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Seminar 1 Dentin
Seminar 1 Dentin
•Matrix proteins are similar in dentin and •Plate shaped crystals, smaller than HA crystals of
bone ; but dentin sialoproein (DSP)and enamel.
dentin phospho-proteins (DPP) are •Small amount of phosphates, carbonates, sulfates.
Present only in dentin.
•In compared to enamel , crystals are rich in
•Matrix contains various growth factors , carbon & poor in calcium.
which help in mineralization of dentin.
Transforming growth
factor
Dentin FGF
Dentin
Acc . to developmental
Acc. to location Acc. to mineralization
pattern
Spreads down from Root dentin begins to form Root dentin formation
Begins at bell stage cusp slope to cervical at slight later stage and it By the time tooth completes at 18th
in papillary tissue requires proliferation of reaches its functional months after tooth
loop of enamel organ epithelial cell( hertwig’s
adjacent to concave position; two third of eruption in deciduous
& dentin thickens epithelial root sheath)
teeth whereas it
tip of inner enamel around pulp to initiate root dentin formation
until all coronal prolongs upto2-3 years
epithelium at cusp tip differentiation of root is completed.
dentin is formed. odontoblasts. in permanent teeth.
dental papilla cells are small and undifferentiated as well as separated from the inner enamel epithelium by an
acellular zone that contains some fine collagen fibrils.
newly differentiated cells are highly polarized, with their nuclei positioned away from the inner enamel
epithelium.
The mineral phase first appears within the matrix vesicles as single crystals believed to be seeded by phospholipids
present in the vesicle membrane
Deposition of mineral lags behind the formation of the organic matrix so that a layer of organic matrix, called
predentin, always is found between the odontoblasts and the mineralization front
After mineral seeding, noncollagenous matrix proteins produced by odontoblasts come into play to regulate mineral
deposition. In this way coronal mantle dentin is formed in a layer approximately 15 to 20 µm thick onto which then is
added the primary (circumpulpal) dentin.
Matrix
Vesicles give
This foci grows
rise to
and coalesce
mineralization
foci
ROOT FORMATION H,F. THOMAS' DEPARTMENT OF PEDIATRIC DENTISTRY, UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER, SAN ANTONIO, TEXAS. USA
Similarly differences have been described in the biochemical composition of root dentin when
compared with crown
For example, differences between crown and root odontoblasts in the quantity and quality of
the phosphoproteins synthesized.
Also, lower levels of both α1, and α2 chains of type I collagen mRNA have been described in root
odontoblasts
ROOT FORMATION H,F. THOMAS' DEPARTMENT OF PEDIATRIC DENTISTRY, UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER, SAN ANTONIO, TEXAS. USA
SECONDARY DENTINOGENESIS
•Secondary dentin is deposited after root formation is completed.
•It is formed by the same odontoblasts that formed primary dentin.
•It is laid down as a continuation of the primary dentin.
•It forms at a much slower pace than primary dentin.
•Histologically it demarcated by a demarcation line of less regular organization of
dentinal tubules.
DENTIN PERMEABILITY-FARID BIN CHE GHAZALI -ARTICLE FROM THE MALAYSIAN JOURNAL OF
MEDICAL SCIENCES
DIFFERENCE BETWEEN PRIMARY AND
PERMANENT TEETH DENTIN
It is suggested that transforming growth factor-beta (TGF-β) is involved in the production of tubular dentin
bone morphogenetic protein (BMP) is involved in the production of osteodentin.
affect nerve
endings within the
dentin tubules
Thermal, or
through direct
Mechanical stimuli
communication
with the pulpal
nerve endings
The exposed dentin surface is subjected to thermal, chemical, tactile or evaporative stimuli
fluid flow within the dentinal tubules will be increased which change pressure.
response of the excited pulpal nerves, mainly in intradentin fibers, will be depended
upon the intensity of stimuli in pain production
DENTIN HYPERSENSITIVITY AND ITS MANAGEMENT: A REVIEW TUSHARLUTHRA, SANDEEP GUPTA, SUDHANSHU BHARADWAJ, ASHISH CHOUBEY, HITENDRA YADAV, HARIMRAN SINGH
Clinical features of Dentinal hypersensitivity
•Pain is the most common clinical feature associated with dentin hypersensitivity
•Intensity of pain varies from mild discomfort to severe sensitivity.
