Biophysical Reviews (2023) 15:35–41

https://doi.org/10.1007/s12551-023-01042-z

REVIEW

The center of resistance of a tooth: a review of the literature

Reene Mary Kuruthukulam1 · Amol Somaji Patil1

Received: 18 May 2022 / Accepted: 5 January 2023 / Published online: 17 January 2023
© International Union for Pure and Applied Biophysics (IUPAB) and Springer-Verlag GmbH Germany, part of Springer Nature 2023

Abstract
The center of resistance is considered the fundamental reference point for controlled tooth movement. Accurate determina-
tion of its location can greatly enhance the efficiency of orthodontic treatment. The purpose of this review was to analyse the
scientific literature related to the location of center of resistance of tooth determined by various approaches. The literature
describes three essential approaches to identify the center of resistance point, one being experimental in nature, one based
on an analytical physical approach, and one using a numerical physical approach that uses a finite element simulation. A
review on data referring to the location of the center of resistance, limited to single rooted tooth has been performed from
electronic databases. It showed variation in its location related to the assumptions used in the model. The center of resistance
of tooth therefore cannot be considered a static point, but rather as the composite point of all factors offering resistance to
the applied force such as the tooth morphology and mass distribution within the tooth, the structure of the periodontium, the
alveolar bone level, the adjacent teeth and direction of force applied.

Keywords Center of resistance · Orthodontic tooth movement · Translation · Bodily movement · Literature review

Introduction single rooted tooth, Fish concluded that, when a horizontal

Orthodontic treatment aims at correction of malocclusion of
teeth. When applying different forces to a tooth, proper control
of its movement is necessary to assure efficiency in clinical
orthodontics (Geiger and Lapatki 2014). Orthodontists consider
the relationship of the force vector to the center of resistance
(CRes) of a tooth or a group of teeth for the orthodontic correc-
tion of teeth. Indeed, whether an object will display a tipping or
a bodily movement when a single force is applied is determined
by the location of its CRes and the distance between the force
applied and this CRes (Burstone 1962) (Fig. 1).
Center of resistance
The concept of CRes was introduced into dental science
from the field of mechanics of rigid bodies by Fish in the
year 1917 (Fish 1917). Analysing the tooth movement of a
* Amol Somaji Patil
amolp66@yahoo.com
1
Department of Orthodontics and Dentofacial Orthopaedics,
Bharati Vidyapeeth Dental College and Hospital, Pune,
Maharashtra, India
force is applied, there is a point, somewhere between the
apex and the alveolar crest, such that if the force be applied
through that point, there will be bodily movement of the
tooth. This point may be called the CRes. It was thought
to be between the alveolar crest and the point halfway to
the apex (Fish 1917). When a force is applied to a body,
its nature of movement is regulated to a large extent by its
center of mass. The center of mass of a body is that point
at which all the body’s mass seems to be concentrated. The
concept of the CRes of a tooth is analogous to the concept
of the center of mass of a free body. The term center of
gravity is used rather than the center of mass, when a body
is restrained by the force of gravity. Besides gravity, teeth
are also restrained by periodontium around it. Therefore,
a force applied through the center of mass or the center of
gravity will not result in translation of the tooth as the sur-
rounding structures alter this point. Hence force should be
applied through a new point, analogous to the center of grav-
ity, called the CRes of tooth (Nanda 2015).
The CRes has been defined as the point of the greatest
resistance to the movement of a tooth (Mulligan 1979). It is
also defined as the point that results in a bodily movement
of tooth without exhibiting a rotational tendency, when the

