Chapter 1—Clinical Significance of Dental Anatomy, Histology, Physiology, and Occlusion 11

Fig. 1-28 Radiograph showing root resorption on lateral incisor after

orthodontic tooth movement.

The cementodentinal junction is a relatively smooth area in

the permanent tooth, and attachment of cementum to dentin
is firm, but this is not understood completely yet. Cementum
joins enamel to form the CEJ. In about 10% of teeth, enamel
Fig. 1-26 Horizontal section in the occlusal third of molar crown. Dark and cementum do not meet, and this can result in a sensitive
blue dye was placed in the pulp chamber under pressure. Deep dentin area. Abrasion, erosion, caries, scaling, and restoration finish-
areas (over pulp horns) are much more permeable than superficial dentin.
ing and polishing procedures can denude dentin of its cemen-
(From Pashley DH, Andringa HJ, Derkson GD, Derkson ME, Kalathoor SR: Regional.
variability in the permeability of human dentin, Arch Oral Biol 32:519–523, 1987,
tum covering, which can cause the dentin to be sensitive to
with permission from Pergamon, Oxford, UK.)
various stimuli (e.g., heat, cold, sweet substances, sour sub-
stances). Cementum is capable of repairing itself to a limited
degree and is not resorbed under normal conditions. Some
resorption of the apical portion of the root can occur, however,
if orthodontic pressures are excessive and movement is too
fast (Fig. 1-28).

Physiology of Tooth Form

Radicular dentin Function
Teeth serve four main functions: (1) mastication, (2) esthetics,
Fibers (3) speech, and (4) protection of supporting tissues. Normal
perforating tooth form and proper alignment ensure efficiency in the
the alveolar incising and reduction of food with the various tooth classes—
bone
incisors, canines, premolars, and molars—performing specific
functions in the masticatory process and in the coordination
Fibers of the various muscles of mastication. In esthetics, the form
perforating and alignment of the anterior teeth are important to a person’s
the cementum
physical appearance. The form and alignment of anterior and
posterior teeth assist in the articulation of certain sounds that
can have a significant effect on speech. Finally, the form and
alignment of the teeth assist in sustaining them in the dental
arches by assisting in the development and protection of gin-
Fig. 1-27 Principal fibers of periodontal ligament continue to course into gival tissue and alveolar bone that support them.
surface layer of cementum as Sharpey’s fibers. (From Avery JK, Chiego DJ:
Essentials of oral histology and embryology: A clinical approach, ed 3, St Louis,
2006, Mosby.) Contours
Facial and lingual surfaces possess a degree of convexity that
affords protection and stimulation of supporting tissues
cementum is deposited to keep the attachment intact. Two during mastication. The convexity generally is located at the
kinds of cementum are formed: acellular and cellular. The cervical third of the crown on the facial surfaces of all teeth and
acellular layer of cementum is living tissue that does not incor- the lingual surfaces of incisors and canines. The lingual sur-
porate cells into its structure and usually predominates on the faces of posterior teeth usually have their height of contour in
coronal half of the root; cellular cementum occurs more fre- the middle third of the crown. Normal tooth contours act in
quently on the apical half. Cementum on the root end sur- deflecting food only to the extent that the passing food stimu-
rounds the apical foramen and may extend slightly onto the lates (by gentle massage) and does not irritate supporting
inner wall of the pulp canal. Cementum thickness can increase tissues. If these curvatures are too great, tissues usually receive
on the root end to compensate for attritional wear of the inadequate stimulation by the passage of food. Too little
occlusal or incisal surface and passive eruption of the tooth. contour may result in trauma to the attachment apparatus.