A scanning electron microscopic study of hypercementosis

Pinheiro, Bethânia Camargo; Pinheiro, Tiago Novaes; Capelozza, Ana Lúcia Alvarez; Consolaro, Alberto

doi:10.1590/s1678-77572008000600005

Cited by 35 publications

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References 17 publications

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“…The P3s, Cs, and Is show marked cementum hyperplasia around the roots (Fig. S2C), which-together with heavy occlusal wear and labial rounding of the occlusal surface of the Is-is indicative of extensive use of the front dentition in paramasticatory activities (41)(42)(43)(44). The external symphyseal surface below the incisor roots shows evidence of bone resorption resulting in a notable infradental depression and a chin-like morphology of the symphysis (Fig.…”

Section: Resultsmentioning

confidence: 99%

Tooth wear and dentoalveolar remodeling are key factors of morphological variation in the Dmanisi mandibles

Margvelashvili

Zollikofer

Lordkipanidze

et al. 2013

Proc. Natl. Acad. Sci. U.S.A.

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The Plio-Pleistocene hominin sample from Dmanisi (Georgia), dated to 1.77 million years ago, is unique in offering detailed insights into patterns of morphological variation within a paleodeme of early Homo. Cranial and dentoalveolar morphologies exhibit a high degree of diversity, but the causes of variation are still relatively unexplored. Here we show that wear-related dentoalveolar remodeling is one of the principal mechanisms causing mandibular shape variation in fossil Homo and in modern human huntergatherer populations. We identify a consistent pattern of mandibular morphological alteration, suggesting that dental wear and compensatory remodeling mechanisms remained fairly constant throughout the evolution of the genus Homo. With increasing occlusal and interproximal tooth wear, the teeth continue to erupt, the posterior dentition tends to drift in a mesial direction, and the front teeth become more upright. The resulting changes in dentognathic size and shape are substantial and need to be taken into account in comparative taxonomic analyses of isolated hominin mandibles. Our data further show that excessive tooth wear eventually leads to a breakdown of the normal remodeling mechanisms, resulting in dentognathic pathologies, tooth loss, and loss of masticatory function. Complete breakdown of dentognathic homeostasis, however, is unlikely to have limited the life span of early Homo because this effect was likely mediated by the preparation of soft foods.aging | compensatory mechanisms | toothpick | local periodontitis | early Pleistocene Homo A lthough patterns of dental micro-and macrowear and wearrelated pathologies are amply documented in the hominin fossil record (1-5), processes of in vivo dentoalveolar remodeling (3, 6, 7) and their potential influence on dentognathic morphology are only beginning to be studied in fossil hominins (8). In modern human hunter-gatherer populations, remodeling of dentoalveolar hard tissue is triggered mainly by dental wear, aging, pathologies, and trauma. Wear-related remodeling can be understood as a mechanism of in vivo modification that maintains masticatory function (3,7,(9)(10)(11)(12)(13)(14). Three main processes are typically identified (Fig. 1): i) Wear-induced reduction of dental crown height leads to alterations in masticatory biomechanics. This triggers alveolar bone remodeling, yielding dislocation of dental structures and eventual continuous eruption of all teeth. As an effect, occlusal contact between upper and lower teeth is maintained (15-17), and the position and orientation of the occlusal plane relative to the temporomandibular joints (TMJs) is held approximately constant, thus preventing the "wear-out" (18) of the TMJs. ii) The reduction of mesiodistal crown dimensions through interproximal dental wear triggers alveolar bone remodeling in the mesiodistal direction. This leads to mesial drift of the postcanine dentition and shortening of the dental arcade (19).iii) In the anterior dentition, remodeling induced by interproximal wear results in increas...

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Section: Resultsmentioning

confidence: 99%

Tooth wear and dentoalveolar remodeling are key factors of morphological variation in the Dmanisi mandibles

Margvelashvili

Zollikofer

Lordkipanidze

et al. 2013

Proc. Natl. Acad. Sci. U.S.A.

