DENTIN

PART 1

Dentin: Basic Concepts

Physical & Chemical Properties [00:38]
• Forms the Bulk: Dentin forms the main body of the tooth and dictates the
crown shape, size, cusps, ridges, and number of roots.
• Color: It is light yellow in young adults and darkens with age.
• Consistency: Dentin is visco-elastic, unlike the brittle enamel.
• Hardness:
• Comparison: Enamel > Dentin > Bone [01:16] (Enamel is the hardest,
followed by dentin, then bone).
• Tooth Type: Hardness is greater in permanent teeth compared to primary
teeth.
• Location: Hardness is greater in the central part of the dentin and less in
the peripheral part.

Composition [02:09]
• Inorganic Matrix (65%):
• Crystals: Primarily composed of hydroxyapatite crystals with the chemical
formula 3Ca3(PO4)2·Ca(OH)2.
• Shape: These crystals are plate-shaped.
• Trace Elements: High carbon content, low calcium, and traces of phosphate,
carbonate, and sulfate.
• Organic Matrix (35%):
• Components: Consists of ground substance and collagen fibers embedded
within it.
• Ground Substance: Made up of mucopolysaccharide, chondroitin sulfate,
decorin, biglycan, dentin sialoprotein, osteonectin, osteopontin, dentin
phosphoprotein, and gla proteins.
• Growth Factors: Contains various growth factors, including transforming
growth factor (TGF), fibroblast growth factor (FGF), insulin-like growth
factor (IGF), and bone morphogenetic protein (BMP).
• Collagen: Predominantly Type I collagen [03:27] (important for MCQs and
vivas).

Structure of Dentin [03:59]

• Dentin-forming Cells: Odontoblasts are the cells responsible for forming
dentin.
 • Location of Odontoblasts: Odontoblast cell bodies line the pulp, and their
cytoplasmic processes extend into the dentinal tubules. [04:47]
• Dentinal Tubules:
• Shape: S-shaped structures with primary curvatures [05:47] that begin at a
right angle to the pulpal surface, with the first convexity towards the root
apex.
• Terminal Branches: Show terminal branches in the root tip and incisal
edge where they are almost straight.
• Secondary Curvatures: Minute sinusoidal-shaped curvatures are also
present along the entire length of the tubule. [06:56]
• Thickness of Dentinal Tubules: [07:22]
• Overall: 3 to 10 mm.
• Gender: Thicker in males than in females.
• Location on Tooth: Thicker on the buccal surface than the lingual surface.
• Proximal Surfaces: Thickness is consistent in both mesial and distal
portions.
• Diameter of Dentinal Tubules: [08:11]
• Near Pulp: Larger (3-4 micrometers).
• Near Outer Surface: Smaller (1 micrometer).
• Number of Dentinal Tubules: [08:59]
• Ratio: The ratio of dentinal tubules per unit area in the pulpal region to the
outer enamel surface is 4:1. This means there are more tubules near the
pulp.

Types of Dentin

Peritubular Dentin (Intratubular Dentin) [09:14]

• Location: Immediately surrounds the dentinal tubule, forming its wall.
• Mineralization: More highly mineralized than intertubular dentin. [09:51]
• Thickness: Twice as thick in the outer dentin than in the inner dentin. [09:44]
• Formation: Deposited in the inner wall of the dentinal tubule. It is also called
intratubular dentin due to its location.
• Decalcification: Completely lost after decalcification. [10:07]

Intertubular Dentin [11:37]

• Location: Present between the dentinal tubules.
• Decalcification: Retained after decalcification. [11:43]
• Composition:
 • Organic Matrix: Composed of collagen fibers that are 0.5 to 0.2
micrometers in diameter and show characteristic cross-banding every 64
micrometers [12:38].
• Inorganic Matrix: Hydroxyapatite crystals (0.1 micrometers in length) are
present parallel to the collagen fibers.

Predentin [12:51]
• Location: Always adjacent to the pulpal tissue.
• Mineralization: Unmineralized.
• Thickness: 2-6 micrometers in diameter. [13:11]
• Appearance: Pale staining.
• Maturation: At the predentin-dentin junction, collagen fibers mineralize, and
predentin becomes dentin. A new layer of predentin is then formed
circumpulpal.

