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Tooth development
Te development of teeth

Bharath.k.p.

CONTENTS
STAGES OF 2] TOOTH DEVP EMBRYOLOGICAL 1] BASIS

3] TOOTH INITIATION

4] DENTINO GENESIS

FACTORS 7] AFFECTING TOOTH DEVP

5] AMELOGENESIS

6] DEVP OF ROOT & ATT APPARATUS

Embryological basis ofthdentalof intra genesis life 4 week tissue uterine

PRIMITIVE ORAL CAVITY LINED BY ST. SQUMOUS EPITHELIUM

Connective tissue cells underlying ectoderm are ectomesenchyme in origin, induce tooth devp
Ruptures at 27th day of gestation

Embryo at 6th week


Basal cells of oral ectoderm proliferates rapidly to form Primary epithelial band

Roughly horse shoe shaped, Total activity of Dental lamina 5yr.

th 7

week

Dental lamina

vestibular lamina

Formation of vestibule of oral cavity


Cells of vestibular lamina proliferate Degeneration of central epi cells

Sulcus of the vestibule

Dental lamina

Contd proliferative activity leads to the formn of a series

of epi ingrowths into the ectomesenchyme

Here mitotic index, labeling index & growth of epi cells are lower than corresponding indices in the underlying

mesnchyme

Function of dental lamina

Phase 1: Initiation of entire deciduous dentition (8th wk). Phase 2:Initiation successors of deciduous dentition. (5thmt to 10th mt) Phase 3:Initiation of permanent molars

Bud stage (8th week)


Basement membrane

Tooth bud

Enamel organ in this stage appears as a simple, spherical to ovoid epi condensation

Poorly morphodifferentiated and histodifferentiated. Cells undergo mitosis & condense Enamel organ , surrounded by mesenchyme

Early cap stage(11th week)

Late cap stage(12th week)

Early cap stage shows.


IEE Low coloumnar OEE Cuboidal Central rounded cells LATE CAP STAGE SHOWS IEE more columnar OEE remain cuboidal stellate reticulum

Cap Stage

Dental papilla dentin & pulp Dental sac cementum & PL

13th week

Tooth germs

Dental lamina

Early bell stage (14th week)

Dental lamina breaks down and enamel organ Looses connection with oral epithelium Shows 4 distinct layers: EEE Satellite reticulum Stratum intermedium IEE

Early bell stage

Outer enamel epithelium


Role of OEE:

Maintenance of the shape of the enamel organ.


Exchange of substances b/w enamel organ & environment

Early bell stage

Stellate reticulum
Role of stellate reticulum

mechanical

nutritive

Protects tissue

Maintains tooth shape

Stratum intermedium
Two to three layers of flattened cells. First appears in this stage.
Function; Synthesis of proteins. Transport of materials to & from the IEE.

Early bell stage

Inner enamel epithelium


FUNCTION:

Cells exert an
organising influence on the underlying mesenchymal cells in the DP that later diff

into odontoblasts

17th week

DL begin to degenerate

Late bell stage (18th week)

Late bell stage

IEE become taller--preameloblasts Peripheral cells of dental papilla--odontoblasts

Secrete ground subs & collagen fibres dentin matrix

Change in cell polarity

With the change in polarity, cell called an ameloblast that begins secretion of enamel matrix

Boundary b/w IEE &

odontoblasts outlines
future DEJ

TRANSITORY STRUCTURES

Enamel knot
Enamel cord Enamel niche

The Enamel knot

Localized mass of cells in IEE Signaling centre during tooth development.

Produce molecules associated with signaling Enamel knot cells do not proliferate

The Enamel cord


Extend from st.intermedium to st.reticulum.

