Structures of teethSuruedee Chinthakanan

Oral biology and Oral diagnostic sciences department

Outline • Position of teeth

• Blood supply

• Nerve supply

• Structures of teeth

• Periodontium

Position of teeth

www.salisburyhouseclinic.co.uk

Position of teeth

client.myoptumhealth.com skullanatomy.info

Position of teeth

en.wikipedia.org

Maxilla

Mandiblewww.nlm.nih.gov

Position of teeth

www.toothclub.gov.hk

• Incisors

• Canines

• Molars

Midsagittal plane

I:C:M = 2:1:2

Position of teeth

• Incisors

• Canines

• Premolars

• Molars

www.toothclub.gov.hk

I:C:P:M = 2:1:2:3

Human teeth

www.toothclub.gov.hk

www.oralanswers.comwww.identalhub.com

Succedaneous & Nonsuccedaneous tooth

Ten Cate R., 2013

Succedaneous tooth

“A permanent tooth that succeeds

an exfoliated deciduous tooth”

Drake R.L., 2010

External carotid artery

Blood supply

Blood supply : max. teeth

Drake R.L., 2010

Ant.sup.alveolar a.

Post.sup.alveolar a.

Maxillary artery

Blood supply

Drake R.L., 2010

Inferior alveolar artery

External carotid artery

Drake R.L., 2010

External jugular vein

Blood supplyMaxillary vein

Pterygoid plexus

Nerve supply

Drake R.L., 2010

Trigeminal nerve

Maxillary nerve

Ant. Sup. Alveolar n.

middle Sup. Alveolar n.

Post. Sup. Alveolar n.

Foramen rotundum

Nerve supply

Drake R.L., 2010

Mandibular nerve

Inferior Alveolar n.

Trigeminal nerve

Innervation

Drake R.L., 2010

Lymphatic drainage• Submandibular nodes

• Submental nodes

• Deep cervical nodes

Drake R.L., 2010

Oral cavity

Drake R.L., 2010

Oral cavity

• Teeth

• Bones

• Supporting tissues of the tooth

• Oral mucosa

• Salivary glands

Teeth

expertbeacon.com

Structures of teeth

• Enamel

• Dentin

• Dental Pulp

• Cementum

en.wikipedia.org

en.wikipedia.org

Enamel

• covering for the crown of the teeth

• most highly mineralized tissue in the body

• Ameloblasts : enamel formation

• nonvital and insensitive matrix

• cannot be replaced or regenerated

en.wikipedia.org

Enamel

• Inorganic material : 96%

• Hydroxyapatite crystals

• Organic material : 1%

• Soluble & non-soluble protein

• Water : 3%

Enamel 2.5mm

• Most thickness at cusp/ incisal edge• Less thickness at Cervical line

Enamel

Reduced thickness in aging Translucent

light yellow to gray-white

Structures of teeth

• Enamel

• Dentin

• Dental Pulp

• Cementum

en.wikipedia.org

en.wikipedia.org

Dentin

• the bulk of the tooth

• bonelike matrix characterized

• dentinal tubules

• Odontoblasts: dentin formation

en.wikipedia.org

Dentin

Dentinal

Tubule

Odontoblastic

process

http://tuberose.com/Graphics/DentinalTubules.jpg

Ten Cate R., 2013

Dentin• Inorganic material : 70%

• Hydroxyapatite crystals

• Organic material : 20%

• 90% : Collagen (mainly type I)

• Non-collagenous matrix protiens and lipids

• Water : 10%

Dentin

• Hardness

• Support enamel

• elasticity provides flexibility and prevents fracture of the overlying brittle enamel.

Enamel Dentin Bone

sites.google.com

Dentin

More yellow in Aging

Dentin

Discoloration of dentinin tooth with pulp disease

Dentin

• Primary dentin• Most of the tooth

• Circumpulpal dentin(outlines the pulp chamber )

• Secondary dentin• Less regular tubular structure than 10 dentin

• Tertiary dentin• Reactive or Reparative dentin

• Reaction to various stimuli

Ten Cate R., 2013

Junction : DEJ -- CDJ

dentin

cementum

CDJCementodentinjunction en.wikipedia.org

DEJDentinoenameljunction

Structures of teeth

• Enamel

• Dentin

• Dental Pulp

• Cementum

en.wikipedia.org

en.wikipedia.org

Dental pulp

• soft connective tissue : supports the dentin

• principal cells : Odontoblasts, Fibroblasts, etc.

