The structure and Function of the Periodontium
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Periodontium
Periodontal fiber
Cementogenesis
Dental cementum
Previously, we demonstrated that the inductive properties of bone morphogenetic protein (BMP) highly depend on the nature of the carrier material used for implantation. In this paper, we show that administration of BMP incorporated in a fibrous collagen membrane can help to regenerate periodontal ligament and cementum both in cat canines and in monkey molars. The partially purified bovine BMP was combined with one or two layers of a fibrous collagen membrane. Although the single layer approach showed partial regeneration of periodontal defects, it also quite often led to ankylosis. The double layer technique in artificially prepared class III furcation defects in monkey molars gave favorable results. After 12 wk, not only the alveolar process but also the periodontal ligament and cementum had regenerated along the entire treated dentin surface. Collagen fibers were arranged more or less perpendicular to the surface of the new cementum. Ankylosis was not seen. It is concluded that the double‐layer approach is superior to the single‐layer technique in regenerating cementum.
Periodontal fiber
Cementogenesis
Dental cementum
Ankylosis
Clinical attachment loss
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Alkaline phosphatase (ALP) is a glycoprotein thought to be involved in processes leading to mineral formation in tissues like bone and cementum. In the rat molar periodontium, several regions are associated with the formation of cementum (periodontal ligament, inner part of the gingiva), whereas other areas are not (e.g., the outer part of the gingiva just beneath the outer oral epithelium). In an attempt to establish how the spatial distribution of ALP activity relates to cementum formation, we assessed the activity of the enzyme quantitatively in the periodontium of the rat maxillary molars, by using the indoxyl-tetrazolium salt method. It appeared that the distribution of enzyme activity in the ligament was heterogeneous, indicating local variations in the phosphate household. Highest activity was found in areas related to mineralization, adjacent to the alveolar bone and cementum. Enzyme activity was higher adjacent to cellular cementum than to acellular cementum. With respect to acellular cementum, a highly significant positive correlation was found between ALP activity and cementum thickness, which indicates a close relationship between local phosphate production and cementum formation rate. An interesting observation in the connective tissue of the gingiva mesial to the first molar was a sharp demarcation between an ALP-positive inner part, adjacent to the tooth, and an ALP-negative outer part, underneath the outer oral epithelium. In the interdental gingiva, the entire connective tissue proved positive for the enzyme, suggesting that this region consists of the combined inner gingival parts of two adjacent teeth.
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Understanding of the structure and metabolism of connective tissue components in recent years has increased drastically.The support and attachment of the tooth in the bones of the jaw is provided by a complex comprising of four connectivetissues and is known as the Periodontium. It is attached to the dentine of the root by the cementum and to the bones ofthe jaw via the alveolar bone. Two of the connective tissues are mineralized and comprise of cementum and alveolarbone, while the other two are essentially fibrous in nature and are represented by the periodontal ligament (PDL) and thegingiva. This review article summarizes the current knowledge of the periodontium and will discuss the most importantvital structure in detail that is Periodontal ligament.
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Immunohistochemical knowledge of the distribution of the collagen types in the cementum and periodontal ligament were reported in this paper. Because of the different localization of each of these collagenous components in the two periodontal tissues its function in the matrix was explored. It was also possible to clarify the role of collagen in healthy periodontium as well as in regeneration and wound healing mechanisms.
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The attachment of the roots of mammalian teeth of limited eruption to the jawbone is reliant in part on the mineralization of collagen fibrils of the periodontal ligament (PDL) at their entry into bone and cementum as Sharpey's fibers. In periodontitis, a high prevalence infection of periodontal tissues, the attachment apparatus of PDL to the tooth root is progressively destroyed. Despite the pervasiveness of periodontitis and its attendant healthcare costs, and regardless of decades of research into various possible treatments, reliable restoration of periodontal attachment after surgery is not achievable. Notably, treatment outcomes in animal studies have often demonstrated more positive regenerative outcomes than in human clinical studies. Conceivably, defining how species diversity affects cementogenesis and cementum/PDL regeneration could be instructive for informing novel and more efficacious treatment strategies. Here we briefly review differences in cementum and PDL attachment in commonly used animal models to consider how species differences may lead to enhanced regenerative outcomes.
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Periodontium is an important tooth-supporting tissue composed of both hard (alveolar bone and cementum) and soft (gingival and periodontal ligament) sections. Due to the multi-tissue architecture of periodontium, reconstruction of each part can be influenced by others. This review focuses on the bone section of the periodontium and presents the materials used in tissue engineering scaffolds for its reconstruction.
