Cementum Thickness and Abnormalities

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Questions and Answers

Which component of the periodontium provides the necessary support for the teeth to maintain their functions?

Periodontal ligament (correct)

Gingiva

Cementum

Alveolar bone

What is the branch of science that investigates and treats the diseases and structures of the periodontium?

Orthodontics

Periodontology (correct)

Endodontics

Prosthodontics

Which structure of the periodontium attaches the teeth to the surrounding alveolar bone and absorbs occlusal forces?

Gingiva

Alveolar bone

Cementum

Periodontal ligament (correct)

What does hypercementosis refer to in relation to the periodontium?

Excessive formation of cementum Signup and view all the answers

What is the main finding in gingivitis?

Gingival bleeding Signup and view all the answers

Which tissue is characterized by clinical attachment and bone loss in periodontitis?

Tooth-supporting tissues Signup and view all the answers

What defense mechanisms are involved in gingival antimicrobial defense?

Gingival epithelium, natural defense systems in the gingival groove, saliva, gingival crevicular fluid Signup and view all the answers

What is the color of cementum?

Yellowish Signup and view all the answers

Where is cementum thickest in relation to the tooth?

In the apical third and furcation areas Signup and view all the answers

Which tissue creates an attachment environment for collagen fibers?

Cementum Signup and view all the answers

What is the primary component of the organic matrix of bone?

Collagen type I Signup and view all the answers

What process forms alveolar bone through differentiation of pluripotent follicle cells?

Intramembranous ossification Signup and view all the answers

Which cells are involved in the resorption of bone?

Osteoclasts Signup and view all the answers

What plays a role in the development of the alveolar processes?

Paracrine factors Signup and view all the answers

How does bone growth occur?

Via the apposition of an organic matrix Signup and view all the answers

Which structure covers the outer layer of bone surfaces?

Periosteum Signup and view all the answers

Which theory explains tooth movement as being controlled by fluid movements and where fibers have a secondary role?

Viscoelastic system theory Signup and view all the answers

What part of the tooth sustains the major part of axial force when force is applied?

Root Signup and view all the answers

What cells undergo formative and remodeling function in response to physical forces in the periodontal ligament and alveolar bone?

Bone cells Signup and view all the answers

What does the high turnover rate of collagen and sulfated glycosaminoglycans in the periodontal ligament indicate?

High activity and rapid changes in the ligament Signup and view all the answers

What is the primary function of periodontal ligament in terms of nutrient supply and drainage?

Supplying nutrients and lymphatic drainage Signup and view all the answers

What is the primary function of bone in terms of supporting organs and enabling mobility?

Producing blood cells and storing minerals Signup and view all the answers

What type of structure does bone possess?

Lightweight yet strong Signup and view all the answers

What composition best describes bone based on its material content?

Equal parts inorganic and organic matter Signup and view all the answers

What does the periodontal ligament regulate to maintain constant dimensions throughout life?

Width Signup and view all the answers

Which age group experiences the greatest increase in cementum thickness?

61-70 years Signup and view all the answers

At what age does hypercementosis typically occur?

60 Signup and view all the answers

What is the radiographic appearance of hypercementosis?

Radiolucent shadow of the periodontal ligament and radiopaque lamina dura Signup and view all the answers

What factors can cause cementum resorption?

Trauma, periapical/periodontal disease, and hereditary fibrous osteodystrophy Signup and view all the answers

What is the proposed role of Malassez epithelial cell rests in cementum repair/regeneration?

Regulation of recruitment and differentiation of cementoblasts Signup and view all the answers

What is ankylosis in dental terms?

Fusion of cementum and alveolar bone with obliteration of the periodontal ligament Signup and view all the answers

What are the physical functions of the periodontal ligament?

Transmits occlusal forces, attaches teeth to bone, and resists impact/shock absorption Signup and view all the answers

What differentiates hypercementosis from periapical cemental dysplasia radiographically?

Presence outside the ligament/lamina dura shadow Signup and view all the answers

What causes excessive deposition of cementum?

Tooth eruption Signup and view all the answers

Which condition may cause hypercementosis?

