ODONTOGENESIS

Dr Smitha S. Shetty

Introduction

The primitive oral cavity (stomodeum) is lined by stratified squamous epithelium (oral
ectoderm). It is separated from gut by a thin membrane known as buccopharyngeal
membrane. On the 27th day of gestation the buccopharyngeal membrane ruptures & the oral
cavity establishes connection with foregut. Most of the connective tissue underlying the oral
ectoderm is derived from neural crest or ectomesenchymal in origin. These connective tissue
cells induce the overlying ectoderm or oral epithelium to start tooth development which
begins in the anterior portion of future maxilla & mandible & proceeds posteriorly. The
primitive oral cavity or stomatodeum at this stage consist of two or three layered epithelium
covering embryonic connective tissue that is of neural crest origin.

TOOTH DEVELOPMENT
It involves

I) Initiation of tooth Development

II) Stages of Tooth Development

I) Initiation of tooth Development:
It begins with
a) Primary epithelial band formation
b) Dental lamina & vestibule formation
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 a) Primary epithelial band formation
 When the embryo is 6 weeks old the basal cells proliferate more rapidly than the
adjacent cells & forms the primary epithelial band.

 Primary epithelial band is a band of epithelium that has invaded the underlying
ectomesenchyme along the horseshoe shaped future dental arches

b) Dental lamina & vestibule formation:

At about 7th week the Primary epithelial band quickly divides into subdivisions-Lingual
process called the Dental lamina & Buccal process called the Vestibular lamina. The Dental
lamina serves as the primodium for the ectoderm portion of the Deciduous teeth. Later, during
the development of the jaws, the permanent molars arise from the distal extension of the dental
lamina. Successors of the deciduous teeth develop from the lingual extension of the dental
lamina known as Succesional lamina
The Vestibular lamina develops labial & buccal to dental lamina. It is also termed as lip
furrow band. The cells enlarge, then degenerate to form cleft that becomes the oral vestibule
between lips, cheek & tooth bearing area.

Development from distal Initiatation at

extension of dental lamina

First permanent molar 4th month in utero

Second permanent molar 1st year after birth

Third permanent molar 4th & 5th yrs.

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 Development from lingual Initiatation at
extension/successional lamina
Permanent central incisor to 5th- 10th month of age
premolar

Fate of Dental Lamina: It is evident that the activity of dental lamina lasts for 5yrs. As the teeth
Continues to develop, they lose their connection with the dental lamina. It degenerates by
mesenchymal invasion. Remnants of the dental lamina persist as epithelial pearls or island within
the jaw or gingiva. These are referred as Cell rests of Serres.

Figure: dental lamina (B) & vestibular lamina(A)

II) STAGES OF TOOTH DEVELOPMENT

TOOTH DEVELOPMENT
At certain points along dental lamina , each representing the location of 10
mandibular & 10 maxillary deciduous teeth, the ectodermal cells multiply still more
rapidly to form knob like structures that grow into underlying mesenchyme called
ENAMEL ORGAN (epithelial part of tooth germ, also known as Dental organ) of tooth
bud of a deciduous tooth. First the enamel organ begins forming in the anterior
mandibular region.

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STAGES OF TOOTH DEVELOPMENT
As cell proliferation continues, each enamel organ increases in size & change in shape.

Based on shape of enamel organ - three morphological stages:

i. Bud Stage
ii. Cap stage
iii. Bell stage
a) Early bell stage
b) Advanced or late bell stage
BUD STAGE
The epithelium of dental lamina undergoes differentiation into round or ovoid swellings
at 10 different points corresponding to the future positions of the deciduous teeth. These are the
pridordia of the enamel organs, the tooth buds. Thus the development of the tooth germs is
initiated; the cells proliferate faster than adjacent cells. Since the main function of certain
epithelial cells of the tooth bud is to form the tooth enamel, these cells constitute the enamel
organ. Enamel organ at this stage consists of: Peripherally located low columnar cells or
cuboidal cells &centrally located polygonal cells. Epithelium of dental lamina is separated from
underlying mesenchyme by a basement membrane.
Ectomesenchymal condensation just below enamel organ is known as dental papilla. It
forms future dentin & pulp. Ectomesnchymal condensation that surrounds tooth bud & dental
papilla is known as dental sac or dental follicle. It forms future cementum, periodontal ligament
& alveolar bone. Dental papilla & dental sac are not well defined in this stage