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Vol.:(0123456789)
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Fig. 1  CRes shown as a red dot.
a A force acting through the
CRes results in bodily move-
ment of tooth. b A force acting
away from the CRes results in
tipping of tooth
force vector, regardless of its direction, passes through it
(Smith and Burstone 1984).
Location of the CRes of a tooth
Accurate force application requires knowledge of the loca-
tion of the CRes of tooth. Various attempts have been made
to assess the location of teeths’ CRes by different methods.
The literature describes basically three approaches to iden-
tify the CRes point, one being experimental in nature, one
based on the application of an analytical physical approach,
and one based on a numerical physics approach conducted
using finite element simulations.
Analytical physical approach
for determination of CRes
The applied orthodontic forces can be treated mathemati-
cally as vectors. In 1962, Burstone introduced the concept of
CRes to be applied in orthodontic treatment. He considered
the root shape of a single-rooted tooth to be similar to that
of a parabola, and the CRes or centroid of this geometric
form to be at a point 40% of the distance measured from the
alveolar crest to the apex of the root (Fig. 2). He assumed
the tooth to be in equilibrium and the stress distribution to
be uniform along the root. He corrected this value to 33%
of the root length when the model was assumed to possess
a tridimensional geometry. In this study, the centroid of a
three-dimensional paraboloid of revolution was consid-
ered (Christiansen and Burstone 1969, Pryputniewicz and
Burstone 1979).
Davidian obtained similar results by the use of a related
mathematical approach on a computer model of the root
13
Biophysical Reviews (2023) 15:35–41
Fig. 2  The centroid of the area
under a parabola is located at
40% of the height, closer to the
base
of a tooth (Davidian 1971). He found that the theoretical
momentary center of rotation was about 50% and the CRes
was about 60% of the way from the apex to the alveolar
crest when an external force was applied to the tooth. The
CRes of tooth was considered to be that point where the
center of rotation would be at infinity. The CRes ranged from
56 to 61% of the distance from the tooth apex to alveolar
crest (Davidian 1971). A slightly different two-dimensional
(2D) mathematical method adopted by Geiger and Lapatki
wherein the 3D morphological data from three maxillary
central incisors were projected to a plane with predefined
coordinate reference system. The CRes was determined by
locating the centroid of the projected 2D model. The relative
CRes level was found to be at 43.3% between the ridge mar-
gin and the apex of the tooth when measured from the alveo-
lar ridge (Geiger and Lapatki 2014). Osipenko et al. showed
that the CRes of a tooth exists only in three-dimensions (3D)
under certain specific circumstances as he could prove the
existence of a CRes point only for a tooth and periodontal
Biophysical Reviews (2023) 15:35–41 37

system with axial symmetry (Osipenko et al. 1999). Similar Fig. 3  The 2D tooth model
findings were given by Dathe (2013). with tapered root shape used
by Nikolai for determination of
Attempts to determine the CRes by the use of analyti- CRes of tooth
cal theory are limited by a number of required simplify-
ing assumptions, such as the anatomy of the root, PDL and
alveolar bone, which were represented by idealized geomet-
ric forms; the physical properties of the PDL were assumed
to be homogeneous, isotropic and linear, whereas these are
actually nonhomogeneous, anisotropic and nonlinear (Toms
et al. 2002, Yoshida et al. 2001b). Even though a single point
CRes in 3D is a special case under specific circumstances,
the concept of CRes is both clinically useful and valid if we
consider it as a region and not as a specific point.

Experimental approach to the determination

of CRes

The location of CRes has been determined experimentally

by optical (Burstone and Pryputniewicz 1980, Vanden Bul-
cke et al. 1987), magnetic (Yoshida 2000) or mechanical
means (Nikolai 1974), via application of defined forces or
moments. Haack and Weinstein observed on a 2D model of
a maxillary incisor that the CRes of a single-rooted tooth to
be at approximately 50% of the distance from apex to the
alveolar crest. The 2D tooth model used for the study had
its root area covered by a rigid model of alveolar process,
with an intervening layer of elastic foam sponge between
root and alveolar process representing PDL. The CRes
was determined by applying posteriorly directed force plus
moment via a bracket placed on the labial surface of crown
and assessing variation in the thickness of the foam sponge
PDL (Haack and Weinstein 1963). Nikolai published simi-
lar results using a 2D computer model of maxillary central
incisor. It was assumed that crown loading induced a state
of uniform stress throughout the tapered PDL. In the labial-
lingual plane along the long axis, a transverse force (2Fo)
and a couple (2Co) comprised the crown loading. From the
load ratio for the bodily movement, the CRes was found to
be located approximately halfway up the root from the apex
along the long axis (Nikolai 1974) (Fig. 3)
Burstone and Pryputniewicz, using laser holography on a
3D model of the maxillary central incisor with a paraboloid
root shape embedded in a viscoelastic material, representing
a uniform thick PDL, found that the CRes was at a point 33%
from the alveolar crest to the apex. The root of 3D model
tooth was made from solid aluminium and the alveolar bone
from dental stone with a PDL modelled from viscoelastic
silicone rubber. The CRes was determined by applying a
labiolingual force along the long axis and varying the point
of force application in an occluso-apical direction until bod-
ily movement was obtained. The experimental CRes was
found to be 9.9 mm apical to the bracket (Burstone and
Pryputniewicz 1980). Similar findings were given by Ped-
ersen et al. using an experimental brass paraboloid model
simulating a maxillary central incisor surrounded by a uni-
form thick silicone rubber, representing PDL (Pedersen et al.
1990).
Nagerl et al., using a human upper canine tooth embedded
in a soft plastic material simulating the PDL, have reported
the location of CRes to be ranging from 27 to 42% from
the alveolar crest. The CRes of tooth was determined by
measuring its displacement after a computer integrated and
controlled application of the forces and torques. The average
location of the CRes was 6.7 mm from the alveolar crest,
which was 34% of the root measured from the alveolar crest
(Nagerl et al. 1991). Halazonetis developed a 2D computer
model of the upper central incisor according to dimensions
given by Wheeler (1965) with an isotropic PDL and found
its CRes to be at a height of 42% the root length, at its mid-
dle, measured from the alveolar crest to the apex (Halazone-
tis 1996), whereas Sia et al. found the in vivo location of
CRes of maxillary central incisor to be approximately at 77%
of the root length measured from the apex. The CRes was

