oral histology

LEC3 (Bell stage)

● so called because the Enamel organ comes to resemble bell . During this stage
a tooth crown assumes its final shape (Morphodifferentiation) , and the cells
that will be making the hard tissues of crown (Ameloblasts and odontoblasts)
acquire their distinctive phenotype (Histodifferentiation) .
‫ض‬ٚ‫ (انزًب‬ٙ‫زخز ربج انغٍ شكهّ انُٓبئ‬ٚ ‫شجّ اندشط خالل ْزِ انًشزهخ‬ٚ ‫ُب‬ًٛ‫● رغًٗ كزنك ألٌ ععٕ ان‬
. )‫خ‬ُٛ‫خ ٔ االسٔيبد انغ‬ٛ‫ُبئ‬ًٛ‫ عزصُع األَغدخ انصهجخ نهزبج (االسٔيبد ان‬ٙ‫ب انز‬ٚ‫) ٔركزغت انخال‬ٙ‫انشكه‬
A- Early bell stage (‫)يشزهخ اندشط انًجكش‬
● High degree of histodifferentiation is achieved in the early bell stage . The
enamel organ shows four distinct layer 1- outer enamel epithelium , 2- stellate
reticulum , 3- stratum intermedium , and 4- inner enamel epithelium .
‫ُب أسثع غجقبد‬ًٛ‫ظٓش ععٕ آن‬ٚ ‫ يشزهخ اندشط انًجكشح‬ٙ‫ ف‬ٙ‫د‬ٛ‫ض انُغ‬ٚ‫خ يٍ انزًب‬ٛ‫ق دسخخ عبن‬ٛ‫زى رسق‬ٚ ●
‫ُب‬ًٛ‫ ظٓبسح ان‬-4 ، ‫ انطجقخ انًزٕعطخ‬-3 ، ‫خ‬ًٛ‫ انشجكخ انُد‬-2 ، ‫خ‬ٛ‫ُب انخبسخ‬ًٛ‫ ظٓبسح آن‬-1 ٍ‫ضح ي‬ًٛ‫يز‬
. ‫خ‬ٛ‫انذاخه‬
1) The outer enamel epithelium : (‫خ‬ٛ‫ُب انخبسخ‬ًٛ‫)ظٓبسح ان‬
● this forms the outer layer of cuboidal cells which limits the enamel organ .
It is separated from the Surrounding ectomesenchymal tissue by a basement
membrane 1-2µm thick .
‫خ‬ٛ‫زى فصهّ عٍ األَغدخ انخبسخ‬ٚ . ‫ُب‬ًٛ‫ رسذ يٍ ععٕ آن‬ٙ‫ب انًكعجخ انز‬ٚ‫خ نهخال‬ٛ‫شكم انطجقخ انخبسخ‬ٚ ‫● إٌ ْزا‬
. ‫كشٔيزش‬ٛ‫ ي‬2-1 ‫طخ ثٕاعطخ غشبء قبعذ٘ ثغًك‬ٛ‫انًس‬
2) The stellate reticulum (‫خ‬ًٛ‫ )انشجكخ انُد‬:
● The intercellular spaces become fluid filled , presumably related to osmotic
effects arising from the high concentration of glycos-aminoglycans . The cells
are star-shaped with bodies containing conspicuous nuclei and many branching
processes . In addition to glycosaminoglycans , the cells also contain alkaline
phosphatase . But have only small amounts of RNA and glycogen .
ٍ‫خ انُبشئخ ع‬ٛ‫شاد انزُبظس‬ٛ‫فزشض أَٓب يشرجطخ ثبنزأث‬ٚٔ ، ‫ب يًهٕءح ثبنغٕائم‬ٚ‫ٍ انخال‬ٛ‫● رصجر انًغبزبد ث‬
‫ذ‬ٚ‫ب عهٗ شكم َدًخ يع أخغبو رسزٕ٘ عهٗ َٕٖ ٔاظسخ ٔانعذ‬ٚ‫ انخال‬. ٌ‫كب‬ٛ‫ُٕخه‬ٛ‫كٕط اي‬ٛ‫ نهده‬ٙ‫ض انعبن‬ٛ‫انزشك‬
. ٕ٘‫ض انقه‬ٛ‫عب عهٗ انفٕعفبر‬ٚ‫ب أ‬ٚ‫ رسزٕ٘ انخال‬، ٌ‫كب‬ٛ‫ُٕخه‬ٛ‫كٕصاي‬ٛ‫ ثبإلظبفخ إنٗ انده‬. ‫بد انًزفشغخ‬ٛ‫يٍ انعًه‬
. ٍٛ‫كٕخ‬ٛ‫ ٔانده‬ٙ‫ج‬ٚ‫شح فقػ يٍ انسًط انُٕٔ٘ انش‬ٛ‫بد صغ‬ًٛ‫ك ك‬ٚ‫ٔنكٍ نذ‬
● The main function ascribed to the stellate reticulum is a mechanical one .
This relates to the protection of the urderlynig dental tissues against physical
disturbance and to the maintenance of tooth shape It has been suggested that
the hydrostatic pressure generated within the stellate reticulun is in
equilibrium with that of the dental papilla .
ٍ‫خ أَغدخ األعُبٌ ي‬ٚ‫زعهق ْزا ثسًب‬ٚ . ‫خ‬ٛ‫ك‬َٛ‫كب‬ٛ‫فخ ي‬ٛ‫ ٔظ‬ْٙ ‫خ‬ًٛ‫خ انًُغٕثخ إنٗ انشجكخ انُد‬ٛ‫غ‬ٛ‫فخ انشئ‬ٛ‫انٕظ‬
‫ انًزٕنذ داخم انشجكخ‬ٙ‫ك‬ٛ‫ذسٔعزبر‬ٛٓ‫خ ٔانسفبظ عهٗ شكم األعُبٌ ٔقذ اقزشذ أٌ انعغػ ان‬ٚ‫االظطشاثبد اندغذ‬
. ٌ‫ًخ األعُب‬ٛ‫ زبنخ رٕاصٌ يع زه‬ٙ‫خ ف‬ًٛ‫انُد‬

