[Development and significance of the cuticula dentis for the epithelial attachment]

The purpose of this study was to identify those conditions governing presence and function of the secondary cuticle (cuticula dentis) by means of a clinical evaluation (Periodontal Status, Plaque Index, Decayed-Missing-Filled-Index) as well as radiological, bacteriological (plaque swabs) and histological studies. The secondary cuticle could be demonstrated mainly in individuals with mild bone resorption and minimal loss of periodontal attachment (age 20-50 years). In most cases there was an intimate attachment of the junctional epithelium to the enamel or cementum surface. However, in most elderly subjects (older than 50 years) the secondary cuticle was found only in fragments or was not detectable at all. In these cases the junctional epithelium had proliferated apically (towards the apex dentis) and was only punctiformly attached to the tooth surface. Our histological findings suggested that the secondary cuticle is a secretory product of the junctional epithelium. Therefore, we assume it to be the essential structure in maintaining epithelial attachment.