DEVELOPMENT OF

TEETH
BY – DR. PRIYANKA SINGH.
M.D.S I YEAR.
INDEX
 Introduction
 Development of oral cavity
 Formation of dental lamina
 Stages of tooth development
 Molecular biology of tooth.
 Developmental anomalies and their clinical
consideration
 Summary &conclusion
 References.
 Continued…
 Growth by Meredith
 Entire series of sequential anatomic and physiologic
changes taking place from the beginning of prenatal life to
senility.
 Development by Moyers
 Allthe naturally occurring unidirectional changes in life of
an individual from its existence as a single cell to its
elaboration as a multifunctional unit, terminating in death.
Hard,inert,acellular ENAMEL

Less mineralized, more resilient, vital & hard DENTIN

Soft tissue PULP

Tooth supporting connective tissue CEMENTUM,PDL,ALVEOLAR BONE

DEVELOPMENT
OF THE ORAL
CAVITY.
 Diploblastic
embryo

Triploblastic
embryo

head face teeth

FERTILIZATION
SEGMENTATION OF FERTILIZED OVUM
Embryonic Folding
The Neural crest .

 As the neural tube form agroup of cell separate from neuroectoderm.

 have capacity to migrate & differentiate within developing embryo.
 FUNCTION:- Formation of cranial sensory ganglia.
 Differentiate to form most of connective tissue.
 Proper migration of neural crest cell is important for development of face &teeth.
 All the tissues of the tooth (except enamel) and its supporting apparatus is
derived directly from neural crest cells.
Continued…
Continued…
Continued…
FORMATION OF DENTAL LAMINA.
 Oral cavity –ectoderm and underlying connective tissue cells that are neural crest
cell.
 Instructs overlying ectoderm to begin tooth development.
 Anterior to posterior in future maxilla & mandible.
 Development of dental lamina under five headings.
 condensation of ectomesenchymal cells.
 Formation of primary epithelial band.
 Formation of dental and vestibular lamina.
 Enamel organ formation.
 Formation of dental papilla and sac.
 Condensation of ectomesenchymal cells.
 Epithelium proliferates into the connective tissue.
 Cells condense around epithelium.
 It occurs in future mandible first and then maxilla.
 begins anteriorly then posteriorly.
Primary epithelial Band
Continued…
 Primary
epithelial
band

Deciduous Dental Vestibular

teeth lamina(lingually) lamina(labially)

Distally give
Lingual rise to
extension permanent
molars.
Formation of enamel organ

10 small swellings develop in the

region of future primary teeth.
They form enamel organ and give
rise to enamel of the teeth.
Dental papilla and sac

• peripheral condensation of
ectomesenchymal cells around
enamel organ forms dental
papilla.
• Surrounding dental papilla and
enamel organ is dental follicle or
sac.
FUTURE…!!

Tooth germ= enamel organ enamel

+
dental papilla pulp & dentin.
+
dental sac/follicle cementum, periodontal
ligament, bone .
STAGES IN THE DEVELOPMENT OF TOOTH

Three morphological stages in the tooth development are seen :-

 BUD STAGE.
 CAP STAGE.
 BELL STAGE – a) early.
b)advanced.
INITIATION OF TOOTH DEVELOPMENT.

Ectodermal signals are required for the initiation of tooth development.

oral epithelium of first arch

produce signaling molecules

Expression of Lhx-6/7(lim-homeobox)genes in the mesenchyme.

Initiation of tooth development.

Determination of tooth shape.

 Determination of specific tooth types at their correct position in jaws

 Patterning of dentition

 2 hypothetical theories

 field model theory clone theory.

Field model theory.

Premolar-Msx1,DLX1,DLX2.
Clone model theory

 Each tooth crown is derived from a clone of ectomesenchymal cells

programmed by the epithelium to produce teeth of a given pattern.
Determination of tooth position.

 PAX-9 Gene- Earliest mesenchymal gene that defines the location of

tooth germ .
 Pax-9 gene expression localizes with the exact sites where tooth germs
appear. Pax-9 is induced by Fgf-8 and is repressed by bone
morphogenetic proteins (BMP-2 and BMP-4).
BUD STAGE

 First morphological stage in tooth development.

