TRUE & FALSE QUESTIONS

Embryology
1- The proliferation period begins by fertilization of the ovum till the development
of three germ layers
2- The embryonic period extends from the beginning of the 5th week of intra-uterine
life (3rd wiu) to the end of the 8th wiu.
3- The embryonic period is considered as the second trimester of pregnancy, so any
maternal illness specially of viral origin and drug therapy are well known to cause
congenital deformities.
4- The fetal period extends from the end of the 8th wiu, until birth.
5- During the embryonic period there is a rapid increase in the overall size of the
fetus.
6- The nervous system begins to develop at the 1st week intra uterine life.
7-At the head and neck regions the neural crest cells give rise to all tooth structures
except enamel only.
8-The stomodeum is separated from the blind end of the foregut by the
nasopharyngeal membrane.
9- buccopharyngeal membrane formed by double layers of ectoderm.
10- At 4th week intra uterine life the buccopharyngeal membrane soon breakdown and
the stomodeum communicates with the foregut.
11-From the roof of the stomodeum, Rathke's pouch develops and forms the anlage
of the posterior lobe of the pituitary glands.
12- The mandibular arch send out a prominence called maxillary process at its distal
end, while its proximal extension is called mandibular process.
13-The first branchial arch is covered by ectoderm from out side and lined by
endoderm from inside.
14- The cartilage bar of the first arch is called Meckel's cartilage and has an
important role in the development of the mandible.
15- The remnants of the posterior portion of Meckel's cartilage forms the mental
ossicles.
16-The remnants of the middle part of Meckel's cartilage forms the lingula of the
mandible.

-1-
17- The stylo-mandibular ligament originates from the fibrous coverage around the
Meckel's cartilage.
18- The posterior portion of Meckel's cartilage forms the incus and the malleus of the
middle ear.
19- The muscles of facial expression are derived from the mandibular arch, while the
muscles of mastication are derived from the second arch.
20- The branchial arches are supplied by blood vessels originating from the aortic
arch.
21-The first arch is supplied by the external and internal carotid arteries, while the
second arch is supplied by the facial artery.
22- The third arch is supplied by facial artery.
23- The sensory nerve that enters the corresponding arch and divide inside the arch is
called post-trematic nerve.
24-The sensory nerves gets from the nerve of the preceding arch is called post-
trematic nerve.
25-The first arch is supplied by the mandibular nerve as a pre-trematic nerve and
chorda tympani as post-trematic nerve.
26-The third arch is supplied by the glossopharyngeal nerve, while the other arches
are supplied by the vagus nerve.
27- The branchial arches are separated by external shallow depression called
branchial clefts
28- The branchial arches are separated from the pharyngeal side by shallow
depression called pharyngeal pouches.
29-The first branchial cleft is involved in the formation of the Eustachian tube. true
30-The second pharyngeal pouch gives rise to the tonsillar fossa and tympanic
membrane.
31-development of the face starts at 4th wiu.
32-The lower lip developed by the median fusion of the two mandibular
prominences.
33-The lateral nasal processes of both sides are separated from the maxillary
processes by a groove named nasolacrimal groove.
34- The lateral nasal process gives rise to the philtrum.
35-The mouth orifice is determined by the degree of fusion between the maxillary
processes of both sides.
36-The primitive lip and cheeks are invaded by the mesenchymal tissues of the third
branchial arch which give rise to the muscles of facial expression.

-2-
37- The mandibular cleft lip is due to failure of union of the mandibular processes at
the midline.
38-The maxillary cleft lip results from failure in the proper union of the medial nasal
process with the mandibular process.
39- Macrostomia occurs as a result of over union between the maxillary and
mandibular processes.
40- Transverse facial cleft is the other name of Macrostomia.
41-Microstomia results from lack of fusion of the maxillary and mandibular
processes, leading to very small mouth.
42-Oblique facial cleft resulting from lack of fusion between the medial and lateral
nasal processes.
43-Cleft palate is result of lack of union of both palatine processes with each other
and with the nasal septum.
44- Vestibular lamina gives rise to oral vestibule.
45- The tongue develops from two separate parts which later on fused together in V
shape line called foramen ceacum.
46- The anterior 2/3 of the tongue is known as papillary portion of the tongue while
the posterior 1/3 of the tongue is named lymphoid portion of the tongue.
47-The median rhomboid glossitis may be located at the anterior part of the posterior
1/3 of the tongue.
48-The posterior part of the post 1/3 of the tongue and the epiglottis originate from
the 4th branchial arch.
49- The foramen ceacum represents the opening of a thyroglossal duct.
50- The circumvallate and foliate papillae are supplied by the glossopharyngeal
nerve for taste sensation.
51- The posterior portion of the posterior 1/3 of the tongue and the epiglottis are
supplied by the glossopharyngeal nerve for general sensation.
52-The hypoglossal nerve supplies the extrinsic muscles of the tongue only.
53-The extrinsic muscles of the tongue are developed from the occipital
myotomes migrating on the glossopharyngeal nerve.
54- The final tongue papilla developed is the foliate papillae.
55- The circumvallate and foliate papillae are the first papillae appears near to
the termination of glossopharyngeal nerve.
56-The fungiform papillae appear near to the termination of the chorda tympani