Strand of cells seen at early bell stage

Reffered as enanel septum when divides st.reticulum into two parts Role; Involved in the process by which the cap stage is transformed into bell stage;

Enamel niche

Seen where tooth germ appear to have a double attachment to dental lamina

Functional significance: unknown

Fate of dental lamina

Epithelial pearls of Serres

Successional dental lamina


In developing primary tooth, dl
deeps an extend to lingual side

success ional lamina

forms the perm incisors, canines & premolars

Stages in tooth development Histophysiologies & clinical considerations


PHYSIOLOGICAL STAGES

MORPHOLOGICAL STAGES
Dental lamina. Bud stage. Cap stage: Bell Stage: early. advanced.

Initiation. Proliferation. Histodifferentiation. Morphodifferentiation. Apposition

Physiological

process
Requires ectomesenc

Anatomical stage LAMINA

Clinical significance Supernumerary teeth: arise from 3rd tooth bud

INITIATION: DENTAL

hymal
epithelial interaction

6TH to 7th wk Natal teeth: accessory I.U bud of dental lamina Anodontia: tooth germs

may fail to initiate.

Physiological process
PROLIFERATION

Anatomical stage

Clinical significance

Bud - 8th wk Cap - 8-14th wk Proliferative activity Early bell ensues at the points 14th wk of initiation & results in bud, cap & bell stages

Dense evaginatus:
due to proliferation of an area of IEE & mesenchyme into dental organ

process

stage
Hutchinsons
Mulberry

Morphodifferentiati Cap-8 -14th wk on: Bell stage 14th Basic form &
relative size of tooth estbld wk onwards

incisors

molars

Macro/microdontia Dens

in dente

Gemination Fusion Dilaceration Taurodontism

Hutchinsons incisors

Microdontia

Dens in dente

Gemination

Fusion

Taurodontism

Physiologica Anatomical l stage process


APPOSITION Formn of enamel deposition of & dentin matrix hard dental structures

Clinical significance

Enamel AI DI Shell

hypoplasia

teeth of

Pigmentation

enamel & dentin


Odontodysplasia

Enamel hypoplasia

DI

Pigmentation

Odontodysplasia

Epithelial-mesenchymal interactions during tooth development


Cells signal to each other through signaling molecules.
Transmit information to adjacent cells. Molecules get attached to receptors of target cells. Cell molecular cascade is activated in the cytoplasm. Activation of transcription factors. Enter the nucleus and regulate gene expression. New proteins are produced. Change in behavior of target cell.

Continues signaling process.

NATURE OF INDUCTIVE MESSAGE


THREE MAIN HYPOTHESES: to explain
how informn leading to induction may be transferred b/w epithelium & mesenchyme Chemical substance pass through intercellular spaces.
2. 3.

1.

Direct cell to cell contact Extracellular matrix

1] Diffusible chemical substance

Epi & mesenchymal components dissected out & separated at early bell

stage Recombined for tissue culture with a porous membrane b/w Absence of differentiation (pore size <0.2m)

2] Direct cell to cell contact (pore size 0.6m)


A .Enamel organ B dental papilla mesenchyme C pre dentine

Third hypotheses: Evidence indicating the extracellular matrix in the inductive process
i.

Lathyrogens added to the medium inhibited differentiation of tooth germ


ii.

Isolated pieces of extracellular matrix produces histological signs of diff in IEE

Questions to be answered
1.

Which of the two components is


more important for inducing

morphogenesis and histogenesis?


Enamel organ or dental papila
2.

What determines the shape of the


tooth?

1] Inducer for morpho & histogenesis

Culturing of dental
papilla mesenchyme with epithelium from developing footpad.

