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AGING ENAMEL
ATTRITION/ WEAR
MORE BRITTLE
reduced permeability
P
U More translucent = darker
L
P
More resistant to caries?
Changes in ion composition
1
AGING in DENTINE
{ SECONDARY DENTINE -
slow increment to pulpal surface
P
U
DEAD TRACT -
L
wide, empty dentinal tubules
P
REPARATIVE DENTINE -
response to caries/erosion
SCLEROTIC DENTINE -
tubules narow, then
become filled with mineral
AGING PULP
2
AGING CEMENTUM
P
U
L
P
HYPERCEMENTOSIS -
excess deposition
Bundles
less distinct
DENTINE
P
D PULP
L
BONE
PDL Width
3
AGING GINGIVA
TOOTH
Hyperkeratosis
DRY - Xerostomia -
“Dry mouth”
Epithelial
attachment INFLAMED
looser,
displaced
PERIODONTITIS
4
EDENTULOUS MANDIBLE
illustrates dependence of bone on use
loss of teeth
BONE RESPONSE TO
TOOTH DISUSE Alveolar SPONGIOSA most
affected, with extensive
loss of trabeculae
However, mandibular
body is less affected
by aging osteoporosis
than spine & long
bones
5
RED MARGIN LIP
VERMILION BORDER
LABIAL MUCOSA
thick strat squam ep thins
MUSCLE
AGING TONGUE
Tongue papillae
smoother
Lingual gland
Sub-lingual blood
vessels engorge
- “Caviar tongue”
6
Mucosa CHEEK
loses elasticity
MUSCLE
BUCCAL MUCOSA
thick strat squam ep thins
BUCCAL GLAND
mucous
ADIPOSE TISSUE
CHEEK
7
AGING PAROTID GLAND
INTER LOBULAR DUCT
SEROUS ACINi
FAT
INTRA LOBULAR
DUCT
less control of
secretion quality
ONCOCYTIC CONVERSION
As cuboidal epithelia and glands age, a few of
their epithelial cells lose most of their normal
organelles and fill up with mitochondria.
Mitochondria-rich cells are eosinophilic.
8
ORAL TISSUE AGING: Interactions with
9
ALVEOLAR BONE: Roles
The bone holds the tooth firmly in position to
masticate and, for the lower jaw, transmits
the muscle-powered movements of the body
of the mandible. It also:
adapts the strength and orientation of
attachment to varying load
helps to move the teeth for better occlusion
supplies vessels for the PDL & cementum
houses & protects developing permanent
teeth while suppporting primary teeth
organizes successive eruptions of primary &
secondary teeth
PDL
LAMINA DURA
ALVEOLAR BONE
SUPPORTING
BONE
Plate
Spongy bone
1
MANDIBULAR CENTRAL
Deciduous tooth INCISORS at 2 y
Gingiva
PDL
Permanent
tooth
ALVEOLAR BONE
in general
ALVEOLAR BONE
specifically
SPONGIOSA
Alveolar crest
CORTICAL PLATE
ALVEOLAR BONE is
also termed Lamina dura
from its X-ray densit, or
cribriform bone from the
many holes for vessels
to reach the PDL
2
PDL Vessels DENTINE
PULP
Lymphatic drainage
PDL
LAMINA DURA
ALVEOLAR BONE
SUPPORTING
BONE
Plate
Spongy bone
3
BONE MATRIX
Fine collagen fibrils - intrinsic
PDL fibers (extrinsic)
become imbedded in
Osteocyte newly formed bone
MATRIX
PROPORTIONS
collagen fibrils and
glycoproteins &
proteoglycans 35%
Imbedded PDL fibers - Organic
Sharpey’s fibers
mineral crystals 65%
Inorganic
OSTEOCYTE PROCESS
4
BONE DEVELOPMENT
BRAIN
MAXILLARY
BONE
TOOTH BUD
TONGUE
MANDIBULAR
BONE
TOOTH
FACIAL REINFORCEMENT
SEPTAL CARTILAGE
NASAL CONCHAE
HARD PALATE
X X
Maxillary bone
X X
X TOOTH BUD
X TONGUE
X X
Mandibular bone
X Skeletal muscle starting
5
TOOTH PRIMORDIUM/GERM
MESENCHYME
DENTAL PAPILLA
DENTAL SAC/FOLLICLE
ALVEOLAR BONE
INTRAMEMBRANOUS OSTEOGENESIS
Condensations are
widely dispersed
and separated to
commit a territory
to becoming bone
Mesenchyme
Vessels present
Continued division
& recruitment to
osteoblast numbers
6
Mesenchyme INTRAMEMBRANOUS OSTEOGENESIS
LESS
ACTIVE
CELLS
OSTEOCLAST
TRABECULA
OSTEOID
ACTIVE OSTEOBLASTS
TRABECULAE
thicken by division &
recruitment of more
osteoblasts to
increase bone density
OSTEOCLASTS
active from the start to
remodel & reshape the
bone
7
Bone matrix = collagen fibrils + BONE CELLS
mineral crystals
Active Osteoblasts
Bone canal
vessels
Osteoclast
Periosteum
Resting cells
Osteocyte
Ca 2+
Osteoblasts filling
in the tunnel
New bone -
start of new
osteon
8
DENSE BONE
Osteoblasts filling
in the tunnel New bone REMODELING*
REMODELING
Eaten-out hole is a
Howship’s lacuna
Sealing ring
of tight Osteoclast
attachment
to bone
BONE starting
LINGUAL PLATE
10 TOOTH GERM
20 Successional
WALLS OF BONY TOOTH GERM
TROUGH OF
DEVELOPING
MANDIBLE
SYMPHYSEAL
CARTILAGE
9
JAW & TOOTH DEVELOPMENT processes
DENTAL LAMINA will grow back to form
germs for 3 permanent molars (5th e m)
BONE
10 TOOTH GERM
10 TOOTH GERM
10
TOOTH & MANDIBLE DEVELOPMENT
Oral ectoderm
TONGUE
DENTAL SAC
10 TOOTH
ALVEOLAR
BONE
20 TOOTH GERM
MECKEL’S
ALVEOLAR CARTILAGE
NERVE
MANDIBLE DEVELOPMENT
DENTAL SAC contributes Remodeling will bring erupting
also to alveolar bone 1o tooth over developing 2o
Bone added to
base of alveolus 20 TOOTH
for tooth eruption GERM
11
TOOTH & MANDIBLE DEVELOPMENT - Next
TONGUE
DENTAL SAC
Higher alveolar bone
- i.e. deeper socket 10 TOOTH
ALVEOLAR
BONE
20 TOOTH GERM
ALVEOLAR
NERVE
MECKEL’S
Denser alveolar bone & more CARTILAGE
body-alveolus distinction
Remodeling brings erupting 1o Meckel’s cartilage gone
tooth over developing 2o
Imbedded ends of
PDL fibers create PULP
BUNDLE BONE
12
Tooth drifts mesially TOOTH MOVEMENT
by combined actions
of osteoclasts &
osteoblasts moving
bone, taking tooth
with it
Osteoblasts
laying down
bundle bone
Plus PDL
reorganization
Osteoclasts
resorbing bone
Osteoclasts
resorbing bone
Osteoblasts
Bony laying down
interdental bundle bone
septum
PDL fibers
incorporated in bone
as Sharpey’s fibers
Cellular cementum added to apex
Compensates for occlusal wear? Basil
13
TOOTH MOVEMENTS Occurring in eruption & use
TOOTH MOVEMENT 2
TILTING Tooth tilts by combined
actions of both osteoclasts
Earlier bone & osteoblasts on bone of
position each side of socket
Basil
14
TOOTH MOVEMENT
Earlier bone
position
Basil
Bone remodellling
has brought 20 tooth
under 10
20 tooth
Bone trabeculae
added by layers at
base of alveolus
20 tooth would be
LARGER than shown
15
STARTING EXFOLIATION of DECIDUOUS MOLAR I
ENAMEL
DENTINE
ALVEOLAR
PULP
BONE
PDL
Root resorption
by osteoclasts
ENAMEL
DENTINE
Erosion of bone and the deciduous root is not steady & continuous,
but may cease briefly, when some repair of eroded cementum &
dentine can occur (by cementum).
