Tooth

origin and
formation

Presentation by: Bugnariu Paul-

Iulian
Buerchi Codru-
Ciprian
Chit-Stnean
 Classification of the human dentition
Teethare the hardest structures of the human body.

The type, number, and arrangement of a set of teeth

represent thedentition.

The human dentition is termed heterodont, which means

it is comprised of different types, or classes, of teeth to
perform different functions in the mastication process. In
comparison, a homodont dentition is one in which all of the
teeth are the same in form and type. This sort of dentition is
found in some of the lower vertebrates.
Furthermore, man has two separate sets of teeth, or
dentitions. This is termed diphyodont as opposed to
monophyodont when there is only one set of teeth, and
polyphyodont, when the are more than two; or continuous,
sets of teeth are developed throughout life.
Humans have two set of teeth :

Primary teeth
Primary teethare also known asdeciduous teeth, milk
teeth, baby teethortemporary teeth. Primary teeth
start to form during the embryo phase and erupt during
infancy (from 6 months to 3 years).
Normally, there are 20 primary teeth, 10 on each dental
arch : 4 incisors (2 central incisors and 2 lateral
incisors), 2 canines and 4 molars.
 Primary
teeth

Generally, by the age of 12 to 14 years, all primary teeth are

replaced by permanent teeth but in the absence of
permanent replacements, they can remain functional for
many years.
 Permanent teeth
Permanent teeth(oradult teeth) are the second set
of teeth and normally consist of 32 teeth. The first
permanent teeth appear around the age of 6 and are
usually the first molars whicherupt right behind the
last "milk" molarsof the primary dentition.
The permanent premolars will replace the milk molars
of the primary dentition and all permanent molars will
eruptbehindthe deciduous teeth.
 Eruption Age
Mandible Order
Maxilla Order
Central Incisor 6-7 2
7-8 2
Lateral Incisor 7-8 3
8-9 3
Canine 9-10 4
11-12 6
First Pre-molar 10-11 5
10-11 4
Second Pre- Molar 11-12 6
11-12 5
 Permanent Incisors

teeth Canine (Cuspid)

Maxilla
Premolars

Molars

Mandible

Up to the age of thirteen years, twenty-eight of the thirty-two

permanent teeth will appear. The four last permanent teeth,
the third molars or the wisdom teeth, usually appear between
the ages of 17 and 25 years.
Histological stages of tooth
development
Tooth formation occurs in the 6th week
of intrauterine life with the formation
of primary epithelial band. At about 7th
week the primary epithelial band
divides into a lingual process called
dental lamina and a buccal process
called vestibular lamina. All deciduous
teeth arises from dental lamina, later
the permanent successors arise from
its lingual extension and permanent
molars from its distal extension
 Dental Lamina

Primary epithelial Dental lamina appears as a
band thickening of the oral

epithelium adjacent to
condensation of
ectomesenchyme


20 areas of enlargement or
Ectomesenchyme knobs appear, which will
form tooth buds for the 20
primary teeth


Not all will appear at the
same time. The first to
develop are those of the
anterior mandible region

At this early stage the tooth
buds have already
Vestibular Lamina

Labial and buccal to the

dental lamina in each dental
arch, another epithelial
thickening develops
independently

It is Vestibular Lamina also

termed as lip furrow band

Subsequently hollows and

form the oral vestibule
between the alveolar
portion of the jaws and the
lips and cheeks.
 Tooth development
At certain points along the dental
lamina each representing the
location of one of the 10
mandibular and 10 maxillary
teeth, ectodermal cells multiply
rapidly and little knobs that grow
into the underlying mesenchyme

Each of these little down growths

from the dental lamina represents
the beginning of the enamel
organ of the tooth bud of a
deciduous tooth

First to appear are those of

anterior mandibular region

As the cell proliferation occurs

 DENTAL PAPILLA

On the inside of the cap, the

ectomesenchymal cells increase in number.
The tissue appears more dense than the
surrounding mesenchyme and represents the
beginning of the dental papilla

B = Dental Papilla
 DENTAL SAC/ DENTAL FOLLICLE

Surrounding the combined enamel organ

or dental papilla, the third part of the
tooth bud forms. It is known as dental
sac/follicle and it consists of
ectomesenchymal cells and fibres that
surrounds the dental papilla and the
enamel organ.

