Tooth Development And Eruption Part 1 Flashcards

1
Q

What is odontogenesis?

A

Odontogenesis is the process of tooth development.

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2
Q

Can developmental disturbances occur during odontogenesis?

A

Yes, developmental disturbances can occur during each stage of odontogenesis.

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3
Q

How can developmental disturbances affect the tooth?

A

They can affect the physiological processes taking place during development.

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4
Q

What are the potential clinical implications of developmental disturbances in odontogenesis?

A

These disturbances may have ramifications that affect the clinical treatment of a patient.

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5
Q

What does the term ‘dentition’ refer to?

A

The term ‘dentition’ refers to the natural teeth in the jaws.

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6
Q

How many types of dentitions are there?

A

There are two types of dentitions: primary and permanent.

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7
Q

When does the primary dentition develop?

A

The primary dentition develops during the prenatal period.

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8
Q

How many teeth are included in the primary dentition?

A

The primary dentition consists of 20 teeth.

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9
Q

What happens to the primary dentition teeth before the permanent teeth erupt?

A

They will be exfoliated (shed).

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10
Q

How many teeth are included in the permanent dentition?

A

The permanent dentition consists of 32 teeth.

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11
Q

How does odontogenesis take place?

A

Odontogenesis takes place in stages, which occur sequentially for both dentitions.

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12
Q

When does odontogenesis of the primary dentition begin?

A

It begins between the sixth and seventh week of prenatal development, during the embryonic period.

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13
Q

What are the initial identifiable stages in tooth development after initiation?

A

The initial identifiable stages are the bud stage, cap stage, and bell stage.

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14
Q

What stage follows the bell stage in odontogenesis?

A

Odontogenesis progresses to the apposition stage after the bell stage.

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15
Q

What happens during the apposition stage?

A

The apposition stage involves the formation of partially mineralized dental tissue types, including enamel, dentin, and cementum.

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16
Q

What is the final stage of odontogenesis?

A

The final stage is the maturation stage, where the dental tissues fully mineralize.

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17
Q

What physiologic processes take place during odontogenesis?

A

The physiologic processes include induction, proliferation, differentiation, morphogenesis, and maturation.

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18
Q

Are the processes of odontogenesis separate or overlapping?

A

Except for induction, many of these processes overlap and are continuous during odontogenesis.

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19
Q

Although the physiologic processes during odontogenesis may occur simultaneously,

A

one process will tend to be predominant, marking each stage of odontogenesis.

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20
Q

What is the first stage of tooth development?

A

The first stage of tooth development is the initiation stage.

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21
Q

What physiologic process is involved in the initiation stage?

A

The initiation stage involves the physiologic process of induction.

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22
Q

What is induction in the context of tooth development?

A

Induction is an active interaction between embryologic tissue types.

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23
Q

What happens at the beginning of the 6th week of prenatal development?

A

At the beginning of the 6th week, the stomodeum (primitive mouth) is lined by ectoderm.

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24
Q

What does the outer part of the ectoderm give rise to?

A

The outer part of the ectoderm gives rise to the oral epithelium.

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25
Q

What does the oral epithelium consist of?

A

The oral epithelium consists of two horseshoe-shaped bands of tissue at the surface of the stomodeum.

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26
Q

What will the horseshoe-shaped bands of tissue form?

A

These bands will form the dental arches.

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27
Q

What happens if there is a lack of initiation within the dental lamina?

A

A lack of initiation within the dental lamina results in the absence of teeth.

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28
Q

What is anodontia?

A

Anodontia, also called hypodontia, is the absence of teeth due to a failure in the initiation process.

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29
Q

How can anodontia manifest?

A

It can manifest as a single missing tooth, multiple missing teeth, or the absence of an entire dentition.

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30
Q

What is partial anodontia?

A

Partial anodontia refers to one or more missing teeth but not the entire dentition.

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31
Q

What is complete anodontia?

A

Complete anodontia refers to the absence of an entire dentition.

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32
Q

Which type of anodontia is more common?

A

Partial anodontia is more common than complete anodontia.

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33
Q

Which teeth are most commonly affected by anodontia?

