Tooth development
INTRODUCTION
• Odontogenesis is a highly co-ordinated and complex
process which relies upon cell-to-cell interactions
that result in the initiation and generation of the
tooth.
2
Initiation of Tooth Development
•Begins at 37 days of development with formation of a continuous
horseshoe-band of thickened epithelium in the location of upper and
lower jaws. Each of these bands is called as Primary Epithelial Band
Primary
Epithelial
Band
Dental lamina Vestibular lamina
(lip furrow band)
3
4
• The key feature of the
initiation of tooth
development is the
formation of localized
thickening or
ectodermal placodes
within the epithelial
bands.
• These are the line of
thickened epithelium at
the site of future dental Schematic representation of the early
oral cavity showing the in t ern a l
arches in the embryonic surface of the upper and lower jaws
maxilla and mandible. and illustrating the position of the
primary epithelial band 5
• Because no placodes have been observed in the oral
epithelium for the second and third molar which
apparently form successionally from the preceding molars
it is believed that the dental placode initiate formation of
each tooth family.
• It is evident that placode formation is an important event
in tooth formation by determining the number of cells that
will generate a tooth family. Hence , a smaller than
normal placode may lead to missing &/or smaller teeth
and a large placode to supernumerary &/or larger teeth
respectively.
6
•Dental lamina appears as a
thickening of the oral epithelium
adjacent to condensation of
ectomesenchyme.
•Acts as a primordium for
ectodermal portion of deciduous
teeth.
•The dental lamina begins to
function at 6th prenatal week
and continues to 5th year of
birth
•Permanent molars arise from
the distal extension of the dental
lamina. 7
Sagittal section through the head of an embryo. A, The thickened epithelium
of the primary epithelial band. B, The same structure at higher
magnification. C, Schematic representation of the change in plane of
cleavage during formation of the band and subsequently of the dental
FATE OF DENTAL
LAMINA
As the tooth continue to develop , they lose their connection with the
dental lamina.
They later break up by mesenchymal invasion, which is at first
incomplete and does not perforate the total thickness of the lamina.
Ramnents of dental lamina persist as epithelial pearl or islands within
the jaw as well as in gingiva. These are referred as cell rest of Serres.
A = Dental lamina
B = Mesenchymal neural crest
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Vestibular Lamina
Vestibule is formed due to
proliferation of vestibular lamina into
the underlying ectomesenchyme
immediately after the development
of dental lamina.
The cells of vestibular lamina
rapidly enlarges and then
degenerate to form a cleft that
becomes vestibule between the
cheek and the tooth bearing area.
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A = Vestibular lamina B = Dental lamina
Oral vestibule Tooth bud
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Tooth development is a continuous
process, however can be
divided into 3 stages:
1. Bud Stage
2. Cap Stage
3. Bell Stage
4. Hertwigs epithelial root
sheath and root formation
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BUD
STAGE
13
• During the bud stage the
dental lamina grows into the
mesenchyme at 10 different
points in future which will
correspond to position of
deciduous teeth.
14
It is represented by the first epithelial incursion into the
ectomesenchyme of the jaw.
Bud stage is characterized by rounded, localized growth of
epithelium surrounded by proliferating mesenchymal cells,
which are packed closely beneath and around the epithelial buds
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ENAMEL ORGAN
Peripherally located
low columnar cells
Centrally located polygonal
cells
Surrounding
ectomesenchyme
undergoes rapid mitosis.
Increased mitotic activity
and migration of neural
crest cells into the area the
ectomesenchymal cells
condenses
The area of condensation immediately subjacent to enamel
organ is the dental papilla. 14
CAP
STAGE
17
As the tooth continue to proliferate it does not expand uniformly into
a larger sphere. Instead unequal growths in different part of tooth
bud leads to the cap stage, which is characterized by shallow
invagination on the deep surface of the bud.
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A: Enamel organ B: Dental lamina
C: Vestibular lamina D: Dental Papilla
E: Dental sac
19
A: Stellate reticulum B:Outer enamel epithelium
C:Inner enamel epithelium D:Dental papilla
E: Dental sac
20
Early cap stage of tooth
development. A condensation of the
ectomesenchyme associated with the
epithelial cap is identified easily
Cap stage of tooth development.