-3-
branch of the hypoglossal nerve.
57- The first sign in the development of fungiform, circumvallate and foliate
papillae is the appearance of taste buds.
58-The fungiform papillae are localized at the tip and border of the anterior 1/3
of the tongue.
59-The parotid gland is the last gland develops at 6 wiu at the angle of the
stomodeum between the mandibular and maxillary prominences of both sides.
60-The mandible develops in the lower part of the first branchial arch by
intramembranous ossification.
61- The development of the mandible starts by the appearance of ossification center
at the bifurcation of the mandibular and incisive nerves.
62- The condylar cartilage appears at 14 miu and continues till the age of 20 years of
life.
63- The condylar cartilage gives rise to the condylar head and neck of the mandible.
64-The coronoid cartilage appears at 4 miu and disappears before birth at 6 miu.
65- The coronoid cartilage gives rise to the the coronoid process and the anterior part
of the ramus to a point as low as the mandibular foramen.
66- The most important secondary cartilage for the growth of the mandible is
coronoid cartilage.
67- The primary center of the ossification in maxilla appears at the bifurcation of the
anterior superior dental nerve and the infra-orbital nerve.
68-Development of maxillary sinus starts at 4 miu as a small depression of the
mucosa of the lateral wall of the nasal cavity.
69-Growth of the maxilla depends mainly on secondary cartilages.
70-Growth of the Maxilla depends mainly on their bony sutures.
71- The sutural growth of the maxilla continues till 15 years of age then become less
significant.
72-The growth at the maxillary sutures allows shift the maxilla forward and upward.
73-The embryonic period characterized by growth.
74-Tuberculum impar is a transient structure but contributed to a significant portion
of the adult tongue.
75-The symphysial cartilage is independent of the Meckel's cartilage remnants.
76-The palatal shelves (palatine processes) are derived from the first branchial arch.

-4-
77- An oblique facial cleft is formed due to the rupture of the buccopharyngeal
membrane.
78- The stomodeum is lined by endoderm.
79- The face starts to develop from nine clear outgrowths termed facial prominences.
80- The maxillary processes give rise to the middle portion of the upper lip only.

-5-
 KEY
Embryology
1- true 21- true 41- false 61- false
2 - false 22- false 42- false 62- false
3- false 23- true 43- true 63- true
4- true 24- false 44- true 64- true
5- false 25- false 45- false 65- true
6- false 26- true 46- true 66- false
7- true 27- true 47- false 67-true
8- false 28- false 48- true 68- true
9- false 29- true 49- true 69- false
10- true 30- false 50- true 70- true
11- false 31- true 51- false 71- false
12- false 32- true 52- false 72- false
13- false 33- true 53- false 73- false
14- true 34- false 54- false 74- false
15- false 35- false 55- true 75- true
16- true 36- false 56- false 76- true
17- false 37- true 57- true 77-false
18- true 38- false 58- false 78- false
19- false 39- false 59- false 79- false
20- true 40- true 60- true 80- false

TOOTH DEVELOPMENT

-6-
1-Odontogenesis of the primary dentition begins between the sixth and seventh week
of intrauterine life.
2- The first stage of tooth development known as the bud stage.
3- The vestibular lamina located lingual to the dental lamina.
4- An oral vestibule is the space between the maxilla and the mandible on one side
and the lips and the checks on the other side.
5-The second stage of odontogensis is called the initiation stage.
6-The ectomesenchymal cells condensation just beneath the enamel organ is called
dental sac.
7- The connective tissue-beneath-and around the enamel organ and dental papilla
forming what is called dental sac (follicle).
8- A basement membrane remains between the bud and the growing underlying
ectomesenchyme.
9-The tooth primordium has three components enamel organ, dental papilla and
dental lamina.
10-The dental organ is ectomesenchymal in origin, while both dental papilla and
dental sac are ectodermal in origin.
11-The field model proposes that ectomesenchyme assumes the dominant role in
crown pattern formation.
12- The clone model proposes that epithelium assumes the dominant role in crown
pattern formation.
13-The third stage of odontogenesis is called the cap stage.
14- The stratum intermedium cells synthesize and secrete glcyosaminoglycans.
15-The lingual extension of the dental lamina is called vestibular lamina.
16-The permanent molars are succedaneous and have no primary predecessors.
17-The permanent molars develop from a posterior extension of the dental lamina.
18-The fourth stage of odontogensis is called the apposition stage.
19-In the bell stage, the connection of dental organ to the dental lamina is elongated
forming a lateral dental lamina.

