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1. Pharyngeal Arches
a. Each arch (pharyngeal membrane) has:
i. Ectoderm (clefts)
ii. Endoderm (pouches)
iii. Mesenchymefrom neural crest cells
b. Each arch consists of cartilage, arteryhas its own blood
supply (arches), and cranial nerve
c. Neural crest cells form:
i. Bones of face/skull
1. mandible, maxilla, alveolar bone
ii. Hyoid cartilage
iii. Cartilage, bone, dentin, teeth, dermis etc.
d. Neural crest cells arise from:
i. Rhombomeresderived from Hoxb5 genes, which
are regulated by Sonic HH and retinoic acid and can
have implications for the potential regrowth of teeth
2. Pharyngeal Arches at 5 weeks
a. Stomadeum is presentis the opening into the pharynx
(future oral cavity)
b. Surrounded by 1st arch
c. Ectoderm surrounds the stomadeum near the tonsillar
fossa
1 st A rch
S u r fa c e E c to d er m
(c lefts)
E p i th e l i u m o f b u c c a l c a v i t y a n d e a r , en a m e l,
s a liv a ry g la n d s , a n te rio r 2 /3 o f to n g u e e p ith e liu m .
N eu r a l E c to d er m
C N V
R h o m b om er es
R 1 & R 2.
S k eleto n
2 M a x illa ry a n d 2 m a n d ib u la r p ro m in e n c e s , a n d
fro n to n a s a l p ro m in e n c e .
M u sc les
M a s tic a to ry
E n d o d er m o f p o u ch es
E u s ta c h ia n (a u d ito ry ) tu b e , m id d le e a r
E c to m esen c h y m e
D e n tin
2n d A rch
S u r fa c e E c to d er m
(c le fts)
N eu r a l E c to d er m
C N V II
R h o m b o m er es
R 4
M u sc les
A ll m u sc les o f fa c ia l ex p r essio n
E n d o d er m o f f o o r
T h y ro id (fro m a d iv e rtic u lu m o f th e fo ra m e n c e c u m
[b e tw e e n tu b e rc u lu m im p a r a n d h y p o b r a c h ia l
e m in e n c e ] w ith 1 st a r c h ) . M ig r a te s d o w n f ro m
p h a ry n x to ju n c tio n o f tra c h e a a n d la ry n x .
E n d o d er m o f P o u ch
S k eleto n
3rd A rch
S u r fa c e E c to d er m
(c lefts)
N eu r a l E c to d e r m
C N IX .
R h om b om er es
R 6 & R 7.
S k eleto n
M u sc les
E n d o d er m o f f o o r
E n d o d er m o f p o u ch es
in fe rio r p a ra th y ro id s , m e d u lla ry th y m u s
3.
G e r m L a y e r s P r e s e n te d
4 th & 5 th ( 6 t h ) A r c h e s
S u r fa c e E c to d er m
(c lefts)
E p ith e liu m a ro u n d e a r.
N eu r a l E c to d er m
C N X a n d m a y b e so m e C N X I.
R h o m b om er es
R 8.
S k eleto n
L a ry n g e a l c a rtila g e s .
M u sc les
P h a ry n g e a l & la ry n g e a l m u s c le s .
E n d o d er m o f f o o r
R o o t o f to n g u e , e p ig lo ttis & p h a ry n x .
E n d o d er m o f p o u ch es
S u p e rio r p a ra th y ro id s ,
th y ro id p a ra fo llic u la r c e lls (n e u ra l c re s t)
Pituitary
a.Fusion of:
Develo
pment
of the
TOOTH DEVELOPMENT
1.Teethdevelop from ectoderm and ectomesenchyme (neural
crest)
2.Intermaxillary segment/nasomedial prominences4 maxillary
incisors
a.Rest of teeth are from either the mandibular or maxillary
prominences.
