TOOTH
DEVELOPMENT
PROF. DR. ASAD
MAHMOOD
B.D.S, [Link]. (UK), FICD (USA)
HEAD OF DEPT. ORAL BIOLOGY
PROFESSOR
RAHBAR COLLEGE OF DENTISTRY
Tooth Development
Complex process divided into three overlapping phases.
1. Initiation
2. Histogenesis (differentiation of cells to form fully formed dental
tissue)
3. Morphogenesis (shape determined by cell proliferation and cell
movement)
Tooth Development
During development of embryo, there is formation of 3 germ layers
a) Ectoderm
b) Endoderm
c) Mesoderm
The primitive oral cavity or stomodeum is lined by 2-3 cell thick
layer of stratified squamous epithelium called ORAL ECTODERM.
Connective tissue cells underlying the epithelium are termed as
ectomesenchymal cells. Induce overlying ectoderm to start tooth
development.
INTITIATION OF TOOTH
Epithelial Mesenchymal Interactions
Signaling between the overlying epithelium and the
underlying mesenchymal tissue.
INTRODUCTION
The initiation of tooth development
begins at 37 days of development
Tooth Development
Primary Epithelial Band
37th day (6th week) of development
Continuous thickened band of epithelium
Horse shoe shaped
Positions of future dental arches
At 7th week, It further divides into,
1. Dental Lamina
2. Vestibular Lamina
PRIMARY EPITHELIAL
BAND
PRIMARY EPITHELIAL
BAND
Vestibular Lamina
Formation of vestibule
Proliferation of vestibular lamina in ectomesenchyme
Cells first enlarge and then degenerate to form cleft between
cheeks and tooth bearing area
This results in the formation of vestibule
2. Dental Lamina
Series of epithelial ingrowths into ectomesenchyme.
Corresponds position of future deciduous teeth.
Dental Lamina
Tooth development proceeds into three stages,
1. Bud Stage
2. Cap Stage
3. Bell Stage
1. BUD STAGE
Epithelial incursion into
the ectomesenchyme.
Simple, ovoid epithelial
condensation surrounded
by mesenchyme.
Epithelial cells show little
changes in shape or
function.
2. CAP STAGE
Condensation of Ectomesenchyme
Continuous proliferation of the epithelial bud into
ectomesenchyme, cellular density increases adjacent to the
epithelial in growth.
This epithelial outgrowth, resembling a cap which sits on the
condensed ectomesenchyme is known as ENAMEL ORGAN.
CAP STAGE
2. CAP STAGE
The ball of the condensed ectomesenchyme is called DENTAL
PAPILLA and this will form the Dentin and Pulp.
The condensed ectomesenchyme limiting the dental papilla and
encapsulating the enamel organ is DENTAL SAC/FOLLICLE
and this give rise to supporting tissues of the tooth.
Enamel organ, dental papilla and dental sac together form the
Tooth germ or dental organ.
CAP STAGE
CAP STAGE
CAP STAGE
ENAMEL NICHE is a structure seen in histological
sections as dental lamina is a sheet and it often
contains the concavity filled with connective tissue.
CAP STAGE
CAP STAGE
In late cap stage, cells in centre of enamel organ
secrete glycosaminoglycans which accumulate in
intercellular spaces.
This is hydrophilic, so pulls water into enamel organ
so cells become separated and become star shaped
known as Stellate Reticulum.
CAP STAGE
CAP STAGE
Enamel knots are clusters of nondividing epithelial
cells visible in sections of molar cap stage tooth
germ.
is the localized thickening in the internal dental
epithelium at the centre of the tooth germ.
Represents an organizational center, which helps in
cuspal morphogenesis.
The knot is continuous with the ENAMEL CORD,
which is a strand of cells running from the knot to
the external dental epithelium
BELL STAGE
This stage is further divided into two sub stages,
a) Early bell stage
b) Late bell stage
By the 14th week further morphodifferentiation and
histodifferentiation leads to bell stage.