A

The most commonly affected teeth are the permanent third molars, maxillary lateral incisors, and mandibular second premolars (in order of occurrence).

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34
Q

What are some etiologic factors for anodontia?

A

Etiologic factors include hereditary conditions, endocrine dysfunction, systemic disease, and excessive radiation exposure.

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35
Q

With which syndrome is anodontia associated?

A

Anodontia can be associated with ectodermal dysplasia.

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36
Q

Why is ectodermal dysplasia linked to anodontia?

A

Ectodermal dysplasia affects components of the tooth germ that are indirectly or directly derived from ectodermal origin.

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37
Q

What can result from abnormal initiation of the dental lamina?

A

Abnormal initiation can result in the development of one or more extra teeth.

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38
Q

What are extra teeth called?

A

Extra teeth are called supernumerary teeth or hyperdontia.

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39
Q

What causes supernumerary teeth?

A

Supernumerary teeth are initiated from persisting clusters of the dental lamina and have a hereditary etiology.

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40
Q

Which regions of the dentition commonly have supernumerary teeth?

A

Common regions include:
• Between the maxillary central incisors (mesiodens)
• Distal to the maxillary third molars (distomolar or ‘fourth molar’)
• In the premolar region of both dental arches (perimolar)

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41
Q

What is the size of supernumerary teeth compared to normal teeth?

A

Supernumerary teeth are often smaller than usual.

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42
Q

Can supernumerary teeth erupt?

A

Yes, they may be either erupted or nonerupted.

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43
Q

What complications can arise from supernumerary teeth?

A

Complications include dentition displacement, crowding, delayed eruption of adjacent teeth, and occlusal disruption.

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44
Q

How are supernumerary teeth treated?

A

Treatment often involves surgical removal and/or orthodontic therapy.

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45
Q

What can smaller-than-normal dental placodes lead to?

A

They can lead to missing and microdontic teeth.

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46
Q

What do larger placodes induce?

A

Larger placodes induce supernumerary and macrodontic teeth.

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47
Q

What is the second stage of tooth development?

A

The second stage of tooth development is the bud stage.

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48
Q

When does the bud stage occur?

A

It occurs at the beginning of the 8th week of prenatal development for the primary dentition.

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49
Q

What happens to the dental lamina during the bud stage?

A

The dental lamina undergoes extensive proliferation into buds.

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50
Q

What are buds in the context of the bud stage?

A

Buds are three-dimensional oval masses that penetrate into the surrounding ectomesenchyme.

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51
Q

How many buds form in each dental arch at the end of the proliferation process?

A

Each dental arch (maxillary and mandibular) will have 10 buds.

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52
Q

What does the ectomesenchyme do during the bud stage?

A

The ectomesenchyme undergoes proliferation and begins to condense around the buds.

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53
Q

What remains between the dental lamina bud and the surrounding ectomesenchyme?

A

A basement membrane remains between them.

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54
Q

What do the buds and surrounding ectomesenchyme develop into?

A

They develop into a tooth germ and its associated supporting tissue types.

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55
Q

What can abnormal proliferation during the bud stage cause?

A

It can cause a single tooth, multiple teeth (partial), or an entire dentition (complete) to be larger or smaller than normal.

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56
Q

What is macrodontia?

A

Macrodontia refers to abnormally large teeth.

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57
Q

What is microdontia?

A

Microdontia refers to abnormally small teeth.

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58
Q

How common is complete microdontia?

A

Complete microdontia is rare in either dentition.

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59
Q

With which conditions can complete microdontia be associated?

A

It can be associated with hypopituitarism or Down syndrome.

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60
Q

What systemic condition can produce complete macrodontia?

A

Childhood hyperpituitarism (gigantism) can produce complete macrodontia.

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61
Q

What is the most common type of microdontia?

A

True partial microdontia, which is often hereditary.

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62
Q

Which teeth are commonly affected by partial microdontia?

A

The permanent maxillary lateral incisor (peg lateral) and the permanent third molar (peg molar) are commonly affected.

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63
Q

What is the third stage of tooth development?

A

The third stage of tooth development is the cap stage.

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64
Q

When does the cap stage occur?