3.Early tooth development
a.Primary epithelial bandforms as a result of mitosis and
the change in orientation of the cells
i. Causes an indentation/invagination, which is the
dental lamina w/ 20 tooth buds
b.Ectomesenchymecondenses and becomes the dental
papilla
c. FirstEctoderm epithelium directs tooth development
i. Any type of neural crest cell that associates with
maxillary or mandibular epithelium will result in a
tooth, meaning you need the appropriate epithelium
to form a tooth.
Slide 1
Image 1
Slide 1
Image 2
Tongue
MS
DL
OC
OC
Adjacent to the oral cavity is a thickening of the epithelium, called the dental
lamina (DL), which is associated with a condensation of mesenchymal
cells (MC). This collection of early developing and condensing cells is the
tooth bud or tooth primordium.
Slide 2
Image 2
Slide 2
Image 1
EO
SR
TB
DP
Tooth Development - Bud Stage - High magnification
Slide 2
Image 3
EO
SR
OEE
IEE
DP
c. Bell StageMorphodifferentiation
i. Tooth assumes its final shape
ii. The dental lamina breaks up so the tooth is no longer
connected to the oral ectoderm, which may cause
cysts
Slide 3
Image 1
Tooth Development Bell Stage - Low
magnification
Slide 3
Image 2
OEE
SR
DS
HRS
Tooth Development - (Late) Bell Stage - Low magnification
DP
IEE
Under this magnification one can see the dental sac or follicle (DS)
surrounding the tooth and even enamel (E) at the crown. The roots are
developing from inward growth of Hertwig s epithelial root sheath (HRS).
Slide 3
Image 4
Slide 3
Image 5
E
D
D
PSA
DE
O
Tooth Development - Late Bell Stage - High magnification
The clear area at the crown represents decalcified enamel (DE) adjacent to
the very basophilic enamel (E) remaining behind. The ameloblasts (A) are
in the cell layer outside of the enamel. The innermost layer of cells are
odontoblasts (O) forming the lighter purple stained dentin (D).
OE
ODL
LDL
SL
OEE
e.Root Formation
i. Cervical loop gives rise to Hertwigs root sheath
ii. Inner epithelial cells of the root sheath induce
odontoblasts to form from the denal papilla, which
forms the dentin of the root
HRS
ENAMEL
1.Composition
a.Inorganic Material
i. Calcium phosphate hydroxyapatite (96%)
b.Organic Material
i. Water (3%)
ii. Tyrosine rich amelogenin
1.Hydrophobic, regulate crystal growth
iii. Nonamelogenins
1.Ameloblastin
a.Promotes mineral formation
2.Enamelin
a.Crystal nucleation and growth
3.Tuftelin
a.Function unclear
2.Structure
a.Enamel rodbasic unit of enamel, long crystals that run
parallel to long axis of rod
i. As they mature, they get larger, and lose water and
organic material. They get pushed together.
b.Interrod enamelareas where rods are not surrounded by
rod sheath and crystals run in various directions
i. Ions can be incorporatedF, Mg, Sr, Pb
c. Rod Sheatharea between rod and interrod (surrounds
rod)
i. Most organic material is here
3.AmelogenesisREQUIRES DENTIN (forms first)!
a.Reciprocal induction
i. Inner enamel epithelium induces dental papilla to
become odontoblasts (make dentin)
ii. Dentin induces inner enamel epithelium to become
ameloblasts
b.Phases/Stages of Amelogenesis
i. Morphogenetic stagecells commit to ameloblast
lineage
1.Cells of internal dental lamina have centrally
located
A
SI
A
nuclei
SI
O
iii.
Moving toward the apex, the columnar ameloblasts (A) can
be seen with their nuclei continuing to move toward the
stratum intermedium (SI). Deep to the ameloblasts,
odontoblasts (O) can be seen just beginning to differentiate.
Presecret
ory Phase
SA
D
T
SA
SE
A
E
A
E
4.Mineralization Stages
a.Stage 1formation of
partially mineralized enamel in secretory stage
b.Stage 2mineralization from surface to deeper layers
c. Stage 3mineralization from inner later to surface
d.Stage 4heavy mineralization of outer layer
5.Organization of Enamel
a.Rods run perpendicular to dentin
b.Stria of Retziusincremental growth lines that represent
weekly changes in enamel formation
i. Neonatal line is an enlarged stria, representing
change in nutrition from umbilical to breast milk
DEJ
c.
