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.

Deciduous dentition period.

-The deciduous teeth start to erupt at the age of six months and the deciduous dentition is complete by the age of approximately two and one half years of age.

-The jaws continue to increase in size at all points until about age one year.

-After this, growth of the arches is lengthening of the arches at their posterior (distal) ends. Also, there is slightly more forward growth of the mandible than the maxilla.

1. Many early developmental events take place.

-The tooth buds anticipate the ultimate occlusal pattern.

-Mandibular teeth tend to erupt first. The pattern for the deciduous incisors is usually in this distinctive order:

(1) mandibular central

(2) maxillary central incisors

(3) then all four lateral incisors.

-By one year, the deciduous molars begin to erupt.

-The eruption pattern for the deciduous dentition as a whole is:

(1) central incisor

(2) lateral incisor

(3) deciduous first molar

(4) then the canine

(5) then finally the second molar.

-Eruption times can be variable.

2. Occlusal changes in the deciduous dentition.

-The overjet tends to diminish with age. Wear and mandibular growth are a factor in this process.

-The overbite often diminishes with the teeth being worn to a flat plane occlusion.

-Spacing of the incisors in anticipation of the soon-to-erupt permanent incisors appears late. Permanent anterior teeth (incisors and canines) are wider mesiodistally than deciduous anterior teeth. In contrast, the deciduous molar are wider mesiodistally that the premolars that later replace them.

-Primate spaces occur in about 50% of children. They appear in the deciduous dentition. The spaces appear between the upper lateral incisor and the upper canine. They also appear between the lower canine and the deciduous first molar.

TOOTH MORPHOLOGY

Descriptive anatomy

• Median sagittal plane: the imaginary plane in the center that divides right from left.
• Median line: an imaginary line on that plane that bisects the dental arch at the center.
• Mesial: toward the center (median) line of the dental arch.
• Distal: away from the center (median) line of the dental arch.
• Occlusal plane: A plane formed by the cusps of the teeth. It is often curved, as in a cylinder. We will speak often of the occlusal surface of a tooth.
• Proximal: the surface of a tooth that is toward another tooth in the arch.
• Mesial surface: toward the midline.
• Distal surface: away from the midline.
• Facial: toward the cheeks or lips.
• Labial: facial surface of anterior teeth (toward the lips).
• Buccal: facial surfaceof anterior teeth (toward the cheeks).
• Lingual: toward the tongue.
• Occlusal: the biting surface; that surface that articulates with an antagonist tooth in an opposing arch.
• Incisal: cutting edge of anterior teeth.
• Apical: toward the apex, the tip of the root.

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

Dentinogenesis

Dentin formation, known as dentinogenesis, is the first identifiable feature in the crown stage of tooth development. The formation of dentin must always occur before the formation of enamel. The different stages of dentin formation result in different types of dentin: mantle dentin, primary dentin, secondary dentin, and tertiary dentin.

Odontoblasts, the dentin-forming cells, differentiate from cells of the dental papilla. They begin secreting an organic matrix around the area directly adjacent to the inner enamel epithelium, closest to the area of the future cusp of a tooth. The organic matrix contains collagen fibers with large diameters (0.1-0.2 μm in diameter). The odontoblasts begin to move toward the center of the tooth, forming an extension called the odontoblast process. Thus, dentin formation proceeds toward the inside of the tooth. The odontoblast process causes the secretion of hydroxyapatite crystals and mineralization of the matrix. This area of mineralization is known as mantle dentin and is a layer usually about 150 μm thick.

Whereas mantle dentin forms from the preexisting ground substance of the dental papilla, primary dentin forms through a different process. Odontoblasts increase in size, eliminating the availability of any extracellular resources to contribute to an organic matrix for mineralization. Additionally, the larger odontoblasts cause collagen to be secreted in smaller amounts, which results in more tightly arranged, heterogenous nucleation that is used for mineralization. Other materials (such as lipids, phosphoproteins, and phospholipids) are also secreted.

Secondary dentin is formed after root formation is finished and occurs at a much slower rate. It is not formed at a uniform rate along the tooth, but instead forms faster along sections closer to the crown of a tooth. This development continues throughout life and accounts for the smaller areas of pulp found in older individuals. Tertiary dentin, also known as reparative dentin, forms in reaction to stimuli, such as attrition or dental caries.

The dentin in the root of a tooth forms only after the presence of Hertwig's epithelial root sheath (HERS), near the cervical loop of the enamel organ. Root dentin is considered different than dentin found in the crown of the tooth (known as coronal dentin) because of the different orientation of collagen fibers, the decrease of phosphoryn levels, and the less amount of mineralization.

The Transition from the Deciduous to the Permanent Dentition.

1. The transition begins with the eruption of the four first permanent molars, and replacement of the lower deciduous central incisors by the permanent lower central incisors.

2. Complete resorption of the deciduous tooth roots permits exfoliation of that tooth and replacement by the permanent (successional) teeth

3. The mixed dentition exists from approximately age 6 years to approximately age 12 years. In contrast, the intact deciduous dentition is functional from age 2 - 2 /2 years of age to 6 years of age.

4. The enamel organ of each permanent anterior tooth is connected to the oral epithelium via a fibrous cord, the gubernaculum. The foramina through which it passes can be seen in youthful skulls

The deciduous second molars are particularly important. It is imperative that the deciduous second molars be preserved until their normal time of exfoliation. This prevent mesial migration of the first permanent molars.

Use a space maintainer in the event that a second deciduous molar is lost prematurely