BIOMEKANIKA

ORTODONTI
Drg Putu Ika Anggaraeni, Sp.Ort
BIOMECHANICS IN ORTHODONTICS

Mempelajari pengaruh prinsip-prinsip mekanika alat

ortodonti terhadap gigi dan jaringan pendukungnya
 THEORY OF ORTHODONTIC TOOTH
MOVEMENTS

1. Pressure tension theory

2. Blood flow theory
3. Piezoelectric theory
 PHASES OF TOOTH MOVEMENTS

1. Initial Phase
- Segera setelah pemberian kekuatan/force pada gigi

- Pergerakan gigi dalam ruang PDL

- Light force / High force  Besarnya pergerakan gigi

hampir sama (0,4 – 0,9 mm)
2. Lag Phase

- Pergerakan gigi minimal / tidak ada

- Terbentuknya jaringan hyalin pada PDL diresorpsi

sebelum fase pergerakan selanjutnya

- Durasi fase ini tergantung besarnya force/kekuatan,

kepadatan tulang alveolar, usia pasien, area hyalinisasi

- Light force : area hyalinisasi kecil cepat diresorpsi

- High force : area hyalinisasi luas  lebih lama diresorpsi

3. Post Lag-phase

- Area hyalinisasi tidak ada

- Pergerakan gigi cepat, dimediasi oleh osteoclast

- Direct resorption of bony surface facing PDL

 PERGERAKAN GIGI

• Bila kekuatan dikenakan pada gigi , maka akan timbul area

yang tertekan dan area yang tertarik.

• Area yang tertekan tulang diresorpsi

• Area yang tertarik tulang akan diaposisi.

• Proses remodeling tulang dirangsang oleh pemberian kekuatan

pada gigi  gigi bergerak dan integritas tulang alveolus tetap
terpelihara

• Proses remodeling dilakukan oleh osteocyt (osteoclast & osteo

blast )
 BONE RESORPTION

The orthodontic treatment is based on the simple premise that whenever pressure is
applied to a healthy tooth for a sufficient long duration of time, its surrounding
bone remodels.

• Bone resorption : terjadi resorpsi tulang alveolar melalui mekanisme selular pada
area yang mendapat tekanan

• Sel : OSTEOCLAST

• Terdapat 2 jenis resorpsi :

1. DIRECT FRONTAL RESORPTION
2. UNDERMINING / REAWARD RESORPTION
 DIRECT FRONTAL RESORPTION

• Light force

• Osteoclast terbentuk pada sisi tulang alveolar &

PDL yang mendapat tekanan (force)  resorpsi
tulang alveolar

• Tekanan tidak menyumbat pembuluh darah 

area hyalinisasi kecil/tidak ada

• Tekanan/force ~ tekanan pembuluh kapiler (20-26

gm/cm2 luas akar)  optimum orthodontic force
 UNDERMINING RESORPTION

• Heavy forces

• Pembuluh darah tersumbat di area yang mendapat tekanan

 PDL nekrosis  hyalinisasi

• Mekanisme seluler meresorpsi area hyalinisasi 

undermining resorpsi (osteoclast dari area sekitar)
 BONE DEPOSITION / APOSISI

• Aposisi terjadi pada sisi tulang alveolar yang tertarik (pada permukaan
alveolus yang berhadapan dengan PDL

• PDL beradaptasi terhadap posisi gigi yang baru  proliferasi intermediate

zone

• Osteoblast

• Osteoblast bertambah melalui proliferasi precursor cell (paravascular

precursor cell)
 ORTHODONTICS FORCE

“If malocclusion is the disease in orthodontics, Force is definitely its medicine”

• Force  magnitude ; direction ; point of application

• Jenis gaya ortodonti (berdasarkan durasi aplikasi) :

1. Continuous force
2. Intermitten force
3. Interrupted force
CONTINUOUS FORCE

• Active orthodontic force that decreases little in

magnitude between appoinment periods
• Ex : light wire appliance, NiTi coil springs
INTERMITTEN FORCE

• Active orthodontics force that decays to zero

magnitude / nearly so prior to next appoinment
• Ex : removable active plate (plat aktif)
INTERRUPTED FORCE
• Orthodontic / orthopaedic force that is inactive for
intervals of time between appoinment (force level
decline to zero between activations )
• Ex : EO appliance (face mask) , screw (RME)
 ORTHODONTICS FORCE

• FORCE : an act upon a body that changes the state of rest / uniform motion of
that body
• COUPLE : a pair of concentrated forces having equal magnitude & opposite
direction with parallel but non-collinear line of action
 ORTHODONTIC FORCE

• Centre of Resistance : point on the tooth when a single force is passe

d through it, would bring about its translation along the line of action
of the force

• Centre of Resistance of Single-Rooted Teeth : between one third &

one half of the root, apical to the alveolar crest

• Centre of Resistance of Multi-Rooted Teeth : between roots, 1-2 mm

apical to the furcation

• Centre of Resistance varies with :

1. Root length
2. Alveolar bone height
3. Root morphology (single/multi root)
 ORTHODONTICS FORCE

• Centre of Rotation : the point around which rotation actually occurs

when an object is being moved/rotated

• As the center of rotation moves towards the apex, the more the
displacement of the crown and vice versa.
TYPES OF TOOTH MOVEMENT

1. Translation
Translation, or bodily movement, occurs when all points on the tooth
move an equal distance in the same direction

2. Pure Rotation
Movement of points of a tooth along the arc of a circle, with
the center of resistance being the center of the circle

3. Combined rotation & translation

Not pure translation or rotation
TRANSLATION
• Intrusi
• Ekstrusi
• Bodily movements (mesio-distal ; labio-lingual)
PURE ROTATION
• Transverse rotation
- Tipping (controlled ; uncontrolled)
- Torquing
• Long axis rotation
COMBINED
Optimum forces for various tooth
movements-Proffit
 ANCHORAGE

The nature & degree of resistance to displacement offered by anatomic

unit for the purpose of effecting tooth movement (Graber)

Source of anchorage :
1. IO : gigi, tulang alveolar, otot, tulang basal, tulang cortical
2. EO : cranial (occipital/parietal), cervical region, facial bones
 KLASIFIKASI ANCHORAGE

MOYERS

1. Manner of force application :

- Simple
- Stationery
- Resiprocal

2. Jaws involved :
- Intramaxillary
- Intermaxillary
 KLASIFIKASI ANCHORAGE

MOYERS

3. Site of anchorage :
- Intra Oral
- Ekstra Oral
- Muscular

4. Number of anchorage units :

- Single / primary anchorage
- Compound
- Multiple / reinforced
 ANCHORAGE REQUIREMENTS

Based on anchorage loss that is permissible, anchorage demand on

extraction case :
1. Maximum anchorage : <1/4 of extraction space should be loss by
forward movement of anchor teeth

2. Moderate anchorage : ¼ - ½ of extraction space

3. Minimum anchorage : >1/2 of extraction space

THANK YOU