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determined on three human subjects by applying a horizontal
retraction force at various heights and the tooth displace-
ments were measured using a magnetic sensor device. The
location of the CRes of the incisor was found to be at 0.77
of the root length from the apex (Sia et al. 2007).
Experimental studies that determined CRes of teeth have
yielded unreliable results as the displacement of tooth was
measured only along one axis even when the force applied
produced 3D displacement of tooth; the experimental appa-
ratuses used in vivo was invasive and could have influenced
the orthodontic tooth movement; various materials that
were used to simulate PDL had properties different from
the actual PDL (Cattaneo et al. 2005, Yoshida et al. 2001b).
Numerical physics‑based approach based
on finite element modelling (FEM)
The finite element method was introduced into biomechani-
cal dental research in 1973 (Farah et al. 1973). Finite ele-
ment modelling (FEM) is a computational method that can
be used to analyse the effects of external forces over objects
such as artificial hard tissues and human anatomical struc-
tures (Cattaneo et al. 2008) by discretizing the system into
a number of individual polygonal plane sections (Fig. 4).
Tanne et al. determined the CRes of an upper central inci-
sor model, based on dimensions given by Wheeler (Wheeler
1965), to be at 24% of the root length, when measured from
the alveolar crest by using finite element method. All the
materials in the analysis were assumed to be isotropic and
linearly elastic. The position of the center of resistance was
found to be at 3.14 mm measured apically from the alveo-
lar crest. He had suggested that the more coronally located
CRes of the tooth, as compared to other studies, was due
to the anatomic shape of the root in the study. It was not an
idealized paraboloid of revolution but an actual root shape,
Fig. 4  The complex geometries can be subdivided or discretized into
smaller “elements” of finite dimensions
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Biophysical Reviews (2023) 15:35–41
and the dipping of the alveolar crest toward the occlusal
level varied at the mesial and distal aspects of the tooth and
the width of the PDL was not uniform. If a parabola (2D) is
compared with a paraboloid of revolution (3D), the geomet-
ric center (centroid) is found on root at a distance of 40% and
33% from the alveolar crest, respectively; suggesting that
2D models tend to place the CRes too far apically (Tanne
et al. 1988).
Provatidis (1999) determined the position of CRes of
maxillary canine with 18mm long root to be at 38.9% of
the root length and that of maxillary incisors with 13.06mm
long root to be at 36.5% of root length measured from the
alveolar crest. According to this study (Provatidis 1999),
this difference from previous studies was because of the dif-
ference in material properties of PDL that was considered.
Also, if a linear-elastic material had been used to imitate
the PDL of thickness 2.29 mm and 2.0 mm, the CRes would
have been found close to 36.5 and 38.0%, respectively, and
not at 33% (Provatidis 1999).
According to the above analysis, the 3D FEM compu-
tations do not generally lead to a CRes near the centroid
(33%). A finite element computer model of an anatomic inci-
sor with a linearly elastic PDL is quite different from the
paraboloidal model supported by viscoelastic material. This
analysis proves that the CRes is not generally found at 40%,
as was shown by Davidian (1971) or Halazonatis (1996).
However, in case of a longer canine, the CRes is closer to
40% than the case of a shorter incisor. In 2D FEM analysis,
on the basis of constant tooth thickness, Matsuura locates the
CRes of a canine tooth during retraction, even more apically,
around 50 to 52% (Matsuura 1984), whereas Geramy (2000)
using FEM determined the CRes of upper incisor modelled
according to Ash dental anatomy (Ash 1984) to be at 38.5%
of root length measured from alveolar crest to apex. The
CRes location was found to lie at approximately 5mm apical
to alveolar crest for a root length of 13mm. Similar results
were obtained by Vollmer et al. (1999).
Meyer et al. provided estimates that were consistent with
most previously reported CRes locations—34 to 64% of root
length measured from the alveolar crest but the results also
show a statistically significant difference between the loca-
tions of CRes in the buccolingual (BL) and mesiodistal (MD)
directions (Meyer et al. 2010). He determined the CRes of
six mandibular central incisors of dogs using finite element
approach after scanning them along with their supporting tis-
sues (PDL and alveolar bone). The average location of CRes