20-The configuration of the inner enamel epithelium maps out the incisal or occlusal
pattern of the crown of the tooth.

-7-
21-The point at which inner enamel epithelium differentiation first occurs represents
the site of future ADJ.
22-The region where the inner and outer enamel epithelia meet at the rim of the
enamel organ is known as cervical loop.
23-The stellate reticulum layer is most fully developed at the cap stages.
24- The cells of stratum intermedium contain much alkaline phosphatase enzyme
which essential for dentin maturation.
25- The remnants of the dental lamina and the lateral dental lamina are called
epithelial pearls.
26-The peripheral cells of the dental papilla will differentiate into odontoblasts
whereas the inner cells are the primordium of the dentin.
27-The final stage of odontogensis is known as apposition stage.
28- The permanent structures seen during the early stages of tooth development are
enamel knot, enamel cord and enamel niche.
29-Enamel knot are clusters of dividing epithelial cells.
30-The enamel cord is a strand of cells extending form the stratum intermedium into
the outer enamel epithelium.
31-The process of root development takes place after the crown is completely
formed.
32-The cervical loop is the structure responsible for root development.
33-The function of cervical loop is to map out the root and induce dentin formation in
the root area.
34- The remnants of epithelial root sheath of Hertwig are called epithelial rests of
Serres.
35- The number of roots that are formed is determined by the number of medial
ingrowths at the epithelial diaphragm.

36-Flexion is the union of the root structure of two or more teeth through the
cementum only.
37- Concrescence commonly occurs in permanent maxillary premolars.
38- Misplaced enamel formed on the cemental root surface is called enamel pearls.
39- Concrescence is distortion in root (or roots) or crown angulations in a formed
tooth.

-8-
40- Flexion is a deviation or bends restricted just to the root portion of the tooth and
less than 90 degrees.
41- Supernumerary roots occurs mainly in the permanent third molars.
42- The dental sac gives rise to periodontal ligament only.
43-Primordium for the permanent dentition appears as an extension of dental lamina
into the ectomesenchyme lingual to the developing primary tooth germ.
44- The epithelial rests in the periodontal ligament are derived from epithelial root
sheath of Hertwing's.
45- The last hard dental tissue to be deposited is bone.
46-The epithelial root sheath of Hertwig disintegrates after odontoblastic
differentiation & before dentin matrix deposition.
47- The lateral dental lamina gives rise to permanent teeth.
48- The stratum intermedium lies between outer enamel epithelium & stellate
reticulum.
49- The downgrowth of an epithelial thickening buccal to the dental lamina is known
as vestibular lamina.
50- The epithelial component of the tooth germ is known as enamel organ.
51- The dental lamina is induced to proliferate into a tooth bud by the ecto-
mesenchyme.
52- The stimulus that initiates the actual formation of enamel matrix seems to be the
presence of predendtin.
53-After the crown of the tooth is formed, the dental papilla is called dentin.
54- A layer of cells that seems to be essential to enamel formation but does not
actually secrete the enamel is preameloblast.

KEY
TOOTH DEVELOPMENT

-9-
1- true 13- true 25- true 37- false 49- true
2- false 14- false 26- false 38- true 50- true
3- false 15- false 27- true 39- false 51- true
4- true 16- false 28- false 40- true 52- true
5- false 17- true 29- false 41- true 53- false
6- false 18- false 30- true 42- false 54- false
7- true 19- true 31- true 43- true
8- true 20- true 32- true 44- true
9- false 21- false 33- false 45- false
10- false 22- true 34- false 46- false
11- true 23- false 35- true 47- false
12- true 24- false 48- false
36- false

Tooth Eruption
1- Tooth eruption continues throughout the whole life span of the tooth.
2- Pre-eruptive phase begins in the cap stage and ends at the beginning of root
formation.

- 10 -
3- Increase in width of the jaws: lead to movement of the germs labially and
occlusally (bodily movement).
4-Increase in height of jaws leads to the occlusal movement (Excentric growth).
5-Bodily (drifting) and eccentric growth are the types of movement in pre-eruptive
phase.
6-Eccentric growth means that the developing tooth germ remains stationary in its
place.
7- In eccentric growth, bone resorption occurs on the whole crypt wall.
8- Eruptive phase begins by root formation and ends when the tooth reaches the
occlusal plane.
9- In extra-osseous stage of eruption, the rate of eruption decelerates.
10-If there are prolonged delays in eruption, ankylosis of tooth to bone can result.
11- Clinically tooth eruption accompanied by discomfort or pain, increased salivation
and bleeding.
12-Eruptive path is achieved by the Gubernacular bony canal which is filled with the
Gubernacular cord.
13-In a dried skull, holes that identified in the jaws on the labial aspects of the
anterior deciduous teeth represents the opening of the Gubernacular canal.
14-Formation of the tooth eruption pathway is a localized, genetically programmed
event that does not require pressure from the erupting tooth.
15-Root formation at first causing bone deposition to provide room for the growing
root tip.
16-pre- eruptive phase begins after the tooth has reached its functional position in the
occlusal plane and continues through the whole life of the tooth.
17-The occlusal wear is compensated by continued bone deposition around the apex
of the tooth.
18-The interproximal wear is compensated by a process known as mesial drift.
19- The vascular pressure theory supposes the existence of cushion- hammock
ligament, running across the base of the socket to provide a fixed base for the
growing root to react against.
20-Periodontal ligament traction theory proposed that the cells and fibers of the
periodontal ligament pull the tooth into occlusion.
21-Vascular pressure theory supposes that a local increase in tissue fluid pressure in
the periapical region is sufficient to move the tooth.

