4th Class Periodontology 2018/2019

Dr. Hadeel Mazin

Periodontal ligament (PDL)

Definition: PDL is a connective tissue structure that surrounds the
root and connects it with the bone.

Structure: the periodontal ligament space has the shape of an

hourglass and is narrowest at the mid root level. The width of PDL is
approximately 0.25+ 50 percent.

Cellular composition: cells of PDL are categorized as:

1. Synthetic cells
a. Osteoblast
b. Fibroblast
c. Cementoblasts
2. Resorpative cells
a. Osteoclasts
b. Cementoclasts
c. Fibroblasts
3. Progenitor cells
4. Epithelial rest of malassez
5. Connective tissue cells (mast cells and macrophages)

Synthetic cells:

1. Osteoblasts: covers the periodontal surface of the alveolar bone.

They are responsible for the formation of alveolar bone.

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2. Fibroblasts: the most prominent connective tissue cells (65%).

The main function of the fibroblasts is the production of various
types of fibers (collagen fibers, Reticulin fibers, Oxytalan fibers
and Elastin fibers). Fibroblasts are also instrumental in the
synthesis of connective tissue matrix.
3. Cementoblasts: are seen lining the cementum and are
responsible for cementum deposition.

Resorpative cells:

1. Osteoclasts: these are the cells that resorb the bone and tend to
be large and multinucleated.
2. Fibroblasts: they synthesize collagen and also possess the
capacity to resorb and degrade the old callogen fibers.
3. Cementoclasts: cementum is not remodeled in the fashion of
alveolar bone and periodontal ligament but that it undergoes
continual deposition during life. However resorption of
cementum occurs in certain circumstances by cementoclasts.

Progenitor cells: they differentiate into functional type of connective

tissue cells.

Epithelial rest of Malassez: they are found close to cementum. When

certain pathologic conditions are present, cells of epithelial rest can
undergo rapid proliferation and can produce a variety of cysts and
tumors of the jaws.

Mast cells: they play a role in inflammatory reaction.

Macrophages: they are capable of phagocytosis.

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Extracellular components:

1. Fibers
a. Collagen
b. Oxytalan
2. Ground substances
a. Proteoglycans
b. Glycoproteins

Periodontal fibers: the most important elements of the periodontal

ligament are the principal fibers. They are collagenous in nature and
are arranged in bundles following a wavy course.

The terminal portion of these principal fibers that insert into the
cementum and bone are termed Sharpey’s fibers.

The principal fibers of the PDL are arranged in five groups:

Alveolar crest fibers: they extend obliquely from the cementum just
beneath the junctional epithelium to the alveolar crest.
Function: retain tooth in socket and resist lateral movement.
Horizontal group: extends from cementum to the alveolar bone at
right angle to the long axis of the tooth.
Oblique group: they are the largest group extending coronally in an
oblique direction from the cementum to the bone.
Function: they resist axial directed forces.
Apical group: they radiate from the cementum of root apex to the
bone.

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Function: it prevents tooth tipping, resists luxation, and protects

blood, lymph and nerve supply of the tooth.
Inter-radicular fibers: Extends from cementum of bifurcation areas,
splaying from apical into furcal bone.
Function: it resists luxation and also tipping and torquing.

Ground substance:

The ground substance is made up of two major groups of substances:

 Glycosaminoglycans: such as hyaluronic acid, proteoglycans.
 Glycoproteins: such as fibronectin and laminin
It also has high water content (70%).

Development of principal fibers of PDL

It will be as follows

1. Small, fine brush like fibrils are detected arising from the root
cementum and projecting into the PDL space.
2. Small fibers are seen on the surface of the bone but only in thin,
small numbers.
3. The number and thickness of fibers originating from the bone
increase and elongate. They radiate towards the loose
connective tissue in the mid portion of the periodontal ligament.
4. The fibers originating from the cementum also increase in length
and thickness and fuses with the fibers originating from the
alveolar bone in the periodontal ligament space.

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5. Following tooth eruption, the principal fibers become organized

in bundles and run continuously from bone to cementum.

Structures present in the connective tissue

1. Blood vessels: periodontal ligament is supplied by branches

derived from three sources dental, inter-radicular and
Interdental arteries.
2. Lymphatics: lymphatic vessels follow the path of blood vessels in
the periodontal ligament.
3. Nerve intervention: periodontal ligament is mainly supplied by
dental branches of the alveolar nerve. The periodontal ligament
has mechanoreceptors providing sense of touch, pressure, pain
and proprioception during mastication.
4. Cementicles: calcified masses adherent to or detached from the
root surface.

Functions of the PDL:

1. Physical
2. Formative and remodeling
3. Nutrional and sensory function

Physical function

A. Provide soft tissue “casing’' to protect the vessels and nerves

from injury by mechanical forces.
B. Transmission of occlusal forces to the bone.
C. Attaches the teeth to the bone.
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D. Maintains the gingival tissues in their proper relationship to the

teeth.
E. (shock absorption) Resists the impact of occlusal forces

Formative and Remodeling function

Cells of the periodontal ligament have the capacity to control

the synthesis and resorption of the cementum, ligament and alveolar
bone. Periodontal ligament undergoes constant remodeling; old cells
and fibers are broken down and replaced by new ones.

Nutritive functions

Since PDL has a rich vascular supply, it provides nutrition to the

cementum, bone, and gingiva.

Sensory functions

The PDL is supplied with sensory nerve fibers which transmit sensation
of touch, pressure and pain to higher centers.

Clinical consideration:
The width of PDL space varies with age, location of tooth,
degree of stress to which the tooth was subjected. In compliance with
the physiologic mesial migration of the teeth the PDL is thinner on the
mesial root surface than on the distal surface.

A tooth in hyperfunction may have a wider PDL space and a

tooth in hypofunction may have a narrow PDL space.
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The width of PDL space is about 0.25mm in normal functions. It

is widest at the cervical and apical portions of the root and narrowest
at the middle.

The most interesting features of the PDL are its adaptability to

rapidly changing applied force and its capacity to maintain its width at
constant dimensions throughout its lifetime.