 Derives its name from shape of developing enamel organ .
 Enamel organ –small ovoid epithelial mass.
 Peripheral low columnar cells; centrally poly gonal cells.
 Epithelial cells have RNA and enzymes
 Underlying ectomesenchymal cells closely packed.
Continued…
CAP STAGE.

 Bud stage 11th week Cap stage.

 Onset of morphological changes in tooth –different types of tooth.
 Due to non uniform expansion of enamel organ.
 Shallow invagination on deep surface of bud.
 Dental papilla cells seems to be contained in the invagination;hence the
name
 Distinct histologic structures seen now.
CAP STAGE.
Histology of cap stage.

 Inner & outer enamel epithelia;

 Peripheral low columnar cells (BUD cuboidal in shape(CAP Stage)
stage)-outer enamel
 epithelium.
 Cells in the con cavity of cap tall columnar-outer enamel epithelium.
 Stellate Reticulum.
polygonal central cells of bud stage

secrete glucosamine glycan's

hydrophilic ;turgor in enamel organ increases

central cells drawn apart

 attached by desmosomes at corners
 acquire star shaped (stellate)
 Stellate reticulum cells act as cushion for the delicate cells of enamel organ.
 Dental papilla
 organizing influence of enamel epithelium
 papillary cells proliferate mitotic activity
 later enlarge odontoblast dentin
 Further condensation occur forms cementum and pdl.
Continued…
TRANSIENT SRUCTURES

 ENAMEL KNOT-clusters of nondividing

epithelial cells in sections of molar cap-
stage tooth germs . These clusters express
genes for several signaling molecules.
 ENAMEL CORD -linear condensation of
cells from Inner to outer enamel epithelium.
 ENAMEL SEPTUM-When the enamel cord
extends to outer enamel epithelium.
 ENAMEL NAVEL-Small depression in OEE.
Continued…

 Function of enamel knot & cord.

 2 school of thought

 Reservoir of cells tooth shape & form

 Represents an organizational centre that orchestrates cuspal

morphogenesis.
BELL STAGE.
 Continued growth of tooth germ leads to next stage of tooth development,
the bell stage so called because the enamel organ resemble the shape of
bell as the undersurface of epithelial cap deepens
 2 stages

 Early Advanced
Continued…

 Crown shape is determined.

 Folding of enamel organ to cause different crown shapes is due to
differential rates of mitosis and difference in cell differenciation time.
 The inner enamel epithelial cells which lie in future cusp tip or incisor
region stop dividing earlier and begin to differenciate first.
 The pressure exerted by continuous cell division on these differenciating
cells from other area of enamel organ cause these cells to be pushed
outinto the enamel organ in form of cusp tip.
 Cells in another future cusp tip begin to differenciate by same process
result in cusp tip formation and area between 2 cusp tip i.e cuspal slopes
form.
Histology of bell stage.
 Cervical loop-junction between inner & outer enamel epithelium.
 Four different types of epithelial cells can be distinguished:-
 Inner enamel epithelium –single layer, diifenciate prior to gametogenesis
into tall columnar cells called as ameloblast. It is 4-5 micrometers in
diameter and 40 micrometer high.
 Elongated cell attached to one another by junctional complexes laterally
and to cells in stratum intermedium by desmosomes.
 Stratum intermedium-few layer of squamous cell between stratum inner
enamel epithelium and stellate reticulum. Cells are closely attached by
desmosomes and gap junctions.
 Stellate reticulum- expand further due to increase in the amount of
intercellular fluid . Cells are star shaped with long process that
anastomoses with those of adjacent cells. Before enamel formation
begins stellate reticulum collapses.
Continued…
 Outer enamel epithelium-cells are flatten to low cuboidal form. At the end of
bell stage ,during the formation of enamel OEE is laid in folds. Between the
folds ,the adjacent mesenchyme of dental sac forms the papilla that contain
capillary loops and provide nutritional supply.
Continued…

 Advanced bell stage-mineralization & root formation .