Primary Dentin [14:52]

• Components:
• Mantle Dentin: The first-formed dentin [15:26], located just below the
dentinoenamel junction. It is softer and less mineralized. Its collagen
fibers are larger and are Type III collagen [16:03], also known as von
Korff's fibers [16:10].
• Circumpulpal Dentin: Surrounds the pulp, forming the bulk of the dentin. It
is harder and more mineralized than mantle dentin, with smaller collagen
fibers.

Secondary Dentin [16:21]

• Formation: Formed after root completion [16:32].
• Appearance: A narrow band surrounding the pulp. [16:47]
• Histology: Shows a bend in the tubules where primary and secondary dentin
meet.
• Protective Role: Seen in high quantity at the roof and floor of the pulp chamber,
protecting against pulp exposure.
• Stimulus: Formed continuously and not in response to any stimulus [17:01].

Tertiary Dentin [17:29]

• Formation: Formed in response to a stimulus [17:36], such as caries or
restorative procedures.
• Other Names: Also known as reparative dentin or reactive dentin [17:47].
• Location: Formed at the junction of the pulp and dentin.
 PART 2

Dentin: Part 2 - Basic Concepts 🦷

This lecture covers several key aspects of dentin, building upon previous
knowledge.

Incremental Lines of Dentin [00:53]

• Dentin is deposited daily in a rhythmic pattern.
• These rhythmic depositions are represented by incremental lines of Von
Ebner.
• These lines illustrate the growth pattern of dentin.
• They appear as fine lines and are perpendicular (90 degrees) to the dentinal
tubules.
• The distance between two incremental lines is typically 4-8 micrometers in the
crown and less in the root.
• Recent studies suggest these lines can be 20 micrometers apart, representing a
five-day interval in dentin formation.

Contour Lines of Owen [01:57]

• These are accentuated or highlighted incremental lines of Von Ebner.
• They represent areas of hypo-calcification (decreased calcification).

Neonatal Line [02:27]

• Similar to enamel, a neonatal line is present in dentin.
• This line differentiates prenatal dentin from postnatal dentin.
• It is also an area of hypo-calcification.

Interglobular Dentin [02:58]

• Interglobular dentin is found in the circumpulpal dentin.
• Mineralization of dentin begins in small globules, which normally fuse to form
a homogeneous mass.
• Interglobular dentin forms when these globules fail to merge completely,
resulting in zones of hypo-mineralization.
• The dentinal tubules pass uninterrupted through interglobular dentin,
indicating a defect in mineralization rather than matrix formation.
• In a ground section viewed under transmitted light, interglobular dentin
appears as black spaces because the dentin is lost.

Tomes' Granular Layer [04:48]

 • When a ground section of a tooth's root portion is observed, a granular zone
appears adjacent to the cementum.
• This is known as Tomes' granular layer.
• This layer is formed due to the coalescing and looping of dentinal tubules in
that area.
• Tomes' granular layer increases in thickness from the cementoenamel junction
towards the root apex.
• It is rich in calcium and phosphorus.

Innervation of Dentin [05:59]

• The dentinal tubule contains the odontoblastic process.
• In addition, small, minute nerves are present inside the dentinal tubule, in
close association with the odontoblastic process.
• These nerves are more prevalent in the predentin and inner part of the dentin.

Theories of Pain Transmission [06:52]

There are three main theories explaining pain transmission in dentin:
1. Direct Neural Stimulation Theory [07:08]
• This theory proposes that external stimuli directly stimulate the nerves in
the dentin.
• However, it is unacceptable because nerves are primarily found in the
inner part of the dentin, not the outer part where stimuli often initiate.
2. Hydrodynamic Theory [07:43] (Most Popular Theory)
• The dentinal tubule contains the odontoblastic process and a dentinal
fluid.
• When a stimulus (e.g., caries, restorative procedure) acts on the tooth, it
causes movement of the dentinal fluid within the tubule.
• This fluid movement irritates the nerve fibers, leading to pain.
3. Transduction Theory [08:52]
• According to this theory, stimuli excite the odontoblast process.
• The impulses are then transferred from the odontoblast process to the
nerves, causing pain.
• This theory is not as popular or accepted as the hydrodynamic theory.

