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      A SCANNING ELECTRON MICROSCOPIC STUDY OF HYPERCEMENTOSIS

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          Abstract

          The purpose of this study was to evaluate morphological characteristics of teeth with hypercementosis that are relevant to endodontic practice. Twenty-eight extracted teeth with hypercementosis had their root apexes analyzed by scanning electron microscopy (SEM). The teeth were divided according to tooth groups and type of hypercementosis. The following aspects were examined under SEM: the contour and regularity of the root surface; presence of resorption; presence and number of apical foramina, and the diameter of the main foramen. The progression of club shape hypercementosis was directly associated with the presence of foramina and apical foramen obstruction. Cases of focal hypercementosis presented foramina on the surface, even when sidelong located in the root. Circular cementum hyperplasia form was present in 2 out of 3 residual roots, which was the highest proportion among the tooth types. The detection of a large number of foramina in the apical third of teeth with hypercementosis or even the possible existence of apical foramen obliteration contributes to understand the difficulties faced during endodontic treatment of these cases.

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          Most cited references38

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          Pathologic interactions in pulpal and periodontal tissues.

          Both endodontic and periodontal disease are caused by a mixed anaerobic infection. The pathways for the spread of bacteria between pulpal and periodontal tissues have been discussed with controversy. This article is an attempt to provide a rational approach to the perio-endo/endo-perio question based on a review of the relevant literature. In the light of evidence, clinical concepts for the diagnosis and treatment of lesions involving both periodontal and pulpal tissues are discussed.
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            Cementum and periodontal wound healing and regeneration.

            The extracellular matrix (ECM) of cementum resembles other mineralized tissues in composition; however, its physiology is unique, and it contains molecules that have not been detected in other tissues. Cementum components influence the activities of periodontal cells, and they manifest selectivity toward some periodontal cell types over others. In light of emerging evidence that the ECM determines how cells respond to environmental stimuli, we hypothesize that the local environment of the cementum matrix plays a pivotal role in maintaining the homeostasis of cementum under healthy conditions. The structural integrity and biochemical composition of the cementum matrix are severely compromised in periodontal disease, and the provisional matrix generated during periodontal healing is different from that of cementum. We propose that, for new cementum and attachment formation during periodontal regeneration, the local environment must be conducive for the recruitment and function of cementum-forming cells, and that the wound matrix is favorable for repair rather than regeneration. How cementum components may regulate and participate in cementum regeneration, possible new regenerative therapies using these principles, and models of cementoblastic cells are discussed.
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              The cemento-dentino-canal junction, the apical foramen, and the apical constriction: evaluation by optical microscopy.

              The cemento-dentino-canal junction, the apical constriction, and the apical foramen are the principal reference points used to determine the apical limit for instrumentation and root canal filling. For a better understanding of these structures, the objective of this study was to evaluate histologically the localization of the cemento-dentino-canal junction and the diameters of the apical foramen and root canal at the cemento-dentino-canal junction. Eighteen anterior maxillary teeth (canines, central, and lateral incisors) were used, from which 269 histological sections were obtained and evaluated by optical microscopy. The results indicated that the longest extension of the cementum into the root canal was observed in the canines, this value decreasing in the lateral incisors, and even more so in the central incisors. The widest diameter of the apical foramen corresponded to the lateral incisors, followed by the canines and the central incisors. The diameter of the root canal at the cemento-dentino-canal junction was greatest in the canines and lowest in the central and lateral incisors. Great variability was observed in the measurements of the extension of the cementum into the root canal. AQ: 1.
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                Author and article information

                Journal
                J Appl Oral Sci
                J Appl Oral Sci
                Journal of Applied Oral Science
                Faculdade de Odontologia de Bauru da Universidade de São Paulo (Bauru )
                1678-7757
                1678-7765
                December 2008
                December 2008
                : 16
                : 6
                : 380-384
                Affiliations
                [1 ]DDS, Master's degree in Oral Pathology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
                [2 ]DDS, MSc, PhD, Associate Professor, Discipline of Radiology, Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
                [3 ]DDS, MSc, PhD, Full Professor, Discipline of Oral Pathology, Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
                Author notes
                Corresponding address: Dra. Bethânia Camargo Pinheiro - Rua Garcia Braga, 126, Centro, 18940-000, São Pedro do Turvo, SP, Brasil. Phone: +55-14-3377-1190 - e-mail: bethaniacp@ 123456hotmail.com
                Article
                S1678-77572008000600005
                10.1590/S1678-77572008000600005
                4327707
                19082395
                7fb8aaa8-cf53-485b-bec0-02b9e52810f5

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 22 February 2008
                : 18 April 2008
                : 08 May 2008
                Page count
                Figures: 5, Tables: 2, Equations: 0, References: 21, Pages: 5
                Categories
                Original Article

                hypercementosis,root canal,morphology,endodontics
                hypercementosis, root canal, morphology, endodontics

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