Enamel

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Facts and Figures

Tooth enamel is the hardest and most highly mineralized substance of the body, and with dentin, cementum, and dental pulp is one of the four major parts of the tooth. Maximum thickness:2-2.5 mmover the cusps and thins down to almost knife edge at the neck of the tooth. It is the hardest calcified tissue in human body. Specific gravity 2.8

Physical properties
Permeability acts like a semipermeable membrane. Colour- yellowish white to greyish white Colour depends on transluscency Transluscency depends on calcification and homogeneity

Chemical properties
Enamel 96% inorganic mat. 4% organic mat. and water

Primary and secondary mineralisation Stone and sponge comparision Organic substances in enamelsulfhydryl groups, keratin, proteins (serine, glutamic acid, glycine), acid mucopolysaccharides

Structure of Enamel
Rods : 5-12 million per tooth Run from dentinoenamel junction towards surface of tooth Accompanied by apatite crystals Striations Gnarled enamel
Transverse section

Electromicrograph of enamel crystals. Coloured just for convenience

Longitudinal section of enamel rods

Hunter-Schreger bands
Due to change in direction of rods Minimizes risk of cleavage Alternating dark and light strips of varying widths Originate from dentino-enamel border and end some distace away from outer enamel surface Due to difference in permeability and organic content

Incremental lines of Retzius

Brownish bands in ground section Indicate successive layers of enamel formation Surround the tip of dentin in longitudinal section Appear as concentric circles in cross section They are formed due toperiodic bending of enamel rods, organic structure and physiologic calcification rhythm

Surface structures
Structureless enamel : 30um thin in 70% permanent teeth and all deciduous teeth Perikymata Rod ends Cracks (lamellae) Neonatal line/neonatal ring

Enamel cuticle
Primary enamel cuticle nasmyths membrane Pellicle- precipitate of salivary proteins

Enamel lamellae
Thin leaflike structures Because of crack development 3 types of lamellae can be differentiated 1. Type A 2. Type B 3. Type C Its a site of weakness in tooth that initiates caries

Enamel tufts

Dentino-enamel junction

Odontoblast processes and enamel spindles

Age changes & Clinical considerations

Attrition (wear) Diminishing rods and perikymata Facial and lingual surfaces wear more. And anterior teeth wear more. Colour change and decay, with less permeability Cavity preparation Unsupported enamel rods and lamellae Fluoride treatment- in dentrifices Fluoride level in communal water supply 1ppm

Development of enamel
Outer enamel epithelium Stellate reticulum Stratum intermedium Inner enamel epithelium

Life cycle of Ameloblasts -stages Morphogenic Organizing Formative Maturative Protective Desmolytic

Amelogenesis
Organic matrix formation mineralisation

Dentino enamel membrane Development of Tomes processes Relation between ameloblasts and enamel rods Ameloblasts covering maturing enamel (1)Immediate partial mineralisation- crystalline apatite (2)Maturation starts from the crown and progresses cervically

Clinical considerations
Defective enamel can be due to systemic, local or genetic effects Hypoplasia and hypocalcification Nutritional deficiency, endocrinopathy,febrile deseases, chemical toxication. 1.5 ppm fluoride content in water-endemic fluorosis If matrix formation defective-hypoplasia If maturation defective-hypocalcification. E.g. Mottled enamel