Why can enamel not renew itself?

:
Because the ameloblast cells that form the enamel are lost when the tooth erupts.
What are the physical characteristics of enamel? :
1. It is extremely mineralized so extremely hard. 2. It is translucent and varies
from light yellow to gray-white. 3. It varies in length and can go up to approx
2.5mm
High mineral content plus its crystalline structure allows what for enamel? :
To withstand the mechanical forces applied during eating.
Why is it difficult to study enamel? :
Because of its highly mineralized nature which get dissolved by regular staining
methods.
Enamel made from ___________ crystals, which span ______ in width/thickness and ___
in length:
carbanapatite crystals, 25-30 nm in thickness, 70nm in width, and upto 2.5mm in
length
What shape do the crystals have while maturing? what about fully mature enamel? :
They have a hexagonal shape. but fully mature ones have an irregular outline
because they press against each other.
What is present between the rods and interrods? What is it called and made up of:
The rod sheath surrounds around 3/4 of the rod and is where organic material is
present.
Basic organizational pattern of enamel:
cylindrical rods embedded in interrod enamel
2 Steps of Amelogenesis:
Stage 1: Mineralization 30% Stage 2: Mineralization 96%
Ameloblasts secrete ______ and are responsible for _________ :
Secrete matrix proteins and responsible for maintain an ECF favorable for
mineralization.
3 phases:
presec, secretory, maturative
4 things in pre-secretory:
1. acquire phenotype 2. change in polarity 3. extensive protein synthetic apparatus
4. prepare to secrete organic matrix
Secretory phase:
ameloblasts elaborate and organize entire enamel thickness
Maturation phase:
ameloblasts modulate and transport ions for mineralization.
Where does enamel formation start?:
At the tips of the cusp outlines then it sweeps down the slopes of the tooth until
all cells have differentiated into ameloblasts.
(p. 125) When differentiation occurs, the distancing of the ameloblasts from the
vascular supply in the dental papilla is compensated by:
blood vessels that invaginate OEE and SR reduction so Amelos are closer to the
vessels
At which tooth dev stage can most of the light microscopic features of amelognesis
be seen?:
Late bell stage
What are the light microscopy features of amelogenesis? :
1. IEE, SR, SI, and OEE are visible. 2. IEE become ameloblasts and secrete enamel
proteins and first layer of rodless enamel. 3. They then move away from dentin and
then Tomes process of cytoplasmic extension can be seen displayign a saw-toothed
appearance at junction. 4. At maturation, can see the ameloblasts shrink into
squatter maturation cells and SR OEE and SI reorganize to form the papillary layer
5. When enamel is mature, PL and ameloblast layer make the REE.
When is the papillary layer formed by what and at which stage? :
At the maturation stage, SR OEE and SI reorganize and blood vessels invaginate to
form a convoluted structure called the papillary layer
When is the reduced enamel epithelium formed and by what?:
Ameloblasts + Papillary layer
7 functional stages of ameloblasts(based on diagram on p125 which u also need to
memorize) :
1. morphogenetic 2. histodifferentiation 3. initial secretory (no tomes) 4.
secretory (tomes) 5 ruffle ended ameloblast of maturative 5. smooth ended
ameloblast of maturative 7. protective stage
Then after modulation ends what do ameloblasts do?:
they reduce their size and assume a low cuboidal to flattened appearance.
what is the funciton of that epithelium of such ameloblasts?:
it doesn't secrete but has a protective function.
The REE remains until:
the tooth erupts
what is the fate of REE after eruption? :
the REE situated incisally is destroyed whereas that found more cervically
interacts with oral epthelium to form the junctional epithelium.
Electron microscopy: Describe the Morphogenetic phase:
1. This is during late bell stage so shape of crown is determined 2. A basal lamina
is present between DP and IEE. 3. Dentin is not mineralized. 4. Cells are cuboidal
or low columnar with large CENTRALLY located nuclei and poorly developed Golgis in
the proximal side, they also can undergo mitotic division 5. Junctional complex
exists near proximal ends.
