Biological aspects of bone growth and metabolism in orthodontics

James K. Hartsfield, Priyanka Gudsoorkar, Lorri A. Morford, W. Eugene Roberts

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


Understanding the mechanisms of bone growth and craniofacial development, as well as recognizing the processes of bone modeling versus remodeling, are key to the practice of orthodontics and dentofacial orthopedics. Although bone manipulation is important to most aspects of dentistry, orthodontists are craniofacial bone specialists. As such, a thorough understanding of these principles and their application to the individual patient will not only aid in generating an esthetically appealing result and stable clinical outcome, but also may enhance the success of a multidisciplinary case. This chapter reviews the basic concepts of bone growth and development with references for further reading. Fundamental to understanding these concepts is the section on bone formation that describes both endochondral bone formation and intramembranous bone formation in detail. The focus then shifts into a discussion of the primary growth centers and sites within the facial bones and introduces the concepts of bone modeling and remodeling. Unfortunately, dental professionals have often used the terms "modeling" and "remodeling" with a different meaning than typically employed by other professionals in medical research and clinical practice. Hence, a discussion of the terms modeling (changes in the shape, size, or position of bone) and remodeling (bone turnover) has been included. In the second half of the chapter, genetic mechanisms for the adaptation of bone to environmental factors are reviewed through a discussion of the importance of vascular invasion, inflammatory response, and cellular agents in bone growth and development. More detail on the understanding of remodeling, the coupling of bone formation to resorption in bone remodeling, and metabolic control of bone remodeling are then discussed. Of interest to the orthodontist are the mechanical aspects of bone modeling, cortical bone remodeling, and trabecular bone remodeling. The section which follows highlights elements of growth and development of facial bones, including temporomandibular joint development and mature temporomandibular joint adaptation that are of importance in gnathology. The relationship of tooth movement, bone modeling and external apical root resorption concurrent with orthodontia are pertinent to the orthodontist and are reviewed at the end of the chapter, as is the topic of dental facial orthopedics and bone modeling because of its importance in any discussion of functional appliances.

Original languageEnglish
Title of host publicationBiological Mechanisms of Tooth Movement
Number of pages23
ISBN (Electronic)9781119608912
StatePublished - Mar 10 2021

Bibliographical note

Publisher Copyright:
© 2021 John Wiley & Sons Ltd. All rights reserved.


  • Biomechanics
  • Bone growth
  • Bone modeling
  • Cortical bone remodeling
  • Mature temporomandibular joint adaptation
  • Metabolism
  • Orthodontists
  • Temporomandibular joint development
  • Tooth movement
  • Trabecular bone remodeling

ASJC Scopus subject areas

  • General Dentistry


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