- 11 -
22- The premature loss of a deciduous tooth occasionally leads to delayed eruption of
its permanent successor.
23-Impaction is a fusion of cementum to alveolar bone due to cellular changes in the
periodontal ligament caused by trauma and other pathologies.
24-The ankylosed tooth appears submerged in relation to adjacent teeth that continue
to erupt.
25- The ankylosis most commonly affects mandibular primary central incisor.
26-Ankylosis can lead to increase loss of arch length.
27-Impaction is a cessation of eruption of a tooth.
28-The second premolars are particularly prone to impaction because they erupt last,
when the least room is available.
29-The upper canine is impacted frequently because of its late eruption.
301-Ectopic eruption is eruption of a developing tooth beyond the range of the
normal eruption date.
31- Eruption of the maxillary third molar in the maxillary sinus represents an
eccentric eruption.
32- Eruption hematoma is a bluish, opaque asymptomatic swelling overlays an
erupting tooth due to the accumulation of blood in the follicular sac around the
eruption crown.

KEY
Tooth Eruption

1- true 12- true 23- false

2- false 13- false 24- true
3- false 14- true 25- false

- 12 -
4- true 15- false 26- true
5- true 16- false 27- true
6- false 17- false 28- false
7- false 18- true 29- true
8- false 19 false 30- false
9- false 20- true 31-false
10- true 21- true 32- true
11- false 22- false

SHEDDING
1- The neural elements remain in the pulp until shedding is completed.
2- Remnants of deciduous teeth are most frequently found in the canine-premolar
region.
3- Shedding is the pathological elimination of the deciduous teeth.
4- The anterior deciduous teeth are often shed with much of their pulp chamber
intact.

- 13 -
5- The permanent incisors and canines develop labial to the deciduous teeth and erupt
in an occlusal and vestibular direction.
6- The resorption of the roots of the deciduous molars often begins early on their
inner surface facing the inter-radicular septum.
7- The premolar tooth germs move apical to the deciduous molars to relieve the
pressure on the roots of the overlying deciduous molars.
8-The resorption of permanent molars may proceed far up into the coronal dentin and
occasionally some areas of the enamel may be destroyed.
9-The process of tooth resorption is continuous; there periods of resorption and
periods of rest and repair.
10-The resorption of the hard dental tissues of deciduous teeth is achieved by highly
specialized multinucleated cells called osteoclasts.
11-Odontoclasts are derived from blood circulating monocytes.
12-Odontoclasts are found on a shallow hollowed out depressions or bays called
Howship's lacunae.
13-Odontoclast cells have been detected in the root canals and pulp chambers of
resorbing deciduous incisors.
14-Odontoclasts are able to resorb all hard dental tissues including cementum, dentin
and on occasions enamel.
15-The tooth sheds with some pulpal tissue intact except that neural elements seem to
be missing.
16-the pulp plays an active role in the shedding process.
17-Loss of the periodontal ligament fibers is abrupt, and cell death in this region
occurs without inflammation.
18-Shedding of teeth is programmed developmental event.
19-Pressure from the erupting permanent molars plays a role in the shedding of
deciduous dentition.
20-Retained deciduous teeth are most often the upper lateral incisor.
21-The most frequently remnants are found in the region of premolars because their
roots are widely divergent.

- 14 -
 KEY
SHEDDING

1- false 12- true

2- false 13- false
3- false 14- true
4- true 15- true

- 15 -
5- false 16- false
6- true 17- true
7- true 18- true
8- false 19- false
9- false 20- true
10- false 21- true
11- true

ENAMEL
1- The ameloblasts having ruffled borders are protective ameloblasts.
2-Maturative ameloblasts are characterized by having a distal cell membrane with
many infoldings.
3-Incremental lines are a result of variation in crystal orientation.
4-Enamel tufts are seen in thick decalcified sections.
5- Organic components of enamel are primarily removed from enamel by secretory
ameloblasts.
6- The main difference between the rod and the interrod region is crystal orientation.