• Collagen fiber

• Blood supply

• Nerve supply

en.wikipedia.org

www.juniordentist.com

Dental Pulp

• Generate Dentin surround Dental Pulp

• secondary and tertiary Dentin

• Circulation

• Tooth sensation

• Temperature

• Pain

en.wikipedia.org

Pulp cavity

• Pulp chamber

• Root canal

• Apical foramen

Pulp chamber

Root canal

Apical foramen

CEJ

what-when-how.com

Pulp cavity

http://what-when-how.com/dental-anatomy-physiology-and-occlusion

Pulp chamber

Root canal

Apical foramen

studydroid.com

Pulpal floor

Dental pulp

• Soft C.T. contained in pulp cavity

• Coronal pulp

• Radicular pulp

• Pulpal horn Coronal pulp

Radicular pulp

Pulpal horn

CEJ

what-when-how.com

Dental pulp

bdsinsights.blogspot.com

Coronal pulp

Radicular pulp

Pulpal horn

studydroid.com

Pulpal floor

Structures of teeth

• Enamel

• Dentin

• Dental Pulp

• Cementum

en.wikipedia.org

en.wikipedia.org

Cementum

• Cover overall root surface

• Light yellow color

• Most thickness at root tip

Ten Cate R., 2013

Cementum

• Similar to bone

• Inorganic material : 45-50%

• Hydroxyapatite crystals

• Organic material : 50%

• Collagen (mainly type I)

• Noncollagenous matrix protiens

Cementum

www.kck.usm.my

• Two types of cementum

• Cellular cementum

• Acellular cementum

• Hardness

Enamel Dentin cementum

CEJ

Cementoenameljunction

Ten Cate R., 2013

Tooth supporting structures

• Periodontal ligament

• Alveolar bone

• Gingiva

Ten Cate R., 2013

Mineral in hard tissues

Hard tissue Hydroxyapatite

Enamel > 90%

Dentin 67%

Cementum 45% to50%

Bone 50% to60%

Periodontal ligament

• PDL space 0.15-0.38 mm

• Collagen fiber

• Gel-like incompressible matrix

• receptor

Ten Cate R., 2013

Alveolar bone

• Surrounding bone

• Attachment of PDL

• Root like shape

• Resorption after extraction

Alveolar bone drramseyamin.typepad.com

www.lookfordiagnosis.com

Gingiva

• Soft tissue cover alveolar bone

• Unstable position

• Not fully-eruption

• Gingival enlargement

• Gingival recession / Bone resorption

Gingiva

http://www.oralhealthnet.co.uk/detail/3/gum-recession/

http://img.medscape.com/pi/emed/ckb/dermatology/1048885-1079711-1720.jpg

Anatomical aspect

Anatomical aspect

• Crown

• Anatomical crown

• Clinical crown

• Root

• Anatomical root

• Clinical root

www.dentistrytoday.com

CEJ

“Cementoenamel junction/cervical line”

Anatomical aspect

• Crown

• Anatomical crown

• Clinical crown

• Root

• Anatomical root

• Clinical root

www.hungariandentalcare.nl

Crown:Root

Anatomical Crown

Anatomical Root

Clinical Crown

Clinical Root

CEJ

Conclusion

Position of teeth

• Maxilla

• Mandible

en.wikipedia.org

Conclusion • Structures of teeth

• Enamel ; Dentin ; Dental pulp ; Cementum

• Tooth supporting structures

• PDL ; Alveolar bone ; Gingiva

• Blood and nerve supply

Mineral in hard tissuesHard tissue Hydroxyapatite

Enamel > 90%

Dentin 67%

Cementum 45% to50%

Bone 50% to60%

Enamel Dentin Bone cementum

References1.Anne M.R. Agur : Grant’s atlas of anatomy, 9thed. Williams&Wilkins, A waverly company, 1991.

2.Ash M. Major, Nelson J. Stanley : Wheeler’s Dental Anatomy, Physiology, and Occlusion, 8thed. Saunders, Saint Louis,Missouri,1993.

3.Ben Pansky : Review of Gross Anatomy, 6thed. McGraw-Hill, Health professions Division, 1996.

4.Klaus H., Edith M. Rateitschak, Herbert F. Wolf, Thomas M. Hassell : Color Atlas of Dental Medicine 1 Periodontology, 2nd ed. Thieme Medical Publishers, Inc., New york, 1989.

5.Richard Ten Cate, et. al : Oral histology, development, structure and function, 5thed. Saint Louis, C.V. Mosby, 8th ed, 2013.

6.Robert C. Zeisz, James Nuckolls : Dental Anatomy, The Form and Function. Henry Kimpton, 25 Bloomsbury Way, W.C.1, London, 1949.

7.Nelson SJ. Wheeler's dental anatomy, physiology, and occlusion. 10th ed. St. Louis: Elsevier; 2016:1-19. 2.

8. ชชัรี สชุาติล ้าพงศ,์บรรณาธิการ: ต าราทนัตกายวิภาคศาสตร์ประยกตุ,์ พิมพค์ร้ังท่ี 1 กรุงเทพมหานคร: บณัฑิตดีไซน;์ 2535

www.stephensdentistry.com

Any questions??

www.sodahead.com

thethingsilearnedfrom.com

Thank you

very much

s.chinthakanan@gmail.com