16
SPONGY BONE at more risk than dense bone
2 Much surface
area for attack by
osteoclasts
17
BONE RESPONSE TO
TOOTH DISUSE
SPONGIOSA
most affected,
with extensive
loss of
trabeculae
18
TOOTH TISSUES: CEMENTUM WABeresford
ENAMEL
GINGIVA
DENTINE
PULP
CEMENTUM
PERIODONTAL
ALVEOLAR BONE LIGAMENT/ PDL
DENTINE CEMENTUM
ENAMEL
1
TOOTH DESIGN: Spear me
Refinements
Shaft is hollow for
ENAMEL PULP
DENTINE CEMENTUM
Hand represented by
PERIODONTAL LIGAMENT
& ALVEOLAR BONE
CEMENTUM: Role
2
Bone matrix = collagen fibrils + REMINDER -BONE CELLS
mineral crystals
Active Osteoblasts
Bone canal
vessels
Osteoclast
Periosteum
Resting cells
Osteocyte
Ca2+
CEMENTUM-BONE DIFFERENCES
Bone matrix = collagen fibrils +
mineral crystals
Active Osteoblasts
FORMING CELLS ARE
CEMENTOBLASTS Bone canal
Osteoclast
Periosteum
ACELLULAR CEMENTUM Resting cells
EXISTS
Osteocyte
Ca2+
NO PERIOSTEUM
3
BONE-CEMENTUM SIMILARITIES
Bone matrix = collagen fibrils +
mineral crystals
MATRIX MATERIALS
Bone canal
LACUNAE WITH
CANALICULI FOR CELLS &
CELL PROCESSES
vessels
APPOSITIONAL GROWTH
FROM SURFACE
EROSION BY
INCREMENTAL GROWTH OSTEOCLASTS
LINES IN MATRIX (cementoclasts)
ORIENTATION: Terms
CUSPAL/
Enamel
OCCLUSAL
CORONAL
P
U
L
CERVICAL { P
A
L
RADICULAR
APICAL Cementum
4
CEMENTUM: Position
ENAMEL
DENTINE
PULP
} CROWN
Cervix
CEMENTUM
} ROOT
5
INTER-RADICULAR CEMENTUM
CEMENTUM: Boundaries
Ligamento-cemental junction
APICAL FORAMEN
6
CEMENTUM: CEJ VARIATIONS
E E E
D D D
CEMENTUM
E E E E
PDL
fibers
D D D D
7
GROWTH OF CEMENTUM III
CEMENTUM MATRIX
Fine collagen fibrils - intrinsic
PDL fibers (extrinsic)
become imbedded in
newly formed cementum
-
MATRIX
PROPORTIONS
collagen fibrils and
glycoproteins &
proteoglycans 35%
Imbedded PDL fibers -
Sharpey’s fibers - not Organic
specific to cementum mineral crystals 65%
Inorganic
8
ROOT FORMATION
REDUCED
DENTAL
EPITHELIUM
DENTINE
CEMENTOGENESIS START
DENTINE
9
SEQUENCES
Directions of
cemental Dentine formed before
growth - cementum
outwards & & cervical before apical
apicalwards
Osteoclasts
resorbing bone
Osteoblasts
Bony laying down
interdental bundle bone
septum
PDL fibers
incorporated in bone
as Sharpey’s fibers
Cellular cementum added to apex
Compensates for occlusal wear? Basil
10
CEMENTUM: Defects
CORONAL CEMENTUM
spurs, etc, on enamel
P
U
L
P
HYPERCEMENTOSIS -
excess deposition
CEMENTICLES
IN PDL CEMENTOCLASIA - eroded
cementum (occurs normally in
decidual-tooth shedding)
CEMENTUM: Repair
P
P
U U
L
L
P P After cementoclasia,
cementoblasts may fill
in the defect with new
cementum.
This cycle can be repeated,
and also occurs a little
during shedding & after
root fracture
11
EXFOLIATION of DECIDUOUS MOLAR III
ENAMEL
DENTINE
CEMENTICLES
Hard mineralized bodies found in
the periodontal ligament or
partially imbedded in cementum
P
U
L
P
12
WABeresford
DENTAL PAIN
DENTAL SENSITIVITIES
SENSITIVE?
Enamel
Dentine
Pulp
Cementum
PDL
1
PULP INNERVATION Sub-odontoblastic plexus
in cell-poor zone of Weil
1
2 3
Blood vessels
Sub-odontoblastic
plexus of Raschkow
2
FIBER CALIBER & MODALITY
80 % unmyelinated C fibers
δ fibers
10 % myelinated Aδ
< β fibers
1/2 % Aβ
No specialized receptors
FIBER FUNCTIONS
< β fibers
1/2 % Aβ
Autonomic roles
3
PNS: AUTONOMICS
Sympathetic fibers
V
Sup Cervical
Ganglion
Pulp vessel
Branch of external
Other targets?
carotid A
CNS
4
PAIN QUALITY
Spinal nucleus of V
CNS
Mesencephalic
“Ruffini” receptors nucleus of V
Mechanoreceptors for stretch
5
CNS: Dental pain pathways
SENSORY CORTEX
Parietal lobe
Thalamic VPM
Reticular formation
Periaqueductal
grey (PAG)
Spinal N V Mesencephalic N of V
Sensory V Nucleus CNS
Spinal V tract
TRIGEMINAL NERVE
Thalamic VPM
Reticular formation
Mesencephalic N
Spinal N V Periaqueductal grey
Sensory V Nucleus (PAG) can inhibit
Spinal V tract
ascending pain
signals by using
TRIGEMINAL NERVE endorphins, enkephalins
6
RETICULAR FORMATION: Roles
Cortex - arousal
Hypothalamus -
autonomic responses
Limbic system -
emotions
Motor nuclei - reflexes
NERVE-FIBER:STIMULI RELATIONS I
Direct pulp
stimuli ODONTOBLASTS Worn dentine brings stimuli
nearer to pulp
Pulp
Heat
Cold
Enamel
Pressure
2 3
Chemicals?
Axons in tubules
Axons around
odondoblast bodies
Sub-odontoblastic plexus
ODONTOBLAST as
sensory transducer ?