- 16 -
7- The striae of Retzius would be seen as concentric rings in a horizontal section of
the crown.
8-The extensions from secretory ameloblast cells that give structure to enamel rods
are called Tomes' fibers.
9- Striae of Retzius are due to rhythmic apposition of enamel.
10- Enamel is formed of 96% organic materials and water& 4% minerals.
11- Cross striations in enamel result from abrupt change in environment before and
after birth.
12- The prism sheath results from abrupt change in crystals orientation.
13- The complex arrangement of rods over the cusps of teeth is termed prismless
enamel.
14- Prismless enamel is less mineralized than prismatic enamel.
15- The predominant organic portion of enamel is calcium.
16-Developmental enamel lamellae are type B enamel lamellae.
17-Enamel prism of the cusp tip passes in twisted course.
18- The predominant organic portion of developing enamel is Enamelin.
19-The enamel lines fissures, grooves and pits.
20- After destruction of enamel by caries or injury, neither the body nor the dentist
can restore the enamel tissue.
21-Enamel is extremely hard because of its high mineral content.
22- The permeability is the property that enables enamel to withstand the mechanical
forces applied during tooth functioning.
23-Enamel of permanent teeth is softer than that of deciduous teeth.
24-Enamel hardness is greatest at the surface and decreases gradually towards the
dentino-enamel junction.
25- The hardness is greater towards the cervical line and decreases at the cusp and
incisal edges.
26- Dentin is less mineralized and less brittle and be necessary as a support for
enamel.
27-Enamel has a certain degree of permeability. The main pathway is from outer
layer of enamel to the saliva.
28-By volume, mature enamel is composed of 88-90 % inorganic material and 10-12
% organic material and water.
29- The mineral content decreases at the surface than at dentino-enamel junction.
30-Enamel crystals are extremely long, relative to their thickness, and are highly
oriented.

- 17 -
31-Fluoro-apatite is 20% more soluble than hydroxyapatite which means that it is
much less susceptible to demineralization.
32- Because fluoride ions help killing cavity-causing bacteria. So, it used as topical
application of fluorides on the teeth to minimize caries.
33- Spread of caries seems to be prevented or reduced by areas of enamel rich in
protein content.
34- 90% of the developing enamel proteins are a heterogeneous group of low-
molecular weight hydrophobic proteins known as Enamelin.
35- In the mature enamel, enamelin predominates.
36- Stippled material secreted by secretory ameloblasts.
37-Tomes' processes interdigitate with the surface of the forming enamel giving it a
picket fence appearance.
38- Tomes' fibers determine the orientation of the newly formed enamel
hydroxyapatite crystals and responsible for the rod structure of enamel.

39- Transitional stage is a brief reorganization stage between enamel secretion and
maturation.
40- During the transitional stage, the overall number of ameloblasts is reduced by as
much as 50%.by programmed cell death (apoptosis).
41- During maturative stage there is selective withdrawal of enamel proteins, mainly
enamelin and water.
42 - The maturative ameloblasts are either ruffled-ended (20 % of maturation
ameloblasts) or smooth-ended (80 %).
43- Maturative ameloblast yielding three complete modulations per day.
44-In the ruffled-ended ameloblasts the distal junctions are leaky and the proximal
are tight.
45- The reduced dental epithelium protects the enamel from being in contact with
connective tissue cells in the dental sac.
46- The reduced dental epithelium and the oral epithelium are joined to form the
dento-gingival junction of the erupting tooth.
47- Human enamel forms at a rate of 10 microns per day.
48- Secretory ameloblasts release small isolated drops of unmineralized enamel
proteins called stippled material.
49- Final prismatic enamel layer the crystals are arranged parallel to each other and
perpendicular to the surface.
50- Tertiary maturation is characterized by gradual completion of mineralization to
reach the 96 % of the total weight of enamel.
51- During the maturation process, amelogenins and ameloblastins are removed
leaving enamelins and tuftelin in the mature enamel.

- 18 -
52-Once tooth enamel is formed, the mineralization is never decreased by any
physiologic process within the tooth.
53-Histological structure of enamel could be described in decalcified sections only.
54-Under the cusp tip and incisal ridges, the course of the rods is more complicated
where they become twisted and braided together and it is called gnarled enamel.
55-Hunter-Schreger bands are an optical phenomenon, viewed by oblique reflected
light under the low power of the microscope.
56- Hunter-Schreger bands are found in the outer two thirds of the enamel.
57- Cross striations appear as dark lines 2.5- 6 microns apart. They represent weekly
increment of growth.
58- Brown striae of Retzius overlying the cusps do not reach the surface unless there
is some enamel loss due to attrition.
59-The base for the formation of striae of Retzius is supposed to be as a result of
daily rhythm in enamel production.
60- Neonatal line mainly appears in deciduous teeth and permanent molars and may
be associated with increased caries susceptibility.
61-The quality of the prenatal enamel is better than that of the post natal enamel due
to the more protected condition and constant nutrition.
62-Enamel spindle results from some Tomes' processes during the early stages of
enamel formation pushed themselves between the pre-ameloblasts.
63- Enamel spindles are most common beneath cusps where most crowding of
odontoblasts would have occurred.
64-Enamel lamellae are always unmineralized. They are narrower, longer and less
common than enamel tufts.
65- Developmental type A lamellae are hypo mineralized. They never extend to
dentin .
66- Non developmental lamellae or cracks occur before amelogenesis is completed.