Florid cemento-osseous dysplasia Signup and view all the answers

What factor is necessary for regeneration of cementum?

Cementoblasts Signup and view all the answers

Which component of the periodontium is primarily responsible for providing an attachment environment for collagen fibers?

Cementum Signup and view all the answers

What is the primary function of the periodontal ligament in terms of supporting organs and enabling mobility?

Absorption of occlusal forces Signup and view all the answers

In which age group does hypercementosis typically occur?

Elderly individuals over 65 years old Signup and view all the answers

Which tissue is characterized by clinical attachment and bone loss in periodontitis?

Gingiva Signup and view all the answers

What factor is necessary for the regeneration of cementum?

Periodontal ligament cells Signup and view all the answers

Which structure of the periodontium attaches the teeth to the surrounding alveolar bone and absorbs occlusal forces?

Periodontal ligament Signup and view all the answers

What is the reported average thickness of cementum at age 60?

215 µm Signup and view all the answers

What is the primary cause of hypercementosis?

Orthodontic appliances Signup and view all the answers

What cells are suggested to play a role in cementum repair/regeneration?

Malassez epithelial cell rests Signup and view all the answers

Which condition may occur with neoplastic and nonneoplastic conditions such as benign cementoblastoma and cementifying fibroma?

Hypercementosis Signup and view all the answers

What is the radiographic appearance of hypercementosis?

Radiolucent shadow of the periodontal ligament and radiopaque lamina dura Signup and view all the answers

What is ankylosis in dental terms?

Fusion of cementum and alveolar bone with obliteration of the periodontal ligament Signup and view all the answers

According to the tensional theory, what is the principal role of the periodontal ligament in tooth support and transmission of occlusal forces?

Transmit forces to bone causing elastic deformation of bony socket Signup and view all the answers

In the viscoelastic system theory, which component controls tooth movement through fluid movements?

Periodontal ligament Signup and view all the answers

What is the primary function of bone in relation to supporting organs, producing blood cells, storing minerals, and enabling mobility?

Transmitting pain sensation and mechanoreception within ligament Signup and view all the answers

Which tissue is characterized by high turnover rate of collagen and sulfated glycosaminoglycans, nutrient supply, and lymphatic drainage?

Periodontal ligament Signup and view all the answers

What differentiates bone from other tissues based on its complex internal and external structure, lightweight yet strong composition?

Inorganic and organic composition Signup and view all the answers

Which component plays a major role in tooth movement when force is applied, sustaining the axial force and causing displacement into the alveolus?

Oblique fibers Signup and view all the answers

What is the primary component of the organic matrix of bone?

Bone sialoprotein Signup and view all the answers

How does bone growth occur?

By the apposition of an organic matrix Signup and view all the answers

What factor plays a role in the development of the alveolar processes?

Insulin-like growth factor (IGF) Signup and view all the answers

What is the proposed role of Malassez epithelial cell rests in cementum repair/regeneration?

Contributing to cementoblast formation Signup and view all the answers

What does hypercementosis refer to in relation to the periodontium?

Excessive deposition of cementum Signup and view all the answers

What type of structure does bone possess?

Both lamellar and woven bone Signup and view all the answers

What is the primary function of gingival crevicular fluid?

To regulate the inflammatory response in the periodontium Signup and view all the answers

Which factor determines the color of gingiva?

Underlying bone density Signup and view all the answers

Where is the gingival groove located?

At the junction of attached and unattached gingiva Signup and view all the answers

What is the primary function of saliva in gingival antimicrobial defense?

To inhibit bacterial growth and colonization Signup and view all the answers

What is the main characteristic of cementum in relation to enamel and dentin?

It is softer than both enamel and dentin Signup and view all the answers

What determines the size and contour of the gingiva?

The alignment of teeth Signup and view all the answers

Which periodontal tissue is characterized by a continuous process of formation and is thickest in the apical third and furcation areas?

Cementum Signup and view all the answers

What is the primary function of the periodontal ligament in relation to supporting organs and enabling mobility?

Enabling mobility Signup and view all the answers

According to the text, what is the color of gingiva?

Coral pink Signup and view all the answers

Which defense mechanisms are involved in gingival antimicrobial defense?

