SEQUENCE AND TIMING

OF DENTAL GROWTH
DIVISION OF FORENSIC ODONTOLOGY
FACULTY OF DENTAL MEDICINE UNIVERSITAS AIRLANGGA
Dental growth is an important basis in dental age estimations, it is
considered useful in forensic matters.
Tooth Development
(Odontogenesis)
THERE ARE MULTIPLE STAGES IN TOOTH
DEVELOPMENT
• initiation stage – 6th to 7th week
• bud stage – 8th week
• cap stage – 9th to 10th weeks
• bell stage – 11th to 12th weeks
• apposition stage – vaires per tooth
• maturation stage – varies per tooth
Initial stages

• induction of ectodermal tissues by the developing mesenchyme

• at the 6th week the stomatodeum is lined with ectoderm – outer
portion is the
oral epithelium ~ the primary epithelial bands
• a developing mesenchyme which contains neural crest cells that
have migrated
to the area
the primary epithelial bands

• there are two subdivisions: vestibular lamina and

dental lamina
• dental lamina ~ develops in the future spot for
the dental arches
• vestibularlamina ~ forms a cleft that becomes
the vestibule of the oral cavity
Bud Stage
• period of extensive proliferation and growth of the dental lamina
• formsinto buds ~ each tooth bud is surrounded by the
mesenchyme
• buds + mesenchyme develop into the tooth germ and the
associated tissues of the tooth
 Cap Stage

• tooth bud of the dental lamina proliferates ~ forms a cap shaped tissue
attached to the remaining dental lamina
• this stage marks the beginning of histodifferentiation
• a depression forms in the deepest part of each tooth bud and forms the
cap or enamel organ (or dental organ) – produces the future
enamel(ectodermal origin)
• below this cap is a condensing mass of mesenchyme – dental papilla –
produces the future dentin and pulp tissue (mesenchymal origin)
• the basement membrane separating the dental organ and the dental
papilla ~ dentinoenamel junction (DEJ)
• remaining
mesenchyme surrounds the dental/enamel organ and
condenses to form the dental sac or the dental follicle
• the enamel organ + dental papilla + dental follicle is considered
the developing tooth germ or tooth primordium
• these primordium will be housed in the developing dental arches
and will develop into the primary dentition
 Bell Stage

• Continuation of histodifferentiation and morphodifferentiation

• differentiation produces four types of cells within the enamel/dental
organ
• 1. inner enamel epithelium
• 2. outer enamel epithelium
• 3. stellate reticulum
• 4. stratum intermedium
• the dental lamina is separated from the dental organ
• the dental papilla undergoes differentiation and produces two types of
cells
• 1. outer cells of the DP – forms the dentin-secreting cells (odontoblasts)
• 2. central cells of the DP – forms the primordium of the pulp
• during the cap stage the development of the permanent
dentition begins – anterior teeth
• theprimordia for these teeth appears as an extension off the
developing dental lamina
• penetrates into the mesenchyme lingual to the primary
primordium
Appositional stage
• secretion of enamel, dentin and cementum
• these tissues are initially secreted as a matrix that is partially
calcified
Maturation stage
• characterized by the completion of calcification
• Week 14:
Dental Lamina degeneration (disconnection between teeth and oral epithelium)
• Week 28 :
- Ameloblast ~ enamel
- Odontoblast ~ predentin ~ dentin
• 6 Month postnatal :
Early deciduous eruption
• 18 Month Postnatal:
All deciduous teeth has been perfectly erupted, permanent incisive crown has
been formed
INTRAUTERINE TOOTH FORMATION SEQUENCE

• Week 14
First deciduous incisive is seen, followed by second deciduous incisive, an
canine
• Dentine and enamel matrix deposition in anterior teeth  Middle line in
incisal edge
Afterwards :
I : Deposition on Mesial and Distal
C : Stays on “simple conical” form
M : cusp formation -> MB-ML-DB-DL
In lower molar, distal cusp formed last, after all cusps has been formed,
ridge formation commence
Lower M1 permanent has been form in-utero

Lower M1 permanent  DB cusp has been formed in week 36 (when

baby is born)
When born Deciduous molars has been a guidance for tooth
eruption
POSTNATAL DEVELOPMENT SEQUENCE
Permanent incisives ( except I2 RA ) started about 3-4 months
after born
Upper first I started in the same time as Upper I2 , Lower I is just
a bit after
Canine crown formed 1 month after Upper I2
P1 P2 and M2 started in the last year 3
M1 permanent crown has been formed about 3 years old followed
by incisives in 4 or 5 years, C and P1 about 6 y.o
P2 and M2 around 7 y.o after born
M1 permanent and incisives usually formed from root formation, it
is perfectly formed around 9-12 y.o, the rest is formed after 12 y.o
M3 permanent having a classification by it self, some cases record
that it hasn’t been formed until later in later juvenile years.
Development varied between 7-13 y.o.
Eruption

• Phases of tooth eruption

• Preeruptive phase: All movements of primary and permanent

tooth germs (crowns) from time of their early initiation and
formation to the time of crown completion (ends with early
initiation of root formation)
• Eruptive phase: Starts with initiation of root formation and
made by teeth to move from its position within bone of the jaw
to its functional position in occlusion.
~ 4 stages: root formation, movement, penetration and occlusal
contact
• Posteruptivephase: Takes place after the teeth are functioning
to maintain the position of the erupted tooth in occlusion while
the jaws are continuing to grow and compensate for occlusal
and proximal tooth wear
Tooth Eruption
1. Alveolar emergence
2. Gingival emergence
3. Entry of the crown into occlusion
4. Exfoliation of deciduous tooth
Chronology of Human Permanent Dentition
Summary
PRIMARY TEETH
• By 5 months in utero, all crowns started calcification
• By 1 year old, all crowns completed formation
• By 2.5 years, all primary teeth erupted
• By 4 years old, all primary teeth completed root formation
PERMANENT TEETH
• At birth, four 1st molars have initiated calcification
• At 4 years of age, all crowns have initiated calcification
• At 8 years, all crowns are completed
• At 12 years, all crowns emerge
• At 16 years, all roots are complete
@FORENSICODONTOUNAIR