ENAMEL AND

DENTINE
Maria jose barragan 40 A
Tooth enamel, along with dentin,
cementum, and dental pulp is one of the
four major tissues that make up the tooth in
vertebrates. It is the hardest and highly
mineralized substance in the human,the
normally visible dental tissue of acovers
the anatomical crown and by underlying
dentin.
* Also define as “Acellut forms the
protecti ” over the entire
Odontogenesistooth development”
• 1- initiation stage - 6th to 7th week
• 2- Bud stage — 8th week
• 3- Cap stage- 9th to 10th week 4- Bell stage — 11th to12th week
• 5- apposition stage — varies per tooth
• 6- maturation stage — varies per
What does tooth enamel do?
Enamel helps protect your teeth from daily use such as chewing,
biting, crunching, and grinding. Although enamel is a hard protector
of teeth, it can chip and crack. Enamel also insulates the teeth from
potentially painful temperatures and chemicals. When it erodes, you
may notice that you react more to hot or cold foods, drinks, and
sweets, since they can get through holes in your enamel to the nerves
inside.
What causes enamel erosion?
Tooth erosion happens when acids wear away the enamel on teeth. Enamel erosion can be caused by the following:
• Having too many soft drinks, which have lots of phosphoric and citric acids. Bacteria in your mouth thrive on sugar, and they
make acids that can eat away at enamel. It gets worse if you don’t clean your teeth regularly.
• Fruit drinks. Some acids in fruit drinks are more erosive than battery acid.
• Sour foods or candies. They also have a lot of acid.
• Dry mouth or low saliva flow (xerostomia). Saliva helps prevent tooth decay by washing away bacteria and leftover food in
your mouth. It also brings acids to an acceptable level.
• A diet high in sugar and starches
• Acid reflux disease (GERD) or heartburn. These bring stomach acids up to the mouth, where they can damage enamel.
• Gastrointestinal problems
• Medications (antihistamines, aspirin, vitamin C)
• Alcohol misuse or binge drinking. People with these conditions vomit often, which is hard on teeth.
• Genetics (inherited conditions)
• Things in your environment (friction, wear and tear, stress, and corrosion)
What are the environmental causes of
tooth surface erosion?
Friction, wear and tear, stress, and corrosion (or any combination of these actions) can cause erosion of the
tooth surface. More clinical terms used to describe these mechanisms include:

Attrition. This is natural tooth-to-tooth friction that happens when you clench or grind your teeth such as
with bruxism, which often occurs involuntarily during sleep.
Abrasion. This is physical wear and tear of the tooth surface that happens with brushing teeth too hard,
improper flossing, biting on hard objects (such as fingernails, bottle caps, or pens), or chewing tobacco.
Abfraction. This occurs from stress fractures in the tooth such as cracks from flexing or bending of the tooth.
Corrosion. This occurs chemically when acidic content hits the tooth surface such as with certain
medications like aspirin or vitamin C tablets, highly acidic foods, GERD, and frequent vomiting from
bulimia or alcoholism.
What are the signs of enamel erosion?
The signs of enamel erosion can vary, depending on the stage. Some signs may include:
Sensitivity. Certain foods (sweets) and temperatures of foods (hot or cold) may cause a twinge of pain in
the early stage of enamel erosion.
Discoloration. As the enamel erodes and more dentin is exposed, the teeth may appear yellow.
Cracks and chips. The edges of teeth become more rough, irregular, and jagged as enamel erodes.
Smooth, shiny surfaces on the teeth, a sign of mineral loss
Severe, painful sensitivity. In later stages of enamel erosion, teeth become extremely sensitive to
temperatures and sweets. You may feel a painful jolt that takes your breath away.
Cupping. Indentations appear on the surface of the teeth where you bite and chew.
Dentin
• Dentin is one of the four tissues that make up a tooth. The
other three are enamel, cementum, and pulp. Dentin is
strong but not as solid as the enamel – and although less
known than the enamel, it actually makes up majority of
the tooth structure.

