Dental Anatomy: Enamel Properties
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Questions and Answers

What is the role of the honeycomb structure in enamel rods?

  • It prevents enamel discoloration.
  • It provides aesthetic properties to the tooth.
  • It enhances the strength of enamel. (correct)
  • It increases the brittleness of enamel.

Which structure in enamel represents areas of less mineralization?

  • Enamel tufts (correct)
  • Lines of Retzius
  • Enamel spindles
  • Enamel lamellae

What are the incremental lines found in enamel referred to as?

  • Imbrication lines
  • Enamel lamellae
  • Gnarled enamel lines
  • Lines of Retzius (correct)

Where are enamel rods positioned in relation to the dentin?

<p>Perpendicular to the dentin. (D)</p> Signup and view all the answers

The pronounced line of Retzius that marks the trauma experienced by ameloblasts during birth is called what?

<p>Neonatal line (A)</p> Signup and view all the answers

What is the function of interrod enamel?

<p>It consists of secretions from adjacent ameloblasts. (C)</p> Signup and view all the answers

How do enamel lamellae differ from enamel tufts?

<p>Lamellae are vertical sheets, while tufts represent areas of less mineralization. (C)</p> Signup and view all the answers

What is the primary structural unit of enamel?

<p>Enamel prisms (A)</p> Signup and view all the answers

What is the primary organic component of mature dentin?

<p>Collagen (C)</p> Signup and view all the answers

Which characteristic best describes the appearance of dentin in comparison to enamel?

<p>Dentin appears radiolucent on radiographs (A)</p> Signup and view all the answers

What can cause dentinal hypersensitivity?

<p>Exposure of dentin due to attrition (B)</p> Signup and view all the answers

What is the primary function of odontoblasts during the formation of dentin?

<p>To produce predentin (B)</p> Signup and view all the answers

Which of the following statements about dentin is false?

<p>Dentin appears more dense than cementum. (C)</p> Signup and view all the answers

What is dentinal caries primarily caused by?

<p>Demineralization from cariogenic bacteria (D)</p> Signup and view all the answers

What can lead to the staining of dentin?

<p>Consumption of food and beverages (D)</p> Signup and view all the answers

What is the pH threshold at which dentin begins to demineralize?

<p>6.8 (C)</p> Signup and view all the answers

What is the primary function of the apical foramen?

<p>To permit the exchange of nutrients and signals between the pulp and surrounding tissues (B)</p> Signup and view all the answers

Which cells are considered the largest group found in the dental pulp?

<p>Fibroblasts (B)</p> Signup and view all the answers

What happens to dental pulp stem cells after an injury?

<p>They can transform into fibroblasts or odontoblasts to aid recovery. (D)</p> Signup and view all the answers

Which zone of the pulp is closest to the dentin and contains odontoblasts?

<p>Odontoblastic layer (B)</p> Signup and view all the answers

Which type of nerve fibers in the pulp are primarily associated with pain sensation?

<p>Nocioreceptors (D)</p> Signup and view all the answers

What defines the cell-free zone within the pulp?

<p>Houses a nerve and capillary plexus but has fewer cells than the odontoblastic layer (A)</p> Signup and view all the answers

Which statement regarding accessory canals is correct?

<p>They form when the Herwig epithelial root sheath intersects with a blood vessel. (C)</p> Signup and view all the answers

In terms of vascular supply, which zone of the pulp has an increased density of cells?

<p>Cell-rich zone (A)</p> Signup and view all the answers

What is a characteristic change in the aging pulp?

<p>Increase in collagen fibers (A)</p> Signup and view all the answers

What is pulpitis?

<p>Inflammation of the pulp (D)</p> Signup and view all the answers

What can happen if the apical foramen becomes obliterated?

<p>Vascular congestion and necrosis (B)</p> Signup and view all the answers

Which statement about pulp stones (denticles) is true?

<p>They may appear radiographically as radiopaque masses. (A)</p> Signup and view all the answers

What are the components of the periodontium?

