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Both acellular and cellular cementum are arranged in lamellae separated by incremental lines parallel to the long axis of the root These lines represent rest periods in cementum formation and are more mineralized than the adjacent cementum Sharpeys fibers make up most of the structures of acellular cementum, which has a principal role in supporting the tooth
CEMENTO-ENAMEL JUNCTION
THICKNESS OF CEMENTUM
The thickness of cementum on the coronal half of the root varies from 16 to 60 microns, or the thickness of a hair It attains its greatest thickness (up to 150 to 200 microns) in the apical third and also in furcations areas
Enamel pearls
Globules of enamel on root surface in cervical region and resemble small pearls, up to several millimeters in diameter Its clinical relevance is that is promotes periodontal lesions by acting as plaque retentive structures It may mimic calculus clinically and radiographically and can be scaled off or can be removed by grinding Large pearls may contain pulpal extensions
Cementicles
Globular masses of acellular cementum generally less than 0.5 mm in diameter, which form within the periodontal ligament Cementicles are not of clinical significance unless they become exposed to the oral environment where they may act as sites for plaque retention
Types:
Free cementicles lie free in periodontal ligament Attached / Sessile cementicles fused or attached to radicular cemental surface Interstitial cementicles totally incorporated or embedded in cementum
Cementoma
Masses of cementum generally located apical to the teeth, to which may or may not be attached Considered either odontogenic neoplasm or developmental malformation Occur more frequently in females and more often found in the mandible than in the maxilla Harmless
Ankylosis
It is the fusion of the mineralized root surface with alveolar bone with obliteration of the periodontal ligament Generalized injury or removal of the periodontal ligament may lead to the condition Results in resorption of the root and its gradual replacement by bone tissue
ALVEOLAR BONE
ALVEOLAR PROCESS It is the part of the maxilla or mandible that forms and supports the teeth ALVEOLAR BONE PROPER It consists of a thin lamella of bone (cortical bone) surrounding the root. Fibers of the periodontal ligament are embedded in this bone SUPPORTING BONE It consists of cancellous trabeculae and surrounds the alveolar bone proper and provides additional support
In radiographs the alveolar bone proper (inner wall of the socket or inner cortical plate) appears as an opaque line called the lamina dura The alveolar bone proper is perforated by many openings through which the blood vessels, lymphatics, and nerves of the periodontal ligament pass and also called the cribriform plate because of these perforations The outer cortical plate is covered by a fibrous and cellular periosteum The interdental septa (singular, septum) are bony partitions that separate adjacent alveoli Alveolar bone proper is formed for the express purpose of supporting and attaching the teeth. The alveolar process depends on the presence of teeth for its existence
Alveolar dehiscence is a dipping of the crestal bone margin exposing the root surface Alveolar fenestration is a circumscribed hole in the cortical plate over the root and does not communicate with
PERIOSTEUM
It is a lining at the outer surface of the alveolar process It contains the neural, vascular, as well as the cellular elements necessary for the maintenance of normal bone function and repair On the alveolar surface, the periodontal ligament serves in the same capacity as the periosteum The endosteum is the corresponding cellular layer found within marrow spaces
BLOOD SUPPLY
Branches of the alveolar artery
VASCULATURE
In advancing age, there is a reduction in blood flow a decrease in connective tissue cellularity and an increase in the number of coarseness of collagenous fibers principal fibers of the periodontal ligament are thicker in ageing humans than in younger individuals fewer fibroblasts, osteoblasts, and cementoblasts degenerative hyaline changes calcified bodies are common in the periodontal ligament of elderly humans
CEMENTUM
Cemental deposition slows in old age The attachment of cementum to dentin may be weakened Spurring of cementum is sometimes the result of the fusion of calcospheroid bodies near cementum or of the calcification of epithelial rest aggregates
ALVEOLAR BONE
Physiologic tooth migration may be slow or halt in old age The vascularity of bone appears to be diminished Osteoporosis may be observed in aging, particularly in the alveolar bone of postmenopausal women There is slowing and even a halt in bone remodeling Thus the replacement of extracted teeth with prostheses in order to prevent overeruption, malpositioning, and tilting of neighboring teeth may not be necessary Function and esthetics will be the principal