Resulted in normal devp Hence DP is the principal organizer in terms of both morpho &

histogenesis

Enamel organ of tooth mesenchyme of foot pad epithelium

Tooth development does not occur

2] Determinant of shape

Genes expressed during tooth development Lef lymphoid enhancer- binding factor (TF)

Pax paired box homeotic gene( TF)

Fgf fibroblast growth factor (SP)


Msx msh like genes in vertebates( TF) Dlx-- distalless homologue Wnt wingless homologue Lhx -- lim homeobox domain gene Bmp bone morphogenetic proteins Shh -- sonic hedge hog Hgf- hepatic growth factor

Barx BarH1 homologue

Lim homeobox domain genes

Lhx-6 & 7earliest mesenchymal markers for tooth


formn exp in nueral crest ectomesenchyme of

first branchial arch at day 9

Fgf 8 & pax 9 earliest mesenchymal genes that det


positions of tooth germs

Shh implicates tooth initiation

Role in determining tooth shape and position ( homeobox code model)


Primary epithelial band
ectomesenchyme
Incisors Msx 1 & 2 Canine Msx 1 & 2, Dlx2
Molars Barx1, Dlx2

BMPs & FGF

Enamel knot a signaling center

Expresses locally BMP-2,-4,-7 FGF-4 Shh p21

Represents a organizational center which orchestrates cuspal morphogenesis

Vitamin A metabolites

DENTINOGENESIS

Definition :
Composition of dentin:
70% 20%

inorganic. organic matrix.


Collagen type I.

proteins. DSP; DPP.


Mucopolysaccharides. Ground substance.

10%

Water.

Pattern Of Dentin Formation

Begins at the late bell stage in

the papillary tissue

Spreads down the cusp slope as far as the cervical loop

In multicusped teeth, begins independently at each future cusp tip

Root Dentin forms later which requires proliferation of epithelial cells at cervical loop.

Differentiation of Odontoblast

: . Dental papilla cells are small undifferentiated,with central

Diff of odontoblast from dental papilla

nucleus and organells Immediately after IEE cells change polarity ectomesenchymal cells adjacent to acellular zone enlarge . Various Signaling molecules, growt factors in the cells of IEE

Life cycle of Odontoblast

Phases of dentin formation


Phase 1: Secretion of matrix. Collagen fibers DPP & DSP
Phase 2:Mineralization. .Globular mineralization.

VON KORFFS FIBERS

FIRST SIGN OF DENTIN FORMATION TYPE3 FIBERS

Types of dentin

primary

secondary

Tertiary

mantle

Circumpulpal

FORMATION OF MANTLE DENTIN:

Predentin

Collagen fibrils ( brown) form an interlacing network perpendicular to odontoblast process

FORMATION OF CIRCUMPULPAL DENTIN

Once mantle dentin is formed dentinogenesis cont to form circumpulpal dentin

Collagen of organic matrix aggregates as smaller fibrils

Odontoblasts adds further


components to matrix Ex: lipids, phosphoproteins

Mineralization of circumpulapal dentin


Odontoblasts

actively

transport Ca ions to mineralzn site Serum Ca is taken up by odontoblast & accumulates in distal

body & process

DPP- transport of ions to minerlzn front

Pattern of mineralization

Globular calcification

HISTOLOGICALLY 2 PATTERNS OF MINERALIZATION SEEN. GLOBULAR LINEAR.

Incremental nature of dentin formn Rate of dentin


deposition 4m per day
Incremental lines. 1.Von ebner lines. 2.Contor lines of ow en. 3. Neonatal line.

Components of Dentin

Formation of tubular dentin

Deposition of tubular dentin beginsjust after formation of mantle dentin is complte. Matrix is synthesized in cell body of odontoblasts and transported through odontolasts and liberatd lateraly into tubules..

Dentin may be classified as Developmental. physiologic/ pathologic

secondary dentin Tertiary dentin

throughout life. Age related.. at a much slower pac less mineralized formed in the same way as primary dentin

Secondary dentin

Tertiary dentin:
Deposited at specific sites in response to injury by damagad cells or recruited cells. Reactionary Reparative

Sclerotic dentin

Sclerotic dentin describes the dentinal tubules that have occluded with calcified material.
cl.sig. sclerotic dentin may serve to confine caries to the dej.

Clinical significance

Dentinogenesis imperfecta.
DSPP

mutation.

Dentin dysplasia.
DSPP

missense

mutation.

Tetracycline Stain.