<p>Alveolar process, cementum, and PDL (A)</p> Signup and view all the answers

How does cementum differ from other tooth structures?

<p>It can regenerate throughout life. (A)</p> Signup and view all the answers

What is a consequence of gingival recession on cementum?

<p>Cemental caries development (A)</p> Signup and view all the answers

What role do cementoblasts play in cementum development?

<p>They become cementocytes as they become entrapped. (D)</p> Signup and view all the answers

Which type of pulpitis is characterized by reversible inflammation?

<p>Reversible pulpitis (D)</p> Signup and view all the answers

What is the primary inorganic component of cementum?

<p>Calcium hydroxyapatite (A)</p> Signup and view all the answers

What is the primary function of odontoblasts in dentin development?

<p>They produce dentin throughout the life of the tooth. (C)</p> Signup and view all the answers

What characterizes primary mineralization of dentin?

<p>It forms calcium hydroxyapatite crystals as globules in predentin. (A)</p> Signup and view all the answers

Which type of dentin is characterized by being less mineralized and is located near the DEJ?

<p>Interglobular dentin (B)</p> Signup and view all the answers

What is the main role of dentinal tubules?

<p>They serve as pathways for nutrients and include the odontoblastic process. (A)</p> Signup and view all the answers

Which of the following statements is true regarding tertiary dentin?

<p>It forms in response to caries and localized injury. (C)</p> Signup and view all the answers

How does aging affect dentinal tubules?

<p>They narrow in diameter due to increased deposition of peritubular dentin. (C)</p> Signup and view all the answers

What is the primary cause of dentinal hypersensitivity?

<p>Exposure of dentin tubules due to various factors. (C)</p> Signup and view all the answers

Which type of dentin is typically found surrounding the pulpal wall and makes up the majority of dentin in a tooth?

<p>Circumpulpal dentin (B)</p> Signup and view all the answers

What affects the formation of contour lines of Owen in dentin?

<p>Disturbances in body metabolism impacting odontoblast activity. (A)</p> Signup and view all the answers

Which of the following characterizes sclerotic dentin?

<p>It appears transparent and is associated with chronic injury. (D)</p> Signup and view all the answers

What is the significance of the smear layer during cavity preparation?

<p>It serves as a barrier to prevent bacterial invasion. (C)</p> Signup and view all the answers

What type of nerve fibers primarily respond to thermal stimuli in dentin?

<p>A fibers (delta &amp; beta) (C)</p> Signup and view all the answers

Which structure within the dental pulp is involved in the formation of dentin?

<p>Central cells of the dental papilla (C)</p> Signup and view all the answers

The process of dentin apposition is distinct in that it occurs in what manner?

<p>In waves, similar to the development of enamel. (B)</p> Signup and view all the answers

What condition is indicated by a pinkish color of the crown of a tooth?

<p>External resorption (A)</p> Signup and view all the answers

What constitutes the major function of Sharpey fibers in cementum?

<p>Attach teeth to the alveolar process (D)</p> Signup and view all the answers

Which type of cementum comprises the first layers deposited at the dentinocemental junction (DCJ)?

<p>Acellular cementum (B)</p> Signup and view all the answers

What type of cementum is primarily located in the apical third of the root and contains embedded cementocytes?

<p>Cellular cementum (C)</p> Signup and view all the answers

What is the consequence of excessive production of cellular cementum known as hypercementosis?

<p>Pulpal necrosis (D)</p> Signup and view all the answers

Which structure serves as a protective layer around the alveolar process and contains blood vessels and nerves?

<p>Periosteum (B)</p> Signup and view all the answers

What type of abnormal cementum formation involves mineralized spherical bodies found in the PDL?

<p>Cementicles (D)</p> Signup and view all the answers

Which factor may contribute to the resorption of alveolar bone following tooth loss?

<p>Absence of functional stimulation from teeth (D)</p> Signup and view all the answers

Which periodontal ligament fiber group is primarily responsible for resisting rotational forces on the tooth?

