Arch. oral Biol. Vo1.8, pp.109-118, 1963. Pergamon Press Ltd. Printed in Gt. Britain.

VERTICAL MOVEMENT OF CHEEK TEETH

DURING BITING

D. C. A. PICTON
University College Hospital Dental School,
London, W.C.l, England

Summary-A method is described for studying the vertical mobility of cheek teeth
relative to neighbouring teeth. The transducers of movement consisted of high
compliance wire strain gauges. Biting force was used via a dynamometer containing a
strain gauge. The reliability and limitations of the method are considered in vitro
and in vivo.
The vertical mobility was studied of forty cheek teeth, lower first premolars and
upper first molars in ten young male subjects with sound supporting tissues. The
load/vertical mobility curves revealed a phase of relatively free movement due to
O-300 or 400 g and a phase of less movement as the load increased to 2 kg. Twelve
contralateral pairs of teeth and eight unilateral pairs had similar mobility curves.
A load of 2 kg produced less movement of premolars than of molars.

INTRODUCTION
ONE OF the earliest writers to comment on the significance of physiological tooth
mobility was Fox (1833). He wrote “The alveolar cavities are lined with a vascular
membrane. . . . On this account it is, that the teeth have a certain degree of motion,
which is of great benefit in mastication, thereby preventing that injury which might
arise from concussion consequent on the breaking of hard substances.” Since this
was written no attempt appears to have been made to estimate the character or
amount of movement of a tooth into the socket during biting or chewing. Axial
movements of upper incisors were studied by PARFITT(1960) under force applied
manually. Movements of teeth in the bucco-lingual plane due to manually applied
force have been examined extensively by M~~HLEMANN (1951,196O) and his co-workers
during the last 10 years and SCH&K (1960) described a method of recording tooth
movements in this plane during chewing. The author (1957) reported a method for
measuring vertical tooth movements under biting loads and the present method has
been developed from this device.
During chewing or biting a large fraction of the force must be directed in the
long axis of the tooth and it is the ability of the supporting tissues to withstand this
force which is of prime importance. It was considered of interest, therefore, to devise
a method for studying the displacement of a tooth under known biting loads. It
was hoped that the character and amount of movement obtained from subjects with
normal supporting tissues would form a basis for study of the onset of functional
changes resulting from periodontal disease.
109
110 D. C. A. PICTON

METHOD
The transducer of movement employed a wire resistance strain gauge. A 2OOQ
“Araldite” brand epoxy resin bonded strain gauge was coated with a thin film
of “Araldite” on one surface. After the resin had set the film was checked to ensure
that a uniform thickness of the resin was present. The film formed the equivalent
of a beam and distortion of this caused tension to develop in the strain gauge. One
end of the strain gauge was then cemented to a wedge-shaped perspex backing, while
on to the free end a steel pointer was added. Leads of 0.01 gauge “Lewkanex”
covered wire were soldered to the gauge and insulated with “Araldite”. The transducer
formed one limb of a wheatstone bridge circuit in which changes in potential were
detected by a pen-recorder.
Two transducers of movement were connected to a rubber dam clamp (Ash No. 9)
by means of an adjustable locking device soldered to each wing of the clamp. The
clamp was mounted on a plaster model of the subject’s dental arch and the position
of the transducers was arranged so that the pointers rested on a buccal cusp of the
two adjacent teeth (PICTON, 1962a). To increase the rigidity of the clamp a length
of half-round german-silver wire was soldered at each end to the wings of the clamp.
When the device was inserted in the mouth movement of the test tooth into its
socket, relative to the neighbouring teeth, caused distortion of the strain gauges.
Biting force was applied to the test tooth by means of a dynamometer which was
attached to the opposing teeth with hot impression compound. The bite was propped
open 2.5 cm. The point of application of the dynamometer to the test tooth was
the centre of the buccal cusps of the lower cheek tooth and the centre of the palatal
cusps of the upper cheek teeth. These are sites of maximum attrition so that the
periodontium must be well adjusted to receiving biting force on these cusps. The
dynamometer was calibrated out of the mouth using standard weights.
The transducers of movement were calibrated on a modified dial gauge at open
mouth temperature, i.e. 30-32” C. As an indication of the order of sensitivity 1 TV
displacement produced a deflection of a pen of the chart-recorder of approximately
1 mm. In a series of tests on reliability the transducers were found to be linear
over a range of O-200 p and the signal produced remained stable during a five-hour
test period.
Vertical movement may be considered as the displacement of a tooth in a plane
perpendicular to the occlusal plane. By the following geometric construction it can
be shown that the vertical displacement of a tooth is estimated by taking the mean
of the deflections from the two movement transducers.
Let AlEI represent the distance between the two transducers of movement. The tooth is then
shown as the vertical line PIQ1. When biting force is applied to the tooth it is displaced to a new
position PaQa so that the transducers record a displacement of AlA, and BIB,. Since the angular
deflection relative to the vertical movement will be small the movement recorded at A2 and B, may
be considered as occurring in the vertical plane.
Draw A,2 and Pz Y parallel to A,&
Now A,P, = P,B,
Or A,P2 = P,B,
Thus XY = Y&
Since A&El and PpYBI are similar triangles
 VERTICALMOVEMENTOF CHEEKTEETHDURING BITING III