The epithelial enamel organ sits over
a mass of ectomesenchymal cells,
the dental papilla
DENTAL
Under the organizing influence of
PAPILLA proliferating epithelium of the
enamel organ the ectomesenchyme
that is partially enclosed by the
invaginated portion of the inner
enamel epithelium proliferates.
It condenses to form dental papilla,
which is the formative organ of the
dentin and primordium of the pulp.
The dental papilla shows active
budding of capillaries and mitotic
figures and its peripheral cells
adjacent to the inner enamel
epithelium enlarges and later on
differentiate into the odontoblasts.
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Enamel organ
Enamel knot
Dental papilla
Dental follicle or sac
Dental follicle or dental sac is the condensed ectomesenchymal tissue
surrounding the enamel organ and dental papilla. This gives rise to
cementum and the periodontal ligament (support structures for tooth)20
Inner enamel Dental papilla Dental sac
epithelium
Odontoblasts Periodontium
Ameloblast
Dentine
Enamel &
Pulp
Histodifferentiation begins at the end of cap stage.
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Temporary structures
Enamel knot
Enamel cord
Enamel niche
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Enamel
Knot:
• Densely packed accumulation
of cells projecting from the
inner enamel epithelium into
dental papilla. Exact role not
known, but currently
• believed to be the
organizational center for cusp
development.
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27
Enamel cord : pattern of enamel knot that extends between IEE and OEE
Enamel knots are clusters of nondividing
epithelial cells visible in sections of molar cap
stage
Enamel knot precursor cells are first noted by expression of
p21 gene expression
Enamel knot and enamel cord are temporary structures that
disappear before enamel formation begins. It has been speculated
that the function of the enamel knot and cord may be to act as a
reservoir of dividing cells for the growing enamel organ
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Enamel niche. This
structure is created by
the plane of a section
cutting through a
curved lateral lamina so
that mesenchyme
a p p e a r s t o b e
surrounded by dental
epithelium.
Lateral Lamina: extension from the dental lamina that is connected to the
enamel organ
Enamel niche: It is an artifact produced during sectioning of the tissue. It
occurs because the enamel organ is a sheet of proliferating cells rather than a
single strand and contains a concavity filled with ectomesenchyme
We can also see that the inner and the outer dental epithelium are being orga2n6ized
• Advanced cap
stage tooth germ
showing the
position of the
enamel knot.
•T h e d e n t a l
papilla extends
around the rim
of the enamel
organ to form
the dental follicle
STAG
E
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Dental lamina
Outer dental
epithelium
Inner dental
epithelium
Dental papilla
Dental follicle
Cervical loop
• Continued growth leads to bell stage, where the enamel organ resembles a bell
with deepening of the epithelium over the dental papilla
• Continuation of histodifferentiation (ameloblasts and odontoblasts are defined)
and beginning of morphodifferentiation (tooth crown assumes its final shap2e8)
Cervical loop
Area where the inner and the outer dental epithelium meet at
the rim of the enamel organ. This point is where the cells will continue to
divide until the tooth crown attains its full size and which after crown
formation will give rise to the epithelium for root formation. Is also called
“Zone of Reflexion”.
A:Cervical loop
B:Inner enamel epithelium
C:Outer enamel epithelium
D:Stratum intermedium
E:Stellate reticulum
Early bell stage of tooth development.
A, The undersurface of the enamel organ has deepened, giving
the organ its bell shape. The dental papilla and dental follicle are
evident.
B, The distribution of alkaline phosphatase in the early tooth
germ is shown. Enzyme activity is demonstrated by the black
precipitate localized largely in the stratum intermedium
Bell Stage (Early)
Outer dental epithelium
Stellate reticulum
Stratum intermedium
Inner dental epithelium
Dental papilla
Inner dental epithelium: Short columnar cells bordering the dental papilla.
These will eventually become ameloblasts that will form the enamel of the
tooth crown by differentiating into tall columnar cells. The cells of inner dental
epithelium exert an organizing influence on the underlying mesenchymal cells
in the dental papilla, which later differentiate into odontoblasts.
