Cementum The cementum is the surface layer of the tooth root (B). Rather than being a passive entity like paint on a wall, cementum is a dynamic entity within the periodontium. It is attached to the alveolar bone (C) by the fibers of the periodontal ligament and to the soft tissue of the gingiva by the gingival fibers (H). Latin caementum Code TA A03.1.03.007
Cementum is a specialized calcified substance covering the root of a tooth. Cementum is excreted by cells called cementoblasts within the root of the tooth and is thickest at the root apex. These cementoblasts develop from undifferentiated mesenchymal cells in the connective tissue of the dental follicle. Cementum is slightly softer than dentin and consists of about 45% to 50% inorganic material (hydroxylapatite) by weight and 50% to 55% organic matter and water by weight. The organic portion is composed primarily of collagen and protein polysaccharides. Sharpey's fibers are portions of the principal collagenous fibers of the periodontal ligament embedded in the cementum and alveolar bone to attach the tooth to the alveolus. Cementum is avascular.
The cementum is light yellow and slightly lighter in color than dentin. It has the highest fluoride content of all mineralized tissue. Cementum also is permeable to a variety of materials. It is formed continuously throughout life because a new layer of cementum is deposited to keep the attachment intact as the superficial layer of cementum ages. Two kinds of cementum are formed: acellular and cellular. The acellular layer of cementum is living tissue that does not incorporate cells into its structure and usually predominates on the coronal half of the root; cellular cementum occurs more frequently on the apical half. Cementum on the root ends surrounds the apical foramen and may extend slightly onto the inner wall of the pulp canal. Cementum thickness can increase on the root end to compensate for attritional wear of the occlusal/incisal surface and passive eruption of the tooth.
The cementodentinal junction is a relatively smooth area in the permanent tooth, and attachment of cementum to the dentin is firm but not understood completely. The cementum joins the enamel to form the cementoenamel junction, which is referred to as the cervical line. In about 10% of teeth, enamel and cementum do not meet, and this can result in a sensitive area. Abrasion, erosion, caries, scaling, and the procedures of finishing and polishing may result in denuding the dentin of its cementum covering, which can cause the dentin to be sensitive to several types of stimuli (e.g., heat, cold, sweet substances, sour substances). Cementum is capable of repairing itself to a limited degree and is not resorbed under normal conditions. Some root resorption of the apical portion of the root may occur, however, if orthodontic pressures are excessive and movement is too fast. Some experts also agree on a third type of cementum, afibrillar cementum, which sometimes extends onto the enamel of the tooth.
The excessive build up of cementum on the roots of a tooth is a pathological condition known as hypercementosis.
- ^ "Cementum". 2007-01-01. http://www.dentalfind.com/glossary/cementum.html.
- ^ Adler, C.J.; Haak, W., Donlon, D., Cooper, A. (2010). "Survival and recovery of DNA from ancient teeth and bones". Journal of Archaeological Science 38 (5): 956–964. doi:10.1016/j.jas.2010.11.010.
Periodontology Tissues of the periodontium
and their physiologic entities
Diagnoses Pathogenesis Pathologic entitiesCalculus · Clinical attachment loss · Edentulism · Fremitus · Furcation defect · Gingival enlargement · Gingival pocket · Gingivitis · Horizontal bony defect · Linear gingival erythema · Occlusal trauma · Periodontal pocket · Periodontal disease · Periodontitis · Plaque · Recession · Vertical bony defect Diagnosis, treatment planning,
Periodontal armamentarium Conventional therapy Surgical therapy and
periodontal surgeryApically positioned flap · Bone graft · Coronally positioned flap · Crown lengthening · Open flap debridement · Free gingival graft · Gingivectomy · Guided bone regeneration · Guided tissue regeneration · Implant Placement · Lateral pedicle graft · Pocket reduction surgery · Sinus lift · Subepithelial connective tissue graft
Important personalities Other specialtiesEndodontology · Orthodontology · Prosthodontology Bones of head and neck, joints: cranial fibrous joints (A03.1.01–03, GA 2.178–199) Cranial syndesmosesPterygospinous ligament · Stylohyoid ligament Cranial sutures
Cranial: frontoethmoidal · frontal or metopic (frontal/frontal) · coronal (frontal/parietal) · occipitomastoid (occipital/temporal) · lambdoid (parietal/temporal) · sagittal (parietal/parietal) · sphenoethmoidal · sphenofrontal · sphenoparietal · sphenosquamosal (sphenoid/temporal) · sphenopetrosal (sphenoid/temporal) · squamosal (temporal/parietal) · petrosquamous (temporal/temporal)Cranial–facial: sphenozygomatic · zygomaticotemporal · zygomaticofrontal
Facial: palatomaxillary suture · Sutura embryonica · Sutura embryonica accessoria
Dento-alveolar syndesmosis SynostosesSynostosis vomerina · Synostosis mandibularis · Synostosis frontalis · Synostosis petrosquamosa · Synostosis incisiva
anat(h/c, u, t, l)/phys
noco(arth/defr/back/soft)/cong, sysi/epon, injr
proc, drug(M01C, M4)
Head and neck anatomy, digestive system: Mouth anatomy (TA A05.1–2, TH H3.04.01, GA 11.1110–2, 1125–1141) MouthTeethsee tooth anatomy Oro-pharynx/
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