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:Enamel

: Constituents
inorganic component 96% .1
organic 4% .2
Can only be seen in ground section not hypo calcified section
( because in hypocalcified section all the inorganic will be
dissolved so most of the enamel will be gone.)
But in ground section the enamel is cut in to pieces and Grinded
to be seen in the microscope, this grinding action generates heat
and so the hypocalcified structures in the tooth will get burnt
and so will appear black ( the pulp will appear as black and thus
will be called pulp space and the dentine will appear brown. )

: Physical properties of enamel

hardness ( the hardest part of the body) .1
Brittle ( although its hard) .2
translucent ( the color of dentin can show through it) .3
semi - permeable ( so the fluoride can pass through it ) .4
yellowish to grey white.5

:Histology of enamel
Enamel consists of enamel rods( or prism) , between each rod and
rod is there is inter-rod substance . and the organic part
.surrounds the rod to form the rod sheath
: So the units of enamel
enamel rods ( or enamel prisms) 2. Inter rod substance ( or .1
inter prism substance) 3. Rod sheath ( prism sheath)

:Shape
Cylindrical shape
:Their numbers
In the smallest tooth (lower central incisor)= 5million
In the largest tooth (lower 6 )= 12 million

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So the number of rods is between 5-12 million rods depending on
.the size of the tooth

:Direction
.The are perpendicular to the dentino-enamel junction
They are vertical in the incisal edge and cusp , oblique in the
crown and horizontal in the cemento-enamel junction. ( this in
deciduous teeth)
In permanent teeth: its the same but it ends oblique again near
.the root
Course of the rods: it starts off from the DEJ as astraight line then
follows a wavy direction and finally it becomes straight again in
.the surface of crown
The course is quiet diifrenet in the incisal edge and cusp tips , in
that the rods start to twist with each other ( to increase the
. strength in this area) and its then called GNARLED ENAMEL

: Cross sectional: it depend on the cut of the enamel

A fine cut : will give hexagonal shape to the rods
A less fine cut : rounded shape of the rods
Far less: oval shaped rods

:Formation of enamel
Its formed by tall columnar cells called Ameloplasts that comes
from the inner enamel epithelium . it deposits enamel in rhythmic
manner in which there is a period of activity and period of rest
( which gives a hypoclacifed enamel ) . thus the amyloplastic cells
will deposit enamel in the period of activity and will deposit less
calcified enamel ( hypo calcified) enamel in the period of rest ,
.thus it will appear as a black line histologically
These black line are called short incremental lines . between each
line and line is 1 day , and 4 microns of enamel is deposited
.between the 2 lines . so in one day 4microns are deposited
What I explained above is the action of one amyloplastic cell,
other amelopasts will follow the same pattern but at different
times of activity and rest. And will also have short incremental
lines , but they will not necessarily be at the same level of the
.neighboring amyloplastic cell
Every 4 days all the amyloplastic cells will lay a hypoclacified
enamel and the same time , and so will appear as a straight dark

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line over the whole surface of enamel . this line was discovered by
a person called retizus and so were named after him.
INCREMENTAL LINE OF RETIZUS
:Course of incremental lines of Retizus
Concentric
rings of line In the incisal edge and cusps: it follows a circular manner where it
leaves the DEJ then returns back to the DEJ ( concentric rings)
of retizus

In the rest
of the
. enamel

:In the rest of the enamel cervical area

It leaves the DEJ and goes to the surface but does not return
back as shown above ( later will be called the perikaymata )

After the birth of the baby ,the quality of the enamel produced by
the ameloplasts changes due to change of nutrition and
environment of the baby . and so will form a hypoclacified line
called Neonatal line which demarcates the the enamel before
.birth and after birth
So this line is present in all deciduous teeth + the permanent 1 st
molar ( because it calcifies at birth)

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: SO the incremental lines of enamel are
incremental line of retizus : due to rhythmic deposition of .1
enamel appears every 4 days
short incremental lines: due to rhythmic deposition of enamel .2
.appears every 1 day
neonatal lines: demarcates the enamel before birth and after .3
.birth

:Other structures in enamel

due to some metabolic disorder some rods will produce .1
hypocalcified enamel ,which appears as a black line in the enamel
called ENAMEL LAMELLA (leaf like structure)
: Types
A; true enamel lamella : due to hypo calcified rods which extends
from the DEJ to the surface of enamel
B; enamel lamella due to trauma before eruption so it forms a
crack which may be filled with epithelium from the reduced
.enamel epithelium or connective tissue from the dental sac
C; enamel lamella due to a crack after eruption which will be filled
of course with saliva

enamel tufts : hypoclacified enamel rods, that emerge from the .2

DEJ ,its take either one third to one fifth of enamel thickness

enamel spindle : which is odontoblastic process that were .3

trapped in the enamel before hard tissue formation . Its anon
calcified tissue that will appear as ablack line coming from the
.dentine and stopping shortly after crossing the DEJ