7
NERVE-FIBER:STIMULI RELATIONS II
ODONTOBLASTS Worn dentine brings stimuli
nearer to pulp
Pulp
Heat
Cold
Enamel
Pressure
2 3
Chemicals
Axons in tubules
Axons around
odondoblast bodies
Heat
Cold
Enamel
Pressure
8
NERVE-FIBER:STIMULI RELATIONS IV
ODONTOBLASTS
Dentine
Heat
Cold
Enamel
Pressure
9
DENTAL PAIN: Unknowns
10
TOOTH TISSUES: DENTINE WABeresford
ENAMEL
GINGIVA
DENTINE
PULP
CEMENTUM
PERIODONTAL
ALVEOLAR BONE LIGAMENT/ PDL
DENTINE CEMENTUM
ENAMEL
1
TOOTH DESIGN: Spear me
Blade Shaft Grip
DENTINE CEMENTUM
ENAMEL
Hand represented by
PERIODONTAL LIGAMENT
& ALVEOLAR BONE
DENTINE: Role
2
DENTINE: Correlates
DENTINE: Position
ENAMEL
DENTINE
} CROWN
Cervix
CEMENTUM
PULP } ROOT
CROWN/CORONAL ROOT/RADICULAR
versus
DENTINE DENTINE
3
DENTINE: Boundaries
Pulp surface
APICAL FORAMEN
DENTINE: Composition
Odontoblasts
in an epithelial- Penetrated by TUBULES containing long thin
like layer processes of cells - ODONTOBLASTS -
whose bodies lie outside and against the
pulpal surface of the dentine
4
DENTINE: Composition
DENTINE: Composition II
Inter-tubular dentine
5
DENTINE: Reality
Processes split
Processes extend
into enamel rare
“ENAMEL
SPINDLES”
DENTINE: Growth
Enamel PREDENTINE
DENTINE
Odontoblasts
Direction of growth -
pulpward from DEJ
Enamel is
Matrix color as seen with H&E: removed by the
dense collagen gives a red color, but decalcification
predentine is paler. Matrix fibrils are needed for wax
unseen. sections
6
TOOTH GERM: Odontoblast recruitment
outermost papilla
cells have become
Odontoblasts
DENTAL
Recruitment site
PAPILLA
becoming
pulp
TOOTH GERM:
Dentinogenesis
Dentine is formed first as predentine -
organic phase precede mineralization
cusp Dentine
formed by
Odontoblasts
Recruitment site
for odontoblasts
DENTAL
PAPILLA
becoming
pulp Ingrowing pulp vessels
7
ORIENTATION: Terms
CUSPAL/
Enamel
OCCLUSAL
CORONAL
P
U
L
CERVICAL { P
A
L
RADICULAR
APICAL Cementum
SEQUENCES
Pulpal-surface dentine is
formed last
Odontoblast
trajectories Coronal dentine formed
during growth before root dentine, AND
cuspal before cervical, &
cervical before apical
8
INCREMENTAL GROWTH
CIRCUMPULPAL DENTINE -
main mass of dentine
{
P
U TERTIARY DENTINE* - slow
L increment to pulpal surface
P
REPARATIVE DENTINE* -
response to caries/erosion
9
REPARATIVE DENTINE 2
REPARATIVE DENTINE
in response to attrition/wear of
the cusp
P
U
L
P
SCLEROTIC DENTINE -
tubules filled with mineral
10
MATURE DENTINE: Usual Defects
INTERGLOBULAR AREAS
lack mineral
P
U
L ‘normal’ development
P
SCLEROTIC DENTINE -
tubules filled with mineral
‘normal’ aging
P
U
L
P
11
DENTINTICLES/ PULP STONES
Hard mineralized bodies found in
the pulp or the dentine
TWO TYPES:
P
U 1 TRUE - constructed of dentine
L by odontoblasts & showing
P dentinal tubules
2 FALSE - mineralized connective
tissue, etc, (not made of dentine)
THREE SUBTYPES:
12
TOOTH TISSUES: ENAMEL WABeresford
ENAMEL
GINGIVA
DENTINE
PULP
CEMENTUM
PERIODONTAL
ALVEOLAR BONE LIGAMENT/ PDL
DENTINE CEMENTUM
ENAMEL
1
TOOTH DESIGN: Spear me
Refinements
Shaft is hollow for
ENAMEL PULP
DENTINE CEMENTUM
Hand represented by
PERIODONTAL LIGAMENT
& ALVEOLAR BONE
ENAMEL: Role
2
ENAMEL: Position
ENAMEL
DENTINE
} CROWN
Cervix
CEMENTUM
PULP } ROOT
ENAMEL: Boundaries
3
CEMENTUM: CEJ VARIATIONS
E E E
D D D
CEMENTUM
ORIENTATION: Terms
CUSPAL/
Enamel
OCCLUSAL
CORONAL
P
U
L
CERVICAL { P
A
L
APICAL
4
ENAMEL: Nature
Enamel is the dead, very hard, but brittle cutting/
grinding oral covering of the tooth
This degree of hardness can be achieved by the
dense packing of curved rods/prisms composed
almost entirely of densely arranged spikey mineral
crystals, with a keying together of the prisms
R
O
Mineral is hydroxyapatite, with
D
Ca2+, OH-, PO4--, etc, ions R
O
D
Cross-section of rods
ENAMEL
5
SEQUENCES
Enamel first formed at DEJ
Enamel
One ameloblast
makes one prism/
rod
Enamel grows
outwards from
the DEJ
DEJ Story I
Starts as basal
lamina between
inner epithelial cells
& dental-papilla cells
Mesenchyme
6
DEJ Story II & III
DEJ Story IV
cusp enamel
Dentine instructs inner epithelial formed by
cells to become ameloblasts - ameloblasts
through an intact, then through a
disintegrating basal lamina?
7
DEJ Story V & VI
ENAMEL
SPINDLE
ENAMEL: Problems
R
Cross-section of rods O
D R
PROBLEMS:
O
the precise wear-resistant architecture needs D
a prior cell-oriented organic precursor
a maturation phase has to replace the
organic with inorganic mineral
the direction of growth outward from the DEJ
leaves the formative cells on the surface
where they cannot survive - no later repair
possible
deleterious agents can substitute for ions in
the crystal lattice, e.g., Pb, Sr90, Fl, &
tetracycline can bind to the mineral
8
ENAMEL FORMATION - AMELOGENESIS
Ameloblast
Tomes’ process
Organic first deposits,
COMPARTMENT FOR
SECRETORY RELEASE e.g., amelogenin, + 30%
mineral
Ameloblast
Process defined by terminal
web of actin etc stretching
between junctional complexes
fastening ameloblasts together
COMPARTMENT FOR
SECRETORY RELEASE Tomes’ process
Releases vesicles of
amelogenin, etc
9
AMELOBLAST’S VASCULAR RELATIONS
CAPILLARY
BASAL LAMINA
Collapse of stellate
reticulum lets vessels
ROD approach closer to the
highly active ameloblasts
TOOTH GERM
Outer dental epithelium
collapsing down
10
Dentine is formed first as predentine. TOOTH GERM:
It will signal to inner dental result & next steps
epithelial cells to become ameloblasts
Stellate reticulum
moving “apically”
cusp Dentine
formed by
Odontoblasts
Enamel is always
DENTAL SAC less extensive than
still quiescent dentine
11
CHANGES IN DENTAL/
Ameloblasts
ENAMEL ORGAN III will finish full
Second reduction in thickness of
enamel epithelium: cusp enamel
retired ameloblasts & & reduce in
compacted outer height
epithelium, stellate-
reticulum cells & Dentine widens
stratum intermedium DENTAL
Stellate reticulum PAPILLA
follows Cervical becomes pulp
process
loop down then proceeds
stops: Crown downs