<p>Alveolar crest group (C)</p> Signup and view all the answers

What may occur during rapid orthodontic treatment that results in changes to the root apex?

<p>Root apex resorption (D)</p> Signup and view all the answers

What is the most coronal part of the alveolar bone proper known as?

<p>Alveolar crest (A)</p> Signup and view all the answers

Which of the following best describes the composition of alveolar process bone by weight?

<p>60% inorganic, 25% organic, 15% water (B)</p> Signup and view all the answers

In the event of trauma causing periodontal ligament damage, which tissue may initially lose its fiber attachments?

<p>Periodontal ligament fibers (D)</p> Signup and view all the answers

Which group of periodontal ligament fibers is most susceptible to the progression of periodontal disease?

<p>Alveolar crest group (B)</p> Signup and view all the answers

Flashcards

Enamel Rod

The crystalline structural unit of enamel.

Hunter-Schreger Bands

Alternating light and dark bands in enamel structure that increase its strength.

Lines of Retzius

Incremental lines or striae in enamel that show daily growth stages.

Imbrication Lines

Raised incremental lines in enamel.

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Neonatal Line

A prominent line of Retzius marking birth-related trauma in ameloblasts.

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Enamel Spindles

Short dentinal tubules near the DEJ (Dentino-enamel junction) that are remnants of odontoblasts.

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Enamel Tufts

Small dark brushes in enamel with bases near the DEJ, showing less mineralization.

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Enamel Lamellae

Partially mineralized sheets of enamel matrix extending from the DEJ to the surface of the tooth.

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Apical foramen

A tiny opening at the tooth's root tip where blood vessels, nerves, and lymphatic vessels connect the pulp to the surrounding periodontal ligament.

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Accessory canals

Additional openings in the tooth root that connect the pulp to the periodontal ligament.

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Pulp Histology

The study of the tissues that make up the tooth's pulp, including fibroblasts, odontoblasts, stem cells, and nerves.

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Fibroblasts

The most abundant type of cell in the pulp, responsible for producing and maintaining the pulp's connective tissue.

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Odontoblasts

Specialized cells that line the outer wall of the pulp and produce dentin.

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Dental pulp stem cells

Undifferentiated cells found in the pulp that can transform into fibroblasts or odontoblasts to repair injuries.

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Secondary dentin

Dentin formed after the tooth has erupted, usually in response to wear or irritation.

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Tertiary dentin

Dentin formed in response to injury or infection, often irregular and irregular.

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Dentin's Hardness

Dentin is harder than bone but softer than enamel, making it a durable yet sensitive material.

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Dentin Composition

Dentin is primarily composed of mineralized material (calcium phosphate), collagen, and water.

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Dentin's Appearance

Dentin appears yellowish and radiolucent on X-rays due to its lower density compared to enamel.

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Dentin's Role in Sensitivity

Dentin is permeable due to its tubules, which act as channels allowing stimuli to reach the pulp, leading to sensitivity.

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Dentin Formation

Dentin is formed by odontoblasts, laying down predentin (non-mineralized collagen) during the apposition stage of tooth development.

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Dentin Demineralization

Dentin demineralizes when the pH drops below 6.8, leading to caries. This is why cavity preparations remove affected dentin.

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Dentin's Clinical Importance

Dentin can be exposed due to enamel wear, trauma, or recession, leading to sensitivity, staining, and altered shape.

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Dentin Whitening

Dentin whitening can be performed, but can lead to hypersensitivity due to the increased permeability of the tubules.

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Odontoblast Function

Odontoblasts produce dentin, a hard tissue that forms the bulk of the tooth, at a rate of approximately 4 micrometers per day.

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Dentin Growth

Dentin formation continues throughout life, filling the pulp chamber in both the crown and root of the tooth.

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Dentin Formation Pattern

Dentin formation follows the same wave pattern as enamel but in the opposite direction, beginning at the incisal/occlusal part and spreading down the cervical loop of the enamel organ.

