ADULT TOOTH STRUCTURE

http://hi-dentfinishingschool.blogspot.com/

DR SHABEEL PN
th
1. In adult humans there are 32 permanent
teeth.
2. These are preceded during childhood by 20
deciduous teeth.
3. The tooth lies in a bony socket, the
alveolus, that is covered my an oral mucosa
called the gingiva (gums) that consist of,
a. keratinized stratified squamous
epithelium
b. lamina propria of loose connective tissue
that lies directly adjacent to the bone of the
alveolus.
The tooth consists of two major parts,
a. the crown - the portion that protrudes
above the gum line.
and
b. the root - the portion that extends
into the alveolus.

Internally, the tooth consists of a layer

of dentin that surrounds a pulp
consisting of loose connective
tissue, nerves and blood vessels.
In the dentin, directly adjacent to the
pulp is a layer of specialized cells
called odontoblasts - secrete organic
matrix that calcifies and forms the
dentin.
Crown region

Dentin is covered by a layer of calcified organic matrix

- the enamel
a. Hardest substance in body
b. Formed by ameloblasts before tooth “erupts” from
socket

Root region
Dentin is covered by calcified organic matrix - the
cementum - similar to bone, but no haversian system

Between the cementum and the bone of the socket lies

the peridontal ligament - consists of fibroblasts and
collagen fibers with glycosaminoglycans in between.

a. forms cushion between tooth and bone

b. Attaches tooth to bone - Sharpey’s fibers
 Figure at web link below.

http://www.iob.uio.no/studier/undervisning/histologi/section/043/index.php
TOOTH DEVELOPMENT

http://en.wikipedia.org/wiki/Image:Molarsindevelopment11-24-05.jpg
There are a number of terminologies that are used to describe the
early development of teeth prior to the cap stage.

In some cases, there is disagreement about what a given term

represents (e.g. dental lamina, tooth bud).

The following description of tooth development tries to make sense

out of the available reference material I’ve been able to find;
however, be aware that you may see other terminologies used in
dental school.

7
1. Prior to the 6th week of gestation in human embryos, the
developing jaws are solid masses of tissue with little differentiation.

2. Tooth development begins during the 5th - 6th week of gestation.

8
3. The first indication is the appearance of a thickened plate of
epithelium (vestibular lamina = labialgingival lamina) between the
tongue and the jaw. This, and the following events occur in both the
upper and lower jaw.

4. This thickened epithelium spreads over the jaw surface.

5. An invagination (labial groove) forms in this thickened epithelium.

This becomes the vestibule that separates the lip or cheek from the
gum.

9
6. The vestibular lamina overlying the forming gums grows into the underlying
gum tissue and forms the dental lamina. Neural crest cells in the underlying
mesenchyme of the gums induce the formation of the dental lamina. The dental
lamina forms a C-shaped band of tissue in the gums of the upper and lower jaw
that is also called the dental ledge.

This ingrowth of the dental lamina is sometimes called the tooth bud.

A - dental lamina; B - Mesenchymal containing neural crest cells

http://dentistry.ouhsc.edu/oral-histology/Chapter1/Chap1.html
6. The vestibular lamina overlying the forming gums grows into the underlying
gum tissue and forms the dental lamina. Neural crest cells in the underlying
mesenchyme of the gums induce the formation of the dental lamina. The dental
lamina forms a C-shaped band of tissue in the gums of the upper and lower jaw
that is also called the dental ledge.
P. 530, Fig. 16-14, Carlson
7. In 10 distinct regions of each jaw, the cells of the dental ledge
proliferate rapidly by mitosis forming a cup-shaped structure called the
enamel organ (A) that is surrounded by jaw mesenchyme. The
enamel organ remains connected to the labialgingival or vestibular
lamina by the cord-like remains of the dental ledge (B).
8. Five enamel organs will develop on the right and left sides of both the
upper and lower jaw. These will form the child’s “milk” (primary)teeth.

Enamel
organ

http://dentistry.ouhsc.edu/oral-histology/Chapter1/Chap1.html
http://32teethonline.com/pedopage2.htm
9. The mesenchyme that fills the enamel organ cup will become the
dental papilla (D) that eventually forms the dentine and the pulp of
the tooth.

