Periodontal force: a potential cause of relapse

Abstract

Relapse of aligned mandibular anterior teeth and the progressive collapse of the mandibular arch is a significant problem for orthodontists. However, identification of a specific cause of such relapse has proved elusive. The transseptal fiber system is thought to stabilize teeth against separating forces. It is hypothesized that this fiber system may actually maintain the contacts of approximating teeth in a state of compression, the long-term result of which could be contact slippage and collapse of the arch. The interproximal force (IPF) at the mandibular first molar-second premolar contact was investigated on the basis of previous studies with this representative contact. The IPF was measured in 10 subjects at six different widths of contact separation. By means of graphic plotting techniques, the IPF at zero separation was calculated to estimate the contact force when the molar and premolar were actually touching. The mean IPF at zero separation was found to be 36.7g (SE = 6.6g), and a t test confirmed the hypothesis that a state of compression between contacts exists (p less than 0.0001). After chewing, the mean IPF at zero separation was 57.2g (SE = 9.1g), and a paired t test revealed an increase in contact compression had resulted (p less than 0.01). It was concluded that the periodontium exerts a continuous force on the mandibular dentition and that this force acts to maintain the contacts of approximating teeth in a state of compression. This force is increased after occlusal loading and may help to explain long-term crowding of the mandibular anterior teeth, physiologic drifting of teeth, and maintenance of posterior dental contacts after interproximal wear.