 Future DEJ is formed & first layer of dentin is laid down in future cusps
and proceeds apically.
 Ameloblasts lay down enamel over the dentin in future incisal and
cuspal area.
 Civically enamel organ give rise to HERS. It outline the future root &
responsible for shape, length, size and number of root.
Continued…

 HERS- Consist of OEE & IEE.

 Cells of IEE remain short and do not produce enamel.
 After the differentiation of radicular dental papilla cells into
odontoblasts ,and first layer of dentin laid down ERS loose its
structural continuity. Remnants persists as epithelial network
known as RESTS OF MALASSEZ.
Stages in root development.
Continued…

 Formation of epithelial diaphragm.

 OEE & IEE bend at future CEJ into a horizontal plane narrowing the wide
cervical opening.
 Proliferation of epithelial diaphragm followed by connective tissue of pulp
 Differentiation of odontoblast and formation of dentin follow lengthening of
root sheath.
 Wide apical foramen is reduced first to the width of diaphragmatic opening
itself and it is further reduced by apposition of dentin and cementum to apex
of root.
 Differential growth of epithelial diaphragm in multirooted teeth causes
division of root trunk into two or three roots.
Physiologic process

 Initiation-initiation induction requires ectomesenchymal epithelial interaction.

 Proliferation Enhanced proliferative activity ensues at the points of initiation and
results successively in the bud, cap, and bell stage.
 Histodifferentiation-the formative cells undergo morphologic as well as
functional changes. Highest phase reaches in highest development in the bell
stage of enamel organ just preceding the brining of formation and apposition of
dentin and enamel.
 Morph differentiation-basic form and relative size of future tooth is established.
Ameloblast, odontoblast and cement oblast deposit enamel ,dentin and
cementum and thus give the complete tooth its characteristic form and size.
 APPOSITION-deposition of matrix. Layer like deposition of extracellular matrix.
It is regular and rhythmic deposition of extracellular matrix.
Continued…
Developmental anomalies and their clinical consideration.

 HYPODONTIA-developmental absence of one or more teeth (excluding

the third molars) which can affect both the primary and permanent
dentition
Microdontia.

 Microdontia is a condition in which one or more teeth appear smaller than

normal. In the generalized form, all teeth are involved. In the localized
form, only a few teeth are involved. The most common teeth affected are
the upper lateral incisors and third molars.
Gemination and Fusion.
 Tooth fusion arises through union of two normally separated tooth germs, and
depending upon the stage of development of the teeth at the time of union, it may be
either complete or incomplete.
  Gemination is the incomplete division of a single tooth bud. 

 F
Anodontia.

 Anodontia is a rare genetic disorder

 characterized by the congenital absence of all 
primary or permanent teeth. It is divided into 2
subsections, complete absence of teeth or only
some absence of teeth.
 Partial or complete.
Amelogenesis imperfecta.
 Amelogenesis imperfecta (AI) refers to a group of rare, inherited disorders
characterized by abnormal enamel formation.
 The  main types are: hypo plastic (type I); hypomaturation (type II); hypo
calcified (type III); and hypomaturation/hypoplasia/taurodontism (type IV).
AI may be inherited as an X-linked, autosomal dominant, or autosomal
recessive genetic trait, depending on the subtype.
Dentinogenesis imperfecta.

 Dentinogenesis imperfecta (DI) is a genetic disorder of 

tooth development. This condition is a type of dentin dysplasia that
causes teeth to be discolored (most often a blue-gray or yellow-brown
color) and translucent giving teeth an opalescent sheen.
 Type I: DI associ
 Type II :Not associated with Osteogenesis Imperfecta (OI).
 Type III: Brandywine TYPE.
Continued…
Summary of tooth formation.
Development of tooth

https://www.youtube.com/watch?v=xrebAYBnKw0&fe
ature=youtu.be
References.

 Tencate’s oral histology-7th edition Antonio Nancy.

 Orban’s oral histology and embryology-13th edition Bhaskar SN..

 Human embryology-7th edition Inderbir Singh.

 Essential of oral histology and embryology –A clinical approach 2nd

edition James k Avery.

 Textbook of oral pathology-7th edition,Shafers.

 Various sites on internet.

Thank you
for your
attention!
Any questions?