ODONTOGENESIS

 The first sign of human tooth  With continued growth by the 7th
development occurs at about 6th week week:
of embryonic life.  The primary epithelial band
 The stomodeum at this time is lined by divides into two processes:
mucous membrane consisting of 1. Dental lamina
epithelium and connective tissue. o Lingually located
o will form into teeth
2. Vestibular lamina
o Buccally located
o which will form the
buccal/ labial
vestibule or
mucolabial fold

 About 30 days …
 localized histologic changes in
the primitive oral ectoderm
indicates beginning of tooth
formation
 Odontogenic epithelium –
proliferation and thickening of
the epithelium
 Primary epithelial band – an
arch-shaped continuous plate
of odontogenic epithelium.

VESTIBULAR LAMINA

 buccally located
 contributes to the development of the
vestibule of the mouth
 delineating the lips and the cheeks
from the tooth-bearing regions
  its cells rapidly enlarge to form a cleft
that becomes the vestibule between
the cheeks and the tooth-bearing areas
 Also known as lip furrow band
DENTAL LAMINA
 The neural crest cells in the jaws induce
the oral epithelium to proliferate and
form the DENTAL LAMINA.
 the FIRST SIGN OF TOOTH
DEVELOPMENT
 serve as primordium for the ectodermal
portion of the deciduous teeth

Dental lamina appears as a thickening of the

oral epithelium adjacent to condensation of
ectomesenchyme.
FORMATION OF VESTIBULE OF ORAL CAVITY
FUNCTION OF DENTAL LAMINA LIFE CYCLE OF A TOOTH

 Phase 1: Initiation of entire deciduous

dentition (8th wk.)
 Phase 2: Initiation of successors of
deciduous dentition (5th mo. – 10th
mo.)
 Phase 3: Initiation of permanent molars
(1st molar 4 MIU (months in utero), 2nd
molar, 3rd molar 4-5 years)
 Growth
SUCCESSIONAL LAMINA o Initiation
o Proliferation
 Successors of deciduous teeth arise
o Histodifferentiation
from lingual extension of free end of o Morphodifferentation
dental lamina, opposite to enamel o Apposition
organ of each deciduous tooth.
 Calcification
 Develops from 5th mo. in utero (for
 hardening of the dentinal &
central incisors) to 10th mo. of age (for
enamel matrix
2nd molars)
 Eruption
 occlusal movement of tooth
into the oral cavity to its
functional position
 Attrition
 physiological wearing away of
tooth structure

DEVELOPMENTAL STAGES

EPITHELIAL RESTS OF SERRES

 remnants of the dental lamina persists

as epithelial rests

By the 8th week

 a series of swellings develops on the

deep surface of the dental lamina
 From this point, tooth development
proceeds in three stages: the bud, cap
and bell stage: descriptive of the
morphology of the developing tooth

BUD STAGE (8th Week)
 At certain points on the dental lamina,
cells multiply still more rapidly and form
a knob-like projection into the
underlying mesenchyme.
 These downward growths are the tooth
buds
o Tooth buds = first sign of
enamel organ formation and
the beginning of tooth germ of
a primary tooth
 The enamel organ in the bud stage
appears as a simple spherical to ovoid
epithelial condensation that is poorly
morphodifferentiated and
histodifferentiated
 The mesoderm exert pressure at the
base of the tooth bud. The pressure of
the mesoderm leads to invagination of
the undersurface of the tooth bud.
 The lower margin of the concavity
proliferates downward to surround the
actively growing mesoderm
 As a result of this topographic
alteration, the round shaped tooth bud
is transformed to a cap shaped
structure.
CAP STAGE (9th – 10th week)
 9th to 10th weeks
 At this stage of tooth development it is
already possible to identify the
formative elements of the tooth and
its supporting tissues.
 By the 11th week, morphogenesis has
progressed, the deeper surface of the
enamel organ invaginating to form a
cap-shaped structure
 Appears poorly differentiated.

  Unequal growth in different parts of the DENTAL PAPILLA
tooth bud leads to concave surface,
 The ball of condensed ectomesenchyme
forming like a cap like structure.
cells; forms the dentin and the pulp
 Formation of tooth germ
 Consists of two parts:
o Periphery – gives rise to the
formative cells odontoblasts –
dentin
o Center – gives rise to the
formative cells fibroblasts-pulp

TOOTH GERM
1. Enamel organ – enamel
2. Dental papilla - pulp and dentin
3. Dental Sac - cementum & periodontal
ligament
ENAMEL ORGAN
 Among other functions, it eventually
forms the enamel of the tooth
DENTAL FOLLICLE / DENTAL SAC
 The condensed ectomesenchyme
limiting the dental papilla and
encapsulating the dental organ
 gives rise to the supporting structures
of the tooth

 Consists of three parts:

o Inner layer – cementoblasts
(cementum)
o Middle layer – fibroblasts
(periodontal ligament)
o Outer layer – osteoblasts
(alveolar bone)