defined
Odontoblast
recruitment
Cervical loop:
site
12
ROOT FORMATION: Coronal consequences
GINGIVAL
EPITHELIUM
Connective
REDUCED tissue broken
DENTAL down
EPITHELIUM will
fuse with gingiva
REDUCED
DENTAL
EPITHELIUM
protects As root
enamel lengthens
crown is
HERTWIG’S
pushed up -
ROOT
Pre-
SHEATH
grows to
EMERGENCE
lengthen root
TOOTH EMERGENCE
CUTICLE
GINGIVAL will wear away
EPITHELIUM
still fusing with
REDUCED DENTAL
EPITHELIUM
ENAMEL
13
ORGANIC ENAMEL SURFACE
CUTICLE
will wear away
PELLICLE of
glycoproteins etc is
acquired later from saliva
PLAQUE
the biofilm of many kinds
of bacteria then attaches
to the pellicle
INCREMENTAL GROWTH
Contour lines of Retzius
reflect varying physiological
circumstances during growth
neonatal line is most prominent
14
ENAMEL IN HISTOLOGY
AFTER DEMINERALIZATION
REDUCED
DENTAL
space where
EPITHELIUM
mature
ENAMEL has
been lost
immature
ENAMEL
matrix remains
DENTINE most recently
formed, hence
immature
PULP
15
FISSURE/PIT
ENAMEL: Special features
TUFT
GNARLED
ENAMEL
LAMELLA
SPINDLE
ENAMEL
SPINDLE
Odontoblast
process stuck into
enamel matrix
while it was soft
16
ENAMEL: Special features Mostly visual
TUFT effect from varied
rod directions
GNARLED
ENAMEL
Mostly
visual
effect
from
unusually
varied rod
directions
LAMELLA
Vertical cracks filled
Lamellae are seen in with mineralized
coronal cross-sections organic material
CORONAL CEMENTUM
spurs, etc, on enamel
P
U
L
P Reduced enamel epithelium
had gaps that allowed
mesenchymal cells in to
become cementoblasts
17
MATURE ENAMEL: Severe Defects
ATTRITION/ WEAR
CARIES/DECAY
P
U
L
P
18
ROOT FORMATION & ERUPTION
WABeresford
PULP
CEMENTUM
DENTINE
PERIODONTAL
ALVEOLAR BONE LIGAMENT/ PDL
Number of roots
Shapes of root
Length of root
Four tissues in sequence
Pulp Dentine Cementum Ligament
Organize surroundings
Times of eruption
& coordinated
Shedding of teeth
e.g., cementum with PDL
with bone
Successional teeth
1
TOOTH TISSUES: Cell Sources
Crest
MECHANISMS OF ERUPTION
Construction & Reorganization of PDL
2
TOOTH GERM:
Outer dental epithelium
approaches inner
next steps
DENTAL LAMINA
Stellate reticulum upper part degenerates
reduces over cusp lower forms 2nd bud
Knot cells
signal to
Stratum intermedium
papilla
DENTAL PAPILLA
Inner & outer dental epithelia
join to form cervical loop DENTAL SAC/FOLLICLE
remaining
Stellate reticulum
Cervical loop:
inner & outer
epithelium DENTAL SAC
still quiescent
3
END OF CROWN Ameloblasts
FORMATION will finish full
thickness of
cusp enamel
& reduce in
height
Dentine widens
DENTAL
Stellate reticulum PAPILLA
follows Cervical become pulp
process
loop down then proceeds
stops: Crown downs
defined
Odontoblast
recruitment
Cervical loop:
site
4
FURTHER ROOT FORMATION
REDUCED
DENTAL
EPITHELIUM
Root sheath
ENAMEL breaks up, allowing
sac mesenchymal
cells to contact
DENTINE
root dentine
PULP
Other sac
HERTWIG’S mesenchymal
ROOT cells construct
PDL & some
SHEATH
alveolar bone
grows to
lengthen root Fibroblasts
Epithelial diaphragm Odontoblast recruitment site
PULP
ROOT
5
ROOT FORMATION: Multirooted
Thus, one dental organ
CROWN can produce two or
three roots
ENAMEL
Similarly, one dental
organ can produce
DENTINE two or more cusps,
using multiple
enamel knots
PULP
ROOT
REITERATIVE SIGNALING V
REDUCED DENTAL
EPITHELIUM
ENAMEL
DENTINE
6
JAW & TOOTH DEVELOPMENT early arch
BONE starting
BUCCAL PLATE DENTAL LAMINA
BONE starting
LINGUAL PLATE
10 TOOTH GERM
20 Successional
WALLS OF BONY TOOTH GERM
TROUGH OF
DEVELOPING
MANDIBLE
SYMPHYSEAL
CARTILAGE
10 TOOTH GERM
7
TOOTH & MANDIBLE DEVELOPMENT
Oral ectoderm
TONGUE
DENTAL SAC
10 TOOTH
ALVEOLAR
BONE
20 TOOTH GERM
MECKEL’S
ALVEOLAR CARTILAGE
NERVE
MANDIBLE DEVELOPMENT
DENTAL SAC contributes Remodeling will bring erupting
also to alveolar bone 1o tooth over developing 2o
Bone added to
base of alveolus 20 TOOTH
for tooth eruption GERM
8
TOOTH & MANDIBLE DEVELOPMENT - Next
Reduced enamel epithelium
fused with gingiva
TONGUE
DENTAL SAC
Higher alveolar bone
- i.e. deeper socket 10 TOOTH
ALVEOLAR
BONE
Longer root with
cementum forming 20 TOOTH GERM
body-alveolus distinction
Remodeling brings erupting 1o Meckel’s cartilage gone
tooth over developing 2o
TOOTH EMERGENCE
CUTICLE
GINGIVAL will wear away
EPITHELIUM
still fusing with
REDUCED DENTAL
EPITHELIUM
ENAMEL
9
ORGANIC ENAMEL SURFACES
CUTICLE
will wear away
PELLICLE of
glycoproteins etc is
acquired later from saliva
PLAQUE
the biofilm of many kinds
of bacteria then attaches
to the pellicle, & later
mineralizes - tartar
DENTINE
ENAMEL
PULP
Rests of Mallassez
Cementum starting as remnants of Root sheath
sheath breaks down
10
LATE ERUPTING TOOTH
ENAMEL
GINGIVA
CEMENTUM PULP
PDL
ROOT SHEATH
BONE
MANDIBULAR CENTRAL
Deciduous tooth INCISORS at 2 y
Gingiva
PDL
Permanent
tooth
ALVEOLAR BONE
11
Go Gubba
Gubernacular cord of
fibrous tissue
Gubernacular cord
runs through a canal
left in the bony crypt,
where the dental
lamina extended
Permanent down to establish the
tooth germ for the 2nd
tooth
Permanent
tooth
Cortical plate
dense bone
12
10/Deciduous tooth Close to EXFOLIATION
of Deciduous/10 Tooth
Odontoclasts have
resorbed most of
PDL attachment is
deciduous root
surprising persistent
Pulp is left
alive
Bone remodellling
has brought 20 tooth
under 10
20 tooth
Bone trabeculae
added by layers at
base of alveolus
20 tooth would be
LARGER than shown
DENTINE
ENAMEL
PULP
13
WHY STILL ERUPTING
APEX INCOMPLETE
BONE
PDL
DENTINE
ENAMEL
PULP
ENAMEL
DENTINE
ALVEOLAR
PULP
BONE
PDL
Root resorption
by osteoclasts
Inter-radicular septum of bone also
Permanent Tooth under deciduous houses 2nd tooth germ & is its crypt
molar, & between its roots
14
EXFOLIATION of DECIDUOUS MOLAR II
Crypt bone
eroded here ENAMEL
DENTINE
ALVEOLAR
BONE
PDL
ENAMEL
DENTINE
15
Occlusal wear FUNCTIONAL ERUPTION
& TOOTH MOVEMENT
Osteoclasts
resorbing bone
Osteoblasts
Bony laying down
interdental bundle bone
septum
PDL fibers
incorporated in bone