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Bell Stage (Early)
Outer dental epithelium
Stellate reticulum
Stratum intermedium
Inner dental epithelium
Dental papilla
Stratum intermedium: Cell layer between the inner dental
epithelium and stellate reticulum which have high alkaline
phosphatase activity. They assist inner dental epithelium
(ameloblasts) to form enamel. The well developed cytoplasmic
organelle acid mucopolysaccharide and glycogen deposits indicate a
high degree of metabolic activity.
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Stellate reticulum:
• They expand further due to an increase in intracellular fluid.
The cells are star shaped. Before enamel formation begins
stellate reticulum collapses, reducing the distance between the
centrally situated ameloblasts and nutrient capillaries near the
outer enamel epithelium.
Outer dental epithelium
Stellate reticulum
Stratum intermedium
Inner dental epithelium
Dental papilla
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Outer dental epithelium
Stellate reticulum
Stratum intermedium
Inner dental epithelium
Dental papilla
Dental Papilla: Before inner dental epithelium begins to produce enamel
the peripheral cells of the mesenchymal dental papilla differentiate into
odontoblasts under the organizing influence of the epithelium. First, they assume
a cuboidal shape and then a columnar form and acquire the specific potential to
produce dentin. The basement membrane that separates the enamel organ and
the dental papilla just prior to dentin formation is called the “membrana
preformativa”
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Odontoblastic differentiation
Preameloblasts initiate the differentiation of odontoblasts
which arise from cells in the dental papilla. The odontoblasts are
called preodontoblasts before they begin the production of
dentin.
A, Preameloblasts
B, Preodontoblasts
C, Stellate reticulum
D, Dental papilla
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Deposition of dentin and enamel
• Mature, elongated odontoblasts begin the deposition of
predentin. This deprives the preameloblasts of their nutritional
source inducing their differentiation into ameloblasts which then
begin to deposit enamel
• Predentin is completely organic when it is formed and gradually is
mineralized to form dentin
• Enamel is partially mineralized when it is deposited
A, Odontoblasts B, Predentin
C, Ameloblasts D, Enamel
E, Dentin
Arrows show the direction of movemen35t of
ameloblasts and odontoblasts.
Bell stage of tooth development. The
dental lamina is disintegrating, so
the tooth now continues its
development separated from the oral
epithelium.
The crown pattern of the tooth has
been established by folding of the
inner enamel epithelium.
This folding has reduced the amount
of stellate reticulum over the future
cusp tip.
Dentin and enamel have begun to
form at the crest of the folded inner
enamel epithelium.
The space indicated by asterisks
results from the artifactual
detachment of the enamel from the
dentin by tissue processing
Bell Stage
Dental lamina (and the lateral lamina) will disintegrate and loose contact
with oral epithelium. Sometimes, these epithelial cells will persist when they
are called “epithelial pearls” or “cell rests of Serre”
Clinical significance: Cysts will develop in these (eruption cysts) and prevent
eruption, or they may form odontomas (tumors) or may form supernumery
teeth
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Eruption Cyst
44
Future crown patterning also occurs in the bell stage, by folding of the inner dental epithelium.
Cessation of mitotic activity within the inner dental epithelium determines the shape of a tooth.
The cessation of mitotic division within cells of
the inner enamel epithelium determines the
shape of a tooth.
When the tooth germ is growing rapidly during
the cap-to-bell stage, cell division occurs
throughout the inner enamel epithelium.
As development continues, division ceases at a
particular point because the cells are beginning
to differentiate and assume their eventual
function of producing enamel.
The point at which inner enamel epithelial cell
differentiation first occurs represents the site
of future cusp development.
Because the inner enamel epithelium is
constrained between the cervical loop and
cusp tip, continued cell proliferation causes the
inner enamel epithelium to buckle and form a
cuspal outline
Thus the future cusp is pushed up toward the
outer enamel epithelium.
Eventually differentiation of inner enamel
epithelium and papilla cells sweeps down
along the cusp slopes and is followed by the
deposition of dentin and enamel first at the
cusp tip.
These two matrices are deposited face-to-face,
thereby defining the dentinoenamel junction.
