Tooth

development
Introduction
 ODONTOGENESIS
Process of tooth development
Involves various stages

Morphologic stages
•Bud Stage Physiologic stages

•Cap Stage •Initiation

•Bell Stage • Proliferation
• Advanced bell •Histodifferentiation
stage • Morphodifferentiation
• Apposition
 Primitive oral cavity
• Tooth formation begins – 6 week old embryo
• Primitive Oral cavity – stomatodeum
• Lined by – stratified squamous epithelium (oral
ectoderm – ectodermal in origin)

Primitive
oral cavity
Developing human embryo – 6 weeks old
Dental lamina
A. Formation of dental lamina

• Embryo-6wks old - certain areas of basal cells of oral

ectoderm proliferate more rapidly than do the adjacent
areas.

• This leads to the formation of PRIMARY EPITHELIAL BAND

• Primary epithelial band – THICKENED
EPITHELIUM

- A band of epithelium that has

invaded the underlying
ectomesenchyme

- along a roughly horseshoe

shaped future dental arches
• At 7th week
PRIMARY EPITHELIAL BAND
Divides
into
Inner lingual process Outer Buccal process

Dental lamina Vestibular lamina

Forms
(lip furrow band)
Forms
Ectodermal portion of
tooth Vestibule
Stages of developing dental lamina and vestibular lamina

Pri. Epi.
band
Lingual extension Distal extension
(successional lamina) (parent dental lamina)
B. Fate of dental lamina

1. Total activity period of 5 yrs.

2. It degenerates after tooth development
3. Anterior dental lamina degenerates first than the posterior
dental lamina….it may be active in the 3rd molar region after it
has disappeared elsewhere
4. Remnants – epithelial pearls or islands in jaw as well as gingiva.
Also called as Cell rests of serres
Morphologic Stages
of
Tooth development
 At certain points along the dental lamina
(future location of 10 mandibular and 10 maxillary teeth)

Ectodermal cells multiply more rapidly

little knobs growing into the underlying mesenchyme.

Enamel organs of the tooth bud of deciduous teeth

 BUD STAGE

• Extensive proliferation or growth of the dental lamina into

the mesenchyme in the shape of buds.

• Mesenchymal condensation around the bud

Dental lamina Tooth bud

Histology of bud stage
• Enamel organ at bud stage consists :-
a. Peripherally located low columnar cells
b. centrally located polygonal cells.

• Due to increased mitotic index and migration of neural crest

cells – ectomesenchymal condensation surrounding to the
tooth bud – DENTAL PAPILLA

• Ectomesenchymal condensation surrounding to the tooth

bud and the dental papilla – DENTAL SAC / DENTAL
FOLLICLE
 Low columnar cells

Polygonal cells

Dental papilla

Dental Sac /
Dental Follicle
Histology of bud stage
• Enamel organ (tooth bud)- Enamel (etodermal
component)

• Dental Papilla – Dentin, pulp

(ectomesenchymal)

• Dental Follicle – Cementum , Periodontal

ligament (ectomesenchymal)
 CAP STAGE
Unequal growth in different parts of the tooth bud
(growth being more active peripherally)

Shallow invagination on the deeper surface of

the bud

CAP STAGE
BUD STAGE
 Stellate Outer enamel
reticulum epithelium

Inner enamel
epithelium

Dental papilla

Dental Sac /
Follicle

Histology of Cap stage

a) Outer Enamel epithelium
- the peripheral cells of the cap stage are CUBOIDAL
- cover the convexity of the cap