Figure: Bud stage

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 CAP STAGE
As the tooth bud continues to proliferates, it does not expand uniformly into a large
sphere. Instead unequal growth in different parts of tooth bud leads to the cap shape which is
characterized by shallow invagination on deeper surface of the bud. Hence called as cap stage.
The Lateral lamina is the extension of dental lamina from the point of attachment to developing
tooth. As epithelial bud proliferate into ectomesenchyme the cellular density adjacent to
epithelial outgrowth increases causing condensation of ectomesenchyme

At this stage, tooth germ consists of:

-Outer Enamel epithelium
-Inner enamel epithelium
-Stellate Reticulum
-Dental papilla
-Dental sac

Outer Enamel epithelium-

 The peripheral cells of the cap stage are cuboidal that cover convexity of cap and
are called the outer enamel (dental) epithelium
 These cells are separated from dental sac by a delicate basement membrane

Inner enamel epithelium

o It covers concavity of cap
o The cells are columnar in shape.
o These cells are separated from dental papilla by a delicate basement membrane

Stellate reticulum
o It consists of polygonal cells located between inner & outer enamel epithelium
o These cells secrete glycosaminoglycans (GAG) into extracellular compartment
between the cells, as GAG is hydrophilic thus water is drawn into enamel organ.
The cells in the center are forced apart & hence form star shaped but remain
connected through desmosomal junctions

o As a result the cells are star shaped with cytoplasmic process in contact- hence
called stellate reticulum

o They give a cushioning consistency that may support & protect delicate enamel
forming cells

Dental papilla:
o Under the influence of proliferating epithelium of enamel organ, the
ectomenchyme gets partially enclosed by invaginated portion of inner enamel
epithelium & condense to form dental papilla
o The dental papilla shows active budding of capillaries
o It forms the formative organ of dentin & primodium of the pulp

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 Dental sac (Dental Follicle)
 It is formed by ectomesenchymal condensation surrounding enamel organ &
dental papilla.
 Gradually this zone becomes dense & more fibrous.
 Enamel organ+ Dental papilla+ Dental follicle= Tooth Germ
 It forms the cementum, periodontal ligament & alveolar bone

Figure: Cap Stage

Additional features
Enamel knot – the cells in the center of the enamel organ are densely packed to form
enamel knot

Enamel cord- is the vertical extension of a enamel knot

Enamel septum- forms when the enamel cord extends to meet the outer enamel
epithelium (OEE)

Enamel navel – is the small depression seen at the point of meeting of enamel septum
with OEE

Functions of enamel knot & cord

 Transitory structure disappear before enamel formation begins.
 These structures (enamel knot & chord) represent organisation center which
orchestrates cuspal morphogenesis or shape of tooth
 Also they may act as a reservoir of dividing cells for growing enamel organ.

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Enamel Niche:

 Apparent structure in histologic sections created by the plane of section cutting

through the curved dental lamina so that the mesenchyme appears surrounded by
dental epithelium.

 The enamel organ may be seen to have a double attachement of dental lamina to
the overlying epithelium enclosing the ectomesenchyme between them is called
the enamel niche

 This appearance is due to a funnel shaped depression of the dental lamina

Figure: Enamel knot, Enamel Niche

BELL STAGE
As the invagination of epithelium deepens & its margins continue to grow, the enamel
organ assumes bell shape.in the bell stage the crown shape is determined. The folding of
the enamel organ to cause different crown shapes is shown to be due to differential rates of
mitosis & differences in the cell differentiation time. The determination of crown shape is
under the control of genes & their signaling molecules & growth factors.