•Character of pain: rapid in onset, sharp in character and is of short duration.
•External stimuli which can elicit pain include:-
Thermal stimuli – Hot/cold food and beverages , Cold blast of air
Osmotic stimuli – Sweet food.
Acidic stimuli – Citrus fruits , Acidic beverages , Medicines
Mechanical stimuli – Toothbrush , Dental instruments
DENTIN HYPERSENSITIVITY AND ITS MANAGEMENT: A REVIEW TUSHARLUTHRA, SANDEEP GUPTA, SUDHANSHU BHARADWAJ, ASHISH CHOUBEY, HITENDRA YADAV, HARIMRAN SINGH
DESENSITIZING AGENTS
CLASSIFICATION
Cover or
Nerve Protein Periodontal soft
At home In office plugging Dentin Sealers laser
desensitization precipitants tissue grafting
dentinal tubules
•Nerve desensitization:- e.g., potassium nitrate
•Cover or plugging dentinal tubules:- calcium hydroxide , Calcium phosphate , Calcium
carbonate , Calcium silicate
•Protein precipitants:- formaldehyde , glutaraldehyde , silver nitrate , strontium chloride
hexahydrate , Zinc chloride
•Dentin Sealers :- Glass ionomer cements ,Composites , Dentinal adhesives , Resinous dentinal
desensitizers , Varnishes , Sealants, Methyl Methacrylate
DENTIN HYPERSENSITIVITY AND ITS MANAGEMENT: A REVIEW TUSHARLUTHRA, SANDEEP GUPTA, SUDHANSHU BHARADWAJ, ASHISH CHOUBEY, HITENDRA YADAV, HARIMRAN SINGH
REMAINING DENTIN THICKNESS
•RDT between the floor of cavity preparation and pulp chamber is
important factor to determine the pulpal response
•2mm RDT will provide adequate insulating barrier against irritants
•RDT decreases pulpal response increases
•At RDT of 0.75 mm, effects of bacterial invasion are seen
•When RDT is 0.25 mm, odontoblastic cell death is seen
Superfical layer which is soft and leathery in Deeper layer which is hard in consistency and
consistency and dark brown in colour. light brown in color.
Collagen irreversibly denaturated Reversibly denaturated
High concentration of bacteria Donot contain bacteria
Must be removed,not remineralizable. Donot require removal
Galvanic shock
STURDEVANT’S ART AND SCIENCE OF OPERATIVE DENTISTRY / ANDRÉ V. RITTER, EDWARD J. SWIFT, JR., HAROLD O. HEYMANN, V. GOPIKRISHNA - A SOUTH ASIA ED -
STURDEVANT’S ART AND SCIENCE OF OPERATIVE DENTISTRY / ANDRÉ V. RITTER, EDWARD J. SWIFT, JR., HAROLD O. HEYMANN, V. GOPIKRISHNA - A SOUTH ASIA ED -
DENTIN ADHESIVES
• They are intermediate materials that can be connected with both dentin tissue and composite resin and are developed to help
ensure the connection between dentin tissue and composite resin surfaces and the retention of restoration, to prevent
microleakage and to prevent dentin sensitivity that may occur after restoration by covering dentin tubules
• Properties of Dentin Adhesives Enamel/dentin bonding systems used to perform adhesive bonding are today called “adhesive
systems”.
Properties sought in adhesive systems:
• Prevention of microleakage and secondary caries,
• To be able to withstand stresses caused by polymerization shrinkage and under chewing forces,
• Micromechanical and chemical bonding to enamel and dentin tissue,
• To be able to connect to enamel and dentin tissue as well as to be able to connect to metal and porcelain,
• Easy application on moist surfaces (Wet-bonding),
• Easy clinical application without technical precision,
• Preventing post operative sensitivity by closing all or part of the dentin channels.
Development of Dentin Bonding Systems from Past to Present- Review article Mağrur
KAZAK1, Nazmiye DÖNMEZ2
CLASSIFICATION OF DENTAL ADHESIVES
Development of Dentin Bonding Systems from Past to Present- Review article Mağrur
KAZAK1, Nazmiye DÖNMEZ2
DENTIN ETCHING
• Etchants are strong acids which are used to remove smear layers and open tubules, increase retention of resin
sealant and promote mechanical retention.