b) Inner Enamel Epithelium

- Cells in the concavity of the cap are TALL COLUMNAR

Basement membrane
- Cells of outer enamel epithelium are separated from the
dental sac by a delicate basement membrane
- Cells of inner enamel epithelium are separated from the
dental papilla by a delicate basement membrane
- Hemidesmosomes anchors the cells to the basement
membrane
c) Stellate reticulum
- These are the star shaped cells present between inner and
outer enamel epithelium
Formation of stellate reticulum
- The initial polygonal cells located between inner and the outer
enamel epithelium, begin to separate due to in drawing of
water from the surrounding dental papilla, as a result of
osmotic force exerted by glycosaminoglycans contained in the
ground substance.
- As a result polygonal cells become star shaped but maintain
contact with each other by their cytoplasmic process.
- As these star-shaped cells form a cellular network, they are
called as Stellate reticulum
Function
- Gives Cushion like consistency and acts as a shock absorber that
may support and protect the delicate enamel forming cells
d) Dental papilla
- Ectomesenchymal condensation enclosed by the invaginated
portion of the enamel organ
- Formative organ of dentin and primordium of the pulp
- Active budding of capillaries nd mitotic figures
- Its peripheral cells adjacent to the IEE enlarge and later
differentiate into the odontoblasts

e) Dental Sac / follicle

- Ectomesenchymal condensation surrounding the enamel
organ and the dental papilla
- Gradually it becomes more dense and fibrous
 Transitory structures
temporary structures that disaapears before enamel
formation begins
1. Enamel niche
• It is an apparent structure in histologic sections.
• enamel organ may be seen to have a double attachment of dental
lamina to the oral epithelium enclosing ectomesenchyme .

• This appearance is due to

a funnel-shaped depression
of the dental lamina
2. Enamel knot
- Cells in the center of the enamel organ are densely packed
forming a knot
- This knot projects in part towards the underlying dental
papilla.
3. Enamel cord
- Vertical extension of the enamel knot

4. Enamel Septum
- when the enamel cord extends to meet the outer enamel
epithelium it is termed as enamel septum
- It divides the stellate reticulum into two parts

5. Enamel navel
- The OEE at the point of meeting shows a small depression
which is called as enamel navel
- It resembles umbiliculs.
Enamel
navel
• Function of enamel knot and cord

- acts as a reservoir of dividing cells for the growing enamel

organ
- enamel knot act as signalling center as many growth factors
are expressed by these cells
 BELL STAGE

• With Deepening of invagination and continued growth at the

margins, enamel organ assumes a bell shape

• In this stage crown shape is determined

• Different crown shape is due to differential mitosis rates and

differences in cell differentiation time.

• Cells of IEE differentiate at the cusp tip / incisal region first

progressing gradually cervically.
CAP STAGE

BELL STAGE
 Histology of bell stage

4 different cells can be distinguished

• Inner enamel epihtelium
• Stratum intermedium
• Stellate reticulum
• Outer enamel epithelium

• The junction between inner and outer enamel epithelium is

called as CERVICAL LOOP. It is an area of intense mitotic
activity
 Bell stage

main dental lamina

successional dental lamina

outer dental epithelium

stellate reticulum

inner dental epithelium

cervical loop
Dental papilla

Dental sac “follicle”

36
• Inner Enamel Epithelium

- Single layer of cells that differentiate into tall columnar cells

(Ameloblast) just prior to amelogenesis

- 4 – 5 microns in diameter, 40 microns high

- These cells are attached together by junctional complexes

laterally and to the cells in the stratum intermedium by
desmosomes
- Cells of IEE exert an organizing influence on the underlying
mesenchymal cells in the dental papilla, which later
differentiate into odontoblasts.
• Stratum intermedium
- Few layers of squamous cells forms the stratum intermedium

- These cells are closely attached by desmosomes and gap

junctions

- Highly metabolically active as indicted by presence of well-

developed cytoplasmic organells, acid mucopolysaccharides
and glycogen deposits

- Essential for the formation of ENAMEL. It is absent from the

part of tooth germ which outline the root
• Stellate reticulum
- Star shaped cells with long processes that anastomose with
the adjacent cells

- Desmosomes connects the adjacent cells

- Stellate reticulum expands further by increase in intercellular

fluid

- before enamel formation begins, the stellate reticulum

collapses, reducing the distance between the centally situated
ameloblasts and the nutrient capillaries near the outer
enamel epithelium. This change begins at the height of the
cusp or the incisal edge and progress cervically.
• Outer enamel epithelium
- These cells flatten to low cuboidal form.
- Before enamel formation – this layers is thrown into folds
- These folds contains mesenchyme of the dental sac
alongwith capillary loop providing nutritional supply for the
avascular enamel organ.