• Dentin, which is creamy-white to yellowish in colour, is

found just beneath the enamel. This is the reason our teeth
appear less bright when the enamel corrodes and more of
the dentin shows up
Development
The formation of dentin begins prior to the formation of the enamel.
Dentin formation is initiated by the odontoblasts of the pulp. Dentin
comes from the dental papilla of the tooth germ. Unlike enamel,
dentin forms throughout your life. The growth of dentin can be
initiated from stimuli, such as tooth decay or attrition.
Structure
Dentin, unlike enamel, can be demineralized and stained for histological study. Dentin contains
microscopic channels, which are called dentinal tubules, which radiate outward through the dentine from
the pulp to the enamel border. The dentinal tubules extend from the dentinoenamel junction which is
located in the crown area or dentinocemental junction in the root area, towards the outer wall of the pulp.
From the outer surface of the dentin to the area closest to the pulp, these tubules create an S-shaped path.
The tubules near the pulp has the greatest diameter and density. Because of dentinal tubules, dentin is
permeable, which can increase the pain sensitivity in addition to the rate of tooth decay.
Types
There are three different types of dentin which include primary, secondary and tertiary. Secondary dentin is
a layer of dentin which is produced after the tooth’s root is completely formed. Tertiary dentin is created in
response to a stimulus, such the presence of tooth decay or wear.
Primary Dentin
Primary dentin, the most prominent dentin in the tooth, lies between the enamel and the pulp chamber
(near dentinoenamel junction). The outer layer closest to enamel is known as mantle dentin. This layer is
unique to the rest of primary dentin. Mantle dentin is formed by newly differentiated odontoblasts and
forms a layer consistently 15-20 micrometers (µm) wide. Unlike primary dentin, mantle dentin lacks
phosphorylation, has loosely packed collagen fibrils and is less mineralized. Below it lies the
circumpulpal dentin, more mineralized dentin which makes up most of the dentin layer and is secreted
after the mantle dentin by the odontoblasts. Circumpulpal dentin is formed before the root formation is
completed.

Newly secreted dentin is unmineralized and is called predentin. It is easily identified in hematoxylin and
eosin stained sections since it stains less intensely than dentin. It is usually 10-47μm and lines the
innermost region of the dentin. It is unmineralized and consists of collagen, glycoproteins, and
proteoglycans. It is similar to osteoid in bone and is thickest when dentinogenesis is occurrin
Secondary Dentin
Secondary dentin (adventitious dentin) is formed after root formation is complete, normally after the tooth
has erupted and is functional. It grows much more slowly than primary dentin but maintains its incremental
aspect of growth. It has a similar structure to primary dentin, although its deposition is not always even
around the pulp chamber. It appears greater in amounts on the roof and floor of the coronal pulp chamber ,
where it protects the pulp from exposure in older teeth. The secondary dentin formed is not in response to
any external stimuli , and it appears very much similar to the primary dentine. It is the growth of this dentin
that causes a decrease in the size of the pulp chamber with age. This is clinically known as pulp recession;
cavity preparation in young patients, therefore, carries a greater risk of exposing the pulp. If this occurs, the
pulp can be treated by different therapies such as direct pulp capping. Previously it was thought that Pulp
capping was most successful if followed by a stainless steel crown, however this procedure is most of the
times unnecessary in children. it requires the unnecessary removal of enamel which is key to the life of the
tooth. Adhesive dentistry allows for conservative restoration techniques that minimize the loss of tooth
structure and should be used. In order to maintain space in the primary dentition, attempts are made not to
extract a pulpal exposure.
Tertiary dentin (including reparative
dentin or sclerotic dentin)
• Tertiary dentin is dentin formed as a reaction to external stimulation such as cavities and wear.[18] It is
of two types, either reactionary, where dentin is formed from a pre-existing odontoblast, or reparative,
where newly differentiated odontoblast-like cells are formed due to the death of the original
odontoblasts, from a pulpal progenitor cell. Tertiary dentin is only formed by an odontoblast directly
affected by a stimulus; therefore, the architecture and structure depend on the intensity and duration of
the stimulus, e.g., if the stimulus is a carious lesion, there is extensive destruction of dentin and damage
to the pulp, due to the differentiation of bacterial metabolites and toxins. Thus, tertiary dentin is
deposited rapidly, with a sparse and irregular tubular pattern and some cellular inclusions; in this case, it
is referred to as "osteodentin". Osteodentin is seen in Vit.A deficiency during development. However, if
the stimulus is less active, it is laid down less rapidly with a more regular tubular pattern and hardly any
cellular inclusions.[19] The speed at which tertiary dentin forms also varies substantially among primate
species
Dentinal sclerosis
• Dentinal sclerosis or transparent dentin sclerosis of primary dentin is a change in the structure of teeth
characterized by calcification of dentinal tubules. It can occur as a result of injury to dentin by caries or
abrasion, or as part of the normal aging process.