as Sharpey’s fibers
Cellular cementum added to apex
Compensates for occlusal wear? Basil
Osteoblasts
laying down
bundle bone
Osteoclasts
resorbing bone
Basil
16
TOOTH MOVEMENT
Earlier bone
position
Basil
TOOTH ERUPTION
17
TOOTH ERUPTION
PERIODONTITIS
18
PASSIVE ERUPTION
Gingival recession onto &
down the cementum with loss
of alveolar-crest bone
P
U Cementum readily abraded &
L eaten by oral acids
P
DEAD TRACT in Dentine -
wide, empty dentinal tubules
easily colonized by bacteria
REPARATIVE DENTINE -
response to caries/erosion
19
TOOTH MOVEMENTS Occurring in eruption & use
TOOTH MOVEMENT 2
TILTING Tooth tilts by combined
actions of both osteoclasts
Earlier bone & osteoblasts on bone of
position each side of socket
Basil
20
3rd MOLAR’S TILTING ERUPTION
2nd
2nd
3rd
3rd
KEY
Time of emergence
10 2nd Molar
Deciduous
20 Incisor Permanent
20 Cuspid
20 2nd PreMolar
21
YOUNG CHILD’S ERUPTION SEQUENCE
YEARS 0 1 2 3 4 5 6 7
10 Incisor
10 Cuspid
10 2nd Molar
20 Incisor
20 Cuspid
20 2nd PreMolar
Oral
Pre-oral
22
5-yr CHILD’S DENTITION: 0ne arch
Oral
Pre-oral
ERUPTION: Problems
Delayed eruption
Early eruption
Missing tooth
Malocclusion
Infra-occlusion (not high enough)
Excessive drift
Tilting (can occur early from germ rotation)
23
GINGIVA: Roles WABeresford
TOOTH
Gingival sulcus/ crevice
} FREE GINGIVA
1
Free & attached gingiva
TOOTH
Gingival sulcus/ crevice
} FREE GINGIVA
Epithelial
attachment
ATTACHED GINGIVA
Muco-gingival junction
TOOTH
Muco-gingival junction
FREE
GINGIVA
Periodontal
ligament
ATTACHED
GINGIVA
Crest of
Alveolar
bone
Alveolar mucosa
lies outside alveolar bone
2
GINGIVAL EPITHELIUM
Stratified squamous
para-keratinized
piled-up, tightly
attached, & internally
reinforced cells
Keratinocytes
Melanocyte
Merkel cell
3
GINGIVAL EPITHELIUM: Cell types
dead
Keratinocytes Melanocyte to
make & transfer
alive pigment
TOOTH
Gingival sulcus/ crevice
GINGIVAL EPITHELIUM*
SULCULAR/CREVICULAR
EPITHELIUM
CUFF/ ATTACHMENT
EPITHELIUM
*Keratinization
4
EPITHELIAL ATTACHMENT
TOOTH
CUTICLE
BASAL LAMINA
JUNCTIONAL/ CUFF/
ATTACHMENT EPITHELIUM
TOOTH MATRIX -
Ground substance
Collagen I & III fibers
Elastic fibers
CELLS -
GINGIVA
Fibroblasts & Myofibroblasts
Macrophages
Mast cells
Leukocytes
Blood vessels
Nerves, receptors
Alveolar Lymphatics
bone
5
GINGIVAL ELEMENTS - Connective tissue cells
PERIODONTITIS
6
GINGIVA ELEMENTS - The elastic question
MATRIX - Ground substance Collagen I & III fibers Elastic fibers
DENTO-GINGIVAL
ALVEOLO-GINGIVAL
CIRCULAR
7
GINGIVAL FIBER GROUPS
TOOTH
DENTO-GINGIVAL
GINGIVA
DENTO- CIRCULAR
PERIOSTEAL
ALVEOLO-
TRANS-SEPTAL in
GINGIVAL
medio-distal plane, Alveolar
not shown here bone Periosteum
TRANS-SEPTAL GINGIVA
in medio-distal
plane
Alveolar
septum
8
GINGIVAL FIBER GROUPS
DENTO-GINGIVAL
TOOTH
ALVEOLO-GINGIVAL
CIRCULAR
DENTO-PERIOSTEAL
TRANS-SEPTAL
DENTO-GINGIVAL
GINGIVA
CIRCULAR
TRANS-SEPTAL
if in medio-distal ALVEOLO-
plane, not as GINGIVAL
Alveolar
shown here bone
9
PERIODONTAL LIGAMENT/ PDL
WABeresford
ENAMEL
GINGIVA
DENTINE
PULP
CEMENTUM
PERIODONTAL
ALVEOLAR BONE LIGAMENT/ PDL
Hand represented by
PERIODONTAL LIGAMENT
& ALVEOLAR BONE
1
PERIODONTAL LIGAMENT: Roles
The PDL is the means of attaching the tooth
to the muscle-driven bone for mastication.
As a labile connective tissue, it:
adapts the strength and orientation of
attachment to varying load
senses loads for proprioceptive feeback
controlling muscle actions
helps to move the teeth for better occlusion
supplies & nourishes cementum & alveolar
bone
defends against microbes
repairs damage to itself, while preventing
damage to cementum
Connect/Support
Transport/Nourish
Defend
EPITHELIUM
*
(Storage)
Control } Connective tissue
Repair VESSEL
2
CONNECTIVE TISSUE - Mechanical functions
Bundles of thick
{
collagen I fibers
{
Looser vascular CT
Elongated fibroblasts - tenocytes between the bundles -
endotendinuem
3
DENSE REGULAR CONNECTIVE TISSUE: PDL
Bundles of thick
{
collagen I fibers
{
PRINCIPAL FIBERS
Looser vascular CT
between the bundles
- interstitial areas
Elongated PDL fibroblasts
PULP
Interstitial Areas
between
4
PDL ELEMENTS - Dense & loose connective tissue
MATRIX -
Ground substance
Reticular fibers
Collagen I fibers
CELLS -
Fibroblasts & Myofibroblasts
Macrophages
Mast cells
Leukocytes
Cementoblasts
Osteoblasts & ‘clasts
Blood vessels
Nerves
Lymphatics
5
LATE ERUPTING TOOTH
Epithelial diaphragm
ROOT SHEATH
GINGIVA
BONE CEMENTUM
PDL
DENTINE
ENAMEL
PULP
Rests of Mallassez
Cementum starting as remnants of Root sheath
sheath breaks down
+ while developing
ROOT SHEATH
CEMENTUM
MESENCHYME
6
TOOTH TISSUES: Cell Sources
Crest
7
FURTHER ROOT FORMATION
REDUCED
DENTAL
EPITHELIUM
Root sheath
ENAMEL breaks up, allowing
sac mesenchymal
cells to contact
DENTINE
root dentine
E E E E
PDL
fibers
D D D D
8
CERVICAL REGION
CONNECTIVE TISSUE
GINGIVA
Periodontal
ligament
Alveolar bone
(GINGIVAL LIGAMENT)
GINGIVA
TRANS-SEPTAL
ALVEOLAR- if in medio-distal
CREST plane, not as
shown here
HORIZONTAL
Alveolar
bone
CEMENTUM
9
PDL TRANS-SEPTAL FIBER GROUP
TOOTH TOOTH
TRANS-SEPTAL GINGIVA
in medio-distal
plane
Alveolar
septum
HORIZONTAL PULP
OBLIQUE
the major group
APICAL
10
III PDL INTER-RADICULAR GROUP
Inter-radicular
Inter-radicular
bony septum
Horizontal
Oblique
Inter-radicular
Apical
GINGIVAL LIGAMENT
11
PDL: Force transduction
Pressure
Oblique fibers
turn pressure
on the tooth into
tension on the
bone
Imbedded ends of
PDL fibers create PULP
BUNDLE BONE
12
PDL: Intermediate plexus Non-imbedded
ends of PDL fibers
meet & attach in
D INTERMEDIATE
E PULP PLEXUS
N
{
T
I
N
E
This arrangement
provides for greater
ease of remodelling &
readjustment of the
plexus for growth &
altered function. But
remodelling occurs
throughout the PDL
Osteoblasts
laying down
bundle bone
Plus PDL
reorganization
Osteoclasts
resorbing bone
13
Wider on bone- PDL in Cross-section
Interstitial Area
depository side
Bundle
DENTINE
CEMENTUM
P
D PULP
L
BONE
Narrow on bone-