E
R
E
HunterSchrager
Bands
optical
pattern
resulting
from
changes in
rod direction
i. Alternating light and dark bands
d.Gnarled enamelthe cuspal region of the crown where
enamel rods twist and are irregular
GE
DEJ
Identify the dento - enamel junction (DEJ). The lines that represent the dentinal
tubules (arrow) can be seen. In the enamel find the regions where the enamel rods
appear to be running in many different directions. This is termed gnarled enamel
(GE) and is found in the cusps.
e.Enam
L
R
T
DEJ
DENTIN
1. Composition
a. Inorganic (70%)hydroxyapatite crystals
b. Organic (20%)Type I collagen and proteins form
scaffold for the mineral deposits
c. Water (10%)
2. Types
a. Predentinunmineralized, like osteoid (newly laid down)
b. Mantle Dentinthin dentin, just below the DEJ
c. Primarycircumpulpal and mantle dentin
i. Bulk of dentin is primary, and is well organized into
tubules
d. Secondarydeposited after root formation
e. Tertiaryreparative dentin, formed in reaction to stimulus
i. Has no organization
3. Organization
a. Dentin is organized into tubules, that are surrounded by
peritubular dentin
i. The odontoblast processes sit inside the tubules,
which is what leaves the space as they move down.
b. In between the tubule/peritubule complex is intertubular
dentin
c. Cannaliculi are
also present in
between tubules
4. Dentinogenesis
a. Odontoblasts (from neural crest/neuralectoderm)form
dentin
i. Inner enamel epithelium induces dental
papillary cells to differentiate into
odontoblasts
b. Dentinogenesis begins in the cuspal region (coronal
dentin)
c. Continues later in the root, induced by Hertwigs
root sheath.
i. Deciduous teethdentin at root finished forming 18
mo. after eruption
ii. Permanent teethdentin at root finished forming 2-3
years after eruption
iii. No dentinal tubules in cementum, unlike coronal
dentin, which have tubules that project into enamel
(spindles).
d. Presecretory odontoblastscells are larger, with more
organelles and polarized nucleus (away from inner
enamel epithelium)
e. Secretory odontoblaststall columnar cells
5.Definitions
a.Enamel spindleOdontoblastic process that becomes
embedded in enamel, and gets longer as the
odontoblasts lay down dentin and move towards the pulp
b. Von
Korffs fibersType I
collagen secreted by
odontoblasts in predentin
c. Tomes granular layerspecial arrangements of collagen
and proteins at the CEJ
d. Lines of von Ebnerincremental growth lines
e. Lines of Owenlarger, more pronounced incremental line
that indicates change in nutrition status after birth
odontoblasts/fibroblasts
d. Core zone
i. Blood supply
Arterioles enter the pulp from the apical and
accessory foramen
1. Main capillary bed is near the odontoblast layer
2. Shunts are present throughout the pulp
ii. Nerves
Sensory and
Sympathetic nerve
bundles also enter
through the apical and
accessory foramen and
regulate the
vasculature.
Myelinated and
Unmyelinated Nerves
(surrounded by Schwann)
o Myelinateddetect pressure and vibration
o Unmyelinateddetect pain
1. Major nerve plexus of Raschkow present in cell
free zone
2. Nerve growth factor is present in dentinal
tubules, meaning that stimulation of dentin may
cause pain sensation. All sensations within the
dentin/pulp complex cause pain.
iii. Lymphatics
Begin in coronal region and exit through the apical
foramen
1. Macrophagefrom monocytes
2. Lymphocytesmostly T cells
3. Dendritic cellsAntigen presenting cells that can
project processes into dentinal tubules
2. Collagen of the Pulp
a. Types I and III (TMJ=Type II)
i. Greatest concentration of collagen is in the most
apical portion of the pulp
3. Pain in the Dentin/Pulp Complex
a. All sensations cause pain (ex. Heat, air, cold, water, etc.)