Changes in Dentin [09:16]

External stimuli like caries, abrasion, attrition, or restorative procedures can
cause changes in dentin, including:
1. Reparative Dentin [09:34]
• When odontoblasts are injured by external stimuli:
 • If the odontoblasts survive, they deposit regenerated dentin.
• If the odontoblasts die, they are replaced by new odontoblasts, which
then form reparative dentin.
• Other names: response dentin, reactive dentin, tertiary dentin.
• Reparative dentin is not identical in quality to normal dentin.
• It contains irregular and fewer dentinal tubules.
• Sometimes, osteodentin (similar to bone) or a combination of osteodentin
and tubular dentin is formed.
• The molecule Dentin Phosphopyrin is absent in tertiary dentin.
• Nestin & Notch protein, which is present during dentinogenesis, is re-
expressed in reparative dentin but absent in adult dentin.
2. Dead Tracts [11:44]
• In a ground section of a tooth, the odontoblastic process within the
dentinal tubule disintegrates.
• The dentinal tubule then becomes filled with air.
• Appearance under microscope (important for viva and MCQs):
• Black in transmitted light (Black is T)
• White in reflected light (White is Rum)
3. Sclerotic Dentin [13:10]
• Commonly found in the teeth of elderly people and in cases of slowly
progressing caries, predominantly in the root dentin.
• When stimuli act on the dentin, collagen fibers and hydroxyapatite crystals
begin to form within the dentinal tubule.
• Over time, these deposits totally block the tubule.
• Also known as transparent dentin because the refractive index of the
dentin within the tubules becomes equalized.
• Sclerotic dentin is very hard, but its fracture toughness is reduced.
• It blocks the dentinal tubule, thereby reducing the permeability of the
dentin.
• Appearance under microscope (opposite to dead tracts):
• White in transmitted light
• Black in reflected light

PART 3

Dentinogenesis: The Formation of Dentin 🦷

Dentinogenesis is a two-step process:
1. Organic Matrix Formation [00:25]
2. Mineralization [00:26]

Factors Influencing Dentinogenesis

Several key factors play a role in this process:
• Dentin Phosphoprotein (DPP): This protein is highly negatively charged and
attracts positively charged calcium ions, which helps in the growth of
hydroxyapatite crystals [00:54].
• Osteonectin: This factor reduces the size of hydroxyapatite crystals but
increases the binding between collagen fibers and hydroxyapatite [01:15].
• Osteopontin: This also aids in the growth of apatite crystals [01:30].
• Gla Proteins: These proteins act as nucleators or "seeds" that attract calcium
ions [01:42].
• Chondroitin Sulfate: This promotes the binding of collagen fibers with
hydroxyapatite crystals [01:57].
• Matrix Vesicles: These vesicles, found in odontoblasts, release enzymes like
alkaline phosphatase. This enzyme attracts calcium ions towards the matrix,
facilitating mineralization [02:05].
• Genes:
• MAP1B Gene: Responsible for odontoblast differentiation [02:37].
• PHEX Gene: Important for the mineralization of the matrix [02:46].

Process of Organic Matrix Formation

• Dentin formation begins in the bell stage of tooth development [03:41].
• The inner enamel epithelium (IEE) sends signals to the dental papilla [03:22].
• In response, dental papilla cells differentiate into pre-odontoblasts [03:51].
• These pre-odontoblasts then mature into odontoblasts [04:03].
• Cytoplasmic processes extend from the apical end of the odontoblasts [04:47].
• As matrix formation continues, these odontoblast processes increase in length
and become enclosed within the dentinal tubules [05:12].
• Pre-dentin is the first formed dentinal matrix, located around the pulp [04:00].
• Daily, 4 micrometers of dentin are formed until the tooth reaches occlusion.
After occlusion, the rate slows to 1 micrometer per day [05:07].

Process of Mineralization
• One day after pre-dentin is formed, it begins to mineralize with calcium
deposition, becoming circumpulpal dentin [05:19].
• A new layer of pre-dentin is then laid down near the pulp [05:40].
• The organic matrix of dentin is composed of ground substance containing
collagen fibers [06:55].
• The earliest crystal deposition occurs as fine plates of hydroxyapatite on these
collagen fibers [07:07].
• Subsequently, hydroxyapatite crystals are also laid down inside the collagen
fibers, resulting in a periodic banding at 64 nm intervals [07:49].
• Mineralization in dentin occurs in the form of spherulites, where crystal
deposition takes place radially from a common center [08:00].
• The final crystal size is 3 nm in thickness and 100 nm in length [08:35].
• Hydroxyapatite crystals in dentin are 300 times smaller than those found in
enamel [08:57].