Then BI Y = [(BIB, - &X)/2] + B,X

= [(BJ* - &4,)/2] + AlAP
Or = [@I& + AA/4
i.e. Vertical movement = average displacement of the two transducers of movement.
If a large angle of tilt is present then A, may have zero displacement and &A, :- 0.
Then vertical movement = transducer displacement/2.
If a still larger angle of tilt is produced then an upward movement will be recorded by one
transducer, i.e. a negative reading.
Then vertical movement = [( +ve reading + --ve reading)/21 - ( ~--ve reading)
i.e. vertical movement = [( +ve reading) - (-ve reading)]/2
Thus if the sign of the reading is observed the three cases may be represented by the general
formula:
Vertical movement = mean of the deflections from the two transducers of movement.
To test this a model was made with the test tooth set in latex, to represent a
periodontal membrane, surrounded by dental plaster. From the apex of the tooth
a wire was suspended. By attaching weights to the wire a thrust was imparted to
the tooth. The apparatus was set up as described with the transducers resting on
two adjacent teeth. The actual movement was measured by a dial gauge in contact
with a cusp of the test tooth. In a series of ten thrusts of 40 p to the tooth the mean
difference between the estimated movement and the actual movement shown by the
dial gauge was 1.2 ~1, s.d.= 61.51.

FIG. I. A geometric construction to explain the method of computing vertical

mobility.

To demonstrate the variation due to the method in vivo tests were carried out
on one lower premolar. Ten consecutive thrusts were made to this tooth and the
vertical movement relative to the adjacent teeth was determined. On another occasion
one thrust was applied to the tooth and the apparatus was then removed from the
mouth. After re-adjustment the device was again inserted in the mouth and a second
thrust was made. This was repeated ten times in all. Finally one thrust was applied
to the tooth on 10 days during a period of 3 weeks. The mean and standard deviation
for these data are given in Table 1.

TABLE I. VARIATION OF VERTICAL MOBILITY IN VIYO (p)

10 thrusts of 2 kg to /S (Subject C.A.)

1. 2. 3.
Consecutive Interrupted On 10 days
x 22.1 15.9 20.2
s.d. ho.48 & 1.91 &4-67
112 D. C. A. hXON

The scatter produced in the first set of ten thrusts was considered to be due to
minor biological variations and minor instrumental changes during the sequence.
The second set of readings probably contained variation due to biological changes
of a similar order to those in the first set, together with an increase in variation
due to repeated positioning of the device. The scatter in the third set of readings
was probably due to an instrumental effect similar to that present in the second set,
and variation due to biological changes in the supporting tissues during the three-
week test period. It would seem that, when estimates from one tooth were made on
different days, biological changes had a greater effect on the results than was pro-
duced by the apparatus. When comparing the mobility of different teeth in the same
individual or teeth from different subjects it would seem probable that the variations
due to the apparatus were appreciably smaller than the variation due to biological
factors.
In the experiment ten male students aged between 20 and 30 years were studied;
they had full dental arches and sound supporting tissues judged clinically. The
vertical mobility of lower first premolars and upper first molars was estimated. All
records were made approximately 30 min following lunch and, when possible,
contralateral pairs of teeth were studied at the same occasion. The device was set
up on a plaster model of the subject’s arch and was then transferred to the test tooth
with minimal adjustment and instrumentation. The cheek and tongue were retracted
and the subject was instructed to bite. No additional instructions were given by the
observer unless the thrust was inadequate in magnitude or outstandingly rapid,
which rendered interpretation of the records difficult. Three thrusts were made to
each tooth. The time interval between thrusts was usually 30 set to 1 min. The
apparatus was then removed from the mouth and calibrated. The amount of vertical
movement was estimated from the records at 100 g intervals up to 2 kg.

