Significance of Dental

Anatomy, Histology,
Physiology, and
Occlusion
 Lesson Objectives

• Discuss the scope of Operative Dentistry

• Assess the importance of the anatomy of teeth in relation

to restoring the tooth/teeth’s function
Introduction to The Course

• What is Operative Dentistry?

• What are Factors Affecting the Treatment?

 Definition
• It is the art and science that relates to:

a. Diagnosis, treatment and prognosis of teeth defects

which do not require full coverage for correction.

b. Restoration of proper tooth form, function and esthetics.

c. Maintenance of physiologic integrity of human teeth in

harmonious relationship with the adjacent hard and soft
tissue.

(All these to enhance the general health and welfare of the

Patient)
 Factors Affecting the
Treatment
• Indication for procedure

• Other factors to consider prior to treatment:

a. Thorough exam of the patient’s entire oral and systemic

condition.

b. Diagnosis of the problem, recognizing its relationship

with other bodily tissues.

c. Treatment plan which can restore the affected area to

health and function, enhancing the overall well being of
patient.
d. Understanding the demands and limitations of the
restorative material to be used.

e. Understanding the oral environment into which the

material will be placed.

f. Biologic knowledge needed to make the previous

determination.

g. Appreciation for and knowledge of correct dental

anatomy.

h. Effects of the operative procedure on the treatment plan

of other disciplines.
i. Understanding of and appreciation for infection control
to safeguard health service personnel and the patient.

j. Understanding of the biological basis and functions of

the various tooth components of supporting tissues.
Dental Anatomy
What are the two sets
of DENTITION?
 Classifications of Teeth
(Based on Form and Function)
 Incisors

• Near the entrance of the

mouth/ Oral Cavity

• Proximal view is triangular in

shape with narrow incisal and
broad cervical base

• Fxn: for cutting and shearing

 Canines

• Located at the corners of the

dental arch; longest root
(stable abuttment/anchorage)

• Proximal view is triangular but

with thick incisal edge (stocky
crown)

• Fxn: seizing, piercing and

tearing of food
 Premolars

• Dual role:

- like canine - tearing

- like molars - grinding
 Molars

• Large multicusped and

strongly anchored teeth

• Fxn: crushing, grinding,

chewing food
4 Structures of the
Teeth
 Enamel

• Covers the anatomical crown

of the teeth; varied thickness

• Formed by the Ameloblasts

which originate from the
ectoderm.

• Semi-translucent: grayish
white, yellowish white
• Chemically : highly
mineralized crystalline
structure

• 95-98% inorganic matter

• Inorganic matter is composed

primarily of hydroxyapatite
which serves as the largest
mineral component.
• 1-2% organic

• 4% H2O by weight

• The hardest substance of the

human body.

• Very brittle and rigid unlike

dentin w/c is highly compressive
and serves as cushion.

• Requires dentin to be able to

stand masticatory stress;
unsupported enamel rods are
easily fractured.
• Enamel Rods or Prisms

- Largest structural component.

- Densely packed and
intertwined in a wavy course
w/c extend from DEJ to
external surface of the tooth

- Rods are aligned

perpendicular to both DEJ
and tooth except in cervical
region of permanent teeth and
is oriented outward in a
slightly apical direction.
• Enamel rods follow a wavy
spiraling course.

• Initially they follow a curving

path through 1/3 of the
enamel next to the DEJ

• Then follow a more direct path

to the enamel surf of the
remaining 2/3.
• Gnarled Enamel

- enamel rods that intertwine

with adjacent groups of rods
and they follow a curving
irregular path toward the
surface.

- occur near cervical, incisal

and occlusal regions.

- doesn’t yield readily to the

pressure of cutting
instruments in cavity
preparation.
• Enamel Tufts

- hypomineralized structure
which project between
adjacent groups of enamel
rods from DEJ.

- extends into dentin: may

play a role in caries spread.
• Enamel Spindles

- Odontoblastic processes
which cross DEJ into the
Enamel and whose ends are
thickened.

- Serve as pain receptors.

• DEJ - interface of enamel and
Dentin

• Scalloped or wavy with crests

penetrating towards the
enamel.
 Other Facts about the
E
• It is incapable or repairing itself once destroyed because the
ameloblast cell degenerates following enamel rod formation.

• Nasmyth’s membrane or Primary Enamel Cuticle - a

secretion of a membrane by the ameloblast considered as its
final act before it degenerates. This cuticle covers newly erupted
tooth/teeth but is worn away by mastication and cleaning.

• Pellicle - organic deposit which replaces the membrane.

- a precipitate of salivary proteins

- invaded by microorganisms to form bacterial plaque

• Enamel is permeable to certain ions and molecules.