C= Dental sac
 DEVELOPMENTAL
STAGES

MORPHOLOGICAL PHYSIOLOGICAL
1. Dental lamina Initiation
2. Bud stage
3. Cap stage Proliferation
4. Early bell stage Histodifferentiation
5. Advanced bell stage Morphodifferentiation
6. Formation of enamel and dentinApposition
matrix
 Toothdevelopmentisacontinuousprocess,howevercanbedividedinto
3stages:

1. BudStage

2. CapStage
3.BellStage
BUD STAGE / PROLIFERATION
This is the initial stage of tooth formation where enamel
organ resembles a small bud
During the bud stage, the enamel organ consists of
peripherally located low columnar cells and centrally located
polygonal cell
The surrounding mesenchymal cells proliferate, which
results in their condensation in two areas
The area of condensation immediately below the enamel
organ is the dental papilla
The ectomesenchymal condensation that surrounds the
tooth bud and the dental papilla is the tooth sac
The dental papilla as well as the dental
sac are not well defined during the bud
stage, they become more defined
during the subsequent cap and bell
stages

The cells of the dental papilla form the

dentin and pulp while the dental sac
forms cementum and periodontal
ligament
 CAP STAGE / PROLIFERATION

As the tooth bud continues to proliferate, it does not

expand uniformly into a large sphere

Instead, unequal growth in different parts of the tooth

bud leads to the cap stage which is characterized by a
shallow invagination on the deep surface of the bud
 BELL STAGE / HISTODIFFERENTIATION

Due to continued uneven growth of

the enamel organ it acquires a bell
shape

In bell stage crown shape is

determined

It was thought that the shape of the

crown is due to pressure exerted by the
growing dental papilla cells on the inner
enamel epithelium

This pressure however was shown to

be opposed equally by the pressure
exerted by fluid present in the stellate
reticulum

The folding of enamel organ to cause

 Formation of enamel and dentin
matrix
1. Mineralization of hard tissues
occur.

2. The inner enamel epithelial

cells change in shape from
cuboidal to columnar. The
nuclei of these cells move
closer to the stratum
intermedium and away from
the dental papilla.

3. The adjacent layer of cells in

the dental papilla suddenly
increases in size and
differentiates into odontoblasts,
which form dentin.

4. The inner enamel epithelium

5. The odontoblasts secrete an
organic matrix into their
immediate surrounding and
form the dentin.

6. After dentin formation

begins, the cells of the inner
enamel epithelium secrete
an organic matrix against
the dentin. This matrix
immediately mineralizes
and becomes the tooth's
enamel.

7. Outside the dentin are

ameloblasts, which are cells
that continue the process of
enamel formation;
therefore, enamel formation
moves outwards, adding
Summary of Tooth Development

(So Far)

1. The epithelium is separated from

the dental papilla by an acellular zone

2. Inner dental epithelial cells are

elongated, and the acellular zone is
lost by differentiation of odontoblasts

3. Odontoblasts retreat toward the

center of the pulp, leaving behind
dentin

4. Ameloblasts begin to migrate

outward and leave behind formed
enamel
 Root Formation
Development of root begins after the enamel and
dentin formation has reached the future
cementoenamel junction

Epithelial cells of the inner and outer dental

epithelium proliferate from the cervical loop of the
enamel organ to form the Hertwigs epithelial root
sheath. The root sheath determines if a tooth has
single or multiple roots, is short or is long, curved or
straight.

Hertwigs epithelial root sheath

 Tissue structure of the teeth

A tooth consists of enamel, dentin, cementum

and pulp tissue. The portion of a tooth exposed to the
oral cavity is known as the dental crown, and the
portion below the dental crown is known as the tooth
root.

The dental pulp cavity exists in the center of the

tooth, through which the dental pulp, called the nerve,
runs. In order to receive an impact on the tooth and to
absorb and alleviate the force on the jaw, the surface of
the tooth root area (cementum) and the alveolar bone
are connected by a fibrous tissue called the periodontal
ligament.

