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PubMed1980

Clinical standardization of horizontal tooth mobility.

The clinical measurement of horizontal tooth mobility is discussed on the background of the current theories regarding the pathogenesis of periodontal disease. The common indices which have been designed to measure horizontal tooth mobility are discussed and critiqued. These indices are not sensitive in that they do not discriminate well between small increments in mobility. In addition, many of the indices cannot be utilized for individual teeth on a longitudinally reproducible basis. The preliminary testing of an in vitro model with mobile teeth which was designed to aid the clinician in assessing tooth mobility is described. Results indicate that the clinician may be capable of discriminating between mobilities that are in the 0.1 mm range, with the aid of the model.

Dental Instruments↗
PubMed1980

Assessment of tooth mobility using small loads. II. Effect of oral hygiene procedures.

Tooth mobility at loads between 20 p and 80 p was studied in maxillary incisors and canines in eight subjects with moderate periodontal disease. The periodontal conditions of the investigated teeth exhibited clinical criteria of gingival inflammation and a moderate loss of attachment. None of the subjects showed subjective or clinical signs of occlusal disturbances. In all, 35 teeth were investigated over the 12-week period following periodontal hygiene treatment, including oral hygiene instructions and removal of supra- and subgingival plaque and calculus. During the course of the investigation, a gradual decrease of tooth mobility was observed amounting to a tooth mobility decrease of 65% (using the corrective formula described by Mühlemann 1960) at 50 p load. Tooth mobility curves within the 20--80 p loading area were transformed to lines of regression (Persson & Svensson 1980). Analyses of the lines showed significantly lower tooth mobility values 12 weeks after start of treatment.

Adult↗
PubMed1981

Assessment of tooth mobility using small loads. IV. The effect of periodontal treatment including gingivectomy and flap procedures.

Tooth mobility at loads below 100 p, gingival fluid amounts and bone score heights were studied in five subjects. In all 28 maxillary anterior teeth were investigated during a period of 68 weeks. In order to enlarge upon a previous investigation of tooth mobility following periodontal surgery (Persson 1980), the effects on tooth mobility of gingivectomy and flap procedures were compared. A split-mouth technique was used for the two surgical procedures which were performed during one session. No preoperative differences of the investigated parameters were found. During the first weeks after surgery, an increase of tooth mobility was seen which amounted to +80% maximum (flap side) and +13.1% (gingivectomy side). The final tooth mobility changes were -60% on the flap side and -40% on the gingivectomy side. No significant differences of tooth mobility were found between the two surgical methods. The present findings of tooth mobility following surgery also indicated a considerable time lapse before any major decrease of tooth mobility took place.

Adult↗
PubMed1997

Tooth mobility and periodontal disease.

Tooth mobility (TM) is an important feature of periodontal disease. This is evidenced by the large number of devices and methods of TM assessment that have been developed and tested. TM had been considered and investigated as an indirect measure of the functional condition of the periodontium as well as possible aggravating co-factor for periodontal disease.

Disease Progression↗
PubMed1978

[Value and significance of tooth mobility measurements].

1. The measurement of tooth mobility by manual and instrumental techniques is necessary for establishing a diagnosis, since it is of considerable importance for decisions in the framework of prophylaxis and therapy. 2. The significance of the measurement of tooth mobility depends upon the respective problem and the sensitivity of the measuring technique used. 3. The specifications for the precision of the measuring technique will be determined by the specific objective of the examination. 4. The instrumental measuring techniques are reproducible and, therefore, imperative in scientific studies.

Humans↗
PubMed1975

An evaluation of clinical tooth mobility measurements.

This study evaluated the reliability and reproducibility of the modified Miller Index of horizontal tooth mobility. Each of three periodontists utilizing the modified Miller Index assessed the horizontal tooth mobility of 50 teeth in five subjects. The same teeth were also evaluated by the periodontometer. The results of these two methods were then compared. It was found that: (1) there were a high positive correlation between the periodontists' (pooled) assessment of clinical tooth mobility and the measurements of the periodontometer, (2) in any given patient the three periodontists (pooled) were highly accurate in their ability to rank teeth in order of their mobility as determined by the periodontometer, and (3) the periodontists (individually) were not as consistent when comparing teeth with the Miller Index across different subjects. The periodontists did not accurately utilize the Miller Index as it was originally described. It appears that the periodontists either ignored the reference to 1 mm in the description of the Miller Index, or they were unable to estimate what constitutes 1 mm of movemnet in the mouth. The periodontists all consistently scored as a 2 degrees mobility a tooth that moved approximately 0.5 mm not 1.0 mm as described by Miller. It is suggested that the modified Miller Index as described here provides an efficacious system for evaluating horizontal tooth mobility. It provides accurate, reproducible mobility scores in clinical studies requiring an estimation of this parameter. However, for individual teeth, when the clinician or researcher is trying to evaluate the effects of therapy on the periodontium and relatively few evaluation are made, the modified Miller Index may not provide the required degree of sensitively.

