Category Archives: Periodontal ligament

Age changes of PDL

Age changes of PDL

-It shows decreased vascularity. -It becomes thinner due to decreased activity. -Free or attached cementicles may be found and increase in number by age.

-There is continuous root migration of the attachment epithelium with detachment of the cervical fibers of the PDL.

Structure Of Periodontal ligament 2

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 Structure Of Periodontal ligament 2

 

C. Alveolodental ligament

□ Alveolar crest group:

The fiber bundles radiate from the crest of the alveolar process and attach themselves to the cervical part of the cementum. These fibers limits vertical and intrusive movements.



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    The horizontal group:

The fiber bundles run horizontally between the cementum and the rim of the alveolar bone in the neck and mid root region. They check horizontal and dipping forces.

 

    Oblique group:

These are the most numerous fiber bundles. They run obliquely inwards and apically from the alveolar bone to the cementum. They constitute the main support of the tooth against masticatory forces. They check vertical and intrusive forces.

 

    Apical group :

The fiber bundles of this group are irregularly arranged and radiate from the apical region of the root to the surrounding bone forming a cushion that check vertical forces.

 

    Interradicular group:

The fiber bundles extend from the crest of the interradicular septum to the furcation of the multi-rooted teeth. They check vertical and lateral forces.

The arrangement of the fiber bundles in these different groups is well adapted to counteract the forces applied to the tooth from different directions.


 



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Intermediate plexus:

Controversy exists concerning the extent of individual principal fibers across the width of the periodontal ligament. One view holds that there are distinct tooth related (dental) and bone-related (alveolar) fibers, and that these intercalate near the middle of the ligament at an intermediate plexus.

However, recent evidence suggests that the fibers cross the entire width of the periodontal space but branch on route and join neighbouring fibers to form a complex three-dimensional network.

The intermediate plexus can only be distinguished in continually growing and erupting teeth such as rodent incisors (rats, rabbits)

 

2-  Oxvtalan fibers

Throughout the PDL are fine fibers (of 150 A0 diameter) that appear to be immature elastic fibers or a variant of them. They are found to run obliquely between blood vessels and cementum and mainly perpendicular to the occlusal plane. They are also affiliated with neural elements. They are numerous and dense in the cervical region especially in teeth which carry abnormally high loads (carrying bridges).

Although their function is unknown, yet they may be part of the supportive system for the blood vessels and the principal fibers. It is thought that they regulate vascular flow in relation to tooth function.

 

3-  Eluanin fibers:

They represent another variant of elastic fibers consisting of bundles of microfibrils within small amount of elastin. It may form a meshwork extending from cementum to bone sheathing the collagen fiber bundles.

4- Elastic fibers:

There is no elastic fibers in the human PDL except around the wall of blood vessels. However, the PDL of some animals may contain such fibers.

 

Interstitial tissue:

Between the bundles of the oblique fibers there are round or oval intervals where the periodontal tissue is much less dense. In these areas it forms a reticular framework of loose connective tissue through which the blood vessels, nerves and lymphatics run. These are termed interstitial tissue.

 

Blood vessels:

The arterial plexus of the PDL are derived from these sources.

1.  Branches from the apical vessels that supply the dental pulp.

2.  Branches from the intra-alveolar vessels which penetrate the alveolar bone and enter the ligament.

3.Branches from the gingival vessels.

 

These branches ramify and form a rich network. In the cervical part and at the root apex the capillaries form a denser network. The capillary vessels may take a coiled course resembling glomeruli.

During mastication, numerous vessels are emptied for a short time from the areas towards which the root moves. The blood is displaced into the surrounding alveolar bone through the inner connecting vessels, thus dissipating any pressure on the cellular elements. The blood can return when the force is removed.

There are numerous arterio-venous anastomosis. The veins tend to run axially and to drain to the apex.

A network of lymphatics, following the path of the blood vessels provides lymph drainage for the PDL. It starts in the gum and runs towards the apex where they join those emerging from the pulp.

Nerves :

The nerves usually are associated with blood vessels. Nerves run from the apical region towards the gingival margin and joined by nerves entering laterally through the foramina of the socket wall. These lateral nerves divide into two branches, one extending apically and the other gingivally.

