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Cementicle
Specialty	Dentistry

A cementicle is a small, spherical or ovoid calcified mass embedded within or attached to the cementum layer on the root surface of a tooth, or lying free within the periodontal ligament.^[1]^[2] They tend to occur in elderly individuals.^[3]^[4]

There are 3 types:^[5]^[6]

Free cementicle – not attached to cementum^[5]
Attached (sessile) cementicle – attached to the cementum surface^[5] (also termed exocementosis)^[3]
Embedded (interstitial) cementicle – with advancing age the cementum thickens,^[3] and the cementicle may become incorporated into the cementum layer^[5]

They may be visible on a radiograph (x-ray).^[2] They may appear singly or in groups,^[1] and are most commonly found at the tip of the root.^[6] Their size is variable,^[5] but generally they are small (about 0.2 mm^[6] – 0.3 mm in diameter).^[5]

Cementicles are usually acellular, and may contain either fibrillar or afibrillar cementum, or a mixture of both.^[5] Cementicles are the result of dystrophic calcification,^[5] but the reason why this takes place is unclear.^[3] Cementicles are thought to form when calcification occurs around a nidus, a precipitating center. Around this nidus they slowly enlarge by further deposition of calcium salts.^[5] Examples of how cementicles are thought to form include:

Calcification due to degenerative changes in the epithelial cell rests of Malassez^[5]
Calcification of thrombosed (blocked) capillaries in the periodontal ligament^[5] (i.e. a phlebolith)^[6]
Microtrauma to Sharpey's fibres^[2] causes small spicules of cementum or alveolar bone to splinter into the periodontal membrane^[4] Some do not consider these as true cementicles.^[5]

References

^ ^a ^b Chiego Jr. DJ (14 April 2014). Essentials of Oral Histology and Embryology: A Clinical Approach. Elsevier Health Sciences. p. 133. ISBN 978-0-323-29100-2.
^ ^a ^b ^c Bath-Balogh M; Fehrenbach MJ (10 December 2010). Illustrated Dental Embryology, Histology, and Anatomy. Elsevier Health Sciences. p. 174. ISBN 978-1-4377-2934-4.
^ ^a ^b ^c ^d Kumar GS (10 February 2014). Orban's Oral Histology & Embryology. Elsevier Health Sciences APAC. p. 196. ISBN 978-81-312-3801-1.
^ ^a ^b Mosby (1 August 2013). Mosby's Dental Dictionary. Elsevier Health Sciences. p. 115. ISBN 978-0-323-10013-7.
^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l Ghom A; Mhaske S (17 September 2010). Textbook of Oral Pathology. Jaypee Brothers Publishers. p. 122. ISBN 978-81-8448-402-1.
^ ^a ^b ^c ^d Chatterjee K (1 December 2006). Essentials of Oral Histology. Jaypee Brothers Publishers. p. 112. ISBN 978-81-8061-865-9.

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