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Primary Mineralization

In the first stage of dentin formation, calcium hydroxyapatite crystals form as globules within the collagen fibers of predentin, allowing for expansion and fusion.

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Secondary Mineralization

In the second stage, new areas of mineralization occur as globules form in partially mineralized predentin, expanding and fusing incompletely, creating a distinct microscopic appearance.

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Globular Dentin

Dentin that has undergone both primary and secondary mineralization.

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Interglobular Dentin

Dentin that has only undergone primary mineralization, resulting in less mineralization.

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Dentinal Tubules

Long tubes that extend from the DEJ (dentino-enamel junction) to the pulp, containing dentinal fluid, odontoblast processes, and afferent axons.

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Dentinal Fluid

Tissue fluid surrounding the cell membrane of the odontoblast, providing nutrients to the avascular dentin.

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Peritubular Dentin

Highly mineralized dentin that forms the walls of the dentinal tubules.

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Intertubular Dentin

Dentin found between the dentinal tubules, highly mineralized but less than peritubular dentin.

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Mantle Dentin

The first predentin to form, located near the DEJ under the enamel, containing large diameter Von Korff fibers.

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Circumpulpal Dentin

Dentin surrounding the pulpal wall, forming the bulk of the dentin.

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Primary Dentin

Dentin formed before the completion of the root's apical foramen, characterized by a regular pattern of tubules.

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Pulpal core

The central region of the pulp chamber containing cells and vascular supply.

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Aging Pulp

Pulp undergoes changes with age, including a reduction in cells and water, an increase in collagen fibers, and a smaller pulp cavity due to secondary dentin formation.

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Pulp Recession

A clinical sign of aging pulp, where the pulp cavity appears smaller due to the formation of secondary dentin.

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Pulp Stones

Mineralized masses of dentin formed during tooth development or later in life, appearing radiopaque on x-rays.

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Pulpitis

Inflammation of the pulp caused by injury, resulting in pain.

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Reversible Pulpitis

Pulp inflammation confined to the coronal portion of the pulp, potentially reversible with treatment.

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Irreversible Pulpitis

Pulp inflammation that spreads to the pulp's root, causing infection and potentially leading to a periapical abscess or cyst.

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Periodontium

The tissues surrounding the tooth, including cementum, alveolar process, and periodontal ligament.

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Cementum

The thin layer of bone-like tissue covering the tooth root, attaching it to the alveolar process.

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Cemental Caries

Dental decay affecting the cementum, leading to chronic infection in the pulp.

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What is cementum?

A specialized bone-like tissue covering the root of a tooth, providing attachment to the periodontal ligament.

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What are Sharpey fibers?

Collagen fibers from the periodontal ligament that embed into both cementum and alveolar bone, anchoring the tooth.

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What is the difference between acellular and cellular cementum?

Acellular cementum is the first layer deposited, lacking cementocytes, while cellular cementum is laid on top, containing cementocytes.

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What is the significance of the dentinocemental junction (DCJ)?

The boundary between dentin and cementum, marking the transition between the tooth's inner core and its outer covering.

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What are cementicles?

Spherical mineralized bodies of cementum found attached to the root or free in the periodontal ligament.

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What are cemental spurs?

Symmetrical cementum spheres attached to the root surface, similar to enamel pearls, often near the CEJ.

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What is the difference between alveolar process and basal bone?

The alveolar process surrounds the tooth root, supporting it, while the basal bone forms the body of the jaw.

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What is the alveolar bone proper (ABP)?

The compact bone lining the tooth socket, with numerous holes for nerves and blood vessels.

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What is the lamina dura?

The radiographic image of the alveolar bone proper, appearing as a thin, dense line.

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What is the alveolar crest?

The most cervical rim of the alveolar bone proper, normally slightly apical to the CEJ.

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What is the difference between cortical bone and trabecular bone?

Cortical bone is a dense, outer layer, while trabecular bone is spongy bone with spaces.

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What are interdental and interradicular septa?