resorptive side
14
PERIODONTAL LIGAMENT INNERVATION
Sup Cervical
Sympathetic Ganglion
Mesencephalic
“Ruffini” receptors nucleus of V
Mechanoreceptors for stretch
PULP
Lymphatic drainage
15
RESTS & CYSTS
ROOT SHEATH
Rests of Mallassez
BONE PDL remnants of Root sheath
DENTINE
ENAMEL
PULP
CEMENTICLES
Hard mineralized bodies found
entirely in the periodontal ligament
or partially imbedded in cementum
P
U
L
P
16
TOOTH TISSUES: Pulp WABeresford
ENAMEL
GINGIVA
DENTINE
ALVEOLAR CEMENTUM
BONE
PERIODONTAL
PULP LIGAMENT/
PDL
1
TOOTH TISSUES: Pulp & its roles WABeresford
ENAMEL
GINGIVA
DENTINE
PERIODONTAL
PULP LIGAMENT/
PDL
PULP CHAMBER
ACCESSORY
CANAL
ROOT CANAL
APICAL FORAMEN
2
PULP REGIONS
ODONTOBLAST
LAYER
Cell-poor
ZONE OF WEIL PULP PROPER/
- peripheral pulp PULP CORE
MATRIX -
Ground substance
Reticular fibers
Collagen I
fibers Elastic fibers
CELLS -
Odontoblasts
Fibroblasts
Macrophages
Mast cells
Leukocytes
Blood vessels
Nerves
Lymphatics
3
PULP INNERVATION Sub-odontoblastic plexus
in cell-poor zone of Weil
1
2 3
Blood vessels
CELLS -
Odontoblasts
Fibroblasts
Macrophages
Mast cells
Leukocytes
Blood vessels
Nerves
Lymphatics
4
DENTICLES/ PULP STONES
Hard mineralized bodies found in
the pulp or the dentine
TWO TYPES:
P
U 1 TRUE - constructed of dentine
L by ectopic odontoblasts & showing
P dentinal tubules
2 FALSE - mineralized connective
tissue, etc, (not made of dentine)
THREE SUBTYPES:
5
TOOTH GERM: Pulp development
MESENCHYME
DENTAL PAPILLA
DENTAL SAC/FOLLICLE
ALVEOLAR BONE
ENAMEL
DENTAL ORGAN DENTAL LAMINA
DENTINE
MESENCHYME
PULP
CEMENTUM
DENTAL PAPILLA
PDL
DENTAL SAC/FOLLICLE
ALVEOLAR BONE
A BONE
6
TOOTH TISSUES: Sources
Crest
PDL
LAMINA DURA
ALVEOLAR BONE
SUPPORTING
BONE
Plate
Spongy bone
7
TOOTH GERM
Outer dental epithelium
DENTAL LAMINA
Stellate reticulum
Stratum intermedium
DENTAL SAC/FOLLICLE
Inner dental epithelium DENTAL PAPILLA
Vessels Nerves
PULP
differentiates
HERTWIG’S
ROOT
SHEATH
grows to
lengthen root
8
EXTRACELLULAR MOLECULAR INTERACTIONS 1
9
ECM MOLECULAR INTERACTIONS - Pathology 2
IL-1
Joint cartilage cells also
Articular respond to the signal:
chondrocytes enzymes enzyme inhibitors
proteoglycans
IL-1
Joint cartilage cells also
Articular respond to the signal:
chondrocytes enzymes enzyme inhibitors
proteoglycans
10
ECM MOLECULAR INTERACTIONS - Pathology 3
Unwanted degradation by:
microbes trying to colonize, e.g., using bacterial hyaluronidase
to liquify ground substance
metastasizing cancer cells breaking through basal laminae
& connective tissues
11
ORAL STRUCTURES Sagittal view
TONGUE
LIP
SALIVARY GLANDS
ORAL STRUCTURES
LIP & CHEEK
HARD PALATE
1
SALIVARY GLANDS - major & minor
Parotid
serous
Sub-mandibular
mixed - SERO-mucous
Sub-lingual
mixed - MUCO-serous
MINOR
Labial mucous
Buccal mucous
Palatal mucous
SEROUS ALVEOLUS
MUCOUS TUBULE
BL
MYOEPITHELIAL CELL
MUCOUS TUBULE
with
SEROUS DEMI-LUNE
2
SALIVA - Functions
Epithelial
PROTECTION lubrication
Anti-microbial materials
For tooth: Rinsing Buffering
Mineralization Pellicle coat
Swallowing
OTHER Vocalization
Excretion ?
Spit as a tool
SALIVA - Functions
Epithelial
PROTECTION lubrication
Anti-microbial materials
For tooth: Rinsing Buffering
Mineralization Pellicle coat
3
SALIVA - Functions & means
Epithelial lubrication Water Mucins
Anti-microbial materials Antibodies IgAs Lysozyme Defensins
For tooth: Rinsing Buffering Mineralization
Pellicle coat Water) Ions - buffering Ions - tooth mineral
Food approval: taste, texture Touch & taste receptors & nerves
Mastication Water Mucins
Digestion Amylase
Swallowing
Water Mucins Mucous glands concentrated
Vocalization at back of mouth
Excretion ? Iodine
Spit as a tool Water
Cleaning
Showing disapproval
Principal duct
Lobule
Interlobular duct
Intralobular ducts
Salivary gland is more compact,
Intercalated ducts
has denser CT, & no islets
4
SALIVARY DUCTS
Principal duct
Interlobular duct
Intralobular duct
Intercalated duct
Interlobular duct
Simple cuboidal/columnar
Accompanied by CT
Intralobular duct
Simple cuboidal
Intercalated duct
Low cuboidal/squamous
5
SALIVARY DUCTS: Synonyms
Classifications by site versus function
Principal duct
Wharton’s, Stensen’s, etc
Interlobular duct
Excretory (drain-pipe)
Intralobular duct
Secretory/Striated (from basal Eosinophilic
mitochondria and membrane
infoldings for ion transport)
Intercalated duct
Intercalated (in between)
PAROTID GLAND
INTER LOBULAR DUCT
SEROUS ACINi
INTRA LOBULAR
DUCT
INTERCALATED DUCT
6
SUBMANDIBULAR GLAND
INTER LOBULAR DUCT
A FEW MIXED
MUCOUS
TUBULES
SEROUS
demilune
SEROUS ACINi
INTRA LOBULAR
DUCT
SUBLINGUAL GLAND
INTER LOBULAR DUCT
MIXED
MUCOUS
TUBULES
SEROUS
demilune
PURE
MUCOUS
TUBULE
INTRA LOBULAR DUCT
(few & not striated)
7
DUCT SYSTEM complex tributaries
The scheme does not do
Principal duct
justice to the length and
branching of a duct sytem for a
Interlobular large compound gland. Think
ducts streams entering Decker’s creek all the
way to the mouth of the Mississippi.
MINOR
Labial mucous
Buccal mucous
Palatal mucous
8
TONGUE
Tongue papillae
Lingual gland
Connective
tissue Muscular core
Blood vessels
Duct
Nerve
Sub-lingual gland
TONGUE - dorsum
TONSILS
CIRCUMVALLATE
PAPILLA
Trench
FUNGIFORM PAPILLA
FILIFORM PAPILLAE
Taste bud
9
TONSILS TONGUE - dorsum
Weber’s posterior mucous
glands to flush out tonsils
CIRCUMVALLATE PAPILLA
von Ebner’s
serous glands
for taste
FUNGIFORM PAPILLA
Neither associated
with glands
FILIFORM PAPILLAE
Blandin/Nuhn’s
mixed anterior
lingual glands
LABIAL MUCOSA
thick strat squam ep
LABIALGLAND
HAIRY SKIN mucous
RED MARGIN
keratin thins away
MUSCLE no follicles or glands
10
CHEEK
MUSCLE
BUCCAL MUCOSA
thick strat squam ep
BUCCAL GLAND
mucous
NO RED MARGIN
HAIRY SKIN
ADIPOSE TISSUE
RAPHE
ADIPOSE CT - anterior
MUCOUS GLANDS -
posterior
11
GUT MOTOR INNERVATION
with H & E staining, the only neural elements seen are the neuron
bodies & characteristic nuclei. The plexuses of fibers are unseen.
