Banner Portal
Dental cementum reviewed: development, structure, composition, regeneration and potential functions


Dental cementum. Review

How to Cite

Gonçalves PF, Sallum EA, Sallum AW, Casati MZ, Toledo S, Nociti Junior FH. Dental cementum reviewed: development, structure, composition, regeneration and potential functions. Braz. J. Oral Sci. [Internet]. 2015 Nov. 17 [cited 2024 Apr. 15];4(12):651-8. Available from:


This article reviews developmental and structural characteristics of cementum, a unique avascular mineralized tissue covering the root surface that forms the interface between root dentin and periodontal ligament. Besides describing the types of cementum and cementogenesis, attention is given to recent advances in scientific understanding of the molecular and cellular aspects of the formation and regeneration of cementum. The understanding of the mechanisms involved in the dynamic of this tissue should allow for the development of new treatment strategies concerning the approach of the root surface affected by periodontal disease and periodontal regeneration techniques.


Bosshardt DD, Selvig KA. Dental cementum: the dynamic tissue covering of the root. Periodontol 2000 1997; 13: 41-75 2. MacNeil RL, D’Errico JA, Ouyang H, Berry J, Strayhorn C, Somerman MJ. Isolation of murine cementoblasts: unique cells or uniquely-positioned osteoblasts? Eur J Oral Sci 1998; 106(suppl 1): 350-6.

Saygin NE, Giannobile WV, Somerman MJ. Molecular and cell biology of cementum. Periodontol 2000 2000; 24: 73-98.

MacNeil RL, Somerman MJ. Molecular factors regulating development and regeneration of cementum. J Periodontal Res 1993; 28: 550-9.

Jones SJ. Cement. In: Osborn JW, editor. Dental anatomy and embryology. Boston: Blackwell Scientific; 1981.

Schroeder HE. Handbook of microscopic anatomy. Vol. 5. The periodontium. Berlin: Springer; 1986. p.23-119.

Listgarten MA. A light and electron microscopic study of coronal cementogenesis. Arch Oral Biol 1968; 13: 93-114.

Listgarten MA, Kamin A. The development of a cementum layer over the enamel surface of rabbit molars. A light and electron microscopic study. Arch Oral Biol 1969; 14: 961-85.

Schroeder HE, Scherle WF. Cemento-enamel junction – revisited. J Periodontal Res 1988; 23: 53-9.

Bosshardt DD, Schroeder HE. Establishment of acellular extrinsic fiber cementum on human teeth. A light- and electron-microscopic study. Cell Tissue Res 1991; 263: 325-36.

Bosshardt DD, Schroeder HE. Initiation of acellular extrinsic fiber cementum on human teeth. A light- and electronmicroscopic study. Cell Tissue Res 1991; 263: 311-24.

Cho MI, Garant PR. Development and general structure of the periodontium. Periodontol 2000 2000; 24: 9-27.

Dastmalchi R, Polson A, Bouwsma O, Proskin H. Cementum thickness and mesial drift. J Clin Periodontol 1990; 17: 709-13.

Lang H, Schuler N, Arnhold S, Nolden R, Mertens T. Formation of differentiated tissues in vivo by periodontal cell populations cultured in vitro. J Dent Res 1995; 74: 1219-25.

Palmer RM, Lumsden AG. Development of periodontal ligament and alveolar bone in homografted recombinations of enamel organs and papillary, pulpal and follicular mesenchyme in the mouse. Arch Oral Biol 1987; 32: 281-9.

Cho MI, Garant PR. Ultrastructural evidence of directed cell migration during initial cementoblast differentiation in root formation. J Periodontal Res 1988; 23: 268-76.

Thomas HF, Kollar EJ. Differentiation of odontoblasts in grafted recombinants of murine epithelial root sheath and dental mesenchyme. Arch Oral Biol 1989; 34: 27-35.

Bosshardt DD, Schroeder HE. Cementogenesis reviewed: a comparison between human premolars and rodent molars. Anat Rec 1996; 245: 267-92.

MacNeil RL, Thomas HF. Development of the murine periodontium. I. Role of basement membrane in formation of a mineralized tissue on the developing root dentin surface. J Periodontol 1993; 64: 95-102.

Thomas HF. Root formation. Int J Dev Biol 1995; 39: 231-7.

Diekwisch TG. The developmental biology of cementum. Int J Dev Biol 2001; 45: 695-706.

Suzuki M, Inoue T, Shimono M, Yamada S. Behavior of epithelial root sheath during tooth root formation in porcine molars: TUNEL, TEM, and immunohistochemical studies. Anat Embryol (Berl) 2002; 206: 13-20.

