Periodontal ligament space/ dental implant courses

PERIODONTAL LIGAMENT SPACE &
LAMINA DURA
INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
www.indiandentalacademy.com

Periodontalligamentspace
• Periodontium is a connective tissue organ covered by
epithelium that attaches the teeth to the bones of the
jaws and provides a continually adapting apparatus for
support of teeth during function.
• It consists of cementum ,periodontal ligament ,bone
lining the tooth socket(alveolar bone),part of gingiva
facing the tooth(dento gingival junction),

• Periodontium occupies the periodontal space located
between the cementum and periodontal surface of
alveolar bone and extends coronally most apical part of
the lamina propria of gingiva.
• Periodontal ligament also called as DESMODONT
,GOMPHOSIS ,PERICEMENTUM ,ALVEO DENTAL
LIGAMENT,PERIODONTAL MEMBRANE.
• It is complex connective tissue providing continuity
between two mineralised tissues.
• Thickness of periodontal ligament varies from 0.15mm to
0.38mm.
• It is thinnest around middle third of root .

• It shows progressive decrease in thickness with age.
• It measures about 0.21mm in young adult ,0.18mm in
mature adult,0.15mm in older adult.
• The ligament appears as the periodontal ligament
space of 0.4mm to 1.5mm in radiographs ,a
radiolucent area between the radiopaque lamina
dura of the alveolar bone proper and the radiopaque
cementum.
• The periodontal ligament spaces of permanent teeth
are narrower than those of deciduous teeth.
ORBANSORALHISTOLOGYANDEMBRYOLOGY-13thedition

Periodontalligament

• Periodontal ligament space is a fibrous connective tissue
contains cells ,fibres ,blood vessels.
• Cells are divided into:
• synthetic cells:
Fibroblasts, Osteoblasts , Cementoblasts.
• Resorptive cells:
Osteoclasts, Fibroblasts, Cementoclasts .
• Progenitor cells
• Epithelial cell rests of malassez
• Defense cells: mast cells ,macrophages , eosinophils

• EXTRA CELLULAR SUBSTANCE:
• FIBERS GROUND SUBSTANCE
• collagen Glycosamino glycons
• Elastin-oxytalan Proteoglycans
• Reticular fibres Glycoproteins
• secondary
• indifferent fibre plexus

• COLLAGEN: Is a protein composed of different amino
acids is gathered to form bundles are termed as
PRINCIPAL FIBERS.
• Main types of collagen are type1 and type3.
• Principal fiber group consists of a:
• Alveolar crest group
• Horizontal group
• Oblique group
• Apical group
• Inter radicular group
• Collagen fibers are embedded into cementum on one
side of periodontal space and into alveolar bone on
other side, these fibers are called as SHARPEYS FIBERS.

Periodontalligament-pricipal fibers

• Connective tissue contains blood vessels, lymphatics,
nerves.
• Functions of periodontal ligament:
• Supportive
• Sensory
• Homeostatic
• Eruptive
• Physical
• AGE CHANGES : Decrease in cell number and activity.

• The primary role of PDL is to support the tooth in the
bony socket.
• Its thickness varies in different individuals ,in different
teeth in same person, and different locations of same
tooth.
• PDL is thinnest at middle third of root indicates that the
fulcrum of physiologic movement is in this region.
• The thickness of periodontal ligament maintained by
functional movements of tooth.
• PDL space is thinnest in:
• Function less tooth
• Embedded tooth

• PDL space varies in some pathological conditions:
• Obliteration of PDL space Is seen in:
Fibrous dysplasia
Hypercementosis
Paget's disease
Hypo function of tooth
Tooth which losts its antagonist.