The apical region of the PDL contains more nerve endings (except in the upper incisors where there are much endings both apically and cervically).

Non-myelinated nerve endings belonging to the autonomic nervous system run on the blood vessels and supply the smooth muscle in their walls and affect regional blood flow.

Myelinated sensory nerves run in small bundles along side the blood vessels. The nerves are either of:

a)     Large diameter which lose their myelin sheath and end in a variety of endings e.g. Khob-like, spindle -like and Meissner-like which appear to be responsible for touch and pressure and especially found at root apex (Mechano-receptors).

b)     Small diameter which lose their myelin sheath and end as free nerve endings which are concerned with detection of pain. These are located at regular intervals along the length of the root and extend to the cementoblast layer.

 

Function

1-    supportive: it maintains the relation of the tooth to the
surrounding hard and soft tissues.

2-  Nutritive: through its blood vessels , the PDL provides nutritive

substances to the cells of the ligament, cementum and the more superficial bone cells. The blood vessels are also concerned with removal of catabolites.

3-  Sensory: It provides a most efficient proprioceptive mechanism
through its’ nerve supply, allowing the organism to detect the
application of the most delicate forces to the teeth. This is important in protecting the substance of the tooth and its supporting structure.

 

4-   Protective: it protects the tissues at the site of pressure. The
ligament transforms the pressure exerted on the teeth into
tension or traction on cementum and bone. This function is
performed by three mechanisms:

a)      The arrangement of the capillaries (coiled).

b)      The arrangement of the principal fibers.

c)      The mechano-receptors (properioceptive stimuli).

 

5-   Homeostatic: It is evident that the cells of the periodontal
ligament have the capacity to resorb and synthesize the
extracellular substance of the connective tissue of the ligament,
alveolar bone, and cementum.

 

Remodeling of the alveolar bone occurs at a higher rate than other bone tissue in the jaws. The PDL collagen shows fast turnover, and it appears that its connective tissue cells are also turned over. There is continual slow death of cells which are replaced by new cells that are provided by the progenitor cells in the PDL.

Cementum deposition, however seems to be a slow continuous process and resorption is not a regular occurrence.

It is evident that these processes are not activated haphazardly, however, the mechanisms controlling the processes of synthesis and resorption are unknown.

If these hemeostatic mechanisms are upset, derangement of the periodentium occurs, which may lead to its progressive destruction and loss of attachment between bone and the tooth occurs.


  

Cementicles:

 

These are calcified masses seen in older individuals in the PDL. It is possible that degenerated epithelial cells form a nidus for their calcification.

Cementicles may be:

-Remain free in the PDL.

-Join the cementum and form excementosis (attached). -Become embedded into the cementum after cementum increases in thickness (hyper cementosis) by advancing age.

 

 

Structure Of Periodontal ligament 1

Structure Of Periodontal ligament
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The connective tissue of the PDL consists of:
(A) Cells
(B) Extracellular substance formed of ground substance and fibers.
There are also rich supplies of blood vessels, nerves and
lymphatics.
 
[A] cells
The cells of the PDL may be divided into the following categories; 1-Synthetic
cells; fibroblasts; cementoblasts; and osteoblasts. 2-Resorpative cells;
fibroblasts; osteoclasts and cementoclasts. 3-Progenitor cells; undifferentiated
mesenchymal cells. 4-Epithelial rests of Malassez.
5-Defense cells; macrophages; mast, plasma cells; and leukocytes.
[ 1 ] Synthetic cells
There are certain general cytological criteria that distinguish all cells that
are synthesizing proteins and these can be applied to the fibroblasts,
cementoblasts and osteoblasts.
 
The criteria of protein synthesizing cells include:
□ The presence of a large open-faced or vesicular nucleus containing prominent
nucleoli. This reflects the increase transcription of RNA and production of
ribosomes in the nucleolus.
□ Presence of large quantities of rough endoplasmic reticulum (RER) and
prominent Golgi saccules which are readily recognized by EM and which reflect
translation and transport of protein.
□ Presence of large number of mitochondria which reflects the increased
requirements for energy.
□ Large amount of cytoplasm to accommodate these organelles.
 
