PERIODONTAL LIGAMENT

Dr. Sehar Naeem

Post-graduate Trainee
Periodontology department
 CONTENTS
• INTRODUCTION
• DEFINITION
• LOCATION
• SHAPE
• DEVELOPMENT
• COMPOSITION
• FUNCTIONS
• REPAIR AND REGENERATION
• AGE CHANGES
✓INTRODUCTION
• DEFINITION
• LOCATION
• SHAPE
• DEVELOPMENT
• COMPOSITION
• FUNCTIONS
• AGE CHANGES
 INTRODUCTION:
• Greek word perio = around and odontos = tooth.
• INTRODUCTION
✓DEFINITION
• LOCATION
• SHAPE
• DEVELOPMENT
• COMPOSITION
• FUNCTIONS
• REPAIR AND REGENERATION
• AGE CHANGES
 DEFINITION:

• Periodontal ligament is soft, richly vascular and cellular connective tissue

which surrounds the roots of the teeth and joins the root cementum with socket
wall
Niklaus P. Lang and Jan Lindhe

• Periodontal ligament is composed of a complex vascular and highly cellular

connective tissue that surrounds the tooth root and connects it to the inner wall
of the alveolar bone
Carranza’s clinical periodontology
• INTRODUCTION
• DEFINITION
✓LOCATION
• SHAPE
• DEVELOPMENT
• COMPOSITION
• FUNCTIONS
• AGE CHANGES
 LOCATION:
• Coronally: Continuous with the connective tissue of the gingiva (demarcated through
alveolar crest fibers) and communicates with the marrow spaces through vascular
channels in the bone
• Apically: At the root apex it merges with the dental pulp
• INTRODUCTION
• DEFINITION
• LOCATION
✓SHAPE
• DEVELOPMENT
• COMPOSITION
• FUNCTIONS
• REPAIR AND REGENERATION
• AGE CHANGES
• Hour-glass
• Narrowest at mid root
• 0.15-0.38mm wide
• Avg. 0.2mm

• It appears as a radiolucent
area 0.4-1.5mm between
lamina dura and cementum
• INTRODUCTION
• DEFINITION
• LOCATION
• SHAPE
✓DEVELOPMENT
• COMPOSITION
• FUNCTIONS
• REPAIR AND REGENERATION
• AGE CHANGES
 Continuous Forms hertwing’s
Begins with root
proliferation of inner epithelial root
formation before
and outer enamel sheath b/w dental
tooth eruption
epithelium papilla and follicle

2.Mesenchymal
Dental follicle cells
cells of perifollicular 1. Mesenchymal
are composed of 2
mesenchyme cells of dental
types of
(stellate, small and follicle proper
mesenchymal cells
random)

Type 1 collagen is
Actively synthetize
Gain polarity, secreted, collagen
and deposit
cellular volume and bundles are
collagen fibrils and
spacing assembled and
glycoprotien
continuity
 HR’s losses
integrity and its
remnants persist
as

Epithelial rest cells

of mallases

Which may give rise

to cementicle
 After tooth
Before tooth eruption:
During tooth Fibers oblique
eruption,
eruption: again but in
alveolar Number of
Alveolar crest
crest is fibers opposite
above CEJ and
above CEJ increased direction.
fibers
and fibers Once functional:
horizontal
oblique
thickness
increases
 MATURE PDL HAS 3 REGIONS:

Bone related region rich in cells

Middle zone with few cells and thinner

collagen fibers

Cementum related region with dense

and ordered collagen fibers
• INTRODUCTION
• DEFINITION
• LOCATION
• SHAPE
• DEVELOPMENT
✓COMPOSITION
• FUNCTIONS
• REPAIR AND REGENERATION
• AGE CHANGES
 fibroblast

SYNTHETIC osteoblast

cementoblast

RESORPTIVE osteoclast
CELLS
PROGINATOR

EPITHELIAL
PDL

REST

DEFENSE

FIBERS
ECM
GROUND
SUBSTANCE
CELLULAR COMPONENTS:
 SYNTHETIC CELLS:

• Increased transcription of RNA

• Increased production of ribosomes
• Increased number of Golgi saccules
• Large number of mitochondria
1. Fibroblasts
2. Osteoblasts
3. Cementoblasts
 1. FIBROBLASTS:

• Predominant cells in PDL

• Also known as architect/ care taker/ builder
• Origin:
Cementum surface: Ectomesenchyme of investing
layer of dental papilla and dental follicle

Alveolar bone:
perivascular mesenchyme
• Oriented with long axis in parallel direction of
collagen fibers
 FUNCTIONS OF FIBROBLASTS:

1. Formation, organization and maintenance of pdl fibers

2. Production and maintenance of extracellular matrix proteins
3. Can give rise to osteoblast and cementoblasts
4. Also act as a defense cell
 2. OSTEOBLASTS:

