MOBILITY – etiology and classification
I- Introduction:
The alveolar ligament is a compressible tissue that ensures the attachment of the dental roots to the alveolar bone, a fixation that is strong enough to hold the dental roots in place but also allows a certain physiological dental mobility, thus facilitating the absorption of the forces applied to the tooth. In certain cases of pathological alterations of one of the elements of the periodontium, the mobility will increase and exceed the ordinary amplitude of physiological mobility, thus we will speak of pathological mobility which requires treatment in the form of retention.
II- dental mobility:
1-Definition :
Mobility is most often defined as an increase in the amplitude of movement of the dental crown under the effect of a defined force.
2-The different types of dental mobility:
a- Physiological mobility:
In the absence of any stress, the teeth exhibit spontaneous physiological mobility. The amplitude of the movements is a function of the periodontal pulse and synchronous with the successive forces of systole and diastole. It was evaluated at 0.4 mm +/- 0.05 mm by Korber (1971).
In the presence of occlusal stresses, either axial or transverse mobility is observed.
b- Pathological dental mobility:
Mobility that occurs beyond the physiological range is called abnormal or pathological mobility.
Pathological mobility can be: reversible or irreversible
- Reversible mobility:
– Of inflammatory origin:
- Any inflammation of the periodontal tissues, superficial or deep.
- Pulp inflammation, septic or not.
- Sometimes the onset of sinusitis can affect the teeth and cause tooth mobility.
Classical treatment of inflammation (in the absence of significant bone lysis) is sufficient to restore physiological conditions
– Of occlusal origin:
- Dental migrations
- prematurity- interferences
- Following uncompensated extractions.
– Of iatrogenic origin:
Prosthetic origin:
Poor prosthetic performance can cause tooth mobility, citing:
– The scholiodontic hook effect
– Elements fixed in extension, poorly distributed.
– Insufficient dento-mucosal support, with rotation effects around the residual teeth.
This mobility is caused by a back and forth effect exerted on the tooth, leading to an increase in the desmodontal space, which returns to normal after rehabilitation of the prosthesis.
Orthodontic origin:
Mobility can also be increased through orthodontic treatment.
Other origins:
Transient mobility may also be observed after endodontic treatment and periodontal surgery.
- Irreversible mobility:
We speak of irreversible mobility when there is irreversible loss of the bone support of the tooth either during periodontitis or sometimes in cases of direct trauma with significant alveolar fracture.
In the presence of periodontitis, tooth mobility is accentuated by the inflammatory reaction within the periodontium.
3-Evolution of mobility:
– without treatment, mobility often progresses to worsening and leads to tooth expulsion. This depends on the severity of the disease; the more aggressive the periodontitis, the higher the chance of tooth loss.
– once treated, the dental organ affected by periodontitis can either regain physiological mobility, or in the event of major irrecoverable bone loss: the range of mobility will decrease but will always remain pathological, which leads us to suggest dental retention.
4- Mobility assessment:
Dental mobility can be qualified using electronic devices:
→ The Heinroth micro elastometer 1928.
→ The Mulhman periodontometer 1950.
Or manually by indices:
→ ARPA index:
Grade 1: Perceptible mobility in the fingers but not visible to the naked eye.
Grade 2: mobility perceptible to the fingers and visible to the naked eye < 1mm
in the VL direction.
Grade 3: mobility visible to the naked eye greater than 1 mm in the VL direction.
Grade 4: Axial mobility. Mobility in all four directions
Dental crowns are used to restore the shape and function of a damaged tooth.
Bruxism, or teeth grinding, can cause premature wear and often requires wearing a retainer at night.
Dental abscesses are painful infections that require prompt treatment to avoid complications. Gum grafting is a surgical procedure that can treat gum recession. Dentists use composite materials for fillings because they match the natural color of the teeth.
A diet high in sugar increases the risk of developing tooth decay.
Pediatric dental care is essential to establish good hygiene habits from an early age.