oral histology (تم الحفظ تلقائيًا)
TRANSCRIPT
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If you remember last time we talked about the
development of the oral region and we started talking
about branchial arches , we said these branchial arches
are structures that appear in the lower part of the face andalso the neck , starting from the end of week three and
they appear as arches , as we said they appear as arches
so this is the head of the embryo and this is the lower jaw ,
we can see the first branchial arches , the second
branchial arch and third branchial arch and so on
These are six arches , each arch is separate from the arch
below it by a groove.
For example these groove is called the branchial cleft ,
from inside if you look at theses groove from inside the
embryo also you will see grooves but these grooves are
called branchial pouches , so the groove is called pouch if
it is from inside , it is called cleft if it's from outside , the
arch itself is called branchial arch and we have six arches
, it is not necessary to see all the arches at the same time
but what you do actually you see , for example arch
number one and two and three maybe but when you start
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see arch number four arch number one is disappear
because arch number one will have added to the
development of the lower part of the face
arches
arch number 4
arch number one
arch
Last time we said that each arch has skeletal elements ,
nervous elements , muscular elements and vascular
elements and we said skeletal elements of face arch aremeckels cartilage and so on , the nervous elements are
trigeminal nerve for first , facial nerve for second ,
glossopharngeal for third and from four to six we have the
vagus nerve and also if you remember , each muscle that
is supplied by one of these nerves should also originate
within the arch , for example if we have the muscle supply
by trigeminal nerve like master muscle or temporalismuscle this means that these muscle develops within the
first branchial arch because this is the nerve for the first
branchial arch .
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And we give an example about one of the muscle that
develops in two arches which is the digastric muscle , the
digastrics muscle located in the floor of the mouth , it has
two bellies , the first belly is supplied by trigeminal , by thisreason it develops in the first arch , the posterior belly is
supplied by facial nerve , for this reason this belly is
developed in the second branchial arch , and also we
discussed the details of the muscular elements and the
vascular elements and now we will come to the
pharyngeal pouches .
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this is how the arches look like from inside , we make a cut
and we are looking at the arches from insidenot from outside . for this reason these grooves here by
this one and this one and this one are not called branchialcleft because these are located inside and called branchial
pouches so branchial pouches important for the
development of the tongue so the tongue is develop from
the branchial pouches .
The first part of the tongue starts to appear at age of
thirty two days and it develops from different swelling
, notice first that here we have the natural swellings
and also we have what we called tuberculum impar
in the middle , these three swelling they are related
to which arch ?? arch number one , so this makes
the anterior part of the tongue , so these swelling ,
the two lateral swelling plus tuberculum impar which
is the medial swelling they later on fused together ,
they swell and fuse together making the anterior two
third of the tongue , now the swelling from the third
arch , also we have a big swelling It's called
Copula/Hypobranchial eminence this develops from
arch # 3 as you see but it over grows the second
arch it over laps the second arch
arch 3
arch 2
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And what does this lead to ?this lead to the development
of the posterior part of the tongue or the posterior third of
the tongue
See here this is the tongue after development , we can
see the first part of the tongue or the anterior two third of
the tongue which is the body of the tongue , this develops
from the first branchial arch and regarding the posterior
part of the tongue it develops from third branchial arch .
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The root of the tongue which is the very much posterior
part of the tongue which is just next to the epiglottis this
develop from arch number 4 , so we have also swelling
from the fourth arch which is particularly . these twoswelling or this part as we see these are the extreme
posterior of the tongue ( root of the tongue )
So on the exam if I said tongue develops from ?? we have
to say arch one , arch three and arch four , these three
gives the body of the tongue . arch one give the anterior
two third of the tongue and arch 3 give the posterior third
of the tongue and arch 4 give the root of the tongue .
Do we have any contribution from the second arch ?yes
the second arch only contribute to the taste buds so the
taste buds of on the tongue they are derived from the
second arch.
For this reason because the anterior part of the tonguefrom arch # 1 , the sensation or the sensory innervation is
from trigeminal nerve and the posterior third of the tongue
is innervated by glossopharngeal nerve which is the nerve
of third arch , and the root of the tongue is from the vagus
nerve , and the taste buds of the tongue are from the
facial nerve because it develops from arch # 2 .