Electron microscopy: Describe the Differentiation phase:
IEE differentiate into ameloblasts: elongate and nuclei shift proximally towards
SI.
From the presec to the secretory phase, what maintains ameloblast alignment? :
Junctional complexes.
Where are these JC's located? :
distal and proximal side.
What do they form via actin?:
terminal webs
These play a role in:
1. tightly holding ameloblasts together and determining at different times what may
and may not pass between them.
Secretory phase: Describe changes in Golgi and what it's doing:
Forms a cyclyndrical organelle surrounded by RER, the RER makes proteins then go to
golgi for posttranslational modification and then are packaged as secretory
granules and sent to tomes process.
Why does the initial layer of enamel not contain rods? :
Only the intial proximal portion of tomes process is formed at that time so it
quickly secretes enamel released against the newly formed mantle dentin.
After the initial layer is formed, ameloblasts do what and what is developed?:
they migrate away from the dentin surface and develop the distal portion(which goes
beyond the intial layer) of tomes process as an outgrowth of the proximal portion.
Distal portion of Tomes vs proximal portion? :
Proximal comes first and makes interrod enamel and distal is an extension of the
proximal making the rods of the enamel and penetrating to a deeper layer within the
enamel.
Fate of the distal process?:
Eventually is squezed out and creates a narrow space that fills with organic
material making the rod sheath
Why is there no rods in the last layer of enamel?:
Because rods are formed by the distal portion of Tomes and that was removed from
existence by this point, the last layer don't contain rods just like the first
layer didn't.
Transitional phase maturation?:
Decrease in ameloblasts size and content as well as 25% apoptosis
Two phases of apoptotic death?:
latent phase: cell looks normal but making preparations for death. execution phase:
series of dramatic structural and biochemical changes that culminate in the
fragmentation of the cell into membrane-enclosed apoptotic bodies.
Activities that cause cell apoptosis: _______, and those that prevent it are
________:
propapoptotic activites, vs antiapoptotic activites.
Two types of cell death:
necrosis (accidental cell death due to injury to the cell, membrane swells, lytic
enzymes destroy contents and release to ECF) and programmed cell death (apoptosis
is one type of this characterized by pattern of morphologic changes).
Family of proteins that is a major regulator of apoptosis :
BCL-2 family
Maturation proper phase :
Removal of water and organic material and mineralization via modulation!
Does mineralization lead to more crystals in maturation phase?:
Nope, just an increase in thickness and width of preexisting crystals.
Amelogenesis is a ______ process that can take up to _____:
slow process, up to 5 years
Modulation in some species happens as fast as ____ /day :
8 hours a day
Ruffle ended ameloblasts:
1. have considerable endocytotic actiity 2. contain numerous lysosomes, calcium-
binding proteins and ATPases
Smooth:
leak proteins, show little endo activity, no AtPase acitivity
How is the organic matrix withdrawn from maturing enamel? :
bulk-degrading enzymes that digest proteins into smaller fragments able to leave
the enamel layer! thought to leave via leaky junctions of smooth ended ameloblasts.

Ruffle ended allow for and smooth ended allow for:

ruffle ended allow for inorganic material incorporation and smooth ended allow for
protein fragment and water exiting
P141: Proteins... 90% of enamel proteins are:
Amelogenins! Low MW.
10%:
nonamelogenins(duh)
the 90% are:
amelogenins are main proteins forming enamel...they are hydrophobic and rich in
proline histidine and glutamine and 5-45 kDA AND regulate growth in thickness and
width of crystals.
They must be ____ to permit subsequent enlarging of crystals during maturation:
removed!
the 10% are:
are NONamelogenins believed to promote and guide the formation of the cyrstals.
Two common nonamelogenins?:
ameloblastin and enamelin
Ameloblastin:
Less than amelogenin, believed to assist ameloblasts in adhering to the forming
enamel surface
Enamelin:
Largest and least abundant believed to promote cyrstal elongation and to function
as a modulator for mineral formation.