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“…2 for dental wear frequency distribution per population). In order to evaluate dentoalveolar structures and structural changes due to pathology we established a dentognathic pathology classification protocol, which is based on existing clinical classifications (Le Fort 1901;Bjork A et al 1964;Baume LJ et al 1973;McNeill et al 1980;Clarkson and O'Mullane 1989;Varrela and Paunio 1994;Ramachandran Nair et al 1996;Armitage 1999;Floyd et al 1999;Lieverse 1999;Huumonen and Ørstavik 2002;Bakland and Andreasen 2004;Nair 2004;Schulze et al 2006;Hassan R. and Rahimmah 2007;Ismail et al 2007;Selwitz et al 2007;Buitrago-Téllez et al 2008;Ogden 2008;Pinheiro et al 2008;Rosenberg et al 2010). We grouped DP features into 9 classes, and scored each feature according to location, and according to presence/absence or level of expression.…”

Section: Measurementsmentioning

confidence: 99%

“…150b). However, hypercementosis is an age-related response to heavy masticatory load (Pinheiro et al 2008) whereas root resorption is an effect of local occlusal overload (Schätzle et al 2005). Hypercementosis is thus more likely to be the cause than the effect of root resorption (Schätzle et al 2005).…”

Section: Tooth Wear and Dentognathic Pathologiesmentioning

confidence: 99%

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Comparative analysis of dentognathic pathologies in the Dmanisi mandibles

Margvelashvili

Zollikofer

Lordkipanidze

et al. 2016

American J Phys Anthropol

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Objectives: Due to the scarcity of the fossil record, in-vivo changes in the dentognathic system of early Homo are typically documented at the level of individual fossil specimens, and it remains difficult to draw population-level inferences about dietary habits, diet-related activities and lifestyle from individual patterns of dentognathic alterations. The Plio-Pleistocene hominin sample from Dmanisi (Georgia), dated to 1.77 million years ago, offers a unique opportunity to study in-vivo changes in the dentognathic system of individuals belonging to a single paleodeme of early Homo. Materials and Methods: We analyze dentognathic pathologies in the Dmanisi sample, and in comparative samples of modern Australian and Greenlander hunter-gatherer populations, applying clinical protocols of dentognathic diagnostics. Results: The Dmanisi hominins exhibit a similarly wide diversity and similar incidence of dentognathic pathologies as the modern human hunter-gatherer population samples investigated here. Dmanisi differs from the modern population samples in several respects: At young age tooth wear is already advanced, and pathologies are more prevalent. At old age, hypercementosis is substantial. Discussion: Results indicate that dentognathic pathologies and disease trajectories are largely similar in early Homo and modern humans, but that the disease load was higher in early Homo, probably as an effect of higher overall stress on the dentognathic system. Key words: aging, tooth wear, caries, periodontitisThe Plio-Pleistocene site of Dmanisi has yielded a large sample of hominin fossils associated with abundant and diverse faunal remains and Mode I stone artifacts (Gabunia et al. 2001;Ferring et al. 2011;Mgeladze et al. 2011). Occupation of the site began shortly after 1.85 Ma. The fossil hominin finds are dated to 1.77 Ma (Ferring et al. 2011). Dmanisi thus represents the earliest evidence of Homo outside of Africa. The well-preserved cranial, mandibular and postcranial remains of five individuals are unique in offering detailed insights into patterns of morphological variation within a paleodeme of early Homo, and into patterns of growth and aging Margvelashvili et al. 2013;Zollikofer et al. 2014). The craniomandibular morphology of the Dmanisi paleodeme has been described previously (Gabunia and Vekua 1995;Gabunia et al. 2000;Gabunia et al. 2001;Gabounia et al. 2002;Lordkipanidze et al. 2005;Lordkipanidze et al. 2006;Rightmire et al. 2006;Rightmire and Lordkipanidze 2010;Lordkipanidze et al. 2013;Margvelashvili et al. 2013). Cranial and mandibular morphological variation within the Dmanisi paleodeme is wide, but well within the range of variation seen in modern humans populations, and in populations of chimpanzee subspecies (Skinner et al. 2006;Lordkipanidze et al. 2013;Margvelashvili et al. 2013;Zollikofer et al. 2014). Variation in size, shape and dentognathic features among the Dmanisi mandibles has received special attention and has been studied to address questions of phylogeny, taxonomy, sexual dimorphism, die...

