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DENTAL ANATOMY &
PHYSIOLOGYPhysiology, Etiology, Epidemiology,
Diagnosis, and Treatment
Reviewed by:
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Dental Anatomy and Physiology
After viewing this lecture, attendees should be able to:
Identify the major structures of the dental anatomy
Discuss the primary characteristics of enamel, dentin, cementum, anddental pulp
Describe the biologic functions that take place within the oral cavity
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Dental Anatomy and Physiology
Primary (deciduous)
Secondary (permanent)
Definition (teeth): There are two definitions
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Dental Anatomy and Physiology
A tooth is made up of three elements:
Water
Organic materials
Inorganic materials
Elements
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Primary (deciduous)
Consist of 20 teeth
Begin to form during the firsttrimester of pregnancy
Typically begin erupting around 6months
Most children have a completeprimary dentition by 3 yearsof age
Dental Anatomy and Physiology
Dentition (teeth): There are two dentitions
1. Oral Health for Children: Patient Education Insert. Compend Cont Educ Dent.
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Dental Anatomy and Physiology
Secondary (permanent)
Consist of 32 teeth in most cases
Begin to erupt around 6 yearsof age
Most permanent teeth have eruptedby age 12
Third molars (wisdom teeth) are theexception; often do not appear untillate teens or
early 20s
Dentition (teeth): There are two dentitions
Mandible
Maxilla Incisors
Canine (Cuspid)
Premolars
Molars
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Classification of Teeth:
Incisors (central and lateral)
Canines (cuspids)
Premolars (bicuspids)
Molars
Dental Anatomy and Physiology
Identifying Teeth
Incisor Canine Premolar Molar
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Dental Anatomy and Physiology
Identifying Teeth2
Incisor Canine Premolar Molar
Incisorsfunction as cutting or shearing instruments for
food.
Caninespossess the longest roots of all teeth and arelocated at the corners of the dental arch.
Premolarsact like the canines in the tearing of food
and are similar to molars in the grinding of food.
Molarsare located nearest the temporomandibular joint
(TMJ), which serves as the fulcrum during function.
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Dental Anatomy
and Physiology
Apical Labial
Lingual
Distal
Mesial
Incisal
Teeth: Identification
Tooth Surfaces
Labial
Apical
Lingual
Distal
Apical
Mesial
Incisal Incisal
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Dental Anatomy
and Physiology
Apical: Pertaining to the apex or
root of the tooth
Labial: Pertaining to the lip;
describes the front surface ofanterior teeth
Lingual: Pertaining to the tongue;
describes the back (interior)
surface of all teeth
Distal: The surface of the tooth
that is away from the median line
Mesial: The surface of the tooth
that is toward the median line
Labial
Apical
Lingual
Distal
Apical
Mesial
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Enamel
Alveolar Bone
Pulp
Chamber
Dental Anatomy and Physiology
Enamel (hard tissue)
Dentin (hard tissue)
Odontoblast Layer Pulp Chamber (soft tissue)
Gingiva (soft tissue)
Periodontal Ligament (soft tissue)
Cementum (hard tissue)
Alveolar Bone (hard tissue)
Pulp Canals
Apical Foramen
The Dental Tissues: Dentin
Odontoblast Layer Gingiva
Periodontal Ligament
Cementum
Pulp Canals
Apical Foramen
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Anatomic Crown
Anatomic Root
Pulp Chamber
The 3 parts of a tooth:
Anatomic Crown
Anatomic Root
Pulp
Chamber
Dental Anatomy and Physiology
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Anatomic Crown
Anatomic Root
Pulp
Chamber
Dental Anatomy and Physiology
The anatomiccrownis the portion
of the tooth covered by enamel.
The anatomic rootis the lower two
thirds of a tooth.
The pulp chamberhouses the
dental pulp, an organ of myelinated
and unmyelinated nerves, arteries,
veins, lymph channels, connective
tissue cells, and various other cells.
