Chapter : Shedding of Deciduous Teeth

Question Bank

Short Notes

1. Define shedding, histology of shedding

2. Mechanism of resorption and shedding
3. Factors in shedding

Learn to write all the answers with relevant diagrams.

1. Define shedding, histology of shedding
Definition: The physiological process resulting in the elimination of deciduous
dentition is called shedding or exfoliation
Histology of shedding:
 The cells responsible for removal of hard tissues- Odontoclasts
 Origin- circulating monocytes- Tartrate resistant acid phosphatase (TRAP +
circulating monocytes. Localization: Pulp-dentin border or at the sites of
resorptions
 Identified: Large, Multinucleated occupying resorption bay on the surface of
the dental hard tissue
 Smaller than osteoclasts, fewer nuclei, smaller resorption lacunae
 Cytoplasm is vacuolated
 Surface resorbing- ruffled border – resolved as an extensive folding of the cell
membrane
 They are 2-3 microns in depth, having mineral crystallites
 Peripheral to the ruffled border, is a clear zone in which cytoplasm is devoid
of organelles.
 Clear zone represents- attachment apparatus of the odontoclast
 Cytoplasm of odontoclast: high of mitochondria +many vacuoles (increased
acid phosphatase)= highly concentrated along the ruffled border.
 Fusions of odontoclasts- multinucleated giant cells

Functions of Odontoclasts:

 Resorb the hard tissues (dentin, occasionally enamel)

 Similar way like osteoclast resorb bone
 On resorption of dentin, the presence of tubules provide a pathway for
extension of odontoclast processes.
4. Mechanism of resorption and shedding / Factors in shedding
 Prior to shedding of primary incisors, canines and molars, the roots of the primary
teeth are resorbed and their crowns shed.
 odontoclasts appear on the apical surface of the roots of the primary teeth, possibly
initiated by the pressure created by the dental sac of the erupting permanent teeth.
 However, even if a permanent tooth is missing, the primary predecessor usually
undergoes root resorption, although commonly at a much slower pace.
 The role of pulpal odontoclasts in this process is still being investigated.
Cementoblasts layer damaged by inflammatory process due to release of factors by reduced enamel epithelium of
successor teeth

Odontoclasts attahed to hard tissue surface peripherally through clear zone

A sealed space is created and lined by ruffled border of the cell

Membrane of the ruffled border acts as proton pump adding hydrogen ions to extracellular region

Acidification and mineral removal

Lysozomal enzyme degrade the organic matrix

Increased forces of mastication and increase in jaw size

Trauma in PDL

Breakdown of PDL

Shedding begins
Notes prepared by Dr Soumya Anandan

Reference: Orban’s 15th edition, chapter 14, Shedding of deciduous teeth

Images and diagrams: Google

Flowcharts: Self made