RESULTS
The collected data for four subjects are represented graphically in Figs. l-4 as
these subjects were considered representative of the whole group. The three thrusts
were plotted with different symbols to reveal any trend in the amount of movement
with a sequence of thrusts. No progressive change in mobility was evident. For
several teeth there was a close similarity in amount of movement for the three thrusts,
e.g. Fig. 2,4i, Fig. 3, q. Other load/mobility curves show variation between thrusts.
Throughout the whole group of forty teeth there is a general similarity in the
character of the movement. Thus, there was an initial phase of relatively free move-
ment as the load increased to 300 or 400 g. This was followed by a phase of less
movement produced by increase in load up to 2 kg. Individual variation from this
pattern was evident, e.g. Fig. 3, 4/ demonstrated a steep zone of movement due to
O-200 g, while for /4 very little movement was produced with this force though the
final displacement at 2 kg was within 5 p of the movement of ;iT. The tooth which
produced the greatest mobility for the group was Fig. 5, ,‘6.
Inspection of the load/mobility curves showed a similaf’lty in the form and amount
of movement in twelve contralateral pairs of teeth, e.g. Fig. 2, 6J and in eight
 VERTICALMOVEMENTOFCHBEKTEETHDIJRINGBlTING 113

unilateral pairs of teeth, e.g. Fig. 3, $1. Several subjects showed one tooth to be
quite different in the amount of movement from the other teeth, e.g. Fig. 5, 16; no
obvious clinical cause for this was found.
As an indication of the amount and range of movement shown by the premolars
and molars collectively Table 2 gives the vertical movement estimated at 2 kg.

TABLE 2. VERTICAL MOBILITY (IN MICRONS) RELATIVE TO ADJACENT TEETH

Due to 2 kg
3 thrusts per tooth

Tooth $1 12 61 I?
No. of teeth 10 10 ib 10
ji 274 24.7 31.1 34.9
s.d. & 10.19 & 11so2 + 13.56 & 18.19
Range 12543.5 12.0-43.5 14.0-61*0 13.5-69.0

Statistical consideration of these results using Student’s ‘t’ test indicates no

significant difference between the mobility of contralateral pairs of teeth (p > O-05)
or for the unilateral pairs $1. For the pair I$ the molars were more mobile than
the premolars and, when considered together, the molars were more mobile than
the premolars as p> 0.05 in both tests. In an attempt to resolve this observation a
comparison was made of the second phase of movement. M~~HLEMANN (1954)
demonstrated that force above 100 g in the bucco-lingual plane caused elastic
deformation of the socket. On the assumption that a similar elastic mechanism of
support may operate in the vertical plane, the slopes of the regression lines were
calculated, using the method of least squares, for each tooth in the range of load
l-2 kg. By restricting the data to this range of force it was presumed that fluid
displacement from the socket was completed.

TABLE 3. INCREA~EIN MOBILITY WITH INCREASE IN LOAD

l-2 kg. (b*S.E.)

Subject 4 14

M.S. 2.5910.14 1.17AO.16 4.24iO.17 6.69hO.17

J.N. 1.75&@17 1.74kO.11 2.16#09 8.62*0.16
M.H. 6*98&O-28 4.57kO.32 1.9lrtO.19 14.53ztl.26
J.C. 3*64&0.11 4.12*0.22 5.32&0.12 7G3910.31
M.C. 4.09hO.16 7.54hO.88 2.57hO.10 3+7*0*14
S.C. 3.18f0.13 1(,79&090 4.71 *IO.37 5.32.kO.27
I.C. 10.27k2.14 2.15kO.66 5.86kO.49 9~73% 1.24
P.T. 2.36f0.18 8.11&0*20 3.36kO.42 3*16iO18
C.A. 4+54&0*30 0.86.to.10 2.91 LO.10 2.543: 0.08
M.W. 4.56ztO.43 - 1*4610.10

The slope b, i.e. the increase in movement from I to 2 kg, was compared using
Students ‘t’ test, between contralateral groups of premolars and molars and between
molars collectively and premolars. In no case was the difference statistically
significant at the 1: 20 level.
 D. C. A. PICTON

0 1-o 20 0 1.0 2.0

LOAD Kg.

