Cementum Solved

CEMENTUM
1. Define Cementum.
Avascular, non-innervated, mineralized connective tissue covering the anatomical roots of human teeth.
It begins at CEJ and continues to apex, surrounds the root. (biochemical composition from notes)
2. Differentiate between the Acellular and Cellular cementum.
3. What are the functions of cementum?

 Cementum furnishes a medium for the attachment of collagen fibers (PDL fibers) that
bind the tooth to alveolar bone
 Tooth wear compensation
 Repair: Cementum serves as the major reparative tissue for root surfaces. Damage to
roots and resorptions can be repaired by the deposition of new cementum, so It
maintains root integrity e-g Root fractures may repair by the formation of a cemental
callus.
 Cementum formed during repair resembles secondary cementum(CIFC) because it forms
faster but it has a wider cementoid zone and the apatite crystals are smaller
 During heavy orthodontic forces, tooth integrity is maintained and alveolar bone being
elastic changes shape fulfilling orthodontic requirement.
4. Define the following:

a. Hypercementosis
It is an abnormal thickening of cementum or excessive deposition of cementum. It may affect all

teeth of the dentition (e-g paget’s disease), be confined to a single tooth, or even affect only parts of
one tooth (localized).
Etiology:
1) Occlusal stress; in localized hypertrophy a spur or prong-like (a thin, pointed, projecting part)
extension of cementum may be formed in teeth that are exposed to great occlusal stress. This
provide a larger surface area for the attaching fibers; thus a firmer anchorage of the tooth to the
surrounding alveolar bone is assured
2) Chronic periapical inflammation
3) non-functional teeth; Hypercementosis of cementum in non-functioning teeth is characterized
by a reduction in the number of Sharpey's fibers embedded in the root
4) The sequel of injuries to the cementum; In some cases an irregular overgrowth of cementum
can be found, with spike like extensions and calcification of Sharpey's fibers and accompanied by
numerous cementicles.
Clinical Significance: The extraction of such teeth may necessitate the removal of bone. This also applies
to extensive excementoses. They can anchor the tooth so tightly to the socket that the jaw or parts of it
may be fractured in an attempt to extract the tooth
This possibility indicates the necessity for taking roentgenograms (X-Ray) before any extraction
Small fragments of roots left in the jaw after extraction of teeth may be surrounded by cementum
and remain in the jaw without causing any disturbance
b. Germination; Tooth gemination is defined as single enlarged tooth or joined tooth

wherein the tooth count is normal when the anomalous tooth is counted as one. It is an
attempt of a single tooth bud to divide.
c. Fusion; the union between two or more separate developing teeth. If contact between
two tooth buds occurs before calcification, complete fusion ensues.
5. Give the type, distribution and function of Cementum.

Types of cementum,
 Presence of cementocytes (cellular cementum)
 Absence (acellular cementum).
 It can also be classified on the basis of the type of fibers
 (intrinsic/ extrinsic fibers) presence
 Absence (afibrillar cementum).
 Acellular extrinsic fiber cementum (AEFC), primary
 cellular intrinsic fiber cementum (CIFC), secondary
 acellular afibrillar cementum
 acelllular intrinsic fiber
 cellular and acellular mixed fiber cementum (containing both intrinsic and extrinsic
fibers)
 cellular mixed stratified cementum (containing alternating layers of acellular extrinsic
fiber cementum and cellular intrinsic fiber cementum
6. Give origin of fibers, location and function of primary and secondary cementum in tabulated
form
Types Origin of fibres Location Function

Acellular Extrinsic Cervical margin to Anchorage
apical 3rd
Cellular intrinsic Middle to apical 3rd & Adaptation & repair
furcations
Mixed (alternating) Extrinsic & intrinsic Apical portion & Adaptation
furcations
Acellular afibrillar Apical portion &
furcations
7. What are the major differences between primary and secondary cementum?
8. Write briefly about initiation of cementogenesis
9. What are cementicles?
• Cementicles are calcified bodies appearing on or in the cementum and in periodontal ligament
• They usually are ovoid or round with a similar appearance to the denticles, they are classified as
free, attached, or embeded
• Cementicles are a response to either local trauma or hyperactivity
• And appear in increasing number in aging person as cementum thickens with age
• The origin of these bodies is not established
• It is possible that degenerated epithelial cells form the site for their calcification
Cementodentinal junction(CDJ
• Junction between cementum and dentin
• The dentin surface upon which cementum is deposited is relatively smooth in permanent teeth
• The cementodentinal junction in deciduous teeth, however, is sometimes scalloped
• The attachment of cementum to dentin is quite firm, although the nature of this attachment is
not fully understood
• The interface between cementum and dentin is clearly visible in decalcified and stained
histologic sections using the light microscope
• In such preparations cementum usually stains more intensely than does dentin
• When observed with the electron microscope, A narrow interface zone between the two tissues
can be detected with the electron microscope
• Cementum is more electron dense than dentine
• Some of the collagen fibrils of cementum are arranged in relatively distinct bundles
• Whereas those of dentin are arranged somewhat haphazardly
• The CDJ junction consists of a wide zone containing:
• Large quantities of collagen
• Glycosaminoglycans like chondroitin sulfate and dermatan sulfate resulting in increased water
content and contributes to the stiffness
• This mechanical property, helps it to redistribute occlusal loads to the alveolar bone
• The cemental fibers intermingle with the dentinal fibers at the CDJ junction more in cellular
cementum than in acellular cementum and aids in attachment of cementum to the dentin
• But the presence of proteoglycans is the major factor in this attachment
• The collagen fibrils of cementum and dentin intertwine at their interface in a very complex
fashion
• It is not possible to precisely determine which fibrils are of dentinal and which are of cemental
origin
Types of Cemento-enamel junction(CEJ)
• The relation between cementum and enamel at the cervical region of teeth is variable
• In approximately 60% of the teeth, cementum overlaps the cervical end of enamel for a short
distance
• CEJ in deciduous teeth
• In deciduous teeth the types of CE junction was different from that of permanent teeth
• Enamel and cementum meeting edge to edge was the commonest type
• Followed by cementum overlapping the enamel
• The failure of enamel and cementum to meet, and enamel overlapping cementum were
observed rarely
•
Give its Biochemical composition

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CEMENTUM

2. Differentiate between the Acellular and Cellular cementum.

3. What are the functions of cementum?

4. Define the following:

It is an abnormal thickening of cementum or excessive deposition of cementum. It may affect all

b. Germination; Tooth gemination is defined as single enlarged tooth or joined tooth

5. Give the type, distribution and function of Cementum.

Types Origin of fibres Location Function

8. Write briefly about initiation of cementogenesis

9. What are cementicles?

Types of Cemento-enamel junction(CEJ)

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