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Slides (7-
(27

Slide
(7)--
If you
take 1
cm
square
on the
surface
of
dentine
and 1 cm
square
on pulpal
dentine
(ya3ni
dentine
at the
pulpal
surface)
in other
words (I
took 1
cm
square from the surface of dentine from the area where we have a junction between
enamel and dentine and I took also 1 cm square at the end of the dentine at the
pulp---- we will see that the numbers of tubules in surface of dentine lesser than
the number of tubules in the pulpal side of dentine ; this means that the
concentration of dentinal tubules at deep areas are much more than the
concentration at surface area …..This makes the deeper portions of dentine more
permeable than the surface
(Portions

Now this has a difficult significant; caries has to actually pass through
dentine from top to bottom, now if we imagine that we have a thickness
.of dentine, lets say (4mm) from the top to the pulpal surface of dentine
Now caries spends more time in passing through the top half than the
bottom half (in other meaning; cariosity (decay) has different speed
It starts slowly in dentine …once the dentine become deeper spreading
become faster….now if we assume that decay needs 2 months to grow
over the dentine from the top to the bottom in the first months we can
see (1mm of caries in the dentine but in the second month we can see 3
mm of caries ) and the reason of that is the size of the dentinal tubules
…first of all we have bigger dentinal tubules in deep portions ,,secondly
the number of these tubules become increased because the surface
. area become decreased

Also the tubules runs from the pulpal surface to dentin enamel junction
…(now the doctor started pointing on the image and said :this is a tooth
cross section here we can see so me of dentinal tubule stained in black,
you can see that they run from enamel dentine junction until they reach
the pulpal surface of dentine ,notice that this curvature is not
necessarily straight …it's sigmoid(S – shaped) ; it follows sigmoidal
curvature and it's actually root wards ;what do we mean by root wards ?
The curvature (s) is toward root near the pulpal surface so as we go
toward the pulpal area the convexity become toward the tooth and
almost straight in the root and beneath the cusps ..See here some
dentinal tubules beneath the cusp (they are also straight) and also if we
see the dentinal tubule in the root, they are straight..((So straight
.((dentinal tubules can be seen under the cusps and in the roots
There is another area which we can find straight dentinal tubules but I)
( couldn't hear it at all sorry guys 
:We have two areas of dentine or two types of dentine
Dentine that surrounds the dentinal tubules called (peritubular .1
.(dentine
.(Area of dentine between tubules is called (intertubular dentine .2

The doctor then moved to another slide which shows the dentinal
tubule (he showed us the wall of the dentinal tubule and also showed
us the dentine between the tubules …these type of dentinaltubules
don't have the same diameter … the (‫ مخروطي الشكل‬are ( tapered
diameter tends to be decrease as we go toward the surface but if we
go toward the pulp it become wider ….diameter from (2.5 micrometer
.((at the pulpal end - 1 micrometer peripherally ((near the surface

Walls of dentinal tubules widely separated at peripheries (surface

(area
not sure) …(and because the surface area of dentine( the external)
surface of dentine) more than the surface area of the pulpal dentine
; the numbers of these tubules become less outside than inside….so
the more widely separated at the periphery because the surface
!?!? area is narrow
( ‫ المنطقة ضيقة بكونوا قريبين من بعض‬، ‫)المنطقة واسعة بكونوا بعاد عن بعض‬

