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Dental Anatomy

As root and cementum formation begin, bone is created in the adjacent area. Throughout the body, cells that form bone are called osteoblasts. In the case of alveolar bone, these osteoblast cells form from the dental follicle. Similar to the formation of primary cementum, collagen fibers are created on the surface nearest the tooth, and they remain there until attaching to periodontal ligaments.

Like any other bone in the human body, alveolar bone is modified throughout life. Osteoblasts create bone and osteoclasts destroy it, especially if force is placed on a tooth. As is the case when movement of teeth is attempted through orthodontics, an area of bone under compressive force from a tooth moving toward it has a high osteoclast level, resulting in bone resorption. An area of bone receiving tension from periodontal ligaments attached to a tooth moving away from it has a high number of osteoblasts, resulting in bone formation.

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

Nerve and vascular formation

Frequently, nerves and blood vessels run parallel to each other in the body, and the formation of both usually takes place simultaneously and in a similar fashion. However, this is not the case for nerves and blood vessels around the tooth, because of different rates of development.

Nerve formation

Nerve fibers start to near the tooth during the cap stage of tooth development and grow toward the dental follicle. Once there, the nerves develop around the tooth bud and enter the dental papilla when dentin formation has begun. Nerves never proliferate into the enamel organ

Vascular formation

Blood vessels grow in the dental follicle and enter the dental papilla in the cap stage. Groups of blood vessels form at the entrance of the dental papilla. The number of blood vessels reaches a maximum at the beginning of the crown stage, and the dental papilla eventually forms in the pulp of a tooth. Throughout life, the amount of pulpal tissue in a tooth decreases, which means that the blood supply to the tooth decreases with age. The enamel organ is devoid of blood vessels because of its epithelial origin, and the mineralized tissues of enamel and dentin do not need nutrients from the blood.

FORMATION OF THE ROOT AND ITS ROLE IN ERUPTION

- As dentin and enamel is deposited the shape of the future crown appears.

- The cells just superficial to the horizontal diaphragm start to proliferate and grow pushing the horizontal diaphragm down into the mesenchym.

- This forms a tube.

- This tube is the epithelial root sheath of Hertwig's.

- The mesenchym cells lying inside the tube nearest to the epithelial root sheath are induced to differentiate into odontoblasts, which then start to deposit dentin.

- After the first dentin of the root has been laid down the inner epithelial cells of the sheath start to deposit an enameloid substance called intermediate cementum.

- The root sheath cells then separate from the intermediate cementum and breaks up in a network of epithelial strands.

- The mesenchym on the outside comes into contact with the intermediate cementum and differentiate into

cementoblasts, which will deposit the cementum.

- This cementum traps the collagenic fibres, of the periodontal ligament, which are also formed.

- Epithelium of the root sheath persists as epithelial rests of Malassez. Because the epithelium of the root sheath forms from enamel epithelium it can develop into ameloblasts which will deposit enamel pearls.

- There is little space for the root to develop.

- To create space the crown is pushed out.

Permanent dentition period  

-Maxillary / mandibular occlusal relationships are established when the last of the deciduous teeth are lost. The adult relationship of the first permanent molars is established at this time.

-Occlusal and proximal wear reduces crown height to the permanent dentition and the mesiodistal dimensions of the teeth

occlusal and proximal wear also changes the anatomy of teeth. As cusps are worn off, the occlusion can become virtually flat plane. -In the absence of rapid wear, overbite and overjet tend to remain stable.

-Mesio-distal jaw relationships tend to be stable,

With aging, the teeth change in color from off white to yellow. smoking and diet can accelerate staining or darkening of the teeth.

Gingival recession results in the incidence of more root caries . With gingival recession, some patients have sensitivity due to exposed dentin at the cemento-enamel junction.

Curve of Spee.

-The cusp tips and incisal edges align so that there is a smooth, linear curve when viewed from the lateral aspect. The mandibular curve of Spee is concave whereas the maxillary curve is convex.

-It was described by Von Spee as a 4" cylinder that engages the occlusal surfaces.

-It is called a compensating curve of the dental arch.

There is another: the Curve of Wilson. Clinically, it relates to the anterior overbite: the deeper the curve, the deeper the overbite.

Maxillary Second Deciduous Molar.

-The notation is A or J.

-It looks like a first permanent molar

-There are three roots.

-Usually it has four well developed cusps.

-It is somwhat rhomboidal in outline.

-They often have the Carabelli trait.

- the shape the maxillary first permanent molar strongly resembles that of the adjacent deciduous second molar.

Tooth development is the complex process by which teeth form from embryonic cells, grow, and erupt into the mouth.. For human teeth to have a healthy oral environment, enamel, dentin, cementum, and the periodontium must all develop during appropriate stages of fetal development. Primary teeth start to form between the sixth and eighth weeks in utero, and permanent teeth begin to form in the twentieth week in utero.

 Overview

The tooth bud (sometimes called the tooth germ) is an aggregation of cells that eventually forms a tooth.These cells are derived from the ectoderm of the first branchial arch and the ectomesenchyme of the neural crest.The tooth bud is organized into three parts: the enamel organ, the dental papilla and the dental follicle.

The enamel organ is composed of the outer enamel epithelium, inner enamel epithelium, stellate reticulum and stratum intermedium.These cells give rise to ameloblasts, which produce enamel and the reduced enamel epithelium. The location where the outer enamel epithelium and inner enamel epithelium join is called the cervical loop. The growth of cervical loop cells into the deeper tissues forms Hertwig's Epithelial Root Sheath, which determines the root shape of the tooth.

The dental papilla contains cells that develop into odontoblasts, which are dentin-forming cells. Additionally, the junction between the dental papilla and inner enamel epithelium determines the crown shape of a tooth. Mesenchymal cells within the dental papilla are responsible for formation of tooth pulp.

The dental follicle gives rise to three important entities: cementoblasts, osteoblasts, and fibroblasts. Cementoblasts form the cementum of a tooth. Osteoblasts give rise to the alveolar bone around the roots of teeth. Fibroblasts develop the periodontal ligaments which connect teeth to the alveolar bone through cementum.

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