CEMENTU

M
INTRODUCTION
Cementum is a specialised hard layer of
calcified mesenchymal tissues which forms the
outer covering of the anatomical root.

It is also called as Substantia Ossea

Cementum is the part of Periodontium.
Human Cementum is avascular & has no innervation.
PHYSICAL PROPERTIES
1. Hardness :
Hardness less than dentin.
Least calcified.
2. Colour :
Light yellow in colour.
Dull surface (Lack of Lusture)
Darker hue than enamel.
3. Permeability :
More permeable than dentin.
Permeability decreases with age.
4. Thickness :
Cellular Cementum : 16-60 micron.
Acellular Cementum : 150-200 micron.

CHEMICAL PROPERTIES

Inorganic Matter (45-50%) Organic Matter (50-55%)

 Mainly Hydroxyapatite
Ca10 (PO4)6 (OH)2
 Fluoride content is highest
than other calcified tissues
of body.
 Mainly Type-I collagen
& interfibrillar ground
Substance consist of
Proteoglycans
 CLASSIFICATION
 I. Based on time of formation
 Primary
 Secondary
 II. Based on Presence or Absence of Cells
 Cellular
 A cellular
 III. Based on Fibers
 Extrinsic
 Intrinsic
 According to above findings cementum classified as :
 1. Acellular Afibrillar Cementum
 2. Acellular Extrinsic Fiber Cementum.
 3. Cellular Mixed Stratified Cementum.
 4. Cellular Intrinsic Fiber Cementum.
 INTERMEDIATE CEMENTUM
 It is an ill-defined zone near the cementodentinal junction of certain teeth that appears
to contain celluar remnants of Hertwig’s sheath embedded in calcified ground substances.
 DEFFERENCE
ACELLULAR CELLUAR CEMENTUM
CEMENTUM
1. First formed Secondary Cementum.

2. Present on cervical third or half Mainly on apical third of root.

of the root.

3. It does not contain cells. It contain cells called cementocytes

in individual spaces lacunae.

4. It is formed before the tooth Formed after the tooth reaches the
reaches the occlusal plane. occlusal plane.

5. More calcified. Less Calcified.

6. Sharpey’s fibers are main Sharpey’s fibers occupy smaller

compenent which inserted at portion & occpy other fibers that are
approximately right angles onto arranged parallel to the root surface.
the root surface.
 SHARPEY’S FIBERS :
Terminal portions of the principal fibers that insert into cementum & bone
are termed as “Sharpey’s Fibers”.
These have a principal role of supporting the tooth within jaw.
CELLS OF CEMENTUM :
1. Cementoblasts
2. Cementocytes
 Cementoblasts synthesize collagen& protein polysaccharides that form
organic matrix of cementum.
 During formation of cellular cementum, the cementoblasts become
incorporated into the cemental matrix. These cells are known as
cementocytes. The cementocytes lie in spaces known as lacunae.
 CEMENTOGENESIS :
Cementum develops from the activity of mesenchymal cells of dental
follicle after fragmentation of the epithelial root sheath.
After formation of dentin, loss of continuity occurs in the epithelial root
sheath. This allows adjacent cells of the investing layer of the dental
follicle to come to lie on surface of root dentin & these are induced to
differntiate into cementoblasts.

CEMENTOENAMEL JUNCTION :
The interface between the Cementum & Enamel at the cervical region of tooth is known as
cementoenamel junction.
It is of 3 types
Pattern I : Pattern Pattern III :
Overlapping Type (60%) Butt joint (30%) Gap joint (10%)

CEMENTODENTINAL JUNCTION
It is interface between the dentin & cementum.
Scalloped in deciduous teeth & smooth in the permanent teeth.

FUNCTIONS OF CEMENTUM :
 Cementum provide a medium for the attachment to the collagen fibers of periodontal ligament.
 Cementum is hard & has no blood supply, It does not show resorption under masticatory or orthodontic
forces. Thus, during heavy orthodontic forces, tooth integrity is maintained & alveolar bone being elastic in
nature changes its shape, fulfilling the orthodontic requirement.
 Cementum has property of continuous deposition & does the patch work or repair for the damage such as
fracture or resorption of tooth surface.
 Regular Cementum deposition at the root apex, helps to replenish the lost tooth height due to occlusal
wear or helps in passive eruption of teeth.
CEMENTAL ANOMALIES :
I. Hypercementiosis means abnormally prominent thickness of the cementum on
root surface

Hypercementiosis

Localized Generalized
 Cemental spikes &  Paget’s disease
 Excementosis  Chronic periapical infection.
Non functional teeth without any
antagonist.
CEMENTAL HYPERPLASIA & HYPERTROPHY :
 Cementum overgrowth when growth does not help in increasing function of the tooth.
eg. due to periapical infection.
 If Cementum overgrowth improves or helps in the functioning of teeth, this is called as
cemental hypertophy.
eg. Cemental spike develps from extensive orthodentic force
 CEMENTICLES :
 Cementicles are round lamellated cemental bodies that lie free in the PDL or are attached to the
root surface.
 Mostly found in aging persons or at the site of trauma.
 CEMENTOMA is also called benign cementoblastoma or cemental dysplasia.
 These are cemental masses situated at the apex of the root which are slowly growing
odontogenic neoplasm and may cause expansion of jaw.
 CEMENTAL RESORPTION & REPAIR :
 Cementum on the root surface undergoes resorption & repiar alternately according to change in
enviroment faced by it.
 CAUSES OF CEMENTAL RESORPTION

Local Causes Systemic Causes

 Trauma from Occlusion Deficiency of Ca
 Cyst & Tumors Deficiency of Vit. A & D
 Periapical Pathology Hypothyroidism
 Excessive orthodontic forces
 Embedded Teeth
 Replanted & Transplanted Teeth

CEMENTAL REPAIR :
Repair of cementum is a process to heal the damage caused by resorption or cemental fracture.
Repair

Anatomic Functional
Root outline is re-established In case of large cemental
as it was before cemental resorption. resorption, repair does not re-establish the same anatomic
contour as before.
AGING OF CEMENTUM :
 Surface become rough.
 Cemental Resorption.
 Permeability Decreases.
 More Cemental deposition may lead to closure of the apical foramen.
 CLINICAL CONSIDERATION :
I. Ankylosis :
Fusion of cementum & alveolar bone with no PDL in
between, known as Ankylosis.
Causes :

Causes :
 Faulty replantation & transplantation of teeth.
 Embedded teeth.
 Chronic Periapical Infection.
 Trauma to deciduous teeth.

II. Importance of Root Planing in

Periodontal Treatment.
Root planing is a treatment to remove necrotic cementum & smoothening the
root surface in order to reduce the pocket depth