Hypercementosis: Review of literature and report of a case of mammoth, dumbbell-shaped hypercementosis
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Abstract:
Hypercementosis is a non-neoplastic condition in which excessive cementum is deposited in continuation with the normal radicular cementum. Although some cases of hypercementosis are idiopathic, this condition is associated with several local and systemic factors such as supra-eruption of a tooth, inflammation at the apex of a tooth, traumatic occlusion, Paget's disease, etc. Hypercementosis may be isolated, involve multiple teeth, or appear as a generalized process. Posterior teeth are more commonly involved. The radiographic appearance of hypercementosis is an altered shape of the root with maintenance of normal relationship of the shadows of the periodontal membrane and lamina dura. The histologic study of teeth with hypercementosis shows that the cementum formed is usually osteocementum (acellular cementum). The differential diagnosis may include any radiopaque structure that is seen in the vicinity of the root, such as a dense bone island or mature cemento-osseous dysplasia. Patients with hypercementosis require no treatment. Because of a thickened root, occasional problems have been reported during the extraction of an affected tooth. Herein, an interesting case of a mammoth, dumbbell shaped hypercementosis associated with maxillary third molar is reported.Keywords:
Conservative Treatment
Dental cementum
Cementum is the calcified tissue covering roots of teeth and serves as attachment sites of the periodontal ligament. Although recent studies have suggested that extracellular matrix of cementum is very similar to that of bone, cementogenesis on a biological basis is still poorly understood. There are variations in the distribution and mineral contents of cementum depending on animal age, tooth species and position within the tooth roots. This paper reviews the formation and age-related changes of cellular and acellular cementum in rat molar roots, and discusses the effect of mechanical stress to the cementum formation.
Cementogenesis
Periodontal fiber
Dental cementum
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Previous data demonstrated that root cementum may affect periodontal regeneration. As such, this study aimed to explore further possible mechanisms involved in this process by investigating in humans whether root cementum modulates gene expression in the regenerating tissue formed under membrane-protected intrabony defects.Thirty subjects with deep intrabony defects (> or =5 mm; 2- or 3-wall) were selected and assigned to the control or test group. The control group received scaling and root planing with the removal of granulation tissue and root cementum; the test group underwent removal of granulation tissue and soft microbial deposits by cleaning the root surface with a microbrush and saline solution, aiming at cementum preservation. Guided tissue regeneration (GTR) was applied to both groups. Twenty-one days later, the newly formed tissue under the membrane was assessed for the expression of the following genes: alkaline phosphatase (ALP), osteopontin (OPN), osteocalcin (OCN), platelet-derived growth factor-alpha (PDGFA), bone sialoprotein (BSP), and basic fibroblast growth factor (bFGF).Data analysis demonstrated that mRNA levels for PDGFA, BSP, and bFGF were higher in the sites where root cementum was kept in place compared to the sites where root cementum was removed completely as part of the periodontal therapy (P <0.05); in contrast, OCN levels were lower (P <0.05). No difference for ALP or OPN was observed between the control and test groups (P >0.05).Root cementum may modulate the expression of growth and mineral-associated factors during periodontal regeneration.
Dental cementum
Cementogenesis
Periodontal fiber
Tooth root
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Abstract Cementum, a bone‐like tissue that surrounds the roots of teeth, anchoring them to the periodontal ligament, is useful for determining the age at and season of death of mammals, an issue of concern for both archaeologists and biologists. When a tooth is sectioned and examined microscopically, cementum appears in bands that differ in their optical properties and are well correlated with seasonal growth. Because it is a continually deposited tissue that is rarely modified or resorbed, cementum records the history of a variety of seasonal factors that affect its growth. An understanding of the biological nature of cementum is crucial to the identification of these factors and interpretation of the resulting incremental structure. This paper outlines current knowledge of the development, histology and function of cementum in the context of the mammalian masticatory apparatus. Of the various types of cementum, acellular cementum is often more appropriate for seasonal correlations. Differences between acellular cementum increments are probably related to specific dietary factors that often vary between seasons. Cellular cementum increments probably result from phasic cementogenesis triggered by tooth eruption. This paper outlines a study of cementum bands in Gazella gazella for which there is an excellent correlation between the season of death and incremental structures in their cementum. This correlation can be used to estimate the season of death of gazelles from archaeological sites in the Levant. Problems for future research are outlined.