Adult↗
PubMed1981

Assessment of tooth mobility using small loads. III. Effect of periodontal treatment including a gingivectomy procedure.

The effect on tooth mobility of periodontal treatment utilizing a gingivectomy procedure was studied during a period of 26 weeks in 25 maxillary anterior teeth of six subjects with moderate to advanced periodontal disease. The gingival conditions were evaluated by gingival fluid measurement and the loss of marginal bone as seen on radiographs. Tooth mobility was measured in a bucco-lingual direction using forces between 20 p and 80 p. The results show a decrease of gingival fluid throughout the study. Tooth mobility was already reduced in the majority of teeth 2 weeks after surgery. An average reduction of tooth mobility amounting to 43.7% (using the corrective formula of Mühlemann 1960) was observed after 4 weeks. No additional reduction took place during the remaining experimental period.

Adult↗
PubMed1980

Tooth mobility and periodontal therapy.

Data collected as part of an 8-year longitudinal study on periodontal therapy involving 82 patients and 1974 teeth were analyzed to determine if tooth mobility influenced the result of treatment. For each patient, pocket depth, attachment level and tooth mobility were scored clinically at the initial appointment, and once a year for 8 years following periodontal therapy. The treatment consisted of scaling, oral hygiene instruction, occlusal adjustment, periodontal surgery (curettage, modified Widman or pocket elimination), followed by recall prophylaxes every 3 months. Tooth mobility data on a scale of 0--3 were related to changes in attachment levels for three grades of severity of periodontal disease, based on initial pocket depth (1--3 mm, 4--6 mm, and 7 + mm). Mean patient attachment changes were calculated from teeth in the same severity category for each patient. The data were analyzed by one-way analysis of variance and Scheffe's multiple comparison procedure to test the hypothesis of equal effects of tooth mobility on the results of the treatment for the three severity groups over 8 years. The results indicate that there is a statistically significant relationship between original tooth mobility and the change in level of attachment following treatment. Pockets of clinically mobile teeth do not respond as well to periodontal treatment as do those of firm teeth exhibiting the same initial disease severity.

Humans↗
PubMed1993

Parameters of tooth mobility in cases of normal function and functional disorders of the masticatory system.

Tooth mobility was measured mechano-electronically with the aid of quasi-static and dynamic methods in 309 patients comprising 2650 teeth being periodontally healthy. Besides, clinical and roentgenographic findings were ascertained to relate functional features to each periodontium. In general the result was that teeth loaded excessively show increased mobility parameters compared to those loaded normally. However, the mobility of teeth loaded poorly or deficiently was even greater compared to teeth stressed excessively. Moreover, follow-up studies showed that tooth mobility decreases after removal of functional disorders of the masticatory system or an immobilisation of splinted teeth. An experimental trauma of the periodontal ligament also brings on an increased tooth mobility which decreases to the original values some days after the trial.

Adolescent↗
PubMed1979

The effect of splinting on tooth mobility. (2) After osseous surgery.

The purpose of this study was to determine if fixed splinting of teeth with intraoral wire and acrylic splints had advantages with respect to tooth mobility, bone level and attachment level over unsplinted teeth following osseous surgery. Ten patients were chosen who exhibited bilaterally similar chronic destructive periodontitis and mobile teeth. One maxillary sextant was splinted, while the other was unsplinted. Both sextants functioned against an unsplinted mandibular arch. Following initial therapy, osseous surgery was performed in both maxillary sextants on the same day. Tooth mobility data was collected 1 week before and at 3, 6, 12, and 24 weeks following surgery. Levels of gingival attachment and bone were recorded before and 24 weeks after surgery. Splints were removed before measurements, then replaced, and the occlusion refined. Prophylaxes and oral hygiene instruction were repeated every 3 weeks throughout the study. For all categories of teeth and mobility examined, tooth mobility increased initially after surgery and subsequently decreased by 24 weeks to about presurgical values. The splinted and unsplinted segments reacted similarly throughout the study; splinting did not significantly reduce the mobility of individual teeth. Pre- and postsurgical bone and gingival attachment levels were also similar for the splinted and unsplinted segments.

Adult↗
PubMed1980

Interrelationship of inflammation and tooth mobility (trauma) in pathogenesis of periodontal disease.

A series of studies has investigated interactions between periodontal trauma and marginal periodontitis in relation to the initiation, progression and treatment of periodontal disease. Lesions of trauma in the periodontal ligament consequent to either single or jiggling displacing forces result in morphologic alterations in the ligament and alveolar bone. These changes do not initiate the loss of connective tissue attachment characteristic of marginal periodontitis. Studies conducted in squirrel monkeys and beagle dogs in which jiggling forces have been produced subjacent to an established marginal periodontitis reported increased loss of alveolar bone, but the accelerated loss of attachment which occurred in the dog model did not occur in the monkey model. To clarify the relative importance of inflammation and tooth mobility in the treatment of advanced periodontal disease, periodontal response was evaluated after removing traumatic and/or inflammatory components. Elimination of trauma in the presence of existing marginal inflammation did not reduce tooth mobility or increase bone volume. Osseous regeneration and decreased tooth mobility occurred after resolving both components, however, similar findings occurred after resolving inflammation in the presence of continued tooth mobility. Resolution of marginal inflammation is of prime importance in the management of periodontal disease. After resolution of inflammation, bone regeneration may occur around mobile teeth and, furthermore, any residual tooth mobility does not result in increased loss of connective tissue attachment.