• Dental lamina
- Lingual extension develop from the main dental lamina which
is termed as Successional dental lamina.
• Dental papilla
- Enclosed in the invaginated portion of the enamel organ.
- before enamel formation begins, the peripheral cells of the
mesenchymal dental papilla differentiate into odontoblasts under
the organizing influence of the IEE.
- First they become cuboidal, later columnar.

• The basement membrane that separates the enamel organ and the
dental papilla just prior to dentin formation is called the membrana
performativa.

• Dental Sac
- Before formation of dental tissues, the dental sac shows a circular
arrangement of its fibers and resemble a capsular structure
- Later, with the development of root, the fibers of dental sac
differentiate into periodontal fibers.
 ADVANCED BELL STAGE
• This stage is characterized by the commencement of mineralization
and root formation

• Boundary between IEE and odontoblasts outlines the future

dentinoenamel junction

• First a layer of dentin is formed along the future DEJ in the region
of future cusps and proceeds pulpally and apically

• After the first layer of dentin is formed, the ameloblast lay down
enamel over the dentin in the future incisal and cuspal areas.
• Enamel formation than proceeds coronally and cervically from DEJ
Bell stage Advanced Bell stage
• The cervical portion of the enamel organ gives rise to the
epithelial root sheath of hertwig.

• This hertwig’s epithelial root sheath (HERS) outlines the future

root.

HERS
Cervical loop region
 Summary of stages
Cap stage Bell stage Advanced bell
stage
Inner enamel Columnar Ameloblast – Forms enamel
epi tall columnar
Outer enamel cuboidal Low cuboidal- Thrown into
epi thrown into folds folds
Stellate Star shaped Star shaped collapsed
reticulum
Stratum in- - Squamous cells Squamous cells
termedium
Dental papilla Ectomesenchymal Differentiated into Dentin formation
condensation odontoblasts
Dental sac Ectomesenchymal Circular Circular
condensation arrangement of arrangement of
fibers fibers
Root formation
 OEE and IEE bend at future CEJ into a horizontal plane forming
epithelial diaphragm (this narrows the wide cervical opening)

Epithelium proliferates coronal to epithelial diaphragm

Proliferation of the cells of epithelial diaphragm is accompanied by

proliferation of pulp cells

Cells of IEE induce the differentiation of radicular dental papilla cells

into ODONTOBLASTS

Odontoblasts lay down the first layer of dentin

 Connective tissue of dental sac proliferates and invades the HERS

HERS looses its structural continuity & its close relation to the
surface of the root

Remnants of HERS persists as an epithelial network of strands or

clumps near the root surface. Later get incotporated into PDL &
called as rests of Malassez

Strands of HERS move away from the surface of Dentin so that the CT
cells comes into contact with Dentin and get differentiated into
CEMENTOBLASTS

Cementoblasts deposit a layer of cementum on the surface of dentin

In the last stage – proliferatin of epi diaphragm lags behind that of

the pulpal connective tissue – thus a wide apical foramen is reduced
In the Multirooted tooth
Long tongue-like extensions develop
(2 – lower molars & 3 in upper molars)

The free ends of these extensions grow toward each

other and fuse

Thus a single cervical opening is divided into 2 or 3

openings
 Physiologic Stages
of
Tooth development
 MORPHOLOGIC STATE PHYSIOLOGIC PROCESS

Dental lamina Initiation

Bud stage

Cap stage Proliferation

Early bell stage Histodiffrentiation

Advanced bell stage Morphodiffrentiation

Formation of enamel & Apposition

dentine matrix
 INITIATION

• Different teeth are initiated at different times

• Specific cells within the horse-shoe shaped dental lamina

have the potential to form the enamel organ of certain teeth
by responding to those factors that initiate tooth formation