Bone separating two neighboring teeth (interdental) or roots of the same tooth (interradicular).

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What is the periodontal ligament (PDL)?

A fibrous connective tissue that attaches the tooth to the alveolar bone, allowing for tooth movement and cushioning.

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What are principal fibers?

The main groups of collagen fibers in the PDL, orientated to resist various forces on the tooth.

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What is the function of the alveolar crest group of fibers?

They attach near the CEJ and resist tilting, intrusive, extrusive, and rotational forces.

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What is occlusal trauma?

Trauma to the periodontium caused by misaligned or unbalanced biting forces.

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Study Notes

Enamel Properties

  • Not a renewable tissue; non-vital; avascular
  • Hardest mineralized tissue in the body
  • Can endure crushing pressure about 100,000 lbs per sq in
  • When healthy, can only be removed by rotary cutting instruments or files
  • By weight: 96% inorganic material, 1% organic material, 3% water
  • Consists mostly of calcium hydroxyapatite
  • Contains less hydroxyapatite than dentin and cementum
  • Ribbon-like enamel crystals are at different angles throughout the crown, each 30% larger than dentin crystals
  • Covers the anatomic crown
  • Each tooth can withstand 20-30 lbs of pressure
  • Thicker at incisal edges & cusps, thinner cervically
  • Protects from physical, thermal, and chemical forces

Clinical Considerations with Enamel Structure

  • Attrition: Wearing of hard tissue due to tooth-to-tooth contact. Increases with age and parafunctional habits. Results in loss of vertical dimension.
  • Wear facets: Occlusal or incisal surfaces worn by attrition, leading to fractured enamel rods and high reflectivity.
  • Abrasion: Enamel loss from friction caused by excessive tooth brushing and abrasive toothpaste.
  • Erosion: Enamel loss through chemical means (e.g., bulimia, gastric reflux, drug use, meth mouth).

Enamel Caries

  • Loss of enamel mineralization due to cariogenic bacteria, occurring when enamel pH is less than 5.5.

Abfraction

  • Enamel loss by an increase in tensile and compressive forces during tooth flexure, commonly associated with parafunctional habits.
  • Appears as a notch in the cervical region.
  • Typically covered with composite fillings.

Enamel Matrix Formation

  • Amelogenesis: Formation of enamel matrix during the apposition stage of tooth development.

Enamel Pathology

  • Noncavitated lesions (incipient caries): Early enamel demineralization, loss of color, glossiness, or surface structure. Potentially reversible if caught early.

Enamel Histology

  • Enamel rod (or prism): Crystalline structural unit of enamel.
  • Cylindrical rods with varied structural arrangements.
  • Crystals bend, increasing enamel strength.
  • Hunter-Schreger bands: Alternating light and dark lines along enamel showing crystal orientations.
  • Interrod enamel: Surrounds enamel rods.
  • Lines of Retzius: Incremental striae (lines) marking incremental growth during enamel formation.
  • Neonatal line: Pronounced line of Retzius marking developmental trauma at birth, clearly seen in primary dentition and the first molar of the permanent dentition.
  • Imbrication lines: Raised lines associated with lines of Retzius.

Dentin-Pulp Complex

  • Dentin properties: Non-vital, less hard than enamel but harder than bone. Contains about 70% inorganic matter, 20% organic matter and 10% water.
  • Consists primarily of collagen and calcium hydroxyapatite.
  • Dentin tubules: Extend from the DEJ to the pulp; contain dentinal fluid and odontoblastic processes.
  • Dentin types: Mantle, primary, secondary, and tertiary.
  • Primary dentin: Forms before the apical foramen completion.
  • Secondary dentin: Formed after apical foramen completion
  • Tertiary dentin: Quickly forms in response to injury.
  • Smear layer: Thin layer of biofilm debris, preventing dentin permeability.

Aging Dentin

  • Dentinal tubule diameter narrows with age due to peritubular dentin deposition, impacting pulp's stimulus response.
  • Dentinal translucency is a useful parameter for determining dental age.