A. Enamel organ/ Dental Organ

B. Outer dental epithelium
C. Inner dental epithelium
D. Dental Papilla
E. Dental Follicle / Dental Sac
TRANSITORY STRUCTURES = Late stage cap-
shaped enamel organ

a. ENAMEL KNOT/ AHORN’S KNOT

 Localized mass of cells
produced by rapid
multiplication of cells in the
center of inner enamel
epithelium
 an important signaling center
expressing ten or more growth
factors
c. ENAMEL NICHE
 Funnel-shaped area between
lateral and medial strands of
dental lamina enclosing
mesenchyme

A. Lateral enamel strand

B. Medial enamel strand
b. ENAMEL CORD
C. Enamel niche
 Strand of cells from the stratum
intermedium into the stellate BELL STAGE
reticulum
 As proliferation continues, the dental
 Act as a reservoir of dividing
organ increases in size and changes in
cells for the growing enamel
shape
organ
 The invagination becomes deeper until
 Together with the enamel knot,
the organ assumes the shape of a bell
form the site of the future cusp
tip or incisal edge
 involved in the process by
which the cap stage is
transformed into the bell stage
Early Bell stage

 By the 14th week, further

morphodifferentiation and
histodifferentiation of the tooth germ
leads to the early bell stage
 The configuration of the inner enamel
epithelium broadly maps out the
occlusal pattern of the crown of the
tooth
 It is here the ameloblast cells form the
enamel, odontoblast cells form the
dentin, and the cementoblasts form the
cementum

 Dental lamina breaks down and

degenerates. 1. Outer enamel epithelium - cells that
 Shows 4 distinct layers: line the convexity of enamel organ, tall
o Outer enamel epithelium (OEE) cuboidal cells
o Stellate Reticulum 2. Stellate reticulum - at the center are
o Stratum intermedium star –shaped network of cells filled with
o Inner enamel epithelium (IEE) mucoid fluid - also known as Enamel
Pulp. Just before enamel formation,
4 Layers Of Cell That Make Up The Enamel stellate reticulum collapses.
Organ 3. Stratum Intermedium - a single layer of
a. outer enamel epithelium cells between stellate reticulum and
b. stellate reticulum inner enamel epithelium
c. stratum intermedium 4. Inner enamel epithelium - start as low
d. inner enamel epithelium columnar cells lining the concavity of
the enamel organ
 Stellate reticulum

ROLE OF STRATUM INTERMEDIUM

 Synthesis of proteins
 Transports of materials to and from the
inner enamel epithelium

ROLE OF INNER ENAMEL EPITHELIUM

 Cells exert an organizing influence on

the underlying mesenchymal cells in the
dental papilla that later differentiate
into odontblasts
 columnar cells
 these cells differentiate into ameloblast
prior to enamel formation
 associated with the future cusp tips

DENTAL PAPILLA

 under the inductive influence of inner

ROLE OF OUTER ENAMEL EPITHELIUM (OOE)
 Maintenance of the shape of the
enamel organ
DENTAL SAC / DENTAL FOLLICLE
 Exchanges of substances between
enamel organ and environment
ROLE OF STELLATE RETICULUM
 Mechanical
 Nutritive
 Protects tissue
 Maintains tooth shape
enamel epithelium, the peripheral cells
of the dental papilla differentiate into
odontoblasts
 these cells initially become cuboidal and
later become columnar
 these cells now acquire the potential to
produce dentine
 just before the formation of dental
tissue begins, the collagen fibers of the
dental sac are arranged in a circular
manner
 look like a capsule around the enamel
organ and dental papilla
 LATE BELL STAGE (18TH WEEK)

LATE BELL STAGE

 The cells of the inner enamel epithelium

CHANGES BEFORE ENAMEL FORMATION cease to divide and change from low to
 The stellate reticulum collapses thus the tall columnar cells
distance between the inner enamel  They increase from 12 to 40
epithelium and the blood capillaries of micrometer in length
the dental sac is reduced, so that more  These tall cells are now referred to as
nutrients reach the ameloblasts during preameloblasts / pre-enamel
period of high metabolic activity.
 The formerly smooth surface of the
outer enamel epithelium is thrown into
folds.
 Between the folds, the mesenchyme of
the dental sac form projections or
papillae that carry capillary loops closer
to the ameloblasts prior to
amelogenesis.
 It is believed that the preameloblasts
17TH WEEK
initiate the peripheral cells of the dental
 Dental lamina begin to degenerate papilla to become odontoblasts, where
dentin is being laid down.
 The secretion of dentin matrix causes
the preameloblasts to change polarity.

EPITHELIAL PEARLS

 A disintegrating dental lamina is viewed

at a much higher power.
 Epithelial Pearls or Glands of Serres
 remnants of the dental lamina, when
they failed to resorb totally
 With change in polarity, these cells are
now referred to as ameloblasts and be
ready to begin the secretion of enamel
matrix
APPOSITIONAL STAGE (CROWN FORMATION)
 At this stage, since there is the
presence of both odontoblasts and
ameloblasts, Apposition stage occur
where dentinogenesis and
amelogenesis is now underway.