:Hunter shrugher bands

Is bands that appears when using reflective light microscopes ,
that shows alternating dark and light zones in the enamel , that
was later asserted to be OPTICAL PHENOMENA ( just like seeing
. the rainbow after the rain) and so it is not a histological entity

Structures found in the outer surface of the enamel: ( with out

:sectioning)

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perikaymata: which are the external manifestation of the .1
incremental lines pf Retizus
Of course will only be seen on the cervical third of enamel only
structerless enamel: due to loss of rods in the surface of the .2
enamel due to loss of tomes process
rods end : after the erosion of the structure less enamel the rod .3
stars to appear in the enamel
enamel cuticle: is a membrane covering the enamel which is the .4
last product of amelobast (its like agift wrap around the enamel)
Not found in the pits and fissures

:Life cycle of amelobalsts

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DENTIEN

:Chemical properties
inorganic % 70-75 .1
organic 30-25% .2
Its the main part of the tooth
Formed by odontoblasts . which is aconnective tissue that is
formed by dental papilla and is situated in the pulp and extends
.through the dentine
Shape. : depends on location: in the pulp horn its: psudo stratified
, columnar
in upper part of root: its columnar
. in the mid-root its cuboidal and in the end of root flat
Its contained in a tube like structure thus its called dentinal
tubules
The dentinal tubules is thickest in the area of the pulp and
.gradually gets thinner in the DEJ
:Types of dentine
peritubular dentine: the one that makes the wall of the tubule .1
intertubular dentin : between the tubules.2
Mantle dentin: first layer of dentine deposited .3
circumpulpal dentine: rest of the dentine.4
:Curvatures of dentinal tubules
S shaped primary curvature : tubules exhibit Sigmoid .1
curvetuers more prominent in crown than root

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secondary curvature due to spiral tract of primary curvatures .2

:Incremental lines
von ebner: due to ryhtmatic deposition of dentin ( rest and .1
.activity) , its cone shaped each line above the other in the crown
In root it straight lines that emerge from the pulp chamber
Neonatal line.2
contour lines of owen: abnormal line due to metabolic .3
disturbances

:Inter globular dentine

Any hard tissue is formed first by laying the matrix then by
mineralization. Mineralization occurs by deposition of calcium in
globules (balls) that fuse to each other . if they donot fuse with
each other the space between then will be filled with dentine
called interglobular dentine ( hypo calcified area) seen in Ground
sections. Found in the crown follows the incremental lines looks
like small black spots

:Tomes granular layer

The dentinal tubules at the root ends will loop with each other
giving a complicated black figure along the root called tomes
.granular layer

:So to recap
There is 2 types of dentin : A) mantle B) circumpulpal
Circumpulpal further divides into : 1) peritubular and 2)
intertubular
: Under the microscope 2 more types are seen
In the crown : inter globular dentin which follows incremental
lines
In the root: tomes granular layer dose not follow incremental lines

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:Peri-odontoblast space
Inside the dentinal tubules you will find the odontoblastic process
, the space between the odontoblastic process and tubule is
.called peri odontoblastic space which is filled with fluid

:Theories of dentinal pain

:direct neural stimulation .1
This theory stipulates that the nerve from the pulp enters the
.dentinal tubules and end in the surface of dentine
The problem with this theory is that it says that the nerve is
present inside the tubule in the peri-odontoblastic space ,which
was later discarded because when the dentinal tubule was
!!!sectioned no nerve was found
:odontoblastic transduction theory .2
This theory declares that the odontoblast cell itself is a neural
. tissue
The problem with this theory is that all neural cells comes from
the Neural crest which is ectodermal in origin. While the
.odontoblast is mesodermal in origin therefore it was not possible
:fluid theory or hydrodynamic theory .3
It stipulates that any stimulus that provoke the dentin will cause
the dentinal fluid to move and the fluid will start moving until it
reaches the pulp . and thus pain occurs
. This is the most accepted theory

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:Dentino gensis
Any hard tissue formation is formed by first laying of matrix and
second by clacification
The Dentin matrix is called Predentin which is connective tissue
.formed of collagen

:Types of calcification of dentin

linear : in the mantle dentin its laid like bricks .1
globular : by globules in circumpuplal dentin .2
combination between the 2 above .3