The tooth is supported by the tissue consisting of

the alveolar bone, gums and the periodontal ligament.
 The 4 main dental
tissues:
Enamel

Enamel Dental
Dentin Dentin Pulp

Cementum
Dental Pulp

Cementum
Enamel
Enamelis the hardest and most
highly mineralized substance of the
body ;96% of enamel consists of
mineral, with water and organic
material comprising the rest.
Enamelcovers the crown of the
toothand varies in thickness over the
surface of the tooth ; it is often
thickest at the cusps, up to 2.5 mm,
and thinnest at its border.
The normal color of enamel varies
from light yellow to grayish white ;
since enamel is semi-translucent, the
color of dentin and any restorative
dental material underneath the
enamel strongly affects the
appearance of a tooth.
Enamel does not contain any
blood vessels or nerves ; therefore,
enamel damage is painless. Enamel
can be stained by coffee, tea, tobacco
 Enamel

Enamel can be lost by:

Physical mechanism
Abrasion (mechanical wear)
Attrition (tooth-to-tooth contact)
Abfraction (lesions)
Chemical dissolution
Erosion by extrinsic acids (from
diet)
Erosion by intrinsic acids (from the
oral cavity/digestive tract)
Multifactorial etiology
Combination of physical and
chemical factors
Dentin
Dentinisthesubstancebetween
enamelorcementumandthepulp
chamber.Itformsthehighestportionof
thetoothanditnormallyhasagray-white
oryellowishcolor.

Dentinissecretedbyspecialized
cells(odontoblasts)locatedinsidethe
dentalpulp.Dentinhasmicroscopic
channels,calleddentinal tubules,which
radiateoutwardthroughthedentinfrom
thepulpcavitytotheexteriorcementum
orenamelborder.

Becauseitissofterthanenamel,
dentindecaysmorerapidlyandissubject
toseverecavitiesifnotproperlytreated,
butitstillactsasaprotectivelayerand
supportsthecrownofthetooth.
Dentin

There are three types of

dentin:
Primary dentin forms the initial
shape of the tooth.
Secondary dentin is deposited
after the formation of the
primary dentin on all internal
aspects of the pulp cavity.
Tertiary dentin, or reparative
dentin is formed by
replacement odontoblasts in
response to moderate-level
irritants such as attrition,
abrasion, erosion, trauma,
moderate-rate dental caries, and
some operative procedures.
 Dentinal tubules connect the dentin and the pulp
(innermost part of the tooth, circumscribed by the dentin and
lined with a layer of odontoblast cells)
The tubules run parallel to each other in an S-shape course
Tubules contain fluid and nerve fibers
External stimuli cause movement of the dentinal fluid, a
hydrodynamic movement, which can result in short, sharp pain
episodes
Dentin
Pulp

