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Teeth and Parodontium structure, development Ivo Klepáček IK

structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

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Page 1: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Teeth and Parodontium structure, development

Ivo Klepáček IK

Page 2: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

OROFACIAL SYSTEM Multifunctional complex of structures

CNS Muscles Joints

Teeth Jaws

Periodontium (parodontium)

fonation speech mastication digestion IK

Page 3: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

TEETH

tooth Dens, dentis lat.

Odus, odontos gr.

DENTES

(dens incisivus, caninus, premolaris, molaris (Y5 formula) IK

Page 4: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Zuby – teeth části parts

• Korunka crown (corona)

• krček neck (cervix)

• kořen root (radix)

• dřeň pulp (pulpa) IK

Page 5: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Teeth

• Firast and second dentition dentes decidui (lactales), permanentes

tooth masticating cusps roots I incisal crest 1 C 2 oblique crests 1 P 2 cusps 1 (2) M - upper 4 ; fissures „H“ 3 - lower 4 (5) ; fissures + 2

„H“

„+“ IK

Page 6: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

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Page 7: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

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Page 8: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

FDI Fedérale Dentaire Internationale ADA American Dental Association IK

Page 9: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Stálé Dočasné

Permanentes Lactei 32 20 IK

Page 10: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Enamel substantia adamantinosa

• The most firm body part • Organic part

– Formed by ameloblasts – glykoproteins

(amelogenins, enamelins)

• Anorganic part 95% – hydroxyapatite

• Arranged in prisms • Among them there is the

interprismatic substance

Prisms; interprismatic substance, crystals

Ameloblasts IK

Page 11: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Ameloblast: structure Secretion and reabsorbtion during enamelic matrix formation

Tomes fibers

Secretion

Tomes fiber

reabsorbtion

Nexus , desmosomes, tight junctions

Sir John Tomes,

(1815-1895), Engl. surgeon IK

Page 12: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Enamel structure Crystals, prisms and interprismatic substance (short and long molecules)

Prisms proceed to surface in various angles IK

Page 13: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Parazones Diazones IK

Page 14: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Hunter-Schreger strips, striae

Retzius strips, striae

Perikymata ridges, grooves IK

Page 15: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Dentine substantia dentinum

• calcified connective tissue

• Organic part – colllagen I,

proteoglycans – Formed by odontoblasts

• Located on the inner dentine surface

• Tomes fibers • Anorganic part

– hydroxyapatite • No-calcified dentine

• predentin • Closely to the enamel and

cementum

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Page 16: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Dentin odontoblasts

dentine tubules

Retzius lines vonEbner

Developmental order: Primary Secondary Terciary Folowing location: Mantle Circumpulpal Interdentin Globular Predentin Odontoblasts, matrix,

fibers

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Page 17: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

ODONTOBLASTS AND AMELOBLASTS

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Page 18: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Dentine tubules Tomes fibers Naumann sheath /sheet/ IK

Page 19: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Mantle dentine Intermingling processes granular Circumpulpal dentine matrix rich Interdentine interglobular

Predentine matrix poor odontoblasts

Dentine structure

External coat Mantle dentine

10-30um; contains alfa-fibrills

Inner dentine Circumpulpal dentine

Stripped; exhibits regular secretion and mineralization layers

Predentine Amorphous; area of synthesis; polymorphous, contains proteoglycans, tropocollagen, glycoproteins IK

Page 20: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Neonatal line

Incremental lines (associated with dentine maturation) Von Ebner Adresen Neonatal Relation between primary and secondary dentine

Mineralizing in birth IK

Page 21: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Flow of fluid around Tomes fibers and nerve endings inside canals are responsible for dentine sensitivity IK

Page 22: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Hypersensitive area Hyposensitive area

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Page 23: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Cementum = substantia ossea

• Thin layer on the root

• Similar to the spongy bone

• Cellular part – cementocytes IK

Page 24: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Cementum Cementoblasts, mucoprotein substance, fibers

Cellulare: Collagen fibers + intercellulare substance + cementocytes Non cellulare: Collagen fibers + intercellular substance

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Page 25: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Relation between cementum, dentine and enamel

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Page 26: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Hypercementosis IK

Page 27: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Pulp

fibroblasts

ramification

• Odontoblasts, • Weil subodontoblastic layer • Layer rich by nuclei

Pulpocytes (mesenchymal cells, fibrocytes) basic substance (collagen fibers, sugars, elastic fibers) free cells (histiocytes, monocytes, plasmatic cells)

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Page 28: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

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Raschkow plexus

Nerve fibers with vesels

Cell contacts

Bipolar pulpocyte

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Page 31: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Exchange of ionts between external environment and pulp IK

