CEMENTOGENESIS

DR SAQLAIN BIN SYED GILANI

 Cementogenesis

• Primary (ACELLULAR)
• Secondary (CELLULAR)

Difference between the cells forming each type

 ACELLULAR/PRIMARY CEMENTUM

• Post crown completion the internal and external enamel epithelia

proliferate downwards and map out the shape/outline of the root/s
• Epithelial root sheath of Hertwig

• Process starts at the cervical margin and extend apically

• The epithelial root sheath is covered by a basal lamina on both surfaces,
dental follicle and dental papilla
• The epithelial root sheath induces the Dental Papilla to differentiate into
odontoblasts
• INDUCTION phase
Odontobalsts First formed
Lay down
retrieve layer of
matrix
inwards predentin

• Predentin comprises of organic matrix and collagen fibrils

• Some collagen fibrils are perpendicular to the surface and some oblique
• First formed layer by odontoblasts is structure-less and glass like (HYLINE LAYER). This is due
to the fact that odontoblasts do not leave their processes behind for the first few microns
• Hyline layer not only is formed by odontoblasts alone but it is believed that
epithelial root sheath also plays a role
• Presence of organelles (E.R, G. material and Mitochondria)
• Secretion of enamel related proteins into hyline’s matrix (amelogenin)

• Fenestrations in epithelial root sheath enable fibroblast-like cells of the

adjacent dental follicle and come lie next to unmineralized hyline layer
• Cementoblasts secrete collagen fibrils which intermingle with those of hyline layer’s
• Newly differentiated odontoblasts retreat inwards leaving a trail
• Mineralization of the first formed dentinal layer occurs with matrix vesicles
• Starts from within the center unlike crown and moves inward and outward
• Delayed mineralization front (Hyaline Layer)
• Mineralization extends centripetally (outwards), extends into the fibrous fringe  this
makes the contact between cementum and dentin mineralized

• Similar to bone at the early stage of Acellular cementum formation,

secretions like osteopontin, cementum-attachment protein, sialoprotein
• May play a role in cell attachment, cell growth, differentiation and mineralization
• Fibrous fringe and PDL Fibers attach for proper tooth support in the socket
• Once the attachment is complete, it can now be termed as Acellular
Extrinsic Fiber Cementum
• Cementum gradually but rather slowly increases its thickness (2µm/ year)
• Cementoblasts lie adjacent to the PDL and secret the ground substance
around collagen
• Mineralization unlike dentin is controlled by HAP in dentin (initiated by
dentin)
• PDL is rich in alkaline phosphatase may play a role in mineralization
 Acellular Afibrillar Cementum

• Deposited as a thin layer overlying enamel at the cervical margin

• REE in an unerupted tooth is damaged
• Cells from connective tissue come in contact with enamel
• Enamel induces DF to form cementoblasts
Cellular/Secondary (CIFC)
Cementoblasts

Precementum
Cementocytes
• Apical region at the time of tooth eruption
• Furcation of multi rooted teeth

• Following the loss of HERS large basophilic cells differentiate from dental
follicle against root dentin or acellular cementum
• These cementoblasts possess more cytoplasm and cytoplasmic processes
• There is also roughened E.R which indicates that cementoblasts not only secrete the
ground substance but also collagen

• These fibers run parallel to the root and no extension into PDL
• Unlike Acellular a layer of precementum is formed in this type
• Mineralization is linear and less mineralized than Acellular
• Cementocytes get entrapped in the matrix due to multipolar secretin of
matrix of cells
• Cementocytes
• These cells enable/facilitates the generation of new cementolasts from stem cells
(found in PDL)

• The rate of formation of Cellular cementum is faster hence the incremental

lines are spaced out more as compared to Acellular cementum
 References

• BKB Berkovitz 4 edition

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• Ten Cate’s 9 edition

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