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Abstract Destruction of the periodontium is normally associated with periodontal disease, although many other factors, such as trauma, aging, infections, orthodontic tooth movement and systemic and genetic diseases, can contribute to this process. Strategies (such as guided tissue regeneration) have been developed to guide and control regeneration using bioresorbable membranes and bone grafts. Although effective to a certain point, these strategies have the problem that they are not predictable and do not completely restore the architecture of the original periodontium. To achieve complete repair and regeneration it is necessary to recapitulate the developmental process with complete formation of cementum, bone and periodontal ligament fibers. Detailed knowledge of the biology of cementum is key for understanding how the periodontium functions, identifying pathological issues and for developing successful therapies for repair and regeneration of damaged periodontal tissue. It is the purpose of this review to focus on the role of cementum and its specific components in the formation, repair and regeneration of the periodontium. As cementum is a matrix rich in growth factors that could influence the activities of various periodontal cell types, this review will examine the characteristics of cementum, its composition and the role of cementum components, especially the cementum protein‐1, during the process of cementogenesis, and their potential usefulness for regeneration of the periodontal structures in a predictable therapeutic manner.
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Abstract Objectives To observe whether preserved healthy cementum could promote differentiation of human periodontal ligament cells to cementoblasts. Materials and methods Symmetrical root slices from each healthy premolar were distributed into either the control group (cementum removed) or test group (cementum preserved). After isolation and characterization, human periodontal ligament cells were inoculated onto root slices for 7 days co‐culture. Two slices per group were studied for cell morphology by scanning electronic microscopy. Twenty‐three slices were detected for expression of cementum attachment protein and cementum protein 23, two putative cementoblast markers, by real‐time polymerase chain reaction. Twenty slices were transplanted into nude mice and analysed using histology and immunohistochemistry for osteopontin and bone sialoprotein expression after 8 weeks. Results Cells of the test group had smoother fibroblast morphology and higher cementum protein 23 and cementum attachment protein expression than those of the control group ( P < 0.01). In the test group, 14 root slices revealed cementum‐like matrix formation resting on old cementum; no splits were observed between newly formed matrix and old cementum. In the control group, 17 specimens had fibrous tissue formation along the root surface and varying width of splits could be seen between new fibrous tissue and dentine surface. Only three specimens demonstrated presence of newly formed thin cementum‐like matrix. Newly formed cementum‐like matrix was positive for osteopontin and bone sialoprotein. Conclusions The results demonstrate that healthy root cementum may promote differentiation of human periodontal ligament cells towards cementoblasts.
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Cementogenesis
Osteopontin
Bone sialoprotein
Dental cementum
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Clinical attachment loss
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Summary The periodontium supports and attaches teeth via mineralized and nonmineralized tissues. It consists of two, unique mineralized tissues, cementum and alveolar bone. In between these tissues, lies an unmineralized, fibrous periodontal ligament (PDL), which distributes occlusal forces, nourishes and invests teeth, and harbors progenitor cells for dentoalveolar repair. Many unanswered questions remain regarding periodontal biology. This review will focus on recent research providing insights into one enduring mystery: the precise regulation of the hard‐soft tissue borders in the periodontium which define the interfaces of the cementum–PDL–alveolar bone structure. We will focus on advances in understanding the molecular mechanisms that maintain the unmineralized PDL “between a rock and a hard place” by regulating the mineralization of cementum and alveolar bone.
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Periodontal fiber
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Periodontal regeneration is the formation of new cementum, periodontal ligament, and alveolar bone followingperiodontal surgery. It is widely believed that tissues formed during regeneration are more resistant to deterioration than thosegained when healing occurs through repair, which is why regeneration is so important. The two main goals of periodontal therapyare controlling the infection and rebuilding the architecture and function of periodontal tissues. Due to the periodontium's highlyhierarchical organization, which calls for a highly coordinated spatiotemporal healing response to enable regeneration, theregeneration of the periodontal apparatus with the formation of the bone-PDL-cementum complex at the same time continues topresent challenges. The final goal of periodontal therapy for tissues destroyed by periodontal diseases is the regeneration of theattachment apparatus, composed of the development of new alveolar bone, periodontal ligament, and cementum. With a clearunderstanding of the periodontal disease process, the regeneration of the periodontium is one of the major goals of periodontaltherapy. This review is an update on the current tissue engineering knowledge as a possible periodontal regeneration technique.
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Periodontal fiber
Cementogenesis
Dental cementum
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