A comparative study of the cemental surfaces of teeth with and without periodontal diseases by scanning electron microscopy.

Abstract

Objectives: The purpose of this study was to compare the cemental surfaces of normal teeth with those of teeth with periodontitis by scanning electron microscopy. Materials and methods: Five normal premolars and 5 premolars with periodontitis were used in this study. The specimens were collected from the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University and private dental clinics. After extractions, the teeth were stored in 10% formalin until required. The specimens were cut in mesiodistal directions, immersed in 5.25% sodium hypochlorite and then dehydrated using increasing ethanol concentrations (two changes 15 minutes each): 50%, 60%, 70%, 85%, 95%, 100% and dried by leaving the specimens at room temperature for 24 hours, mounted on aluminum stubs, coated with gold, 100-300 Å thick, with an ion sputter coater, and viewed with a JEOL JSM-6610 LV scanning electron microscope, at three magnifications: X500, X1,000, and X 2,000. The photomicrographs were described and compared between 2 groups. Results: The nondiseased roots showed an area with a pebbly appearance. Sharpey fibers appeared as low confluent mounds and dish-topped projections. The surfaces of periodontally diseased roots were uneven pebbly. The cemental surfaces appeared as numerous low confluent mounds or dish-topped projections and were covered by irregular, thin and sheet-like deposits. Discrete clusters of spherical mineral particles were distributed over the surfaces of the mounds. Each mound was low and consisted of close-packed Sharpey fibers. In between mounds, presence of some intrinsic matrix fibers parallel with the surface was clearly seen. In some areas, some elevations were dish-topped and contained intrinsic matrix fibers parallel with the surface. In areas of dense deposits, the mineral particles appeared as spherical and irregular thin sheet-like deposits. An extensive area of the root covered by irregular thin sheet-like deposits was seen. In many roots, large, multiloculated resorption bays were seen. Conclusions: The root surfaces of the normal teeth show no calculus retention and no destruction of the cemental surfaces, but those of the teeth with chronic periodontitis show cemental surfaces which are full of calculus retention and resorption areas which are large and widely distributed.