Faculty of Dentistry

Oral Biology I
Tooth Development and Growth
Ø Tooth development or Odontogenesis takes place in many
stages, which occur in a stepwise fashion for both dentitions.
Ø Odontogenesis is a continuous process, and there is no
clear-cut beginning or end points between these stages.
Ø These stages of tooth development described according to
the morphology of the developing tooth as well as the
function and physiological changes that occur in the
developing tooth.
The primitive oral cavity
o At this stage the primitive oral cavity (Stomodeum) begins
as invagination between the forebrain and adjacent
ventrally developed heart.
o It is lined by primitive ectoderm formed of two layers:
Ø Basal layer of columnar cells separated from the
underlying primitive connective tissue
(ectomesenchyme) by a basement membrane.
Ø Superficial layer of flattened cells.
o Odontogenesis of the primary dentition begins between
the 6th and 7th WIU.
Neural crest cells
o They are group of cells coming from neuroectoderm
o They separate from the neural plate and migrate beneath
the epithelium along the entire free margin of the jaw.
o By then the oral mesenchyme is called ectomesenchyme.

Tooth Development Menatalla M. Elhindawy

 Faculty of Dentistry
Oral Biology I
Morphological stages of tooth development
The nomenclature of the developmental stages is based on the
shape of the developing tooth, which are:
1. Dental lamina.
2. Bud – stage.
3. Cap – stage.
4. Bell – stage (early and late).
1. Dental lamina
• During 6th WIUL, in the region of the future alveolar
processes, the underling ectomesenchyme cells induce the
oral epithelium to proliferate and invaginate into the
mesenchyme to form the primary epithelial bands.
• These bands are roughly
horseshoe shaped and
correspond in position to the
future dental arches of the
upper and lower jaws.
• By the 7th week the primary
epithelial bands divide into two
laminae, a buccally located
vestibular lamina and a
lingually situated dental lamina.
• The dental lamina is formed by proliferation of the basal
layer of the oral epithelium in the underlying mesenchyme.
• In certain areas the basal cells proliferate in a rapid rate
than the adjacent cells.

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 Faculty of Dentistry
Oral Biology I
Neural crest cells → Induction → Proliferation
of basal cell layer of oral epithelium → Dental
lamina
• The epithelial cells of the dental lamina form a sheet-like
structure of basal cell layer and superficial cell layer.
Ä The vestibular lamina
• Then the central cells of this lamina hollow out and
disintegrate to form a cleft (the oral vestibule) which is the
space between the maxilla and the mandible on one side
and lips and the cheeks on the other side.

2. Bud stage
• The tooth buds of deciduous teeth
develop by cell division of dental
lamina on its labial side.
• The cell division at this area of the
dental lamina is more rapidly than the adjacent cells to form
round or ovoid swellings (bud shape) of epithelial structure.
• The buds of the anterior deciduous teeth appear at first followed
by deciduous canine and deciduous molars.

Tooth Development Menatalla M. Elhindawy

 Faculty of Dentistry
Oral Biology I

• Histology of bud stage

I. The enamel organ (the
epithelial part) of bud stage
contains two types of cells that
separated from the underlying
ectomesenchymal condensation
by a basement membrane.
o Polygonal or rounded cells, which are centrally situated.
o Low columnar or cuboidal cells, which are peripherally
situated.
II. The condensation of ectomesenchyme cells beneath the
tooth bud is called the dental papillae and that encapsulating
the dental organ is called dental sac (tooth follicle).
Enamel organ + dental papilla + dental sac
=
tooth germ.
3. Cap stage
• The tooth bud continues to grow; it does not expand
uniformly into a larger sphere due to unequal growth in the
different parts of the enamel organ leading to a shallow
invagination on the deep surface of the bud.
• The enamel organ assumes a cap shape in appearance, and
it has a broad connection with the dental lamina.

Tooth Development Menatalla M. Elhindawy

 Faculty of Dentistry
Oral Biology I
• Histology of cap stage
I. Enamel Organ:
It is the epithelial tissue that shows three different
regions
o Outer dental epithelium (OEE)
§ It consists of a single layer of cuboidal epithelial cells
with deeply stained rounded nucleus.
§ Arranged at the outer convex surface of the enamel
organ.
o Inner dental epithelium (IEE)
§ It consists of a single layer of columnar epithelium with
deeply stained nucleus.
§ Arranged at the inner concave surface of the enamel
organ.
Ü The basement membrane is continuous all around the enamel
organ to separate the outer and inner enamel epithelium from
the surrounding mesodermal tissue
(dental sac and dental papilla).
o Stellate reticulum (SR)
§ It occupies the central portion of
the enamel organ between its
outer and inner enamel epithelia.
§ It consists of several layers of
branching star shaped cells. Their branches anastomose
(connect) with those of adjacent cells and with the outer
and inner enamel epithelium.