Now what happens later on ?after fusion we still see some
v-shape sulcus so when the anterior two third of the
tongue fuse with the posterior third of the tongue , fusion
leads to sulcus
Fusion 011 %
v-shape sulcus this is called sulcus terminalis , its the
junction between the anterior part and posterior part of the
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tongue or if you like its the junction between the part of
the tongue that develops from the first branchial arch and
the part developing from the third branchial arch.
what is located anterior the sulcus terminalis should be
supplied by trigeminal nerve which is the cranial nerve of
the first arch , and what is located posterior to it is
supplied by glossopharngeal nerve .
the very median part of the median end of sulcus
terminalis we have what we call foramen cecum which is
small depression , this foramen cecum is importantbecause this is the origin for the development of thyroid
gland .
this actually happen by a duct that drops down from this
foramen cecum its called thyroglossal duct , why do we
call it thyroglossal ?? because it's now within the tongue
so glossal , thyro from thyroid so thyroglossal, this drops
down from foramen cecum and descend until it reach the
neck region where it swell and develop the thyroid gland.
this means thyroid gland develops from the area between
the anterior two third and posterior third of the tongue , forthis reason we may see thyroid tissue within the tongue ,
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why ?? because this tissue is eminence Of the thyroid
gland , we call it ectopic thyroid tissue , also this ectopic
thyroid tissue is functional.
we have group of papillae that are usually located
anteriarly To sulcus terminalis , so these are located within
the anterior two third of the tongue , but the origin of these
papillae is from the posterior third , for this reason these
taste buds that are present on the circumvallate papillae
these are supplied by glossopharngeal nerve although
they are located anterior to sulcus terminalis ,, why ??
because during the development of the tongue these
papillae migrate from the posterior third to the anterior two
third so they cross sulcus terminalis.
we have taste buds on vallate papillae , these taste buds
are response for the sour taste . innervation for this
papillae is glossopharngeal nerve
sulcus papillae terminalis anterior two third of the tongue
supplied by trigeminal supplied by
glossopharngeal
posterior third sulcus terminalis sulcus terminalis
For this reason they take the embryological innervationwith them . the tongue sensory the first nerve which is
trigeminal nerve provides sensory innervations for the
anterior two third of the tongue , sure except the region of
the circumvallate papillae , the taste in the anterior two
third of the tongue is from the facial nerve , the taste at the
posterior part of the tongue is from glossopharngeal nerve
this is also include the taste buds located at the vallatepapillae , the extreme posterior of the tongue is from
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vagus nerve which is the cranial nerve # 10 that is
responsible for the innervations of the 4th , 5th , 6th arches ,
so thats why the 4th arch nerve through the branch called
superior laryngeal nerve , its supply both sensory andtaste to the root of the tongue , if we have taste buds at
the extreme posterior part of the tongue this is supplied by
vagus nerve , the posterior third sensory and taste from
third branchial arch which is glossopharngeal nerve and
regarding the motor supply , the muscles of the tongue
they get very special innervations from another nerve , this
nerve is called hypoglossal nerve which is cranial nerve #12 hyogloosal nerve , the innervations of the muscles of
the tongue the intrinsic and extrinsic muscle.
Remember the myotoms , they are from the metotic
somites , remember last lecture we said we have the head
somites , we have the prootic somites will form the
muscles of the eye and the myotom of metotic somites will
form the muscles of the tongue , so thats why metotic
somites carry with them the hypoglossal nerve supplied
muscle .
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The development of the face :
The face grows by number of process .we have the
maxillary process , mandibular process and frontonasal
process , together these proceses they make the face .
Maxillary and mandibular process are paired process ,
one process on the right and the another on the left .
Let us see this big process , FNP this is the frontonasal
process , this process here and here are the maxillary
process , and this long process here is the mandibular
process .
Face develop around stomodeum ,stomodeum is the
primitive mouth .
Can you see here this depression above the mandibular
process ?this cavity is called stomodeum or the primitive
mouth of the embryo .