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Structure
Highly calcified and hardest tissue inthe body
Crystalline in nature Enamel rods
Insensitiveno nerves
Acid-solublewill demineralize at a pHof 5.5 and lower
Cannot be renewed
Darkens with age as enamel is lost
Fluoride and saliva can help withremineralization
Dental Anatomy and Physiology
Dental TissuesEnamel2
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Dental TissuesEnamel2
Dental Anatomy and Physiology
Enamel can be lost by:3,4
Physical mechanism
Abrasion (mechanical wear)
Attrition (tooth-to-tooth contact)
Abfraction (lesions)
Chemical dissolution
Erosion by extrinsic acids (from diet)
Erosion by intrinsic acids (from the oralcavity/digestive tract)
Multifactorial etiology
Combination of physical and chemicalfactors
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Softer than enamel
Susceptible to tooth wear (physicalor chemical)
Does not have a nerve supply but canbe sensitive
Is produced throughout life
Three classifications Primary
Secondary
Tertiary
Will demineralize at a pH of 6.5 andlower
Dental TissuesDentin2
Dental Anatomy and Physiology
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Three classifications:
Primary dentinforms the initial shape of the tooth.
Secondary dentinis deposited after the formation of the primary dentin on all internal aspects ofthe pulp cavity.
Tertiary dentin, or reparative dentin is formed by replacement odontoblasts in response to
moderate-level irritants such as attrition, abrasion, erosion, trauma, moderate-rate dental caries,
and some operative procedures.
Dental TissuesDentin2
Dental Anatomy and Physiology
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Dentin
Pulp
Tubule
Fluid Nerve Fibers
Odontoblast
Cell
Dental Anatomy
and Physiology
Dental TissuesDentin (Tubules)2
Dentinal tubulesconnect the dentinand the pulp
(innermost part of the tooth, circumscribed by thedentin and lined with a layer of odontoblast cells)
The tubules run parallel to each other in an S-
shape course
Tubules contain fluid and nerve fibers
External stimuli cause movement of the dentinal
fluid, a hydrodynamic movement, which can result
in short, sharp pain episodes
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Association between erosion anddentin hypersensitivity3
Open/patent tubules
Greater in number
Larger in diameter
Removal of smear layer
Erosion/tooth wear
Enamel
Exposed
Dentin
Receding
Gingiva
Tubules
Odontoblast
Dental Anatomy
and Physiology
Dental TissuesDentin (Tubules)2
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Dental Anatomy and Physiology
Thin layer of mineralized tissuecovering the dentin
Softer than enamel and dentin
Anchors the tooth to the alveolarbone along with the periodontalligament
Not sensitive
Dental TissueCementum2
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Innermost part of the tooth
A soft tissue rich with blood vessels andnerves
Responsible for nourishing the tooth
The pulp in the crown of the tooth isknown as the coronal pulp
Pulp canals traverse the root of the tooth
Typically sensitive to extreme thermalstimulation (hot or cold)
Dental TissueDental Pulp2
Dental Anatomy and Physiology
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Pulpitisis inflammation or infection of the dental pulp, causing extreme sensitivity and/or pain.
Pain is derived as a result of the hydrodynamic stimuli activating mechanoreceptors in the nervefibers of the superficial pulp (A-beta, A-delta, C-fibers).
Hydrodynamic stimuli include: thermal (hot and cold); tactile; evaporative; and osmotic
These stimuli generate inward or outward movement of the fluid in the tubules and activate thenerve fibers.
A-beta and A-delta fibers are responsible for sharp pain of short duration
C-fibers are responsible for dull, throbbing pain of long duration
Pulpitis may be reversible (treated with restorative procedures) or irreversible (necessitating rootcanal).
Untreated pulpitis can lead to pulpal necrosis necessitating root canal or extraction.
Dental Tissue
Dental Pulp2,5
Dental Anatomy and Physiology
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Gingiva
Alveolar Bone
Periodontal Ligament
Cementum
Periodontal Tissues6
Dental Anatomy and Physiology
Gingiva
Alveolar bone
Cementum
Periodontal Ligament
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Gingiva:The part of the oral mucosa overlying
the crowns of unerupted teeth
and encircling the necks of erupted teeth,
serving as support structure forsubadjacent tissues.