A

It occurs between the 9th and 10th week of prenatal development, during the fetal period.

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65
Q

What happens to the enamel organ during the cap stage?

A

The enamel organ grows and forms a cap over the tooth bud, shaping the tooth’s outer layer.

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66
Q

What processes are involved in the cap stage?

A

The cap stage involves proliferation and differentiation to form the tooth germ, the primordium of a primary tooth.

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67
Q

What causes the cap shape of the enamel organ to form?

A

Unequal growth in different parts of the tooth bud leads to the formation of a three-dimensional cap shape overlying the ectomesenchyme.

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68
Q

What forms during the cap stage?

A

The tooth germ, which contains each primordial tissue necessary to develop the future tooth, forms during this stage.

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69
Q

What is the predominant physiologic process in the cap stage?

A

Morphogenesis is the predominant physiologic process during the cap stage.

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70
Q

What results from the combined physiologic processes during the cap stage?

A

A depression forms in the deepest part of each tooth bud of the dental lamina, creating the cap shape of the enamel organ.

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71
Q

What is the future role of the enamel organ?

A

The enamel organ will produce enamel on the outer surface of the crown of the tooth.

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72
Q

From what is the enamel organ originally derived?

A

The enamel organ is originally derived from ectoderm, making enamel an ectodermal product.

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73
Q

What forms on the innermost margin of the cap shape during the cap stage?

A

A cluster of non-dividing epithelial cells called the enamel knot forms.

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74
Q

What is the function of the enamel knot?

A

The enamel knot acts as a signaling center that directs the shape and position of tooth cusps.

The enamel knot determines the overall morphology of the tooth and is a key component in tooth morphogenesis.

It regulates cell growth and differentiation within the developing tooth germ.

75
Q

What happens to the ectomesenchyme deep to the buds during the cap stage?

A

It condenses into a mass within the concavity of the cap of the enamel organ.

76
Q

After development of the cap shaped enamel organ during the cap stage, What is the condensed mass of ectomesenchyme now considered?

A

It is now considered the dental papilla.

77
Q

What will the dental papilla produce in the future?

A

The dental papilla will produce the future dentin and pulp for the inner part of the tooth.

78
Q

What separates the enamel organ and the dental papilla during the cap stage?

A

A basement membrane separates the enamel organ and the dental papilla.

79
Q

What is the significance of this basement membrane?

A

It is the site of the future dentinoenamel junction (DEJ).

80
Q

From where is the dental papilla derived?

A

The dental papilla is derived from ectomesenchyme, which is in turn derived from neural crest cells (NCCs).

81
Q

What is the origin of dentin and pulp?

A

Dentin and pulp are of mesenchymal origin.

82
Q

What happens to the remaining ectomesenchyme surrounding the enamel organ?

A

It condenses into the dental sac (or dental follicle).

83
Q

What will the dental sac produce in the future?

A

The dental sac will produce the periodontium, including cementum, the periodontal ligament, and the alveolar process.

84
Q

What separates the enamel organ and the dental sac?

A

A basement membrane separates the enamel organ and the dental sac.

85
Q

What is the origin of the supporting dental tissue from the dental sac?

A

The supporting dental tissue is of mesenchymal origin, derived from ectomesenchyme.

86
Q

What structures together form the tooth germ at the end of the cap stage?

A

The enamel organ, dental papilla, and dental sac together form the tooth germ, which is the primordium of the tooth.

87
Q

When does initiation for permanent teeth occur?

A

Initiation occurs at the 10th week of prenatal development during the cap stage for each primary tooth.

88
Q

Which teeth are the first permanent teeth to initiate development?

A

The anterior teeth of the permanent dentition are the first to initiate development.

89
Q

Which teeth follow the anterior teeth in the initiation process?

A

The premolars of the permanent dentition follow the anterior teeth in the initiation process.

90
Q

Where and how does the primordium for permanent teeth form?

A

The primordium appears as an extension of the dental lamina into the ectomesenchyme lingual to the developing primary tooth germs.

91
Q

What is the site of origin for the primordium of permanent teeth?

A

The site of origin is called the successional dental lamina.

92
Q

Which permanent teeth are considered succedaneous?