• They cover the periodontal surface of

alveolar bone
• Lines tooth socket
• Microfilaments are prominent beneath
the cell membrane at secreting surface
• Contacts one another by desmosomes
and tight junctions
 3.CEMENTOBLASTS:

• Structure resembles osteoblasts

• Lines the cementum
• Cementum forming cells
 RESORBTIVE CELLS:
OSTEOCLASTS
• Present against the bony surface occupying
shallow depression called howship’s lacuae
• The part of plasma membrane lying adjacent
to bone that is being resorbed is raised in
characteristic folds and is termed as ruffled
and striated border
• This border is separated from plasma
membrane through clear zone (specialized
membrane devoid of organelle)
 PROGENITOR CELLS

• Undifferentiated mesenchymal cells

• Perivascular location i.e. within 5micrometer
• Present in all CT
• Have capacity for mitotic activity
• Can be converted into fibroblast, osteoblast or cementoblast
EPITHELIAL REST CELLS OF MALASSEZ

• 1st described by Malassez in 1884

• Remnants of hertwing epithelial root sheath
• Numerous in apical and cervical area
• Numerous in children than adults and diminishes with age
• Function not known but may be involved in repair and
regeneration
• May proliferate to form cyst or tumor
• May calcify to form cementicles
 DEFENCE CELLS
EOSINOPHILLS MACROPHAGES

MAST CELLS
 EXTRACELLULAR SUBSTANCE

• Fibers: • Ground substance

1. Collagen 1. Proteoglycans
2. Elastin 2. Glycoproteins
3. Reticular
4. Secondary
5. Indifferentiated
 COLLAGEN
• Collagen is a protein that is composed of different amino acids, the most important of
which are glycine, proline, hydroxylysine, and hydroxyproline
• It has 19 recognizable species out of which
• Main type in PDL are I and III
• Type I: more than 70% and uniformly distributed
• Type III: 20% and found in periphery of sharpey’s fiber attachment to the alveolar
bone
• Type IV and VII are associated with epithelial rest cells and blood vessels
• Type XIII: occurs only when pdl is fully functional
• Collagen gathers to form collagen fibrils subunit… they unite and
form bundles called principal fibers (5um in dm)
• Molecular configuration of collagen fibers provides them with
tensile strength greater than that of steel

Click to add text

RATE OF TURNOVER OF COLLAGEN FIBERS
IN PDL:
• Greatest than in any other tissue
• 2 folds greater than gingiva
• 4 fold greater than skin
• 6 folds greater than bone

• The rate appears to be highest at the root apex

• More turnover rate on the bone site than on the tooth site
• Radioautographic studies with radioactive thymidine, proline, and glycine
indicate a high turnover rate of collagen in PDL
 PRINCIPAL PDL FIBERS

• Collagenous
• Follows wavy pattern
• Contributes in regulation of mineralization and tissue cohesion at sites
of increased biomechanical strain
• Adult pdl fiber:54-59nm in diameter
 SHARPEY’S FIBER
• Terminal portions of principal fibers embeded in bone
or cementum
• Orientation---similar to that of adjacent ligament
• At cementum: more in number but smaller in size at
attachment
• At acellular cementum----fully mineralized
• At cellular cementum as well as alveolar bone----
partially mineralized
• Few pass uninterruptedly through alveolar bone
process----transalveolar fibers
 ELASTIN
FIBERS:

Immature
elastic fibers

Eulanin:
Bundles present Oxytalan:
in small amount Microfibrils
Supporting only in
function to the vertical
tooth and direction.
facilitates Regulates
fibroblast
vascular flow
attachment
• RETICULAR FIBERS:
Immature collagen fibers with argyrophilic staining and are related to
basement membrane of blood vessels and epithelial cells of the PDL

• SECONDARY FIBERS:
Newly formed collagenous element, not incorporated in principal fiber
bundle
Located between and among the principle fibers
Non-directional and randomly oriented
Associated with path of vasculature and nervous element

• INDIFFERENTIATED FIBER PLEXUS:

Irregular arrangement of fibers
 GROUND SUBSTANCE
Gel like matrix synthetized by fibroblast family
Fills space between fibers and cells

• COMPOSITION: Glycoprotein---
70% water---contributes to tooth’s ✓ Fibronectin
ability to withstand forces ✓ Tenascin
✓ Vitronectin
Glycosaminoglycans----
✓ hylaruronic acid (main volume),
✓ proteoglycan----
Versican & decorin
• INTRODUCTION
• DEFINITION
• LOCATION
• SHAPE
• DEVELOPMENT
• COMPOSITION
✓FUNCTIONS
• REPAIR AND REGENERATION
• AGE CHANGES
 FUNCTIONS OF PDL

