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The Cementum: Its Role In Periodontal Health and Disease

1961; American Academy of Periodontology; Volume: 32; Issue: 3 Linguagem: Inglês

10.1902/jop.1961.32.3.183

1049-8885

Donald A. Kerr,

Periodontal Regeneration and Treatments

T HE cementum is a specialized calcified tissue of mesenchymal origin which provides for the attachment of the periodontal fibers to the surface of the root.It consists of 45 to 50 per cent inorganic material and 50 to 55 per cent organic material with the inorganic material in a hydroxyl apatite structure. The primary cementum is formed initially by appositionalgrowth from the dental sac and later from the periodontal membrane under the influence of cementoblasts.It is formed in laminated layers with the incorporation of Sharpey's fibers into a fibrillar matrix which undergoes calcification.Cementum deposition is a Continuous process throughout life with new cementum being deposited over the old cemental surface.Cementum is formed by the organization of collagen fibrils which are cemented together by a matrix produced by the polymerization of mucopolysaccharides.This material is designated as cementoid and becomes mature cementum upon calcification.The significance of the continuous deposition of cementum has received various interpretations.1. Continuous deposition of cementum is necessary for the reattachment of periodontal fibers which have been destroyed or which require reorientation due to change in position of teeth.It is logical that there should be a continuous deposition of cementum because it is doubtful that the initial fibers are retained throughout the life of the tooth, and therefore new fibers must be continually formed and attached by new cementum.There is without question some wear and tear damage due to traumatism which would necessitate replacement.However, some question the need of new cementum for reattachment of fibers associated with functional reorientation.If we accept the premise that the fibers of the periodontal membrane are not continuous from bone to cementum but that cemental fibers and alveolar fibers are united by an intermediate layer, then functional reorientation can occur in the intermediate layer and reattachment by new deposition of cementum is unnecessary.