FIG. 2

FIGS. 2-S. Typical vertical mobility curves from four of the subjects. Each point
represents the mean displacement from the mesial and distal transducers of movement
at a given level of biting load. Estimates of mobility were made from three thrusts.
13 = First thrust. . ; Second thrust. 0 == Third thrust.

LOAD ‘9
FIG. 3
 VERTICAL MOVEMENTOF CHEEK TEETHDUR~NG BITrrx3 115

LOAD
FIG. 4

08
40, 08
0.
0
0
30. .
0
q*
O
.__ 20. 0.
0 1.0 2.0
t ",O

‘Oaso
0
I I

1.0
I
a0 0
i.. I..,,’
1.0 2%

LOAD Kg.
FIG. 5
116 D. C. A. PICTON
DISCUSSION
Since the long axis of the majority of teeth is not perpendicular to the occlusal
plane of the intact arch biting must cause a combination of axial displacement and
tilt of a tooth. By estimating the vertical movement the resultant of this combined
displacement was measured. In a previous study (PICTON, 1962a) tilt in the mesi-
odistal plane was found to occur in the majority of cheek teeth, but by using the
algebraic mean of the deflections from the transducers of movement the estimates
of vertical movement were independent of the degree of tilt in this plane. Bucco-
lingual tilt also probably occurred. The point of application of the dynamometer,
i.e. the buccal cusp of the lower teeth and palatal cusp for the upper teeth, was close
to the long axis of the teeth in the bucco-lingual plane. The amount of tilt was
probably small and therefore would have had little effect on the readings from the
transducers. Marked alteration in direction of thrust caused the dynamometer to
slip off the test tooth. Slip of the clamp on the test tooth was discounted as a sudden
and persisting change in the base-line of the transducers was immediately evident.
In the previous study (PICTON,1962a) biting force to posterior cheek teeth was found
to cause forward tilting of more anterior teeth and as the mesial transducer of
movement, in the present tests, rested on the neighbouring anterior tooth this
reference point was probably displaced during the thrust. It must be emphasized,
therefore, that all measurements of vertical mobility were made relative to the
adjacent teeth and were not absolute. PARFITT(1960) used the adjacent incisor as
the reference point and preloaded this tooth with a force of 100 g. This manoeuvre
reduced the displacement of the reference tooth during the thrust to the test tooth
but may have also displaced the test tooth from the rest position prior to the thrust.
The estimates of mobility made by M~~HLEMANN (1954) employed a group of teeth
on the contralateral side as the reference point and this appears to be a more stable
arrangement. However, distortion of the jaws with muscular exercises was demon-
strated by JUNG (1952), MCDOWELLand REGLI (1961) and with biting force (PICTON,
1962b). The problem of a “fixed” reference point remains unanswered, therefore.
M~~HLEMANN (1951) and PARFITT(1960) found that there was an initial phase of
relatively free movement followed by a phase of less movement as the force increased.
An abrupt change was noted by M~~HLEMANN at 100 g, but PARFITTdescribed a
transition of logarithmic form from the first to the second phase.
The general character of the load/vertical mobility curves in the present study
conformed to this pattern of two phases but the initial phase, for the majority of
teeth, extended over the range O-300 or 400 g. Comparing the amount of movement
of teeth into their sockets PARFITT found variation in axial mobility of incisors
during the day and between successive thrusts but for one upper central incisor the
mean displacement at 1 kg for 500 thrusts was 28 ~1. This estimate is clearly of the
same order as the movement recorded in the present experiment for cheek teeth.
As the root surface area of the molars was substantially greater than for the
premolars it was expected that, under the same force, premolars would be more
mobile since they were supported by fewer fibres and a smaller volume of bone. In
the bucco-lingual plane M~~HLEMANN (1961) found that multi-rooted teeth were less
 VERTICAL MOVEMENT OE CHEEK TEETH DURING BITING 117