The previous curvature which I explained before minutes (sigmoidal

curvature) is also called primary curvature because there is another
curvature called (secondary curvature of dentine); they are small
.… curvatures
Now when a number of tubules have the same secondary curvatures
they produce what they call (( contour lines of Owen)) when
secondary curvatures go inside in adjacent tubules… see here (the
doctor pointing on the slide )--------- we can see lines ;these lines is
called contour lines of Owen they represent in secondary curvature of
. dentinal tubules
: Slide 8
Tubules actually branch but the only branch at the third piece….but it
(can also branch near the surface of dentine (peripherally; outside
..…
Moving to another slide which shows the longitudinal section of
dentine … this cross section of tubule (looks like dots shows the cross
.(section through dentinal tubule
:Slide 9
Peritubular dentine which is the walls of the dentinal tubule has
another synonym of intratubular dentine
Deposited by the processes (odontoblastic processes) and this causes
.… narrowing of dentinal tubules
We said that odontoblast call -- body elha extension da5el bel
dentine we called it (odontoblatic process) this extension da5el bel
dentinal tubule and continuously b9eer fe 3na press (not sure) 3al cell
wall…so it becomes narrower; when this press happened this gives us
peritubuar dentine giving the walls of these tubules, these tubules
are wide in most young people but it tend to be narrow in old people
because dentinogenesis is continuous (produce more dentine in old
people( the size of dentine secretion is bigger)…makes the walls
narrower ) that's why caries progression is faster in young people
than in old people because narrow walls don't allow caries to enter it
. will be so difficult and slower
The parts which are affected by odontoblastic processes are walls
.and this leads to narrowing the dentinal tubules
Peritubular dentine lacks collagenous fibrous matrix it's not based on
collagen...It's based on something else …so the organic material is not
collagen but in the rest of dentine organic material based on
hypocollagen (not sure) as we discussed before…increased ( radio
density; the amount of minerals in peritubular dentine is more than in
inter tubular dentine ( it's 15% more mineralized than in
intertubular dentine) that's why it may actually makes a radioductive
image of dentine ,of coarse microradioductive image we will see this
lighter in color why because it's small radiodense
And the crystals are not hydroxyapatite but carbonated apatite which is
similar for those in Sea shells. ;) 
.which is smaller than those of intertubular dentine

A student asked a question and I think it was about the X-ray

image ? The doctor answered that once you put your hand under x-
ray …bones look in white color and the skin in black and that's what
happens with peritubular dentine (whiter /lighter) than the
.intertubular dentine

: Slide 10
The odontoblastic process becomes embedded in the extra-cellular
matrix and we have already discussed how cells form dentine..This is
an odontoblast, it deposits first layer of dentine and then it starts
to move towards the pulp which have process that is keeping inside
the dentine so that's why the odontoblastic process becomes
invaded in the extra-cellular matrix that become later on mineralized
. and this creates a dentinal tubule
Odontoblastic process elongates as the odontoblast moves toward
pulp and it stimulates the differentiation of ameloblasts, so the part
of the odontoblast which is active in sending signals through this
interaction is the (odontoblastic process) <<not the body of the
.<<cell

:Slide 11
:Layers of dentine
In the crown we have three layers of dentine and we have also three
… layers of dentine in the root
The top layer in dentine in the crown called (mantle dentine) then we
have (interlobular dentine) then (circumpulpal dentine- means
.(surrounded actually it surrounded the pulp
In the root we have the (hyaline layer), (granular layer of tomes),
(circumpulpal dentine). Now let's see talk about each layer --
: Slide 12
(Mantle dentine: (thin .1
.It's the outermost layer of dentine in the crown*
*.It's (20- 150 micrometer) in thickness
It's the first formed layer (as we said before the odontoblastic*
cells move towards the pulp so the first layer of dentine is the layer
away from the odontoblastic process which is the layer just under
.(enamel called (mantle dentine
.It's 5% less mineralized*
(Collagen fibers are perpendicular to dentinoenmel junction (DEJ*
We have more dentinal tubule branching in mantle dentine (tubules*
tend to branch more at the peripheral part of dentine than the inner
part of dentine; that's why we find most of the branches in the
.(mantle dentine
The weight of mantle dentine is (matrix vesicle mineralization) --*
.we discussed that in the previous lecture