The cell that is actively secreting protein will be seen under the light
microscope to exhibit a large open-faced or vesicular nucleus with prominent
nucleoli and to have abundant cytoplasm. The cytoplasm tend to be
haematoxyphilic which reflects the presence of large quantities of RER. A clear
area representing the Golgi saccules may be recognized in the cytoplasm if the
plane of section is favorable.
Low or nonactive secreting cells will be seen under the light microscope to
exhibit little of cytoplasm, very few organelles and a close-faced nucleus.
Cells of different stages of activity are present in the PDL.
□ Fibroblasts
They are found in the PDL surrounded by fibers and ground substance and oriented
mostly parallel to the collagen fibers. They are the most important PDL cells
because of the high density of collagen composing the tissue.
PDL fibroblasts are motile – contractile cells and they are capable of
generating a force responsible for tooth eruption.
Beside the above described criteria of the protein synthetic cells, the PDL
fibroblasts show numerous microtubules and microfilaments which run along the
length of the cell (assume the property of motile ceils).
There is evidence that a single cell can function information {fibroblastic
function) and in resorption or destruction (jibroclastic function) of the
ligament collagen. One end of the cell is active in phagocytizing collagen and
contains lysosomal system as well as intracellular collagen profiles and
vacuoles, while the other end of the same cell is active in assembling the
pro-collagen molecules.
 
□ Cementoblasts
They are found distributed on the cementoid tissue of the root surface, as
described in the cementum section.
 
□ Osteoblasts
They are found at the periodontal surface of the alveolar bone in various stages
of differentiation. It is an oval cell with eccentric nucleus and show few
cytoplasmic processes. Under the EM, it shows the above criteria of the protein
synthetic cells. It is also rich in alkaline phosphatase and pyrophosphatase
enzymes which are concerned with calcification.
They synthesize organic components of bone matrix to form osteoid tissue as well
as its maturation.
[21 Resorptive cells
□ The fibroblasts : having a fibroclastic action.
□ Osteoclasts:
The presence of osteoclasts on the periodontal surface of the alveolar bone
indicates that resorption is active. Osteoclasts are seen regularly in normal
functioning periodontal ligament in case of bone remodeling. They are found in
Howships's lacunae present on surface of bone or surrounding the end of bone
spicule.
The cells are formed as a result of fusion of multiple blood monocytes.
They are large multinucleated (6-12 nuclei) cells presenting striated or ruffled
border and eosinophilic cytoplasm rich in lysosomes.
They show high activity of acid phosphatase, collagenase, and other proteolytic
enzymes that are important in bone resorption.
They also liberate carbon dioxide (C02) which is important in decalcification of
bone matrix.
The osteoclasts appear io accomplish both demineralization of the inorganic
substances and disaggregation of the organic bone matrix, as well as elimination
of debris during bone resorption.
Under the EM, the osteoclasts show numerous mitochondria, lysosomeSj abundant
Golgi saccules and free ribosomes with little RER.
 
□ Cementoclasts
Because cementum does not remodel regularly, cementoclasts or more properly
odontoclasts ( since they destroy dentin and enamel ) are rarely found in the
PDL.
 
They may be seen during:
a) Resorption of deciduous teeth (exfoliation).
b) When excessive force is applied during orthodontic tooth movements.
c) Due to traumatic occlusion.
d) In certain pathological conditions.
 
The cementoclasts are similar in appearance to the osteoclasts. They are mono or
multinucleated giant cells often located in Howship's lacunae on the surface of
cementum.
Their origin is unknown, but they may arise in the same manner as osteoclasts.
They are rich in acid phosphatase and other proteolytic enzymes.
 
[3] Progenitor cells
They are undifferentiated mesenchymal cells that have the capacity to undergo
mitotic division and can differentiate to different specialized cells.
Progenitor cells tend to have small, closed-faced nucleus and very little
cytoplasm and found in highest concentrations close to blood vessels.
It is not known whether a single population of progenitor cells gives rise to
all of the specialized synthetic cells in the PDL, or if there are a number of
populations, each of which gives rise to different specialized cells.
 