Tubule

Fluid Odontoblast
Nerve Fibers
Cell
Cementum
Cementumis a specialized
bone like
substancecovering the root
of a tooth. Its coloration is
yellowish and it is softer
than either dentin or
enamel.
The principal role of
cementum is to serve as a
medium by which the
periodontal ligaments can
attach to the tooth for
stability.
In case of gingival
recession, the gum retracts
from the tooth leaving part
of the roots naked. In these
Dental pulp
The dental pulp (also
called "the nerve" of the
tooth) is the central part
of the tooth and is filled
with soft connective
tissue that contains blood
vessels and nerves. Along
the border between the
dentin and the pulp are
odontoblasts, which
initiate the formation of
dentin. The pulp tissues enter the tooth from a hole at the tip
of the root called apical foramen or the root's apex. That is
why most pulp infections spread through the apical
foramen from the pulp to the periapical tissue and the
surrounding bone.
 Dental pulp ensures the tooth
vitality and nutrition ; the pulp tissue has
two main divisions: coronal pulp and
radicular pulp :
o Coronal pulp
The crown of a tooth contains the coronal
pulp. The coronal pulp is the largest mass
of the pulp and is housed in a closed
space with rigid walls, called the pulp
chamber.
The shape and size of each pulp chamber
ocorresponds
Radicular directly
pulp to the overall shape
andradicular
The size of the tooth,
pulp andpulp
is that thusextending
is from the cervical
individualized
region for every
of the crown tooth.
(where the coronal pulp ends) to the
root apex. The radicular pulp is located inside the tooth's
root, in a narrow and elongated space, called the root canal.
Root canals are not always straight and may vary in shape,
size and number ; sometimes there are more than one root
canal per root.
The radicular portion of the pulp is continuous with the
periapical tissues through the apical foramen. Apical
foramen is the opening of the radicular pulp into the
 Pulpitis is inflammation or infection of the dental pulp,
causing extreme sensitivity and/or pain.
Pain is derived as a result of the hydrodynamic stimuli
activating mechanoreceptors in the nerve fibers of the
superficial pulp (A-beta, A-delta, C-fibers).
Hydrodynamic stimuli include: thermal (hot and cold);
tactile; evaporative; and osmotic
These stimuli generate inward or outward movement of
the fluid in the tubules and activate the nerve fibers.
A-beta and A-delta fibers are responsible for sharp pain of
short duration
C-fibers are responsible for dull, throbbing pain of long
duration
Pulpitis may be reversible (treated with restorative
procedures) or irreversible (necessitating root canal).
Untreated pulpitis can lead to pulpal necrosis
necessitating root canal or extraction.
Periodontal Tissues

Include the following:

Gingiva
Alveolar Bone
Periodontal Ligament
Cementum Gingiva

Periodontal Ligament

Alveolar bone

Cementum
 Gingiva

The part of the oral mucosa overlying the crowns of

unerupted teeth and encircling the necks of erupted
teeth, serving as support structure for subadjacent
tissues.
The gingiva is divided anatomically
into marginal, attached, and
interdental areas.
Gingiva
 The marginal, or unattached, gingiva is the terminal
edge or border of the gingiva surrounding the teeth in
collar.
In about 50% of cases, it is demarcated from the adjacent,
attached gingiva by a shallow linear depression, the free
gingival groove. Usually about 1 mm wide, it forms the
soft
Thetissue wallsulcus
gingival of the is
gingival sulcus.
the shallow It mayorbe
crevice separated
space
from the tooth
around surface
the tooth with aby
bounded periodontal probe.
the surface of the tooth on
one side and the epithelium lining the free margin of the
gingiva on the other. It is V shaped and barely permits
the entrance of a periodontal probe. The clinical
determination of the depth of the gingival sulcus is an
important
The attacheddiagnostic
gingiva parameter.
is continuous with the marginal
gingiva. It is firm, resilient, and tightly bound to the
underlying periosteum of alveolar bone.
The interdental gingiva occupies the gingival
embrasure, which is the interproximal space beneath
the area of tooth contact.
 Alveolar Bone

Also called the alveolar process; the thickened ridge of bone

containing the tooth sockets in the mandible and maxilla, and

consists
1. An of the
external following:
plate of cortical bone
formed by haversian bone and
compacted bone lamellae.
2. The inner socket wall of thin,
compact bone called the alveolar Alveolar bone
bone proper, which is seen as the
lamina dura in radiographs.
Histologically, it contains a series of
openings (cribri form plate) through
which neurovascular bundles link the
periodontal ligament with the central
component of the alveolar bone, the
cancellous bone.
3. Cancellous trabeculae, between
these two compact layers, which act
as supporting alveolar bone. The
 Periodontal Ligament

Connects the cementum of the tooth root to the alveolar bone of the
socket.
Dentogingival group these fibres
are the most numerous, extending
from the cervical cementum to the
lamina propria of the gingiva.
Alveologingival group these
fibres extend from the alveolar crest Periodontal Ligame
to the lamina propria of the gingiva.
Circular of Circumferential fibres
continuous around the neck of the
tooth.
Transseptal fibres these fibers
extend from the cervical cementum
of one tooth to the cervical
cementum of the other.

