PREPEARED

BY DR. HUDA AL GALALI

Tooth development is a complex process
by which the teeth form from embryonic
cells, grow and erupt into the mouth.
It started at 6weeks of development,
and involves the development of primary
and permanent dentition.
 In the human
20 primary teeth and 32 permanent teeth
develop from the interaction of:
1. The oral epithelial cells and

2. The underlying
ectomesenchymal cells.
Each developing tooth grows as an
anatomically distinct unit, but the basic
developmental process is similar for all
teeth
The development of deciduous and
permanent teeth are similar, but at
different time.
First teeth to develop are lower centrals
then upper centrals, and then progress in
a posterior direction.
Timing
The entire primary dentition is initiated
between the 6th and 8th weeks of
embryonic development
The successional permanent teeth
between the 20th week in utero and the
10th month after birth.
Permanent molars between the 20th week
in utero and the fifth year of life.
Tooth develops by interaction of:
1-Ectomesenchymal tissue (neural crest
in origin), that will form the dentin, pulp,
cementum and alveolar bone
2-Oral Epithelium (Ectoderm); that is
epithelial product and form the enamel
Formation of Primary Dentition
1- Initiation Stage
The first sign is appearance of
condensation of ectomesenchymal tissue
and capillary network beneath the dental
epithelium.
Certain areas of basal cells of oral
ectodermal epithelium proliferate to
form the Primary Epithelial Band.
By the seventh week the primary
epithelial band divide to give rise two
processes;
- A buccally located Vestibular Lamina
and
- A lingually positioned Dental Lamina
Vestibular lamina
No vestibule or sulcus can be seen
between the cheek and the tooth bearing
areas at 6 weeks of development.
The vestibule forms as a result of the
proliferation of vestibular lamina into the
ectomesenchyme.
As the cells rapidly enlarge, they
degenerate in the center to form a cleft
that becomes the vestibule between the
cheek and the tooth-bearing area.
Dental lamina
-contributes to the development of the
teeth.
-Result from interaction between oral
epithelium and underlying
ectomesenchyme that go in many stages
-It appears as a thickening of the oral
epithelium adjacent to condensation of
ectomesenchyme
Dental lamina
 5

1. oral epithelium
1
2. dental lamina
3. tooth bud
4. ectomesenchymal
2
cells
5. vestibular lamina

3
4
Stages of tooth development
After initiation of tooth development, the
developmental stages based on the shape
of the epithelial part of the developing
tooth germ. These stages are called the
bud, cap and the bell stages.
During these stages of tooth
development, many phsiological processes
occur, which represented by:
Initiation and proliferation: stimulation
of certain cells to multiply(dental
lamina),(bud and cap stages).
Morphodifferentiation: establishment of
tooth pattern)bell stage)
Histodifferentiation: differentiation of
certain cells to perform special
functions( bell stage)
Apposition: dental tissues secreted as
matrix in successive layers
Maturation: dental tissues fully
mineralize to their mature levels
Eruption: emergence of the crown in the
oral cavity
 1- Bud Stage
characterized by rounded, localized growth of
epithelium surrounded by proliferating
ectomesenchymal cells, which are packed closely
beneath and around the epithelial buds
It is named due to extensive proliferation
of the dental lamina into buds swelling
penetrating into the mesenchymal cells

This penetration occurs at 10 sites at

maxillary arch and 10 sites at mandibular
arch.
Not all of these enamel organs start to
develop at the same time the anterior
mandibular buds are the first to
appear, and the maxillary buds follow a
few days.
A tooth germ consist of three parts:
1) An enamel organ, which is derived
from the oral ectoderm produce tooth
enamel
 2) A dental papilla, which is derived
from ectomesenchyme produce tooth
pulp, dentin.

Dental papilla
 3) A dental sac(dental follicle), which
is also derived from the
ectomesenchyme produces cementum,
periodontal ligament and the alveolar
bone.