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The primitive mouth of the embryo is separated from the
beginning of gastrointestinal tract by the buccopharngeal
membrane which came from prochordal plate , and we
said before the age of 21 day this membrane is active sothis means that the stomodeum is separated from the
gastrointestinal tract . But at the age of 21 days this
buccopharngeal or oropharungeal membrane is rupture
Q: the mouth is communicated with GIT tract at the age of
1 _ 10 days ( F )
2_ one month ( T )
Each branchial arch is covered outside by ectoderm and
inside by endoderm . for example arch 2 the outside
covering is ectoderm and the covering inside is endoderm.
the tongue in the first brachial arch from inside and
outside is covered with ectoderm. *** question in the exam
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**The frontonasal process is not from the brachial arch
only the maxillary and mandible processes from firstbrachial arch.
The frontonasal process " the area in pink " develops pits
and it's called nasal pits later it will become nostrils and at
the sides of these pits we find some swellings 2 one
medial called the medial nasal prominence and the lateral
nasal prominence . notice how big the distance isbetween the pits at the beginning after that they start to
migrate towards each other , around each nasal pit there
is swelling , lateral nasal swelling and medial nasal
swelling , the 2 medial nasal process of the 2 nostrils fuse
together forming the intermaxillary segment which form
the tip of the nose , the collamela of the nose (area
between the nostrils )and the median part of the upper lip.and we call it like that because it descends down and take
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place between the 2 maxillary processes , the lateral nasal
process remain within the frontonasal process this gives
the mid portion of the nose and the philtrum of upper lip
inside it there is the area of bone that carries the maxillarypalate ( contain the maxillary incisors central and lateral
incisors ) .
**The upper margin of the upper lip is like M but the lower
lip is one piece and why is that ? because the median part
of the upper lip from the frontonassal process
Regarding to the lateral nasal swelling it becomes the alaeof the nose ( lateral to the nostril ) , the maxillary
processes become the maxilla and the mandibular
processes fuse together forming the mandible .
Nasolacrimal duct :
Its a canal that take the tears down to the nose and its
form in the groove between the maxillary process and thelateral nasal swelling.
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Between the maxillary process and lateral nasal swelling
we have a groove this groove will deepen and create a
canal called lacrimal canal or nasolacrimal duct ( joints the
lacrimal bone with the nose ) when u start crying when ustart releasing tears the first thing to feel is running nose
now the extra tears that the duct can't coop with will go out
and wet your skin . so what happens if something went
wrong the maxillary process fails to fuse with the philtrum
of the upper lip we will have a condition called cleft lip .
We have to define two types of two part of the palate ,
primary palate and secondary palate , the anterior region
of the palate that carries the central and lateral incisors is
called the primary palate and the remain part is called the
secondary palate , primary and secondary palate are
formed separately and finally they fuse together forming
the whole palate .
Secondary palate has two parts one on the left side andone on the other side , these are called the palatine
processes , at first these processes are vertical , why are
they vertically oriented not horizontal ? because we have
a structure that occupies the space between them , this
space is occupied by the tongue , with time , with the
facial growth , the tongue becomes lower and drops in the
space between the two palatine processes , which allowsthe processes to go horizontally and fuse with the primary
palate , so now we have primary palate anteriarly and two
palatine processes posteriorly , the three part fuse
together and form the whole palate , thats why they start
to adjust themselves ( they start to go horizontal instead of
vertical )
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In anatomy the palate is formed by two bones the maxilla
and the palatine bones , here we talk about separate
processes and not separate bones , that help in forming
the palate , so , the tongue is in between , horizontalreorientation and then they start to reorient themselves ,
the tongue goes down , first they fuse with the nasal
septum , because in the nasal cavity we have the nasal
septum so all of these fuse together.
The palate is completed by 60 days , the point of fusion is
the point where the two sides meet with primary palate ,
and then fusion goes in three directions .