Gingival crevicular fluid Signup and view all the answers

What is the reported average thickness of cementum at age 60?

$1mm$ Signup and view all the answers

Which tissue is characterized by color variations from 'coral pink' to darker shades and is tightly bound to underlying bone?

Gingiva Signup and view all the answers

What is the function of the periodontal ligament in relation to the occlusal forces?

Absorbing occlusal forces and providing attachment for collagen fibers Signup and view all the answers

What is the primary organic composition of bone based on its material content?

Collagen Signup and view all the answers

Which factor determines the color variations of the gingiva?

Amount of melanin in the epithelium Signup and view all the answers

What is the radiographic appearance of hypercementosis?

Excessive deposition of cementum around the root apex Signup and view all the answers

Which defense mechanisms are involved in gingival antimicrobial defense?

Keratinization of the epithelium Signup and view all the answers

Which cells are suggested to play a role in cementum repair/regeneration?

Cementoblasts Signup and view all the answers

What is the radiographic appearance of hypercementosis?

Radiolucent shadow of the periodontal ligament and radiopaque lamina dura Signup and view all the answers

According to the tensional theory, what is the principal role of the periodontal ligament in tooth support and transmission of occlusal forces?

Transmitting forces to bone, causing elastic deformation of bony socket Signup and view all the answers

What causes excessive deposition of cementum?

Malassez epithelial cell rests Signup and view all the answers

Which component of the periodontium provides the necessary support for the teeth to maintain their functions?

Periodontal ligament Signup and view all the answers

What is the primary function of saliva in gingival antimicrobial defense?

Neutralizing acidic secretions from bacteria Signup and view all the answers

What is the main characteristic of cementum in relation to enamel and dentin?

It is softer than enamel and dentin Signup and view all the answers

Which factor is necessary for regeneration of cementum?

Enamel matrix derivatives Signup and view all the answers

In the viscoelastic system theory, which component controls tooth movement through fluid movements?

Fluid movements Signup and view all the answers

What factor plays a role in the development of the alveolar processes?

Malassez epithelial cell rests Signup and view all the answers

What differentiates bone from other tissues based on its complex internal and external structure, lightweight yet strong composition?

Complex internal and external structure Signup and view all the answers

What differentiates bone from other tissues based on its complex internal and external structure, lightweight yet strong composition?

High turnover rate of collagen and sulfated glycosaminoglycans Signup and view all the answers

What is ankylosis in dental terms?

Fusion of cementum and alveolar bone Signup and view all the answers

What is the primary function of paracrine factors in the development of alveolar processes?

Stimulating osteoblast differentiation Signup and view all the answers

What is the main source of osteoclasts, which resorb bone?

Hematopoietic tissue Signup and view all the answers

What is the process through which bone growth occurs?

Appositional growth Signup and view all the answers

Which cell type produces the organic matrix of bone?

Follicle cells Signup and view all the answers

What is the function of endosteum in relation to bone surfaces?

Differentiating into osteoblasts Signup and view all the answers

What characterizes the inner layer of the periosteum?

Osteoblasts and osteoprogenitor cells Signup and view all the answers

Which periodontal tissue is characterized by clinical attachment and bone loss in periodontitis?

Gingiva Signup and view all the answers

What is the proposed role of Malassez epithelial cell rests in cementum repair/regeneration?

Activation of osteoclasts Signup and view all the answers

What differentiates bone from other tissues based on its complex internal and external structure, lightweight yet strong composition?

Lamellar bone organization Signup and view all the answers

What factor plays a role in the development of the alveolar processes?

Salivary pH Signup and view all the answers

What is the radiographic appearance of hypercementosis?

Focal sclerotic masses Signup and view all the answers

What is the primary function of bone in relation to supporting organs, producing blood cells, storing minerals, and enabling mobility?

Harboring hematopoietic tissues Signup and view all the answers

Which neurotransmitter is released by preganglionic neurons of the sympathetic nervous system to activate nicotinic receptors on postganglionic neurons?

Acetylcholine Signup and view all the answers

What type of drugs mimic the effects of the sympathetic nervous system neurotransmitters norepinephrine and epinephrine?