‫كلية الحدةاء الجامعة‬ ‫ المرحلة الثانية‬- ‫طب األسنان‬

oral histology

3) Stratum intermedium (‫خ‬ُٛٛ‫ )انطجقخ انج‬:

This first appears at the early bell stage and as layers of flattened cells lying
between the inner E. epithelium and stellate reticulum . The cells of this layer
consists of several layer of squamous cells , closely attached by desmosomes
and gab junction . The cells of stratum intermedium characterized by high
degree of alkaline phosphatase enzyme wich is important in the mineralization
of the enamel . The cells of this layer concern in the transport of materials to
and from the E. forming cells in inner E. epithelium (amelobtasts) .
‫ٍ ظٓبسح‬ٛ‫ب انًغطسخ انٕاقعخ ث‬ٚ‫ يشزهخ اندشط انًجكشح ٔ كطجقبد يٍ انخال‬ٙ‫ظٓش ْزا ألٔل يشِ ف‬ٚ ●
‫ يشرجطخ اسرجبغب‬، ‫خ‬ٛ‫ب انسششف‬ٚ‫ب ْزِ انطجقخ يٍ عذح غجقبد يٍ انخال‬ٚ‫ رزكٌٕ خال‬. ‫خ‬ًٛ‫خ ٔ انشجكخ انُد‬ٛ‫انذاخه‬
‫ض‬ٛ‫ى انفٕعفبر‬ٚ‫خ يٍ أَض‬ٛ‫ض ثذسخخ عبن‬ًٛ‫ رز‬ٙ‫خ انز‬ُٛٛ‫ب انطجقخ انج‬ٚ‫ خال‬. ‫غًٕعٕيبد ٔرقبغع انفدٕح‬ٚ‫قب ثبنذ‬ٛ‫ٔث‬
ٙ‫ب انًكَٕخ ف‬ٚ‫ب ْزِ انطجقخ ثُقم انًٕاد يٍ ٔ إنٗ انخال‬ٚ‫ رٓزى خال‬. ‫ُب‬ًٛ‫ٍ آن‬ٚ‫ رعذ‬ٙ‫انقهٕ٘ انز٘ ْٕ يٓى ف‬
. ‫خ‬ٛ‫انظٓبسح انذاخه‬
4) Inner enamel epithelium (‫خ‬ٛ‫ُب انذاخه‬ًٛ‫ )ظٓبسح ان‬:
● It consists of a single layer of cells that differentiate prior to amelogenesis into
columnar cells , the ameloblasts .
‫ األسٔيبد‬ْٙٔ ‫خ‬ٚ‫ب عًٕد‬ٚ‫ٍ انُشٕء انٗ خال‬ٕٚ‫ض قجم رك‬ٚ‫ رزًب‬ٙ‫ب انز‬ٚ‫● رزكٌٕ يٍ غجقخ ٔازذح يٍ انخال‬
. ‫خ‬ٛ‫ُبئ‬ًٛ‫ان‬
● The inner E, - epith . cells rich in RNA but unlike the stratum intermedium
do not contain alkaline phosphatase .
‫ض‬ٛ‫ ٔنكٍ عكظ انطجقخ انًزٕعطخ ال رسزٕ٘ عهٗ انفٕعفبر‬ٙ‫ج‬ٚ‫خ ثبنسًط انُٕٔ٘ انش‬ُٛ‫خ انغ‬ٛ‫ب انذاخه‬ٚ‫● انخال‬
. ٕ٘‫انقه‬
5) Dental papilla (d.p.) in early bell stage (‫ يشزهخ اندشط انًجكشح‬ٙ‫ًخ االعُبٌ ف‬ٛ‫ )زه‬:
Before the inner E. epith . differentiate into ameloblast to produce E . , the
peripheral cells of d.p. differentiate into odontoblasts (dentin forming cells)
under the organizinig influence of inner E. epithelium .
ٌ‫ًخ األعُب‬ٛ‫طخ نسه‬ٛ‫ب انًس‬ٚ‫ض انخال‬ٚ‫ رزًب‬E. ‫خ إلَزبج‬ٛ‫ُبئ‬ًٛ‫ض إنٗ أسٔيخ ان‬ٚ‫ رزًب‬. ٙ‫ انذاخه‬ٙ‫ح أنطالئ‬ٛ‫● قجم انُغ‬
. ‫خ‬ٛ‫ش انًُظى نهظٓبسح انذاخه‬ٛ‫ب رشكم انعبج) رسذ انزأث‬ٚ‫خ (خال‬ُٛ‫ب انغ‬ٚ‫إنٗ انخال‬
6) Dental sac (d.S.) in early bell stage (‫ يشزهخ اندشط انًجكشح‬ٙ‫ظ األعُبٌ ف‬ٛ‫ )ك‬:
Before formation of dental hard tissue begins , the d.S . shows a circular
arrangement of Its fibers and it resemble a capsular structure , With the
development of the root .
‫خ انًسفظخ‬ُٛ‫شجّ ث‬ٚٔ ّ‫بف‬ٛ‫ب ألن‬ٚ‫جب دائش‬ٛ‫ظ األعُبٌ رشر‬ٛ‫ظٓش ك‬ٚ ٌ‫ٍ األَغدخ انصهجخ نألعُب‬ٕٚ‫جذأ رك‬ٚ ٌ‫● قجم أ‬
. ‫بف‬ٛ‫ يع رطٕس اندزس ٔ األن‬،