: Slide 13
:The interglobular dentine .2
It's a layer just beneath the mantle dentine and this layer results*
… because (calcopherites) failed to fuse
Dentine formation is not similar to enamel formation actually*
mineralization of dentine forms in globules (spheres) that grow and
fuse together (3ala shakel korat :p) normally it fuse completely but in
this layer they fuse incompletely so we may see areas without
mineralization because these spheres failed to fuse completely giving
.…interglobular (IGD) dentine so
In general, much of the mineral in the dentine is deposited as*
.globules as the (calcospherites) eventually fuse
*.In IGD calcospherites fuse incompletely
IGD is located beneath the mantle dentine in crown and also beneath*
.the granular layer of tomes in the root
IGD appears dark in transmitted light--when light passes through*
.these nonmineralized areas it appears dark
Tubules pass through without deviation (the absence of some minerals
in this area doesn't mean that tubules are deviated; they continue in
.(there path whether straight lines or sigmoid paths (S_shaped
Peritubular dentine is also absent (as the tubules go through the IGD,
if one tubule passes through the nonmineralized part it also will loose
the peritubular dentine), this is a slide showing dentine (slide 14)
***---- this information is important
Mineralization is not even: when we say that dentine is( 70%)
mineralized this doesn't mean that it's 70% in area of dentine if we
take for example this area it could be (90%) mineralized or if you
take this light area it's possibly only (40%_50%) but (70%) means the
average mineralization in dentine (some areas high minerals and some
.have less minerals

talking now about dentine in the root, the first later below cementum,
… (it's called (hyaline layer
: Slide 15
It's very narrow
Non -tubular structureless band (so it is a band which appears whitish
(in color, very narrow and non-tubular (we find no tubules
The origin of this layer is unknown it's (obscure- some people say
that it's from cementum and some people say that it's from dentine)
!!….until now they are searching for the origin of this layer

: Slide 16

: Granular layer of tomes

Under the hyaline layer we have the black area which shows the*
(granular layer of tomes) this is only in the roots and actually Tomes
… is the first scientist which discovered the process of ameloblast
.It's located just beneath the hyaline layer and cementum*
This granular layer of tomes results because also branching and*
looping of tubules and tubules in this area they tend to have
branches and also some they tend to spiral (belefo 7awl nfsohom)
.make loops
Could also be formed because of incomplete fusion of*
(calcospherites)--so if we consider *this reason granular layer of
tomes would be similar to (IGD) because the reason why we have
.((IGD) is incomplete fusion of (calcospherites

:Slide 17
Circumpulpal dentine is the rest of dentine in the crown and the
rest of the dentine in the pulp, it's beneath mantle and IGD in crown
and beneath the granular layer of tomes and also the hyaline layer in
.the root

:Slide 18
:Predentine
Results because dentine mineralization is not immediate, enamel*
mineralization is immediate …y3ni if we actually lay down a layer of
enamel still now in organic material, this will calcify straight away but
in dentine this will calcify after 24 hours, the difference between
the deposition of organic matrix and the mineralization of this matrix
results in what we call predentine for example (pointing on the slide
.#18) ---white color shows the predentine
If I come to this layer after 24 hours suppose that this tooth is*
alive I will find that this layer will become mineralized and there will
.be new predentine layer
The innermost layer of dentine is (10-40 micrometer) in thickness …*
it's thicker in young teeth because the deposition of dentine is faster
in young teeth, it's not mineralized and it results because matrix
deposition precedes mineralization ,we have time gap between matrix
.deposition and mineralization of almost 24 hours

It's secreted by the odontoblasts not by the odontoblastic*

processes by way of Golgi apparatus and mitochondria (this
.(secretion should be very active secretes too much of dentine

.It appears pale compared with the mineralized circumpulpal dentine

Mineralization front is actually delight between predentine and
dentine (it's the interphase (not sure) between the dentine and the
predentine) we called it mineralization front, sometimes its straight
.(linear) and sometimes it's globular depending on the activity

