Coast Dental Blog
Fast Facts - Perio Edition Episode 18

Fast Facts

Fast Facts: Perio Edition “Cemento Enamel Junction”
 
A Message for Coast Dental Hygienists and Doctors:
 
Happy Monday! There has been a huge shift in the thinking regarding the CEJ and how that will pertain to your SRP, Perio Maintenance, and normal hygiene appointments. This is the kind of up-to-date, evidence-based information we are learning here at Coast Dental! Knowing things like this will keep you ahead of the curve in the hygiene world. Keep up the good work!
 
Andrew Johnston, RDH, BSBM
Director of Hygiene Coast Dental
 
[Andrew Johnston, RDH]
 
Welcome back,  everyone. You are listening to another episode of Fast Facts- Perio Edition brought to you by A Tale of Two Hygienists in partnership with DentistRX. And now, please welcome your host, Katrina Sanders.
 
[Katrina Sanders, RDH]
 
This week, we are continuing the anatomy talk, but this week, you guys, I have some drama for you. Get this, there is some major drama about these Cemento Enamel Junction, and I'm so excited to unpack this drama for you this week.
 
So let's talk about the CEJ or the relationship of cementum and enamel. So we know that the relationship of cementum to enamel margins are going to vary. Many of us learned in hygiene school, for example, that in anywhere between 60 to 65 percent of the population, we're going to see a situation where the cementum overlaps the enamel. In about 30 percent of our patient population, the cementum and the enamel are going to meet. When you look at those patients, anatomically, those are the patients where you can obviously see that CEJ, right?  Versus in some patients where you're like, what am I even looking at here? Right?
 
Which leads us to the smallest of our patient population, in about 5-10%  of our population the cementum and the enamel will not meet. This is where we're going to see exposure of the dentin and again, clinically, these can be relatively difficult to see. These are the patients where we now are struggling to identify the cemento enamel junction because we don't have that delineated band of meeting, which we prefer to see. In these patients the dentin is exposed, and of course, that leaves a high likeliness that there could be possible sensitivity with those patients.
 
You guys with me so far? That's what most of us learned in dental hygiene school but dun dun dun, there's some drama out there, you guys. The new Darby text, which actually was the Moseby textbook, but is now the newer Darby text actually states that meets. So when the cementum and enamel meet together, that that actually occurs most frequently according to new research.
 
So the current Darby text actually states that 76 percent of our patient population, we see a meet's where the cementum and the enamel meet. 14 percent of our population we see that overlap and 10 percent of our patients we see a gap.
 
Now, we want to share this because although this text book says one thing, of course, we're always moving back and forth on where the text book gathers this research from. And the current research that they're looking at is a research study that was done by the Journal of Punjab Academy of Forensic Medicine and Toxicology. This research study actually indicated that enamel overlapping cementum is not the most common, specifically edge to edge contact of the cementum and enamel was most frequent. There was no correlation between the prevalence of CEJ type and the gender.
 
So because of this morphological diversity, there's a call to action within the dental community that we need to be careful about dental interventions in the region of the CEJ because there could be other pathological changes or hypersensitivity of the teeth associated with the CEJ. Therefore, know that we may start to see some shifts or changes in what this means for us with regards to using the CEJ as our baseline for identifying attachment loss.
 
Stay tuned as the Academy of Periodontology figures out next steps. Thank you for joining us. Thank you for joining me for the drama and I look forward to seeing you next week.
 
This has been another episode of Fast Facts - Perio Edition with Katrina Sanders, RDH. Please feel free to reach me on Instagram @thedentalwinegenist or on my website www.KatrinaSanders.com Cheers.
 
[Andrew Johnston, RDH]
 
Thank you for listening to another episode of Fast Facts - Perio Edition, brought to you in part by DentistRX makers of the InteliSonic line of power brushes. Find out more by visiting their website at www.dentistrx.com. We'll see you next week for another Fast Fact!

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