiss ues 10 th e re new ed lo ad . ph ically widen.
In I he case of a n e xpe rimen tal traum a b y o n hod urn ic sc p a ra tion o f th e te e th the mo bility the o the r at lc:
pa ra me le rs we re increa sed by ubour 30 -7f1% o f the o r igina l d at a ( Fig . I I ) . T hereby H owever, the ·
ca nine s sho we d a st ill signi fica nt (P < lH IOl) , m in imu m incre as e . T he S f-val ues rose is why th e sur
10 a ran ge eq uiva le nt to tha t u f teeth lo ade d e xcess ive ly. Ho we ver. mea surem ents i.c . the hor izoi
take n a week afte r finishin g the exper ime n t s howed mo b ilit y pa ram et e rs sim ilar 10 the Howeve r. Pe r
stare befo re the tr ial. T he refore t h e ~
nu l generally ~
Discussion we ll. alt hou gh
T he pr esent study d eals with th e ph ysiul ogy o f Ihl' peri od on tium . It co nsists o f an D icpgen & P:
e p ide m io logical a nd a n e xperime ntal part . T he aim wa s to investi gat e mobi lity para- do ubt on obvic
me te rs d ue to the fu nctio na l stress o n the tee t h. Co rre latio ns be twee n fun ction and a\'c ragc dat a I
mob ility o f tee th have bee n po inted o ut re peat edl y. Ho we ve r. th er e a re no sta tisticullv proved by me
rel e va nt stud ies upon q uasi- stati c a nd d ynam ic param e ters o f to o t h mob ility depe nd en t The cha ng
on fun ct io na l va ria bles o f the ma st icatory syste m. :1Il excessive t

T he e ffec t o f per iod o nta l the rap y 0 11 toot h mo b ility was st ud ied by Fe rr is ( 1966) , standa rdized J

Rcn ggf & Muhlcmnnn ( llJ70) , Rat c itsch a k ( 19H2) . E inr a uch- Ho rncc kc r. Kr uger & hig hly sc usitiv
M ansbcrg ( llJH2) a nd Niedermeier ( l lJXX) . To el iminate impli cation s du e to an infl am- velocity a nd t
ma rio n o f Ihl.' t i :-' s l h.: ~ co nce rned. in the p rese n t stud y we co ns id e red o nly tee th which ance (Niede r:
did nor s how ob vio us s igns o f intl um m a to ry pe rio dont al di sease s. i.c . it PI > I . A no th er dia gra m of thl
pre req uis ite was that a ll te eth eva lua te d co u ld he measured both by th e Pcri oicst- gap which is l
me th od and in ev e ry dire ction o f th e DDM . III add ition to that . the tee th co nce rne d of the diagnll
o ugh t to -, ho w nei th e r ro ta ted o r tilted po sitio ns no r appro xirna l restora tio ns to avo id signs o f an a
a ~ far i1 ~ po ssible facto rs wh ic h co u ld xignifica n fly a ffec t th e measure ment o f 10 Ulh co uld give sc
mo bility (Ni ede rme ie r. I t)}-\7) . liga ment b ut
No do ub t. it co uld no t eas ily he d ecided wh e the r tee th we re lo aded no rmally o r The unrni
d ys fun c tio nnlly . Wh e reas teeth lo ade d d eficie ntl y co uld he :-. ing lcd ou t wi t ho ut diffi- (P <O ·OI ) inf
i ~ co nfirmed I
IlJ:'4: Miihlc
20 0
160
r .. .. . .. . .. .. I l 156: K orber
that te e th wi
160 directio n. w
140 -. S 1 (de grees ) Ho we ve r , in
120 bea r e xcessiv
• H 100 (I'm )
10 0 to pre mo lar.
60 . . A 100 (pm) of the sampl
60 canine s hype
!: PTW (x10)
40 te e t h. Ho we

