Beruflich Dokumente
Kultur Dokumente
V.NIVEDHA
First year MDS
14.07.2017
CONTENTS:
History
Introduction
Stages of tooth development
Physical properties
Composition
Dentinal tubules
Peritubular dentin
Intertubular dentin
Predentin
Dentino-enamel junction
Odontoblasts
Primary denin
CONTENTS
Secondary dentin
Tertiary dentin
Incremental lines
Interglobular dentin
Granular layer
Innervation of dentin
Age and functional changes in dentin
Dentinal fluid
Clinical considerations
Developmental disturbances
New study,facts and evolution
HISTORY
1891 – Von Ebner gave the term – Ebner’s growth lines or Imbrication lines .
Second layer of the tooth Structure that provides the bulk and
general
form of the tooth
CAP STAGE
The tooth bud assumes the shape of a cap that is surrounded by the
dental papilla.
Dental organ assumes the shape of a bell as cells continue to divide but at
differential rates.
A single layer of cuboidal cells called the external or outer dental epithelium,
lines the periphery of the dental organ
Cells that border the dental papilla and are columnar in appearance form the
internal or inner dental epithelium.
The inner epithelium gives rise to the ameloblasts, cells responsible for
enamel formation and outer enamel epithelium leads to the formation of
mineralised dentin.
In the region of the apical end of the tooth organ, the internal and external
dental epithelial layers meet at a junction called the cervical loop.
These extends apically to form the Hertwigs Epitheial root sheath which
forms the root dentin
LATE BELL STAGE
The dental lamina that connects the tooth organ to the oral epithelium
gradually disintegrates at the late bell stage.
Colour
Consistency
Proteoglycans Phospholipids
Growth factors:
Starts at right angles at the pulpal surface, the first convexity of this
doubly curved course is directed towards the apex of the tooth
These tubules end perpendicular to the DEJ & CDJ
It is almost straight near the root tip and along the incisal edges and
cusps
No. of tubules per square millimeter varies from 15000 at the DEJ
to 65000 at the pulp – density and diameter increases with depth
There are more tubules per unit area in the crown than in the root
PERITUBULAR DENTIN
Calcified tubule wall has an inner organic lining termed the Lamina Limitans
which is high in glucosaminoglycans
INTERTUBULAR DENTIN
The processes are largest in diameter near the pulp and taper further
into dentin The odontoblast cell bodies are approximately 7µm in
diameter & 40µm in length 37
PRIMARY DENTIN
Mantle dentin is the first formed dentin in the crown underlying the DEJ
Regular in structure
It is the outer or most peripheral part of the primary dentin and is about
150µm thick
CIRCUMPULPAL DENTIN:
Circumpupal dentin forms the remaining primary dentin or the bulk of the
tooth
The collagen fibrils are much smaller in diameter and are more closely
packed together
The course of the lines indicates the growth pattern of the dentin
INTERGLOBULAR DENTIN
These nerves and their terminals are found in close association with
the odontoblasts process within the tubule
THEORIES
TRANSDUCTION THEORY
Vitality of dentin
Although after the teeth have erupted and have been functioning for
a short time, dentinogenesis slows and further dentin formation is at
a slower rate. This is secondary dentin Pathologic changes in dentin
such as dental caries, abrasion, attrition or the cutting of dentin in
operative procedures cause changes in dentin. They are the dead
tracts, sclerosis and the addition of reparative dentin
REPARATIVE DENTIN
This reparative dentin has fewer and more twisted tubules than
normal dentin
Histological difference between reactionary and reparative dentin is
that reactionary dentin is deficient in acid proteins so it doesn’t stain.
• Also serve as a vehicle for egress of bacteria from a necrotic pulp into
periradicular tissue
CLINICAL CONSIDERATIONS:
“Exposure of Dentinal Tubules”
Smear Layer - term most often used to describe the grinding debris
left on dentin by cavity preparation
THE DENTINAL BRIDGE repair tissue that forms across the pulpal
wound.
Ellis Class I
Enamel fracture: This level of injury includes crown fractures that
extend through the enamel only. These teeth are usually nontender and
without visible color change but have rough edges.
Ellis Class II
Enamel and dentin fracture without pulp exposure: Injuries in this
category are fractures that involve the enamel as well as the dentin
layer. These teeth are typically tender to the touch and to air exposure.
A yellow layer of dentin may be visible on examination.
Ellis Class III
Crown fracture with pulp exposure: These fractures involve the enamel, dentin,
and pulp layers. These teeth are tender (similar to those in the Ellis II category)
and have a visible area of pink, red, or even blood at the center of the tooth.
Ellis Class IV
Traumatized tooth that has become non-vital with or without loss of tooth
structure.
Ellis Class V
Luxation: The effect on the tooth that tends to dislocate the tooth from the
alveolus.
Teeth loss due to trauma.
Ellis Class VI
Ellis Class IX
Fracture of deciduous teeth.
TREATMENT OF CLASS II ELLIS
Simple restorations
PIGMENTATION:
Tetracycline Pigmentation
1.etching removes smear layer and exposes collagen fibers .It also
removes hydroxy apetite with in the intertubular dentin
The above picture shows how a cut dentin surface is covered with
such a "smear layer."
This picture shows how the smear layer covers the dentin and form
so called "smear plugs."
Before any serious bonding attempt can be made, this "smear" layer
must be removed. Such a removal is achieved with a so-called
"conditioner." In most cases, the conditioner consists of an acid.
Dentin should be etched for 15 - 30 s. During this time, the smear
layer is removed and the outer surface of the dentin is demineralized
leaving a demineralized collagen mesh, attached to the mineralized
dentin located a few microns under the collagen surfaces.
The above figure shows how the dentin surface looks after it has
been etched for 15 s.
As long as this collagen mesh remains moist, it is fluffy. However,
if it is desiccated, the mesh structure densifies.
• This gap then fills with fluid from the outflow of tubules or saliva
from external surface.
CLINICAL FEATURES
However in case of D.I III with thin root are not good cases for
full coverage because of cervical fractures.
TYPE I- RADICULAR
TYPE II – CORONAL
TYPE I(RADICULAR) TYPE II (CORONAL) CLINICAL
FEATURES
RADIOGRAPHIC FEATURES
• No treatment
CLINICAL FEATURES:
RADIOGRAPHIC FEATURES:
“Ghost Teeth.”
HISTOLOGIC FEATURES:
TREATMENT
Radiographically-
The activation of stem cells in the centre of teeth works to repair small
cracks and holes in dentine. Enhancing this ability could allow the
tooth’s own cells to rebuild cavities.
The new treatment would not eliminate the need for the dentist’s drill,
however, since decaying sections of the tooth would still need to be
removed..
M.brannstrom,odont.dr