67-Type B lamella is a crack occurs in the enamel before the tooth eruption due to a
stimulus on the enamel surface causing its fracture.
68-Type B lamella is a crack occurs in the enamel after the tooth eruption while it is
functioning in the oral cavity.
69-Dentino-enamel junction is less curved on the lateral surfaces.
70-The convexities of the scallops of the DEJ are directed towards the enamel.

- 19 -
71- The outer prismless enamel is 20-100 microns of newly erupted deciduous teeth
and 20-70 microns of newly erupted permanent teeth.
72-Rodless enamel may be lost rapidly by abrasion, attrition and erosion in erupted
teeth.
73- Perikymata are numerous near the cusp region and nearly disappear at the
cervical region.
74- Rod-end markings are deepest in the cervical region and shallowest near the
occlusal and incisal surfaces.
75- Afibrillar cementum occurs in 30 % of cases.
76- Attrition is the physiological wearing away of the tooth hard substance as a result
of tooth to tooth contact.
77-The wear rate of enamel is nearly 8 micrometers a year from normal factors.

KEY
ENAMEL
1- false 12- true 23-false 34- false 45- true 56- false 67- true
2- true 13- false 24True 35- true 46- true 57- false 68- false
3- false 14- false 25- false 36- false 47- false 58- true 69- true
4- false 15- false 26-true 37- true 48- false 59- false 70- false
5- false 16- false 27- false 38- false 49- false 60- false 71- true

- 20 -
6- true 17- true 28- true 50- false 61- true 72- true
39- true
7- true 18- false 29- false 40- true 51- true 62- false 73- false
8- false 19- true 30- true 41- false 52- true 63- true 74- false
9- true 20- true 31- false 42 – false 53- false 64- false 75- false
10- false 21- true 32- true 43- true 54- true 65- true 76- true
11- false 22- false 33- true 44- false 55- true 66- false 77- true

Dentinogenesis & Dentin Structures

1- Enamel is highly mineralized tissue that forms the bulk of the tooth.
2-Two major properties distinguish dentin from enamel: First, dentin is sensitive.
Second, dentin is formed throughout life.
3-Dentin is slightly harder than bone and is less hard than cementum.
4-On radiographs, dentin appears more radioopaque than enamel and more radio-
lucent (lighter) than pulp.
5-Mature dentin couldn't be seen either in ground or decalcified sections.
6- The collagen of dentin comprises over 90% of the organic matrix. The principle
collagen fibril is type II collagen.

- 21 -
7-The odontoblasts are highly specialized connective tissue cells that differentiate
from the peripheral cellular layer of the dental papilla.
8-Secretory odontoblasts exhibit alkaline-phosphatase and Ca-ATPase activity along
their plasma membranes.
9- The resting odontoblast doesn't produce dentin.
10-In resting odontoblasts, there are increase in number and size of lysosomes and
phagosomes.
11- In Mantle dentin, ground substance is incorporated with some pre-existing
ground substance of the cell free zone.
12- ''Mantle dentin'' varying in width from 200-300 µm. The large collagen fibrils
(0.1-0.2 mm in diameter) aggregate in the cell free zone.
13- The collagen fibrils of mantle dentin are aligned at right angles to the basal
lamina,while in the mantle dentin of the root they are parallel to it.
14- The circumpulpal dentin is the basic structure of dentin and forms its bulk.
15- The collagen fibers of circumpulpal dentin are smaller in diameter (0.05Mm) and
are more closely packed and interwoven with each other.
16- The fibers of circumpulpal dentin are present parallel or oblique angles to the
tubules.
17- Odontoblastic transduction theory contends that a dental stimulus excites the
odontoblastic process which then transmits the excitation to the adjacent nerve
plexus.
18-The matrix vesicles are rich in calcium and phosphate ions but not contain
alkaline phosphatase enzyme.
19-The sclerosis slows down an advancing carious process, so it may help to prolong
pulp vitality.
20- The function of matrix vesicles is to provide a special micro-environment in
which the first hydroxyappatite crystals can form.
21-the presence of matrix vesicles is limited to mantle and circumpulpal dentin.
22-Linear calcification founds in secondary dentin.
23-Globular calcification (calcospherite) usually presents in circumpulpal dentin
formed just below mantle dentin.
24-In the rest of the circumpulpal dentin, a combined pattern of calcification occurs
with a globular phase alternating with a linear phase.
25-The concavity of the primary curvatures of dentinal tubules nearest the pulp
chamber faces root ward.