20 :Illl agonisls.
o ~---~---~ ~ guide fUIICl i,
o 1 2 3 4 5 6 7 days aft er remo vr
t----- p h t ' 1I01ll (' 1l0 1
trauma
... tr c ngth cn ir
Fi~ . I I. Av cragc vulu c:- 0 1 mohllily porum c te e, of tccrb cxpcnmcmutly rraum utizcd (n = 1:c;4 ) by omium to n
orth odontic so.: (laf al lll ); rubber ring:- fo r 2..1 h : i ll ore!..: f hi be clcurly unungccl. S O i.. nOI :-11I.lw l\ i n this \) 1 the pe ril
gruph: th c values taken inuuc diutcly after l i n: trau ma (,Il"foWI dirkr ..iguificautt y (/' < IH" II) lrom the
pen....Hcd af
:-1;ln ing n..-adin gs .
 Purunu-ters of /OO/h mobilitv 20 1

n ee more th a i j cult ies . th os e st resse d hypcrfuncti onufl y ha d to co m ply wit h se ve ra l prere q uisi tes : T he se
.hanical stress were di stinct mo rp hol o gica l signs o f a n e xce ss ive stress . like a u rit ions . a ro c ntgcn ora -
re new ed lo ad . phicall y wide ne d per io donta l ga p o r o cc lusa l discr c pa nccs o n t he o ne han d a nd . o n
h t he mobilu v the o the r a t lea st one pron ou nced findin g of a m yopath y o f th e mast ica tory IllUSCIeS .
I I). The reh \ H owever . th e d irec tio n of :t hyocrfu ncrion ul lo a d co u ld no t ye t he (h..terrnined . T ha t
;I -va lues rose is why the sum o f the vcs tibulo-o ra l ( \I 1(0 ) a nd or o-vc .-ubular (0 1( 0) read ings .
ncasurcm cnrs i.e . th e ho rizont al ( H 1( 0) to o th mob ility was used for till' e va lua tio n o f DDM -data .
simila r to the Ho we ve r, Pcriot est-rcadings co uld o nly be tak en ill th e vcs tibulo- oru l di rect ion .
Th erefo re th e y co u ld not be co m pa re d d ire c tly with DD M -da la. Fur th i ~ reason it is
no t ge ne ra lly surprising that mobi lity param et e rs o f diffe ren t me tho ds assoc iate q uite
we ll, alth o ugh the read ings the mse lves do not co rre late su ffic ie n tly ( Ni ederme ier.
:o nsists o f a n D iepgcn & Pa iva . IlJ8LJ) . In add itio n to th is . thc great varia nce of the PT\V C<l:-Is
nobility pa ra- 'l doub t o n o bv io us d iffere nces o f (he average d a ta . On t he ot her h an d . s liglu diffe re nce :"> o f
functio n an d ave rage da ta o f qu asi -sta tic DDM- pa ra mc1ers o f tooth mo bili ty co u ld he s t a t i ~ ( i ca ll y
10 sta tistica lly p ro ved by 111 l: i111 ~ o f the ir grea t rep ro ducibi lity .
ity dependent T he cha nges o f th e phvsiolo gicul properti es o f the peri od ont al tissues ca used by
o an ex cess ive o r a de ficient fun ct ion of t he tooth coul d hl' ve rifie d hy observin g t hc
Ferris ( 1% 6). s tanda rd ized p rim a ry ve loc ity of th e to o th mo vem e n t (5 1) o f th e D OM . T h is is a
: 1',Kru ger & highl y se nsit ive mo bi lity para me te r which es tablis hes <t rel a tion betw een t he re a l init ia l
to an inllam- ve loci ty a nd 111L' quasi- stati c amplitude o f 1001h mo vem e nt sho win g a ve ry sma ll va ri-
of tee th whic h o a nce {Niede rmei e r & Kuhl wcin . I W~X ) . A gre a t initia l s tcc pncs-, o f t he sumd ardizc d
> I , A no ther d iag ra m o f the D DM (sec als o Fig . 2) wa s oft en asso cia te d w it h it w ide ned periodo nt al
he Pc rioi cst- ga p whic h is usua lly se e n in te eth loaded hypc rfuncrion all y. H o we ve r. a flat ini tia l rise
th co nce rne d of th e d iagr a m ca n be o bse rved in te et h s ho wi ng a narro w periodo ntal ga p o r eve n