EARLY BELL STAGE
Tooth crown assumes its final shape (morpho
differentiation)
Cells forming the hard tissue of crown acquire their
phenotype (histodifferentiation)
EARLY BELL STAGE
Outer enamel epithelium (low cuboidal shape)
Inner enamel epithelium (short columnar shape)
Cervical loop/ Zone of relaxation (point where
cells of internal and external epithelium meet)
Cells between the inner enamel epithelium and
stellate reticulum differentiate into layer called
Stratum Intermedium. This has high content of
enzyme alkaline phospotase
EARLY BELL STAGE
EARLY BELL STAGE
EARLY BELL STAGE
DENTAL
LAMINA
OUTER ENAMEL
EPITHELIUM
STELLATE
RETICULUM
STRATUM
INTERMEDIUM
INNER ENAMEL
EPITHELIUM
DENTAL
PAPILLA
CERVICAL
LOOP
DENTAL
SAC
EARLY BELL STAGE
EARLY BELL STAGE
Outer dental epithelium:
A single rows of cuboidal cells. Involved in maintenance in shape of enamel
organ and exchange of substances btw enamel organ and their environment
Stellate reticulum:
In addition to alkaline phosphatase have RNA and glycogen. Its mesenchyme
like features include synthesis of collagen I, II, III. Main function is
mechanical as there is increase in intercellular fluid and layer expands. The
cells assume star shape with long processes that anastomose with adjacent
cells.
Stratum Intermedium:
2-3 layers of flattened cells appear between stellate reticulum and inner
dental epithelium. They resemble stellate reticulum but have less alkaline
phosphatases. It has been proposed that this is concerned with synthesis of
proyeins, the transport of materials to and from the enamel forming cells
(IEE) and concentration of materials.
EARLY BELL STAGE
Dental papilla separated from enamel organ by basal lamina.
This forms the dentine (odontoblasts) and pulp.
It is the mesenchyme enclosed portion of the Dental organ. The
peripheral cells under the influence of inner enamel epithelium
assume an cuboidal shape first & columnar later and are called
Odontoblast, which produce dentin. The basement membrane
separating the epithelial dental organ and dental papilla is called
membrana performativa which forms future dentino enamel
junction.
Dental follicle is distinguished as it has more collagen in
extracellular space and this give rise to the supporting structure
of the tooth (periodontal fibers, cementum and alveolar bone)
BELL STAGE
The dental lamina disintegrates, leaving the
developing teeth completely separated from the
epithelium of the oral cavity.
crown of the tooth, which is influenced by the shape
of the internal enamel epithelium, also takes shape
during this stage
EARLY BELL STAGE
DENTAL
LAMINA
OUTER ENAMEL
EPITHELIUM
STELLATE
RETICULUM
STRATUM
INTERMEDIUM
INNER ENAMEL
EPITHELIUM
DENTAL
PAPILLA
CERVICAL
LOOP
DENTAL
SAC
BELL STAGE
Remnants of dental lamina may persist and are
known as epithelial perls of serres, that may
contain keratin and involved in the etiology of cysts.
Crown of tooth is mapped by the folding of the IEE
which is due to differential mitotic rates. The future
cusps associated with cessation of mitosis whereas
areas of fissures and margins remain mitotically
active.
Thus cusp height is related more to the continued
downward growth at margins and fissures than to
upward extension of cusps.
LATE BELL STAGE
At about 18th week
Formation of dental hard tissue
Dentine formation always proceeds enamel formation.