• Physical,
• Formative and Remodeling,
• Nutritional, and Sensory
 PHYSICAL FUNCTIONS

• The physical functions of the periodontal ligament entail the following:

1. Provision of a soft-tissue “casing” to protect the vessels and nerves
from injury by mechanical forces
2. Attachment of the teeth to the bone
3. Maintenance of the gingival tissues in their proper relationship to
the teeth
4. Resistance to the impact of occlusal forces (i.e., shock absorption)
5. Transmission of occlusal forces to the bone
SHOCK ABSORPTION THEORIES
SHOCK ABSORPTION THEORIES CONTD.
TRANSMISSION OF OCCLUSAL FORCES TO
BONE Tipping/horizontal
Axial force force applied
applied
2 phases of tooth
movement
Oblique fibers
wavy untensed Displaceme
pattern Movemen nt of facial
t of pdl and lingual
bony plates

Becomes straight Rotation of the

and attains full tooth
length
FORMATIVE AND REMODELING FUNCTION:
• Continuous remodeling by variations in enzyme activity
• Causative factor can be:
✓Physical forces in response to mastication,
✓Parafunction,
✓Speech, and
✓Orthodontic tooth movement
• Increased mitotic activity in the fibroblasts and the
endothelial cells forming collagen fibers
• Residual mesenchymal cells develop into osteoblasts and
cementoblasts thus cells of the PDL also participate in remodeling of
cementum and bone during
✓ physiologic tooth movement,
✓accommodation of the periodontium to occlusal forces, and
✓repair of injuries

• Cartilage formation in the PDL represents a metaplastic phenomenon

in the repair of this ligament after injury.
 NUTRITIONAL FUNCTION

• Supplies nutrients to the cementum, bone, and gingiva by way of the

blood vessels, and it also provides lymphatic drainage.
• In relation to other ligaments and tendons, the PDL is highly
vascularized tissue; almost 10% of its volume in the rodent molar is
blood vessels.
• Providing hydrodynamic damping to applied forces as well as high
perfusion rates to the PDL
 SENSORY FUNCTION

• The periodontal ligament is abundantly supplied with sensory nerve fibers that are
capable of transmitting tactile, pressure, and pain sensations via the trigeminal pathways.
• Nerve bundle divide----myelinated fibers----loose their myelin sheath end in one the 4
types of nerve endings:
1. Free endings, which have a treelike configuration and carry pain sensation;
2. Ruffni-like mechanoreceptors, which are located primarily in the apical area;
3. Coiled Meissner corpuscles and mechanoreceptors, which are found mainly in the
midroot region; and
4. Spindle-like pressure and vibration endings, which are surrounded by a fibrous
capsule and located mainly in the apex
 ADAPTATION TO FUNCTIONAL
CHANGES

With increased functional With reduction in functional

demand: demand:

• Width of PDL increases upto 50% • Narrowing of the ligament

• Thickness of fiber bundles also • Decrease in number and
increases thickness of fiber bundles

Width of PDL according to functional state of the tooth:

Time of eruption 0.1-0.5mm
At function 0.2-0.35mm
Hypo function 0.1-0.15mm
• INTRODUCTION
• DEFINITION
• LOCATION
• SHAPE
• DEVELOPMENT
• COMPOSITION
• FUNCTIONS
✓REPAIR AND REGENERATION
• AGE CHANGES
 REPAIR AND REGENERATION

• High potential for repair and regeneration

• Regeneration development of functionally oriented fiber as well as
correlated bone and cementum for attachment of fibers

• Repair involves replacement of small areas of defected pdl

• New collagen matrix is laid rapidly and without functional orientation
as well as attachments
• INTRODUCTION
• DEFINITION
• LOCATION
• SHAPE
• DEVELOPMENT
• COMPOSITION
• FUNCTIONS
• REPAIR AND REGENERATION
✓AGE CHANGES
• Decrease in cell number and cell activity
• Calcified tissues of the periodontium appears
• As activities like eating decreases
• Decrease in structural organization

Age in years Avg. number of fibroblasts

0-9 51.1
10-19 40.9
20-29 29.9
30-39 28.2
40-49 24.6
50 and above 19.9
 CHANGES IN WIDTH OF PDL WITH AGE

Young age (11-16y)

0.21mm
Mature adult (35-52y)
0.18mm
Older adult (51-67y)
0.15mm
 REFERENCES:

• Carranza’s clinical periodontology 11th edition

• Carranza’s clinical periodontology 13th edition
• Orban’s oral histology and embryology
• Clinical periodontology and implant dentistry by Niklaus P. Lang and
Jan Lindhe
• Ten Cate’s Oral histology
THANK YOU