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The human teeth function to mechanically break down items of food by cutting and crushing them in preparation for swallowing and digesting. Humans have four types of teeth: incisors, canines, premolars, and molars, which each have a specific function. The incisors cut the food, the canines tear the food and the molars and premolars crush the food. The roots of teeth are embedded in the maxilla or the mandible and are covered by gums. Teeth are made of multiple tissues of varying density and hardness.
Cementum is a specialized calcified substance covering the root of a tooth. The cementum is the part of the periodontium that attaches the teeth to the alveolar bone by anchoring the periodontal ligament.
Tooth enamel is one of the four major tissues that make up the tooth in humans and many other animals, including some species of fish. It makes up the normally visible part of the tooth, covering the crown. The other major tissues are dentin, cementum, and dental pulp. It is a very hard, white to off-white, highly mineralised substance that acts as a barrier to protect the tooth but can become susceptible to degradation, especially by acids from food and drink.. In rare circumstances enamel fails to form, leaving the underlying dentin exposed on the surface.
Dentin or dentine is a calcified tissue of the body and, along with enamel, cementum, and pulp, is one of the four major components of teeth. It is usually covered by enamel on the crown and cementum on the root and surrounds the entire pulp. By volume, 45% of dentin consists of the mineral hydroxylapatite, 33% is organic material, and 22% is water. Yellow in appearance, it greatly affects the color of a tooth due to the translucency of enamel. Dentin, which is less mineralized and less brittle than enamel, is necessary for the support of enamel. Dentin rates approximately 3 on the Mohs scale of mineral hardness. There are two main characteristics which distinguish dentin from enamel: firstly, dentin forms throughout life; secondly, dentin is sensitive.
Ameloblasts are cells present only during tooth development that deposit tooth enamel, which is the hard outermost layer of the tooth forming the surface of the crown.
The enamel organ, also known as the dental organ, is a cellular aggregation seen in a developing tooth and it lies above the dental papilla. The enamel organ is responsible for the formation of enamel, initiation of dentine formation, establishment of the shape of a tooth's crown, and establishment of the dentoenamel junction.
The dental lamina is a band of epithelial tissue seen in histologic sections of a developing tooth. The dental lamina is first evidence of tooth development and begins at the sixth week in utero or three weeks after the rupture of the buccopharyngeal membrane. It is formed when cells of the oral ectoderm proliferate faster than cells of other areas. Best described as an in-growth of oral ectoderm, the dental lamina is frequently distinguished from the vestibular lamina, which develops concurrently. This dividing tissue is surrounded by and, some would argue, stimulated by ectomesenchymal growth. When it is present, the dental lamina connects the developing tooth bud to the epithelium of the oral cavity. Eventually, the dental lamina disintegrates into small clusters of epithelium and is resorbed. In situations when the clusters are not resorbed, eruption cysts are formed over the developing tooth and delay its eruption into the oral cavity. This invagination of ectodermal tissues is the progenitor to the later ameloblasts and enamel while the ectomesenchyme is responsible for the dental papilla and later odontoblasts.
Tooth development or odontogenesis is the complex process by which teeth form from embryonic cells, grow, and erupt into the mouth. For human teeth to have a healthy oral environment, all parts of the tooth must develop during appropriate stages of fetal development. Primary (baby) teeth start to form between the sixth and eighth week of prenatal development, and permanent teeth begin to form in the twentieth week. If teeth do not start to develop at or near these times, they will not develop at all, resulting in hypodontia or anodontia.
Amelogenesis is the formation of enamel on teeth and begins when the crown is forming during the advanced bell stage of tooth development after dentinogenesis forms a first layer of dentin. Dentin must be present for enamel to be formed. Ameloblasts must also be present for dentinogenesis to continue.
In embryology and prenatal development, the dental papilla is a condensation of ectomesenchymal cells called odontoblasts, seen in histologic sections of a developing tooth. It lies below a cellular aggregation known as the enamel organ. The dental papilla appears after 8–10 weeks intra uteral life. The dental papilla gives rise to the dentin and pulp of a tooth.
The inner enamel epithelium, also known as the internal enamel epithelium, is a layer of columnar cells located on the rim nearest the dental papilla of the enamel organ in a developing tooth. This layer is first seen during the cap stage, in which these inner enamel epithelium cells are pre-ameloblast cells. These will differentiate into Ameloblasts which are responsible for secretion of enamel during tooth development.
