QUIZ 3 Periodontium II Flashcards

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1
Q

cementum serves to do what 2 things?

A
  • cover the root
  • provide PDL attachment
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2
Q

what are the origins of cementum?

A
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3
Q

describe the composition of cementum

A
  • very similar to bone
  • 50% organic, 50% inorganic
  • inorganice component: hydroxyapatite
  • organic component around 90% collagen type I
  • other collagens: type III and XII
  • bone-associated non-collagenous proteins
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4
Q

what are the bone-associated non-collagenous proteins of cementum?

A
  • bone sialoprotein (BSP)
  • osteopontin (OP)
  • osteocalcin (OC)
  • osteonectin (ON)
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5
Q

cementum is thinner at the CEJ and thicker at the apex. what are the relative thicknesses?

A
  • CEJ: 20-50um
  • apex: 150-200um
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6
Q

cells in the ___ become cementoblasts

A

dental follicle

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7
Q

HERS cells that break off become ___. HERS cells that remain attached to roots can form ___, which is ___.

A
  • cell rests of malassez
  • enamel pearls, which is enamel like material that remains attached to roots
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8
Q

what are two possible scenarios to explain how cells in the dental follicle become cementoblasts?

A
  1. HERS or dentin induces cells in the dental follicle to beome cementoblasts
  2. some HERS cells become cementoblasts themselves
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9
Q

describe the frequency of the 3 types of CEJs

A
  • cementum overlaps enamel - 60% (this is the ideal CEJ because dentin is not exposed)
  • cementum and enamel meet to form a blunt end - 30%
  • there is a gap between cementum and enamel - 10%
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10
Q

what are the two cementum subtypes?

A
  • acellular (primary)
  • cellular (secondary)
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11
Q

describe the differences between acellular and cellular cementum

A
  • classified by the presence of encapsulated cells (cementoblasts) and the predominant origin of the collagen fibers
  • collagen fiber origin: extrinsic from the PDL, or intrinsic from the cementoblasts themselves
  • acellular has extrinsic fibers, cellular has intrinsic fibers
  • primary cementum - acellular extrinsic fiber cementum
  • secondary cementum - cellular intrinsic fiber cementum
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12
Q

where is acellular and cellular cementum located?

A
  • acellular extrinsic fiber cementum - coronal 2/3 of root
  • cellular intrinsic fiber cementum - apical 1/3 of root
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13
Q

describe AEFC formation

A
  • predentin (unmineralized) forms in the roots
  • cementoblasts send processes into this predentin and produce collagen fibers, termed the “fibrous fringe”
  • mineralization occurs internally in the dentin and spreads into the cementum
  • thus cementum and dentin are mingled forming the CDJ
  • after 15-20um of deposition, collagen synthesis stops, and only non-collagenous protein is produced (to induce mineralization)
  • collagen fibers from the developing PDL fibroblasts merge with the fibrous fringe and mineralize in place forming Sharpey’s Fibers (hence extrinsic fiber)
  • cementoblasts end up only on the surface of the cementum (hence acellular)
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14
Q

describe CIFC formation

A
  • starts very similar to AEFC with intermingling to create the CDJ
  • cementoblasts become entrapped in the advancing cementum and become cementocytes
  • form lacunae as in bone, but do not establish a complex cellular network like osteocytes (hence cellular)
  • cementoid visible at the surface
  • there is an initial rapid phase of cementum production, followed by a slower more regular deposition
  • the collage fibers present are produced by cementoblasts, not PDL fibroblasts (hence intrincis)
  • Sharpey’s fibers can still be present: cementum forms around PDL collagen fibers
  • mixed cementum is also possible: alternating layers of AEFC and CIFC with both intrinsic and extrinsic fibers
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15
Q

inner cementoblasts are generally ___

A

non-vital (no vasculature)

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16
Q

describe the main differences between AEFC and CIFC

A
  • AEFC:
    • no cells inside, no cementoid, slower deposition, more mineralized
    • functionality: attachment of PDL to cementum
  • CIFC:
    • more laminar, cells encapsulated, cementoid visible, often absent in canines and incisors
    • functionality: some attachment, adaptation and adjustment for wear
17
Q

what is intermediate cementum?

A
  • between granular layer of tomes and dnetal cementum proper
  • mineralization level higher
  • may function to seal the surface of root dentin: reduce sensitivity
18
Q

what is mixed cementum?

A
  • alternating layers of AEFC and CIFC
  • extrinsic and intrinsic fibers, generally located apically
  • perhaps quite a lot of the secondary cementum is actually mixed
19
Q

what is hypercementosis?

A
  • abnormal thickening of cementum
  • diffuse or circumferential around the whole root
  • can affect entire dentition, single tooth, or portions of one tooth
  • tooth can become ankylosed
20
Q

in physiological and orthodontic tooth movement, cementum is more resistant to ___ than alveolar bone

A

resorption

thus, bone tends to be remodeled first, effectively moving teeth “through” bone

21
Q

the periodontium is generally affected by what 5 types of tooth movements?

A
  • tipping
  • bodily movement
  • extrusive movement
  • intrusive movement
  • rotational movement
22
Q

orthodontists effectively manipulate the ___

A

periodontium

23
Q

in tooth movements, what are the 3 factors that determine the degree of the effect of an applied force?

A
  • tranduction: efficiency of the conversion of physical force into biologic response
  • time: effect is time-dependent
  • magnitude of force: degree of force determines response
24
Q

what are the 4 net results of tooth movements?

A
  • compression
  • tension
  • hyalinization
  • undermining resorption
25
Q

describe compression that can result from tooth movement

A
  • resorption of alveolar bone on the side toward which the tooth moves
26
Q

describe tension that can result from tooth movements

A
  • formation of alveolar bone on the side opposite to compression
27
Q

describe hyalinization that can result from tooth movements

A
  • results from too great or too rapid a compression force (ex. visit to orthodontist)
  • loss of cell activity and vascularity
28
Q

describe undermining resorption that can result from tooth movements

A
  • occurs in conjugation with hyalinization
  • resorption occurs on the opposite surface of compressed bone