submucosa
muscle Clumped
neurons of A’s
plexus
Parasympathetic post-
gangionic fibers
Clumped neurons
of minor ganglia
12
TEMPOROMANDIBULAR JOINT/ TMJ
One jaw has two TMJs *
C *
Each joint is between the C
condyle of the mandible and
the temporal bone of the skull
The joint is a freely moveable
synovial joint with a cavity
There are actually two cavities because
of an intervening cushioning disc
There are other differences from the
typical synovial joint
WABeresford
ALVEOLAR RIDGE
CONDYLAR RAMUS TEETH
PROCESS
BODY
1
RELATED SKULL FEATURES
EXT AUD MEATUS FOSSA
ARTICULAR
TUBERCLE
ZYGOMA
in outline
Lateral pterygoid
plate (deep)
STYLOID PROCESS
CORONOID PROCESS
RAMUS
BODY
2
FIBROUS ATTACHMENTS TO SKULL
Joint capsule Lateral ligament
Sphenomandibular
ligament inserts on
medial side (lingula)
Stylomandibular
ligament
These attachments
allow an anterior
dislocation of the
mandible, taking the
condyle in front of
the tubercle
3
DISLOCATION beyond art. tubercle
Anterior dislocation of
the mandible: condyle in
front of the tubercle
RESET: Pressure
down on the molars,
while pushing back
the mandible &
tipping it past the
tubercles
TMJ ARTICULAR
upper synovial cavity TUBERCLE/
GLENOID FOSSA PROTUBERANCE
/ EMINENCE
ARTICULAR DISC
CONDYLE
MUSCLE
lower synovial cavity
4
TMJ DISC
ELASTIC FIBERS Posterior band/ enlargement
Thin intermediate
region avascular
Anterior band
5
DISC: Attachments & Pulls
ARTICULAR
ELASTIC FIBERS
RETRODISCAL
REGION
DISCO-MANDIBULAR
LIGAMENTS to condyle
condyle moves - disc moves?
Attachment failure
Wrong muscle pull
Lubricant loss & condyle
‘catching’
Disc dislocation/
displacement
6
EASY SLIDING
BOUNDARY
FIRM ELASTIC SUBSTRATE
LUBRICANT
FLUID FILM
Articular layer
WATER +
HYALURONAN
+ PROTEINS
7
EASY SLIDING: Synovial Joint
Attached, polar
PHOSPHOLIPID molecules
DISC
Hydrophilic side
attaches to cartilage
Bond to
Articular layer
Hydrophobic side
lowers surface
WATER + energy for NON-
HYALURONAN STICK surface
+ PROTEINS
JOINT COMPONENTS
SYNOVIUM
8
JOINT CAPSULE & SYNOVIUM
SYNOVIUM JOINT CAPSULE
JOINT SPACE
Synovium lines
the joint capsule,
but it itself has a
lining or surface
SYNOVIUM: Layers
SUB-INTIMA
INTIMA
INTIMA - epithelial-like
layer of attached CT cells
SUB-INTIMA - layer of
loose irregular CT
no basal lamina
9
SYNOVIUM: Cell types
FIBROBLAST
MACROPHAGE
MAST CELL
LYMPHOCYTE
DENDRITIC CELL
antigen-presenting cell
‘FIBROBLAST’ &
SYNOVIOCYTES
‘MACROPHAGE’
SUB-INTIMA - core of
projections - synovial villi
SUB-INTIMA - substitutions of
denser fibrous CT or adipose
tissue for the loose irregular
10
SYNOVIOCYTE ROLES
SYNOVIAL FLUID
‘FIBROBLAST’
synthesizes hyaluronan
& glycoproteins
‘MACROPHAGE’
phagocytoses debris
in the joint space
IL-1
Joint cartilage cells also
Articular respond to the signal:
chondrocytes enzymes enzyme inhibitors
proteoglycans
11
MUSCLE ATTACHMENTS I
TEMPORALIS M
Lateral pterygoid
plate (deep)
lat
LATERAL & MEDIAL
PTERYGOID Ms
med
MYLOHYHOID M
MUSCLE ATTACHMENTS II
MASSETER M
ELEVATION
12
MUSCLE & JOINT ACTIONS
LATERAL
PROTRUSION
RETRACTION
ELEVATION
DEPRESSION
TMJ ACTIONS
hinge & slide
PROTRUSION
RETRACTION OPEN
CLOSE DEPRESSION
ELEVATION
TMJ ACTIONS
hinge & slide
13
MUSCLE ACTIONS I
RETRACTION
TEMPORALIS M
ELEVATION
MYLOHYHOID M
tenses floor of mouth only
MUSCLE ACTIONS II
MASSETER M
ELEVATION
major biter
14
TMJ RECEPTORS: Proprioceptive
1 MUSCLE SPINDLE Nuclear-bag
encapsulated
Ruffini
5 corpuscle
3 Golgi tendon organ 4 encapsulated
Pacinian
corpuscle
6 Free endings
encapsulated
encapsulated
encapsulated
Ruffini
5
4 corpuscle
3 Golgi tendon organ Pacinian encapsulated
corpuscle
6 Free endings
encapsulated
encapsulated
15
TMJ ARTICULAR
upper synovial cavity TUBERCLE/
GLENOID FOSSA PROTUBERANCE
/ EMINENCE
ARTICULAR DISC
CONDYLE
MUSCLE
lower synovial cavity
MANDIBULAR CONDYLE
Condylar cartilage
(not all cartilage)
Spongy bone
16
MATURE CONDYLAR LAYERS
ARTICULAR
} (FIBROUS)
I
PROLIFERATIVE II
} FIBROCARTILAGE III
} CALCIFICATION IV
} OSSIFICATION
TUBERCLE COVERING
}} Dense BONE
OSSIFICATION
CALCIFICATION
IV
}FIBROCARTILAGE III
}PROLIFERATIVE II
} ARTICULAR I
(FIBROUS)
17
LINING OF FOSSA
} Dense BONE
PROLIFERATIVE
} ARTICULAR
(FIBROUS)
ARTICULAR
} (FIBROUS)
I
PROLIFERATIVE II
} FIBROCARTILAGE III
} CALCIFICATION IV
} OSSIFICATION
18
YOUNG CONDYLAR LAYERS
} ARTICULAR I
} PROLIFERATIVE II
}} HYALINE CARTILAGE
HYPERTROPHY
III
IV
} CALCIFICATION V
} OSSIFICATION
VI
Chondrocytes not in columns
new bone on calcified cartilage
for endochondral ossification
Hyaline cartilage later will turn into fibrocartilage
19
STRUCTURES OF A WORKING JOINT
Articular cartilage absorbs & spreads the load
Joint capsule
Ligament
Periosteum
Tendon Nerve Muscle dense irregular
Joint capsule
Ligament
Periosteum
Tendon Nerve Muscle dense irregular
20
BONE COMPONENTS
Joint capsule
EPIPHYSIS
SHAFT
Fibrous
Periosteum
Osteoblastic
vessels
marrow
Joint cartilage
absorbs and
spreads load Spongy bone with
struts/ trabeculae Dense bone
Inner surfaces of both types lined by ENDOSTEUM of
resting cells, active osteoblasts, & osteoclasts
Bone canal
vessels
Osteoclast
Periosteum
Resting cells
Osteocyte
Ca2+
21
DENSE BONE
Osteon/Haversian system with
concentric lamellar/layered bone REMODELING
Osteoblasts filling in
the tunnel
SKELETAL DEVELOPMENT
Cell
enlargement/hypertrophy
Matrix calcification
Calcified cartilage can be
resorbed like bone, and selective erosion into
be attached to bone mineralized cartilage
22
EARLY ENDOCHONDRAL OSSIFICATION
perichondrium
periosteum
} EPIPHYSIS
Bony collar
provides support
as mineralized
cartilage is eaten
away
} DIAPHYSIS/SHAFT
primary ossification
front
Expansive/interstitial
growth by cartilage Hypertrophy of chondrocytes
cell division and precedes calcification
matrix synthesis
23
MIDDLE ENDOCHONDRAL OSSIFICATION
}
Secondary ossification
centers start by repeating EPIPHYSIS
the processes of the 1o
center
} SHAFT
primary ossification
front
Bone would be larger than
in the previous view
}RESTING
Expansion
} PROLIFERATION
} HYPERYTROPHY
} CALCIFICATION
Matching erosion
24
TOOTH & RELATED TISSUES: Developmental goal
WABeresford
ENAMEL
GINGIVA
DENTINE
PULP
CEMENTUM
PERIODONTAL
ALVEOLAR BONE LIGAMENT/ PDL
1
MECHANISMS OF DEVELOPMENT 10
Ectodermal laminae can be used:
DENTAL ORGAN
DENTAL LAMINA
Dental lamina
Mesenchyme the line of thickened ectoderm
Oral ectoderm
2
TOOTH DEVELOPMENT
BRAIN
TOOTH BUD
TONGUE
TOOTH
3
DENTAL LAMINA
Dental lamina line of
Mesenchyme thickened ectoderm
Oral ectoderm
MECHANISMS OF DEVELOPMENT 10
Ectodermal laminae can be used:
DENTAL ORGAN
4
DENTAL LAMINA: Two meanings
LAMINA
Dental lamina first refers to the
LAMINA thickening in the ectoderm along the
tectal ridge. From this a secondary
dental lamina grows down into the
mesenchyme. At intervals along this
deep lamina, dental organs (tooth
buds) form.