mobile than single rooted teeth. At 2 kg, however, the vertical mobility of the molars
in the present study was significantly greater than for the premolars. Since no
significant difference was shown in the slope of the regression lines for the molars
and premolars over the range l-2 kg the difference at 2 kg was probably due to a
greater amount of movement in the range O-l kg. Movement due to the first few
hundred grams was shown by M~~HLEMANN (1954)and PARFI-IT (1960) to be associated
with fluid displacement from the socket. In consequence the rate of thrust may have
affected the character and amount of movement in the present study. Other contri-
butory factors may have been the difference in volume of the periodontal membrane
for the molars and premolars and the point of application of the biting force relative
to the axis of movement.

CONCLUSIONS
The method of measuring tooth mobility proved robust and reliable in the series
of forty teeth. Preliminary adjustment of the transducers of movement on a plaster
model of the subjects’ dental arch enabled records to be made with minimal dis-
placement of the test tooth and reference teeth. It was considered that a satisfactory
estimate of vertical movement was obtained by using two transducers of movement
directed mesially and distally and by taking the mean of the recorded deflections.
The dynamometer proved a satisfactory method of recording biting load of up
to 2 kg applied to a cusp of the test tooth. Biological variation was thought to
account for a greater range in mobility estimates at 2 kg during a three week period
when compared with ten separate estimates on the same day.
The load/vertical mobility curves for forty cheek teeth showed some features
in common with findings of previous workers. The initial phase of movement,
however, extended over a larger range of load. In spite of variations due to biological
effects a similarity was found in the curves for twelve contralateral pairs of teeth,
indicating that the mechanism for resisting biting forces was developed equally on
each side of the arch in these subjects. Eight unilateral pairs of teeth had similar
mobility, suggesting that the supporting tissues of these premolars and molars
behaved in a similar way under the same load although alveolar and root surface
area were distinctly greater for the molars.
Considered collectively contralateral pairs of teeth moved a similar amount under
a load of 2 kg and premolars moved significantly less than molars. This observation
was thought to be due to the differences in amount of movement due to load below
1 kg. Further study is needed with more precisely controlled conditions of the rate
and direction of thrust before this observation can be explained.

Acknowledgements-This study has been carried out during the tenure of a

Nuffield Research Fellowship and I am indebted to the Trustees of the Foundation.
The work reported formed part of a thesis submitted for the degree of Ph.D. at
the University of London. I would like to thank Professor A. S. PROPHET for
provision of facilities and encouragement during supervision at University College
Hospital Dental School; Dr. D. J. ANDERSON for his help and advice and Dr. 1.
118 D. C. A. PICTON
MACDONALDfor statistical advice at Guy’s Hospital Medical School: Mr. G. BRYANT
of the Electronics Department, University College Hospital Medical School, and,
for their generous co-operation, the subjects from University College Hospital Dental
School.

REFERENCES
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JUNG, F. 1952. Die Elastizitat der Skeletteile des Gebissystems. Stoma. 5, 74-85.
MCDOWALL, J. A. and REGLI, C. P. 1961. A quantitative analysis of the decrease in width of the
mandible during forced movements of the mandible. J. dent. Res. 40, 1183-l 185.
MUHLEMANN,H. R. 1951. A method of measuring tooth mobility. Oral Surg. 4, 1220-1234.
M~~HLEMANN, H. R. 1954. The mechanism of tooth mobility. J. Periodont. 25, 128-135.
MUHLEMANN,H. R. 1960. Ten years of tooth mobility measurements. J. Periodont. 31, 110-I 18.
PARFITT, G. 1960. Measurement of the physiological mobility of individual teeth in an axial
direction. J. dent. Res. 39, 608-618.
F’ICTON,D. C. A. 1957. A method of measuring physiologic tooth movements in man. J. dent.
Res. 36, 814 (Abstract).
PICTON, D. C. A. (1962a). Tilting of teeth during biting. Arch. oral Biol. 7, 151-159.
PICTON,D. C. A. (1962b). Bending of the jaws with biting. Arch. oral Biol. 7, 573-580
SCH~HL, H. 1960. Measurement of tooth mobility in functional movement. Zahniirztl. Z. 15,
1185-1192.