NEET MDS Lessons
Dental Anatomy
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
Periodontal ligament development
Cells from the dental follicle give rise to the periodontal ligaments (PDL).
Formation of the periodontal ligaments begins with ligament fibroblasts from the dental follicle. These fibroblasts secrete collagen, which interacts with fibers on the surfaces of adjacent bone and cementum. This interaction leads to an attachment that develops as the tooth erupts into the mouth. The occlusion, which is the arrangement of teeth and how teeth in opposite arches come in contact with one another, continually affects the formation of periodontal ligaments. This perpetual creation of periodontal ligaments leads to the formation of groups of fibers in different orientations, such as horizontal and oblique fibers.
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
INNERVATION OF THE DENTIN-PULP COMPLEX
- Dentine Pulp
- Dentin
- Nerve Fibre Bundle
- Nerve fibres
The nerve bundles entering the tooth pulp consist principally of sensory afferent fibers from the trigeminal nerve and sympathetic branches from the superior cervical ganglion. There are non-myelinated (C fibers) and myelinated (less than non, A-delta, A-beta) fibers. Some nerve endings terminate on or in association with the odontoblasts and others in the predentinal tubules of the crown. Few fibers are found among odontoblasts of the root.
In the cell-free zone one can find the plexus of Raschkow.
Mandibular First Deciduous Molar
-This tooth doesn't resemble any other tooth. It is unique unto itself.
-There are two roots.
-There is a strong bulbous enamel bulge buccally at the mesial.
- the mesiolingual cusps on this tooth is the highest and largest of the cusps.
MAXILLARY LATERAL INCISORS
it is shorter, narrower, and thinner.
Facial: The maxillary lateral incisor resembles the central incisor, but is narrower mesio-distally. The mesial outline resembles the adjacent central incisor; the distal outline--and particularly the distal incisal angle is more rounded than the mesial incisal angle (which resembles that of the adjacent central incisor. The distal incisal angle resembling the mesial of the adjacent canine.
Lingual: On the lingual surface, the marginal ridges are usually prominent and terminate into a prominent cingulum. There is often a deep pit where the marginal ridges converge gingivally. A developmental groove often extends across the distal of the cingulum onto the root continuing for part or all of its length.
Proximal: In proximal view, the maxillary lateral incisor resembles the central except that the root appears longer--about 1 1/2 times longer than the crown. A line through the long axis of the tooth bisects the crown.
Incisal: In incisal view, this tooth can resemble either the central or the canine to varying degrees. The tooth is narrower mesiodistally than the upper central incisor; however, it is nearly as thick labiolingually.
Contact Points: The mesial contact is at the junction of the incisal third and the middle third. The distal contact is is located at the center of the middle third of the distal surface.
Root Surface:-The root is conical (cone-shaped) but somewhat flattened mesiodistally.
Enamel
Structural characteristics and microscopic features
a. Enamel rods or prisms
(1) Basic structural unit of enamel.
(2) Consists of tightly packed hydroxyapatite crystals. Hydroxyapatite crystals in enamel are four times larger and more tightly packed than hydroxyapatite found in other calcified
tissues (i.e., it is harder than bone).
(3) Each rod extends the entire thickness of enamel and is perpendicular to the dentinoenamel junction (DEJ).
b. Aprismatic enamel
(1) The thin outer layer of enamel found on the surface of newly erupted teeth.
(2) Consists of enamel crystals that are aligned perpendicular to the surface.
(3) It is aprismatic (i.e., prismless) and is more mineralized than the enamel beneath it.
(4) It results from the absence of Tomes processes on the ameloblasts during the final stages of enamel deposition.
c. Lines of Retzius (enamel striae)
(1) Microscopic features
(a) In longitudinal sections, they are observed as brown lines that extend from the DEJ to the
tooth surface.
(b) In transverse sections, they appear as dark, concentric rings similar to growth rings in a tree.
(2) The lines appear weekly during the formation of enamel.
(3) Although the cause of striae formation is unknown, the lines may represent appositional or incremental growth of enamel. They may also result from metabolic disturbances of ameloblasts.
(4) Neonatal line
(a) An accentuated, dark line of Retzius that results from the effect of physiological changes
on ameloblasts at birth.
(b) Found in all primary teeth and some cusps of permanent first molars.
d. Perikymata
(1) Lines of Retzius terminate on the tooth surface in shallow grooves known a perikymata.
(2) These grooves are usually lost through wear but may be observed on the surfaces of developing teeth or nonmasticatory surfaces of formed teeth.
e. Hunter-Schreger bands
(1) Enamel rods run in different directions. In longitudinal sections, these changes in direction result in a banding pattern known as HunterSchreger bands.
(2) These bands represent an optical phenomenon of enamel and consist of a series of alternating dark and light lines when the section is viewed with reflected or polarized
light.
f. Enamel tufts
(1) Consist of hypomineralized groups of enamel rods.
(2) They are observed as short, dark projections found near or at the DEJ.
(3) They have no known clinical significance.
g. Enamel lamellae
(1) Small, sheet-like cracks found on the surface of enamel that extend its entire thickness.
(2) Consist of hypocalcified enamel.
(3) The open crack may be filled with organic material from leftover enamel organ components, connective tissues of the developing tooth, or debris from the oral cavity.
(4) Both enamel tufts and lamellae may be likened to geological faults in mature enamel.
h. Enamel spindle
(1) Remnants of odontoblastic processes that become trapped after crossing the DEJ during the differentiation of ameloblasts.
(2) Spindles are more pronounced beneath the cusps or incisal edges of teeth (i.e., areas where occlusal stresses are the greatest).