:Age changes of dentin

Stimulus types affecting the dentin differs from mild(attrition) to
. sever stimuli( caries)
When a mild stimulus effects the tooth the odontoblast start
depositing dentin in a slow regular manner all over the pulp thus
.called REGULAR SECONDARY DENTIN
The regular secondary dentin has less dentinal tubules than
primary dentin and is separated from the primary dentin by a line
.called line of demarcation
The more regular dentin deposited will cause the pulp chamber
.to get smaller , the pulp horns obliterated and the canals blocked
When a sever stimulus affects the tooth like caries ,it will cause
the odontoblast to work faster and deposit dentin at the caries
site , the main goal is to increase the distance between the
stimulus and the pulp, thus producing IRREGULAR SECONDARY
.DENTIN
(.has irregular dentinal tubule )
But when the stimulus destroys the odontobasts , its replaced by
differentiating the undifferentiated mesenchymal cells in the pulp
to new odontoblasts. These new odontoblasts lack the experience
of the pervious ones ,and so will start depositing dentin without
dentinal tubules called ATUBULAR DENTIN. When these
odontoblast deposits dentin and starts receding to the pulp, they

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may get trapped in the dentin they deposits when this happens
.its called OSTEODENTIN( odontoblasts trapped in dentin)
.The irregular dentin its then also called Reparative dentin
When a mild stimulus affects the odontoblast it causes fatty
degeneration thus causing calcium to be deposited around it , the
calcium deposited inside the tubule its intratubular dentin. When
calcium fills the tubule it gives a translucent look thus its called
. translucent dentin or sclerotic dentin

If sever stimulus affects the odontoblast it will completely

degenerate the odontoblast thus leaving an empty dentinal
tubule that forms a pathway for bacteria to get to the pulp this
empty tubule is called DEAD TRACT. The neighboring odontoblast
will start depositing secondary irregular dentin at the sides and
infront of the dead tracts to form a road block against bacteria to
.reach the pulp

Cementum
:Definition
Highly calcified connective tissue that covers the anatomical
.root,that serves a medium for periodontal ligament attachment
Fibers that are found inside the cementum is called sharpey's
fibers
:Chemical properties
Inorganic: 45-50
Organic= 50-50

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:Histology
:Types: 4
.cellular

2) acellular 3)afribrillar 4) intermediate cementum (1

Cellular cementum

Acellular cementum

Found in apical 1/3

Found in cervical third

microns thickness 150-200

microns thickness 20-50

Rapid formation

Slow formation

Imprisoned cementoblasts
called cementocytes

Incremental lines far from

each other
Called ( incremental lines of
salter)

incremental lines close to

each other

:Cells of cementum
The cementocytes are cementoblast that got entrapped in the cementum
matrix ,found in in a cavity called lacunae of cementocyte. has process
emerging from it called canaliculi . its found in greater number towards
.the periodontal ligament side and much less towards the dentin
.Its main function is nutrition
: cementicles
entrapment of eptheial rest of malsaaz in the cementum is called
:cementicles and has 3 types
a) free : not attached to cementum
b) attached to cementum
c) or embedded deep to cementum

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:Afibrilar cementum
Its cementum found in the enamel due to degeneration of the
reduced enamel epithelium at the cervical area thus exposing the
enamel to the dental sac which in turn starts to deposit
cementum in the enamel. Because no periodontal ligament is
.attached to this cementum its called Afibrilar cementum

: Cemento enamel junction

:This junction has 3 possiabilites
either the cementum overlaps the enamel ( afribilar cementum) (1
(60% of cases)
the cementum and enamel meet edge to edge ( 30% of cases ) (2
the cementum and the enamel fail to meet thus exposing an (3
area of dentin in the junction area ( 10% of cases )

:Intermediate cementum
During root development the hertwig epithelium that lines the
root induces the production of root dentin then degenerates
leaving the dentin exposed to the dental sac to deposit the
.cementum over the dentin
Unfortunately sometimes the epithelial sheath of hertwig
degenertes before the completion of root dentin thus exposing
this undeveloped dentin to the dental sac which starts depositing
cementum resulting in amixture between dentin and cementum
.called intermediate cementum

:Age changes of cementum

:hypercementosis : increase in size of cementum has 2 types (1
a) hyperatrophy: in functioning teeth ,there is increase of
periodontal ligament because of increased load
b)hyperplasia: in non functioning teeth , there is decrease in
periodontal liagaments because decrease in load

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Bone

Its a specialized hard connective tissue

:Chemical properties
Inorganic : 65%
Organic: 35%
: Types of bones
lamellar bone ( formed in layers) has 2 subtypes: 1)compact (1
2) cancellous

