ORAL MIC ANA LEC FINALS (2) PERIODONTAL LIGAMENT

Cushion-hammock Ligament - shock absorber of occlusal

forces Non-calcified tissue of the teeth Comes from dental sac Gomphosis - attachment of teeth to bony socket. Fibers help connect teeth to its socket Made up of fibers (mainly collagen) Helps absorb the forces placed upon the tooth by disseminating the force to underlying tissues

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CHARACTERISTICS OF PERIODONTAL LIGAMENT Fibers are inserted into the alveolar bone from the cementum It's quite cellular, well innervated, vascular and contains epithelial aggregates It occupies the narrow space between the calcified surfaces of the cementum and alveolar bone Periodontal Space - detectable in radiographs; a radioluscent parallel to the root surface (lamina dura in radiographs - radiodense line that represents the alveolar proper); vaires in thickness (0.1-0.25mm) depending on age, stage of eruption of the tooth and functional characteristic; thicker in adolescents than older individuals dense fibrous connective tissue attaching the tooth to alveolar bone teeth withour antagonists (opposing tooth) would have thinner ligaments; with impacted (lies inside the bone) teeth they're even thinner under normal function, PDL tends to be narrower near the middle part of the root and wider near the apex PRINCIPAL FIBER GROUPS One common thing: all of them will come from the cementum surface (mesial attachment)

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Function is to sustain the normal occlusal forces that to resist intrusive masticating forces Prevents the tooth from being pushed into the socket Extrusive force outward Trauma Apical Group of Fibers - attached to apex/fundus and radiates like a fan Radiate from apical region of the tooth Radiating from the cementum around apex of root of the bone, forming the base of socket Function: prevents vestibulo-oral tipping and tooth rotation Interradicular Group of Fibers - found in multi-rooted tooth in between roots; crest of interradicular septum (only in multi-rooted teeth) Found only between roots of multi-rooted teeth and running from the cementum into the bone forming the crest of interradicular septum Resists tipping and torque

INTERSTITIAL SPACES Houses interstitial tissues Produced as a result of grouping of fiber bundles Result of functional changes in the marrow (rupture) Present between each bundle of ligament fiber Contains blood vessels and nerves Designed to withstand the impact of masticating forces FIBROBLASTS Fiber-forming cells Spindle-shaped or flat disks and have long ovoid nuclei and numerous cytoplasmic processes of various lengths makes up the largest cell population of the heart; however, this appears to vary for different species, especially mice CEMENTOBLASTS Are observed during the phase of active deposition of cellular cementum Cementum-forming cells Cementoclasts cementum-resorbing cells OSTEOBLASTS Bone-forming cells Peripheral part of the periosteum have arisen from periosteal cells, and extremely likely that they are young osteoblasts OSTEOCLASTS & ODONTOCLASTS Multinucleated cells that are morphologically and functionally indistinguishable Remodel existing alveolar bone Odontoclasts resorb mineralized dental tissue, including cementum Usually located within superficial bone EPITHELIAL CELLS Originates from HERS Found in the ligament to the cementum Epithelial Rests of Malassez DEFENSE CELLS Few in disease-free periodontal ligament (has reparative capabilities) Undifferentiated Mesenchymal Cells / Progenitor Cells Have a perivascular location within 5m of blood vessel

1. Free Gingival Ligament - comes from cementum 2. 3.

surface and attaches to lamina propia of free gingiva Distal attachment: anywhere to alveolar bone or gingiva Transseptal Fibers - only group of fiber bundle that has cementum to cementum attachment; it helps maintain mesio-distal relationship of teeth Alveolar Crest Group of Fibers - all attach to alveolar bone; origin is always on cementum a. Alveolar Crest Group of Fibers - group of fibers that attaches to the crest of alveolar bone radiate from crest of alveolar process and attached to the cervical cementum attached to the cementum just below the CEJ and running downward and outward insert into the rim of the alveolus Function: resist vertical forces b. Horizontal Group of Fibers run at right angle to the long axis of tooth from cementum to bone near the crest Immediately apical to the alveolar crest at right angle to the axis of the tooth Function: resist horizontal or lateral pressures applied to the tooth crown c. Oblique Group of Fibers - fibers run obliquely; most numerous Most numerous and constitutes the main support of the tooth Running from cementum in an oblique direction to insert into bone coronally

Macrophages Important defense cells because of their phagocytic activity and mobility Take up bacteria, dead cells and foreign bodies Leukocytes Leukocytes, especially small lymphocytes and plasma cells may appear in periodontium when it is stressed by disease Periodontitis inflammation of periodontal ligament VASCULAR SUPPLY Main blood supply is from superior and inferior alveolar arteries THREE SOURCES SUPPLYING PERIODONTAL BLOOD SYSTEM 1. Branches from the dental artery 2. Branches of the interalveolar and interradicular arteries 3. Branches of the periodontal artery FUNCTION OF BLOOD VESSELS OF PERIODONTAL LIGAMENT 1. Nutritive function 2. Removal of cellular waste 3. Acts as a hydraulic shock-absorbing system cushioning the tooth against light occlusal forces NERVES Four types of neural termination 1. Free Nerve Ending Most numerous Most frequent neural termination that ramifies in a tree-like configuration Located at regular intervals along the length of the root Such endings are thought to be both nociceptors and mechanoreceptors 2. Ruffinis Corpuscles Found around the root apex appear dendritic and end in terminal expansions among the periodontal ligament fiber bundles The known physiologic function is mechanoreceptors 3. Coiled Ending Found in the midregion of periodontal ligament where function and ultrastructure are not yet been determined 4. Encapsulated Spindle Type Ending Lowest frequency, found associated with root apex and consists of spindle-like FUNCTIONS OF PERIODONTAL LIGAMENT 1. Formative formation of cells 2. Supportive shock absorber 3. Nutritive blood vessels 4. Hemostatis blood stream 5. Sensory nerves CLINICAL CONSIDERATIONS Filling the tooth Check on occlusion of patient Can damage periodontal ligament if restoration is too high Original occlusion must be restored Prosthesis Artificial denture Abutment tooth where denture is clasped Feel pain

Rearrangement of periodontal ligament Produce more periodontal ligament as a reaction to sudden load (of abutment tooth)

Mesial Drifting Site of tension and pressure Site of TENSION Osteoblasts are stimulated to form new bone Periodontal ligament stretched Bone deposition Site of PRESSURE Alveolar bone stimulates osteoclasts to resorb the bone Periodontal ligament compressed Bone resorption (bone destruction/bone loss)