LATE BELL STAGE
FORMATION OF
PERMANENT DENTITION
Permanent dentition arises from dental lamina
Incisors, canines, premolars develop
Down growths of the external enamel epithelium from the
lingual side of the enamel organ give rise to tooth germ of the
permanent successor.
succesional dental lamina
these permanent teeth are called succedaneous teeth (anterior
teeth and the premolars)
teeth that form with the primary tooth buds (primary
predecessors
FORMATION OF
PERMANENT DENTITION
Molars have no decidious predecessors, so their tooth germ don't
originate this way
With passage of time there is increase in length of jaws, dental
lamina burrows posteriorly beneath lining epithelium of oral
mucosa into ectomesenchyme
This backward extension gives off epithelial outgrowths which by
ectomesenchymal interaction form tooth germ of the 1st, 2nd and
3rd molars
LATE BELL STAGE
HARD TISSUE FORMATION
Next step is the formation of two principal hard tissues,
1. Enamel by ameloblasts
2. Dentin by odontoblasts
(Histodiffrentiation)
Firstly at future cusp tips a layer of dentin will first appear,
mitotic activity ceases and short columnar cells of IEE
elongate & reverse polarity, become taller nuclei shift
towards stratum intermedium and golgi complex towards
dental papilla and transform into ameloblasts.
Changes also occurring in the cells of adjacent dental papilla ,
the undifferentiated mesenchymal cells increase in size and
transform into odontoblasts.
42-48 days Dental lamina formation
55-56 days Bud stage, deciduous incisor canine &
molar.
14 weeks Bell stage for deciduous teeth, bud
stage for permanent teeth
18 weeks Dentin and functional ameloblastes
in deciduous teeth.
32 weeks Dentine & functional ameloblast in
permanent teeth
ROOT FORMATION
Root start forming after dentin formation has
reached future cementoenamel junction. Both
dental organ and dental papilla play part in
formation of root.
Hertwig's epithelial root sheath
The outer and inner dental epithelium meets one
another at future cervical area and is called cervical
loop.
This cervical loop forms epithelial sheath of
Hertwig, which moulds the shape of the root and
initiates dentin formation.
ROOT FORMATION
This sheet of epithelial cells grows around dental papilla
between the papilla and dental follicle and it encloses all
but the basal portion of the papilla. This rim of root sheath
Epithelial Diaphragm encloses the primary apical
foramen.
As the Inner epithelial cells of root sheath encloses more
and more of dental papilla it causes the differentiation to
odontoblasts from the outer cells of papilla to form the root
dentin.
Hertwig's sheath is destroyed due to infiltration of
connective tissue and the root sheath breaks up into small
strands of epithelium called epithelial rests of Malassez.
ROOT FORMATION
FORMATION OF SUPPORTING
TISSUES
Form from dental follicle.
Cementogenesis in the root area occurs upon degradation of
the H. root sheath
The degradation allows contact of the dental follicle cells with
the root dentin surface – induces the formation of
cementoblast cells
The cementoblasts cover the root dentin and undergo
cementogenesis – laying down cementoid
only upon mineralization of the cementoid can it be called
cementum
the region of contact between cementum and root dentin =
FORMATION OF
SUPPORTING
TISSUES
the surrounding tissues of the
tooth also develop as the
crown and root form
the mesenchyme of the dental
sac/follicle condenses to form
the periodontal ligament
forms adjacent to the new
cementum
ends of these fibers insert into
the outer layer of cementum
and surrounding alveolar bone
the cells of the disintegrating
H. root sheath develop into
discrete islands of epithelial
cells
become epithelial rests of
Malassez
no known function
they can be identified in the
periodontal ligament and are
responsible for the
development of radicular
cysts.
Multi rooted tooth
formation:
1. Formation is essentially same as in single rooted tooth.
2. Imagine root sheath as a collar or skirt hanging from enamel organ
3. From this skirt, "tongue-like" extensions of tissue grow
inward toward each other.
4. When two tongues grow and meet, they divide the bottom opening
(apical foramen) into two separate ones, leading to two roots.
5. In same way, if three epithelial tongues are formed, it will give rise to
three secondary apical foramina.
6. .Around each opening, HERS forms a tube-like structure, just like in
single-rooted teeth.