due to presence of nerves in the dentinal tubules
b. Theories of Painnone are proven
i. Dentin is directly innervated
ii. Odontoblasts act as receptors for neurons
1. No synapses have ever been found
THE PERIODONTIUM
1. Parts
a. Gingivasupport teeth
b. Alveolar Processesbone that supports teeth
c. Periodontal ligamentfibers that connect
cementum/roots to bone
i. Inserts into cementum (Sharpeys fibers) between
cementocytes
ii. Made of Type XII collagen
d. Cementumcovers root of teeth
e. Composition
1. Matrix (50%)
a. Mostly collagen Type I, III, XII (also V, VI, XIV)
b. Proteins
2. Mineral (50%)
a. Hydroxyapatite
2. Types of Cementum
a. Primary
Image 1
IL
PC
TGL
Dentin
b. Secondary
low
i. Cellular intrinsic
Image3
fiber cementum
Cementum - low & high
magnifications
1. Has
On the right side of the
upper image is alveolar
cementocytes
bone (ALV) and on the
left side is the tooth.
in lacunae
Between them are the
embedded in
collagen fibers of the
periodontal ligament
mineralized
(PDL). The thin
basophilic area on the
cementum
surface of the tooth is
the cementum (C) with
2. Adaptive role
embedded Sharpey s
fibers.
to tooth wear,
movement,
high
repair
3. Found at the apical root
4. Formed after tooth is in occlusion
ALV
PDL
PDL
C
TGL
Image2
SC
Image6
Human adult tooth, decalcified.
The tooth is seen at the
alveolar crest (AC). The
alveolar bone facing the
vestibule or lingual aspect of
the mouth is compact bone
called cortical plates (CP);
the bone facing the root is
alveolar bone proper (aka
known as lamina dura or
cribiform plate) (LD) is also
compact bone. Between these
inner and outer plates is
spongy bone (SB).
Connecting the lamina dura
and the root of the tooth is the
periodontal ligament (PDL).
Gingiva
Root
AC
PDL
LD
CP
SB
Image5
F
CP
LD
SB
CP
2. Horizontal
fibers
3. Oblique fibers
4. Apical fibers
5. Interradicular
fibers
b. Has significant nerve
supply
i. Free nerve endings
pain
ii. Ruffini endings
pressure
c. Blood supply is
extensive
Image7
Image8
5
1
2
3
interradicular
crest
4
Two decalcified molar teeth of a rat.
Fiber groups of the PDL include:
1- Alveolar crest - cementum to alveolar crest
2 - Horizontal - top 1/3rd of cementum to alveolar bone
3 - Oblique fibers - bottom 2/3rds of cementum to alveolar bone
4 - Apical - apex to fundic crypt
5 - Interradicular - cementum to interradicular crest
7. Important Definitions
a. Sharpeys (extrinsic acellular) fibersCollagen fibers of
the PDL that become embedded in the ingoranic
cementum matrix
b. Cementoidnewly laid unmineralized cementum made
up of collagen fibers which intermingle with dentin
collagen
c. Cell rests of Malassezremnants of the epithelial sheath
(Hertwig) that are part of the PDL and maintain/regernate
it.
SALIVARY GLANDS
1. Salivary GlandsTubuloalveolar exocrine glands
a. Glands form from epithelium and differentiate to be
ducts or secretory cells
L
n
SD
SG
SD
A
PC
ID
Submandibular gland
MC
SD
This a predominantly serous gland which in places has mucous secretory endpieces
with serous demilunes (SD). The gland has both blue, pure serous acini and pale,
mucous endpieces (MC).
c.
Sublingualmixed,
mostly mucous due to mucin (pale staining cells)
Sublingual gland
Sublingual gland
This gland has serous and (SC) mucous
cells (MC) but it is primarily mucous.
Nuclei in mucous cells are often flat
and pressed to the cells base. In
some endpieces a few serous cells
form a serous demilune (SDL).
Intercalated ducts (ID) drain to
striated ducts (SD).