DENTAL LAMINA
Dental lamina
Mesenchyme first sense - the line of
thickened ectoderm
Oral ectoderm
5
DENTAL LAMINA
TOOTH PRIMORDIUM/GERM
MESENCHYME
DENTAL PAPILLA
DENTAL SAC/FOLLICLE
ALVEOLAR BONE
6
TOOTH TISSUES: Sources
ENAMEL
DENTAL ORGAN DENTAL LAMINA
DENTINE
MESENCHYME
PULP
CEMENTUM
DENTAL PAPILLA
PDL
DENTAL SAC/FOLLICLE
ALVEOLAR BONE
A BONE
Crest
7
TOOTH TISSUES: Sources
PDL
LAMINA DURA
ALVEOLAR BONE
SUPPORTING
BONE
Plate
Spongy bone
TOOTH GERM
Outer dental epithelium
DENTAL LAMINA
Stellate reticulum
Stratum intermedium
DENTAL PAPILLA
Inner dental epithelium
DENTAL SAC/FOLLICLE
8
TOOTH GERM:
context Dental lamina
Oral ectoderm
Vestibular lamina
Mesenchyme
Oral ectoderm
Dental
Vestibular lamina lamina
will grow down and
split on the tooth’s
labial/buccal side
creating alveolar &
labial/buccal
mucosae
9
DENTAL LAMINA
Dental lamina
Mesenchyme first sense - the line of
thickened ectoderm
Odontogenic mesenchyme
10
DENTAL ORGAN: Cap,
Outer dental epithelium becoming Bell stage
Enamel knot DENTAL LAMINA
Stellate reticulum
Stratum intermedium
Basal lamina
TOOTH GERM:
Outer dental epithelium
approaches inner
next steps
DENTAL LAMINA
Stellate reticulum upper part degenerates
reduces over cusp lower forms 2nd bud
Knot cells
signal to
Stratum intermedium
papilla
DENTAL PAPILLA
Inner & outer dental epithelia
join to form cervical loop DENTAL SAC/FOLLICLE
11
TOOTH GERM:
Outer dental epithelium
collapsing down
result & next steps
Stellate reticulum DENTAL LAMINA
reducing over cusp upper degenerates
lower forms 2nd bud
Knot cells
signal to outermost papilla
papilla cells have become
Odontoblasts
DENTAL
Recruitment
PAPILLA
site
becoming
pulp
Cervical loop
defines extent of
crown to crown
DENTAL SAC base; then it
quiescent starts the root
Ingrowing pulp vessels sheath
12
TOOTH GERM: all crown-forming elements present
ROOT FORMATION
REDUCED
DENTAL
EPITHELIUM
ENAMEL
CROWN
DENTINE
PULP
13
FURTHER ROOT FORMATION
REDUCED
DENTAL
EPITHELIUM will
fuse with gingiva
Root sheath
ENAMEL breaks up, allowing
matures sac mesenchymal
cells to contact
DENTINE
root dentine
deepens
PULP
differentiates Other sac
HERTWIG’S mesenchymal
ROOT cells construct
PDL & some
SHEATH
alveolar bone
grows to
lengthen root Fibroblasts
Epithelial diaphragm Odontoblast recruitment site
Crown details
continue
Root details in
Eruption.ppt
14
CHANGES IN DENTAL/ENAMEL ORGAN I
Ameloblasts Capillaries
Stellate
reticulum Starting at the
cusp the dental
organ reduces to
two layers: active
ameloblasts & a
narrow layer of
compacted outer
epithelium,
stellate-reticulum
cells & stratum
intermedium
Stratum intermedium
Cervical loop moving apically to
define extent of crown & pinches in
CHANGES IN DENTAL/
cusp enamel
ENAMEL ORGAN II formed by
First reduction in ameloblasts
enamel epithelium:
active ameloblasts & Dentine
compacted outer
epithelium, stellate- PULP
reticulum cells & from Dental
stratum intermedium Papilla
remaining
Stellate reticulum DENTAL
PAPILLA
still becoming
Cervical loop: pulp &
odontoblasts
inner & outer
epithelium DENTAL SAC
still quiescent
15
CHANGES IN DENTAL/
Ameloblasts
ENAMEL ORGAN III will finish full
Second reduction in thickness of
enamel epithelium: cusp enamel
retired ameloblasts & & reduce in
compacted outer height
epithelium, stellate-
reticulum cells & Dentine widens
stratum intermedium DENTAL
Stellate reticulum PAPILLA
follows Cervical becomes pulp
process
loop down then proceeds
stops: Crown downs
defined
Odontoblast
recruitment
Cervical loop:
site
16
ROOT FORMATION: Coronal consequences
GINGIVAL
EPITHELIUM
Connective
REDUCED tissue broken
DENTAL down
EPITHELIUM will
fuse with gingiva
REDUCED
DENTAL
EPITHELIUM
protects As root
enamel lengthens
crown is
HERTWIG’S
pushed up -
ROOT
Pre-
SHEATH
grows to
EMERGENCE
lengthen root
ENAMEL
Root
lengthening
not shown
17
TOOTH EMERGENCE
CUTICLE
GINGIVAL will wear away
EPITHELIUM
still fusing with
REDUCED DENTAL
EPITHELIUM
ENAMEL
Which reduced-
REDUCED DENTAL epithelial cells
EPITHELIUM cells join the
gingiva, which
contribute to the
cuticle, & which
die, is unclear;
along with the
mechanisms
determining fate
18
ORGANIC ENAMEL SURFACE
CUTICLE
will wear away
PELLICLE
of glycoproteins etc
is acquired later
from oral sources
DENTAL LAMINA
Dental lamina
Mesenchyme first sense - the line of
thickened ectoderm
Oral
ectoderm
19
DENTAL LAMINA: Bud stage
Formation of a BUD from
the dental lamina
Odontogenic mesenchyme
Dental lamina
Odontogenic
mesenchyme
SIGNALS: FGFs,
BMPs, Wnt, etc
20
REITERATIVE SIGNALING II
Enamel knot
Inner enamel
epithelium
Odontoblasts
21
REITERATIVE SIGNALING IV
REITERATIVE SIGNALING V
REDUCED DENTAL EPITHELIUM
ENAMEL
DENTINE
22
What has to be controlled:structures & mechanisms
W hether teeth are to form (turtles & birds have beaks) Dental lamina
Number of teeth # of buds
Position of teeth siting of buds
Shape(s) of teeth shape of dental organ
Crown formed before root start with cusp tissues
root sheath for root control
Four tooth tissues in sequence mesenchyme for three,
ectoderm for one tissue
Organize surroundings alveolar bony trough &
dental sac mesenchyme
Fasten tooth to surroundings dental sac mesenchyme
23