Dental sac
Histological features:
-the enamel organ consists of
Peripherally located low columnar cells
and centrally rounded cells with small
intercellular spaces
-The supporting
ectomesenchymal
cells are closely packed
beneath and around the
epithelial bud
 2-Cap stage
The continuously high rate
of cell division leads to both
a farther growth of the bud
and to direct change in the
shape of the tooth germ.
The vestibular and lingual borders of the
bud begin to lengthen cranially in the
maxilla and caudally in the mandible so
that the basal surface of the bud that
is next to the cluster of
ectomesenchymal cells becomes deeply
concave
The enamel organ acquires a peripherally
proliferating rim that begins to enclose
a large part of the ectomesenchymal cell
cluster.
This rim becomes
what is later called
the cervical loop.
 Histological features
1-Enamel Organ has 3 cell layers:
a- Outer enamel epithelium(OEE):
Cuboidal cell line the convexity.
b-Stellate reticulum; situated
between the outer and inner
epithelium
secrete extracellular matrix rich with
Glycoseaminoglycan that is hydrophilic
and will attract water into the enamel
organ. The increased amount of
extracellular fluid will force the cells
apart.
The cells will retain connected through
their desmosomal contact, and become
star shaped cells.
.
c- inner enamel epithelium(IEE): low
columnar cell line the concave surface of
the enamel organ single layer
characterized by high glycogen content.
Both types of epithelium(outer and inner)
are separated from the dental sac and
dental papilla
respectively by
a delicate
basement
membrane.
Ultrastructurally the basement membrane
is formed of basal lamina and
hemidesmosomes anchoring the cells to
the basal lamina
2-Dental sac; is the marginal condensation
of the ectomesenchyme surround enamel
organ and dental papilla, these cells are
important for cementum, PDL, alveolar
bone.
3-The dental papilla; the
ectomesenchymal cells beneath the
inner enamel epithelium(increase
density)
Clusters of blood vesseles are found
ramifying around the tooth germ in the
dental follicle and entering the dental
papilla during the cap
 Transitory Structures
Enamel knot;is a signalling center formed of
a small group of closely packed, nondividing
cells located adjacent to the IEE.
Enamel knot act as a signaling center
regulating cusp outline of the developing
tooth by inducing cell proliferation
within the enamel organ and dental
papilla
Enamel cord; strand of cells running
from the knot toward stellate reticulum.
When the enamel cord completely divides
the stellate reticulum into two parts,
reaching the OEE it is
termed the enamel
septum.
 3-Bellstage(morphodifferentiation,
histodifferentiation & Apposition)
In this stage, the dental organ is bell
shaped.
In this stage, the cells between the inner
enamel epithelium and the stellate
reticulum form a layer known is stratum
intermedium. They are characterized by
the high activity of alkaline
phosphatase.
The rim of the dental organ where outer
and inner enamel epithelium join is
called the Cervical loop
A-Early Bell Stage
(Histodifferentiation)
In this stage the enamel organ resembles
a Bell, with increased epithelium depth
over the dental papilla.
Continuation of histodifferentiation
(ameloblasts and odontoblasts are
defined) and beginning of
morphodifferentiation (tooth crown
assumes its final shape)
Histological features
a) Enamel organ
A high degree of histodifferentiation is
achieved in this stage. It consists of
four distinct layers.
1- Outer (external) enamel epithelium
-low cuboidal cells
- Ultrastructurelly they are separated
from the surrounding, tissue by the
basal lamina and hemidesmosomes. The
adjacent cells are joined by junctional
complexes
2-Stellate Reticulum
- This tissue is most fully developed at the
bell stage.
-The cells are star-shaped with many
branching processes.
-They contain glycosaminoglycans
-The main function of this layer is the
protection of the under-lying dental tissue
against physical disturbance and to the
maintenance of tooth shape.
 Stellate
reticulim

Stratum
intermedium

IEE
3. the stratum intermedium
-is a new layer appears in the bell stage
- consist of two or three layers of
flattened cells lying over the IEE.
-The cells are characterized by high
activity of enzyme
alkaline phosphatase,
needed for enamel
mineralization
the stratum intermedium is concerned
with the synthesis of proteins, the
transport of materials to and from the
ameloblasts cells.
4- Inner enamel epithelium
The cells of this layer are columnar at the
bell stage but beginning elongated at the
regions associated with the future cusp
tips (i.e. the sites of initial enamel
formation)
They are separated from the peripheral
cells of the dental papilla by a basement
.membrane and a cell free zone
have a high glycogen content
both layers the stratum intermedium and
the inner enamel epithelium have been
considered as a single function unit
responsible for the formation of enamel
The cervical loop is an area of active cell
proliferation and lies in a region that will
become the cervix of the tooth.
Following the formation of the crown, the
cells in the cervical loop will give rise to
the epithelium root sheath and epithelial
diaphragm.
B-Dental Papilla
The dental papilla is separated from the
enamel organ by a basement membrane
and a cell-free zone.
The cells of dental papilla are
undifferentiated ectomesenchymal cells,
a few fine scattered collagen fibrils
occupy the extracellular spaces.
number of blood vessels.
C-The dental follicle
It is clearly distinguished from dental
papilla, in that more collagen fibrils
occupy the extracellular spaces between
the follicular fibroblasts.