The periodontal enigma: eruption versus tooth support.

The response of the periodontal ligament is reviewed when single or repeated loads are applied to the tooth, as in mastication. A more nearly elastic recovery is produced with simulated chewing than is indicated by single semi-static applications of force. The resting position of the tooth between loadings changes with the time of day and recent loading history. An unstressed tooth extrudes at a variable rate. Soon after entry into the mouth, extrusion is a progressive feature, which manifests as eruption with consequent structural rearrangement of the periodontium. Rates of extrustion are substantially higher than eruption. Experimental evidence is presented that newly erupted teeth of monkey erupt in a similar manner to rodent incisors. Thus reduction in masticatory loads allows teeth to erupt faster than control teeth. It is concluded that the ligament is well constructed to withstand the large but short-acting forces which occur in mastication and which cause relatively small, long term effects, on the position of the tooth in the alveolus. When unstressed, mechanisms in the ligament of a tooth with a developing or fully formed root, generate a continuous net force in the order of a gram tending to cause extrusion. The position a tooth adopts is determined by the interplay of these opposing sets of greatly differing forces.