• Dentin etching is more technique sensitive than enamel etching because of complexity of dentin structure. Unlike
enamel , dentin is living tissue, consisting of 50% (volume%)of hydroxyapatite, 30% organic material,
20%fluid.Acid etching removes hydroxyapatite almost completely from several microns of sound dentin ,
exposing a microporous network of collagen suspened in water.
• Application of acid to dentin results in partial or total removal of the smear layer and demineralization of the
underlying dentin.
• Acids demineralize intertubular and peritubular dentin, open the dentin tubules, and expose a dense collagen
fibrils , increasing the microporosity of the intertubular dentin .
• Dentin is demineralized by up to approximately 7.5 µm depending on the type of acid, application time, and
concentration.
• 37% phosphoric acid is used for etching
• Other materials used as etchants are maleic acid, tartaric acid, citric acid, EDTA, acidic monomers, polyacrylic
acid, hydrochloric acid, nitric acid and hydrofluoric acid
STURDEVANT’S ART AND SCIENCE OF OPERATIVE DENTISTRY / ANDRÉ V. RITTER, EDWARD J. SWIFT,
JR., HAROLD O. HEYMANN, V. GOPIKRISHNA - A SOUTH ASIA ED -
PRIMER ?????
DENTIN
HYDROPHILIC
COMPOSITE
HYDROBHOBIC
DENTIN BONDING
• Bonding to enamel is a relatively simple process, whereas bonding to dentin presents a much greater challenge.
• Several factors account for this difference between enamel and dentin bonding
• Dentin contains a substantial proportion of water and organic material, primarily type I collagen.
• Dentin is an intrinsically hydrated tissue, penetrated by a maze of fluid-filled tubules.
• Movement of fluid from the pulp to the DEJ is a result of a slight but constant pulpal pressure . Pulpal pressure
has a magnitude of 25–30 mmHg
• Dentinal tubules enclose cellular extensions from the odontoblasts and are in direct communication with the
pulp.
• Adhesion can be affected by the remaining dentin thickness after tooth preparation. Bond strengths are
generally less in deep dentin than in superficial dentin
• Dentin is in close proximity to pulp , so different chemicals used for etching and dentin bonding may irritate
the pulp
STURDEVANT’S ART AND SCIENCE OF OPERATIVE DENTISTRY / ANDRÉ V. RITTER, EDWARD J. SWIFT,
JR., HAROLD O. HEYMANN, V. GOPIKRISHNA - A SOUTH ASIA ED -
ADHESION ENHANCING AGENT
• The primer molecules are bipolar and contain two different functional groups. Of these, the hydrophilic one
interacts with moist dentin, while the hydrophobic one interacts with adhesives. Primers are binding-
enhancing materials that dissolve in solvents such as water, ethanol, or acetone.
• The primer containing the HEMA monomer is applied to the surface of the enamel/dentin, where the
surface conditions have been changed, in order to increase the surface energy due to its wettability.
• The primer is applied to the dentin surface with a microbrush until a bright surface is obtained in two or
more layers according to the case after the roughening stage with acid, and dried with air for 5-10 seconds.
• During the drying process, care is taken to fully vaporize the solvents (acetone, ethanol) in the adhesive
content.The primer prepares the surface for adhesive bonding by altering the sequences of collagen fibrils,
and then helps make the penetration of the monomer more effective.
• The primer, which passes through the residual smear base in the acidified dentin tissue, is replaced by
water on the dentin surface due to the volatile property of acetone and/or ethanol and fills the nano-
cavities left by hydroxyapatite crystals that melt between the collagen fibrils.