- 22 -
26-The "secondary curvatures" result from the spiral track taken by the odontoblast
during its course from the outer dentin surface to the pulp.
27-Each dead tract is surrounded and isolated by a narrow zone of reparative dentin.
28-Dentin located between the dentinal tubules is called "intra-tubular dentin".
29- Intratubular dentin contains little amount of collagen. It is about 40% more
mineralized than intertubular dentin.
30- External stimulus accelerates inter-tubular dentin formation that eventually may
obliterate the tubules spaces.
31- Peritubular dentin will be seen as translucent rings in ground sections.
32-Inter-globular dentin is the area of hypomineralized dentin where globular zones
of mineralization have failed to fuse within mature dentin.
33-Inter-globular dentin is seen most frequently in the mantle dentin.
34-In the inter-globular dentin, the tubules run uninterrupted through the
interglobular areas.
35- Tomes' granular layer is a transient feature of the root dentin immediately
adjacent to cementum.
36- Tomes' granular layer do not follow any incremental pattern and usually smaller
than interglobular dentin.
37-The dentinal tubules do not cross through Tomes' granular layer.

38- Incremental lines of Von-Ebner run parallel to the dentinal tubules.

39- Contour line of Owen may results from a coincidence of the secondary
curvatures between neighboring dentinal tubules.

40- Neonatal line could be seen in all deciduous teeth as well as in the mesio lingual
cusp of the first permanent molar.
41-Regular secondary dentin develops by odontoblasts before root formation is
completed.
42-Irregular secondary dentin (Reparative dentin) is produced only by those cells
directly affected by the stimulus.
43- The dentin with no tubules at all named "atubular dentin". While the dentin with
trapped forming cells named "vasodentin".

- 23 -
44- Sclerotic dentin is characterized by calcification of dentinal tubules, where the
odontoblastic processes undergo fatty degeneration and then calcification.
45-In transparent dentin, the most likely source of the calcium salts is the fluid of
"dental lymph" within the tubules.
46- Sclerotic dentin appears translucent when viewed by transmitted light while with
reflected light these areas appear white.
47-Dentin areas characterized by degenerated odontoblastic processes have been
called "dead tracts".
48-Dead tracts may be caused in some teeth by the death of odontoblasts crowded in
narrow pulpal horns.
49- Fluid or hydrodynamic theory proposes that dentin contains nerve endings,
which respond when dentin is stimulated.

KEY
Dentinogenesis & Dentin Structures

1- false 11- true 21- false 31-true 41- false

2- true 12- false 22- false 32- true 42- true

3- false 13- true 23- true 33- false 43- false
4- alse 14- true 24- true 34- true 44- true
5- false 15- true 25- false 35- false 45- true
6- false 16- false 26- true 36- true 46- false

- 24 -
7- true 17- true 27- false 37- true 47- true
8- true 18- false 28- false 38- false 48- true
9- false 19- true 29- true 30- true 49- false
10- true 20- true 30- false 40- true

Cementum Structure and Cementogenesis

1-Cementogenesis comprises both matrix formation and mineralization.

2- The inner dental epithelium will induce the neighboring cells of the dental papilla
to differentiate into ameloblasts.
3-When the epithelial root sheath of Hertwig will loss its continuity, its cells become
the epithelial rests of Serres.
4- The cells entrapped in the mineralized cementum are referred to as cementoblasts
and occupy lacunae.
5-cellular cementum has the same mineral content than acellular cementum.

- 25 -
6-The Sharpey's fibers of cellular cementum generally retain an unmineralized core.
7-The Sharpey's fibers in cellular cementum exhibit a more complete degree of
mineralization.
8-Sharpey's fibers are derived from periodontal fibers, which are not classifiable in
their original location.
9- The mineral content of cementum once formed changes significantly with age.
While that of the root dentin shows no change in mineral content with age.
10-Acellular afibrillar cementum covers minor areas of the enamel, particularly at the
cementoenamel junction.
11- Cementum hyperplasia is characterized by the presence of Sharpey’s fibers.
12- Acellular afibrillar cementum consists of a mineralized matrix, which contains
neither collagen fibrils nor embedded cells.
13- Acellular afibrillar cementum plays an important role in tooth attachment.
14-acellular extrinsic fiber cementum has significant function in tooth anchorage to
the surrounding bone through numerous Sharpey’s fibers inserting into it.
15- The furcations of human teeth are covered with thick cementum layers before
they emerge into the oral cavity.
16- Impacted and erupted teeth without antagonists appear to have thinner cementum
layers than fully erupted and functioning teeth.
17- Over-compression of the periodontal ligament causes root resorption.
18-An increase of cementum in a non-functioning tooth or in an embedded tooth, this
is called cementum hypertrophy.
19- Cementum is unique in that it is avascular, does not undergo continuous
remodeling like enamel, but continues to grow in thickness throughout life.
37-More cementum is formed apically and in the furcations areas of multi-rooted
teeth than cervically.
21-Cementum has been shown to be impermeable from both the dentin and the
periodontal ligament side.
22-Cementum contains 45% to 50% inorganic substances and 55% to 50% organic
materials.
23-Under the light microscope two types of cementum can be differentiated: the
acellular and the cellular cementum.