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oral histology

B-Advance (late) bell stage or appositional stage :

: ‫خ‬ٛ‫يشزهخ اندشط انًزقذيخ (انًزأخشح) أٔ انًشزهخ انًٕظع‬
● This stage of tooth development is associated with the formation of the dental
hard tissues . Dentine formation always precedes enamel formation . During
this stage the boundary between inner E. epith . and odontoblasts outlines the
future D.EJ . (dentino enamel junction) . In addition , the basal margin of the
E. organ (cervical loop) gives rise to the epithelial root sheath .
‫م‬ٛ‫غجق دائًب رشك‬ٚ ‫م انعبج‬ٛ‫ رشك‬. ٌ‫ٍ األَغدخ انصهجخ نألعُب‬ٕٚ‫● رشرجػ ْزِ انًشزهخ يٍ ًَٕ األعُبٌ ثزك‬
‫عخ نهًغزقجم‬ٚ‫خ انخطٕغ انعش‬ُٛ‫خ ٔ االسٔيبد انغ‬ٛ‫ انذاخه‬ٙ‫ٍ انُغح أنطالئ‬ٛ‫ُب خالل ْزِ انًشزهخ انسذٔد ث‬ًٛ‫آن‬
‫ؤد٘ إنٗ غًذ‬ٚ )ٍ‫ فبٌ انٓبيش انقبعذ٘ نهععٕ (زهقخ عُق انغ‬، ‫ُٕ) ثبإلظبفخ إنٗ رنك‬ٛ‫ُب دَز‬ًٛ‫(رقبغع ان‬
. ٘‫اندزس انظٓبس‬
Function of dental lamina : (‫خ‬ُٛ‫سخ انغ‬ٛ‫فخ انصف‬ٛ‫)ٔظ‬
The functional activity of the dental lamina and its chronology may be
considered in three phases :
: ‫ عهٗ ثالس يشازم‬ُٙ‫خ ٔرغهغهٓب انضي‬ُٛ‫سخ انغ‬ٛ‫ نهصف‬ٙ‫ف‬ٛ‫ انُشبغ انٕظ‬ٙ‫ًكٍ انُظش ف‬ٚ
1- The first phase is concerned with initiation of the entire deciduous dentition
that begins at the 6 weeks of intra-uterian life of embryo .
. ‫ٍ داخم انشزى‬ُٛ‫بح اند‬ٛ‫ع يٍ ز‬ٛ‫ أعبث‬6 ٙ‫ رجذأ ف‬ٙ‫خ ثبنكبيم ٔانز‬ُٛ‫ رٓزى انًشزهخ األٔنٗ ثجذء األعُبٌ انهج‬-1
2- The second phase deals with the initiation of the successors of the deciduous
teeth .
. ‫خ‬ُٛ‫خ ثذء خهفبء األعُبٌ انهج‬َٛ‫ رزُبٔل انًشزهخ انثب‬-2
3- The third phase is preceded by the extension of the dental lamina .
. ‫خ‬ُٛ‫سخ انغ‬ٛ‫ذ انصف‬ٚ‫غجقٓب رًذ‬ٚ ‫ انًشزهخ انثبنثخ‬-3
Fate of dental lamina (‫خ‬ُٛ‫سخ انغ‬ٛ‫ش انصف‬ٛ‫)يص‬
1- Dental lamina is functional in developing 52 teeth from 6 prenatal weeks
until 4 years after birth (development of third permanenttooth)
. ‫ عُٕاد ثعذ انٕالدح‬4 ٗ‫ع قجم انٕالدح زز‬ٛ‫ أعبث‬6 ٍ‫ عُب ي‬52 ‫ش‬ٕٚ‫ رط‬ٙ‫فزٓب ف‬ٛ‫خ ٔظ‬ُٛ‫سخ انغ‬ٛ‫ انصف‬-1
2- The dental lamina degenerates by mesenchymal invasions in late bell stage
. ‫ يشزهخ اندشط انًزأخشح‬ٙ‫خ ثغجت غضٔاد انهسًخ انًزٕعطخ ف‬ُٛ‫سخ انغ‬ٛ‫ رزذْٕس انصف‬-2
3- Developing tooth lose its connection with dental lamina .
. ‫خ‬ُٛ‫سخ انغ‬ٛ‫خ اسرجبغٓب ثبنصف‬ٛ‫ رفقذ األعُبٌ انُبي‬-3
4- Sometimes remnants of dental lamina remains in the jaws asepithelial rests
of Serres (Serres' pearls) .
. )‫ظ‬ٚ‫ش‬ٛ‫ظ (النٗ ع‬ٚ‫ش‬ٛ‫خ نغ‬ٚ‫ٍ كًغبَذ ظٓبس‬ٛ‫ انفك‬ٙ‫خ ف‬ُٛ‫سخ انغ‬ٛ‫ب انصف‬ٚ‫بٌ رجقٗ ثقب‬ٛ‫ ثعط األز‬ٙ‫ ف‬-4
Disturbance of epithelial-mesenchymal interactions : This disturbances can
markedly disturb tooth development :
ٌ‫ًكٍ أٌ رؤد٘ ْزِ االظطشاثبد انٗ اظطشاة ًَٕ األعُب‬ٚ : ‫خ انًزٕعطخ‬ٚ‫اظطشاة انزفبعالد انظٓبس‬
: ‫انًشرجػ ثشكم يهسٕظ‬