 After the dentin matrix is laid down, this

acts as a barrier between the dental
papilla and the ameloblasts.
 The change of inner enamel epithelium
to ameloblasts fulfilled the second
physiologic process which is
MATURATION STAGE
histodifferentiation
 With the presence of both odontoblasts  Dental tissues fully mineralizes to their
and ameloblasts, APPOSITION STAGE mature levels
occur where dentinogenesis (process of
development of dentin) and ERUPTION
amelogenesis (process of development  Dental tissues fully mineralizes to their
of enamel) is now underway. mature levels

ROOT FORMATION

 Initiated through the contributions of

the cells:
o Enamel organ  root dentin
o Dental papilla  root pulp
o Dental sac / dental follicle 
 We will presume we have a fully formed
cementum, periodontal
crown, because it has reached its future
ligament, alveolar bone
cemento-enamel junction
 The ameloblasts will give its last (final)
product— primary enamel cuticle or
Nasmyth membrane, which also serves
as the first protective covering of
enamel
 The development of the root begins
after enamel and dentin formation has
reached the future CEJ (cementoenamel
junction), but before the full crown is
calcified
Cervical loop

Dental papilla

 Begins after the outline of the crown

has been established, but before the
full crown is calcified
 The area where the outer and inner
enamel epithelium come together is
termed the Cervical Loop.
o Cervical loop forms the
epithelial root sheath (of
Hertwig)
  When the crown is complete, the  The remnants of the root sheath of
cells continues to lengthen, forming Hertwig are called epithelial rests of
a double layer of cells termed Malassez.
Hertwig’s Epithelial Root Sheath.

Hertwig’s epithelial root sheath

 Hertwig’s epithelial root sheath

(HERS) proliferates and bend
inward or towards the medial side
to form the horizontal plate known
as Epithelial Diaphragm.
 This remains fixed during the
development of the root.
 When the continuity of HERS is
destroyed, the layers of the dental sac
comes in contact with the root dentin
where cementogenesis occur.
 HERS continues to grow longer forming
the root length.

Epithelial Diaphragm

 During the course of root formation,

HERS bend inward to form the
epithelial diaphragm and establish the
apical boundary of the dental papilla
 These Hertwig’s epithelial root sheath
 As the vertical epithelial root sheath
determines if a tooth has single of
continues to grow longer, forming root
multiple root, is short or long, or is
sheath, the horizontal epithelial
curved or straight
diaphragm continues to grow inward
 However, if there is insufficient space, toward the midline of the tooth.
roots conform to the space available
 The inward growth of the epithelial
 Then the root sheath loses its continuity diaphragm will determine whether the
and begins to degenerate. It does not tooth will have 1, 2, 3 or more roots.
disappear altogether.
  If the entire circumference grows
evenly, it will eventually form a mono-
rooted tooth.
 If 2 areas opposite one another grows
inward more rapidly and meet, it will
separate into 2 columns of root
formation to form birooted tooth.
 The formation of human permanent
teeth takes place over an extended
period of time.
 Time for ameloblasts and odontoblasts
3. Supernumerary teeth - Hyperactivity of
to form coronal enamel
dental lamina
o 3.5 years – permanent canine
o 3.1 to 3.4 years – premolar
o 2.1 years – first molars
o 2.8 years – second and third
molars
 Root formation takes an additional 5 to 4. During differentiation stage
9 years until the apex is completed.  Peg-shaped laterals

CLINICAL CONSIDERATIONS

 Developmental disturbances are

caused by genetics, trauma,
chemical and microbial irritation,
which may result in anomalies in
number, size, structure or shape of
 Gnarled enamel
tooth.
1. Dermoid tumor or cyst - Tooth develop
in abnormal locations like in ovary or in
hypophysis

2. Anodontia - Absence of initiation stage

Anomalies in number:  Dens Evaginatus
o Total anodontia – very rare
o Partial anodontia or
hypodontia
o Hyperdontia (supernumerary
teeth)
 5. During Apposition Stage MORPHOLOGIC ANOMALIES
 Enamel Hypoplasia – a
developmental defect that results
in inadequate enamel. In severe
cases, no enamel forms on teeth.
On standard cases, tooth enamel is
thin and weak

6. During Hardening Process

 Enamel Hypocalcification

TEETH VARY GREATLY IN SIZE AND SHAPE

 Macrodontia – oversized but with typical

form
 Microdontia – abnormally small but with
typical form
 Morphologic anomalies – gemination or
twinning, concrescence, fusion,
deformation and dilacerations
 Retarded eruption in persons with
hypopituitarism
 Hypothyroidism results in a small clinical
crown that often mistaken for a small
anatomic crown