[41 Epithelial cells
Remnants of the epithelial root sheath of Hertwig are found close to the
cementum as isolated columns, network, or islands of epithelial cells
(epithelial rests of Malassez ).
EM shows that the epithelial rest cells exhibit tonofilaments and are attached
to each other by desmosomes.
The functional capability of these cells is unknown, however, in certain
pathological conditions, cells of the epithelial rests can undergo rapid
proliferation and can produce a variety of cysts and tumors.
[5] Defensive cells
Defensive cells including macrophages, mast cells, plasma cells and leucocytes
may be found in the PDL whenever an inflammatory reaction takes place. They are
discussed in the pulp section.
 
[B1 extracellular substances :
It consists of a ground substance with embedded fibers and rich supply of blood
vessels, lymphatics and nerves
 
The ground substance
It is formed of 70 % water and the rest is organic material formed of:
□ Glycosaminoglycans with much hyaluronate.
□ Glycoproteins (including fibronectin and tenascin).
□ Proteoglycans such as proteoglycans dermatan sulphate and chondroitin sulphate.
□ Glycolipids.
 
The ground substance has many important functions, Lit controls collagen
fibrillogenesis.
2. If assists fiber orientation.
3. It is especially important in ion and water binding and exchange.
 
Fibers
The fibers of the PDL consists of:
1. Mainly collagen fibers.
2. Oxytalan fibers. 3.Eluanin fibers.
4. Elastic fibers.
 
1- Collagen fibers
90 % of the PDL fibrils are collagen.
 
They are mostly type I collagen, while only 20 % are type III collagen.
The collagen fibrils may be either:
a) Gathered together forming distinct fiber bundles that constitutes the highly
oriented Principal fibers. These fiber bundles can be easily recognized by the
light microscope. They run a wavy course and straighten out under tension. This
gives the fibers the appearance of being elastic.
b) Collagen fibrils may show random fashion distribution ramifying between the
principal fibers. This minor fibril group can only be observed by the EM.
 
The principal bundles of the collagen fibers are arranged in particular groups.
They are named according to their location with respect to teeth into:
1. Gingival ligament.
2. Transseptal (interdental) ligament.
3. Alveolodental ligament which consists of:
 
□ Alveolar crest group.
□ Horizontal group.
□ Oblique group.
□ Apical group.
□ Interradicular group.
 

a. The gingival ligament
Its fibers spread radially from the cervical cementum to the lamina propria of
the gingiva. Its function is to hold the gum tightly against the neck of the
tooth.

b. Transseptal ligament
It connects the adjacent teeth. The fibers run from the cementum of one tooth
over the crest of the alveolar bone horizontally to the cementum of the
neighbouring tooth.
They are important in the physiological mesial drift of the
teeth.
 

Development Of Periodontal ligament

Development Of Periodontal ligament

PDL is derived from the dental follicle that envelops the developing tooth germ.

Some delicate fiber bundles of the forming PDL appear as root formation begins.

The innermost cells near the forming root differentiate into cementoblasts and lay down cementum, while the outermost cells differentiate into osteoblasts and furnish the lining of the bony socket.

The more centrally located cells are differentiated into fibroblasts which synthesize the fibers and the ground substance of the PDL. The fibers of the PDL become embedded in newly developed cementum and alveolar bone (Sharpey’s fibers).

As the tooth eruption proceeds, a gradual functional orientation of the fiber bundles takes place in the characteristic fashion instead of being loose and irregular.

Changes in the structural arrangement of the PDL occur throughout life due to changes in functional stresses and the eruptive and drifting movements

Periodontal ligament

Periodontal ligament

 

The periodontal ligament (PDL) is the dense fibrous connective tissue which occupies the periodontal space between the root of the tooth and the alveolus.

It is continuous with the connective tissue of the gingiva above the alveolar crest, and with the dental pulp at the apical foramen.

The average width of the periodontal space is from 0.15-0.38 mm with its narrowest portion around the middle of the root.

It is wider in the teeth under excessive occlusal stress, and is thin in function less and embedded teeth.

The periodontal space is narrower in the permanent teeth than those of the deciduous. It shows also progressive decrease in the width with age.

 

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The PDL possesses high rate of turnover than virtually all other connective tissues. The half life of collagen fibers of the PDL has been reported as being 3-23 days, but vary in different parts of the tooth, being highest towards the root apex and lowest towards the cervix.