7. In upper molars (maxillary), three tongues form, making three
roots.
8. In lower molars (mandibular), two tongues form, making two
roots.
SUMMARY
TRANSITORY
STRUCTURES
Enamel knot
Enamel cord
Enamel niche
Tooth Type Determination
The determination of specific tooth type at their
correct positions in jaws is referred to as
“Patterning of dentition“
Two hypothetical models,
1. Field model
2. Clone model
Tooth Type Determination
FIELD MODEL, proposes that factors responsible for tooth
reside within the ectomesenchyme in distinct graded and
overlapping fields for each tooth family.
Each of the fields expresses different combinations of patterning
homobox genes.
Field Model:
• Says that tooth shape is controlled by signals in the jaw
tissue (ectomesenchyme).
• Different regions (or "fields") in the jaw give rise to different
tooth types.
• These fields express special genes called homeobox genes,
which help decide what kind of tooth grows there (like incisor or
molar)
Tooth Type Determination
CLONE MODEL, proposes that each tooth class is derived
from clone of mesenchymal cells programmed by the
epithelium to give teeth of given pattern
Clone Model:
• Suggests that each group of similar teeth comes from a group
(clone) of cells programmed to make a certain tooth shape.
• These cells keep growing in a sequence to form similar teeth
(like molars one after the other).
Both models may be correct, just explaining different
parts of how tooth shapes are decided.
GENES INVOLVED
IS TOOTH SHAPE
Msx-1 and Msx-2: Found
where incisors and canines will grow.
Dlx-1 and Dlx-2: Found in areas
where molars will grow.
Barx-1: Helps form molars and
overlaps with the Dlx genes.
These genes don’t point to one exact
tooth, but rather help mark broad
zones in the jaw.
GENES INVOLVED IS
TOOTH SHAPE
• Msx-1 and Msx-2: Found where incisors and canines will
grow.
• Dlx-1 and Dlx-2: Found in areas where molars will grow.
• Barx-1: Helps form molars and overlaps with the Dlx genes.
These genes don’t point to one exact tooth, but rather help
mark broad zones in the jaw.
Genes involved in regionalization of Oral and
Dental Ectoderm
HH and wingless signalling are involved in ectodermal cell boundary
specification
Wnt-7b is found in most of the oral ectoderm, except in the area where teeth
will form (the dental ectoderm).
Shh is found in the dental ectoderm, where Wnt-7b is not present.
Wnt-7b has reciprocal expression pattern to Shh in Oral ectoderm
means Wnt-7b and Shh are found in opposite areas of the oral
ectoderm.
If Wnt-7b is placed where Shh normally is, Shh disappears and tooth
development doesn't happen.
This means Wnt-7b stops Shh from being active in those cells.
Hence, Wnt-7b and Shh control each other and help keep the boundary clear
between where regular mouth lining forms and where teeth will grow.
.
How is the oral–aboral axis established?
How is the tooth type determined?
The position of tooth germ in the established oral–
aboral axis is determined by the expression of Fgf-8,
Pitx-2 and Bmp-4 in oral epithelium and Pax-9 in
tooth mesenchyme.
After establishing the tooth position, the tooth type
determination is regulated through a subfamily of
Homeobox genes that include Msx gene and Dlx gene.
The Dlx-1, Dlx-2 and Barx-1 are seen in the posterior
regions while Msx-1, Msx-2 and Dlx-2 are seen in the
anterior region.
RECIPROCAL
INDUCTION
Inner enamel epithelium send signals (growth factors, enamel
proteins, bone morphogenic proteins)…...... to dental papilla
cell…..........differentiation to odontoblast…........secrete mantle
dentin…........send signals to inner Enamel Epithelium….........
Ameloblasts……...... (Ameloblasts) secrete enamel
Differentiating odontoblasts must receive signals from
differentiating Ameloblasts and vice versa (RECIPROCAL
INDUCTION)