MORPHOLOGICAL ANALYSIS OF CEMENTOENAMEL JUNCTION TYPES IN PREMOLARS AND MOLARS OF A SAMPLE OF PAKISTANI POPULATION
AbstractBackground: Cementoenamel junction represents the demarcation between enamel covered crown and cementum covered root surface. There is paucity of population specific data of the morphological variability of cementoenamel junctions of permanent and primary teeth. The objective of this study was to investigate the morphological diversity and interrelationship of cementoenamel junction of premolar and molar teeth in permanent dentition of a sample of Pakistani population with potential forensic and anthropological implications. Method: This cross-sectional study was conducted at Oral Biology department of Dr Ishrat ul Ebad khan institute of oral health science, Dow University from March 2016 till September 2016. Seventy-five maxillary and mandibular permanent premolar and molars from adult patients of both sexes were selected and sectioned. Longitudinal ground sections were prepared to study the morphological interrelationship between Cementum and Enamel in each specimen to be viewed under light microscope. A chi-square test was applied between the categorical variables. Results: Results showed 57.3% of sections had cementum overlapping enamel interrelation, 32% showed edge to edge cementum and enamel relation and 9.3% showed that cementum and enamel failed to meet resulting in exposed dentine, while 1.3% sample showed enamel over cementum relation. No significant correlation was found between gender, type of tooth, maxillary, mandibular arches and the morphological variation of CEJ (p>0.05). Conclusion: Based on the findings of this study, it can be concluded that there are considerable morphological variations in CEJ of premolars and molars with preponderance of cementum overlapping enamel in these teeth. Based on these findings, dentists are advised to be mindful of dental procedures involving the CEJ and that these interventions should be performed meticulously avoiding any detachment of cementum and subsequent exposure of dentin resulting in dentin hypersensitivity.Keywords: Cementoenamel junction; light microscopy; ground section
Zafar MS, Ahmed N. Nano-mechanical evaluation of dental hard tissues using indentation technique. World Appl Sci J 2013;28(10):1393–9.
Lang NP, Lindhe J. Clinical Periodontology and Implant Dentistry, 2 Volume Set. John Wiley & Sons; 2015.
Hug HU, van 't Hof MA, Spanauf AJ, Renggli HH. Validity of clinical assessments related to the cemento-enamel junction. J Dent Res 1983;62(7):825–9.
Esberard R, Esberard RR, Esberard RM, Consolaro A, Pameijer CH. Effect of bleaching on the cemento-enamel junction. Am J Dent 2007;20(4):245–9.
Aw TC, Lepe X, Johnson GH, Mancl L. Characteristics of noncarious cervical lesions: a clinical investigation. J Am Dent Assoc 2002;133(6):725–33.
Reisstein J, Lustman I, Hershkovitz J, Gedalia I. Abrasion of enamel and cementum in human teeth due to toothbrushing estimated by SEM. J Dent Res 1978;57(1):42.
Newman MG, Takei H, Klokkevold PR, Carranza FA. Carranza's clinical periodontology: Elsevier health sciences; 2011.
Francischone LA, Consolaro A. Morphology of the cementoenamel junction of primary teeth. J Dent Child (Chic) 2008;75(3):252–9.
Vandana KL, Haneet RK. Cementoenamel junction: An insight. J Indian Soc Periodontol 2014;18(5):549–54.
Neuvald L, Consolaro A. Cementoenamel junction: microscopic analysis and external cervical resorption. J Endod 2000;26(9):503–8.
Arambawatta K, Peiris R, Nanayakkara D. Morphology of the cemento-enamel junction in premolar teeth. J Oral Sci 2009;51(4):623–7.
Singh N, Grover N, Puri N, Singh S, Arora S. Age estimation from physiological changes of teeth: A reliable age marker? J Forensic Dent Sci 2014;6(2):113–21.
Singh A, Gorea R, Singla U. Few tips for making ground sections of teeth for research purpose. J Punjab Acad Forensic Med Toxicol 2006;6:11.
Charania A, Akhlaq H, Iqbal Z. A Simple Method Adopted for Tooth Sectioning in Dr. Ishratul-Ebad Khan Institute of Oral Health Sciences, DUHS. J Dow Univ Health Sci 2010;4(2):84–6.
Ceppi E, Dall'Oca S, Rimondini L, Pilloni A, Polimeni A. Cementoenamel junction of deciduous teeth: SEM-morphology. Eur J Paediatr Dent 2006;7(3):131–4.
Leonardi R, Loreto C, Caltabiano R, Caltabiano C. The cervical third of deciduous teeth. An ultrastructural study of the heard tissues by SEM. Minerva Stomatol 1996;45(3):75–9.
Grossman ES, Hargreaves JA. Variable cementoenamel junction in one person. J Prosthet Dent 1991;65(1):93–7.
Badersten A, Nilvéus R, Egelberg J. Effect of non‐surgical periodontal therapy. VI. Localization of sites with probing attachment loss. J Clin Periodontol 1985;12(5):351–9.
Walters PA. Dentinal hypersensitivity: a review. J Contemp Dent Pract 2005;6(2):107–17.
Vandana KL, Gupta I. The location of cemento enamel junction for CAL measurement: A clinical crisis. J Indian Soc Periodontol 2009;13(1):12–5.
Chaudhry M, Babar Z, Akhtar F. Frequency of chronic periodontitis in a cross section of Pak Army Personnel. Pak Armed Forces Med J 2008;58:185–8.
Stein TJ, Corcoran JF. Pararadicular cementum deposition as a criterion for age estimation in human beings. Oral Surg Oral Med Oral Pathol 1994;77(3):266–70.
Schroeder HE, Scherle WF. Cemento-enamel junction--revisited. J Periodontal Res 1988;23(1):53–9.