Adrenergic agonists Signup and view all the answers

Which system is responsible for 'Rest and Digest' functions of the body?

Parasympathetic System Signup and view all the answers

Where do postganglionic neurons of the sympathetic nervous system release norepinephrine to activate adrenergic receptors?

Directly into the target organ Signup and view all the answers

What is the primary function of adrenergic receptors?

Bind and produce adrenergic effects Signup and view all the answers

What is the main function of adrenergic drugs?

Mimic the effects of SNS neurotransmitters Signup and view all the answers

Which cholinergic blocking drug is used to treat vestibular disorders?

Scopolamine Signup and view all the answers

What effect does high drug levels have in the brain with cholinergic blocking drugs?

Depressing effect Signup and view all the answers

Which drug is administered pre-operatively to reduce GI and respiratory secretions, salivation, and prevent bradycardia during anesthesia?

Atropine Signup and view all the answers

Which cholinergic blocking drug is used for the treatment of motion sickness and Parkinson's disease?

Scopolamine Signup and view all the answers

Which type of drug interaction/adverse reaction can occur with cholinergic blocking drugs?

Decreased bronchial secretions Signup and view all the answers

Which cholinergic blocking drug can lead to adverse effects such as dry mouth, blurred vision, and anhidrosis in an overdose?

Atropine Signup and view all the answers

Which type of adrenergic receptor is primarily located on presynaptic nerve terminals?

Alpha2-adrenergic receptors Signup and view all the answers

Which adrenergic receptor is primarily found in the smooth muscle of bronchioles, arterioles, and visceral organs?

Beta2-adrenergic receptors Signup and view all the answers

Which type of drug primarily stimulates dopaminergic receptors?

Dopamine Signup and view all the answers

What is the primary therapeutic use of norepinephrine among the listed medications?

Hypertension Signup and view all the answers

Which term best describes drugs that inhibit the actions of acetylcholine in the parasympathetic nervous system?

Cholinergic blockers Signup and view all the answers

What is the primary effect of activation of beta receptors in heart cells?

Inhibitory response Signup and view all the answers

Which type of adrenergic blocking drug disrupts sympathetic nervous system function and is used to treat hypertension, congestive heart failure, and pheochromocytoma?

Beta-blockers Signup and view all the answers

Which class of adrenergic blocking drugs acts at different receptor sites to produce effects such as increasing peripheral vasoconstriction?

Alpha-blockers Signup and view all the answers

Which adrenergic blocking drug interrupts catecholamine actions and is used to relax smooth muscle and decrease blood pressure?

Alpha-1 agonists Signup and view all the answers

Which type of adrenergic drug stimulates dopaminergic receptors to improve kidney blood flow?

Catecholamines Signup and view all the answers

Which type of adrenergic drug has a short duration of action limiting therapeutic usefulness, and may cause serious drug interactions/adverse reactions including hypertension, arrhythmias, seizures, and hyperglycemia?

Synthetic catecholamines Signup and view all the answers

Which type of adrenergic drug acts on alpha receptors like ephedrine and phenylephrine to provide an antihypotensive effect?

Non-catecholamines Signup and view all the answers

Which drugs are primarily used for heart conditions but can also cause severe bronchospasm?

Beta-Adrenergic Blockers Signup and view all the answers

Which drugs mimic the action of acetylcholine and promote salivation, bradycardia, and bronchiolar contraction?

Cholinergic agonists Signup and view all the answers

Which type of anticholinesterase drugs have short durations and are used to diagnose myasthenia gravis and treat Alzheimer's dementia?

Reversible anticholinesterase drugs Signup and view all the answers

Which drugs interrupt parasympathetic nerve impulses and are absorbed from various routes, distributed widely, and metabolized by the liver?

Cholinergic blocking drugs Signup and view all the answers

Which drugs block the enzyme acetylcholinesterase, extending the effects of acetylcholine, and are primarily used as toxic insecticides or nerve gas in chemical warfare?

Irreversible anticholinesterase drugs Signup and view all the answers

Which drugs are used to treat atonic bladder conditions, post-operative urinary retention, and glaucoma?