GOOD MORNING

AMELOGENESIS

Definition: Sequence of events which ultimately result in the formation of mature enamel.

Composition: Inorganic Organic Water

Life Cycle Of AMELOBLAST

STAGES OF AMELOGENESIS
1.
2. 3. 4. 5.

Presecretory
Secretory

Transition
Maturation

Postmaturation

Amelogenesis

1] PRESECRETORY

Diff of pre ameloblasts Formn & resorption of basal lamina Epithelial mesenchymal interactions Pre ameloblasts synthesize & secrete proteins

2] Formative/ Secretory stage placed nucleus, Proximally


Strands of RER II to long axis of cell, Prominent GA Basic enamel proteins assembled in ER

Amelogenesis

Carried by vesicles to GA

Package into secretory granules

Transported to secretory pole

Amelogenesis

2] Secretory or Formative stage


Initial layer of aprismatic enamel formed Secretory end become

pyramidal in shape forming


tomes process

Marked aggregation of

vesicles at the distal end


represent organic matrix

Within this matrix,

hydroxyapatite crystals
appear represent the

Tomes Process and Enamel Prism

Amelogenesis

3] TRANSITION STAGE

Enamel secretion stops


& amelogenin removed

Ameloblasts shorten,

50% die

Vascularisation of enamel organ

Protein :
90% --amelogenin 10% -- enamelin &

Amelogenesis

4] MATURATION STAGE

Removal of

water & proteins


Addition of Ca & P.

Organic matrix

also removed

Tomes process

Lost

Cell modulation

Mineralization of Enamel

Current Concept on the role of Amelogenins in the mineralization of Enamel

Pattern of mineralization during maturation

Post maturation / Protective stage

Ameloblasts become
flattened Enamel cuticle, amorphous layer of protein separates the

cells from enamel

Period of AMELOGENESIS in Permanent Teeth of Human Dentition

Applied aspect

Amelogenesis imperfecta.

ENVIRONMENTAL:

Nutritional deficiencies: vit A,C,D. Ca&PO4. Infections. Trauma.

Fluoride, stronsium, cobalt, manganese.


Drugs (chemotherapeutics, tetracycline

Porphyria
Erythroblastosis fetalis.

Development of Dental Pulp

At bud stage,

mesenchymal cells
becomes evident around developing

enamel organ

Some of these cells will form dental papila

dental pulp

As dentinogenesis begins, the dental papila becomes surrounded by dentin, it is then termed dental pulp

Vascular Pattern in the Dental Papilla

Vascular Plexus Beneath the Developing Cusp

Vascularity of odontoblast layer

as

dentin is progressively laid down

Development of Root
Initiated through the contributions of the cells: Enamel organ

Dental papila
Root pulp

Dental sac
Cementum PL Alveolar bone

Root dentin

ROOT SHEATH DEVELOPMENT

SINGLE ROOT FORMATION

Development of root

Occurs by growth of root

sheath, like a cuff around


the cells of pulp

Followed by devp of root

dentin

As dentin matrix mineralizes, sheath cells

form a thin deposit of


cementum on root surface

Formation of multirooted teeth

Formation of Single and Multirooted Teeth

Apices of Developing Roots

Root formation anamolies

Accessory root canals: Small lat canal connecting the PL with the main RC cl.sig. acessary canals spread infection from one site to other.

Enamel pearls:

root sheath may remain adherent to dentin


near the furcation.

Dilaceration: If root sheath becomes dislocated after partial root mineralization, remaining portion becomes bent/ twisted

Cementogenesis Primary/ acellular


Secondary/ cellular
Cementoblasts align along newly formed, unmineralized mantle dentin.