Proteins involved in degradation of the matrix:
Enamelysin and Protease KLK4
Enamelysin:
Believed to cleave amelogenins.
enamel matrix serine protease (KLK4):
slowly degrades amelogenins into small polypeptides
Amelotin:
Related to the basal lamina covering maturative enamel
ODAM:
Related to the basal lamina.
SCPPPQ1:
Related to the basal lamina.
Why are there different structural and organizational features of enamel instead of
one uniform consistency?:
1. They are veritcal near cusp tip and horizontal near cervical side. 2. Rods
follow an irregular pattern of bending 3. In nearly 2/3 enamel, Adjacent groups of
rods intertwine and have dissimilar local orientations
5 types of features mentioned:
1. Striae of Retzius. 2. Cross Striations 3. Hunter Schreger Bands 4. Gnarled
Enamel 5. Enamel Tufts and Lamellae
Striae of Retzius:
Longitudinal: extending from DEJ toward surface, Cross: concentric rings. Weekly
rhythm of enamel production.
2 types of Retzius:
Neonatal line which when present is an enlarged stria representing great
physiologic changes at birth. And accentuated incremental lines can also be
produced by systemic disturbances (fever) that affect amelogensis.
Cross Striations:
Periodic bands at 4 nm intervals.
Hunter Schreger Bands:
Optical phenomen produced by changes in direction between adjacent group of rods
that are found in inner two thirds of enamel.
Gnarled Enamel:
Over the cusps of teeth the rods appear twisted around each other, they are caused
by undulation of vertically directed rods around a ring of small circumference.
Enamel Tufts and Lamellae:
likened to geological faults. TUFTS: DEJ into enamel and branched, LAMELLAE: from
surface down, linear and with organic material. Cracks don't have organic material
like lamellae do.
DEJ :
Junction of the two, the crystals of both intermix and is a series of ridges rather
than spikes, that probably increases adherence of the two.
Enamel spindles:
Some odontoblast that extend into the ameloblast layer and when enamel formation
begins become trapped. Most commonly found at cusp tips.
Age Changes:
Worn out, discoloration, reduced permeability, and modifications of the surface
layer. Topical application of fluoride also affects it.
Fluoride does what to the equilibrium of calcium and phosphate:
the equilibrium between these two ions in the saliva and in the enamel and fluoride
shifts the equilibrium to favor the enamel.
Fluoridation:
At a certain threshhold, more fluoride ions leads to enamel being more resistant to
acid dissolution. Fluoride causes reactions that lead to the preicipitation of
calcium phosphate.
Acid etching and its two steps?:
Technique used in clinical practice for example for braces. First it removes plaque
and other debris and a thin layer of enamel. Second it increases porosity of
exposed surfaces which provides a better bonding surface for the restorative and
adhesive materials.
Three etching patterns predominate:
Type I: preferential removal of rods, Type II, interrod enamel is removed
preferentially, Type 3: irregular and indiscriminate removal.
Shallow furrows at surface of enamel?:
Perikymata, which run in horizontal lines across the face of the crown.
As the tooth erupts it is covered by a _______ consisting of debris from the enamel
organ that is lost rapidly:
Pellicle! A salivary pellicle i salso formed on surface of teeth after mechanical
pollishing where plaque forms more easily.
Amelogenesis imperfecta is:
group of inherited defects that cause disruption to the structure and clinical
appearance of tooth enamel, it gives rise to hypoplastic, hypocalcified, or
hypomature defective enamel.
3 common conditions that effect enamel formation:
febrile diseases, tetracycline-induced disturbance, fluoride-ion disturbance.
Febrile disease:
all teeth forming at the time become characterized by distinctive bands of
malformed enamel.
tetracycline induced:
Over 5ppm fluoride:
interferes with ameloblast function and produces mottled enamel