Академический Документы
Профессиональный Документы
Культура Документы
LIGAMENT
Periodontal Ligament is the integral
part of the periodontium
• Periodontium is an attachment apparatus of the teeth. Teeth
are attached to the bones of the jaws by periodontium. It
consists of four connective tissues.
(a) Cementum.
(b) Periodontal Ligment.
(c) Bone that lines the alveolus.
(d) Deeper part of the gingiva.
The cementum & the alveolar bone are
the mineralized tissues while the periodontal
ligament & the part of the gingiva are fibrous
tissues.
DEVELOPMENT:-
• Shortly after the beginning of root formation & the formation of the outer
dentinal layer of root, the PDL is formed.
• The external & internal dental epithelia proliferate from the cervical
loop of dental organ to form a Hertwigs epithelial root sheath, which then
fragments to form the discrete clusters of the epithelial cells called as "
epithelial cell rests of Malassez"
• The enamel organ & root sheath are surrounded by dental sac which is
formed by condensed cells.
• A thin layer of cells lying adjacent to the dental
organ, known as dental follicle, divide &
differentiate into cementoblasts, fibroblasts &
osteoblasts.
• The fibroblasts synthesize the fibers & ground
substance of the PDL.
• These fibers initially occupy the periodontal
space without any specific orientation, but just
before tooth eruption acquire an orientation
oblique to the tooth towards the coronal portion.
• Similar fibers appear on the side of bone
also.
• They fibers elongate, meet & fuse in the
middle.
• They mature progressively towards the
root apex as the eruption progresses & with the
establishment of occlusal contact the proper
arrangement of the principle fibers of the PDL
occurs.
• The damaged periodontal fibers are
replaced & remodeled by newly formed fibers.
CELLS:
Synthetic Cells
- contains a large open faced nucleus, with prominent nucleoli & an abundant
hematoxylophilic cytoplasm . The cells are follows:-
1. Osteoblasts:
Derived from the multipotent mesenchymal cells.
They cover the periodontal surface of the alveolar bone.
The collagen fibers of ligament that penetrate the alveolar bone are present b/w
the cells.
2. Fibroblasts:-
Principal cells of PDL
Ovoid or elongated cells oriented along the principal fibers & exhibiting
pseudopodia like processes.
The collagen turnover is regulated by fibroblasts.
Phenotypically distinct & functionally different subpopulations of fibroblasts
exists in adult PDL.
They look identical at both light & electron microscopic levels but may have
different functions such as secretion of collagen of different types or production of
collagenase.
3- Cementoblasts:-
found on the surface of the cementum.
help in cementum formation.
produce cementoid layer which undergoes mineralization.
some of these cells get embeded in the cementum as
cementocytes.
Resorptive Cells:
1. Osteoclasts:-
multinucleated cells which resorb bone.
helps in remodeling, which allows functional changes in the position
of tooth.
2. Fibroblasts:-
help in both synthesis & resorption of collagen.
the collagen fibers can be resorbed by the mononuclear fibroblasts.
help in remodeling process of PDL.
they exhibit lysosomes, which contain collagen fragments undergoing
digestion.
3. Cementoclasts:-
found on surface of cementum.
cementum is not remodeled like alveolar bone &
PDL
Progenitor Cells
are the undifferentiated mesenchymal cells.
have the capacity to undergo mitotic division & replace the
differentiated cells dying at the end of their lifespan.
located in perivascular region.
histamine.
ages:
Lymphatics:
Cementicles:-
- cementicles are the small calcified bodies present in PDL, they are not the cells of cementum.
- may be fused with cementum or may be free.
FUNCTIONS OF PDL:-
1. Physical function:-
Provision of a soft tissue "casing" to protect the vessels & nerves from
injury by mechanical forces.
Transmission of occlusal forces to the bone.
Attachment of the teeth to the bone.
Maintenance of the gingival tissues in their proper relationship to the
teeth.
Resistance to the impact of occlusal. forces (shock absorption).
3.Sensory function:-
The PDL nerve fibers transmit sensation of touch, pressure & pain to
higher centers.
also provide the proprioceptive mechanism to detect an application of
small force to the teeth & also very small displacement of teeth.
Thus, it helps in protecting the supporting structures of tooth &
substance of crown from effects of the masticatory force.
Pain sensation is transmitted through small diameter nerves,
temperature by intermediate type & pressure by large myelinated
fibers
4. Nutritive function :-
PDL has rich vascular supply
It provides nutrition to the cementum, bone & gingiva.
5. Homeostatic Mechanism.
AGING OF LIGAMENT:-
- The number of cells & their activity decrease, scalloping occurs in cementum &
alveolar bone.
- Some fibers are attached at the peaks of those scallops only & not in the
depressions.
CLINICAL CONSIDERATIONS:-
-The main function of PDL is to support the tooth in its socket.
-It is thick in the teeth that are exposed to excessive occlusal stress & thin in functionless & embedded
teeth.
- If a tooth is long out of function, the supporting tissues of this tooth are not fully adapted to
carry the load suddenly placed on the tooth by a restoration like full cast crown.
1. The width of PDL varies from 0.15 to 0.38 mm. It decreases as the age advances. The
thickness varies in different teeth in the same person & in different locations on the same tooth.
2. Aging results in more no. of elastic fibers & decrease in the vascularity, mitotic activity,
fibroplasia & in the no. of collagen fibers & mucopolysaccharides.
3. If the gingivitis is not cured & supporting structures becomes involved, the disease is
termed as periodontitis.
4. Resorption & formation of both bone & PDL play an important role in the orthodontic teeth
movement.
5. Trauma to PDL may produce changes such as fracture or resorption of the cementum,
tears of fiber bundles, hemorrhage & necrosis. These result in resorption of bone & PDL is widened,
so teeth become loose. If trauma eliminated, repair will take place.
6. Chronic periodontal disease can lead to infusion of micro-organism into the blood stream.
7. Inflammation of pulp reaches to the apical PDL & replaces its fiber bundles with granulation
tissue, called as a granuloma. It progresses into apical cyst - most common pathologic lesion of the
jaws.
REFERENCES