CEMENTUM AND

ALVEOLAR BONE

SWATI Y. RAWAL, BDS, MDS, MS

 Cementum

 Cementum is the mineralized tissue covering the

roots of teeth
 It furnishes a medium for the attachment of
collagen fibers that bind the tooth to the
surrounding structures
 It is avascular. Thus, it exhibits increased resistance
to resorption
CEMENTUM
 Similar in composition to bone and dentin.
 Inorganic portion is hydroxyapatite ranging from 45-50%
 Organic portion is a protein carbohydrate-protein
complex ranging from 20-25%
 The remaining 30-35% is water
 Cementum is softer than calculus
 Cellular Intrinsic fiber
cementum
 Also called secondary cementum
 After half the root is formed , a rapidly forming less
mineralized variety of cementum is laid down
 The fibers are derived from the synthetic and
secretory activity of cementoblasts
 Found in the apical third and inter-radicular
regions of the tooth
 Because of rapid deposition, an un-mineralized
layer of cementum called cementoid and cells
become entrapped in the extra-cellular matrix to
form cementocytes.
Extrinsic, mixed, and
afibrillar cementum
 In This form the extrinsic fibers originating the
principal fibers of the PDL, that is Sharpey’s fibers

 Mixed fibers cementum: Contains both extrinsic

and intrinsic fibers
 Afibrillar cementum: When the reduced enamel
epithelium retracts from the cervical region of the
enamel, mesenchymal cells differentiate into
cementoblasts and deposit a layer of cementum
on the enamel surface
 Cementoenamel Junction

65% 25% 10%

CEMENTUM

 Primary
 Secondary
 Cellular
 Acellular
 Afibrillar *
 Reparative

Listgarten, M.: J Canadian

Dent Assn 1970
CEMENTUM

 Primary
 Secondary
 Cellular
 Acellular
 Afibrillar *
 Reparative
Listgarten, M.: J Canadian
Dent Assn 1970
 CEMENTUM

 Primary
 Secondary
 Cellular
 Acellular
 Afibrillar
 Reparative
ALVEOLAR BONE
MOST LABILE OF PERIODONTAL
HARD TISSUES

ALVEOLAR PROCESS

BASAL BONE
ALVEOLAR BONE
CHEMICAL COMPOSITION IS
SIMILAR TO CEMENTUM
 40% HYDROXYAPATITE
 40% TYPE I COLLAGEN
 REMAINDER IS INTERSTITIAL GLYCOPROTEINS
ALVEOLAR BONE
MOST LABILE OF PERIODONTAL
HARD TISSUES

ALVEOLAR PROCESS

BASAL BONE
ALVEOLAR BONE
ALVEOLAR PROCESS
CORTICAL PLATES
TRABECULAR BONE
ALVEOLAR BONE PROPER

BASAL BONE
Structure of bone

 Bone cells present in a bone matrix

 Bone matrix made of collagen fibers and grond
substance, ie. Complex mucopolysaccharides
 Inorganic or crystalline part comprises
hydroxyapatite crystals
 Bone cells are called osteocytes and are
distributed throughout the matrix
 Osteocytes occupy small spaces in the matrix
called lacunae
 Lacunae are connected to each other by a
system of canals called canaliculi
Structure of bone

 Canaliculi open into certain canals that contain

capillaries
 Mature bone is arranged in thin layers called
lamellae
 Lamellae are arranged in concentric circles
called Haversian system
 Haversian system consists of a concentric
lamellae around a central canal called Haversian
canal which contain capillary blood vessels
ALVEOLAR PROCESS

CORTICAL PLATES
TRABECULAR BONE
ALVEOLAR BONE
PROPER

BASAL BONE
Cortical plate

 Continuous with cortical plate of basal bone

 Mature lamellated bone
 Dense lamellated Haversian system
The spongiosa

 Lies between the cortical plates and alveolar

bone proper
 Contains marrow spaces
 Maxilla has more cancellous bone than mandible
 Inter-radicular and interdental septae consist of
spongy bone
 These septae transmit blood vessels and the
radiolucent lines of these on radiographs are
called Hirschfield’s canals
Cribriform plate or the
alveolar bone proper
 Layer of compact bone which forms the bony
wall of the tooth socket
 Appears radiopaque in radiographs and is called
Lamina dura
 It is sieve like and transmits numerous blood
vessels and nerves and is called cribriform plate
 Consists of bundle and lamellated bone
 Gives attachment to Sharpey’s fibers
osteoblasts

 Connected with bone formation

 Found where new bone is forming
 Active in the formation of collagen fibrils and
ground substance that constitute organic matrix
 Also participate in calcification
 Produce a homogeneous intercellular substance
called primary osteoid tissue
osteocytes

 Osteoblasts become entrapped in osteoid tissue

during its formation and are termed osteocytes
 Occupy a space called lacuna and anastomose
with each other by means of processes contained
in canaliculi
 Processes of osteocytes communicate with each
other and with central canal of Haversian system
osteoclasts

 Large multinucleated
connective tissue cells
and are active in bone
resorption
 Seen in areas of bone
resorption and reside in
irregular scalloped
surfaces of bone called
Howship’s lacunae
ALVEOLAR PROCESS
ALVEOLAR BONE PROPER

TOOTH SOCKET
CRIBRIFORM
PLATE
HIGHLY
VASCULARIZED
NOT MORE
HIGHLY
MINERALIZED
ALVEOLAR BONE
Response to Function

Tension Pressure
BLOOD SUPPLY
CLINICAL
SIGNIIFICANCE
Relationship Between
Gingival and Bony Contours
in Health
Most Coronal Aspect of the
Interdental Bone
Relationship Between Gingival Contours
and Possible Bony Dehiscence
CLINICAL CROWN LENGTHENING
CLINICAL CROWN LENGTHENING
CLINICAL CROWN LENGTHENING
CLINICAL CROWN LENGTHENING
CLINICAL CROWN LENGTHENING
CLINICAL CROWN LENGTHENING
CLINICAL CROWN LENGTHENING!!!
QUESTIONS?

COMMENTS?