(46% of root length from the alveolar crest) for BL movement
was more apical than its mesiodistal MD counterpart (38%).
The variations in the locations of CRes in thetwo directions
is most likely because the root is wider in the BL direction
than in the MD direction (Meyer et al. 2010).
Schepdael et al. determined the CRes of a maxillary cen-
tral incisor to be at 35% of the root length, measured from
Biophysical Reviews (2023) 15:35–41
the alveolar crest (Schepdael et al. 2013). They found the
CRes location to be at 8.43mm from the alveolar crest for
a root of 13mm length. Geiger and Lapatki found the CRes
location of maxillary central incisor to be at 45% of root
length for distal translation and 51.1% for lingual translation
when measured from the alveolar crest to apex (Geiger and
Lapatki 2014). Jiang et al. calculated the average location
of CRes of maxillary canine tooth to be at 60.2% measured
from the root’s apex in the MD direction and 58.4% in the
BL direction for an average root length of 16.5+/−1.7 mm.
Finite element models of the canines and their surrounding
tissues were obtained for determination of CRes from max-
illary cone-beam computed tomography (CBCT) scans of
18 patients. The PDL was modelled as 0.2 mm thick, fiber
reinforced matrix (Jiang et al. 2016).
The complexity of tissue composition of the dental region
does, however, set limitations on the validity of the results
of many of these studies. The transferring of load from the
tooth through the PDL to the alveolar bone depends on the
mechanical properties and the structure of the periodontium
(Cattaneo et al. 2009). The choice of simulation of these
parameters determines the results of FEM analysis (Cattaneo
et al. 2005). A limitation of FEM study is the assumption of
homogenous, isotropic and linearly elastic behaviour of PDL
when it is actually nonlinear viscoelastic in nature (Cattaneo
et al. 2008).
Factors influencing CRes of the tooth
The effects of orthodontic force application on a tooth in
its alveolus depends not only on its own characteristics
(anatomy, form and so forth) but also of the characteristics
of the constraining elements (PDL, alveolar bone, connec-
tive tissue) (Kusy and Tulloch 1986, Pedersen et al. 1991,
Choy et al. 2000, Cattaneo et al. 2009). Many studies con-
firmed that the location of the CRes can be influenced by the
surrounding alveolar bone support, root morphology, PDL
thickness, the biomechanical properties of the tissues, and
also the teeth inclination (Kusy and Tulloch 1986, Pedersen
et al. 1991, Choy et al. 2000, Cattaneo et al. 2009, Geramy
et al. 2014).
Kusy and Tulloch (1986) reported that as the root
length increased and alveolar bone height decreased, the
CRes shifted to an apical position, which is in accord-
ance with the findings of Pedersen et al. (1991) and Choy
et al. (2000). The CRes shifted 1.3 mm apically with a root
length increase of 50% and the CRes shifted 4 mm apically
with an alveolar bone height decrease of 50% according to
Tanne et al. (1991). Choy et al. found that the location of
the CRes does not remain a constant even when the width
and length of the root was kept a constant. It was affected
by the anatomic shape and form of the root (Choy et al.
39
2000). The location of CRes of the tooth shifted coronally
with an increase in root taper (Choy et al. 2000). Also, as
the root length was reduced, the CRes moved coronally as
in case of root resorption (Kusy and Tulloch 1986, Ped-
ersen et al. 1991, Choy et al. 2000). Thus, it is of clinical
significance to apply optimal force for patients with altered
crown-to-root ratios (Cattaneo et al., 2009).
An investigation by Geramy et al. showed that by increas-
ing an incisors’ inclination, the CRes of anterior teeth moved
to an apical position; but it was noticed that this apical shift-
ing continued only until a certain inclination after which the
CRes moved to an incisal position. In a sagittal dimension,
the CRes shifted to a posterior position when the incisors’
inclination was increased (Geramy et al. 2014). Thus, labio-
lingual inclination of tooth should have been considered dur-
ing retraction in previous studies. In clinical scenario, the
anterior teeth are either inclined labially or lingually, and the
labial and palatal bone levels also vary with respect to the line
of horizontal force application (Tian et al. 2015).
The CRes of tooth was also located in different occlu-
soapical positions, depending on the direction of the force
applied (Melsen et al. 2007). Schmidt et al. observed a slight
difference in the position of CRes depending on the direc-
tion of force applied. In BL direction the CRes was found to
be 0.04–0.42 mm closer to the force application point than