Page 32: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Teeth: Vascular and nervous supply

n.V/2 br.alveolares sup. post. br.alveolares sup. ant. n.V/3 n. alveolaris inf. plexus dent. (sup., inf.) br. dentales, gingivales aa. alveolares sup. post. aa. alveolares sup. ant. a. alveolaris inf. vv. – follow arteries to the pterygoid plexus lnodi. submandibulares (x M3) IK

Page 33: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Periodontium (Parodontium) Cementum, Cortical layer of alveolus Periodontal ligaments Gingiva (Mucoperiosteum) Cells Fibers Matrix Ligaments Plasma Vessels Nerves

“hydroelastic pillow“ IK

Page 34: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

PARODONTIUM Periodontium IK

Page 35: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Sulcus gingivae

Paramarginal sulcus

Gingiva = relation to the teeth – “cuff (collar) attachment“ IK

Page 36: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Gingiva proper (attached) =

pink, stippled, keratizing

Alveolar mucosa (“loose gingiva“) =

shiny red, nonkeratizing

Gingiva = fibrous tissue + mucous membrane Free: Interdental; embrasured; circumdental Attached: Adjacent,fixed IK

Page 37: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Gum = Gingiva • Non-keratinized

epithelium - parakeratosis

• Multilayered epithelium

• Gingival groove • Junctional epithelium

– gingivodental junction / closure IK

Page 38: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Interdental, circumdental, dentoalveolar, interalveolar ligaments

Ligamentous slings and circles help to tight attachment between gingiva and tooth IK

Page 39: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Upper teeth arch exhibits parabolic form Lower teeth arch exhibits hyperbolic form IK

Page 40: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Arches

parabolic

hyperbolic IK

Page 41: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Function of the Tooth

fixation system

Tooth fixation, elasticity, (hydroelastic cushion) nutrition, asistance during eruption

0.3-0.5

0.1-0.2

About 0.2 mm

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Page 42: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

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Page 43: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Free gingival groove changes

into periodontal

pocket IK

Page 45: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

frontal

lateral IK

Page 46: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Wilson curve

Spee curve

Monson

IK

Page 47: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Variations and

anomalies • Mesiodens • Paramolar • Tuberculum Carabelli • Divergention or convergention of roots • Fusion of roots • Intradental location of tooth (dens in dente) • Root hyperplasia IK

Page 48: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

IK

Page 49: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Teeth as a whole complex mordex = dentition

• ortodental position (vertical axes of teeth) • articulation = occlusion

– 80% psalidodontia (scissor-like occlusion) = norm – progenia = lower teeth in front of the upper ones – (hiatodontia (= mordex apertus), stegodontia, prognathia,

opisthodontia) IK

Page 50: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

IK

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Page 52: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Anodontia;

hypodontia;

diastema

Tooth abnormalities in shape and position;

Gingivitis IK

Page 53: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Bodily shift

Mesial shift

Resorbtion -

Apposition + IK

Page 54: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

“to palate“ “to tongue“

“wedge from“

“contact form“

Abrasion VII classes IK

Page 55: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

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Page 57: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Tooth development

• week 6 development of the dental lamina (dental molding) – Thick epithelium

inside oralmucous membrane

• Each molding has about 10 center of the proliferations – Dental buds IK

Page 58: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

Tooth developmental stages • Dental bud

– Local thick epithelium, 10 in each jaw

• Dental cap – Ectoderm part → enamel organ – Invagination of the mesenchyme → dental papilla

week 8

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Page 59: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

• Dental bud (hat) → bell – External dental organ – Dental reticulum – Inner dental organ – Dental papilla → dental pulp – Dentl sac → cementum, periodontal ligaments

Tooth developmental stages

week 8

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Page 60: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

• Epithelial dental sheath (cervical sling) – Area of the contact between

inner and outer enamelic epithelium

– Ingrowth to the mesenchyme; root induction

Tooth developmental stages

month 3 IK

Page 61: structure, development IK Ivo Klepáček · Periodontium (parodontium) fonation speech mastication IK digestion . TEETH tooth Dens, dentis lat. Odus, odontos gr. DENTES ... Tooth

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Použitá literatura

R. Čihák: Anatomie 1, 2, 3 Grada Publishing 2003

M. Dykes : Anatomy 2th edition, Mosby 2002

S.Snell: Clinical anatomy for Medical Students 6th edition, Lippincott, Williams & Wilkins

I.Klepáček, J.Mazánek et al.: Klinická anatomie ve stomatologii

Grada Publishing 2001

G.J.Tortora : Principles of Human Anatomy 4th edition, Williams & Wilkins

K.L.Moore, A.F.Dalley: Clinically Oriented Anatomy 4th edition, Williams & Wilkins

F.H.Netter: anatomický atlas člověka Vlastní archív

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