ID
SD
SDL
SC MC
STR
MC
ID
SD
i.
ORAL MUCOSA
1. Masticatory Mucosa/Oral Mucoperiosteum (hard palate, gums)
a. Epitheliumstratified squamous wet
skin
ts
Image 1
Oral
side
lp
bv
low
sg
med
sk
med
3. Epithelium Types
a. Keratinizedtough, resists abrasion
i. St. Basaledivides and has tonofilaments
ii. Prickle cell layertonofibrils, membrane coating
granules, desmosomes
iii. Granular layerkeratohyaline granules, tonofibrils,
membrane coating granules
iv. St. corneum is highly keratinized and cells have no
nucleus/organelles
v. Found in hard palate, gingiva
b. Para-keratinized
i. St. corneum is highly keratinized but some cells still
have nuclei
c. Non-keratinizedthick but flexible
i. St. Basaledivides and has tonofilaments
ii. Prickle cell layertonofilaments, membrane coating
granules, desmosomes
iii. Intermediate layertonofilaments, glycogen
iv. St. corneum cells have nuclei
v. Found in lips, cheek, soft palate, floor of the mouth,
underside of tongue
1. Floor of mouth is thinnest stratified squamous
epithelium and is often used as a site for
administering drugs directly into the
bloodstream as they dissolve easily
4. Turnover Rate
a. Cheek15-25 days
b. Gingiva40-50 days
c. Influenced by cytokines, which are produces by
epithelium cells, fibroblasts, and inflammatory cells
i. Inflammation can either stimulate (slight) or slow
(severe) mitosis
5. Nerve supply
a. Better anteriorly to detect temperature and taste (buds
on tongue)
Muscle
Image7
LP
TONGUE/TASTE
BUDS
SS
2. Anterior 2/3
a. Filliform
keratinized
Low
Med
highly
C
G
SM
G
SM
Tongue - med & low mag.
The mucosa covering the tongue consists of epithelium (E) & underlying connective tissue.
Dorsal & ventral mucosae cover a core of skeletal muscle (SM) running in 3 planes. Embedded in the skeletal
muscle may be glands (G). The ventral surface of the tongue (not shown) is a thin smooth stratified
squamous epithelium (wet).
The anterior 2/3rds of the dorsal surface is covered by many papillae. Most numerous are conical, keratinized
filiform (f) papillae; non-keratinized mushroom-shaped fungiform papillae (not shown) are scattered. At the
junction of the anterior & posterior regions, i.e., the sulcus terminalis, lie 8 -12 large circumvallate papillae
(C). These cushion-shaped connective tissue structures are covered by a non-keratinized stratified
squamous epithelium in which there are many taste buds.
b. Fungiformnonkeratinized,
mushroom-like and
occasionally have taste
buds
fp
tb
high
med
cv
cv
tb
low
tb
ve
high
4. Taste Buds
Tongue,
.
a. Function
i. Microvilli on taste
pores bind ligands
which turns on Gcoupled protein receptor pathways
ii. This activates channels allowing NaCl in, which
depolarizes the neuroepithelial cells and releases
neurotransmitters to the brain about taste (sweet,
sour, salty, umami, bitter).
PALATES
1. Hard Palatemasticatory mucosa
a. Stratified squamous epithelium w/ different composition
based on area. Gets more keratinized at the midline, and
keratinization decreases as you more laterally and
posteriorly.
i. Anterior Hard palatekeratinized
- low & high mags.
Each circumvallate papilla (cv) is large & surrounded by a moat-like invagination (m)
of epithelium, the walls of which contain many barrel shaped taste buds (tb). Ducts
of the serous glands of von Ebner (ve) empty secretions into the base of the moat.
Image9
Image8
Hard palate anterior
The masticatory mucosa (MM) in
the midline of the anterior part
of the hard palate has an
epithelium (E) which is (ortho)
keratinized. It is tightly bound
to the bony shelf of the palate
(BS) by a thin layer of dense ct
(CT) which, in the mid-line, has
no glands or fat.