io ns to a voi d signs of an ankvlosis.of th e periodontal ligam e n t. II is su pposed t hat th e S l-val uc
rent o f to o th co uld give so me inform a tion ubuut the plasto -clasric pro pe rties o f t he pe riodont a l
ligam ent hu t co uld not he co ncl us ivel y pro ved.
no rma lly or T ile unmi sta kabl e result o f tile MAN OVA wa s rluu toot h mo bili ty is sig nir-lcCl ntly
witho ut (/iffi- o (P < 0'0 I) influ e nce d bo th h y the ch an ge of func tion an d the t yp~ o f th e to oth . Th is re sult
is co nfirme d by some st ud ies u~ i n g co mparable method s o f measuremen t [Muhlcmann .
LlJ54 ; M uhlcrnunu . W a rtmann & M art ha ler . LtJ55 ; Muhl cmann . H erzo g, & Vo ge l.
L956 : Korb e r , ILJ62 : N ie de rmeie r. It)X5) , In thi s co nne c tio n it ha s been c le a rl y sho wn
th a t teeth wit h lo ng ro ot s an: ab le to tol erat e excesivc l oa d ~ more in th e ho rizon ta l
• di rection , whe reas po ster io r tceth a rc fav o u ra b ly su ite d fo r a xia l- int rusive lo a ds .
H owe ver, in th e case o f a hypo fun ct io n . canine s wh ich use d I l ) he a p pr o pr ia ted 10
be ar excessive lo ads show e d bo th a g re a te r horizon tal a nd intr usi ve mo bili ty co m pared
to premo lars a nd mol a rs . T his re sul t was sign ific.uu U' «).( H) , a lt ho ugh th e size
o f the sam p le nat ura lly has be e n limi ted (11 = 20) . T he re aso n for thi s co uld be tluu
ca nines hypofun ct io na lly loaded get u lo we r sha re o f res idua l fun c tion th a n th e o the r
tee th . H o we ve r, post erior teeth ca n tak e a liut c pan o f mast icati on e ve n in th e a bse nce of
a nta go n ists . where as in th e sa me ca se c a ni nes ne ver ca n ac co mp lis h the ir o r igina l
guide func tio n . T he fact tha i te eth lo ad ed poo rl y ca n a dju s t to a new me cha n ica l lo a d
a fte r remo va l o f a splin ting spe a ks f~lr the ada p ta b ility o f t he pe r iodo nta l tissues . T h is
ph en om en on se e ms to be the resp onse o f th e o rga n ism 10 me ch a nica l s t im u li like rlu,
s tre ng the ning o f m uscles whe n the y arc tr ai ned . T he a du p tub iliry o f a health y pe riod -
d (I' = I ~" ) by
o nt iu m to mec ha n ica l stre ss a pp ea red abo to be e vide nt in th e case o f h ypcrfu uct ion
I shown in this
I-(I{) l ) from th e of the peri odo nt iu m. O n tha t o cca sion . inc reased too t h mobili ty \V as la rge ly C0 111 -
pensa rcd afte r rem o va l o f a n e xces sive lo a d , wh e t her thi s wa s long-te rm o r con fined
2.02 W. Niedermeier
lournal {J

10a n expe rime ntal tr aum a , T hese fe atu re s c rnp lu e.izc the ph ysio lo gica l co ntro l o f
mecha nica l stre ss ac ti ng n il natur al peri odo nt a l tiss ue s.

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be divio.
I L D f. II.M I:lI: K . W. ( 11JXN) O il' Dcsmodo momc tri c - cin nc uc s v crfah rcn z ur Bcs timm un g und Anal yse
dcr Z nlm bc wcg tich kcit . III . Die ph ysiol ogisch c un d pathologischc Zahnbcwcgfichkcit . Il eiusc he .Ixb and
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mcclum o -clc kt runi sch cn Bcsun uuuu g de l' Zuhubc wcglichk c u . D eutsche Zalmiir;: l!i che Z ei/scll,.;j ; . removal-
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Gc hiU? ScJllvei:.a M rnlllfH d lriji ji"ir Zal lllhe ilJ.. /II"le . 92. ~J7-t .
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