Tooth Development Menatalla M. Elhindawy

 Faculty of Dentistry
Oral Biology I
§ These cells synthesize and secrete glucose-
aminoglycans (GAGs) into the extracellular compartment
between the epithelial cells.
§ (GAGs) are hydrophilic (water loving) substances and so
pull water into the enamel organ.
§ The increasing amount of fluid increases the volume of
the extracellular compartment of
the enamel organ, so that the
cells of the organ are forced
apart. Since the cells retain
connections with each other
through desmosomal
attachment, they become star
shaped.
I. Ectomesenchyme
Ü The dental papilla
o Cell condensation that is partly enclosed by the concave IEE
o It is formed of
A: Cell rich zone contains undermaintained
mesenchymal cells (UDMCs), fibers and ground
substance.
B: Cell free zone at peripheral part of the dental papilla
underneath the enamel organ, it appears free from
cells but contains their cytoplasmic processes and fine
fibers.
Ü Dental Sac
o Cell condensation that surrounds the enamel organ and
dental papilla.

Tooth Development Menatalla M. Elhindawy

 Faculty of Dentistry
Oral Biology I
o In this zone, gradually a denser and more fibrous layer
develops.
Transitory structures
§ During cap stage, some transient
structures occur and those, are not
necessarily present in every tooth
germ, or present at the same time.
§ It disappears before the deposition of
tooth hard structure.
The enamel knot.
• It is clusters of non-dividing epithelial
cells localized at the center of the tooth
germ, in the region of the IEE.
The enamel cord.
• Appears as a stand of cells running from the enamel knot
to the OEE at a point of a small depression termed enamel
navel as it resembles the umbilicus that seems to divide
the dental organ into two halves.
NOTE: The function of these two structures is not known, but
evidence is emerging that both structures are involved in:
1- Determining the initial position of the first cusp of the
tooth during the crown pattern information.
2- It may give another type of the cells. Both structures
disappear before enamel formation begins.
3- May act as reservoir of dividing cells for the growing
dental organ.

Tooth Development Menatalla M. Elhindawy

 Faculty of Dentistry
Oral Biology I
4. Bell stage:
• The unequal growth of the epithelium of enamel organ
progresses and its margins continue to grow.
• The invagination becomes deeper, and the enamel organ
assumes a bell shape that surrounds such a large part of the
dental papilla.
• At first the tooth development can be considered as early bell
stage.
• Once the first layer of dentine is laid down it becomes
advanced or late bell stage.
« The Early Bell Stage
I. Dental lamina
The main dental lamina begins
to break up by mesenchymal
invasion which divides it into:
a. Lateral dental lamina that
connects the dental
organ with the main
dental lamina that carrying the enamel organ of the
deciduous tooth. It is present labially to the dental lamina
proper.
b. The dental lamina proper (Successional) carrying the
tooth germ of the permanent successors.
c. Permanent molars that have no deciduous teeth
preceding them arise from distal extension of dental
lamina.

Tooth Development Menatalla M. Elhindawy

 Faculty of Dentistry
Oral Biology I

II. Enamel organ

• Outer dental epithelium
o The cells of outer enamel epithelium decrease in
height and become low cuboidal.
• Inner dental epithelium
o These cells become tall columnar.
o Most of this elongation is towards the dental papilla
resulting in the disappearance of the cell free zone.
o As the IEE cells get in contact with the UDMCs of the
dental papilla.
o They exert an organizing
influence on the UDMCs to
differentiate into odontoblasts;
this process is known as
induction.
o At this stage the inner dental
epithelium begins to be arranged
on the basement membrane of
future amelodentinal junction.
• Stellate reticulum
o At this stage the stellate cells expand further apart
mainly by the increase of the intercellular fluid.
• Stratum intermedium
o It is composed of 2 – 3 layers of flat epithelial cells, and
is differentiated in between the IEE & SR.

