In the early stage of cemental caries, surface and subsurface areas of carious cementum became markedly poor in mineral components. Even in inner areas of carious cementum, the gradual decrease of minerals is evidently recognized with carious defects of various forms and sizes. This is apparently due to remarkable carious demineralization that took place first in the beginning of cemental caries. Following this step, carious destruction seems to appear in organic substance of cementum which has been exposed through carious demineralization out of embedding in cemental minerals. Consequently, cross-striations characteristic of collagen fibrils in the matrix of cementum are usually shown in the weakened or lost state as a result of carious devastation, and numerous carious defects can be seen in carious cementum in different forms and sizes as clear indications of carious destruction of inorganic and organic components in cementum. Repetition of the above carious process goes on making increase carious defects in size.
Microbial parasitism is found concentrated mostly on the surface areas, being sometimes sparsely found in subsurface portions of carious cementum. In the inner areas of carious cementum, there exist no microbes at all.
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