PERIODONTOLOGY LECTURE 1
So the Periodontium
eriodontium is the tissues that surround and
support the teeth ,
It is composed of four main parts :
- Gingiva
ingiva : which covers everything .
- Periodontal ligaments (PDL):black lines extending
between the teeth and the alveolar bone .
- Alveolar bone .
- Cementum : covers the dentine of the roots .
In this lecture we will talk about the first two of them ,
and remember that we will study each one of them
separately , although they are interconnected .
DENTAL LAMINA
DL (It attaches the enamel organ
to
the oral cavity )
in the pic : we can see the
AB dental lamina (DL),
we can see also from the previous picture :
outer enamel epithelium (OEE),inner enamel epithelium
(IEE),dental follicle (DF),dental papilla (DP),stellate
reticulum (SR).
and we can see the alveolar bone (AB) is being formed
alongside the development of tooth bud.
- Once we reach the late bud stage , the inner and
outer enamel epithelium continue together alone
without the stellate reticulum .
- Then they will form a very tiny structure called THE
EPITHELIAL DIAPHRAGM (ED).
- In multi rooted teeth ,The epithelial diaphragm will
give the shape of the furcation area .
- In single rooted teeth ,the ED is very small ,it
continues downward apically at something called the
hertwing epithelial root sheath which is very
important structure in cementum formation .
THE GINGIVA :
- The gingiva is part of the masticatory mucosa
because it is keratinized ,
- It is the part that covers the necks of the teeth and
the coronal portion of the alveolar process
THE EPITHELIUM :
It is stratified squamous keratinized epithelium
Cytokeratins :
They are proteins that fill the keratinocytes ,
- We have keratin subtypes (k1-k19).
- Different epithelial cells contain different cytokeratins
,and not all the epithelial cells produce all the types of
cytokeratins .
- The epithelial cells also produce other types of
proteins such as keratolinin ,involucrin ,filaggrin
in the picture :
- This is the last junctional epithelial cell
(the final cell which lies on the PDL )
So it is attached on one side to the tooth
by what is called inner basal lamina ,
- and on the other side it is attached to
the connective tissue by an outer basal
lamina .
- the basal lamina is also composed of two
parts :
1) a translucent part called lamina lucida .
2) a denser part called lamina densa
in the picture :
- This is during tooth development
- What is left of the enamel organ is
Called the reduced enamel epithelium
- It covers the crown of the tooth before it
Erupts
- Once eruption starts ,the tooth will move
More coronally ,and the epithelium of the oral
Cavity will thicken and move downward .
- then they will meet ,and the epithelium between them
will disintegrate ,
- this is why eruption of teeth happens without
bleeding .
- the tooth continue to erupt ,and the junctional
epithelium is formed from this reduced enamel
epithelium .
- this epithelium loses its ability to form ameloblasts
forever .
- and remember that the sulcular epithelium and the
oral epithelium originates from outer epithelium of the
oral cavity .
2) Transseptal fibers :
They cross the septum (interdental
alveolar bone) ,these fibers join the
adjacent teeth together ,and they are
part of the PDL fibers .
3) Dentoperiosteal fibers :
They originate from the cementum of the tooth ,and
they go down ,but they don’t touch the periosteum
,they still within the C.T of the gingiva .
4) circular fibers :
they are circular in a longitudinal section .
in the picture :
PDL : are the black fibers that are drawn
around the tooth.
In the picture :
- This is a very high
Magnification of PDL
Inserted into a cellular
Cementum .
- We can see the wavy
course of the PDL.
PDL
In the picture :
- This is again PDL fibers
Drawn in yellow ,and then
they are inserted inside
cementum and bone ,and
become named
sharpey's fibers .
PDL fibers are arranged into specific groups :
1) Transseptal fibers : they are the same
As the transseptal fibers of the gingiva .
So we can consider them gingival or
PDL fibers .
Function : they connect the cementums
of the adjacent teeth together .
5) Sensory cells
- Physical functions :
1) Protection of vessels and nerves
2) Transmission of occlusal forces to bone by tension
and compression of the fibers ,which will affect the
alveolar bone .
3) Attachment of teeth to the bone
4) Maintenance of gingival position
5) Shock absorption .
in the pic :
- Suppose this tooth is moved by a wire into that
direction (in red ),there will be a compression in the
(right part) of the PDL ,this will lead to bone
resorption on that side
- At the same time ,the PDL fibers on the (left side) will
be stretched ,and this will lead to bone deposition on
that side ,
- So each time the PDL is compressed ,this leads to
bone resorption
- PDL stretching bone deposition .
- This is a simplified picture for the orthodontic
treatment .
Jiggling forces ;means vibration
In this picture :
Just to show you how the PDL fibers can
adapt the forces .
in this picture :
- Widened PDL due to
Adaptation because of
occlusal problems .
DONE BY
OMAR MARZOUQ