Cholinergic agonists Signup and view all the answers

Study Notes

Between the ages of 11 and 70, the average thickness of cementum increases threefold, with the greatest increase in the apical region.
Reported average thicknesses: 95 µm at age 20 and 215 µm at age 60.
Cementum abnormalities range from absence (cemental aplasia/hypoplasia) to excessive deposition (cemental hyperplasia/hypercementosis).
Hypercementosis is an age-related phenomenon, affecting one tooth or entire dentition.
Distinguishing between hypercementosis and normal cementum thickness can be challenging due to individual variation.
Hypercementosis may occur with neoplastic and nonneoplastic conditions, such as benign cementoblastoma, cementifying fibroma, periapical cemental dysplasia, florid cemento-osseous dysplasia, and other benign fibro-osseous lesions.
Radiographically, hypercementosis has a radiolucent shadow of the periodontal ligament and radiopaque lamina dura.
Periapical cemental dysplasia, condensing osteitis, and focal periapical osteopetrosis are differentiated from hypercementosis due to their presence outside the ligament/lamina dura shadow.
Causes of hypercementosis include orthodontic appliances, occlusal forces, tooth eruption, and periapical irritation.
Cementum resorption occurs in erupted and unerupted teeth due to local or systemic factors, or idiopathically.
Local factors include trauma, orthodontic movement, malaligned erupting teeth, cysts, tumors, teeth without functional antagonists, embedded teeth, and periapical/periodontal disease.
Systemic factors include calcium deficiency, hypothyroidism, hereditary fibrous osteodystrophy, and Paget disease.
Regeneration of cementum requires cementoblasts, but the origin and regulation of their recruitment and differentiation are not fully understood.
Recent research suggests that Malassez epithelial cell rests may play a role in cementum repair/regeneration.
Malassez rests may activate potential to secrete matrix proteins, such as amelogenins, enamelins, and sheath proteins.
Several growth factors, including bone morphogenetic proteins, platelet-derived growth factor, insulin-like growth factor, and enamel matrix derivatives, have been shown to aid in cementum regeneration.
Ankylosis is the fusion of cementum and the alveolar bone with obliteration of the periodontal ligament.
Ankylosis occurs with cemental resorption, chronic periapical inflammation, tooth replantation, occlusal trauma, and around embedded teeth.
Ankylosis is relatively uncommon and most frequently occurs in the primary dentition.
The periodontal ligament is a complex vascular connective tissue surrounding the tooth root, connecting it to the alveolar bone.
Physical functions: protects vessels/nerves, transmits occlusal forces, attaches teeth to bone, maintains gingival tissues, and resists impact/shock absorption.
Two theories explain tooth support and transmission of occlusal forces: tensional theory and viscoelastic system theory
Tensional theory: principal fibers of periodontal ligament transmit forces to bone, causing elastic deformation of bony socket
Viscoelastic system theory: tooth movement controlled by fluid movements, fibers have secondary role
When force is applied to tooth, oblique fibers sustain major part of axial force, while root tendencies to displace into alveolus
Tooth movement consists of two phases: within periodontal ligament and producing displacement of bony plates
Periodontal ligament and alveolar bone cells undergo formative and remodeling function in response to physical forces
High turnover rate of collagen and sulfated glycosaminoglycans in periodontal ligament
Periodontal ligament supplies nutrients and lymphatic drainage, highly vascularized tissue
Nerve bundles transmit pain sensation and mechanoreception within ligament
Periodontal ligament regulates width to maintain constant dimensions throughout life
Bone: rigid organ supporting organs, producing blood cells, storing minerals, and enabling mobility
Bone structure: complex internal and external structure, lightweight yet strong, hard and hard, composed of inorganic and organic matter.
Periodontium anatomy and periodontal health introduction
Periodontal health defined: no inflammatory periodontal disease or clinical inflammation
Gingivitis: inflammatory lesion limited to the gingiva, colored "coral pink," interacts with dental plaque and host's immune-inflammatory response, main finding is gingival bleeding