If we have a problem in fusion , this problem actually will
be seen as failure of fusion , some people ( one case in
every 700 birth ) are born with the cleft palate . why this
happen ? It is because we have many reasons of fusion
failure . most of the cases are because of genetic
problems , so when the two palatine processes failed todevelop , they form what we call cleft palate , what
happens when the primary palate fails to fuse with one or
both of the secondary palates ? it gives cleft lip , the
primary palate which also called the premaxilla is formed
by the palatine processes of the maxilla so when the
intermaxillary projections are failed to fuse to each other
the resultant will be cleft lip and failure of the primary andsecondary palate to each other .
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Sometimes when the patient is unlucky we will have a
bilateral cleft . For example when the two palatine bones
fail to fuse to each other and also fail to fuse with the
primary palate ( premaxilla ) .These patients of cleft lip andpalate require multiple surgical procedures which needed
to be completed before the age of 12 , so the
management is going to be at early age .
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Development of the maxilla :
Just to remember we have two type of bone formation :
0-Endochondral in which the preexisting cartilagetransform into bone
2-Interamembranous no preexisting cartilageThe maxilla is formed by intramembranous
ossification in which membranous mesenchymal
tissue become bone.
We have two ossification center in the maxillary
development which are :
0-Maxilla proper2-Premaxilla ( primary palate )
Ossification at the maxilla proper begin 40 days
after fertilization and become hollowed out later to
form the maxillary sinus.
The ossification of the maxillary proper begin
below the infraorbital foramen from here the
process of the maxilla arise which are :
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0-Frontal process which fuse with themaxillary process of the frontal bone
2-Palatine process
3-Alveolar process which carry the teeth 4-Zygomatic processThe most important thing mentioned above is
the medial and lateral alveolar plate which forms
the alveolar process which carries the teeth
Development of the mandible
We will divide its development into two parts the
body and the ramus
The body is formed by intramembranous
ossification , despite the fact we have cartilage
in the region of the body of the mandible which
called meckels cartilage but this cartilage have
nothing to do with development itself it only
guide the development so it act as scaffold
The ramus of the mandible is formed by
endochondoralossification , we have two site of
cartilage : condylar cartilage : it appears at the
11 week after fertilization and continues to
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provide growth for the mandible until 21 years
and it provide growth for the mandible in height
Coronoid cartilage : it only active prenatally because just
before birth it gets replaced by bone
The other thing that we need to understand is that when
we have muscle attachment there will be growth of bone
The angle of the mandible had two muscles of mastication
attached to which contribute to its growth :
0-Medial pterygoid2-MasseterThe coronoid process has muscle attached to it
which also contribute to its growth and called
temporalis muscle
Also in the mandible we have alveolar process which
carry the teeth .
Lecture 2 :Development of the tooth and its supporting
structures
The stomodeum (primitive mouth ) the primitive
mouth is lined by ectoderm and beneath the
ectoderm we have the mesoderm (and we said that
mesoderm in this region the head region is notactually the real mesoderm it is ectomesenchymal
tissue which means that it rises from neural crest
cells ) the site where one tooth is going to develop
we have condensation of ectomesenchymal tissue
just under the ectoderm
We start to see the condensation of the
ectomesenchymal tissue and capillary networkbeneath oral epithelium at specific sites . Why at
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specific sites ? Because we have more than one
tooth and each tooth should be developed at specific
site so at the site where the tooth should be
developed we have condensation of theectomesenchyme
Also we have capillary network at specific site then it
leads to the formation of primary Epithelium band
(PEB) when the oral epithelium thickens and
invagenates into condensed ectomesenchyme . After
that the PEB divides into two parts : one part goes
buccully and also called vestibular lamina and theother part goes lingually and also called dental
lamina
The dental lamina is the structure that will develop
the tooth and the vestibular lamina will become the
sulcus (space ) it goes buccully and labially to form
the oral vestibule ( vestibular lamina with time the
cells inside it become lost and well get a space thisis the space between the teeth and the cheeks _
posteriorly _ or the teeth and the lips _ anteriarly _ )
and the remaining part which goes lingually is called
the dental lamina
So the vestibular lamina goes buccully to form the
oral vestibule ( the space between the teeth and the
cheeks or the teeth and the lips)The dental lamina goes lingually to form the teeth .Thats why its called arch shaped because we r
talking about all teeth together _arch shaped banded
tissue going lingually and it is surrounded by a
condensation . At the end of each one it will form a
teeth but not at the same time .A series of swelling
happens at the deep surface , the terminal end of thedental lamina .These swelling at the terminal end is
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called Enamel organ which is the swelling that
happens in the first part of the tooth bud
.