Zeichner-David M, Oishi K, Su Z, Zakartchenko V, Chen LS, Arzate H, Bringas P Jr. Role of Hertwig’s epithelial root sheath cells in tooth root development. Dev Dyn 2003; 228: 651-63.

Bosshardt DD, Nanci A. Immunolocalization of epithelial and mesenchymal matrix constituents in association with inner enamel epithelial cells. J Histochem Cytochem 1998; 46: 135-42.

Slavkin HC, Bessem C, Fincham AG, Bringas P Jr, Santos V, Snead ML et al. Human and mouse cementum proteins immunologically related to enamel proteins. Biochim Biophys Acta 1989; 991: 12-8.

Fong CD, Hammarstrom L. Expression of amelin and amelogenin in epithelial root sheath remnants of fully formed rat molars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000; 90: 218-23.

Cho MI, Garant PR. Radioautographic study of [3H]mannose utilization during cementoblast differentiation, formation of acellular cementum, and development of periodontal ligament principal fibers. Anat Rec 1989; 223: 209-22.

Pitaru S, McCulloch CA, Narayanan SA. Cellular origins and differentiation control mechanisms during periodontal development and wound healing. J Periodontal Res 1994; 29: 81-94.

Alatli I, Lundmark C, Hammarstrom L. The localization of epithelial root sheath cells during cementum formation in rat molars. J Periodontal Res 1996; 31: 433-40.

Cohen M, Garnick JJ, Ringle RD, Hanes PJ, Thompson WO. Calcium and phosphorus content of roots exposed to the oral environment. J Clin Periodontol 1992; 19: 268-73.

Selvig KA, Selvig SK. Mineral content of human and seal cementum. J Dent Res 1962; 41: 624-32.

Furseth R. A microradiographic and electron microscopic study of the cementum of human deciduous teeth. Acta Odontol Scand. 1967; 25: 613-45.

Soni NN. A microradiographic and polarized light study of cementum in Paget’s disease. J Oral Med 1969; 24: 27-30.

Selvig KA. The fine structure of human cementum. Acta Odontol Scand 1965; 23: 423-41.

Nakata TM, Stepnick RJ, Zipkin I.Chemistry of human dental cementum: the effect of age and fluoride exposure on the concentration of ash, fluoride, calcium, phosphorus and magnesium. J Periodontol 1972; 43: 115-24.

Neiders ME, Eick JD, Miller WA, Leitner JW.Electron probe microanalysis of cementum and underlying dentin in young permanent teeth. J Dent Res 1972; 51: 122-30.

Nakagaki H, Weatherell JA, Strong M, Robinson C.Distribution of fluoride in human cementum. Arch Oral Biol 1985; 30: 101-4.

Hals E, Selvig KA. Correlated electron probe microanalysis and microradiography of carious and normal dental cementum. Caries Res 1977; 11: 62-75.

Ganss B, Kim RH, Sodek J. Bone sialoprotein. Crit Rev Oral Biol Med 1999; 10: 79-98.

Sodek J, Ganss B, McKee MD. Osteopontin. Crit Rev Oral Biol Med 2000; 11: 279-303.

Somerman MJ, Shroff B, Agraves WS, Morrison G, Craig AM, Denhardt DT et al. Expression of attachment proteins during cementogenesis. J Biol Buccale 1990; 18: 207-14.

Giachelli CM, Steitz S. Osteopontin: a versatile regulator of inflammation and biomineralization. Matrix Biol 2000; 19: 615-22.

Hynes RO, Yamada KM. Fibronectins: multifunctional modular glycoproteins. J Cell Biol 1982; 95: 369-77.

Grzesik WJ, Narayanan AS. Cementum and periodontal wound healing and regeneration. Crit Rev Oral Biol Med 2002; 13: 474-84.

Hauschka PV, Wians FH Jr. Osteocalcin-hydroxyapatite interaction in the extracellular organic matrix of bone. Anat Rec 1989; 224: 180-8.

Mariotti A. The extracellular matrix of the periodontium: dynamic and interactive tissues. Periodontol 2000 1993; 3: 39-63.

Bartold PM, Miki Y, McAllister B, Narayanan AS, Page RC. Glycosaminoglycans of human cementum. J Periodontal Res 1988; 23: 13-7.

Groeneveld MC, Everts V, Beertsen W. Alkaline phosphatase activity in the periodontal ligament and gingiva of the rat molar: its relation to cementum formation. J Dent Res 1995; 74: 1374-81.

Cochran DL, Wozney JM.Biological mediators for periodontal regeneration. Periodontol 2000. 1999; 19: 40-58.