• Permeability decreases with age due to changes in the

enamel matrix leading to enamel maturation.

• Soluble when exposed to acid medium (dissolution is not

uniform).

• Solubility increases from enamel surface of the DEJ

(outer: less soluble)
 Dentin

• forms the larges portion of the

tooth structure

• formed by cells called

odontoblasts.
 Difference from
Enamel
• Color - yellow-white but darker and less translucent.

• Reflectance - opaque and dull.

• Sound - when explorer is passed, dull unlike sharp, higher

pitch of enamel.

• Hardness - felling of greater yield to pressure than enamel

because dentin tends to catch and hold when scratched
with explorer.
• Less mineralized than enamel; hardness averages about
1/5 that of enamel.

• Chemically

- 75% inorganic

- 20% organic (collagen)

- 5% water
• Dentinal Tubules

- small canals that extend

across the entire Dentin
from DEJ or DCJ to the
pulp.

- course resembles a slight S-

curve in the crown.

- ends are perpendicular to

DEJ and DCJ.
• Primary Dentin

- Dentin formed before and

shortly after eruption
(completed 3 years after
eruption)

- forms the initial shape of the

tooth
• Secondary Dentin

- continuation of the primary

dentin.

- forms at a slower rate as the

tooth age (even without
external stimuli)
• Tertiary or Reparative
Dentin

- defense reaction to an area

of moderate-intensity injury.

- formed by replacement or
secondary odontoblast in
response to irritation.
• Example: when cavities are prepared

- Tomes processes are cut within 1.5mm from pulp. The

fibers die along with the odontoblasts and leaves dead
tracts.

- New odontoblasts are differentiated from mesenchymal

cells of pulp (appr 15days) and these replacements lay
down the reparative dentin and is localized in the irritated
area of the pulp cavity wall.

• Highly atubular so impervious to most irritants.

• Causes of Irritations: attrition, abrasion, erosion, trauma,

caries by way of walling off injury to the pulp.
• Dead Tracts

- Regions of empty tubules in

primary dentin which results
in degeneration of odontic
processes.
• Sclerotic Dentin

- harder, denser, less

sensitive

- also known as transparent

dentin.

- Results from: aging thru

physiological dentin
sclerosis or mild irritation
thru reactive dentin
sclerosis.
 Cementum
• hard dental tissue covering
the anatomical roots of teeth.

• formed by cementoblasts.

• softer than dentin (slightly)

• Chemically:

- 45 to 50% inorganic
(hydroxyapatite)

- 50 to 55% organic matter

and water
• Light yellow and slightly lighter than dentin (but darker than
enamel)

• Has highest Fluoride content of all mineralized tissue yet

permeable to a variety of materials.

• Formed continuously thru life because a new layer is deposited to

keep the attachment intact as the outer layer ages.

• Fxn:

- Attachment of periodontal ligaments

- Compensates for occlusal wearing.

- Main reparative tissue of the root.

• Types:

- Accelular - coronal half

- Cellular - apical half

 Pulp

• Occupies the pulp cavity of

the tooth.

• Surrounded by dentin and

lined by odontoblasts.
• Parts

- Coronal pulp - in the pulp

chamber including pulp
horns (cusp tips or incisal
ridges)

- Radicular pulp - in the pulp

canals in root portion.
Continuous with periapical
tissue by connecting thru
apical foramen.
• Composition:

- Myelinated and unmyelinated nerves

- arteries
- veins
- lymph channels
- CT cells
- intercellular substances
- odontoblasts
- collagen and fine fibers
- macrophages
• Pulp - unique specialized organ with the ff functions:

- Formative - produce primary and secondary dentin thru

odontoblasts.

- Nutritive - supplies nutrients and moisture to the dentin.

- Sensory - provides sensory nerve fibers within pulp to mediate
sensation of pain (protective)

- Defense - as a response to irritation, produces reparative dentin

(reparative) 100 days = 0.12mm reparative dentin
• With age it decreases in size, becomes more fibrous
because of irritation.

• Contour and size - miniature contour of the external

surface of tooth.
 Pulp Irritants
• Injudicious cutting of dentin

‣ Pulp reaction depends on depth of cutting

‣ > # of tubules cut, > reaction

• Heat (Thermal) produced during cavity preparation

‣ heat is a very good irritant so water coolant should be

used to minimize pulp reaction during drilling.

‣ metallic restorations are not pulp friendly due to

conductivity.
• Chemical irritants

‣ from fillings, acidic cements (e.g. Zinc Phosphate thru

phosphoric acid)

‣ composites

• Mechanical forces / irritants

‣ forces on dentin will be transmitted to the pulp

‣ condensation forces, masticatory forces

 Fxn Of Teeth

• Mastication

• Esthetics

• Speech

• protection to supporting tissues