The periodontal ligament is a specialised fibrous connective tissue connecting the root of each tooth to the alveolar bone socket. Its principal fibres are arranged in groups (alveolar crest, horizontal, oblique, apical, and interradicular) that resist multidirectional occlusal forces.
Suspends the tooth within its alveolar socket, distributes masticatory forces as tension across the alveolar bone, provides proprioceptive feedback about bite force, allows physiological tooth movement during orthodontic treatment, and maintains the separation between tooth root and bone.
PDL inflammation (periodontitis) is the leading cause of tooth loss in adults. The PDL space width on periapical radiograph reflects inflammation and loading — widening indicates pathology. Orthodontic tooth movement compresses the PDL on one side and stretches it on the other, triggering bone resorption and apposition. Ankylosis (PDL obliteration) prevents orthodontic movement.
Bacterial infection destroying the periodontal ligament and alveolar bone causing progressive tooth mobility and eventual tooth loss — the leading cause of adult tooth loss.
Periodontal ligament space widening on periapical radiograph indicating inflammation from trauma, occlusal overload, or periodontal disease, requiring periodontal assessment.
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