The cervical loop is the location on an enamel organ in a developing tooth where the outer enamel epithelium and the inner enamel epithelium join. The cervical loop is a histologic term indicating a specific epithelial structure at the apical side of the tooth germ, consisting of loosely aggregated stellate reticulum in the center surrounded by stratum intermedium. These tissues are enveloped by a basal layer of epithelium known on the outside of the tooth as outer enamel epithelium and on the inside as inner enamel epithelium. During root formation the inner layers of epithelium disappear and only the basal layers are left creating Hertwig's epithelial root sheath (HERS). At this point it is usually referred to as HERS instead of the cervical loop to indicate the structural difference.
The stratum intermedium in a developing tooth is a layer of two or three cells between the inner enamel epithelium and the newly forming cells of the stellate reticulum. It first appears during the early bell stage of tooth development, at around the 14th week of intrauterine life. The stratum intermedium has a notably high alkaline phosphatase activity. This layer, along with the inner enamel epithelium, is responsible for the tooth enamel formation. It is a part of the dental (enamel) organ.
The reduced enamel epithelium, sometimes called reduced dental epithelium, overlies a developing tooth and is formed by two layers: a layer of ameloblast cells and the adjacent layer of cuboidal cells from the dental lamina. As the cells of the reduced enamel epithelium degenerate, the tooth is revealed progressively with its eruption into the mouth. The degeneration of reduced enamel epithelium also mediates the initial epithelial attachment to the tooth, which is called the junctional epithelium.
The vestibular lamina is responsible for the formation of the vestibule and arises from a group of cells called the primary epithelial band. This band is created at about 37 days of development in utero. The vestibular lamina forms shortly after the dental lamina and is positioned right in front of it. The vestibule is formed by the proliferation of the vestibular lamina into the ectomesenchyme. The vestibular lamina is usually contrasted with the dental lamina, which develops concurrently and is involved with developing teeth. Both the vestibular lamina and the dental lamina arise from a group of epithelial cells, called the primary epithelial band.
Botryoid odontogenic cyst is a variant of the lateral periodontal cyst. It is more often found in middle-aged and older adults, and the teeth more likely affected are mandibular (lower) canines and premolars. On radiographs, the cyst appears "grape-like". Often patients with this condition are symptomatic.
An ameloblastic fibroma is a fibroma of the ameloblastic tissue, that is, an odontogenic tumor arising from the enamel organ or dental lamina. It may be either truly neoplastic or merely hamartomatous. In neoplastic cases, it may be labeled an ameloblastic fibrosarcoma in accord with the terminological distinction that reserves the word fibroma for benign tumors and assigns the word fibrosarcoma to malignant ones. It is more common in the first and second decades of life, when odontogenesis is ongoing, than in later decades. In 50% of cases an unerupted tooth is involved.
An odontoma, also known as an odontome, is a benign tumour linked to tooth development. Specifically, it is a dental hamartoma, meaning that it is composed of normal dental tissue that has grown in an irregular way. It includes both odontogenic hard and soft tissues. As with normal tooth development, odontomas stop growing once mature which makes them benign.
The junctional epithelium (JE) is that epithelium which lies at, and in health also defines, the base of the gingival sulcus. The probing depth of the gingival sulcus is measured by a calibrated periodontal probe. In a healthy-case scenario, the probe is gently inserted, slides by the sulcular epithelium (SE), and is stopped by the epithelial attachment (EA). However, the probing depth of the gingival sulcus may be considerably different from the true histological gingival sulcus depth.
Enamel hypoplasia is a defect of the teeth in which the enamel is deficient in amount, caused by defective enamel matrix formation. Defects are commonly split into one of four categories, pit-form, plane-form, linear-form, and localised enamel hypoplasia. In many cases the enamel crown has pits or a groove on it, and in extreme cases, sections of the tooth have no enamel, exposing the dentin. Enamel hypoplasia varies substantially among populations and can be used to infer health and behaviour in past populations. Defects have also been found in a variety of non-human animals.
References
- Cate, A.R. Ten. Oral Histology: development, structure, and function. 5th ed. 1998. ISBN 0-8151-2952-1.
- Orban's Oral Histology and Embryology edited by GS Kumar, 12 edition