American

Journal
of

ORTHODONTICS
(411

VOL. 38

Tights

AUGUST, 1952

Original
PRESSURE

TtWTVed)

HABITS,

Articles

ETIOLOGICAL

ERNEST T. KLEIN,

No. 8

FACTORS

IN MALOCCLUSION

D.D.S., DENVER, COLO.

HERE is no tissue in the human body which the orthodontist should know
and understand more intelligently
than living bone. Although
living bone
feels hard and rigid to the touch of the hand, it is the most plastic structure in
l.he whole organic complex and should be so considered by the orthodontist. I
Bone is an ever-changing tissue that constantly is being repaired and replaced from infancy to old age. Siche? tells us that, although bones are permanent structures in our bodies and although we have no more bone at any part
of our bodies than is reasonably needed plus a certain amount for marginal
safety, constant daily repair goes on just as it does in our famous cathedrals.
Scaffolds always can be seen on the sides of these cathedrals where workmen
are replacing defective stones with solid ones, so that the structure is in constant
repair. In like manner, bone constantly is being repaired and replaced. Sicher
believes that one cannot grow or destroy bone but merely stimulate it. He says
t.hat bone never grows under pressure but that cartilage grows under pressure
and, in turn, is replaced by bone. Sir Arthur Keith declares, Osteoblasts at
all times build or unbuild according to the stress to which they are subjected.
On the other hand WolfY believed that pressure, not tension, is the cause of bone
development.
The amount of growth in bone depends upon the need for it.
Although bone is extremely susceptible to the guidance and influence of
pressure and stimulus, the extent to which bone can be changed with pressure
or stimulus is controversial.
Conservative authorities on bone growth believe
that orthodontic treatment (intentional pressure) cannot change basal bone ; due
to the hereditary factor, the pattern of the basal bone remains the same. However, even the most conservative group will agree that alveolar bone can be
changed and the teeth in that bone regulated with orthodontic treatment.
Pressure habits (unintentional
pressures) also change alveolar bone and move teeth
in that bone because the bone-building cells on the receiving end of the stimulus
cannot differentiate whether that stimulus is intentional
(planned orthodontic
treatment)
or whether it is unintentional
(abnormal pressure habit).
Since
changes take place in the bone whether the stimulating factor is intentional or
unintentional,
one cannot deny pressure habits as an etiological factor in mal-Head before the Rocky Mountain Society of Orthodontists, Nov. 6. 1951.
569