Abstract
Root cementum is a specialized connective tissue with a critical role in tooth function and periodontal health. This narrative review aims to consolidate current knowledge regarding the influence of cementum on the pathophysiology of periodontitis and root caries, its remodeling during orthodontic tooth movement, its significance in regenerative strategies and implantology, along with the effect of selected stimulants. A comprehensive literature search was conducted across PubMed, Embase, and Scopus databases for articles fulfilling the inclusion criteria. The analysis revealed that cementum's unique biological characteristics are fundamental to the success of periodontal regeneration, with biomimetic approaches showing promise for enhancing osseointegration of dental implants. Furthermore, the tissue is highly susceptible to mechanical forces, leading to adverse effects such as root resorption during orthodontic treatment. Its composition also renders it vulnerable to demineralization from root caries and damage from external stimulants. In conclusion, a profound understanding of the intricate biology of root cementum is essential for developing safer and more effective treatment modalities. The findings strongly support the development of targeted, cementum-oriented interventions and preventive strategies, thereby improving long-term success in restorative, periodontal, and orthodontic treatment.