Deposit collagen fibers

Dentine cementum fibers intermingles

cementoblasts migrrate away from surface but continue to deposit collagen

this continues untill pdl fiber bundles become stitched to fbrous stringe

Acellular extrinsic fiber cementum

Once PL fibers become


attached to cementum, its classified as AEFC

AEFC Principal tissue of att ,covers 2/3rds of root

For this type, all collagen


is derived as sharpeys fibers from PL

Ground subs may be produced by

cementoblasts

Cellular cementum

Cementoblasts lay down organic matrix

Deposited around apical 3rd of root & interradicular regions of premolar & molar teeth

This becomes mineralized due to cementoblasts budding off matrix vesicles in which apatite crystallites appear

When PL organized, CC cont to be deposited around ligament fiber bundles

Cellular intrinsic fiber cementum

CC commonly present as CIFC

Runs parallel to root


surface Found in patches in the apical region

Hyper cementosis

Increased cementum formn Seen in pagets disease h/o chronic periapical inflmn progressive root elongation

Development of Periodontal ligament

Pdl originates from dental sac. . Three different cell zones can be recognized

. Outer ells. osteoblst

Inner cell
Central cells

cementoblast
fibroblasts

Principle Collagen fibres

PL is in a cont state of

remodeling

Achieved by fibroblasts

that synthesize collagen

Rapid turnover of collagen takes place throughout the thickness of ligament.

Maturation & thickening


occurs as the teeth reach functional occlusion

Alveolar bone

New bone is formed

by cells from DF

As root & pri cem form against the crypt wall

new bone is deposited

FACTORS AFFECTING TOOTH DEVELOPMENT

Vitamin A, C & D deficiency


Parathyroid hormone

Tetracycline & fluoride

Vitamin A deficiency

Hypovitaminosis A: metaplasia of enamel organ defective enamel & dentin formn Dentin: Excessive osteodentin

depsn or insufficient depsn


Enamel; degeneration of ameloblasts hypoplastic

enamel matrix

Vitamin C deficiency
Def during dentinogenesis: Dentinal tubules become irregular, reduced in no

Vascular inclusions
Odontoblasts become spindle shaped.

Vitamin D deficiency
Abnormally wide non mineralised zone of predentin & interglobular spaces in dentin
Enamel hypoplasia & hypomineralization Hypomineralization of cementum

Parathyroid hormone
Excess PTH
Mobilzn of Ca from skeleton into blood Ca excreted in urine, feces, Bone density Decreased PTH

low blood conc of Ca ions


in gland activity

levels of blood Ca
Mobilzn of Ca from bone thickness of lamina dura & density of bony trabeculae

in bone density around tooth

Tetracycline & fluoride

If available during mineralization, gets


incorporated in dentin, enamel, cementum & bone

Period of minrlzn of crown extends from 5 months in utero to 12 yrs of age

Tetracycline & to a limited extent Na F cross


placental barrier

Tetracycline

Mechanism: believed that a chelate of Ca & tetracycline forms

Amount of damage is
directly related to the magnitude & duration of dosage

Tetracycline staining

Fluoride crystals form, they may incorporate F either As hydroxyapatite

by an exchange with the hydroxyl groups by simple adsorption

F in inner enamel is absorbed mainly during secretory stage of amelogenesis


F found in outer 30 50 m of enamel occurs during maturative stage

Fluoride

Na F in conc of 5ppm causes mottled enamel, that may or may not be mineralized
Rods follow irregular course Hypomineralized dentin with interglobular spaces

Conclusion .
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REFERENCES

ORAL CELLS AND TISSUES

P.R. GRANT.

ORAL ANATOMY, HISTOLOGY AND EMBRYOLOGY 3RD ed BERKOVITZ ORAL HISTOLOGY, DEVELOPMENT, STRUCTURE AND FUNCTION 5TH ed . TENKATE. A. R. ORBANS ORAL HISTOLOGY AND EMBROLOGY 11TH ed. BHASKAR.S.N. ESSENTIALS OF ORAL HISTOLOGY AND EMBRYOLOGY 2ND ed JAMES.K.AVERY. COLOUR ATLAS OF ORAL HISTOLOGY AND EMBRYOLOGY. BERKOVITZ.

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