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Optimum stresses for a favorable response to orthodontics are still unknown. Here, we compared the effects of initial periodontal ligament (PDL) stresses over time in orthodontic external root resorption (OERR), necrosis, and the TRAP+ cell population. Forty-two rats (Fischer CDF) were treated with 10 cN of force for 5 different time periods. Finite element (FE) models of the first maxillary molars were constructed from μCT scans to calculate initial PDL stresses. The scans were also used for OERR measurements before histology. Time, stress, and their interaction were significant to result in an OERR increase only in the regions of medium and high stress. OERR was not significantly different between control and treated animals over time in the region of low stress. After 30 days, OERR was increased by 5- and 3-fold in the zone of high- and medium-stress regions, respectively. The TRAP+ cell population initially followed the stress gradient, but changed after bone and necrotic tissue resorption. In the 30-day modeling cycle, the correspondent 3rd principal stress range to promote direct bone resorption and insignificant OERR was between -9.92 and -7.75 KPa. These translate to approximate forces of 30 to 40 cN applied at the bracket level (tipping) of a human maxillary canine.

Introduction: Tooth movement simulation is important for planning the optimal force system and appliance design to correct a specific malocclusion. Experimental verification of a 3-dimensional force system is described for a unique molar root movement strategy that can be adapted to many clinical scenarios., Methods: The force system was measured for molar root movement springs that had adjustable alpha (anterior) and beta (posterior) moments. A 3-dimensional transducer assessed moments and forces in 3 planes during deactivation and simulated molar rotation. Two experimental situations were compared by using 10 springs in each group: spring reactivation was performed to compensate for changes in the force system caused by molar movement, or there was no reactivation., Results: Without reactivation, the force system becomes unfavorable after approximately 5 degrees of molar movement (rotation). With reactivations, a favorable force system through 20 degrees of molar movement is maintained., Conclusions: Present root-movement appliances require periodic adjustment to achieve optimal tooth movement. Additional studies are needed to design orthodontic appliances for delivering optimal force systems for the entire range of tooth movement.