Ace Achievers

Dental Academy

DENTIN
• Dentin is a vital tissue containing cell processes of odontoblasts & neurons.
• Odontoblasts form dentin matrix & neurons convey sensory information.
• The dentin provides the bulk and general form of the tooth and is characterised as
a hard tissue with tubules throughout its thickness. In the crown it is covered by
enamel, in the root by cementum.
• It is primarily formed as a secretory product of the odontoblasts and their processes.

Physical and Chemical Properties

Specific gravity 2.14
Knoop Hardness Number
- Dentin 68
- Sclerotic dentin 80
- Carious dentin 25
Modulus of Elasticity 15-20GPA
Compressive Strength 266 MPa
Tensile Strength 50 MPa

Physical Properties
Organic Matrix (20% by weight) Inorganic matrix
Consist of fibrils embedded in an amorphous (70% by weight)
ground substance. Fibrils are collagen and Calcium
comprise over 90% of the organic matrix. Hydroxyapatite:
Collagen – 90%, Mainly TYPE I and some amount Ca10(PO4)6(OH)2
of Type III and V. - Thin plate like
Non-Collagenous Matrix Proteins- 10%: crystals, shorter
Phosphoproteins- DPP (Phosphoryn), Gla- than enamel.
Composition Protein. - 3.5 nm thick, 100
Proteoglycans- Chondroitin SO4 (seen mainly in nm long.
Predentin) Salts- calcium
Glycoproteins- Dentin Sialoprotein, Osteonectin, carbonate,
Osteocalcin (Seen in mineralized matrix) sulphate,
Enzymes- Acid Phosphatase, Alkaline phosphate etc.
Phosphatase. Trace Elements -
Lipids- phospholipids, glycolipids etc. (2%) Cu, Fe, F, Zn
Water 10% (by weight)
Slightly darker than enamel and generally light yellowish
Becomes darker with age.
Colour
On constant exposure to oral fluids and other irritants, the colour
becomes light brown or black
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Structure of Dentin
Structure Features
Follow a ‘S’ shaped curve in the tooth crown and are straighter in
the incisal edges, cusps and root areas.
- The ends of the tubules are perpendicular to dentin enamel and
dentino cemental junctions.
- Lateral branches, termed as canaliculi or microtubules are
present throughout the dentin.
- Each dentinal tubule is lined with a layer of peritubular dentin,
which is more mineralized than the surrounding intertubular
dentin.
- Number of tubules increase from 15,000-20,000/mm2 at DEJ to
Dentinal
45,000-65,000/mm2 towards the pulp.
Tubules
- Diameter is 2-3 μm near pulp to 0.5 – 0.9μm near DEJ.
- Dentin tubules may extend from the odontoblastic layer to the DEJ
and give high
permeability to the dentin.
- Contents of dentinal tubule:
- Odontoblastic process
- Dentinal fluid, a complex mixture of proteins such as
albumin, transferrin, tenascin and proteoglycans
- Lamina limitans: Organic sheath or membrane lining the tubules
seen in EM
Lines the dentinal tubules and is more mineralized than intertubular
dentin.
It is twice as thick in outer dentin (approximately 0.75 µm) than in
Peritubular
inner dentin (0.4 µm). By its growth, it constricts the dentinal tubules
Dentin
to a diameter of 1 µm near the DEJ.
↓ collagen fibrils, ↑ sulphated proteoglycans
Hardness of H.A crystals – 250KHN
The main body of dentin is composed of intertubular dentin. It is
located between the dentinal tubules or, more specifically, between
Intertubular
the zones of peritubular dentin.
Dentin
Less mineralized
Hardness of H. A crystals -52KHN

Predentin
• The predentin is located always adjacent to the pulp tissue and is 2–6 µm wide,
depending on the extent of activity of the odontoblast. It is not mineralized.
• The predentin appears to be pale staining than the mineralized dentin owing to
differences in composition of the matrix.
• As the collagen fibers undergo mineralization at the predentin–dentin junction, the
predentin becomes dentin and a new layer of predentin is formed circumpulpally.

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Types of Dentin

Primary Dentin
• Dentin, which is formed before root completion, is known as primary dentin.
• The primary dentin is of two types: mantle dentin and the circumpulpal dentin.

Mantle Dentin Circum pulpal Dentin

It is the first-formed dentin in the crown It forms the remaining primary dentin or
underlying the DEJ. This zone below the bulk of the tooth.
DEJ is soft and thus provides cushioning The collagen fibrils in circumpulpal dentin
effect to the tooth. It is are much smaller in diameter (0.05 µm)
thus the outer or most peripheral part of and are more closely packed together
the primary dentin and is about 20 µm compared to the mantle dentin.
thick The circumpulpal dentin may contain
The larger diameter collagen fibers (0.1– slightly more mineral than mantle dentin.
0.2 µm Interdigitates with cementum – CEJ &
in diameter) are argyrophilic (silver Tomes
stained) and are known as von Korff’s granular layer
fibers. They contain mainly type III Circumpulpal dentin mineralizes either by
collagen globular or linear pattern
It is less mineralised and has fewer
defects than circumpulpal dentin.
Mantle dentin undergoes globular
mineralization.