• INCREASE IN PERIODONTAL LIGAMENT SPACE:
• Inflammatory conditions:
Apical periodontitis
periapical abscess
Periapical cyst
Chronic osteomyelitis
Osteoradionecrosis
Bisphosphonate induced osteoradionecrosis
• Malignant conditions:
Squamous cell carcinoma
Metastatic tumours
chondrosarcoma
Fibrosarcoma

• Widening also seen in:
Progressive systemic sclerosis
Periapical cemento osseous dysplasia
During orthodontic treatment
Trauma from occlusion
Osteosarcoma
Tooth mobility
Intermaxillary fixation

Normalperiodontalligament space

WideningofPDLspaceseeninchronicapicalperiodontitis

IncreasedPDLspaceinperiapicalcyst

PictureofosteosarcomashowingincreasePDLspace
andlossoflaminadurainapicalregion:

IncreasedPDLspaceinprogressivesystemic
sclerosis

IncreasedPDLspaceinosteoradionecrosis

IncreasedPDLspaceduringorthodontictreatment

ExtrusiveluxationshowingincreasedPDLspace

Fibrousdysplasia-obliterationof PDLspace

ANKYLOSIS:
It is a condition in which the roots of the tooth loose their
normal attachment to bone and become fused directly to the
bone.
Most common ankylosed tooth are primary lower 1st molar.
Ankylosed primary tooth prevent the eruption of permenent
tooth.
Abnormal cemental deposition can sometimes leads to fusion
of bone to cementum.

Ankylosis:

LAMINADURA:
• The part of alveolar bone that surrounding the tooth socket is
thin layer of dense cortical bone called e LAMINA DURA.
• It is a bundle bone lies adjacent to PDL lining the tooth socket
• In radiographs lamina dura appears as a radiopaque
surrounding each root.
• Increased radiopacity due to presence of thick bone without
trebeculations ,x-rays must penetrate and not to any increased
mineral content.

lamina dura:

Normalradiographicappearanceof lamina
dura:

• Lamina dura is still intact in recently extracted tooth.

• In some pathological conditions lamina dura is partially
or completely lost.
• Partial lost of lamina dura is seen in:
• Odontogenic keratocyst
• lateral periodontal cyst
• simple bone cyst
• Ameloblastoma
• Periapical abscess
• Periapical granuloma
• periapical cyst
• Cushing syndrome

• Malignant tumors : squamous cell carcinoma
• Metastatic tumors
• Fibrosarcoma
• Multiple myeloma
• Leukemia
• Fibrous dysplasia
• Peri apical cemento osseous dysplasia
• Central gaint cell granuloma
• Burkitts lymphoma
•

• Complete loss of lamina dura is seen in:
• Hyperparathyroidism
• Hypophosphatemia
• Pagets disease
• Renal osteodystrophy
• Hypophospatesia

• Thinning of lamina dura:
• Hypothyroidism
• Osteoporosis
• Thalaseemia
• Rickets
• Hyperthyroidism
• Increased thickness of lamina dura:
• Osteopetrosis

Periapicalabscessshowinglossoflaminadurain
apicalregion

Periapicalcystshowingloss of lamina dura in
apicalregion of tooth

Central gaint cell granuloma-lossof lamina
dura in apicalregion

Radiographof leukemia-lossof lamina dura

Hyperparathyroidism-completelossoflaminadura

Chronicrenal failure-completeloss of lamina
dura

Hypophosphatemia-lossof lamina dura

Hypercementosis-thickeningof lamina dura

Cushingsyndrome-thinningof lamina dura

Osteomalacia-thinningof laminadura

• REFERENCES: ORBANS ORAL HISTOLOGY AND
EMBRYOLOGY-13th edition
• STUART C.WHITE MICHAEL J.PHAROAH-6th edition

Periodontal ligament space/ dental implant courses

Empfohlen

Empfohlen

Weitere ähnliche Inhalte

Was ist angesagt?

Was ist angesagt? (20)

Andere mochten auch

Andere mochten auch (11)

Ähnlich wie Periodontal ligament space/ dental implant courses

Ähnlich wie Periodontal ligament space/ dental implant courses (20)

Mehr von Indian dental academy

Mehr von Indian dental academy (20)

Kürzlich hochgeladen

Kürzlich hochgeladen (20)

Periodontal ligament space/ dental implant courses