The occurrence of a second zone of cell
differentiation within the inner enamel
epithelium leads to the formation of a second
cusp, a third zone leads to a third cusp, and so
on until the final cuspal pattern of the tooth is
determined.
These zones are determined by molecular
signals in the enamel knot.
• Cytodifferentiation becomes apparent .
• The successional lamina (permanent tooth
bud), which will give rise to the permanent
tooth, arises from the dental lamina.
A: Inner enamel epithelium
B: Outer enamel epithelium
C: Stellate reticulum
D: Successional lamina E:
Dental lamina F:Dental
papilla
G: Dental sac
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Formation of Permanent Dentition
Successional tooth bud
The tooth germs that give rise to permanent incisors, canines and
premolars form as a result of further proliferative activity within the
dental lamina, lingual to the deciduous tooth germ.
The developing permanent molars have no deciduous predecessor and
their tooth germs originate from the dental lamina that extends posteriorly
beneath the oral epithelium after the jaws have grown.
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The molars of the permanent dentition have no deciduous predecessors, so their tooth germs
do not originate in the same way. Instead, when the jaws have grown long enough, the dental
lamina burrows posteriorly beneath the lining epithelium of the oral mucosa into the
ectomesenchyme. This backward extension successively gives off epithelial outgrowths that,
together with the associated ectomesenchymal response, form the tooth germs of the first,
second, and third molars . Because of this backward extension of the dental lamina of the
forming mandible, on occasion, teeth occur in the flattened, bony ramus of the adult mandible
•Entire primary dentition initiated between 6 and 8 weeks of embryonic
development.
•Successional permanent teeth initiated between 20th week in utero
and 10th month after birth
•Permanent molars between 20th week in utero (first molar) and 5th
year of life (third molar)
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Hard Tissue Formation
• Deposition of dental hard
tissues is called “apposition”.
• After the crown attains its final
shape during cap to early bell
stage, the inner dental
epithelial cells stop to
proliferate, except the cells at
the cervical loop
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For dentinogenesis and amelogenesis to take
p l a c e n o r m a l l y, t h e d i f f e r e n t i a t i n g
odontoblasts and ameloblasts will receive
signals form each other – “reciprocal induction”
Stages of Apposition
1. Elongation of inner dental epithelium
2. Differentiation of odontoblasts
3. Formation of dentin
4. Formation of enamel
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First layer of dentin appears at the cusp tips and progresses cervically, and
the columnar cells of the inner dental epithelium become elongated and
show reverse polarization, with the nuclei adjacent to stratum intermediate
(ameloblasts)
The boundary between the odontoblasts and inner dental epithelium
defines the future dentino-enamel junction
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Ameloblasts
First layer of enamel
Dentin
Odontoblasts
At the same time or soon after the first layer of dentin (mantle dentin)
is formed, the inner dental epithelial cells differentiate into
ameloblasts and secrete enamel proteins. These proteins further will
help in the terminal differentiation of odontoblasts. The ameloblasts
will then start laying down organic matrix of enamel against the newly
formed dentinal surface. The enamel matrix will mineralize
immediately and form the first layer of enamel. The formation of
enamel is called amelogenesis. 47
• At the same time when the inner dental epithelium is
differentiating, the undifferentiated ectomesenchymal cells
increase rapidly in size and ultimately differentiate into
odontoblasts
• The increase in size of the papillary cells leads to elimination
of the acellular zone between dental papilla and inner dental
epithelium
56
•Immediately after the inner dental epithelial cells undergo reverse
polarization, ectomesenchymal cells immediately subjacent to the
acellular layer, will rapidly enlarge and elongate to become
odontoblasts and appear like protein-producing cell. The acellular
layer is eliminated and the odontoblasts will occupy this zone.
•Odontoblasts are highly polarized with the nuclei away from inner
dental epithelium.
