INTERMEIDATE PLEXUS

The dental literature of the 18th and 19th centuries showed that there existed a strong intervening membrane, commonly called the periosteum, between the root of a tooth and its bony socket. Black has coined the terms "principal fibers" and "indifferent tissue" in describing the histological appearance of the peridental membrane implying that this membrane was more than a periosteum.

 Noyes has referred to Black's work but has used the terms "alveolo-dental periosteum" and "alveolo-dental membrane synonymously. Noyes has attributed three functions to the alveolo-dental membrane. These were to hold the tooth in position, to be the seat of sensation for the tooth, and to be a source of formative elements for the alveolus and the cementum.

 Waugh has stated that the principal fibers of the alveolo-dental membrane were responsible for holding the tooth in its socket. These fibers passed from the alveolar wall to the cementum and firmly suspended the tooth in its socket. He has described the fibers as lying parallel with one another except where they deviated to make room for vessels and nerves. He has stated that the principal fibers passed directly from the alveolus to the cementum.

 The idea of the periodontal membrane being something other than a periosteum had not been fully accepted by the beginning of this century. Cupit has discussed the similarity of the periodontal membrane to the periosteum of bones in that it is both bone forming and nourishing. In further discussions of the "peridental membrane," as he has preferred to call it, Cupit has men-tioned that it consisted of two parts, the pericementum and the alveolar periosteum.

 He did not describe the histology of such an arrangement with regard to the passing of the fiber bundles from the alveolus to the tooth. Widdowson has used the terms "periodontal membrane" and "alveolo-dental membrane" interchangeably.

 C. S. Tomes has described the alveolodental periosteum as being synonymous with the term "periodontal membrane" and has stated that the soft tissues investing the root and lining the socket were one and the same membrane.

 In his opinion there was a marked difference in the histological character of the alveolodental fiber bundles lying next to the alveolar bone as compared to those fibers next to the cementum, but that there was no break in the continuity of the fiber bundles as they passed from the alveolus to the cementum.

 He has mentioned that the fibers attached both to the cementum and the alveolar bone were imbedded into the calcified tissues much like the fibers are imbedded into other bone and could also be called "Sharpey's fibers."

PERIODONTAL FIBERS
The most important element of periodontal ligament has principal fibers, the principal fibers are collagenous in nature and a arranged in bundles and follow a wavy course. Collagen is a high molecular weight protein. Collagen macromolecules are rod like and are arranged in form of fibrils. Fibrils are packed side by side to form fibers.

Vitamin C help in formation and repair of collagen.

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 Half life of collagen fibers is between 3 to 23 days and collagen imparts a unique combination of flexibility and strength to tissue.

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TYPES OF PERIODONTAL LIGAMENT FIBERS 1. TRANSEPTAL GROUP

These fibers extend interproximally over alveolar bone crest and are embedded in the cementum of adjacent teeth. They are reconstructed even after the destruction of alveolar bone resulting from periodontal disease. These fibers may be considered as belonging to the gingiva because they do not have osseous attachment.
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DIAGRAM OF PRINCIPAL FIBER GROUPS

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ALVEOLAR CREST GROUP

These fibers extend obliquely from the cementum just beneath the junctional epithelium to alveolar crest. Fibers also run from the cementum over the alveolar crest and to fibrous layer of periosteum covering alveolar bone. The alveolar crest fibers prevent extrusion of tooth and resist lateral tooth movements. The incision of these fibers during periodontal surgery does not increase tooth mobility unless significant attachment loss has occurred.
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3. HORIZONTAL GROUP
Horizontal fibers extend at right angles to long axis of tooth from the cementum to alveolar bone.

4.

OBLIQUE GROUP
Oblique fibers, the largest group in periodontal ligament, extend from cementum in a coronal direction obliquely to bone.

They bear the brunt of vertical masticatory stresses and

transfer them into tension on the alveolar bone. 5. APICAL GROUP

The apical fibers radiate in a rather irregular manner from the

cementum to bone at apical region of the socket. They do not occur on incompletely formed roots.
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INTER-RADICULAR FIBERS
The interradicular fibers fan out from the cementum to the tooth in furcation areas of multirooted teeth. The remodeling of fibers take place in intermediate plexus. This allows adjustments in the ligament, which accommodate small movements of tooth.
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OXYTALAN FIBERS
These are immature elastic fibers restricted to walls of blood vessels and are oriented in an axial direction. The function is to support the bloods vessels in the periodontal ligament.

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STRUCTURES PRESENT CONNECTIVE TISSUE

IN

THE

BLOOD VESSELS Main blood supply is from superior and inferior alveolar arteries. The blood vessels are derived from the following: 1. BRANCHES FROM APICAL VESSELS Vessels supplying the pulp.

2.

BRANCHES FROM INTRA-ALVEOLAR VESSELS:- Vessels run horizontally and penetrate the alveolar bone to enter into the periodontal ligament.
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3. BRANCHES FROM GINGIVAL VESSELS:- The arterioles and capillaries ramify and form a rich network. Rich vascular plexus is found at the apex and in cervical part of ligament.

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NERVE SUPPLY
Nerves found in ligament pass through foramina in alveolar bone. The nerves are the branches of second and third division of fifth cranial nerve (trigeminal nerve) and follow same path as blood vessels.
These nerve fibers provide sense of touch, pressure, pain and proprioception during mastication.
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