Tooth mobility – the need for teeth immobilization

Dental mobility is the degree of freedom teeth have in the tooth socket.

Normally, the tooth does not remain rigidly fixed in the dental socket, a small mobility of the order of millimeters is physiological, which allows it to better adapt to masticatory demands.

Physiological tooth mobility is almost impossible for the patient to perceive, but when the patient experiences tooth mobility, it is always pathological tooth mobility.

Pathological mobility occurs when changes occur in the tooth’s supporting structures, i.e. bone and ligaments, that are incompatible with the state of health.

Structures that play a role in keeping teeth in their sockets often undergo inflammatory processes which, left unchecked and untreated in time, lead to their deterioration.

Periodontitis or periodontal disease is a condition of the bone marked by resorption and atrophy of the bone due to loss of minerals. All periodontitis begins with gingivitis.

Due to the considerable deposition of bacterial plaque in the hard and soft structures of the oral cavity, without proper hygiene, the inflammation produced in the gums progresses to the deeper structures, i.e. ligaments and bone. When the bone is affected, dental mobility is noticeable by the patient.

The patient may also notice that the size of dental crowns is increased, based on gingival retraction. Teeth appear elongated and interdental black spaces appear due to retraction of the dental papilla.

Tooth retention is a method of keeping the teeth on the arch for as long as possible and is aimed at teeth with a certain degree of mobility.

In order to hold them together, they are bonded by means of immobilization systems, thus creating a block that will be able to resist forces that have the potential to worsen the clinical situation.

Immobilization systems are applied prior to therapeutic procedures or after the completion of drug treatment to suppress or reduce the bacterial gradient on the tooth surfaces.

Immobilization should precede surgery in cases of very high mobility to avoid trauma to the marginal periodontium, the vascular nerve bundle or accidental tooth extraction.

Conditions

The requirements for an immobilization system are as follows:

• It must not aggravate existing pathology and during mastication it must not generate stronger and more dangerous forces on ligament integrity.

• It must not damage the temporomandibular joint – through the teeth and muscles, the temporomandibular joint acts as a buffer, a shock absorber for occlusal forces. Poor alignment of the dental units can cause harmful forces that affect the health of the joint.

• Allow efficient cleaning of teeth

• When applying immobilization systems, the sacrifice of hard tooth substance should be kept to a minimum so as not to jeopardize the strength of the teeth.

• Not be harmful to the marginal periodontium or surrounding soft tissue – immobilizers should not cause damage to the surfaces they come into contact with, so as not to increase inflammation or open new portals for bacteria to enter the tissues.

The doctor will decide which immobilization system will suit the case and monitor the patient’s progress.