Periodontitis: progressive destruction of tooth-supporting tissues, characterized by clinical attachment and bone loss, periodontal pocket, and gingival bleeding
Gingiva: color varies from "coral pink" to darker shades, size varies, contour and shape determined by teeth alignment, firm and resilient, tightly bound to underlying bone
Gingival antimicrobial defense mechanisms: 1) Gingival epithelium, 2) Natural defense systems in the gingival groove, 3) Saliva, 4) Gingival crevicular fluid
Cementum: calcified tissue covering the root, yellowish color, softer than enamel and dentin, creates an attachment environment for collagen fibers, continuous process of formation, thickest in apical third and furcation areas, thicker in distal surfaces than mesial surfaces.
Periodontium anatomy and periodontal health introduction
Periodontal health defined: no inflammatory periodontal disease or clinical inflammation
Gingivitis: inflammatory lesion limited to the gingiva, colored "coral pink," interacts with dental plaque and host's immune-inflammatory response, main finding is gingival bleeding
Periodontitis: progressive destruction of tooth-supporting tissues, characterized by clinical attachment and bone loss, periodontal pocket, and gingival bleeding
Gingiva: color varies from "coral pink" to darker shades, size varies, contour and shape determined by teeth alignment, firm and resilient, tightly bound to underlying bone
Gingival antimicrobial defense mechanisms: 1) Gingival epithelium, 2) Natural defense systems in the gingival groove, 3) Saliva, 4) Gingival crevicular fluid
Cementum: calcified tissue covering the root, yellowish color, softer than enamel and dentin, creates an attachment environment for collagen fibers, continuous process of formation, thickest in apical third and furcation areas, thicker in distal surfaces than mesial surfaces.
Beta1 and beta2-blockers have cardiac effects, but also constrict bronchioles in the lungs.
Beta-Adrenergic Blockers are used primarily for heart conditions such as heart attacks, angina, hypertension, supraventricular arrhythmias, and hypertrophic cardiomyopathy. They also treat anxiety, thyrotoxicosis symptoms, essential tremor, migraines, open-angle glaucoma, and pheochromocytoma.
Beta-Adrenergic Blockers can cause cardiac and respiratory depression, arrhythmia, severe bronchospasm, and severe hypotension as drug interactions/adverse reactions.
The Parasympathetic System's drugs include cholinergics, anticholinergics, ganglionic blocking agents, neuromuscular blocking agents, and ganglionic stimulating agents.
Cholinergic drugs, a subtype of parasympathetic drugs, promote the action of the neurotransmitter acetylcholine and are divided into cholinergic agonists and anticholinesterase drugs.
Cholinergic agonists mimic the action of acetylcholine, including bethanechol, carbachol, pilocarpine, and others. They have pharmacodynamic effects such as salivation, bradycardia, vasodilation, bronchiolar contraction, increased GI activity, increased bladder tone, and pupil constriction.
Cholinergic agonists are used to treat atonic bladder conditions, post-operative and postpartum urinary retention, GI disorders, and glaucoma.
Anticholinesterase drugs block the enzyme acetylcholinesterase, extending the effects of acetylcholine. They are divided into reversible and irreversible types.
Reversible anticholinesterase drugs, such as donepezil and edrophonium, have short durations and are used therapeutically to reduce eye pressure, increase bladder tone, improve GI tone and peristalsis, promote muscular contraction, diagnose myasthenia gravis, and treat Alzheimer's dementia.
Irreversible anticholinesterase drugs, including MALATION, PARATION, PARAOXON, ECOTHIOPHATE, ISOFLUROPHATE, are primarily used as toxic insecticides, pesticides, or nerve gas in chemical warfare, causing SLUDGE symptoms.
Cholinergic blocking drugs, such as atropine, interrupt parasympathetic nerve impulses and are also anticholinergic drugs.
Cholinergic blocking drugs are absorbed from various routes, distributed widely, cross the blood-brain barrier, have moderate protein-binding, are metabolized by the liver, and excreted by the kidneys.

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Description

Explore the changes in cementum thickness between ages 11 and 70 and the potential abnormalities that can occur. Understand how the average thickness increases and the range of abnormalities observed in cementum thickness.