10. The enamel organ and dental papilla are surrounded by a sheath of
connective tissue called the dental sac (E).

11. The entire structure is called the cap stage of tooth development.

A, Enamel organ; B, Dental lamina; C, Vestibular lamina; D, Dental Papilla; E, Dental sac

http://dentistry.ouhsc.edu/oral-histology/Chapter1/Chap1.html
Fig. 16-14, p. 530, Carlson
 12. The cap stage of tooth development continues to differentiate, forming the
bell stage. Concurrent with this, the successional lamina (D), that will form
the secondary tooth later in life, forms as a outgrowth of the dental lamina (E).
13. This differentiation includes the enamel organ. As is the case for the optic cup, the
cup of the enamel organ consists of two adjacent layers of cells that result from the
formation of the cup. These are an inner layer of cells (adjacent to the dental papilla -
F) that is called the inner enamel organ epithelium (A) and an outer layer of cells
(adjacent to the dental sac - G) called the outer enamel organ epithelium (B).

A - Inner enamel epithelium; B - Outer enamel epithelium; C - Stellate reticulum; D - Successional

lamina; E - Dental lamina; F - Dental papilla; G - Dental sac.
http://dentistry.ouhsc.edu/oral-histology/Chapter1/Chap1.html
 P. 531, Fig. 16-15, Carlson

Outer enamel
organ
epithelium Fig. 16-15, p. 531, Carlson
Inner enamel
organ
epithelium

Dental papilla

Dental sac
14. The ectodermally derived tissue between these two layers forms a matrix of cells called
the stellate reticulum. This matrix is essentially a connective tissue with lots of
extracellular material (mainly mucopolysaccharides) between the cells.
15. The inner enamel organ epithelium will differentiate into cells called ameloblasts
that will be responsible for forming the enamel of the teeth. - Crown region

16. Neural crest cells in the dental papilla will form an epithelial layer directly adjacent
to the inner enamel organ epithelium that will differentiate into cells called
odontoblasts which will be responsible for forming the tooth dentine.

17. The remainder of the dental papilla will form the dental pulp of the tooth.

A - Inner enamel organ epithelium; B - Outer enamel organ epithelium; C - Stellate reticulum; D -
Successional lamina; E - Dental lamina; F - Dental papilla; G - Dental sac.

http://dentistry.ouhsc.edu/oral-histology/Chapter1/Chap1.html
See Pp. 532 - 533, Figs. 16-16 and 16-17, in Carlson - similar figures

Outer enamel
organ epithelium

(Inner enamel organ

epithelium)

Dental sac
Dental papilla
18. The lips of the cup that forms the enamel organ are called the cervical loop. This
structure consists of a portion of the inner and outer enamel epithelium at the region
where they join.

19. Research indicates that the inner enamel epithelium portion of the loop is a source of
stem cells for the developing ameloblasts (the cells that produce the tooth enamel).
The cervical loop will partially degenerate as the root of the tooth develops and will
become Hertwig's Epithelial Root Sheath. In species with continuously growing teeth
(e.g. rodents), the cervical loop is retained through adulthood, thus emphasizing its
importance in providing stem cells to produce ameloblasts for enamel formation.

A - Inner enamel epithelium; B - Outer enamel epithelium; C - A, Cervical loop; B, Inner enamel
Stellate reticulum; D - Successional lamina; E - Dental lamina; epithelium; C, Outer enamel
F - Dental papilla; G - Dental sac. epithelium; D, Stratum intermedium;
E, Stellate reticulum
http://dentistry.ouhsc.edu/oral-histology/Chapter1/Chap1.html
 20. As differentiation of the inner enamel epithelium proceeds, cells called
preameloblasts form from the inner enamel organ epithelium, adjacent to the dental
papilla. These cells induce neural crest cells in the dental papilla to differentiate into
preodontoblasts.

C
A

D
B
A - Preameloblasts; B - Preodontoblasts; C
A - Inner enamel epithelium; B - Outer enamel epithelium; C - - Stellate reticullum; D - Dental papilla
Stellate reticulum; D - Successional lamina; E - Dental lamina;
F - Dental papilla; G - Dental sac.

http://dentistry.ouhsc.edu/oral-histology/Chapter1/Chap1.html
 21. The preodontoblasts become odontoblasts as they begin to secrete predentin
(which will become dentin). The predentin blocks nutrients from moving from the pulp to
the preameloblasts. This causes the preameloblasts to become ameloblasts and begin
their secretion of enamel. The odontoblasts and ameloblasts move away from each other as
the dentin and enamel layers increase in thickness.