STURDEVANT’S ART AND SCIENCE OF OPERATIVE DENTISTRY / ANDRÉ V. RITTER, EDWARD J. SWIFT, JR., HAROLD O. HEYMANN, V. GOPIKRISHNA - A SOUTH ASIA ED -
STURDEVANTS ART AND SCIENCE OF OPERATIVE DENTISTRY
DENTIN BONDING AGENTS
CLASSIFICATION OF MODERN DENTIN BONDING
AGENTS
CLINICAL OPERATIVE DENTISTRY PRINCIPLES AND PRACTICE RAMYA RAGHU RAGHU SRINIVASAN-2ND EDITION
HYBRID LAYER/ RESIN-DENTIN
INTERDIFFUSION / INTERDIFFUSION ZONE
•The distinct zone between the bulk adhesive and nondemineralized
dentin (i.e.,) consisting of 50%collagen matrix and 50%resin is termed as
hybrid layer.
•Hybrid layer is formed when an adhesive resin penetrates a de-
mineralized or acid etched dentin surface infiltrates the visible collagen
fibrils .
•Infiltration of demineralized collagen fibers with resin and formation of
hybrid layer results in Successful bonding.
•The superiority of the hybrid layer that is formed decides the strength of
resin-dentin interface.
MCDONALD’S AND AVERY’S DENTISTRY FOR THE CHILD AND ADOLESCENT 11TH EDITION
CLINICAL PRESENTATION
•Clinically teeth appears reddish-brown to blue-gray opalescent color.
• Soon after the primary dentition is complete, enamel is worn and often breaks away from
the incisal edges of anterior teeth and the occlusal surfaces of posterior teeth.
• The exposed soft dentin abrades rapidly, occasionally to the extent that the smooth,
polished dentin surface is continuous with the gingival tissue.
•Multiple root fractures are often seen, particularly in older patients.
•Crowns of the permanent teeth often seem to be of better quality and have less destruction.
•Broad crowns with constriction of the cervical area resulting in a “tulip ” shape
•Radiographically, slender roots and bulbous crowns present ; as well as pulp chamber is
large initially which undergoes obliteration later.
MCDONALD’S AND AVERY’S DENTISTRY FOR THE CHILD AND ADOLESCENT 11TH EDITION
•Caused by mutation in the DSPP gene, encoding dentin phosphoprotein and dentin sialoprotein.
•The gene maps to chromosome number 4 .
•It is distinct from osteogenesis imperfecta with opalescent teeth, and affects only the teeth
•There is no increased frequency of bone fractures in this disorder
•The teeth are blue-grey or amber brown.
MCDONALD’S AND AVERY’S DENTISTRY FOR THE CHILD AND ADOLESCENT 11TH EDITION
Radiographic appearance:
•The teeth have bulbous crowns,
•Roots that are narrower than normal
•Pulp chambers and root canals are smaller than normal or completely
obliterated.
•The enamel may split readily from the dentin when subjected to
occlusal stress
MCDONALD’S AND AVERY’S DENTISTRY FOR THE CHILD AND ADOLESCENT 11TH EDITION
RADIOGRAPHIC FEATURES :-
- In both dentitions, the roots are short, blunt, conical
- Deciduous teeth-pulp chambers and root canals are usually
completely obliterated,
- Permanent dentition-crescent shaped pulpal remnant seen in
the pulp chamber.
- This obliteration in the permanent teeth commonly occurs
pre-eruptively.
MCDONALD’S AND AVERY’S DENTISTRY FOR THE CHILD AND ADOLESCENT 11TH EDITION
Clinical features:-
•Both dentitions are affected.
•Deciduous teeth-yellow, brown, or bluish-grey opalescent appearance
•Permanent teeth-clinical appearance is normal.
Intraoral photograph showing Ellis Class II fracture with respect to 11 and 21 with
normal color, texture and shape of teeth
JOURNAL OF ORAL MAXILLOFACIAL PATHOLOGY 2019
Journal of oral maxillofacial pathology 2019
DENTIN HYPOCALCIFICATION
•Normal dentin is calcified by deposition of calcium salts in the
organic matrix in the form of globules, which increase in size by
further peripheral deposition of salts until all the globules are
finally united into a homogeneous structure.
•In dentinal hypocalcification there is failure of union of many of
these globules, leaving interglobular areas of uncalcified matrix.
•Hypocalcified dentin is softer than well-calcified dentin.
•Conditions like parathyroid deficiency or rickets, could produce
hypocalcification
Clinical Features:-
The teeth affected by odontodysplasia exhibit either a delay or a
total failure in eruption.
Shape is altered,very irregular in appearance,with defective
mineralization.