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Abstract Objectives The present study aimed to evaluate the effects of conservatively treated diseased cementum on in vitro cementoblast differentiation and in vivo cementum‐like tissue formation of human periodontal ligament cells ( hPDLC s), and observe differential effects of enamel matrix derivative ( EMD ) on in vivo cementum formation by hPDLC s. Materials and methods Forty‐eight cementum slices and 48 dentin slices were prepared from periodontitis compromised teeth, and hPDLC s were inoculated on to all root slices. Twenty‐four co‐cultured root slices of each group were used for mRNA expression of cementum attachment protein and CEMP1. With application of EMD , 24 co‐cultured root slices (divided into groups C, D, C+E, D+E) were transplanted subcutaneously into nude mice. All root fragments were reviewed by histological analysis and immunohistochemical staining for bone sialoprotein. Results mRNA expressions of cementum attachment protein and cementum protein ‐ 1 from hPDLC s on cementum slices were statistically higher than those of dentin slices. Seven specimens of group C and 10 specimens of group C+E revealed a layer of cementum‐like tissue ( NFC ) on surfaces of pre‐existing cementum. NFC was thicker in group C+E than in group C. All NFC s were positively stained for bone sialoprotein, however, there was no NFC formation on dentin slices. Conclusion Conservatively treated diseased cementum promoted in vitro cementoblast differentiation and in vivo cementum‐like tissue formation by hPDLC s, and the in vivo effect was enhanced by the presence of EMD .
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Periodontal fiber
Dental cementum
Cementogenesis
Bone sialoprotein
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Dental cementum
Immunogold labelling
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Background and Objective: The aim of the present study was to evaluate comparatively the effect of two different approaches for root decontamination on new cementum formation following guided tissue regeneration (GTR). Material and Methods: Nine mongrel dogs were used to obtain bilateral chronic class III furcation defects by placing cotton ligatures around both third mandibular premolars. The teeth were randomly assigned to receive one of the following treatments: scaling and root planing, by means of hand and rotatory instruments, in order to remove soft and hard deposits as well as all root cementum (group A); or removal of only soft microbial deposits, by polishing the root surface with rubber cups and polishing paste, aiming for maximum root cementum preservation (group B). Both groups were treated with GTR, with the use of resorbable polyglycolic‐lactic acid membranes (RESOLUT XT ® ). Results: Four months later, data analysis showed that a superior length (mm) (3.59 ± 1.67 and 6.20 ± 2.26 for groups A and B, respectively; p = 0.004) and a thicker layer (µm) (18.89 ± 9.47 and 52.29 ± 22.48 for groups A and B, respectively; p = 0.001) of new cementum was achieved by keeping the root cementum in place during root decontamination (group B). Regardless of the treatment modality, the new cementum was predominantly of a reparative, cellular extrinsic and intrinsic fiber type. Conclusion: Within the limits of the present study, it may be concluded that root cementum preservation may affect the new cementum formation following GTR in class III furcation defects, and the treatment modality did not influence the type of newly formed cementum.
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Furcation defect
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T he purpose of the study was to determine if total cementum removal from periodontally involved root surfaces was a clinically realistic objective. The experimental specimens were 36 periodontally involved teeth, extracted because of advanced periodontal disease. Eighteen teeth were from patients under age 36 while the other 18 were from patients over 36. All teeth had at least 6 mm of attachment loss on the proximal surface tested and showed no evidence of forceps damage. After removing all visible calculus, equal numbers of each tooth type in each age group were given 50 planing strokes with either a Jacquette scaler, a Gracey curet. or an Indiana University curet. Following the planing procedure the specimens were fixed, decalcified, and 7 μ thick sections prepared and stained with hematoxylin and eosin. Two teeth were excluded from the evaluation due to poor orientation. In none of the remaining 34 teeth was cementum totally removed over the entire proximal test surface. There was no apparent difference between the instruments in the amount of residual cementum found. Larger amounts of residual cementum were seen in more apical areas in both age groups.
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The authors present a study on the cementum of impacted teeth. It was not possible to correlate the thickness of the cementum and the age of the patients. Significant differences were found, on the other hand, between the thickness and distribution of the cementum in different teeth. Third molars showed in almost all cases an increase in the thickness of cementum.
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Cementogenesis
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Objective To observe the changes of root surface and analyze the mineral contents in cementum after local application of CPP-ACP,and to evaluate the effects of CPP-ACP paste on the cementum.Methods Cementum slices were obtained from healthy molars,then the slices were coated with GC Tooth Mousse(comtaining 10% CPP-ACP)for 21,14 and 7 days,respectivel.Control groups were set up.After the treatments,the surfaces were observed under field emission-scanning electron microscopy(FE-SEM).The SEM observations revealed different morphological features brought about by CPP-ACP,and the energy spectrometry analysis was used to measure the mineral contents in cenentum(Ca,P).Results There were obvious morphological differences between each group: a layer of membrane could be seen on the surface of cementum in the slices that were coated with GC Tooth Mousse for 14 and 21 days.The mineral contents of each groups were similar to that of control groups.Conclusion Local application of GC Tooth Mousse on healthy cementum after 14 days,a layer of member can been seen on the surface,and this member have protective effect on cementum.
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Smear layer
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One of the most common and ubiquitous methods to age mammals is by counting the cementum annuli in molars, premolars, incisors, or canines. Despite the ubiquity and perceived simplicity of the method, cementum annuli analysis can be time-consuming, expensive, inaccurate, and imprecise, and require specialized equipment. Using beavers (
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Mandibular molar
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