Tooth Development Menatalla M. Elhindawy

 Faculty of Dentistry
Oral Biology I
o This layer seems to be essential for enamel formation
as they contain the enzyme alkaline phosphatase
which is essential for mineralization of
enamel.
• Cervical loop
• The IEE meets the OEE at a stable rim.
• It is a functional zone, important for the
future root formation.
III. Dental papilla
• At the end of the early bell stage the
differentiated odontoblasts at the periphery of the dental
papilla assume a cuboidal form then become columnar in
shape and acquire the specific potential to produce
dentine.
IV. Dental sac
• It shows a circular arrangement of its fibers resembling a
capsular structure.
• Its inner layer is more vascular
• The outer layer of the dental sac lies against the wall of
the bony crypt.
« Late bell stage
I. Dental lamina:
• By the deposition of the first layer of dentine, the lateral
dental lamina undergoes disintegration by mesenchymal
invasion of the dental sac.

Tooth Development Menatalla M. Elhindawy

 Faculty of Dentistry
Oral Biology I
• Remnants of the dental lamina may persist in the gingival
and the jaw and they are called epithelial rests of Serres
(Serres' pearls).
II. Enamel organ:
• It increases in size.
• Its cervical portion gives rise to epithelial root sheath of
Hertwig (ERSH)
• Its layers show the following changes:
• Outer dental epithelium
o When the first layer of dentin is laid down the nutrition of
the dental organ via the dental papilla will stop.
o Compensation will be created by folding of the smooth
surface of outer enamel epithelium to increase its
surface area and to elongate the extent of the outer
enamel epithelium which becomes in contact with the
nutrition donor, the adjacent mesenchyme.
o At the region of these folds the dental sac contains many
capillary loops, to provide a rich nutritional supply for the
intense metabolic activity of the
avascular enamel organ.
o At the same time the OEE
becomes flattened and
increased number of
mitochondria at the end facing
the capillary loops giving the cells
specialization for active transport
of materials.

Tooth Development Menatalla M. Elhindawy

 Faculty of Dentistry
Oral Biology I
• Inner dental epithelium
o Tall columnar reaching 40 microns in length
o Under the influence of the first formed dentin layer the
IEE will be stimulated to be differentiated into tall
columnar cells which have the power to produce enamel
matrix, called ameloblasts.
o The boundary between inner dental epithelium and
odontoblasts outlines the future dentino- enamel junction.
• Stellate reticulum
o The space needed for the developing enamel will be
attained through the shrinkage of the stellate reticulum
by the loss of the intercellular fluid, which later becomes
hardly distinguished from the stratum intermedium.
o The shrinkage begins at the height of the cusp or the
incisal edge and
progresses cervically.
• Stratum intermedium
o These layers show
strong reaction for
alkaline phosphatase
enzyme, which is
needed for the
mineralization of the enamel.

Tooth Development Menatalla M. Elhindawy

 Faculty of Dentistry
Oral Biology I
Histological stages of tooth development
This classification is based on the changes in the histophysiological
growth pattern. It is divided into
1. Initiation.
2. Proliferation.
3. Histodifferentiation.
4. Morphodifferentiation.
5. Apposition
1. Initiation
The dental lamina and tooth buds represent that part of the
oral epithelium that has potencies for tooth formation.
Initiation is set off by unknown factors where specific cells
contain the entire growth potentiality of certain tooth
development.
2. Proliferation
Proliferative activity is found in dental lamina, bud, cap,
early bell stage and late bell stage where the dental
matrices are not yet deposited. The unequal growth by
mitotic division causes regular changes in size and
proportions of the growing tooth germ.
3. Histodifferentiation

• In this stage the cells of the tooth germs undergo definite

morphologic as well as functional changes and thus
achieve their functional requirements.
• This phase reaches its highest development in the bell
stage just preceding the beginning of matrix formation. So,
the differentiation of ameloblasts and stratum intermedium

Tooth Development Menatalla M. Elhindawy

 Faculty of Dentistry
Oral Biology I
is essential for enamel formation, also the differentiation of
odontoblasts is important for the producing of dentine.
4. Morphodifferentiation
The morphologic pattern and relative size of the future tooth
is started at the early bell stage when the inner enamel
epithelium arranges them on the basement membrane. At
late bell stage the morphodifferentiation is established by
outlining the future amelodentinal junction and
amelocemental junction. The morphology of the tooth is
performed at this stage by differential growth of the formative
cells just prior to matrix deposition.
5. Apposition
The apposition is the deposition of the matrix of the hard
structures. It is confined to the late bell stage. The matrix is
deposited by the cells along the site outlined the formative
cells at the end of morphodifferentiation. The dentine and
enamel matrices are deposited in a rhythmic manner.

Tooth Development Menatalla M. Elhindawy