‫كلية الحدةاء الجامعة‬ ‫ المرحلة الثانية‬- ‫طب األسنان‬

oral histology

A- Malformation of teeth related to variation in size , shape , number or in

structure :
: ‫خ‬ُٛ‫ انسدى أٔ انشكم أٔ انعذد أٔ انج‬ٙ‫ رشِٕ األعُبٌ انًشرجػ ثبالخزالف ف‬-‫أ‬
1- macrodoritia (enlarge tooth) . )ٌ‫ش األعُب‬ٛ‫(ركج‬
2- microdontia (small size tooth) . (‫شح انسدى‬ٛ‫)األعُبٌ صغ‬
3- germination (partial cleavage of tooth germ) . (ٌ‫ ندشثٕيخ األعُب‬ٙ‫)االَقغبو اندضئ‬
4- fusion (union of 2 adjacent teeth) . (‫ أعُبٌ يزدبٔسح‬2 ‫)ارسبد‬
5- hypodontia (reduction in No of teeth) . (ٌ‫ عذد األعُب‬ٙ‫)اَخفبض ف‬
6- anadontia (complete absence of teeth) . (ٌ‫بة انزبو نألعُب‬ٛ‫)انغ‬
7- dens in dente (tooth within tooth) . (ٍ‫)األعُبٌ داخم انغ‬
B- malformation of teeth related to the development of specific dental tissue :
: ‫ُخ‬ٛ‫ رشِٕ األعُبٌ انًزعهق ثزطٕس أَغدخ أعُبٌ يع‬-‫ة‬
1- Amelogenesis imperfecta . (‫ٍ االخزالء انُبقص‬ٕٚ‫)رك‬
2- dentinogenesis imperfecta . (‫ٍ انعبج انُبقص‬ٕٚ‫)رك‬
3- Truma and infection of deciduous teeth may cause malformation in
permenant teeth .
. ‫خ إنٗ زذٔس رشِٕ األعُبٌ انذائًخ‬ُٛ‫ األعُبٌ انهج‬ٙ‫قذ رؤد٘ انصذيخ ٔ انعذٖٔ ف‬

‫كلية الحدةاء الجامعة‬ ‫ المرحلة الثانية‬- ‫طب األسنان‬