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woven bone ( its a temporary bone or immature usually found (2
in the fetus or ahealing bone)
Bundle bone : this the type which has fibers bundle attached to (3
bone.( like alveolar bone which has periodontal ligament)

:Cells of bone
osteoblasts (1
osteoclasts ( large multinucleated giant cells ) found in a cavity (2
. called hawship's lacunae has ruffle borders
It does its action in to 2 steps: 1) demineralization (by releasing
acids)
breaking down of collagen (2
and protein
osteocytes ( osteoblasts entrapped inside bone matrix) (3
bone progenitor cells ( undifferentiated mesenchymal cells) (4

:Alveolar bone
Its the bone surrounding the tooth, and supported underneath by
the basal bone ( bone of the jaw ) so when you extract a tooth the
alveolar bone resorpes leaving behind the basal bone
The alveolar bone on the side of the root is called alveolar bone
proper. The outer side of the alveolar bone is called outer
supporting bone (buccal side) or inner supporting bone (lingual
side)

Micro anatomy : the alveolar bone proper is where the periodontal

ligament attach and thus its a Bundle bone.and underneath it its
.supported by compacted bone
Its hypercalcified bone and so will appear more radiopaque and
.will be called lamina dura
If we have acloser look at the alveolar bone proper we will see
many perforations that permits blood vessles and nerves to pass
.through it,thus it is called cribriform plate
:So if summarize the above info
:Alveolar bone proper has 3 descriptions
histology: its a bundle bone and supported by compact bone (1

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radiographically : its called lamina dura (2
microanatomy : cribriform plate (3

The supporting bones and any other bone in the body have a hard
.compact bone and underneath it spongy bone ( cancellous bone)
The spongy bone has 2 types : in the mandible is type1 where it
has ladder like manner so its highly organized thus making the
. mandible harder
In the maxilla its type2 in which its in an irregular shape making
the maxilla weaker than the mandible

: Incremental lines of bone

resting lines ( period activity and rest) .1
reverse lines.2
. faint lines.3
Please note all the incremental lines in all hard tissues are hypo
mineralized except the lines of the cementum ( salter)

Periodontal ligaments
:Definition

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Is agroup of specialized connective tissue fibers that essentially
attach a tooth to the alveolar bone within which it sits

: Cells of PDL
.Formative cells: fibroblasts , osteoblast and cementoblast
Destructive cells: osteoclasts , cementoclasts and fibroblasts
Defensive cells: Mast cells , histocytes and lymphocytes
Undifferentiated mesenchymal cells (stem cells)
Epithelial rests of malsaazes ( the only epithelial component of
the PDL)

Or can
calcify in the
cementum
causing

Can get
inside the
pulp to
create pulp
stones

Can cause a
pathology
.such as cysts

:PDL fibers
:types 3
collagen fiber (1
oxytalan fiber (2
elastic fiber ( wall of blood vessels )(3

:Collagen fibers
: Has 2 types
principal fibers

2) accessory fiber (1

: principal fibers (1
a) gingival fibers b) Transpetal fibers or inter dental
alveolodental fibers

c)

:gingival fibers(1
from cementum to the lamina propria of the gingiva ,its function
. is to adhere the gingiva to the tooth

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:Interdental fibers(2
runs from the cementum of one tooth to the cementum of
adjacent tooth , its function is to pull teeth next to each other to
create tight contact

:alveo dental fibers(3

alveo-crestal : from crest of bone to the cementum . since the (1
cemntum is higher than the crestal bone the fibers direction will
. be from up to down
horizontal : from bone to the cementum horizontally in the (2
same level
oblique: from bone (higher level ) to the cementum (lower level) (3
. this is the most abundant type
apical : found in the apex (4
interradicualr : between the roots of multi rooted teeth (5

: Functions : depends on the force applied

occlusally :resisted by oblique fibers
Avulsion: resisted by crestal and apical and
interradicular
Bodily ( lateral ) : horizontal or inter dental fibers

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accessory fibers: found only in single rooted teeth its function (2
is to resist rotational movement . its located near the horizontal
fibers

:Oxytalan fibers
Its runs from the wall of blood vessles to the cementum or bone .
its function is support blood vessel its nature is amateur elastic
fibers

Sensation of the PDL : is by 1) pain by nerve endings 2) and

pressure by proprioceptive nerves

:Age changes of PDL

The width of the PDl= 0.15 to 0.38 mm
.Which decreases with age
Blood vessels decreases and hypertrophy of cells and the
epithelial rests of malssazes may manifest any of the types
mentioned before