• Initiation induction requires Epithelial – mensenchymal

interaction

• The dental papilla mesenchyme can induce or instruct tooth

epithelium and even non tooth epithelium to form enamel
 PROLIFERATION

• At the points of initiation – proliferative activity is enhanced –

resulting in bud, cap and bell stages of the enamel organ

• Proliferation causes growth of the enamel organ

Bud Stage Cap Stage Bell Stage Advanced

Bell Stage
 HISTODIFFERENTIATION
• Formative cells of the tooth germ undergo morphologic and
functional changes
- IEE differentiates into ameloblasts
- Peripheral cells of dental lamina – differentiates into
Odontoblasts

• Differentiated cells looses the capacity to multiply

• Histodifferentiations is maximum in BELL stage just before

enamel formation.
 A B C
Under the Odontoblasts lay Ameloblasts lay
organizing down a layer of down a layer of
influence of IEE, dentin. enamel matrix over
peripheral cells Due to dentin the dentin.
of dental papilla formation the cells
differentiates of IEE gets Enamel does not
into differentiated into form in the absence
ODONTOBLASTS AMELOBLASTS of dentin
a. Epithelial Mesenchymal Interaction
IEE cells
Organizing influence
Peripheral cells of Dental papilla cells

Differentiates into Odontoblasts

Odontoblasts forms dentin

With the formation of dentin, IEE cells differentiates

into Ameloblasts

Ameloblasts forms enamel against dentin

 MORPHODIFFERENTIATION
• The future Shape and size of the tooth is determined by
morphodifferentiation

• maximum in Advanced bell stage, when the future

dentinoenamel junction is outlined.

• Dentinoenamel junction and cementodentinal junction are

different and characteristic of each tooth, acting as a
blueprint pattern.

• Ameloblasts, odontoblast and cementoblasts lay down

enamel, dentin and cementum respectively, in conformity
with this pattern
 APPOSITION
• Apposition is the deposition of the matrix of dental hard
tissues
• It is regular and rhythmic
• Periods of activity and rest alternate at definite intervals
during tooth formation.
1. Successional lamina gives rise to 4. Morphodifferentiation
a) Premolars and molars a) occurs after enamel & detine formation
b) canines, premolars & molars b) Takes place mainly during Bell stage
c) incisors, canines & premolars c) IEE cells differentiates into Ameloblasts
d) incisors, premolars & molars d) Results cap stage formation
2. The tooth germ is composed of 5. Ectodermal derivative of tooth is
a) Oral epithelium, dental lamina & a) Enamel
vestibular lamina
b) Dentin
b) Primary epithelial band, dental lamina
c) Cementum
& vestibular lamina
d) pulp
c) Enamel organ, dental papilla ,dental sac
6. Blue print pattern for
d) Enamel organ, dental lamina & morphodifferentiation is established
vestibular lamina by
3. The cells of stratum intermedium a) Dentinoenamel & cemetodentinal
a) are squamous in appearance junction
b) are essential for enamel formation b) Dentinoenamel & cementoenamel jun.
c) located above IEE c) Cementoenamel & cementodentinal jun
d) All of the above d) All of the above
7. Hertwig’s epithelial root sheath
a) Remanants persists as Cell rest of Serres
b) At cervical region, bends in a vertical plane forming epithelial diaphragm
c) Consists of outer enamel epithelium and Stratum intermedium
d) Outlines the future root
8. Ameloblasts are
a) Short columnar b) Tall columnar c) Cuboidal d) None of the above
9. Enamel knot
a) A transitory structure seen in bud stage
b) Acts as a signalling center
c) Is a knob-like projection of ectomesenchyme
d) All of the above are true
10. Membrana performativa is
a)Basement membrane that separates the enamel organ and the dental papilla
just prior to dentin formation
b) Basement membrane separating outer enamel epithelium and dental follicle
c) Basement membrane separating IEE and OEE
d) Basement membrane separating dental papilla from dental sac
Short notes