NEET MDS Lessons
Dental Anatomy
TYPES OF TEETH
The human permanent dentition is divided into four classes of teeth based on appearance and function or position.
Incisors, Canines, Premolars & Molars
Embryonic development
The parotid derives from ectoderm
The sublingual-submandibular glands thought to derive from endoderm
Differentiation of the ectomesenchyme
Development of fibrous capsule
Formation of septa that divide the gland into lobes and lobules
The parotid develops around 4-6 weeks of embryonic lofe
The submandibular gland develops around the 6th week
The sublingual and the minor glands develop around the 8-12 week
Amelogenesis and Enamel
Enamel is highly mineralized: 85% hydroxyapatite crystals
Enamel formation is a two-step process
The first step produces partially mineralized enamel: 30% (secretory)
The second step: Influx of minerals, removal of water and organic matrix (maturative)
Again, dentin is the prerequisite of enamel formation (reciprocal induction)
Stratum intermedium: high alkaline phosphatase activity
Differentiation of ameloblasts: Increase in glycogen contents
Formation of the enamel matrix
Enamel proteins, enzymes, metalloproteinases, phosphatases, etc.
Enamel proteins: amelogenins (90%), enamelin, tuftelin, and amelin
Amelogenins: bulk of organic matrix
Tuftelin: secreted at the early stages of amelogenesis (area of the DE junction)
Enamelin: binds to mineral
Amelin
Mineralization of enamel
No matrix vesicles
Immediate formation of crystallites
Intermingling of enamel crystallites with dentin
"Soft" enamel is formed
Histologic changes
Differentiation of inner enamel epithelium cells. They become ameloblasts
Tomes' processes: saw-toothed appearance
Collapse of dental organ
Formation of the reduced enamel epithelium
Hard tissue formation (Amelogenesis )
Enamel formation is called amelogenesis and occurs in the crown stage of tooth development. "Reciprocal induction" governs the relationship between the formation of dentin and enamel; dentin formation must always occur before enamel formation. Generally, enamel formation occurs in two stages: the secretory and maturation stages. Proteins and an organic matrix form a partially mineralized enamel in the secretory stage; the maturation stage completes enamel mineralization.
In the secretory stage, ameloblasts release enamel proteins that contribute to the enamel matrix, which is then partially mineralized by the enzyme alkaline phosphatase. The appearance of this mineralized tissue, which occurs usually around the third or fourth month of pregnancy, marks the first appearance of enamel in the body. Ameloblasts deposit enamel at the location of what become cusps of teeth alongside dentin. Enamel formation then continues outward, away from the center of the tooth.
In the maturation stage, the ameloblasts transport some of the substances used in enamel formation out of the enamel. Thus, the function of ameloblasts changes from enamel production, as occurs in the secretory stage, to transportation of substances. Most of the materials transported by ameloblasts in this stage are proteins used to complete mineralization. The important proteins involved are amelogenins, ameloblastins, enamelins, and tuftelins. By the end of this stage, the enamel has completed its mineralization.
Permanent teeth
1. The permanent teeth begin formation between birth and 3 years of age (except for the third molars)
2. The crowns of permanent teeth are completed between 4 and 8 years of age, at approximately one- half the age of eruption
The sequence for permanent development
Maxillary
First molar → Central incisor → Lateral incisor → First premotar → Second pmmolar → Canine → Second molar → Third molar
Mandibular
First molar → Central incisor → Lateral incisor → Canine → First premolar → Second premolar → Second molar → Third molar
Permanent teeth emerge into the oral cavity as
Maxillary Mandibular
Central incisor 7-8 years 6-7 years
Lateral incisor 8-9 years 7-8 years
Canine 11-12 years 9-10 years
First premolar 10-Il years 10-12 years
Second premolar 10-12 years 11-12 years
First molar 6-7 years 6-7 years
Second molar 12-13 years 11-13 years
Third molar 17-21 years 17-21 years
The roots of the permanent teeth are completed between 10 and 16 years of age, 2 to 3 years after eruption
HISTOLOGY OF SALIVARY GLANDS
Parotid: so-called watery serous saliva rich in amylase
Submandibular gland: more mucinous
Sublingual: viscous saliva
Parotid Gland: The parotid is a serous secreting gland.