The dorsal aspect of the palatine
shelf contains the glands of the
nasal cavity.
BS
K
CT
MM
squamous epithelium stain brightly pink (K) due to the keratin in them. Nuclei are
not present in these outermost cells.
ii. Anterolateralpara-keratinized
KE
Image11
Image10
SG
SG
M
LP
F
SM
Hard palate, anterolateral region
Somewhat lateral to the midline raphae the mucosa (M) has a more generous amount of ct in
the submucosa (SM) which includes fatty tissue (F). The junction between the
(ortho)keratinized epithelium (KE) and its underlying lamina propria (LP) shows deep
interdigitations.
KE
iii.
Posterolateralnon-keratinized
Image12
Hard palate, posterior region
Parakeratinized palatal epithelium covers
the hard palate. The four major strata
of the epithelium are seen: basale (B),
spinosum (S), granulosum (G), and
corneum (C).
C
G
b. Oral surfacewet
stratified squamous w/
mucous glands and
lymphatic nodules
ss
sg
sm
Nasal cavity
NE
SM
Image14
ln
SM
SG
SM
oral cavity
NK
Oral cavity
Soft palateAt low mag both the oral and nasal surfaces are seen. The oral mucosa is
surfaced by a non-keratinized stratified squamous epithelium (NK) while the nasal
epithelium (NE) is pseudostratified columnar. At the core of the soft palate is
skeletal muscle (SM). Between the muscle and the oral epithelium are many minor
salivary glands (SG).
Image15
skeletal muscle
SG
S
V
SG
E
LP
LOW
High
Soft palateAt low mag minor salivary glands (SG) can be distinguished from the
fatty ct (F) in the submucosa (S). The greater vascularity of the mucosa of the soft
palate (than the hard palate) is seen by the abundant vessels (V) in its lamina
propria. A layer of elastic fibers (E) separates the lamina propria (LP) from the
gland-containing submucosa.
GINGIVAmasticatory mucosa
1. Alveolar mucosanonkeratinized
a. Meets with attached gingiva at the mucogingival junction
2. Attached gingivapara-keratinized
3. Free gingivakeratinized
a. >3 mm sulcus means periodontal disease
b. Has junctional epithelium where the free gingiva attaches
to the enamel
i. Enamel is separated from epithelium by a basal
lamina
ii. Epithelium is separated from lamina propria by a
basal lamina
Image16
Image 17
FG
Enamel
Rat molar - The free and attached gingiva (FG, AG) are keratinized here. The
stratified squamous epithelium is (ortho)keratinized as noted by the intense
staining of the keratin (K) in the upper layers and the lack of nuclei in the
most superficial layers of the epithelium.
GS
GG
DG
AG
AG
RP
FG
PK
Gingiva - The free gingiva (FG) is seen between the gingival sulcus (GS) and the gingival
groove (GG). Below the gingival groove is the attached gingiva (AG) that is found over
the alveolar bone (not seen here). Note the long rete pegs (RP) found in the free and
attached gingiva. The junctional epithelium (JE) is attached to the enamel. Dentogingival
fibers (DG) connect the gingiva to the cementum (not seen).
Image 18
SS
Freegingiva - High
magnification
The interdigitations (rete ridges; RR)
of the gingival epithelium and the
connective tissue in the lamina
propria help withstand the abrasive
forces being applied. The
keratinocytes form the stratum
basale (SB) and stratum spinosum
(SS). In this image the
keratinocytes have formed
parakeratin (PK) on the surface.
JE
SS
SB
RR
RR
TOOTH ERUPTION
1. Stages of Tooth Eruption
a. Pre-eruptive stage
i. Tooth changes location during Bell Stage
b. Eruptive Stage
i. Upward movement of the tooth that begins with root
formation and ends when the tooth reaches the
occlusal plane
ii. There is an intraosseous and extraosseous phase as
the teeth move through the bone
c. Post-eruptive Stage
i. Normal growth of jaw up until age 20, with
readjustment between 14 and 18
1. Teeth move occlusally with root formation and
jaw growth
Monocyte