Philbrick WM, Dreyer BE, Nakchbandi IA, Karaplis AC. Parathyroid hormone-related protein is required for tooth eruption. Proc Natl Acad Sci USA 1998; 95: 11846-51.

Ikezawa K, Hart CE, Williams DC, Narayanan AS.

Characterization of cementum derived growth factor as an insulin-like growth factor-I like molecule. Connect Tissue Res 1997; 36: 309-19.

Arzate H, Olson SW, Page RC, Gown AM, Narayanan AS. Production of a monoclonal antibody to an attachment protein derived from human cementum. FASEB J 1992; 6: 2990-5.

Saito M, Iwase M, Maslan S, Nozaki N, Yamauchi M, Handa K et al. Expression of cementum-derived attachment protein in bovine tooth germ during cementogenesis. Bone 2001; 29: 242-8.

Olson S, Arzate H, Narayanan AS, Page RC. Cell attachment activity of cementum proteins and mechanism of endotoxin inhibition. J Dent Res 1991; 70: 1272-7.

Pitaru S, Narayanan SA, Olson S, Savion N, Hekmati H, Alt I et al. Specific cementum attachment protein enhances selectively the attachment and migration of periodontal cells to root surfaces. J Periodontal Res 1995; 30: 360-8.

McCulloch CA. Basic considerations in periodontal wound healing to achieve regeneration. Periodontol 2000 1993; 1: 16-25.

Thesleff I, Nieminen P. Tooth morphogenesis and cell differentiation. Curr Opin Cell Biol 1996; 8: 844-50.

Ten Cate AR. The development of the periodontium—a largely ectomesenchymally derived unit. Periodontol 2000 1997; 13: 9-19.

MacNeil RL, Somerman MJ. Development and regeneration of the periodontium: parallels and contrasts. Periodontol 2000 1999; 19: 8-20.

Liu HW, Yacobi R, Savion N, Narayanan AS, Pitaru S. A collagenous cementum-derived attachment protein is a marker for progenitors of the mineralized tissue-forming cell lineage of the periodontal ligament. J Bone Miner Res 1997; 12: 1691-9.

Bar-Kana I, Savion N, Narayanan AS, Pitaru S. Cementum attachment protein manifestation is restricted to the mineralized tissue forming cells of the periodontium. Eur J Oral Sci 1998; 106(Suppl 1): 357-64.

BarKana I, Narayanan AS, Grosskop A, Savion N, Pitaru S. Cementum attachment protein enriches putative cementoblastic populations on root surfaces in vitro. J Dent Res 2000; 79: 1482-8.

Somerman MJ, Foster RA, Imm GM, Sauk JJ, Archer SY. Periodontal ligament cells and gingival fibroblasts respond differently to attachment factors in vitro. J Periodontol 1989; 60: 73-7.

Hughes FJ, Smales FC. Immunohistochemical investigation of the presence and distribution of cementum-associated lipopolysaccharides in periodontal disease. J Periodontal Res 1986; 21: 660-7.

Coldiron NB, Yukna RA, Weir J, Caudill RF. A quantitative study of cementum removal with hand curettes. J Periodontol 1990; 61: 293-9.

Polson AM. The root surface and regeneration; present therapeutic limitations and future biologic potentials. J Clin Periodontol 1986; 13: 995-9.

Ivanovski S, Li H, Daley T, Bartold PM. An immunohistochemical study of matrix molecules associated with barrier membrane-mediated periodontal wound healing. J Periodontal Res 2000; 35: 115-26.

Hirooka H. The biologic concept for the use of enamel matrix protein: true periodontal regeneration. Quintessence Int 1998; 29: 621-30.

Lekic P, Sodek J, McCulloch CA. Relationship of cellular proliferation to expression of osteopontin and bone sialoprotein in regenerating rat periodontium. Cell Tissue Res 1996; 285: 491-500.

D’Errico JA, MacNeil RL, Takata T, Berry J, Strayhorn C, Somerman MJ. Expression of bone associated markers by tooth root lining cells, in situ and in vitro. Bone 1997; 20: 117-26.

D’Errico JA, MacNeil RL, Strayhorn CL, Piotrowski BT, Somerman MJ. Models for the study of cementogenesis. Connect Tissue Res 1995; 33: 9-17.

Grzesik WJ, Kuzentsov SA, Uzawa K, Mankani M, Robey PG, Yamauchi M. J Normal human cementum-derived cells: isolation, clonal expansion, and in vitro and in vivo characterization. J Bone Miner Res 1998; 13: 1547-54.

The Brazilian Journal of Oral Sciences uses the Creative Commons license (CC), thus preserving the integrity of the articles in an open access environment.


Download data is not yet available.