The stage involves:

a) Early Bell Stage

b) Advanced Bell Stage

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 a) Early Bell Stage

At this stage, tooth germ consists of:

 Inner enamel epithelium
 Outer enamel epithelium
 Stratum Intermedium
 Stellate reticulum
 Dental Papilla
 Dental Sac
 Cervical loop or zone of
reflexion
Inner enamel epithelium (IEE)

 Consists tall columnar cells about 4 to 5 microns in diameter & about 40 microns
 It contains nucleus away from basement membrane- reversal of polarity
 Differentiates- Ameloblasts prior to enamel formation
 Attached to one another by junctional complex & to stratum intermedium by
desmosomes
 It is separated from dental papilla by basement membrane
 It exerts influence on mesenchymal cells in dental papilla to differentiate into
odontoblasts to form dentin

Outer enamel epithelium (OEE)

 Consists of low cuboidal epithelial cells
 In the end of bell stage, it is thrown into folds for better nutrition of the enamel
organ
 It joins to adjacent cells by means of Junctional complexes & to stratum reticulum
by desmosomes.
 In this stage the dental Lamina extends lingually to forms the successional dental
lamina that gives rise to bud for permanent tooth

Stratum Intermedium
 A few layers of squamous cells form stratum intermedium between IEE & stellate
reticulum
 These cells are closely attached by desmosomes & gap junctions
 This layer is essential for enamel formation.

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 Stellate reticulum

 It expands further mainly by an increase in amount of intracellular fluid

 The cells are star shaped
 The cells attached to one another & to outer enamel epithelium and stratum
intermedium by desmosomes
 Before enamel forms the stellate reticulum collapses thus reducing the distance
between the ameloblasts & the nutrient capillaries near OEE

Dental Papilla
 It is enclosed in the invaginated portion of enamel organ
 In dental papilla the cells differentiate to odontoblasts by organising influence of
epithelium
 It is separated from dental organ by a basement membrane called Membrana
preformativa

Dental Sac
o It consists of undifferentiated mesenchymal cells & circularly arranged collagen
fibrils around enamel organ & dental papilla.
o The fibers of dental sac differentiates into periodontal fibers
o Collagen fibrils are more in dental sac than dental papilla.
o Ramifying nerves & vessels are also seen

Cervical loop or zone of reflexion- It consists of only outer & inner enamel epithelium

Figure: Early Bell Stage

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b)Advanced Bell Stage:
This stage involves the following changes:

 Dental lamina joining tooth germ to oral epithelium breaks into discrete islands of
Epithelial cells, thus separating developing tooth germ from oral epithelium &
form cell rest of Serres
 IEE exerts influence on mesenchymal cells in dental papilla to differentiate into
odontoblasts

 The boundary between IEE & odontoblasts- outlines future DEJ (Dentino-enamel
Junction)
 The Odontoblasts first lay down Dentin at future cuspal region then proceeds
pulpally & apically

 After first layer of dentin is formed- ameloblasts differentiated from IEE- lay
down Enamel- at cuspal areas- then proceeds coronal & cervically

 Cervical loop which consists of IEE & OEE forms Hertwig’s epithelial root
sheath that outlines the future root

 Once enamel formation completes ameloblast layer and rest of the enamel organ
regresses and together constitute the Reduced enamel epithelium.