Secondary Dentin
• Secondary dentin is a narrow band of dentin bordering the pulp and representing
that dentin formed after root completion. This dentin contains fewer tubules than
primary dentin.

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• There is usually a bend in the tubules where primary and secondary dentin interface.
• Secondary dentin is not formed uniformly and appears in greater amounts on the
roof and floor of the coronal pulp chamber, where it protects the pulp from exposure
in older teeth.
• The secondary dentin formed is not in response to any external stimuli, and it
appears very much like primary dentin. Due to the regular arrangement of dentinal
tubules, it is known as regular secondary dentin.

Tertiary Dentin
• Tertiary dentin is reparative, response, or reactive dentin. This is localized formation
of dentin on the pulp–dentin border, formed in reaction to trauma such as caries or
restorative procedures.
• Tertiary Dentin is sub-classified as:

Reactionary Dentin Reparative Dentin

Formed by pre-existing Formed by newly differentiated
odontoblasts odontoblast cells
Stimulus for Mild Aggressive
formation
Surviving post mitotic New odontoblast like cells from
Formative cells
odontoblasts progenitors
Physiologic Dentin Heterogenous
Change in the direction of - Tubular (Organised)
Structure
new dentinal tubules - Osteodentin, Fibrodentin
(Disorganised)

Interglobular Dentin
• Sometimes mineralization of dentin begins in small globular areas that fail to
coalesce into a homogeneous mass. This results in zones of hypomineralization
between the globules, known as globular dentin or interglobular spaces.
• This dentin forms in the crowns of teeth in the circumpulpal dentin just below the
mantle dentin, and it follows the incremental pattern.
• The dentinal tubules pass uninterruptedly through interglobular dentin, thus
demonstrating defect of mineralization and not of matrix formation
• Interglobular dentin occurs most frequently in the cervical and middle thirds
followed by intercuspal and coronal third in the crown. In roots, the highest
occurrence is seen in the cervical third followed by the middle third.

Granular Layer
• When dry ground sections of the root dentin are visualized in transmitted light, a
zone adjacent to the cementum appears granular, known as (Tomes’) granular layer.
• This zone increases slightly in amount from the cementoenamel junction to the root
apex and is believed to be caused by a coalescing and looping of the terminal
portions of the dentinal tubules.

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Incremental Lines of Von Ebner

• The incremental lines of von Ebner appear as fine lines or striations in dentin. They
run at right angles to the dentinal tubules and correspond to the incremental lines in
enamel or bone.
• These lines reflect the daily rhythmic, recurrent deposition of dentin matrix.
• The distance between lines varies from 4 to 8 mm in the crown to much less in the
[Link] lines are 20 µm apart and, they represent a 5-day interval in dentin
formation.

Lines of Shreger
• These lines appear due to congruence of primary curvatures of Dentinal tubules.

Contour Lines of Owen

• Occasionally, some of the incremental lines are accentuated because of
disturbances in the matrix and mineralization process. Such lines are readily
demonstrated in ground sections and are known as contour lines of Owen.
• Analysis with soft X-ray has shown these lines to represent hypocalcified bands.
• The contour lines of Owen are due to the coincidence of secondary curvatures.

Functions of Dentin
• Dentin constitutes the body of each tooth serving as:
- A protective covering for the pulp
- As a support for the overlying enamel
- Since dentin is a vital tissue it responds to any stimulus that poses a threat to
the vitality of tooth.

Age and Functional Changes

• From, 20 years to 70 years of age odontoblasts decrease in number by about half.
• Degeneration of the nerve axons causes reduction in sensitivity.
• The age changes in dentin include the formation of sclerotic dentin and dead tracts.

Sclerotic Dentin
• Sclerotic dentin occurs when hydroxyapatite crystals are laid down in the
intertubular dentin and within dentinal tubules to block the tubules against the entry
of bacteria, etc.
• The dentin then becomes transparent in transmitted light hence often called
transparent dentin.
• Permeability of dentin reduces while hardness increases in these regions.
• Breakage of apical thirds of roots during extraction of teeth of elderly is due to the
brittle nature of sclerotic dentin.

Dead Tracts
• Dead tracts are areas containing degenerated dentinal tubules which appear dark in
transmitted light and white in reflected light.

