Classification of Cementum

1. Embryologically

Primary and secondary

2. According to cellular component

Acellular: Thin, Amorphous, First layer to seal the dentin tubules

Cellular: Thick, Better structure, Apical surface

Layers of cellular and acellular cementum alternate (randomly)

3. Based on the origin of the collagenous matrix
Extrinsic
Intrinsic
Mixed

4. Combined classification
a. Primary acellular intinsic fiber cementum
b. Primary acellualar extrinsic fiber cementum
c. Secondary cellular intrinsic fiber cementum
d. Secondary cellular mixed fiber cementum
e. Acellular afibrillar cementum

5. Depending on the location and patterning
Intermediate and mixed stratified cementum

Participating Cells

Cementoblasts

Active
Cells are round, plump with basophilic cytoplasm (rough endoplasmic reticulum)
Inactive
Cells have little cytoplasm
Cementocytes

1. Cementocyte lacuna
2. cementocyte canaliculus

Cells have fewer organelles compared to cementoblasts. They are found in lacunae and have numerous processes toward the periodontal ligament. Eventually they die due to avascularity

Cementicles

a) free
b) attached
c) embedded

Cap stage

The first signs of an arrangement of cells in the tooth bud occur in the cap stage. A small group of ectomesenchymal cells stops producing extracellular substances, which results in an aggregation of these cells called the dental papilla. At this point, the tooth bud grows around the ectomesenchymal aggregation, taking on the appearance of a cap, and becomes the enamel (or dental) organ. A condensation of ectomesenchymal cells called the dental follicle surrounds the enamel organ and limits the dental papilla. Eventually, the enamel organ will produce enamel, the dental papilla will produce dentin and pulp, and the dental follicle will produce all the supporting structures of a tooth

MANDIBULAR THIRD MOLAR

Facial: The crown is often short and has a rounded outline.

Lingual: Similarly, the crown is short and the crown is bulbous.

Proximal: Mesially and distally, this tooth resembles the first and second molars. The crown of the third molar, however, is shorter than either of the other molars

Occlusal: Four or five cusps may be present. Occlusal surface is a same as of the first or second molar, or poorly developed with many accessory grooves. The occlusal outline is often ovoid and the occlusal surface is constricted. Occasionally, the surface has so many grooves that it is described as crenulated--a condition seen in the great apes

Contact Points; The rounded mesial surface has its contact area more cervical than any other lower molar. There is no tooth distal to the third molar..

Roots:-The roots, two in number, are shorter in length and tend to be fused together. they show a distinct distal curve

Nerve and vascular formation

Frequently, nerves and blood vessels run parallel to each other in the body, and the formation of both usually takes place simultaneously and in a similar fashion. However, this is not the case for nerves and blood vessels around the tooth, because of different rates of development.

Nerve formation

Nerve fibers start to near the tooth during the cap stage of tooth development and grow toward the dental follicle. Once there, the nerves develop around the tooth bud and enter the dental papilla when dentin formation has begun. Nerves never proliferate into the enamel organ

Vascular formation

Blood vessels grow in the dental follicle and enter the dental papilla in the cap stage. Groups of blood vessels form at the entrance of the dental papilla. The number of blood vessels reaches a maximum at the beginning of the crown stage, and the dental papilla eventually forms in the pulp of a tooth. Throughout life, the amount of pulpal tissue in a tooth decreases, which means that the blood supply to the tooth decreases with age. The enamel organ is devoid of blood vessels because of its epithelial origin, and the mineralized tissues of enamel and dentin do not need nutrients from the blood.

LOCATION OF THE TEETH

Normally, a human receives two sets of teeth during a lifetime.

The first (deciduous or primary) set consists of 20 teeth ("baby" teeth).

The second (permanent) set usually consists of 32 teeth. In each quadrant, there are eight permanent teeth: two incisors, one cuspid, two bicuspids, and three molars 

The tooth positioned immediately to the side of the midline is the central incisor, so called because it occupies a central location in the arch.

To the side of the central incisor is the lateral incisor. Next is the cuspid, then the two bicuspids (the first bicuspid, followed by the second bicuspid). The last teeth are three molars. After the second bicuspid comes the first molar, followed by the second molar, followed by the third molar or more commonly called the "wisdom tooth."

Another method of describing the location of teeth is to refer to them as anterior or posterior teeth .

Anterior teeth are those located in the front of the mouth, the incisors, and the cuspids. Normally, these are the teeth that are visible when a person smiles.

The posterior teeth are those located in the back of the mouth-the bicuspids and molars.

PULP

Coronal

Occupies and resembles the crown,

Contains the pulp horns

It decreases in size with age

Radicular

Occupies roots

Contains the apical foramen

It decreases in size with age

Accessory apical canals

PULP FUNCTIONS

Inductive: The pulp anlage initiates tooth formation and probably induces the dental organ to become a particular type of tooth.

Formative: Pulp odontoblasts develop the organic matrix and function in its calcification.

Nutritive: Nourishment of dentin through the odontoblasts.

Protective: Sensory nerves in the tooth respond almost always with PAIN to all stimuli (heat, cold, pressure, operative procedures, chamical agents).

Defensive or reparative: It responds to irritation by producing reparative dentin. The response to stimuli is inflammation.

 Histologically the pulp consists of delicate collagen fibers, blood vessels, lymphatics, nerves and cells. A histologic section of the pulp reveals four cellular zones:

Odontoblastic

Cell-free (Weil)

Cell-rich

Pulp core