SHEDDING OF TOOTH

DR. R. SATHISH MUTHUKUMAR

PROFESSOR & HEAD
DEPARTMENT OF DENTAL ANATOMY &
ORAL HISTOLOGY
 SYNOPSIS
• LOSS OF TOOTH
• SHEDDING – DEFINITION, SYNONYM
• WHY ?
• HOW?
• HISTOLOGY OF RESORPTION
• CLINICAL SIGNIFICANCE
 SHEDDING OF TOOTH
LOSS OF TOOTH
•PHYSIOLOGICAL
•PATHOLOGICAL
 SHEDDING - DEFINITION
THE PHYSIOLOGICAL PROCESS RESULTING IN
THE ELIMINATION OF THE DECIDUOUS
DENTITION IS CALLED SHEDDING OR
EXFOLIATION

4
DIPHYODONT
 SHEDDING – WHY?
• TO REPLACE THE PRIMARY TEETH
• INABILITY OF THE TEETH TO GROW IN SIZE
• ACCOMDATION IN THE SMALL JAW OF THE INFANT
• NEED OF LESS NO AND SMALL SIZED TEETH
• TO ALLOW ERUPTION OF PERMANENT TEETH
• SYNCRONISED WITH SKELETAL AND MUSCULAR
GROWTH
 SHEDDING – HOW ?
• LOSS OF ROOT
• LOSS OF BONE
• INCREASED FORCE
• REDUCED REGENERATION OF PERIODONTAL
LIGAMENT
HISTOLOGY OF SHEDDING
– LOSS OF ROOT
PRESSURE FROM THE GROWING
& ERUPTING TEETH

DIFFERENTIATION

ODONTOCLASTS

PRIMARY TEETH ROOT RESORPTION

REDUCED ROOT SURFACE AREA

LESS PDL ATTACHMENT

& LOOSENING OF TOOTH
 HISTOLOGY OF SHEDDING
– LOSS OF BONE

FACIAL GROWTH OF ALVEOLAR BONE

BONE REMODELLING

MODIFICATION OF THE ALVEOLAR BONE

SPACE

POSITIONING OF THE PERMANENT SUCCESSOR

HISTOLOGY OF SHEDDING
– INCREASED FORCE
INCREASE IN AGE

MUSCULAR GROWTH

INCREASED MASTICATORY FORCE

COMPRESSION OF PERIODONTAL LIGAMENT,

RESORPTION OF ROOT & ALVEOLAR BONE

WEAKENING OF THE
ATTACHMENT APPARATUS
 HISTOLOGY OF SHEDDING
– REDUCED REGENERATION OF PDL

MUSCULAR GROWTH

INCREASED MASTICATORY FORCE

COMPRESSION OF PERIODONTAL LIGAMENT

MORE PDL DEGENERATION BUT LESS REGENERATION

LOOSENING OF TOOTH
PATTERN OF RESORPTION IN
ANTERIOR TEETH
PATTERN OF RESORPTION IN
POSTERIOR TEETH
 CLINICAL SIGNIFICANCE
• REMANANTS OF PRIMARY TOOTH (ROOT
REMANANTS )
 CLINICAL SIGNIFICANCE
• PINK TOOTH

PRIMARY TOOTH CROWN

APPEAR PINK FOLLOWING
DENTIN RESORPTION
 HISTOLOGY OF SHEDDING
• RESORPTION OF ROOT AND BONE BY RESORPTIVE
CELLS (ODONTOCLAST & OSTEOCLAST )
 RESORPTIVE CELLS
(ODONTOCLAST & OSTEOCLAST )
• ARE MULTINUCLEATED, NON-DIVIDING CELLS
THAT MOVE AROUND ON TOOTH / BONE
SURFACES, RESORBING THE TOOTH / BONE
MATRIX FROM SITES WHERE IT IS
DETORIATING OR NOT NEEDED
RESORPTIVE CELLS - ORGIN
CIRCULATING MONOCYTES

ESCAPE FROM THE BLOOD VESSEL

FUSION OF CELLS

MULTINUCLEATED CELLS

OSTEOCLAST / ODONTOCLAST
RESORPTIVE CELLS - FEATURES
• LARGE / GAINT CELLS
• NON-DIVIDING, MULTI-NUCLEATED (6-12 NUCLEUS)
• LOCATION: “CUP – SHAPED” DEPRESSION /
“HOWSHIP’S LACUNAE”
• “LIMPET – LIKE” ATTACHMENT ON THE RESORBING
SURFACE
 RESORPTIVE CELL - PARTS
• RUFFLED BORDER / VILLOUS LIKE PROCESS
• CLEAR ZONE
• VESICULAR REGION
• BASAL REGION
RESORPTIVE CELL - PARTS

BASAL REGION

RUFFLED BORDER

VESICULAR REGION

CLEAR ZONE
 RESORPTIVE CELL - RUFFLED BORDER
• FINGER-LIKE PROCESSES
• TRANSITORY, HIGHLY MOTILE
• VARYING DIAMETER
• LACKS ORGANELLES, CONTAIN MICROFILAMENTS
• POKE INTO THE RESORBING SURFACE
 RESORPTIVE CELL - CLEAR ZONE
• RING-SHAPED REGION, ENCIRCLES THE PERIPHERY
OF RUFFLED BORDER
• MOTTLED APPEARANCE
• LACKS ORGANELLES, CONTAIN ABUNDANT
MICROFILAMENTS
RESORPTIVE CELL - VESICULAR REGION

• DEEP TO THE RUFFLED BORDER

• CONTAIN VESICLE WITH ALKALINE PHOSPHATASE
• VESCLES OF VARYING SHAPES AND DIMENSIONS
 RESORPTIVE CELL - BASAL REGION

• FAR FROM THE RESORBING SURFACE

• MULTIPLE NUCLEUS
• STACKS OF GOLGI SACCULES, MANY MITOCHONDRIA
• SECRETORY VESICLES, LYSOSOMES, FEW ROUGH
ENDOPLASMIC RETICULUM
 PHASES OF RESORPTION

EXTRACELLULAR PHASE INTRACELLULAR PHASE

PHASES OF RESORPTION - EXTRACELLULAR PHASE
RESORPTIVE CELLS

EXOCYTOTOSIS

RELEASE OF
HYDROLYTIC ENZYMES
FREE CRYSTALS

FOCAL DECALCIFICATION DISRUPTION OF

OF BONE MATRIX COLLAGEN MESHWORK

LOCAL ACIDIC ENVIROMENT ORGANIC ACIDS

PHASES OF RESORPTION - EXTRACELLULAR PHASE

BONE MATRIX

RUFFLED PROCESS
PHASES OF RESORPTION - INTRACELLULAR PHASE
END OF EXTRACELLULAR PHASE

DISRUPTED COLLAGEN FREE CRYSTALS

PHAGOCYTOSIS

FIBROBLASTIC OSTEOCLAST /
PHAGOCYTOSIS ODONTOCLAST

CYTOPLASMIC
COLLAGENASE VACUOLES

COLLAGEN DEGRADATION CRYSTAL DIGESTION

PHASES OF RESORPTION - INTRACELLULAR PHASE

RUFFLED PROCESS
OF RESORBING CELL

ACIDIC COMPARTMENT
THANKS