The developmental biology of cementum

In conclusion, we have reviewed an extensive literature on early cementogenesis and performed a detailed morphological and molecular analysis to illustrate and verify key issues in the current debate about epithelial and mesenchymal contributions to root cementum. We have demonstrated that prior to cementogenesis, Hertwig's epithelial root sheath disintegrates and dental follicle cells penetrate the epithelial layer to invade the root surface. Our studies confirmed that HERS became disrupted or disintegrated prior to cementum deposition. We visualized how mesenchymal cells from the dental follicle penetrated the HERS bilayer and deposited initial cementum, while immediately adjacent epithelial cells were separated from the root surface by a basal lamina and did not secrete any cementum. Human specimen from the Gottlieb collection indicated that HERS was removed from the root surface prior to cementum deposition. Our in situ hybridization and immolocalization data revealed that both amelogenin mRNAs and enamel proteins were restricted to the crown enamel and were absent from the root surface and from the cervical-most ameloblasts adjacent to the root margin. On Western blots, cementum protein extracts did not cross-react with amelogenin antibodies. Our studies in conjunction with our literature review together confirmed the classical theory of cementum as a dental follicle derived connective tissue that forms subsequent to HERS disintegration.