Animals↗
PubMed1967

Tooth mobility.

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Dentistry↗
PubMed1988

Upper anterior tooth mobility. Selected associations in untreated periodontitis.

The relationship between buccolingual tooth mobility (TM) and other clinical parameters was studied in 124 upper anterior teeth in 21 patients with untreated periodontitis. Periapical long-cone radiographs were available for 74 teeth in the same population. TM was measured with Mühlemann's macroperiodontometer. Probing depths, attachment levels and bleeding were measured with a constant force probe. Bone levels were estimated from radiographs. Presence of occlusal contact was noted in the intercuspal position and excursive movements of the mandible. Attachment levels showed the highest correlation with TM, and radiographically estimated bone support was the next highest. Results varied according to tooth type: the attachment level of the lateral incisors showed the highest correlation with TM, while probing depths and proximal bone support showed lower associations with TM in all cases. In this population, no association was detected between the presence of occlusal contact and TM, or between inflammation and TM. Multiple and partial correlation analysis indicated that probing attachment level was the most important correlate of tooth mobility.

Adult↗
PubMed1975

Selection of retainers in lower overlay denture-in relation to the abutment tooth mobility--(a laboratory study).

This study was done to evaluate the art of retaining the lower sub/complete, overlay denture, in relation to the abutment tooth mobility while the force was applied to the denture. The lower overlay denture was placed on a simulated model which was constructed of methylmethacrylate and silicone rubber. The author developed and used the special devices for measuring the tooth mobility. Results obtained were as follows: 1. When a force is applied directly to the abutment, the tooth mobility, i.e. the lateral excursion of the tooth, is markedly reduced according to the favorable ratio of the clinical crown to the root length. Splinting by the bar is effective to reduce the lateral excursion. 2. When a force is applied to the denture indirectly to the abutment tooth, the lateral excursion changes greatly according to the retainer selected. 3. The clasp retainer shows the greatest change in the lateral excursion against every loading on the denture. 4. All three types of bar attachment show the least value of lateral excursion.

Dental Abutments↗
PubMed1979

The effect of splinting on tooth mobility. I. During initial therapy.

The purpose of this study was to assess whether fixed splinting aided in the reduction of posterior tooth mobility during initial therapy. A "split-mouth" approach was used in order to compare splinted segments with similar unsplinted segments. Seven patients were selected, all of whom demonstrated chronic destructive periodontitis and mobile teeth. Initial therapy, consisting of oral hygiene instruction, root curettage and occlusal adjustment, was performed over a 2-week period. At the time of initial therapy, teeth in contralateral segments were splinted with an intracoronal wire-and-acrylic splint. Tooth mobility and gingival inflammation were recorded in all four segments every 3 weeks for a 15-week monitoring period following initial therapy. The splints were removed before each data recording session and then replaced and the occlusion refined. Prophylaxis and oral hygiene instruction were repeated every second week throughout the monitoring period. The reduction in the mobility of teeth splinted during the entire therapy period did not differ from the reduction observed in the unsplinted segments. The reduction in tooth mobility observed in both the splinted and unsplinted segments over the 17-week period can be attributed to the improved occlusal relationships and reduction in inflammation.

Adult↗
PubMed1980

[New control technic for tooth mobility].

The method described, used to establish tooth mobility, is a refinement of the method of Mühlemann, 30 years old. The improvements include a larger sensitivity of the chain of measures, a better stabilizatiin of the intraoral fixatioin of the instruement, the utilization of a retainer on the tooth to be tested, which ensures the precision of the point of forcetesting. This point remains the same for all measurements. Finally, the recording of the test on paper allows for an objective comparison of the course of the case.

Dental Abutments↗
PubMed1978

[Tooth mobility in several age groups with reference to various periodontal diagnostic aspects].

The present study deals with a study of the tooth mobility, the pocket depth and the bone destruction in 616 periodontally healthy subjects. It was found that the mobility of the upper lateral incisor is inferior to that of the central one. Furthermore, relations of age to tooth mobility and bone destruction were established, whereas no relationship between age and pocket depth was evident.

Adult↗
PubMed1989

[Studies on the mechano-electronic measurement of tooth mobility].

The correlations between dynamic and quasi-static mechano-electronic measurements of tooth mobility were investigated in more than 1500 teeth. The two methods correlate quite well with the conventional classification (in Germany). On the other hand, there is no correlation between dynamic and quasistatic mechano-electronic measurements. Nevertheless distinctive signs and periodontal findings could be verified by mechano-electronic evaluation of tooth mobility.

Dental Stress Analysis↗