There are also fat cells in the parotid.
Submandibular Gland
This gland is serous and mucous secreting.
There are serous demilunes
This gland is more serous than mucous
Also fat cells
Sublingual Gland
Serous and mucous secreting
Serous cells in the form of demilunes on the mucous acini.
more mucous than serous cells
Minor Salivary Glands
Minor salivary glands are not found within gingiva and anterior part of the hard palate
Serous minor glands=von Ebner below the sulci of the circumvallate and folliate papillae of the tongue; palatine, glossopalatine glands are pure mucus; some lingual glands are also pure mucus
Functions
Protection: lubricant (glycoprotein); barrier against noxious stimuli; microbial toxins and minor traumas; washing non-adherent and acellular debris; calcium-binding proteins: formation of salivary pellicle
Buffering: bacteria require specific pH conditions; plaque microorganisms produce acids from sugars; phosphate ions and bicarbonate
Digestion: neutralizes esophageal contents, dilutes gastric chyme; forms food bolus; brakes starch
Taste: permits recognition of noxious substances; protein gustin necessary for growth and maturation of taste buds
Antimicrobial: lysozyme hydrolyzes cell walls of some bacteria; lactoferrin binds free iron and deprives bacteria of this essential element; IgA agglutinates microorganisms
Maintenance of tooth integrity: calcium and phosphate ions; ionic exchange with tooth surface
Tissue repair: bleeding time of oral tissues shorter than other tissues; resulting clot less solid than normal; remineralization
Crown stage
Hard tissues, including enamel and dentin, develop during the next stage of tooth development. This stage is called the crown, or maturation, stage by some researchers. Important cellular changes occur at this time. In prior stages, all of the inner enamel epithelium cells were dividing to increase the overall size of the tooth bud, but rapid dividing, called mitosis, stops during the crown stage at the location where the cusps of the teeth form. The first mineralized hard tissues form at this location. At the same time, the inner enamel epithelial cells change in shape from cuboidal to columnar. The nuclei of these cells move closer to the stratum intermedium and away from the dental papilla.
The adjacent layer of cells in the dental papilla suddenly increases in size and differentiates into odontoblasts, which are the cells that form dentin. Researchers believe that the odontoblasts would not form if it were not for the changes occurring in the inner enamel epithelium. As the changes to the inner enamel epithelium and the formation of odontoblasts continue from the tips of the cusps, the odontoblasts secrete a substance, an organic matrix, into their immediate surrounding. The organic matrix contains the material needed for dentin formation. As odontoblasts deposit organic matrix, they migrate toward the center of the dental papilla. Thus, unlike enamel, dentin starts forming in the surface closest to the outside of the tooth and proceeds inward. Cytoplasmic extensions are left behind as the odontoblasts move inward. The unique, tubular microscopic appearance of dentin is a result of the formation of dentin around these extensions.
After dentin formation begins, the cells of the inner enamel epithelium secrete an organic matrix against the dentin. This matrix immediately mineralizes and becomes the tooth's enamel. Outside the dentin are ameloblasts, which are cells that continue the process of enamel formation; therefore, enamel formation moves outwards, adding new material to the outer surface of the developing tooth.
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Maxillary (upper) teeth |
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Primary teeth |
Central |
Lateral |
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First |
Second |
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Initial calcification |
14 wk |
16 wk |
17 wk |
15.5 wk |
19 wk |
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Crown completed |
1.5 mo |
2.5 mo |
9 mo |
6 mo |
11 mo |
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Root completed |
1.5 yr |
2 yr |
3.25 yr |
2.5 yr |
3 yr |
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Mandibular (lower) teeth |
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Initial calcification |
14 wk |
16 wk |
17 wk |
15.5 wk |
18 wk |
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Crown completed |
2.5 mo |
3 mo |
9 mo |
5.5 mo |
10 mo |
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Root completed |
1.5 yr |
1.5 yr |
3.25 yr |
2.5 yr |
3 yr |
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