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DEVELOPMENT OF TOOTHAND PERIODONTIUM
Dr. SONI BISTA1ST YEAR PG STUDENTPERIODONTOLOGY AND ORAL IMPLANTOLOGY
UNDER THE GUIDANCE:Assoc.Prof.Dr.MANDEEP SINGH DINGRAAsst.Prof.Dr.BIKASH KUMAR
A STAR IN THE
MAKING!!!
DEFINITIONOVERVIEW OF DEVELOPMENT OF TOOTHROOT FORMATIONSTAGES IN TOOTH GROWTHSIGNALING IN TOOTH DEVELOPMENTCEMENTOGENESISPDL FORMATIONALVEOLAR BONE FORMATIONDENTINOGINGIVAL JUNCTION FORMATIONCLINICAL CONSIDERATIONCONCLUSIONREFERENCES
CONTENTS
PERIODONTIUMGREEK MEANING: “PERI”_AROUND “ODONT”_TOOTH
“Tissue investing and supporting the teeth consists of Cementum, PDL, bone lining the alveolus and that part of the gingiva facing the tooth”_Tencate 5th edi.
“Tissue supporting the tooth are developmentally derived from the dental follicle proper, whereas those investing the tooth, that is gingiva, are an adaptation of oral mucosa” _Richard ten Cate
OVERVIEW OF DEVELOPMENT OF
TOOTH
NEURAL CREST DEVELOPMENT3 germ layer..Neural plate within ectoderm..
Neural tubes…Neural crest cells…
DERIVATIVES
PRIMARY EPITHELIAL BANDAfter 37 days of development
A continuous band of thickened epithelium forms around the mouth in upper and lower jaws
This band are roughly horseshoe shaped
Corresponds in position to the future dental arches of upper and lower jaws
Each band of epithelium called as primary epithelial band (Gives rise to)
DENTAL LAMINA VESTIBULAR LAMINA
(At about 7th week)
• First evidence of tooth development.• Continued and localized proliferative activity lead to formation of a
series of epithelial ingrowth into the ectomesenchyme at the sites corresponding to the position of the future deciduous teeth.
FATE: Total activity is about 5 years Eventually, the dental lamina disintegrates into small clusters of epithelium and is
resorbed. In situations when the clusters are not resorbed, (this remnant of the dental lamina is sometimes known as the cell rest of Serres) eruption cysts are formed over the developing tooth and delay its eruption into the oral cavity.
• From this, tooth development proceeds in 3 stages: bud stage, cap stage, bell stage.
DENTAL LAMINA
VESTIBULAR LAMINA:The vestibule forms as a result of proliferation of vestibular lamina into the ectomesenchyme
BUD STAGE
8TH WEEK
Represented by 1st epithelial incursion into the ectomesenchyme of the jaw.Supporting ectomesenchymal cells are closely packed beneath and around the epithelial bud…
CAP STAGE9-10
WEEKS
CONDENSATION OF ECTOMESENCHYME
DENTAL ORGAN
DENTAL PAPILLA
DENTAL FOLLICLE
Proliferativestage
Epithelial bud_proliferate into ectomesenchyme
enameldentin
pulpSupporting
tissue
BELL STAGE
11-12TH WEEK
OUTER DENTAL EPITHELI
UM
STRATUM
INTERMEDIUM
INNER DENTAL EPITHELI
UM
Histodifferentiation and morphodifferention
glycosaminoglycans
CERVICAL LOOP
ADVANCEDBELL
STAGE
Two important events:1.Dental lamina
joining the tooth germ to the oral epithelium breaks up into discrete islands of epithelial cells…
Separating the developing tooth from the oral epithelium.
2. Inner dental epithelium__folds__making it possible to recognize the shape of future crown pattern of the tooth.
INNERVATION:Clusters of blood vessels and pioneer nerve fibers are found ramifying around the tooth germ in dental follicle .
ROOT FORMATION
Major function of HERS(Schour and Massler) Induce and regulate root formation including the size, shape, number of root.HERS characters:1. Consists of inner and outer enamel
epithelium only.
Innercells(short in size) cells in
coronal root
region
Differentiation of radicular differentiation ofPapilla cells dental
follicle
Odontoblasts cementoblasts
First layer of acellular cementum
radicular dentin.
Enamel matrix protein Components of epithelial Basement
membrane
Hertwig’ epithelial root sheath
STAGES IN TOOTH GROWTH
DENTAL CEMENTUMThe dynamic tissue covering the root….