A

Permanent teeth with primary predecessors, such as anterior teeth and premolars, are considered succedaneous.

93
Q

Where do the crowns of permanent succedaneous teeth erupt in relation to their primary predecessors?

A

They erupt lingual to the roots of their primary predecessors if the primary tooth has not been fully shed.

94
Q

Which permanent teeth are nonsuccedaneous?

A

Permanent molars are nonsuccedaneous because they do not have primary predecessors.

95
Q

From where do the permanent molars develop?

A

They develop from a posterior extension of the dental lamina distal to the dental lamina of the primary second molar.

96
Q

Which structures are involved in the development of permanent molars?

A

The dental lamina and its associated ectomesenchyme are involved in the development of permanent molars.

97
Q

What is gemination?

A

Gemination occurs when a single tooth germ attempts to divide into two tooth germs.

98
Q

What is the result of gemination?

A

It results in a large single-rooted tooth with a common enlarged pulp cavity.

99
Q

How does gemination appear in the crown?

A

The crown exhibits “twinning,” appearing broader and falsely macrodontic.

100
Q

How can gemination be differentiated from fusion?

A

Radiographic examination shows only one pulp cavity in gemination, with the correct number of teeth present in the dentition.

101
Q

What is fusion in tooth development?

A

Fusion is the union of two or more adjacent tooth germs.

102
Q

What may cause fusion?

A

Fusion may result from pressure in the area during tooth development.

103
Q

How does fusion affect the appearance of the tooth?

A

It creates a broad, falsely macrodontic tooth, similar to gemination.

104
Q

Which parts of the tooth can be involved in fusion?

A

Fusion can involve only the crown or both the crown and root.

105
Q

How does fusion affect the total number of teeth in the arch?

A

The dentition with fusion will have one less tooth than normal.

106
Q

How is fusion verified?

A

Radiographic examination shows two distinct pulp cavities with the enamel, dentin, and pulp united.

107
Q

Where is fusion more commonly observed?

A

Fusion is more commonly seen in the anterior region of the primary dentition.

108
Q

What are tubercles in tooth development?

A

Tubercles are small, round enamel extensions forming extra cusps.

109
Q

Where are tubercles most commonly found?

A

They are most commonly found on the occlusal surface of permanent molars, especially third molars.

110
Q

Where else can tubercles be present?

A

They can be present as a lingual extension on the cingulum of permanent maxillary anteriors, especially lateral incisors and canines.

111
Q

What is a specific type of tubercle called?

A

A specific type of tubercle is called a talon cusp.

112
Q

Can tubercles occur on any tooth?

A

Yes, tubercles can be found on any tooth in both dentitions.

113
Q

What is the fourth stage of tooth development?

A

The fourth stage of tooth development is the bell stage.

114
Q

When does the bell stage occur?

A

It occurs between the 11th and 12th week of prenatal development for the primary dentition.

115
Q

What happens to the dental lamina during the bell stage?

A

The dental lamina breaks down, and the tooth germ epithelium forms a bell-shaped structure that will become the tooth’s crown.

116
Q

What occurs during the bell stage at the cellular level?

A

Differentiation occurs at all levels to its furthest extent.

117
Q

What results from the differentiation in the enamel organ during the bell stage?

A

Four different types of cells are found within the enamel organ:
• Outer enamel epithelium (OEE)
• Stellate reticulum
• Stratum intermedium
• Inner enamel epithelium (IEE)

118
Q

How does the cap shape change during the bell stage?

A

The cap shape of the enamel organ deepens, forming a three-dimensional bell shape.

119
Q

What happens to the tooth crown during the bell stage?

A

The tooth crown assumes its final shape through morphodifferentiation.

120
Q

Which cells undergo further histodifferentiation during the bell stage?

A

Ameloblasts (enamel-forming cells) and odontoblasts (dentin-forming cells) undergo further histodifferentiation.

121
Q

What are the outer cuboidal cells of the enamel organ called?

A

They are called the outer enamel epithelium (OEE).

122
Q

What are the innermost tall columnar cells of the enamel organ called?

A

They are called the inner enamel epithelium (IEE).

123
Q

What is the future role of the IEE?

