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Shaju_Jacob@imu.edu.my
Extension 2755
Senior Lecturer Dentistry
(Periodontology)
LEARNING OBJECTIVE
This presentation is a continuation from the previous
lecture on healthy periodontium, in this lecture
cementum and bone will be discussed.
At the end of this lecture you will be able to:
Describe clinical and macroscopic features of
cementum and bone
Describe the microscopic feature of cementum and
bone
Discuss its function and its importance
CEMENTUM
IN HEALTH
CEMENTUM
COMPOSITION
INORGANIC:
Calcium and phosphate in the form of HYDROXYAPATITE
crystals
These crystals are 55nm wide,8nm thick
Highest fluoride content
Calcium and magnesium
TRACE AMOUNT:
Copper, Fluorine, Iron, Lead,
Potassium, Silicon, Sodium and Zinc
ORGANIC:
Collagen:
Type I - 90%
Type III - 5%
Non-Collagenous Protein:
Cementum is rich in glycoconjugates, which represent
either glycolipids, glycoproteins or proteoglycans and harbors
a variety of other proteins.
3) Osteonectin
4) Fibronectin, Tenasin
CELLS OF CEMENTUM:
a) Cementoblast
b) Cementocytes
c) Cementoclast
CEMENTOCYTES
CEMENTOBLASTS
Cemental Fibers
Sharpeys Fibers (extrinsic):
These fibers are embedded
portions of the principal fibers
of the periodontal ligament and
are formed by fibroblasts.
Structure of cementum
Under light microscope, two types of cementum
are visible. Based on the presence or absence
of cells they are classified as:
Bone sialoprotein
Cellular
Cementum
Canaliculi of
cementocytes
Lacunae of
cementocyte
Some cementoblasts
become trapped in the matrix
to form cementocytes and sit
in lacunae.
Cementoid
Cementocyte
Cementum
Anatomic Characteristics of
Cellular cementum
It is the cementum is formed after the tooth
reaches the occlusal plane.
It is more irreglular and contains cells within
its matrix called cementocytes.
Cellular cementum is more on the apical half
of the root.
It is less calcified than acellular cementum.
Sharpeys fibers make up smaller portions and
are separated by collagen fibers.
Classification of Cementum:
Based on the findings Schroeder 1985
classified cementum:
Acellullar afibrillar cementum: (AAC):
Intermediate cementum:
1. Acellular Afibrillar
cementum
2. Acellular Extrinsic fiber
cementum
3. Cellular intrinsic fiber
cementum
4. Cellular Mixed stratified
cementum
Periodontal
ligament
cementum
Intermediate
cementum
Dentin
Cementodentinal Junction:
The terminal apical areas of the
cementum where it joins the internal root
canal dentin is known as the
cementodentinal junction (CDJ).
When root canal treatment is performed
the obturating material should be at CDJ.
It remains stable without any increase or
decrease.
The CDJ is 2 to3 um wide.
FUNCTIONS:
Anchorage
Attachment
ALVEOLAR
BONE IN
HEALTH
matrix.
INORGANIC MATTER:
ORGANIC MATTER:
Hydroxyl
Osteocalcin
Osteonectin
Phosphoproteins
Proteoglycans.
Carbonate
Citrate
circumferential lamellae
Osteons (Haversian
lamella)
Cementing lines
Haversian canal
Blood vessels,
nerves,
mesenchymal
tissue, endosteum
Interstitial lamella
ALVEOLAR PROCESS
The alveolar process is the portion of the maxilla and mandible
that forms and supports the tooth sockets (alveoli). Develops in
response to presence or absence of teeth.
The alveolar process consists of the following:
1. An external plate of cortical bone formed by haversian bone
and compacted bone lamellae.
2. The inner socket wall of thin, compact bone called the
alveolar bone proper, which is seen as the lamina dura in radiographs.
3. Cancellous trabeculae, between these two compact layers,
which act as supporting alveolar bone.
In addition, the jaw bones consists of the basal bone, which is the
portion of the jaw located apically but unrelated to the tooth
ALVEOLAR PROCESS
Cortical plate.
Dense outer covering of the spongy bone.
Provides strength and protection.
Spongy bone.
Less dense and cancellous bone.
Makes up the central portion of the alveolar process
INTERDENTAL
SEPTUM:
Interdental
septum consists of
cancellous bone
bordered by the
socket wall cribriform
plates of
approximating teeth
and the facial and
lingual cortical plates.
Lamina dura
openings for
blood vessels
and nerve fibers.
OSTEOBLASTS
OSTEOCLASTS
Osteoid
(or prebone)
Mineralized matrix
Osteoid
Cell process
SOCKET WALL:
BONE MARROW:
In the embryo and newborn, the cavities of all bones are
occupied by red hematopoietic marrow.
Periosteum
Endosteum
It consists of
1) Inner layer osteogenic layer
2) Outer layer fibrous layer.
Fibrous layer
of periosteum
Periosteum Osteoblasts
Osteogenic or
cellular layer
of periosteum
Osteocyte in lacuna
Endosteum
(Osteoblasts)
REMODELLING:
It is the major pathway of bony changes in shape,
resistance to forces, repair of wounds, and calcium and phosphate
homeostasis in the body.
The interdependency of osteoblasts and osteoclasts in
nonmineralized osteoid.
Bone resorption is a complex process morphologically
REFERENCES