Cementum is the calcified, avascular mesenchymal tissue that forms
the outer covering of the anatomic root.Latin: “Caementum”:quarried stone[i.e. Chips of stone used
in making mortar]
It was first demonstrated microscopically in 1835 by two pupils of purkinje.
It is a specialized connective tissue that shares some physical, chemical & structural characteristics with compact bone.
cEmEnTum
CEMENTOGENESIS Cementum is deposited on the surface of root dentin HERS Hyaline layer of Hopewell-Smith/Intermediate Cementum (after basement supporting root sheath breaks up) • Secrete distinct class of enamel protein in the gap between
collagen fibers(from mantle dentin) and basement membrane.
This layer contains product of epithelial cell activity/form of enameloid
Thus the dentin of the root surface is covered by an epithelial product of the root sheath cells that is more mineralized than other dentin.
+ Functions to “cement” cementum into dentin as well as
provide the initial attachment of ligament fibrils to the tooth.
[Hertwig’s epithelial root sheath is broken up & separated from root, and differentiation of
cementoblasts lead to formation of cementum]
Cementogenesis….• Root sheath fragments into network that allows: follicular cells to pass through it + it comes into
apposition with newly formed root surface. differentiate into cememtoblasts deposit organic matrix against root surface and around
forming ligament fiber bundles/extrinsic fibers. mineralization of this matrix is called cementoid occurs with
deposition of apatite crystals
initially is matrix vesicles
followed by mineralization of collagen fibrils.
Growth factor families involved in the differentiation of cemetoblasts from dental
follicle....TGFβ 1-5BMP2-8
EGF & IGFPGE2 & PGF2α enhance
differentiation by activating protein
kinase cell signalling pathwayFibroblast growth
factor promotes proliferation, migration
& angiogenesisCAP, BSP and osteopontine helps in
attachment of differentiated cells to newly forming tissue
PRIMARY CEMENTUM First formed cementum is acellular
Develops slowly as tooth is erupting
Covers coronal two third of the root
Highly calcified.
Its collagenous component may be derived entirely from extrinsic fibers of the PDL(Sharpey’ fiber)
Also contain intrinsic fibers that are calcified and irregularly arranged or parallel to the surface.
SECONDARY CEMENTUM Develops after tooth is in occlusion. Rapidly formed and less mineralized Deposited around apical two third of the root. Cellular as cementoblasts gets trapped in lacunae within
matrix they form. Its Organic matrix contains collagen fibers derived from
2 sources extrinsic fibers of PDL_are arranged obliquely
as they enter cementum. intinsic fibers(formed as a result of cementoblastic activity)__are parallel to root. Secondary cementum formation is a continuous process Thus thickness of cementum on root surface increases with
age.
FATE OF HERS… Fragmentation of root sheath
disruption of its basal lamina
some cell are lost Most cells persists as strands/clusters
(transform into mesenchymal cells) (where collagen are trapped)
called as epithelial rests of malassez
-dark staining nuclei and little cytoplasm
-appear as a network within PDL close to cementum
-proliferate -are source of
epithelial cells that line dental cysts
PDL formation• After root formation_dental follicle PDL• In front of forming PDL increase rate of cell
division fibroblasts
collagen fibrils of PDL (oblique orientation) + ground substances of
PDL
First collagen bundle appear in the region immediately apical to the CEJ and give
rise to gingivodental fiber groups
Transeptal and alveolar crest fibers develop when tooth merge
into oral cavity
Sharpey’s fiber are fewer in no. and more widely spread
than those emerging from
cementum. _carranza’s
• Rearrangement of fiber ends in the plexus is supposed to accommodate tooth eruption without necessitating the embedding of new fibers into tooth and the bone.
BEFORE TOOTH ERUPTION:•Crests of alveolar bone is above CEJ•Developing fiber bundles of PDL are all directed obliquely.•More apical orientation
DURING TOOTH ERUPTION:•Level of alveolar crest comes to coincide with CEJ•Oblique fibers below the free gingival fibers becomes horizontally aligned called as alveolar crest fibers.•More coronal orientation.
TEETH IN FUNCTION:•Fiber bundles of PDL thickens and are constantly remodeled by fibroblasts
PDL homeostasis A remarkable capacity of PDL is that it maintains its width more or
less, despite the fact, it is squeezed in between two hard tissues. Various molecules have been proposed, which play a role in
maintaining an unmineralized PDL.
• Inhibit mineralized bone tissue
Msx2
• Prevents osteogening differentiation of PDL fibroblasts by repressing cbfa1 activity
Bone sialoprotein
• osteopontin
Matrix Gla protein(Inhibitors of mineralization)
Prostaglandins
ALVEOLAR PROCESS It is the portion of maxilla and mandible that
forms and support the tooth socket(alveoli)
It develops and undergoes remodeling with tooth formation and eruption; they are dependent bony structure.
