Background: The function of periodontal ligament (PDL)-cementum enthesis (PCE) in transferring the mechanical stimuli within the tooth–periodontium (PDT)–bone complex was not made clear yet. This study aimed to evaluate the effects of PCE on the mechanical stimuli distribution within the PDL and alveolar bone in the tooth–PDT–bone complex under occlusal forces using the finite element method.

Methods: A computed tomography-based model of alveolar bone and second premolar of mandible was constructed, in which the PDT was considered at the interface of alveolar bone and tooth. Under a 3 MPa distributed occluso-apical masticatory load, applied over the uppermost surface of crown, the von Mises strain (vMST) and strain energy density (SED) within PDL, and von Mises stress (vMSR) and SED within alveolar bone were calculated in two situations: 1. When the PCE was absent; and 2. When the PCE was present between the PDL and cementum.

Results: PCE levels-off SED and vMST within PDL up to 59% and 27%, respectively, compared to the model with no PCE. Moreover, in the alveolar bone, SEDs and vMSR increased up to 28% and 30%, respectively, compared to the model without PCE.

Conclusion: By including PCE in the tooth–PDT–bone model, the mechanical stimuli shifted from PDL to its surrounding alveolar bone. Thus, it can be speculated that the tooth–PDT–bone complex has the capability of reducing the risk of PDL damage, through shifting excess mechanical stimuli from PDL toward the alveolar bone, during prolonged cyclic masticatory loading, as well as while one applies nonphysiologic and therapeutic loads, such as in orthodontic tooth movement.