Cementum Flashcards

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1
Q

What is Cementum?

A
  • Thin layer of calcified tissue covering radicular tissue
  • Cervically (top of root) it’s 10-15μm in thickness
  • Could exceed 600μm at root apex
  • Adheres to dentine and to the periodontal ligament
  • Capable of repair and regeneration
  • Formed throughout life; allowing re-attachment of the periodontal ligament
  • Layer of uncalcified precementum
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2
Q

What are the physical properties?

A
  • Pale yellow in colour
  • Dull surface
  • Softer and more permeable than dentine
  • Easily abraded cervically (at CEJ)
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3
Q

What’s the chemical composition of Cementum?

A

65% inorganic:

  • Mainly hydroxyapatite
  • Thin plate like apatite crystals

23% organic:

  • Collagen type I
  • Non-collagenous elements similar to bone (Sialoprotein & Osteopntin)

12% water by weight

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4
Q

What are the classifications of Cementum?

A

Presence or absence of cells:
+ Cellular cementum
+ Acellular cementum

Nature and origin of the organic matrix:
+ Extrinsic fibre cemen.
+ Intrinsic fibre cemen.
Mixed fibre cemen.

Combination of both:
\+ Acellular extrinsic fibre cementum
\+ Cellular intrinsic cementum
\+ Mixed fibre cementum (cellular and acellular)
\+ Afibrillar cementum
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5
Q

What’s Cellular cementum?

A
  • Cementum containing cementocytes in lacunae within cementum matrix
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6
Q

What’s Acellular cementum?

A
  • Cementum without any cells in its matrix
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7
Q

What’s Fibrillar cementum?

A
  • Cementum with a matrix that contains well-defined fibrils of type I collagen
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8
Q

What’s Afibrillar cementum?

A
  • Cementum that has a matrix devoid of detectable type I collagen fibrils - the matrix tends to have a fine, granular consistency
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9
Q

What’s Extrinsic fibre cementum?

A
  • Cementum which contains primarily extrinsic fibres
  • I.e Sharpey’s fibres that are continuous with the principle fibres of the periodontal ligament
  • Since Sharpey’s fibres were originally produced by periodontal ligament fibroblasts, they are orientated perpendicularly to the cementum surface
  • Play a major ole in tooth anchorage
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10
Q

What’s Intrinsic fibre cementum?

A
  • Cementum which contains primarily intrinsic fibres
  • Fibres produced by cementoblasts and that are orientated more or less parallel to the cementum surface
  • Located primarily at sites undergoing repair, following surface resorption
  • No role in tooth anchorage
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11
Q

Specific types of cementum: What’s Acellular, afibrillar cementum?

A
  • Cementum is mostly composed of mineralised matrix, without detectable collagen fibrils or cementocytes
  • Produced exclusively by cementoblasts
  • Typically found as coronal cementum on human teeth
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12
Q

Specific types of cementum: What’s Acellular, extrinsic cementum?

A
  • The cementum has a matrix with well defined, type I collagen fibrils
  • Fibrils are part of the densely packed Sharpey’s fibres; that are continuous with the principle fibres of the periodontal ligament
  • Due to being densely packed, the individual Sharpey’s fibres that form the bulk of the matrix may not by identifiable as individual fibres within the cementum layer
  • Cementum is acellular, located in the cervical 2/3 of the root of human teeth
  • Major role in tooth anchorage
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13
Q

Specific types of cementum: What’s Cellular, intrinsic fibre cementum?

A
  • Contains cementocytes in a matrix composed almost exclusively of intrinsic fibre cementum
  • Located almost exclusively at sites of cementum repair
  • No role in tooth anchorage
  • May be covered over by extrinsic or mixed fibre cementum; both of which provide new anchorage
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14
Q

Specific types of cementum: What’s Cellular, mixed fibre cementum?

A
  • Found on apical 3rd of the root and in furcations
  • Rate of cementum formation is more rapid compared to cervical region
  • Mineralised, extrinsic collagen fibres (Sharpey’s) run a more irregular course than in acellular, extrinsic fibre cementum
  • Intrinsic fibres are found interspersed among the etrinsic fibres of the cementum matrix; meaning individual Sharpey’s fibres are more readily identifiable than in extrinsic fibre cementum
  • Cementoblasts are trapped in lacunae where they become cementocytes
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15
Q

Which variation of cementum is cellular and which is acellular?

A
  • Primary cementum = acellular

- Secondary cementum = cellular

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16
Q

What’s the appearance of acellular cementum?

A
  • Structureless
17
Q

What causes the difference between cellular and acellular cementum?

A
  • Formation rate of both tissues
18
Q

What’s the orientation of the cementocytes canaliculi?

A
  • Face the periodontal ligament - direction of nutrients
19
Q

Are cementocytes active or inactive?

A
  • No not in acellular cementum
  • Low cytoplasmic/nuclear ratio
  • Minute amounts of energy and protein sythesising organelles
  • Deposited with an irregular rhythm resulting in INCREMENTAL LINES OF SALTER
20
Q

What do the incremental lines mark?

A
  • Differences in both mineralisation and in organic matrix composition
21
Q

What are the 3 arrangements between cementum and enamel at the Cemento-Enamel Junction?

A

Pattern 1: cementum overlaps enamel (60%)

Pattern 2: Cementum and enamel meet at butt joint (30%)

Pattern 3: Cementum and enamel fail to meet and the dentine between them is exposed (10%)

ALL THESES PATTERNS MAY BE PRESENT IN A SINGLE TOOTH

22
Q

At the Cenemto-dentinal junction; cementum acts as an intermediate layer between which 2 tissues?

A

Dentine and Periodontal ligament fibres

23
Q

How do Periodontal ligaments attach to the cementum?

A
  • Fibres in the Periodontal ligament run into the organic matrix of the precementum
  • Mineralisation of the precementum leads to the incorporation of the fibres = SHARPEY’S FIBRES
24
Q

What can cause cementum resorption and repair?

A
  • Associated with trauma and pressure

- Via multinucleated odontoclasts

25
Q

Can deficiencies in dentine be resolved by cementum?

A

YES

  • Resorption in dentine can be filled by deposition of cementum
  • A reversal line is visible; boundary where repair cementum is located against the Dentine
  • Less mineralised and has smaller crystals compared to regular cementum
26
Q

What are Cemenicles?

A
  • Calcified masses within the cementum - attached or free

- Typically in the apical and middle thirds & furcation areas