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“…Various reasons attributed for hypercementosis include functional stress due to occlusal forces [4], continuous dental eruption [5], incorporation of periodontal cementicles during physiologic cementum deposition, reactionary deposition in response to periapical inflammatory processes as well as systemic factors such as atherosclerosis, acromegaly, deforming arthritis, hypertrophic arthritis, thyroid diseases and Paget's disease [6]. Based on the macroscopic appearance, hypercementosis is classified as a) Club shaped b) Focal and c) Circular cemental hyperplasia [7].…”

Section: Discussionmentioning

confidence: 99%

Localized Multiple Cemental Excrescences: A Rare Presentation of Hypercementosis

Jeddy

Prabakar

2014

JCDR

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A 24-year-old male patient reported to a private Dental clinic for oral prophylaxis. He also complained of pain in right lower back region due to impingement of right upper back tooth on the mucosa of the lower jaw. On intraoral examination, it was noted that 18 was impinging on the mandibular alveolar mucosa distal to 47 during occlusion. 38 and 48 were impacted. OPG revealed mesioangular impaction of both mandibular third molars. Maxillary third molars were completely erupted [Table/ Fig-1]. His medical history was noncontributory and vital signs were normal. Patient did not give a history of any orthodontic treatment or any other major dental procedures. His haemogram and blood sugar values were normal.Extraction of all four third molars was planned. When extraction of 18 was attempted, there was resistance to the movement of the tooth upon traction; but it was carefully and patiently manipulated out of the socket and removed in toto. However, morphology of all third molars appeared apparently normal on the pre-operative radiograph and there was no associated pathology. The extracted tooth in this case showed multiple calcified spike like projections (6 in number) on the mesiobuccal and distobuccal roots of 18 [Table/ Fig-2]. These spikes were seen on the buccal and palatal aspects as well as the middle and apical thirds of both the buccal roots; the palatal root however, did not have any cemental spikes. Intra oral digital radiograph of the extracted tooth was taken to confirm the nature of the spikes. The radiograph confirmed the presence of spike like projections which were continuous with the external surface of the root suggesting their origin from the cementum [Table /Fig-3]. The tooth showed no evidence of caries or attrition and appeared ABSTRACTHypercementosis is an abnormal thickening of cementum which may be generalized or localized. Localized hypercementosis is usually characterized by nodular enlargement of apical third of root. Hypercementosis in the form of multiple cemental spikes distributed throughout the entire length of root is a very rare finding. In this article, we report such a rare manifestation of localized hypercementosis affecting right maxillary third molar in a 24-year-old male. This finding was an accidental observation following a difficult extraction procedure as the spikes were not evident in the orthopantamogram. It is imperative that every dental practitioner be aware of several presentations of hypercementosis and ensure that such an entity is considered in the differential diagnosis of difficult extraction procedures as an Intraoral Periapical (IOPA) radiograph or even an Orthopantamogram (OPG) could not differentiate the root morphology.[ Table/ [Table/ Fig-3]: Digital intra oral radiograph showing the spikes which is continuous with the cementum.

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A scanning electron microscopic study of hypercementosis

Cited by 35 publications

References 17 publications

Tooth wear and dentoalveolar remodeling are key factors of morphological variation in the Dmanisi mandibles

Tooth wear and dentoalveolar remodeling are key factors of morphological variation in the Dmanisi mandibles

Comparative analysis of dentognathic pathologies in the Dmanisi mandibles

Localized Multiple Cemental Excrescences: A Rare Presentation of Hypercementosis

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