Figure: Advanced bell stage

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Root Formation
 The root formation begins after enamel & dentin formation has reached cemento
enamel junction
 The enamel organ plays important role by forming Hertwig’s epithelial root
sheath (HERS) by proliferation of cervical loop cells
 It molds the shape of root & initiate radicular dentin formation
 Prior to root formation- root sheath forms the Epithelial diaphragm
 OEE & IEE bend at CEJ into horizontal plane narrowing the wide cervical
opening of tooth germ
 Proliferation of cells of epithelial diaphragm & CT of pulp takes place coronal to
Epi Diaphragm
 HERS consists of OEE & IEE but donot produce enamel
 Cells of Hertwig’s epithelial root sheath induce the differentiation of radicular
dental papilla cells into odontoblasts & first layer of dentin is laid down
 When dentin is formed, HERS loses its structural integrity & its close relation
with root surface
 This loss of structural integrity is as a result of invasion of surrounding connective
tissue of dental sac
 The connective tissue cells of dental sac contact with outer surface dentin &
differentiate into cementoblasts that deposite a layer of cementum onto surface
of dentin
 Remnants of Hertwig’s epithelial root sheath are found in periodontal ligament &
are called rests of Malassez
 In last stages of root development,the proliferation of epithelium in diaphragm
lags behind that of pulpal connective tissue
 Thus wide apical foramen is first reduced to width of diaphragmatic opening
itself, later reduced by apposition of dentin & cementum at the apex of root.

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 Figure: Root formation

In case of multirooted teeth, there is differential growth of epithelial diaphragm

in the form of tongue like extensions which grow towards each other & fuse causing
division of trunk into two or three roots. Two such extensions are found in the tooth
germ of lower molars & three in the tooth germ of upper molars. Before division of
the root trunk occurs, the free ends of these horizontal epithelial flaps grow toward
each other & fuse. The single cervical opening of the coronal enamel organ is then
divided into two or three openings. On the pulpal surface of the dividing epithelial
bridges, dentin formation starts & on the periphery of each opening, root
development follows same way as in the single-rooted teeth.

Clinical Considerations related root formation

 If the epithelial root sheath remains adherent to the dentin surface,they may
differentiate into fully functional ameloblasts and produce enamel. Such droplets
of enamel are,called Enamel pearls. These are found in the area of furcation of
the roots of permanent molars.
 If continuity of root sheath is broken prior to dentin formation, a defect in dentinal
wall of pulp results in Accessory root canals. These defects are found in the
pulpal floor corresponding to the furcation.

Figure : Root formation in Multirooted teeth

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 HISTOPHYSIOLOGICAL PROCESSES
The physiological growth processes participate in the progressive development of the
Teeth-it involves

a. Initiation
b. Proliferation
c. Histodifferentiation
d. Morphodifferentiation
e. Apposition

a) Initiation
 Dental lamina & associated tooth bud- represent those parts of oral
epithelium that have potential for tooth formation
 Specific cells within the dental lamina have the potential to form the
enamel organ of certain teeth by responding to those factors that initiate or
induce the tooth development
 Initiation – requires- Epithelial Mesenchymal Interation

Clinical consideration: (Refer Assignment)

b)Proliferation

o Seen in bud, cap & bell stages-

o Proliferation causes regular changes in the size & proportions of the growing
tooth germ

c)Histodifferentiation

 Cells undergo –morphological & functional changes

 Hence differentiate to gain new function

 Histodifferentiation reaches its highest development in Bell stage

 Eg : differentiation of ameloblasts, odontoblasts

Clinical consideration: (Refer Assignment)

d)Morphodifferentiation

o The morphologic pattern, or basic form & relative size of future tooth –
morphodifferentiation
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 o Advanced bell stage – outlines the future DEJ – crown form

Clinical consideration: (Refer Assignment)

e)Apposition

Deposition of the matrix of the dental hard tissue- layer like deposition of
extracellular matrix- Enamel, Dentin & Cementum

Clinical consideration: (Refer Assignment)

CLINICAL CONSIDERATION

Refer Assignment

TIME LINE OF HUMAN TOOTH DEVELOPMENT

AGE DEVELOPMENTAL CHARACTERISTICS

 42 to 48 days -Dental lamina formation

 55 to 56 days -Bud stage for deciduous teeth

 14 weeks - Bell stage for deciduous teeth; Bud stage for permanent teeth

 18 weeks - Dentin & functional ameloblasts in deciduous teeth

 32 weeks - Dentin & functional ameloblasts in permanent teeth.

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SUMMARY

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