Pulp Properties

  • Innermost soft tissue, appearing radiolucent (less dense).
  • Connective tissue composed of fibroblasts.
  • Involved in dentin support, maintenance and continued formation.
  • Serves as sensory tissue (pain).
  • Serves nutritional function for itself and dentin.
  • Contains white blood cells.

Pulp Anatomy

  • Pulp chamber: Shape corresponds to tooth shape.
  • Coronal pulp: Located in crown, extends into cusps of posterior teeth as pulp horns; these are not present in anterior teeth.
  • Radicular pulp: Located in root; extends to apex.

Pulp Histology

  • Fibroblasts: Largest cell type.
  • Odontoblasts: 2nd largest, located along outer pulpal wall.
  • Dental pulp stem cells: In pulp tissue; can transform into fibroblasts and odontoblasts.
  • 4 Pulp Zones: Odontoblastic layer, cell-free zone, cell-rich zone, pulpal core.

Pulp Pathology & Repair

  • Pulp stones (denticles): Mineralized masses of dentin.
  • Pulpitis: Inflammation of the pulp.
  • Reversible pulpitis: Localized inflammation to coronal portion.

Periodontium Properties

  • Includes cementum, alveolar process, and periodontal ligament (PDL).
  • Cementum properties: Attaches teeth to alveolar process, not visible in health.
  • Thickest at the apex, thinnest near CEJ.
  • Avascular, no nerve supply; receives nutrition from surrounding PDL vascular tissue.
  • Composed of 65% inorganic material, 23% organic material, and 12% water.

Cementum Development

Cementum formation occurs after root formation is complete and continues throughout life. Divided into prefunctional (throughout root formation) and functional (post-occlusion) stages.

  • Cementoblasts become entrapped as cementocytes.
  • Cementoid forms, then mineralizes into cementum.
  • Appositional growth of cementum over dentin forms the dentinocement junction (DCJ).

Cementum Histology

  • Sharpey Fibers: Collagen fibers from PDL that run perpendicular to the cementum surface into the alveolar bone.
  • Cementocytes: Cells housed within lacunae (cavities) within cementum with canal-like processes.

Cementum Types

  • Acellular Cementum (Primary Cementum): First cementum deposited at the dentinocement junction; slower deposition, does not contain cementocytes, and shows no change in width throughout life.
  • Cellular Cementum (Secondary Cementum): Deposited over acellular cementum, primarily in the apical third of the root and contains cementocytes.

Cementum Pathology

  • Cementicles: Mineralized spherical bodies of cementum that may form either attached to the root surface or lying free in the PDL.
  • Cemental Spurs: Similar to enamel pearls (found at or near the CEJ).
  • Hypercementosis: Excessive production of cellular cementum.

Alveolar Process Properties

  • Supports and protects teeth, and is part of the periodontium.
  • Composed of 60% non-organic, 25% organic and 15% water components.
  • Contains calcium hydroxyapatite.

Jaw Anatomy & Histology

  • Jaw is composed of two types of bone with different physiologic functions.
  • Alveolar Process: Part containing roots (alveolar bone or ridge).
  • Basal Bone: Part of the maxilla or mandible (below the root region and not considered part of the periodontium).
  • Alveolar Bone Proper (ABP): Lines the tooth socket; composed of compact bone.
  • Supporting Alveolar Bone: Contains trabecular bone (cancellous or spongy bone) between the ABP plate.

Clinical Considerations for Jaw Development

  • Anodontia (missing teeth) can potentially interfere with development of the alveolar process. Teeth need to be present in the jaw to stimulate proper bone formation.

Periodontal Ligament Properties

  • Connects tooth to the alveolar bone.
  • Blood vessels, lymphatics, and nerve supply transmit pain, pressure & temperature sensations.
  • Fibroblast: Most abundant cell type.
  • Cementoblasts: Form cementum.
  • Osteoblasts: Form bone.
  • Osteoclasts & odontoclasts: Resorb tissue.

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