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Dental Anatomy - NEETMDS- courses
NEET MDS Lessons
Dental Anatomy

Clinical importance of cementum

1) Deposition of cementum continues throughout life.
The effects of the continuous deposition of cementum are the maintenance of total length of the tooth (good) and constriction of the apical foramen (bad).
2) With age, the smooth surface of cementum becomes more irregular due to calcification of some ligament fiber bundles. This is referred to as spikes.

Behavior of cementum in pathologic conditions

Bell stage

The bell stage is known for the histodifferentiation and morphodifferentiation that takes place. The dental organ is bell-shaped during this stage, and the majority of its cells are called stellate reticulum because of their star-shaped appearance. Cells on the periphery of the enamel organ separate into three important layers. Cuboidal cells on the periphery of the dental organ are known as outer enamel epithelium.The cells of the enamel organ adjacent to the dental papilla are known as inner enamel epithelium. The cells between the inner enamel epithelium and the stellate reticulum form a layer known as the stratum intermedium. The rim of the dental organ where the outer and inner enamel epithelium join is called the cervical loop

Other events occur during the bell stage. The dental lamina disintegrates, leaving the developing teeth completely separated from the epithelium of the oral cavity; the two will not join again until the final eruption of the tooth into the mouth

The crown of the tooth, which is influenced by the shape of the internal enamel epithelium, also takes shape during this stage. Throughout the mouth, all teeth undergo this same process; it is still uncertain why teeth form various crown shapes—for instance, incisors versus canines. There are two dominant hypotheses. The "field model" proposes there are components for each type of tooth shape found in the ectomesenchyme during tooth development. The components for particular types of teeth, such as incisors, are localized in one area and dissipate rapidly in different parts of the mouth. Thus, for example, the "incisor field" has factors that develop teeth into incisor shape, and this field is concentrated in the central incisor area, but decreases rapidly in the canine area. The other dominant hypothesis, the "clone model", proposes that the epithelium programs a group of ectomesenchymal cells to generate teeth of particular shapes. This group of cells, called a clone, coaxes the dental lamina into tooth development, causing a tooth bud to form. Growth of the dental lamina continues in an area called the "progress zone". Once the progress zone travels a certain distance from the first tooth bud, a second tooth bud will start to develop. These two models are not necessarily mutually exclusive, nor does widely accepted dental science consider them to be so: it is postulated that both models influence tooth development at different times.Other structures that may appear in a developing tooth in this stage are enamel knots, enamel cords, and enamel niche.

Pulp

1. Four zones—listed from dentin inward

a. Odontoblastic layer

(1) Contains the cell bodies of odontoblasts.

 

Note: their processes remain in dentinal tubules.

 

(2) Capillaries, nerve fibers, and dendritic cells may also be present.

 

b. Cell-free or cell-poor zone (zone of Weil)

(1) Contains capillaries and unmyelinated nerve fibers.

 

c. Cell-rich zone

(1) Consists mainly of fibroblasts. Macrophages, lymphocytes, and dendritic cells may also be present.


d. The pulp (pulp proper, central zone)

(1) The central mass of the pulp.

(2) Consists of loose connective tissue, larger vessels, and nerves. Also contains fibroblasts and pulpal cells.


2. Pulpal innervation

a. When pulpal nerves are stimulated, they can only transmit one signal pain.

b. There are no proprioceptors in the pulp.

 

c. Types of nerves:

(1) A-delta fibers

(a) Myelinated sensory nerve fibers.

(b) Stimulation results in the sensation of fast, sharp pain.

(c) Found in the coronal (odontoblastic) area of the pulp.


(2) C-fibers

(a) Unmyelinated sensory nerve fibers.

(b) Transmits information of noxious stimuli centrally.

(c) Stimulation results in pain that is slower, duller, and more diffuse in nature.

(d) Found in the central region of the pulp.


(3) Sympathetic fibers

(a) Found deeper within the pulp.

(b) Sympathetic stimulation results in vasoconstriction of vessels.

ERUPTION

. Root completion (approximately 50% of the root is formed when eruption begins)

Generally mandibular teeth erupt before maxillary teeth,

Primary teeth

I. Emerge into the oral cavity as follows:

           Maxillary                       Mandibular

Central Incisor                          7½ months                     6 months

Lateral incisor                           9 months                       7 months

Canine                                     18 months                      16 months

First Molar                               14 months                     12 months

Second Molar                          24months                       20 months

 

The sequence of  primary  tooth development is central incisor, lateral incisor, first molar, second molar

3. Hard tissue formation begins between 4 and 6 months in utero

4. Crowns completed between 1½ and 10 months of age

5. Roots are completed between I½ and3 yearsof age 6 to 18 months after eruption

6. By age 3 years all of the primary and permanent teeth (except for the third molars) are in some stage of development

7. Root resorption of primary teeth is triggered by the pressure exerted by the developing permanent tooth; it is followed by primary tooth exfoliation in sequential patterns

8. The primary dentition ends when the first permanent tooth erupts

 

Maxillary (upper) teeth

Primary teeth

Central
incisor

Lateral
incisor


Canine

First
molar

Second
molar

Initial calcification

14 wk

16 wk

17 wk

15.5 wk

19 wk

Crown completed

1.5 mo

2.5 mo

9 mo

6 mo

11 mo

Root completed

1.5 yr

2 yr

3.25 yr

2.5 yr

3 yr

 

 Mandibular (lower) teeth 

Initial calcification

14 wk

16 wk

17 wk

15.5 wk

18 wk

Crown completed

2.5 mo

3 mo

9 mo

5.5 mo

10 mo

Root completed

1.5 yr

1.5 yr

3.25 yr

2.5 yr

3 yr

 

 

 

 

 

 

MANDIBULAR THIRD MOLAR

Facial: The crown is often short and has a rounded outline.

Lingual: Similarly, the crown is short and the crown is bulbous.

Proximal: Mesially and distally, this tooth resembles the first and second molars. The crown of the third molar, however, is shorter than either of the other molars

Occlusal: Four or five cusps may be present. Occlusal surface is a same as of the first or second molar, or poorly developed with many accessory grooves. The occlusal outline is often ovoid and the occlusal surface is constricted. Occasionally, the surface has so many grooves that it is described as crenulated--a condition seen in the great apes

Contact Points; The rounded mesial surface has its contact area more cervical than any other lower molar. There is no tooth distal to the third molar..

Roots:-The roots, two in number, are shorter in length and tend to be fused together. they show a distinct distal curve

LOCATION OF THE TEETH

Normally, a human receives two sets of teeth during a lifetime.

The first (deciduous or primary) set consists of 20 teeth ("baby" teeth).

The second (permanent) set usually consists of 32 teeth. In each quadrant, there are eight permanent teeth: two incisors, one cuspid, two bicuspids, and three molars 

The tooth positioned immediately to the side of the midline is the central incisor, so called because it occupies a central location in the arch.

To the side of the central incisor is the lateral incisor. Next is the cuspid, then the two bicuspids (the first bicuspid, followed by the second bicuspid). The last teeth are three molars. After the second bicuspid comes the first molar, followed by the second molar, followed by the third molar or more commonly called the "wisdom tooth."

Another method of describing the location of teeth is to refer to them as anterior or posterior teeth .

Anterior teeth are those located in the front of the mouth, the incisors, and the cuspids. Normally, these are the teeth that are visible when a person smiles.

The posterior teeth are those located in the back of the mouth-the bicuspids and molars.

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