Cementum

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CEMENTUM

Submitted by:-
Madhuri arora
BDS intern
1

Cementum
Derived from dental follicle
Hard, Calcified, avascular mesenchymal tissue
Yellowish in color
Lighter and le...

Composition
Organic:- Inorganic:-
 50-55%  40-45%
 Type 1 Collagen  Hydroxyapetite...

Matrix proteins
predominantly of Type I Collagen &
Glycosaminoglycans (Chondroitin sulphate
mainly)
Bone matrix ...

Collagen fibers
two sources
Extrinsic fibers Intrinsic fibers
incorporation of the Produced ...

According to presence or absence
of cells

Acellular cementum

Cellular cementum

...

CLASSIFICATION OF
CEMENTUM

9

Acellular cementum Cellular cementum
 First formed cementum  Formed after...

B

A

Cellular cementum (B) overlying acellular cementum

...

According to content of fibrils
Fibrillar cementum Afibrillarcementum
Contains well it lacks de...

According to Schroeder et al
1. Acellular afibrillar cementum
 Neither cells nor fibers
 Mineralized ground substance
 ...

2. Acellular extrinsic fibre
cementum
 Densely packed bundles of sharpey’s fibers
 Lacks cells
 Product of fibroblast ...

3. Cellular mixed stratified
cementum
 Extrinsic and intrinsic fibers
 May contains cells
 Co-product of cementoblast a...

CMSC

17

4. Cellular intrinsic fiber
cementum
 Contains cells
 no extrinsic collagen fibers.
 Formed by cementoblast
 It fil...

CIFC

19

5. Intermediate cementum
 Hyaline layer of Hopewell Smith
 Poorly defined zone near the cemento-dentinal
junction of c...

Intermediate cementum
(layer of calcified tissue
embedded in between
dentin and cementum at
the periphery of dental
roots)...

•Incremental lines of Salter

• These lines represent
the rest periods in
cementum formation
and ...

Cemento-enamel junction

23

Pattern 1- Where the cementum overlaps the
enamel for a short distance
Pattern 2- Where the cementum and the
enamel me...

Functions of cementum
Medium of attachment of collagen fibers
that bind to alveolar bone
Continue deposition helps t...

AGE CHANGES IN CEMENTUM
 the width of cementum increases with age
Average thickness of 95 µm at age of 20 and
215 µm at...

HYPERCEMENTOSIS

Refers to non-neoplastic deposition of excessive
cementum that is continuous with the normal
radicul...

Etiology
Spike like type of hypercementosis
Generally results from excessive tension from ortho
appliances or occlusal...

Factors associated with hypercementosis
can be classified as:
LOCAL SYSTEMIC
FACTORS: FACTO...

Of these factors, Paget’s disease of bone has
received the most attention.
Numerous authors have reported significant
...

Radiographically,affected teeth demonstrate a
thickening or blunting of root, but the exact
amount of increased cementu...

Histologically, the periphery of root exhibits
deposition of an excessive amount of
cementum over the original layer of...

Hypercementosis itself does not require
treatment
It could cause problem if the affected
tooth requires extraction
...

Cementicles
Globular masses of acellular cementum
generally less than 0.5mm in diameter which
form with in periodont...

Types
 Free – with in PDL space
 Attached- fused to cellular cementum
 Interstitial(totally incorporated in the
...

Cementoma
Benign tumors of cementum

37

Cementum Hypertrophy

1- Cemental Hypertrophy:
If overgrowth of cementum improves the
functional qualities of the cemen...

Cementum hyperplasia

Ifthe overgrowth occurs in nonfunctional
teeth or it is not correlated with
increased function it...

Cementum Resorption

 permanent teeth do not undergo physiological
resorption as do primary teeth
But cementum is subje...

Local factors Systemic factors
 TFO  Calcium deficiency
 Ortho movement ...

Cementum resorption appears
microscopically as baylike concavities in
the root surface
Multinucleated giant cells ...

CEMENTAL REPAIR

 Cementum resorption is not necessarily continous
After resorption has ceased, the damage is usua...

However, if only a thin layer of cementum is
deposited on surface of deep resorption, the
root outline is not recons...

Ankylosis:
Fusion of cementum and alveolar bone with
obliteration of the periodontal ligament is
termed as ankylosis
...

Ankylosis results in resorption of the
root and its gradual replacement by bone
tissue.for this reason reimplanted te...

Clinical features of ankylosed teeth
They lack the physiological mobility of
normal teeth(this is one of the diagnosti...

Changes in ankylosed teeth
As the periodontal ligament is replaced with
bone in ankylosed teeth proprioception is lost
...

oEXPOSURE OF CEMENTUM TO
ORAL ENVIRONMENT
o Cementum becomes exposed to oral
environment in cases of gingival
re...

THANK YOU

52

CONCLUSION

Cementum is probably the least understood of
all dental tissues.
But this does not lessen it’s role in...

References
 Caranza’s clinical periodontology
 Orban’s dental anatomy and histology
 Bath, M., Balogh, M. & Fehrenbach...

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