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Pediatric Dentistry 5

Pediatric Dentistry 5

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Published by Salam Bataieneh

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Published by: Salam Bataieneh on Jul 26, 2013
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08/05/2013

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 1 |Page 
Tooth development, Eruption and development of occlusion
Tooth development
 - At 8 weeks intrauterine the epithelium of the oral cavity bulges into the mesodermforming the horseshoe shaped dental lamina in each jaw, from this dental lamina budsevolve to form
tooth bud
.The
tooth bud
is organized into three parts:
1-
Enamel organ
 –
originates from ectoderm.
2-
Dental papilla - originates from ectomesenchyme.
3-
Dental follicle.
-
Tooth formation begins at 8 weeks intrauterine, and mineralization begins later atthe 4
th
month intrauterine.
-
The dental lamina goes through
three stages
of maturity to start secretory functionsto form different dental tissues: Enamel, Dentin and Cementum these stages are:
1-Bud stage
Consists of the ectodermal outgrowth of the dental lamina with the adjacentmesenchyme.
2-Cap stage
Is where you have the enamel organ growing from the dental lamina around thedental papilla like a cap.
3-Bell stage
Is where the enamel organ will differentiate into four different histological layers:1-Outer enamel epithelium2-Stellate reticulum3-Stratum intermedium4-Inner enamel epithelium
 
 2 |Page 
(1) Outer enamel epithelium (OEE)
 I
t’s a layer that is adjacent to the dental sac , it’s a single layer of cuboidal
cells , priorto enamel formation capillaries in the connective tissue surrounding the enamel organproliferate and protrude toward it to increase vascularity, they also have thin walls toenhance the process of diffusion by which nutrients will be reaching the enamelmatrix.
(2) Stellate reticulum (SR)
-Forms the middle part of enamel organ, filled by a large amount on intracellularsubstance (fluid).- Cells are star-shaped with long processes
 
reaching all directions; they are connectedwith each other and with the cells of outer enamel epithelium and cells of the stratumintermedium with desmosomes.-I
t’s
a resistant and elastic structure so its act as a buffer against physical forces.- It also permits the flow of nutrients to formative cells, as it reduces in thickness.After first layers of dentine form cutting the inner enamel epithelium from its originalsupply which is the dental papilla.
(3) Stratum intermedium (SI)
 These are flat to cuboidal in shape arranged in three layers, they are believed to play arole in enamel formation through control of fluid diffusion or by contribution of formative elements or enzymes.
(4) Inner enamel epithelium (IEE)
Derived from the basal cell layer of the oral epithelium, before enamel formationbegins, they become columnar and differentiate into ameloblasts starting at the incisalor cuspal edges .These cells are continuous with the outer enamel epithelium at the border of the widebasal opening of the enamel organ thus, forming the cervical loop.
 
 3 |Page 
Formation of hard tissues:
1- Dentinogenesis
: in which the dentin is formed
2- Amelogenesis
: in which the enamel is formed
(1) Dentinogenesis:
 dentine is the first tissue to be laid, its laid before enamel, once the dentin is laid it willinduce the enamel formation, and then enamel will induce more dentin to be formed
it’s
like a mutual induction between the enamel and dentin.-the dentin formation occurs when the inner enamel epithelium (IEE) cells lengthenand induce differentiation (become ameloblasts), and when they become ameloblastthey will induce the differentiation of the odontoblast (cells that are responsible fordentin formation) from dental papilla.The first formed layer of dentin which is less mineralized is the
mantle dentin
its
poorly mineralized because it’s the first layer to be formed ( the minerals are not
enough in the blood) but the layers after that are much more mineralized and called
circumpulpal dentin
.So dentin formation like any other mineralized tissue its formation occurs in
twosteps:
 
1-
Matrix formation
2-
Mineralization of the matrix
the matrix is called predentin before mineralization and after the mineralization itwill called dentin.
 

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