Dentogingival group and

alveologingival group fibers are
embed in attached gingiva and free
 Tooth morphology
A brief definition and
description of the various
anatomical features of a normal
tooth, and its supporting structures,
Anatomic Crown
include the following:

Dental Structures:

1. Anatomical crown - That portion

of the tooth which is covered by Pulp
enamel. Chamber
2. Clinical crown - That portion of
the tooth which is visible in the
mouth. The clinical crown may, or
may not, correspond to the
anatomical crown, depending on the Anatomic Root
level of the tooth's investing soft
tissue, and so may also include a
portion of the anatomical root. As
can be seen from this description,
 3. Anatomical root - That portion of the tooth which is
covered with cementum.
4. Clinical root - That portion of the tooth which is not visible
in the mouth. Again, the clinical root is an ever changing
entity, and may, or may not, correspondApical
to the anatomical
Apical
root.
Surfaces of tooth :
Apical: Pertaining to the apex or
root of the tooth
Mesial Distal
Labial: Pertaining to the lip;
describes the front surface of
Labial
anterior teeth
Lingual: Pertaining to the tongue; Lingual
describes the back (interior) surface
of all teeth
Distal: The surface of the tooth that Incisal Incisal
is away from the median line
Mesial: The surface of the tooth that
is toward the median line
 Divisions of the crown of a tooth

Divisions cervico-
occlusally

Cervical 3rd Cervical 3rd

Middle 3rd Middle 3rd
Incisal 3rd Occlusal 3rd
Anterior Posterior
Divisions mesio-
distally

Distal 3rd

Middle 3rd

Mesial 3rd
Divisions labio-
lingually

Lingual 3rd

Middle 3rd

Labial 3rd
 Divisions Of The Crown And Root Of A Tooth

Divisions Cervico-occlusally

Apical 3rd Apical 3rd

Middle 3rd Middle 3rd
Cervical 3rd Cervical 3rd
Cervical 3rd Cervical 3rd
Middle 3rd Middle 3rd
Incisal 3rd Occlusal 3rd
Anterior Posterior
 Permanent
teeth
Classification of Teeth:
Incisors (central and lateral)
Canines (cuspids)
Premolars (bicuspids)
Molars
 Teeth are divided into four main groups, each with a
well-defined position and function.

Incisors
Incisors are the most visible of all teeth and have a
pronounced aesthetic role. They are divided into two
osubcategories:
Central incisors

The central incisors are located in the front part of

the jaws and normally the midline of the face goes
right between them. Central incisors (particularly the
upper ones) are the most visible of all teeth. As with
all teeth, variations of size, shape, and color exist
among people.
The upper central incisors (two in number) have a
"shovel" shape and on the back side (palatal side),
they typically show a cusp called the incisal ridge or
edge. The two maxillary central incisors play an
important part in the pronunciation of consonants.
The lower central incisors (two in number) are
much smaller than the uppers. As for chewing,
o Central incisors

Labial Lingual Mesial Distal

Incisal
o Lateral incisors

The lateral incisors are small teeth located between the

central incisors and the canines. There are 4 lateral incisors : 2
upper and 2 lower.
Lateral incisors function is for shearing or cutting food
during mastication. They have an important aesthetic role,
although not as pronounced as the central incisors.
The upper lateral incisors can also play a part in consonants
pronunciation. Lateral incisors have a single root, usually very
Relation
small
The andincisor
lateral thin. make contact mesially with the central
incisor and distally with the mesial surface of the canine.

3 2 2 3
o Lateral incisors
They have four surfaces and incisal aspect.

Labial Lingual Mesial Distal

No. of roots
.They have one root Incisal
 Canines
Canines are one of the
strongest of all teeth and are
4 in number : two upper and
two lower. They are extremely
important teeth from several
points of view ; therefore,
canine extraction is only
performed when no other
alternatives are available.
The "V shape peak" from
the top of the canines is
called cusp.
Canines make the transition
between the anterior teeth
(incisors) and the posterior
teeth (premolars and molars)
and are located in the place
where the dental arch curves.
 The location of the canines reflects their dual function as they
complement both the premolars and incisors during mastication
and at the same time, they have a pronounced aesthetic impact.
The canine teeth are able to withstand the tremendous
lateral pressure caused by chewing ; the most common action is
tearing of food.
Canines have a single root, very long and well implanted into the
jawbone. In fact, the upper canine is the longest tooth in total
length. They are extremely strong and resistant and are among
the most important abutment teeth when a fixed dental bridge is
designed.
4 3 2 2 3 4
 Canines They have four surfaces and
incisal aspect.