•Following differentiation of odontoblasts, first layer of dentin is
produced, characterized by appearance of large-diameter type III
collagen fibrils (0.1 to 0.2 m in dia) called von Korff ’s fibers,
followed by type I collagen fibers – MANTLE DENTINE
57
• At the same time as initial dentin deposition, the
odontoblasts will develop stubby processes at the side close
to the inner dental epithelium which extend into forming
extracellular matrix
• As the odontoblasts move pulpward, the odontoblast
process (Tomes´ fiber) will elongate and become active in
dentine matrix formation
• It is initially called predentin and following mineralization
is called dentin
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The odontoblasts as they differentiate will start elaborating organic matrix of
dentin, which will mineralize. As the organic matrix of dentin is deposited,
the odontoblasts move towards the center of the dental papilla, leaving behind
cytoplasmic extensions which will soon be surrounded by dentin. Therefore,
a tubular structure of dentin is formed.
ameloblasts
odontoblasts dentin
Odontoblasts with cytoplasmic processes forming dentinal tubules
2 steps of dentinogenesis: 1. Formation of collagen matrix
2. Deposition of calcium and phosphate
(hydroxyapatite) crystals in the matrix
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Advanced Stages of Apposition
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Growth areas of developing crown.
Growth at cusp tip, intercuspal
region, and cervical region
Incremental pattern of
dentin and enamel
formation from
initiation to completion
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Root Formation
Hertwig’s epithelial
root sheath
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 Hertwig’s epithelial root sheath.
The root sheath determines if a tooth has single or multiple roots, is short or
long, or is curved ir straight 55
• The epithelial root sheath induces the differentiation of
odontoblasts which form root dentin. The apical most portion of
the root sheath turns inward toward the radicular pulp cavity
(that portion of the pulp cavity inside the root) and is called the
epithelial diaphragm
A: Epithelial diaphragm;
B: Radicular pulp cavity;
C: Dentin;
D: Enamel space;
E: Alveolar Bone;
F: Root 56
Epithelial diaphragm: The proliferating
end of the root sheath bends at a near
45-degree angle. The epithelial
diaphragm will encircle the apical
opening of the dental pulp during root
development
Primary apical formen
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• The epithelial root sheath = inner + outer enamel epithelial
layers.
• Following the induction of odontoblast and dentin formation, the
epitheal root sheath disintegrates forming epithelial rests (small
groups of epithelial cells that can remain around the root)
A:Radicular pulp cavity
B:Dentin
C:Dental sac
D:Point at which epithelial root sheath begins
to disintegrate
E:Epithelial diaphram F:Epithelial rests
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Inner dental epithelium
Outer dental epithelium
Hertwig’s epithelial
root sheath
Stratum intermedium
Eventually the root sheath will fragment to form several discrete clusters
of epithelial cells known as epithelial cell rests of malassez.
59
These will persist in adults within the periodontal ligament.
Epithelial Cell Rests of Malassez
The epithelial rests appear as small clusters of epithelial cells which
are located in the periodontal ligament adjacent to the surface of
cementum. They are cellular residues of the embryonic structure
known as Hertwig's epithelial root sheath.
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Secondary apical foramen form as a result of two or three tongues of
epithelium growing inward toward each other resulting in multirooted teeth
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Direction of root growth versus eruptive movement of tooth
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Cementum formation
As the epithelial root sheath
breaks down, cells from the
dental sac migrate to the
surface of the root dentin
and differentiate into
cementoblasts. These cells
lay down cememtum on the
surface of the root.
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Tooth eruption and Development of
supporting structures
Soon after root formation begins, tooth begins to erupt until it reaches its
final position
While roots are forming, the supporting structures of tooth also
develop – periodontal ligament and cementum
As the root sheath fragments, the dental follicle cells will penetrate between
the epithelial cells and lie close to the newly formed root dentin
These cells will differentiate into cementoblasts, which will make cementum
Fibers of the periodontal ligament, which will also form from the cells of the
dental follicle will get anchored in the organic matrix of the cementum which
will later get mineralized
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Time Line of Human Tooth Development
Age Developmental Characteristics
42 to 48 days Dental lamina formation
55 to 56 days Bud stage; deciduous incisors;
canines and molars
14 weeks Bell stage for deciduous teeth; bud
stage for permanent teeth
18 weeks Dentin and functional ameloblasts
in deciduous teeth
32 weeks Dentin and functional ameloblasts
in permanent first molars
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