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• These are often seen in attrited or abraded teeth or below the carious lesions.
Innervations
• Dentinal pain is characterized by brief, sharp, well localized pain is response to
various stimuli.
• The pulp-dentin complex is innervated by:
- Myelinated Aβ and Aδ fibers
- Unmyelinated C fibers
• Dentin sensitivity:
- Aβ and Aδ fibers are present within the dentinal tubules and at the dentin pulp
junction.
- They are most numerous over the pulp horns , less in cervical dentin and least in
root dentin
Dentin Sensitivity
Theories of Pain transmission through Dentin
• Direct neural stimulation theory: This theory states that the nerves in the dentin get
directly stimulated. The nerves in the dentinal tubules are not commonly seen and
even if they are present, they do not extend beyond the inner dentin. Topical
application of local anesthetics does not abolish sensitivity. Hence, this theory is not
accepted.
• Hydrodynamic theory (Most accepted theory): The fluid movement, either inward
(due to cold stimuli) or outward (due to drying of exposed dentinal surface),
stimulates the pain mechanism in the tubules by mechanical disturbance of the
nerves closely associated with the odontoblast and its process. Thus, these endings
may act as mechanoreceptors as they are affected by mechanical displacement of
the tubular fluid.
• Transduction theory: The odontoblast process is the primary structure excited by
the stimulus and that the impulse is transmitted to the nerve endings in the inner
dentin. This is not a popular theory since there are no neurotransmitter vesicles in
the odontoblast process to facilitate the synapse or synaptic specialization.
However, odontoblasts, by modifying the local ionic environment, alter the threshold
of intradentinal nerves.

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Dentinal Fluid
• Between the odontoblastic process and the peritubular dentin, a space known as
periodontoblastic space is reported to be present. This space contains the dentinal
fluid.
• The normal flow of the fluid is outward from the pulp.
• The dentinal fluid has a higher K+ and a lower Na+ content. Composition of dentinal
fluid is similar to plasma. Calcium content in dentinal fluid of pre-dentin is 2-3 times
higher than in plasma.
• Dentin sensitivity is explained on the basis of this fluid movement:
- Exposure of tubules (during cavity preparation or due to #) → outward movement
→ tiny droplets → Dehydrate the surface → Rapid flow of fluid → Dentin
sensitivity.

Hypersensitivity
• The nerves, which enter dentin, do not extend beyond the inner two thirds of dentin.
The stimulation of dentin by any agent causes a pain like sensation called
hypersensitivity.
• The pain is sharp and easily localised.
• Etiology: Exposure of Dentinal tubules:
- Loss of enamel due to attrition, abrasion, erosion etc
- Loss of cementum due to scaling and root planing, gingival recession
• It is best explained by hydrodynamic theory
• Desensitizing toothpastes-AgNo3, SrCl2, fluorides, Bonding Agents, lasers etc.

Dentinogenesis
• Dentinogenesis begins at the cusp tips after the odontoblasts have differentiated
and begin collagen production.
• It is a 2-phase sequence:
a. Formation of collagen matrix
b. Calcification of the matrix

Continuous process can be subdivided into five stages:

1. Differentiation of odontoblasts
2. Deposition of organic matrix
3. Mineralization and modification of the organic matrix
4. Peritubular and secondary dentin formation
5. Tertiary dentin formation in response to injury

Differentiation of Odontoblasts
• In odontoblast differentiation, fibronectin, decorin, laminin, and chondroitin sulphate
may be involved.
• As the odontoblasts differentiate, they change from an ovoid to a columnar shape,
and their nuclei become basally oriented at this early stage of development. One or
several processes arise from the apical end of the cell in contact with the basal
lamina.

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• The length of the odontoblast increases, although its width remains constant.

Deposition of Organic Matrix

• First sign of dentin formation is the appearance of distinct, large diameter collagen
fibers (0.1 – 0.2 µm diameter) called Von Korffs fibers (type III collagen +
fibronectin).
• Other proteins associated are DPP, DSP.
• As the dentin is formed the odontoblasts develop cell process called the
‘Odontoblastic process’ or the ‘Tomes fibers’, which are left behind in the forming
dentin matrix as odontoblasts move towards the pulp.

Mineralisation and Modification of Organic matrix

• Matrix Vesicles are involved in mineralisation of mantle dentin.
• Odontoblasts are involved in mineralization of circumpulpal dentin.

Matrix vesicles
• The matrix vesicles, prior to its release by the odontoblast promotes the formation
of apatite.
• It contains enzymes like alkaline phosphatase, which locally increases the
concentration of phosphates, and these combine with calcium taken up from the
tissue fluid to form apatite within it.

Globular Mineralisation
• Deposition of hydroxyapatite crystals occur in several discrete areas of matrix at any
one time.
• Continued crystal growth → globular masses → enlarge and fuse → single layer of
calcified mass.
• Mantle dentin undergoes globular mineralisation.

Linear Mineralisation
• When the rate of dentin formation occurs slowly, mineralisation front appears more
uniform.
• This type of mineralisation is seen in circumpulpal dentin.

Root Dentin Formation

• The radicular dentin formation compared to coronal dentin is slower and less
mineralized with collagen fibers laid down parallel to the cementodentinal junction.
• These collagen fibers unlike in coronal dentin are laid adjacent to the
noncollagenous matrix of Hertwig’s epithelial root sheath.
• Root dentin formation is completed:
• 18 months after eruption in Primary dentition while 2-3 yrs after eruption in
permanent teeth.

Vascular Supply
• It is provided by the Capillaries found in the subodontoblastic layer of the pulp.
• The capillaries migrate between odontoblasts, and are regressed later.
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