A

The IEE will differentiate into enamel-secreting cells called ameloblasts.

124
Q

What separates the IEE and the adjacent dental papilla?

A

A basement membrane separates them.

125
Q

How do the IEE cells influence the dental papilla?

A

IEE cells exert an organizing influence on the underlying mesenchymal cells of the dental papilla, which later differentiate into odontoblasts (dentin-producing cells).

126
Q

What role does the OEE play in enamel formation?

A

The OEE organizes a network of capillaries to bring nutrition to the ameloblasts during enamel production.

127
Q

What happens to the OEE surface at the end of the bell stage?

A

The formerly smooth surface of the OEE becomes folded to prepare for enamel formation.

128
Q

How does the adjacent mesenchyme of the dental sac respond to the folded OEE?

A

The adjacent mesenchyme forms papillae containing capillary loops, which supply nutrition to the avascular enamel organ.

129
Q

What two layers are found between the outer and inner enamel epithelium during the bell stage?

A

The stellate reticulum and the stratum intermedium.

130
Q

What is the stellate reticulum?

A

It consists of star-shaped cells in many layers, forming a network within the enamel organ.

131
Q

Where is the stellate reticulum located in the enamel organ?

A

It is found in the center of the enamel organ in a developing tooth.

132
Q

What do the cells of the stellate reticulum synthesize?

A

They synthesize glycosaminoglycans.

133
Q

What is the stratum intermedium?

A

It is a compressed layer of flat to cuboidal cells.

134
Q

Where is the stratum intermedium located?

A

It is located between the inner enamel epithelium and the newly forming cells of the stellate reticulum.

135
Q

When does the stratum intermedium first appear?

A

It appears during the early bell stage of tooth development, around the 14th week of prenatal development.

136
Q

What is the role of the stratum intermedium?

A

Along with the inner enamel epithelium, it is responsible for supporting the production of enamel.

137
Q

What happens to the dental lamina during the bell stage?

A

The dental lamina disintegrates.

138
Q

How does the tooth develop after the disintegration of the dental lamina?

A

The tooth continues to develop separated from the oral epithelium.

139
Q

What may form from remnants of the disintegrated dental lamina?

A

Remnants may become entrapped in the tissues, forming epithelial pearls.

140
Q

How is the crown pattern of the tooth established during the bell stage?

A

The crown pattern is established by the folding of the inner enamel epithelium (IEE).

141
Q

What begins to form at the crest of the folded IEE?

A

Dentin and enamel begin to form at the crest of the folded IEE.

142
Q

What happens to the dental papilla during the bell stage?

A

The dental papilla undergoes extensive histodifferentiation and differentiates into two types of tissue.

143
Q

What are the two types of tissues in the dental papilla?

A

The outer cells of the dental papilla and the central cells of the dental papilla.

144
Q

What do the outer cells of the dental papilla differentiate into?

A

They differentiate into odontoblasts, which are dentin-secreting cells.

145
Q

What do the central cells of the dental papilla become?

A

They become the primordium of the pulp.

146
Q

What happens to the dental sac during the bell stage?

A

The dental sac increases its amount of collagen fibers.

147
Q

Into what does the dental sac undergo histodifferentiation?

A

The dental sac undergoes histodifferentiation into its mature dental tissue types.

148
Q

What mature dental tissue types does the dental sac form?

A

The dental sac forms cementum, the periodontal ligament, and the alveolar process.

149
Q

How is the dental lamina related to root development?

A

The disintegration of the dental lamina allows root development to proceed, separating the tooth from the oral epithelium.

150
Q

What are the final stages of tooth development?

A

The final stages are the apposition stage and the maturation stage.

151
Q

What happens during the apposition stage?

A

During the apposition stage, enamel, dentin, and cementum are secreted in successive layers upon the existing layers.

152
Q

How are the hard dental tissue types secreted initially during the bell stage?

A

They are secreted as a partially mineralized matrix.

153
Q

What is the matrix in the context of tooth development?

A

The matrix is an extracellular substance that serves as a framework for full mineralization later.

154
Q

What marks the maturation stage?

A

The maturation stage is reached when the matrices of the dental tissues fully mineralize.

