Regeneration of the apical region of the tooth after the treatment of destructive periodontitis with cement resorption

Abstract

Aim. Destructive changes in the tissues of the tooth and periodontium entail resorption of the hard tissues of the tooth in the apical region. The goal is to identify morphological changes in root tissues with destructive periodontitis and resorption phenomena after the treatment of the tooth with calcium-containing preparations using a scanning electron microscope. Materials and methods. Examination of teeth treated for destructive forms of periodontitis with apical resorption was performed using a JSM-6490LV scanning electron microscope (JEOL, Japan) with an energy-dispersive attachment INCA Penta FETx3 (OXFORD Instruments, England). Results. In the apical part of the root there is a cellular mixed layered cementum. The dentin and the dentin-cementum junction are highly calcified. On top of them is cellular cement with lacunae of cementoblasts. The relief of the zone of cell-free cement has a wavy structure, consists of dense collagen fibers with a high content of calcium. With external root resorption, we observe extensive destruction of the cementoblast layer. An area of newly formed cementum was found inside the apical foramen. On the apical surface, where the resorption covered the dentin layer, there was an area of newly formed cementum. Its cellular layer consisted of round-shaped cells rising above the tissue of a homogeneous structure, smoothly flowing into the spongy tissue denting the bone. Discussion. It can be assumed that prolonged use of calcium-containing drugs leads to calcification. The presence of dense connective tissue in the periodontium indicates regenerative processes. The control of cement formation remains uncertain. Conclusions. Perhaps we are seeing a reparative atypical regeneration of the cement of the apical part of the tooth root. Dentinal calcification. In the lateral parts of the apical region, there is an outer layer of cementum with no cementoblasts. An increase in the thickness of the cement was noted. It can be assumed that we observe the phenomenon of osteogenesis in the area of strong resorption.