Dental Tissue
Dental Tissue6
Dental Anatomy and Physiology
Gingiva
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Alveolar Bone:Also called the alveolar
process; the thickened ridge of bone
containing the tooth sockets in the mandible
and maxilla.
Dental Tissue
Dental Tissue6
Dental Anatomy and Physiology
Alveolar bone
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Periodontal Ligament:Connects the
cementum of the tooth root to the alveolar
bone of the socket.
Dental Tissue
Dental Tissue6
Dental Anatomy and Physiology
Periodontal Ligament
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Cementum:Bonelike, rigid connective tissue
covering the root of a tooth from the
cementoenamel junction to the apex and lining
the apex of the root canal. It also serves as anattachment structure for the periodontal
ligament, thus assisting in tooth support.
Dental Tissue
Dental Tissue6
Dental Anatomy and Physiology
Cementum
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Plaque
Saliva
pH Values
Demineralization
Remineralization
Oral Cavity/Environment7,8
Dental Anatomy and Physiology
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Dental Anatomy
and Physiology
Plaque:7,8
is a biofilm
contains more than 600 differentidentified species of bacteria
there is harmless and harmful plaque
salivary pellicle allows the bacteria toadhere to the tooth surface, which begins
the formation of plaque
Oral Cavity
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Dental Anatomy
and Physiology
Saliva:7,8
complex mixture of fluids
performs protective functions:
lubricationaids swallowing
mastication
key role in remineralization of
enamel and dentin
buffering
Oral Cavity
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Dental Anatomy
and Physiology
Demineralization:7,8
mineral salts dissolve into the
surrounding salivary fluid:
enamel at approximate pH of 5.5 or
lower
dentin at approximate pH of 6.5 or
lower erosion or caries can occur
Oral Cavity
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Dental Anatomy
and Physiology
Remineralization:7,8
pH comes back to neutral (7)
saliva-rich calcium and phosphates
minerals penetrate the damaged enamelsurface and repair it:
enamel pH is above 5.5
dentin pH is above 6.5
Oral Cavity
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Dental Anatomy & PhysiologyReferences
References
1. Oral Health for Children: Patient Education Insert. Compend Contin Educ Dent. 2005;26(5 Suppl 1):Insert.
2. Sturdevant JR, Lundeen TF, Sluder TB Jr. Clinical significance of dental anatomy, histology, physiology, and occlusion. In: Robertson TM,
Heymann HO, Swift EJ Jr, eds. Sturdevants Art and Science of Operative Dentistry . 4th ed. Mosby: St. Louis, MO; 2002:13-61.
3. Strassler HE, Drisko CL, Alexander DC. Dentin hypersensitivity: its inter-relationship to gingival recession and acid erosion.Inside
Dentistry. 2008;29(5 Special Issue):3-4.
4. Imfeld T. Dental erosion. Definition, classification and links.Eur J Oral Sci. 1996;104(2 (Pt 2)):151-155.
5. Dentin hypersensitivity: current state of the art and science. In: Pashley DH, Tay FR, Haywood VB, et al. Dentin Hypersensitivity:
Consensus-Based Recommendations for the Diagnosis and Management of Dentin Hypersensitivity.Inside Dentistry. 2008;4(9 Special
Issue):8-18.
6. Dorlands Medical Dictionary. 29thEd. Philadelphia, PA: W. B. Saunders Company; 2000.
7. Robertson TM, Lundeen TF. Cariology: the lesion, etiology, prevention, and control. In: Robertson TM, Heymann HO, Swift EJ Jr, eds.
Sturdevants Art and Science of Operative Dentistry . 4th ed. Mosby: St. Louis, MO; 2002:63-132.
8. Tooth Erosion in ChildrenUS Perspective.Inside Dentistry. 2009;5(3 Suppl):8.
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Dental Anatomy and Physiology
For more in-depth, categorized information, please
visit the IFDEA at www.ifdea.org
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Dental Anatomy & Physiology
This I FDEA Educational Teaching Resource was
underwritten by an unrestr icted educational grant from:
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