It forms when the tooth erupts to provide the osseous attachment to the forming PDL & it disappears gradually after the tooth is lost.
BONE FORMATION
As PDL is forming;
new bone deposition
takes place around developing
Ligament fiber bundles against
crypt walls
Cells migrate into PDL from bone marrow (by way of vascular channels)
Occupy perivascular location within PDL
Reinforce the resident perivascular cells
To provide daughter cells
Migrate to bone and cementum
Differentiate into osteoblast and cementoblast and also PDL fibroblast.
Bone formationIntramembranous ossification
Formation of bone matrix
Formation of woven bone
Appositional growth & formation of harvesian system (osteon)
Endochondral bone formationFormation of cartiagenous
model
Stages of Intramembranous Ossification
Stages of Intramembranous Ossification
Stages of Intramembranous Ossification
Stages of Intramembranous Ossification
Formation of bone collar around hyaline cartilage model.
1
2
3
4Invasion of internal cavities by the periosteal bud and spongy bone formation.
5Formation of the medullary cavity as ossification continues; appearance of secondary ossification centers in the epiphyses in preparation for stage 5.
Hyaline cartilage
Primary ossification center
Bone collar
Deteriorating cartilage matrix
Spongy bone formation
Blood vessel of periosteal bud
Secondary ossification centerEpiphyseal
blood vessel
Medullary cavity
Epiphyseal plate cartilage
Spongy bone
Articular cartilage
Stages of Endochondral Ossification
Cavitation of the hyaline cartilage within the cartilage model.
Ossification of the epiphyses; when completed, hyaline cartilage remains only in the epiphyseal plates and articular cartilages
GINGIVAGingiva is the part of the oral
mucosa that covers the alveolar processes of the jaws and tooth
root to a level just coronal to CEJ_McCall
DENTOGINGIVAL JUNCTION
• The epithelium of the gingiva which gets attached to the tooth is called as junctional or attachment epithelium.
• Consists of collarlike band of stratified squamous nonkeratinizing epithelium.
• Forms an epithelial barrier against bacteria.
JUNCTIONAL EPITHELIUM
DEVELOPMENT OF JUNCTIONAL EPITHELIUM AND GINGIVAL SULCUS
After enamel formation is complete, the enamel is covered with REE, which is attached to the tooth by a basal lamina & hemidesmosomes
When tooth penetrates oral mucosa, the REE unites with oral mucosa and transformed into JE
JE proceeds in an apical direction, forming a shallow groove, the gingival sulcus between circumference of tooth & gingiva that encircles the newly erupted tip of the crown
Gingival sulcus deepens as a result of separation of the REE from actively erupting tooth & JE attains its position at CEJ of fully erupted tooth
STAGES OF PASSIVE ERUPTION
SHIFT OF DENTOGINGIVAL JUNCTION
The teeth reach the line of occlusion.J.E and base of gingival sulcus are on the enamel
Stage 1
STAGES OF PASSIVE ERUPTION
SHIFT OF DENTOGINGIVAL JUNCTION
J.E proliferates so that part is on cementum and part is on enamel.
Stage 2
STAGES OF PASSIVE ERUPTION
SHIFT OF DENTOGINGIVAL JUNCTION
Entire J.E is on cementum and base of the sulcus is at CEJ.As J.E proliferates from the crown into the root,it doesnot remain at CEJ any longer than at any other area of the tooth.
Stage 3
STAGES OF PASSIVE ERUPTION
SHIFT OF DENTOGINGIVAL JUNCTION
J.E has proliferated farther on the cementum.the base of the sulcus is on the cementum, a portion of which is exposed.Proliferation of the J.E onto the root is accompained by degeneration of gingival and PDL fibers and their detachment from the tooth.
Stage 4
DURING INITIATION
ANODONTIA
SUPERNUMERY
DURING MORPHODIFFERENTIATION
CLINICAL SIGNIFICANCE
CONCLUSIONThe widespread occurrence of periodontal disease and the
realization that periodontal tissue lost to the disease can be repaired has resulted in considerable effort
to understand the factors and cells regulating the
formation,maintenance and regeneration of the
periodontium…..TenCate et al
REFERENCES• Carranza’s clinical periodontology,11th
edition• Orban’s oral histology and embryology,12th
edition.• Oral histology:development,structure and
function,A.R Tencate,4th edition.• Oral development and
histology,James.K.Avery,Pauline.F.Steele, Nancy Avery.• Images_Google .