the CRes in MD direction (Schmidt et al. 2016). Thus, the
location of CRes cannot be considered a static point, inde-
pendent of the direction of force application, for a tooth in
its alveolus. As the PDL is non-linear with an asymmetric
material behaviour the applied force level also has an impact
on its location (Nagerl et al. 1991). Most of these influencing
factors also show high interindividual variability.
Yoshida et al. found a relation between the location of
the CRes and the palatal alveolar bone height and not on
the labial alveolar bone height during anterior tooth retrac-
tion due to the variation of the marginal bone level on the
palatal side (Yoshida et al. 2001a). The distances meas-
ured from the incisal edge to the labial alveolar crest were
nearly the same between the patients observed. In cases of
reduced palatal alveolar bone height, the CRes was found to
be located at a more apical position (Yoshida et al. 2001a).
Vanden Bulcke et al. stated that structural and spatial rela-
tionships of the dentofacial structures vary among subjects
and this may affect the CRes location. It is stated that bone,
root anatomy and PDL morphology might affect the location
of the CRes in vivo (Vanden Bulcke et al. 1987).
Conclusions
Studies in this field show substantial disagreement between
the various approaches of determination of CRes of tooth.
The differing results between studies are most likely due
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40
to the assumptions used in each model of study. Mathe-
matical approaches using simple geometries with uniform
physical and mechanical properties have been developed,
but the dentofacial structures are known to be have more
complex geometry. The experimental studies had also used
simplified models compared to actual anatomical struc-
tures. The mechanical properties of substitutional material
used to simulate the PDL during in vitro studies might not
reflect the actual physical distortion of the periodontium
during force application (Cattaneo et al. 2005). Similarly,
the results of experimental models are highly dependent on
the give results according to the properties of the elastic
material that was used to simulate the PDL. Even though
the finite element analysis had tried to an extent to over-
come these problems by dividing complex geometrical
structures into finite elements to better simulate the actual
clinical situation, the mechanical behaviour of PDL and
bone was assigned to be uniform and linearly elastic. These
basic assumptions for simulation when the bone and PDL
are known to be nonlinearly elastic might have influenced
the results of FEM studies. Yoshida et al. believed that the
variations in the location of CRes in each method resulted
from differences in the properties of the periodontal tissues
in each model (Yoshida et al. 2001a). In vivo studies have
mainly focused on the location of the center of rotation.
Thus, in vivo studies on the location of the CRes are still
lacking (Pedersen et al. 1991, Vanden Bulcke et al. 1987).
Taking the individual variations of root geometry into
account, it is difficult to define a specific point in the tooth
as the CRes. The CRes should not therefore be regarded
as a fixed point within a tooth, but rather as the composite
point of all factors offering resistance to force application.
Analysis of the CRes should therefore take into considera-
tion, the tooth morphology and mass distribution within
the tooth, the structure of the periodontal attachments, the
alveolar bone level, the adjacent teeth and direction of
force applied. The determination of the CRes location for
each subject with consideration of alveolar bone support,
root morphology and tooth inclination would be more reli-
able (Kusy and Tulloch 1986, Pedersen et al. 1991, Choy
et al. 2000, Cattaneo et al. 2009, Geramy et al. 2014).
The axes of resistance can vary during the course of
orthodontic tooth movement as the PDL, root and alveolar
bone are subjected to constant remodelling. Hence, the
clinician should not consider the position of the CRes as
a static point but should determine the CRes based on
scientific literature and then continually correct the force
system, depending on the movement that was achieved
during treatment.
Author contribution Amol Somaji Patil contributed to the study con-
ception and design. Data collection and drafting the manuscript were
13
Biophysical Reviews (2023) 15:35–41
performed by Reene Mary Kuruthukulam. Both the authors read and
approved the final manuscript.
Declarations
Ethics approval Not applicable.
Consent to participate Not applicable.
Consent for publication Not applicable.
Competing interests The authors declare no competing interests.
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