:Slide 19

:Structure lines in dentine

.lines associated with primary curvatures*

We said we have sigmoid curvature (it's **** curvature of dentinal
tubule). If we have a layer of dentine with the same curvature of
tubules they will produce what we call (Schreger lines) -- these are
equivalent to ((hunter- schreger bands) in enamel, when we have a
group of enamel prisms having the same curvature) ….here (slide 13)
we have the group of dentinal tubule of the same of the same
.(curvature giving lines called (Schreger lines
Coincidence at the peaks of sigmoid curvatures (the peaks of these
.(curvatures meet

We have also -
.lines associated with secondary curvatures*
These are called contour line of (Owen), they look like
‫)مطعوجه زي‬
) path ‫كأنه في طيات لنه مجموعة منهم بكون إلهم نفس ال‬
They are unusual in primary dentine; they are more visible in
secondary dentine. Now the difference between secondary and
primary dentine is that the primary dentine is all dentine deposited
before root completion, secondary dentine is dentine deposited after
root completion so that's why we do not see too many of these
contour lines of owen in primary dentine we see them in secondary
.dentine

In addition to these lines associated with curvatures also we have the

incremental lines similar to enamel we have also incremental lines in
enamel, the short term incremental lines are called (Von Ebner's
(lines in dentine
Which are equivalent to cross striations in enamel but the long term
of contour lines or long period lines are called (Andresen lines); it's
.equivalent to enamel striae in enamel

The long period lines reflect (*****/can't hear it  ) and the short
term lines they reflect the daily rhythm …we said that enamel
everyday form a layer ; between a layer and the other we haven
enamel striation and between every (7-10 layers) we have enamel
striae …in the dentine the same thing presents ; everyday a new
Layer forms between one layer and the other we have (von-Ebners
lines) and (between 7-10 days) we can notice an obvious line called
(Andersen lines--- they are (16-20 micrometer apart + they are
((associated with changes in collagen fibrils orientation
And of these Andresen lines is ((exaggerated line=one of the
Andresen line very obvious =Neonatal line=we can see it at the
((time of birth from the word natal: p

When we have the fetus that is going to be outside, what happens?

The environment will change because this fetus has his (can't hear)
inside the uterus and suddenly this fetus will be delivered outside so
we will have a sudden change in the surrounding environment so at the
time of birth or at the time of giving birth we will have nature
changes of what is forming at this particular moment ..Among this
things is dentine; dentine can be forming at time of birth so that's
.why this is produces much interpreted lines of neonatal lines
Neonatal lines separate any part of mineralized tissue prenatal and
(postnatal
‫)تفصل بين جزء من الدينتين الذي يتكون قبل الولدة عن الدينتين الذي يتكون بعد‬
(‫الولدة‬

:Slide 20
Now talking about primary and secondary dentine …primary dentine is
any dentine forming before the root completion and any dentine form
.after root completion is called secondary dentine
?Do we have primary enamel and secondary enamel
No, because enamel formation is completed when the crown is
completed (ya3ni) once enamel is formed it's formed we don't have
enamel deposited after the completion of the enamel but dentine is
. different; dentinogenesis is continuous 

:Secondary dentine
.is dentine formed after complete formation of the tooth*
Because we have secondary dentine forming the surface area become
.(less (the surface area of the pulp decreases
(Cells arranged comfortably when (tooth is young
The pulp is big and the cell (odontoblast is also arranged comfortably;
has a good space) but with time when the size of dentine become
bigger, the size of pulp become lesser become pressed so all the
.spaces between the cells become lesser
Secondary dentine is less perfect than primary dentine---)
When these cells work in narrow spaces (****) become lesser
That's why secondary dentine is less perfect than primary dentine (it
was produced while the cells where actually active because they have
good space, secondary dentine is produced while these calls are
colorless (not sure :0 ) so that's why it has less quality than primary
.dentine