Labial Lingual Mesial Distal

Incisal
 Premolars
The premolar teeth, or bicuspids, are transitional
teeth located between the canine and molar teeth.
Premolars have properties of both the anterior canines
and posterior molars, and so food can be transferred
from the canines to the premolars and finally to the
molars for grinding, instead of directly from the canines
to the molars.
Premolars have two cusps.
Premolars function is for tearing
and grinding food during
chewing. Normally, the first
upper premolar has 2 roots and
the rest of the premolars a single
root. However, there are
variations on that.
 Molars
Molars are the most posterior and most complicated kind
of teeth. Normally, adult have 12 molars, in four groups of
three at the back of the mouth.
o First molar located immediately behind (posterior) the
second premolar. It erupts around the age of 6 right behind the
last "milk" molars.
o Second molar located immediately behind (posterior) the
first molar. It erupts around the age of 12.
o Third molar or wisdom tooth ; it is the rearmost molar
and it is the last tooth to appear, breaking through the front of
the gum at about the age of 20, although this varies from
individual to individual. Sometimes, wisdom teeth can cause
various problems.

Molars have 4 or 5 cusps. The main function of all

molars is grinding of food during mastication.

Molars can have a various number of roots (from one to

four, even five). Generally, the first upper molars have three
roots while the lower molars have two roots.
Molars are extremely powerful and strong teeth. Like
Ex: First maxillary molar
Tooth surfaces

Cusp - is a point, or peak on the

chewing surface of premolar or
molar tooth
 Tooth surfaces

Cusp slopes or Ridges - are the inclined

surfaces
that form an angle at the cusp tip
 Tooth surfaces
How many cusp ridges does this tooth
possess?
Ridges :
- marginal
- oblique
- triangular
- transvers
 Tooth surfaces

Cingulum - is the
enlargement or bulge on
the cervical third of the
lingual surface of the
crown of anterior teeth
 Tooth surfaces

Marginal Ridge - on incisor and

canine located on the mesial and distal
border of the lingual surface
Tooth surfaces

Marginal Ridge - on
posterior teeth located on
the mesial and distal border
of the occlusal surface
 Tooth surfaces

Triangular Ridge - on the occlusal surface of posterior teeth, is

the ridge from any cusp tip to center of the occlusal surface the
mesio-lingual cusp of upper molars have two
Tooth surfaces

Oblique Ridge - found only on

maxillary molars made of the
triangular ridges of the
mesiolingual and distobuccal
cusps
 Tooth surfaces

Transverse Ridge - ridge crossing the occlusal surface of

posterior teeth in a bucal-lingually direction and made of
connecting triangular ridges
Tooth surfaces

Mamelon - is one
of three tubercules
sometimes present
on the incisal edge
of an incisor tooth
that has not been
subject to wear
Tooth surfaces

Sulcus - is a broad
depression or valley
on the occlusal
surface of posterior
teeth
 Tooth surfaces

Developmental Groove - is a
sharply defined, narrow and linear
depression, formed during tooth
development separating lobes or a
major portion of a tooth - a fissure
may be found at the depth of a
developmental groove
Tooth surfaces

Supplemental Groove
- small irregularly placed
grooves not at the junction
of lobes or major portions of
the teeth
Tooth surfaces

Fossa - a depression or hollow found

on the lingual surfaces of some
anterior teeth and on the occlusal
surfaces of posterior teeth
Tooth surfaces

Pits - often occur at the depths of fossa

where two or more grooves join
 Tooth surfaces

Furcation - is the place

on multi-rooted teeth
where the root trunk or
base divides into
separate roots Root
Trunk
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