When a patient develops periodontitis, the gum tissue recedes from the teeth creating pockets. Disease causing bacteria accumulate in the pockets leading to an infection that if left untreated, destroys bones, ligaments, and tissues in the mouth and could ultimately result in tooth loss.
Once the PDL is lost, the adjacent bone is not attached to the tooth and therefore, unable to provide any support. The periodontal ligament does not regenerate easily in any areas where it was lost and is prone to periodontal inflammation. The training that Dr. Husain is proficient in dental surgical procedures involving bone and soft tissue grafting, dental implant placement, minimally invasive LANAP and other laser procedures, and treating chronic periodontal diseases.
He became a Diplomate of the American Board of Periodontics in and has been practicing periodontics in private practice in Dallas since Meet Dr. Sheppard has been in private practice since She takes pride in providing her patients with the highest quality care using the latest technology and using a patient centered approach.
Although called a ligament, your PDL is not like the ligaments that surround an articulating joint. However, this special ligament plays a crucial function in your overall oral health. The periodontal ligament does not support the outer gum tissues and is only found between the root part of the tooth and the adjacent bone. This complex tissue allows the tooth to function under the load of chewing and absorb excess pressure from clenching and grinding. The ligament is also involved in tooth movement and aids in the eruption of the tooth.
The PDL is also what makes orthodontic tooth movement possible. If the tooth were directly connected to the bone, the tooth would function similarly to a dental implant and not be able to move. Because the tooth is held in the socket by the periodontal ligament and not a direct bone-to-tooth interface, it can usually be extracted without removing any significant areas of the jawbone. The periodontal ligament also allows the tooth to adapt to forces from tooth grinding also known as bruxism or other jaw clenching habits.
The ligament can enlarge and allow the tooth to become loose. Once the excessive forces on the tooth are reduced, the PDL will heal, and tooth mobility will decrease. Advanced gum disease can lead to the destruction of bone and the loss of the periodontal ligament. The transseptal fibers extend interproximally just over the alveolar bone crest. They are embedded into the cementum of the adjacent teeth where they form an interdental ligament. These fibers work to maintain alignment of the teeth.
Some consider these fibers to belong to the gingival tissue as they do not contain an osseous attachment. The loose connective tissue contains the following: fibers, extracellular matrix, cells, nerves, and blood vessels.
The extracellular compartment includes type 1, 3, and 5 collagen fiber bundles which are embedded in intercellular substance. The collagen fibers of the PDL are classified based on how they are oriented and their specific location on the tooth. The cells contain defence cells, fibroblasts, and undifferentiated mesenchymal cells.
They hold the tooth in the jaw. The same blood vessels that provide nourishment to the pulp supply nutrients to the ligament as well. Similarly, the nerves that provide sensation to the dentinal tubules are the same nerves that provide the feeling of touch to the ligament. They tell the brain when your teeth come into contact with anything. They have shown that if you touch a tooth with a feather, the brain will register that contact.
An important aspect of the periodontal ligament is the presence of cells that can repair, regenerate, or even destroy the tissues related to this important dental structure.
Osteoblasts which make bone, osteoclasts which destroy bone; Cementoblasts and cementoclasts which make and destroy cementum; fibroblasts which make collagen fibers are just a few of these important cells. Rather than provide all these cells at the same time, the body provides stem cells which can turn into any one of these cells depending on the proper stimulation.
The periodontal ligament like the pulp is very rich in stem cells. In fact extracted teeth have become an important source in stem cell research, reducing the reliance on fetal tissue. An example of this stem cell activity happens when you go to the orthodontist and teeth are moved around.
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