:increased crowding in odontoblasts leads to**

.Slower deposition than primary dentine -
.Less regular pattern of deposition -
.Change in orientation and curvature of tubules -

form most rapidly at the pulpal roof and floor (in posterior teeth **
‫ حجرةاللب‬we have something called pulp chamber in crown
Chamber with 4 walls-- mesial +distal + buccal +lingual+ roof +floor
so always the deposition of secondary dentine is more on the roof and
.the floor

: Slide 21
:Translucent dentine
forms with aging because of tubular occlusion by peritubular*
.Dentine
When we become older in age the tubule become narrower and it
could become completely closed ….when it completely closed we call it
.((translucent dentine
Translucent dentine belongs to old people; we can not see it in young
.people, why? Because the dentinal tubules are big and opened
It can be pronounced at the root apex and it's used in forensic
dentistry in age determination. 

Doctor Ashraf skipped the slide which is about (tertiary dentine) and
started with -----

:Slide 23
:Sclerotic dentine
‫ إغلق‬It's also caused by tubular occlusion
But it's not causing by aging it's caused by stimulus
‫ تغلق لنه تجمع فيها‬tubules ‫هناك مؤثر خارجي مثل التسوس جعل هذه ال‬
minerals

Very very important 

How can we distinguish between Sclerotic dentine and the **
?translucent dentine
 Always sclerotic dentine it should be apposing stimulus like---
!caries but in translucent there is no caries; it appears due to aging

Note: sclerotic dentine has similar appearance to translucent dentine
.(but related in site to the stimulus (caries/ trauma

Doctor Ashraf went back to slide (22/tertiary dentine)--

:Slide 22
:Tertiary dentine
When we have a very severe stimulus outside the tooth (outside the
dentine); like caries for example, if this stimulus is not severe we will
see build up (not sure) of dentine in the internal side slowly as the
!?caries spread out
Severe stimuli lead to pulp necrosis because they actually destroy
.dentine faster than our capability in building new dentine

:Notes
This severe stimuli increase the production of tertiary dentine which*
.is produce when we have pulp necrosis

* Tertiary only appears in people who don't care about there

.(Teeth (who have caries for example :0

*Tertiary dentine formed by odontoblast newly differentiated

.From the pulpal mesenchyme after original cells have died

:It varies in appearance and dentition it can be *

regular or tubular structure (if the caries was chronic not acute so-
.(the odontobast will form the dentine very very slowly having tubules
it can be irregular arranged tubular structure if the dentine-
.formation was fast
it can be atubular (having no tubules because of the randomly fast-
.(formation
:We have also 2 types of tertiary dentine
Reactionary dentine: results because cells injured which produced .1
.dentine after injury
.Reparative dentine: because of differentiation of new cells .2
The doctor asked us to go back to the book and know what is the ***
difference between them he is not responsible about them!!!!! And it's
required in the exam …always there is a question about this subject
!!!O.o in the final exams

: Slide 24
:Dead tracts
Sometimes a stimulus don't lead to occlusion in tubules
tubule ‫ ما بسكر ال‬occlusion ‫بعض ال‬
But it can kill the odontoblastic processes inside the dentinal tubule it
makes the dentinal tubules empty (have no odontoblastic process) and
because it appears as a space (EMPTY TUBULES); under transmitted
(light microscope it tends to appears dark (black) ------ slide (24

:(Slides (25,26,27
Tetracycline---- antibiotic was used in1970s and 1980s it was very
common but they found that this antibiotic it tends to precipitate in
dentine and enamel giving staining of teeth. Newborn kids found to
have colored teeth (pigmented: because pregnant used to take
tetracycline or the newborn was given tetracycline when one of his
teeth was forming so it becomes incorporated within the cell and it
leads to pigmentation and it tends to be actually pigmented in lines
(slide 25) these lines are related to the curvature of the dentinal
..tubules
The last three slides are required but the doctor didn't explain
any details he asked us to refer to the book ….it's very
important …many questions will be in the exam about them !!!!! O.o
.(The title of these slides (tetracycline stain
Done by: Raya Hijazi
Good luck all  <3