This is a mandible this is the lower lip this is the area
that is covered by oral epithelial as u see this is the
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primary epithelial band (PEB) starts here and divided
to vestibular lamina and lingual lamina.
Lingual is a band as u see at the edge of this
mandible we have swelling each swelling isresponsible of one of the teeth.
Q: do u think that the band appear as one?? no each
one will form a tooth but not at the same time as we
said in dental anatomy for example mandible central
incisor erupt before the maxillary central incisor
We cant see all the tooth forming together
crown formation
*The dental lamina is responsible for formation ofprimary tooth but also each primary tooth in addition
to the dental lamina which forms primary tooth there
is another swelling responsible for forming the
successor of that tooth ( successor tooth that come
to replace the primary tooth )Q: what is the tooth successes the mandibular
deciduous central incisor ?
Permanent mandible central incisor
That means if we lost the formed structure no
permanent tooth will be developed if the deciduous
tooth is missing also the permanent tooth ( the
successor ) will be missing why ?? because both thedeciduous pre successor and the permanent
successor they develop originally from the same
germ layer
But the opposite is not true if the primary is there but
without swelling the permanent successor will not
***if the primary is missed no permanent will develop
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What about non successor permanent teeth like
permanent first, second and third molar???
They will develop from this extension of the generallamina
And here is the PEB (primary epithelium band )
divide the vestibular lamina from dental lamina where
we find swellings that will form the teeth
Tooth germ : is the early part of the tooth that formed
it includes the enamel organ and the surroundingectomesenchymle tissue and we divide it into 3
different stages:0_bud stage
2-cap stage3bell stage
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Here is the first stage of development we call it bud
stage it looks like a bud we see the oral epithelium
invaginating against condensed ectomasnchyme
later on this epethilium invaginating will start to forma concavity so it looks like a cap so we call it a cap
stage then this cavity will become a big cavity and
that will gives the bell shape then at the end of bell
stage we start to see the formation of dentine in
Dentinogenesis and the after a short while we start
to see the formation of enamel which is
Amelogenesis and finally the crown appear andcrown completion after this the root start to develop
and that will lead to the eruption of the tooth :D
Bud stage
It involves the formation of enamel organ which will
form the outer surface of the crown which is the
enamel
Enamel organ : early structure of tooth that comefrom ectoderm.
So the enamel organ is the one which determine the
three dimensional shape of the crown
REMEMBER that teeth can't develop at the same
time .It s impossible to see the entire tooth
developing at the same time
In the bud stage the enamel organ look spherical orovoid
In the bud stage we cant differentiate the shape of
the tooth it is poorly morpho differentiated so the
three dimensional shape of the crown is not
recognized and poorly histo differentiated so we cant
recognize different type of cell .
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Successive development of tooth germ involve
complex interaction between epithelial and
mesenchymal component
In order to the development of the tooth there mustbe kind of interaction between the epithelium and
ectomasynchyme or between ectoderm and
ectomesnchyme so if we make tissue culture for the
enamel organ there will be no tooth development
because there no mesenchymal tissue which is
needed for process to continue and the opposite is
true and it is similar to the development of nails
The basement membrane which separate between
the epithelium and the underlying mesenchymal
tissue play an important role in order to facilitate this
interaction
Remember the epithelium is the enamel organ and
the epithelium is ectodermal origin .
