Republic of Yemen Faculty of dentistry Department of conserve Feb 2012

Cementum
Cementum is a very thin , avascular and calcified layer of tissue that covers the surface of the root of the tooth and ensures the cohesion with the alveolar bone. It is produced by cells called cementoblasts, and is softer and less mineralized than enamel and dentin.

Cementum

One of of main tissues * One the four functions of cementum is to anchor the supporting the toothof principal collagen fibers (periodontium) the periodontal ligament to the least known of : *Theroot surface, but it also has important adaptative and - Periodontium tissues. reparative functions, playing - All mineralized a crucial role tissues. to maintain occlusal relationship and to protect the integrity of the root surface.

The Properties of cementum Physical properties Composition -Pale yellow

-Softer than dentine 1- hydroxapatite. -Permeability 2- collagen fiber type 2 Varies with age and type of cementum 3- protien polysaccarride Decreases with age 4- water
Cellular is more permeable More permeable than dentine

-Readily removed by abrasion after gingival recession

The origin of cementum

2 layers extension of reduced enamel epithelium that proliferate apically from cervical loop
A. Enamel organ

C. Dental follicle

B. Dental papilla

The cementogensis

The classification of cementum

According to the location

Radicular cementum
The cementum which is found on root surface .

Coronal cementum
The cementum which is found on enamel covering the root crown.

A-Cornal Cementum C- radicular cementum

The classification of cementum

According to cells
Cellular cementum(primary)
The cementum containing cementoblasts found in champers called lacuna within cementum matrix and found at apical third of root .

Acellular cementum(secondary)
Cementum without any cells within matrix and found at cervical third of roots

The classification of cementum

According to presence of collagen fibril

Fibrillar cementum
The cementum with matrix contain defined type 1 collagen fibrils

Afibrillar cementum
Cementum with matrix devoid detectable type 1 collagen fibrils.

The classification of cementum

According to origin matrix fiber

Extrinsic fiber cementum (from fibroblast)
The cementum contain Sherpey's fibers which extrinsic surface and play role in tooth anchorage

Mixed fiber cementum

Cementum contain mixture of extrinsic and intrinsic fiber cementum

Intrinsic fiber cementum (form cementoblast)

Cementum contain intrinsic fibers produced by cementoblasts and play no role in tooth anchorage

The cemental anomalies

1-Hypercementosis:
Types:
1- local : Occur in single tooth. eg:cemental spikes ; exocementosis 2- Generalized: Occur in roots of all the teeth. Causes: Hypercementosis (HC) refers to abnormally -Paget disease bone [hereditary]. large cellular cementum deposits on the apical -chronic periapical infection. third of one or more teeth. is abnormally prominent thickness of cementum root.

Radiographic appearance of maxillary posterior teeth with evidence of hypercementosis. HC, hypercementosis

The cemental anomalies

2- Hypocementosis: 3- Cementicals:
Hypoplasia or Aplasia , It is lack of cellular cementum following the deposition of cellular cementum. Round cemental bodies found free in periodontal Scanning ligament or adherent to the electron micrograph root surface. of root Cause: surface with -In aging person. numerous -Trauma.
sessile cementicles. Imbedded cementicle within a thick layer of Histologic section throughcementum. a a free and Legends: sessile cementicle. AEFC, acellular C, root cementum , extrinsic fiber FC, free cementicle cementum PDL, periodontal CTC, imbedded ligament cementicle SC, sessile cementicle

The cemental anomalies

4- Cementoma:
Synonyms: benign cementoblastoma or cemental dysplasia. Occurs: in apex of root . Mostly mandibular first molar, in female more that male(under age 25). Structure: cementoblasts surround by C.T capsule

THE CEMENTUM Types of cemental Repair RESORPTION

Reasons:

1- anatomic repair: * Local : Occurs -Trauma from occlusion. when the degree of periapical infection, destruction is low. cyst and tumor. - Embedded teeth - functional repair: 2. * Systemic: Occurs when the ;degree of Deficiency of Ca or vitamin A and D destruction is high. hypothyroidism

CLINICAL CONSIDRATION
1- Ankylosis:
Fusions of cementum to alveolar bone.

2- Extraction of teeth . 3- fracture.

Prepared by: - Amani abdoNaser ..B() - Bahia abdrahman .. B(15) - Daneen ..B(2) -Iman ..B() - Suad Mohammed .. B(17) - Tariq ..B()