- 26 -
24-The cementum is usually covered by a zone of cementoid tissue 3-4 microns wide
in acellular cementum and is thinner in cellular cementum.
25- Over compression of the periodontal ligament can result in the physiologic
resorption of cementum and dentin.
26-Increase in the thickness of cementum does not enhance the strength of
attachment of the individual fibers.
27-cementocytes cells have processes directed toward the pulp to provide nutrition
for the cementum.
28-cementocytes present in the superficial layers show definite signs of degeneration
such as cytoplasmic clumping and vesiculation.
29- The number of cells that become incorporated in cementum is proportional to the
rate of cementum deposition.
30-Incremental Lines of Salter are highly mineralized areas with less collagen and
more ground substance.
31-The incremental lines are roughly parallel to the long axis of the root.
32- The cellular cementum is formed at a faster rate than the acellular cementum and
so, the incremental lines are closer in acellular cementum.
33- In 60% of all teeth, cementum meets the cervical end of enamel in a relatively
sharp line.
34-In about 60% of the teeth cementum overlaps the cervical end of enamel for a
short distance.
35- Cementum is markedly thicker on the mesial than on the distal root surface,
indicating a relationship to mesial drift.
38-Hypercementosis is an abnormal thickening of cementum.
39-cementum hypertrophy is increase of cementum in good function teeth to permit
more periodontal fibers to be attached to the tooth.

- 27 -
 KEY
Cementum Structure and Cementogenesis

1- true 11- false 21- false 31- true

2- false 12- true 22- true 32- true
3- false 13- false 23- true 33- false
4- false 14- true 24- false 34- true
5- false 15- true 25- false 35- false

- 28 -
6- true 16- false 26- true 38- true
7- false 17- true 27- False 39- true
8- true 18- false 28- false
9- false 19- false 29- true
10- true 37- true 30- true

Periodontal ligament
1- The width of PDL ranges from 1.05-1.69 mm.
2- The PDL is formed from dental sac shortly after root development begins.
3- The connective tissue fibers are mainly collagenous. The main types of collagen in
the PDL are types I and III. More than 70 % of the periodontal collagen is type I.
4- The intercellular spaces of the PDL contain fibers and cells.
5- The oblique group running from the cementum in an oblique direction to be
inserted into the bone apically.

- 29 -
6- Synthetic cells include: fibroblasts, odontoblasts and cementoblasts only.
7- Periodontal nerve fibers are myelinated and unmylenated.
8- In PDL there are two types of nerve endings.
9- The PDL through aging shows decreases in vascularity.
10- mechanoreceptors are responsible for localization of pain on the teeth.

KEY
Periodontal ligament

1- false 3- true 5- false 7- false 9- true

2- true 4- false 6- false 8- false 10- false

- 30 -
 Bone structure

1- The cytoplasm of the osteoblasts is rich in vesicular structures.

2- Type II and type III collagen are the principal collagen in the mineralized bone.

3- Incremental lines are hypermineralized.

- 31 -
4- All the bones of the body are covered externally by a membrane of specialized
dense connective tissue called periosteum.

5- The periosteum consists of three layers: The outer layer known as vascular layer,
The inner layer known as osteogenic and the intermediate layer known as cambium
layer.

6- Bundle bone is generally described as containing more intrinsic collagen fibrils

than lamellar bone and exhibiting a fine fibered texture.

7- Radiographically, bundle bone appears more radioluscent than lamellated bone.

KEY
Bone structure

1- false 5- false
2- false 6- false
3- false 7- false

- 32 -
4- false

THE TEMPROMANDIBULAR JOINT

1- The Temporomandibular joint is a unilateral fibrous articulation between the
mandible and the temporal bone.
2- The development of the joint starts at 3 W.I. U.
3- Meckel's cartilage provides the skeletal support for the development of the lower
jaw and extents from the midline upward and ventrally, where it terminates incus &
malleus cartilages.

- 33 -
4- The articular surface of the condyle is strongly concave in the antroposterior
direction and slightly convex postero-laterally.
5- Only the articular eminence forms the cranial articulation of the TMJ.
6- The fossa is extremely concave while the articular eminence is convex.
7- In general, the tempromandibular ligament restricts displacement of the mandible
in different planes except backward with the head of the condyle slipping in front of
the eminence.
8- The fibers of inner layer of the eminence are at right angle to the bony surface,
while fibers of outer layer are oblique to the surface.

KEY
THE TEMPROMANDIBULAR JOINT
1- false 5- false
2- false 6- false
3- false 7- false

- 34 -
4- false 8- false

- 35 -