This is a tooth in the bud stage and here is the oral
epithelium and underlying it we have the condensed
ectomesenchymal tissue
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Cap stage
We divide it into early cap stage and late cap stageEarly cap stageThe down surface of enamel organ
invaginate to form a cap shaped structureCell is still poorly differentiated : not similar to each
other but still we able to differentiate between two
populations of cell which are :
1_ Inner ( central )_ related to the concavity _cellwhich have no specific function and it rounded in
appearance
peripheral cell which further divided into_2 (Internal enamel epithelium (IEE(External enamel epithelium ( EEE
Late cap stage
Here we have the development of cells called stellate
reticulum which in the early cap stage were roundcell with no specific function but here in this stage the
cell start to develop intercellular spaces.
the IEE cell become columnar in shape
the EEE become cuboidal
the ectomesenchymal tissue which surround the
enamel organ is recognized here in 2 different region
1-Dental papilla which is the future pulp and dentine(related to the cells in the central of the concavity)
2-Dental follicle is very important in the formation of
the supporting structure of the tooth like cementum ,
alveolar bone and periodontal ligament
So the whole structure is called enamel organ it has
a concavity that looks like a cap so it is called capstage of enamel organ at this stage we can identify
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Then we have the bell stage which is divided into
early and late
What happens in early bell stage ?? The concavity
deepens starts to become deep until the tooth lookslike a bell thats why it called the bell stage
So what happens during the early bell stage???*Deferential cell division a long IEE ( not at the
same way at different locations ) different rates of
cell division at different sites that what gives different
shapes of the tooth.
What will happen if the rate of cell division rate is thesame in all sites?
***important***
Mapping out the occlusal pattern of the crown*(Cessation of cell division ( stopping*
For example if I have a cell division at a cusp or anincisal edge after awhile I dont want cell division to
continue here because the tip of the tooth will swell
*Active cell division At fissure sites and margin
*Dental lamina breaks down
*losing connection with oral epithelium
*Dental lamina between tooth germs is lost
-Remnants of dental lamina may remain as epithelialrests of series that may be involved in the aetiologyof cysts
*We can identify here in early bell stage
Histodifferentiation :
We can identify different groups of cells each with
different function
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EEE*
Cuboidal cells and they maintain the shape of the
enamel organ and exchange substances betweenenamel and dental follicle
**enamel organ is avascular in order to maintain the
shape of the enamel
Cervical loop*Increased cell division*
At junction EEE and IEE*Stellate reticulum :are found in the center of enamel
organ
stellate because it is a star shape with many branchy
processes and reticulum because it is a net work
they have dendrites processes function in interacting
nutrientsSR are those white cells
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function : *it protects the underlying tissue against
physical disturbance and that maintain the tooth
shape
its hydrostatic pressure is in equilibrium with that ofthe dental papilla allowing the proliferation of IEE to
determine crown morphogenesis
What happens if the hydrostatic pressure inside here
in dental papilla area increase over the hydro static
pressure of SR??The tooth will look like spherical ( it will swell )
IEE : most important cells they are columnar
cells that become elongated starting from the cusp
tips and incisal edges
Dental papilla : less differentiated than enamelorgan
And now what happens In the late stage (
appositional stage)Hard tissue formation ** dentine formation precedesenamel formation**
The first part of the tooth that start to calcify is
the tip of the tooth ( incisal edge or cusp tip)
the last part of the crown that calcify is the most
cervical partAppearance of a lingual down growth of EEE*
In a deciduous tooth germs-Successor lamina
-gives rise to tooth germs of permanent successorteeth
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*In permanent tooth germs :it is a transient
structure that disappears eventually
Behind the second deciduous molars we should
have first , second and third molars which are nonsuccessors dental lamina grows backwards to bud
off permanent molars successively .
:Reciprocal interactionvery important
Dentine and Enamel formation commences at-Cusp tips
-preameloblasts (mature IEE cells ) induce adjacentmesenchymal cells to become columnar and
differentiate into odontobasts and secret predentine
and dentine, then dentine induces ameloblasts to
secrete enamel.
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Done by :Ala'a Al_ Selawi Mais Maloul Al _Selawi
o"It takes a little courage, and a little self-control, Ifyou want to reach the goal. It takes a great deal ofstriving, and a firm and stern-set chin. No matterwhat the battle, if you really want to win, there's noeasy path to glory. There is no road to fame. Life,however we may view it, Is no simple game; But itsprizes call for fighting For a rugged disposition thatwill not quit."
GD LUCK TO U ALL