Ultrastructural alterations of cementum and periodontal ligament in fluorosed teeth: an SEM and EDS study

This in-vitro study compared cemental and periodontal ligament changes in fluorosed and non-fluorosed teeth using Scanning Electron Microscopy. Sixty premolar teeth (30 fluorosed and 30 non-fluorosed) extracted for orthodontic indications were retrieved from the Department of Oral and Maxillofacial Surgery, Mamata Dental College, Khammam, Telangana. Teeth were sectioned transverse to the cemento-enamel junction to separate crown and root portions. scanning electron microscopy photomicrographs of root specimens were analyzed for hypermineralized surfaces, mineralized debris, resorption bays/cavitation, calculus-related debris, fiber insertion areas, and mineralization of connective tissue fibers. Results revealed a higher percentage of resorption bays, calculus and calculus-related debris, and globular mineralized debris in fluorosed teeth compared to non-fluorosed counterparts. Additionally, partial and initial mineralization of connective tissue fibers was more prevalent in fluorosed teeth. These findings suggest that dental fluorosis induces distinct structural alterations at the cemental and periodontal ligament level, even in periodontally healthy teeth. This study concludes that fluorosis causes definite cemental and periodontal ligament changes on the root surface, which may have implications for periodontal health and clinical management of fluorosed dentition.