When a tooth has been out of function for an extended period, it can experience changes in the periodontal ligament that supports it. The periodontal ligament is a fibrous connective tissue that connects the tooth to the bone and allows for a certain degree of movement. This movement is essential for the health of the ligament and the surrounding tissues. When a tooth is no longer subjected to the normal forces of biting and chewing, the periodontal ligament fibres can become weak or atrophied.
When this tooth is then used as an abutment for a fixed partial denture (FPD), it is once again exposed to the functional stresses that were previously absent. These stresses can cause traction on the periodontal ligament fibres, leading to pain and discomfort. The pain is mainly due to the sudden reintroduction of forces to the ligament that it is not accustomed to handling.