22. As this begins to occur, the developing tooth enters the crown stage.

D
C

B
A

1 - Ameloblasts; 2 - Enamel; 3 - Dentin; 4 - Odontoblasts; 5 - Pulp A - Odontoblasts; B - Predentin; C - Ameloblasts;

D - Dentin; E - Enamel
http://www.histol.chuvashia.com/atlas-en/digestive-05-en.htm
http://dentistry.ouhsc.edu/oral-histology/Chapter1/Chap1.html
 Dental papilla

Dental sac

Outer enamel
organ
epithelium

Enamel
organ

(Inner enamel organ

epithelium)

P. 533, Fig. 16-17, Carlson

23. Once enamel depostion is completed and the crown is fully formed, the enamel
organ collapses and the cells form a sheath called the reduced enamel epithelium
that covers the tooth until eruption.

A - Reduced enamel epithelium; B - Maturative/protective ameloblasts; C - Capillary

http://dentistry.ouhsc.edu/oral-histology/Chapter1/Chap1.html
24. Folloowing the formation of the crown, the root forms. The inner and outer enamel
epithelial layers of the cervical loop region continue to grow toward the future base of
the tooth. (Hertwig’s epithelial root sheath).

25. The root sheath induces neural crest cells in the pulp mesenchyme to differentiate into
additional odontoblasts that form the dentin of the root.

26. The central region of the root is called the radicular pulp cavity.

B
F

E
A

A - Epithelial diaphragm; B - Radicular pulp cavity; C - Dentin; D

- Enamel space; E - Alveolar Bone; F, Root

http://dentistry.ouhsc.edu/oral-histology/Chapter1/Chap1.html
26. The leading edge of Hertwig’s epithelial root sheath turns inward toward the
root of the tooth and forms the epithelial diaphram.

B
F

E
A

A - Radicular pulp cavity; B - Dentin; C -

Dental sac; D - Point at which epithelial root A - Epithelial diaphragm; B - Radicular pulp cavity; C - Dentin; D
sheath begins to disintegrate; E - Epithelial - Enamel space; E - Alveolar Bone; F, Root
diaphram; F - Epithelial rests

http://dentistry.ouhsc.edu/oral-histology/Chapter1/Chap1.html
28. In regions where the root odontoblasts have formed and are secreting dentin, the
epithelial root sheath begins to break down. At this time, cells from the dental sac
that surrounds the developing tooth migrate to the surface of the newly formed dentin
and become cementoblasts. These cells secrete the cementum layer that acts as an
attachment region for the peridontal ligaments that bind the root of the tooth to the
bone.

A - Radicular pulp cavity; B - Dentin; C -

Dental sac; D - Point at which epithelial root
sheath begins to disintegrate; E - Epithelial
diaphram A - Cementoblasts; B - Odontoblasts; C - Predentin

http://dentistry.ouhsc.edu/oral-histology/Chapter1/Chap1.html
29. As the epithelial root sheath degenerates it leaves small groups of cells around the root
that are called epithelial rests.

A - Epithelial rests; B - Mantle dentin; C - Globular dentin; D - Circumpulpal dentin

http://dentistry.ouhsc.edu/oral-histology/Chapter1/Chap1.html
30. Once the tooth is fully formed it is ready to undergo eruption. This process involves active
movement of the tooth such that it penetrates the gum tissues and extends above them.

31. In humans, eruption of the milk (primary) teeth generally begins in the second month
after birth and continues until the end of the second year.

32. It is likely that there are a number of factors involved in eruption. While there is no
consensus on the cause of tooth eruption, there seems to be agreement that root growth,
alveolar bone remodeling, and possibly the peridontal ligaments are involved in this process.

33. Permanent (secondary) teeth develop in the same manner as primary teeth. The primary
teeth will be replaced and 12 additional teeth will be added to the dentition.

34. 28 of the secondary teeth erupt

between the ages of 6 and 13
years. The four wisdom teeth may
erupt between 17 and 21 years;
however, they often remain
impacted.

http://www.uic.edu/classes/orla/orla312/Teeth%20in%20Function%3B%20Life%20History%20of%20Teeth.htm
THE END