155
Q

How does the level of mineralization vary among dental tissues?

A

Enamel is the hardest, dentin is the next hardest, and cementum is the least hard, similar in hardness to bone tissue.

156
Q

Which part of the tooth does tooth development begin?

A

Tooth development begins in the crown and then proceeds to the root.

157
Q

What happens after the formation of the inner enamel epithelium (IEE) in the enamel organ?

A

The innermost cells of the IEE elongate and differentiate into preameloblasts.

158
Q

What occurs during the differentiation of preameloblasts?

A

The nucleus in each preameloblast cell moves away from the center to the position farthest from the basement membrane, a process called repolarization.

159
Q

What happens to preameloblasts after inducing odontoblasts?

A

Preameloblasts themselves differentiate into ameloblasts, which secrete enamel.

160
Q

What happens after the IEE differentiates into preameloblasts?

A

The outer cells of the dental papilla are induced by preameloblasts to differentiate into odontoblasts.

161
Q

What process do odontoblasts undergo during differentiation?

A

Odontoblasts undergo repolarization, where their nuclei move to a position farthest from the basement membrane.

162
Q

How do the repolarized odontoblasts align?

A

They line up adjacent to the basement membrane.

163
Q

What is the next step for odontoblasts after alignment?

A

Odontoblasts begin dentinogenesis, which is the appositional growth of dentin matrix (predentin), laying it down on their side of the disintegrating basement membrane.

164
Q

Where is the basement membrane located during this stage?

A

The basement membrane is located between the IEE of the enamel organ and the odontoblasts in the dental papilla.

165
Q

What happens after odontoblasts form predentin?

A

The basement membrane between the preameloblasts and the odontoblasts disintegrates.

166
Q

What does the disintegration of the basement membrane allow?

A

It allows preameloblasts to contact the newly formed predentin.

167
Q

What does contact of the preameloblasts with the predentin induce in preameloblasts?

A

It induces preameloblasts to differentiate into ameloblasts.

168
Q

What do ameloblasts begin producing?

A

Ameloblasts begin amelogenesis, the appositional growth of enamel matrix.

169
Q

What side of the basement membrane is the enamel matrix laid down?

A

It is laid down on their side of the disintegrating basement membrane.

170
Q

From where is the enamel matrix secreted?

A

The enamel matrix is secreted from Tomes’ process, a histologic feature of ameloblasts.

171
Q

What is Tomes’ process?

A

Tomes’ process is a projection of the ameloblast surrounded by developing enamel during its formation.

172
Q

What happens when the enamel matrix contacts the predentin?

A

Mineralization of the disintegrating basement membrane occurs.

173
Q

What does mineralization of the basement membrane form in the context of tooth development?

A

It forms the dentinoenamel junction (DEJ), which is the inner junction between the dentin and enamel tissues.

174
Q

What do odontoblasts leave behind as they move away from the DEJ?

A

Odontoblasts leave attached cellular extensions called odontoblastic processes.

175
Q

Where are odontoblastic processes located?

A

They are located in the length of the predentin.

176
Q

What surrounds the odontoblastic processes?

A

Each process is contained within a mineralized cylinder called a dentinal tubule.

177
Q

What are dentinal tubules?

A

Dentinal tubules are microscopic channels that run from the pulp of a tooth through the dentin and end just beneath the enamel.

178
Q

What is the function of dentinal tubules?

A

They transport nutrients from the pulp to the dentin and transmit sensations such as touch and temperature.

179
Q

What can interfere with the metabolic processes of ameloblasts?

A

Certain factors can interfere, leading to enamel dysplasia.

180
Q

What is enamel dysplasia?

A

Enamel dysplasia is the faulty development of enamel.

181
Q

What types of causes can lead to enamel dysplasia?

A

Enamel dysplasia can have either local or systemic causes.

182
Q

What can cause local enamel dysplasia?

A

Local enamel dysplasia may result from trauma or infection affecting a small group of ameloblasts.

183
Q

What can cause systemic enamel dysplasia?

A

Systemic enamel dysplasia may result from traumatic birth, systemic infections, nutritional deficiencies, or dental fluorosis.