TOOTH

DEVELOPMENT
DR. ASAD MAHMOOD
B.D.S, M.SC. (UK)
HEAD OF DEPT. ORAL BIOLOGY
ASSOCIATE PROFESSOR
LAHORE MEDICAL & DENTAL COLLEGE
 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.
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.

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 =

 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. Visualize two tongues of epithelium growing towards each
other from this collar.
4. In this way the primary apical foramen is converted to two
secondary apical foramina.
5. In same way, if three epithelial tongues are formed, it will
give rise to three secondary apical foramina.
6. Hertwig's epithelial root sheath extends around each foramen
forming as many epithelial tubes, same as in single rooted
tooth.
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 in distinct graded and
overlapping fields for each tooth family.
Each of the fields expresses different combinations of patterning
homobox genes.

 CLONE MODEL, proposes that each tooth class is derived

from clone of mesenchymal cells programmed by the
epithelium to give teeth of given pattern
 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)