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Menatalla M. Elhindawy
Enamel
Amelogenesis
Enamel
 Life cycle of ameloblast
I. Morphogenic.
II. Differentiation.
III. Secretory.
IV. Transitional.
V. Maturative.
VI. Protective.
VII. Desmolytic
 Amelogenesis
I. Formation of enamel
matrix.
II. Mineralization and
maturation.
 Defects of amelogenesis.
 Age changes of enamel.
Stages of Tooth Development
Life cycle of Ameloblast
I. Morphogenic.
II. Differentiation.
III. Secretory.
IV. Transitional.
V. Maturative.
VI. Protective.
VII.Desmolytic
Life cycle of Ameloblast
I. Morphogenic Stage.
 Early bell stage.
 IEE ; still can undergo mitosis at the cervical region.
 Low cuboidal cells.
 Resting on basement membrane; separating it from cell
free zoon of dental papilla.
 EM
 Large n. filling the cytoplasm.
 Golgi apparatus; less developed and centrioles
are located in the proximal end of the cell
(adjacent to the stratum intermedium).
 mitochondria are evenly scattered throughout
the cytoplasm.
 Cell attachment.. Proximal junctional complex.
Life cycle of Ameloblast
II. Differentiation “organization” Stage.
 Late bell stage.
 Ameloblast cell; can’t undergo mitosis.
Elongated up to 40 microns.
Resting on basement membrane; separating it from newly
formed odontoblasts.
 EM
 Shift of the n. to the proximal end.
 Golgi apparatus; developed and condensed and
centrioles are moved to the distal end.
 mitochondria clustered infra nucleus.
 rER increased in number.
Life cycle of Ameloblast
III. Secretory “Formative” Stage.
 At late bell and developing tooth stage.
 Ameloblast cell.
EM
 Golgi apparatus; developed and condensed
occupying a major part of the central core.
 mitochondria clustered in the proximal
region.
 rER increased in number.
Cell attachment.. Proximal and distal junctional
complexes.
The synthesis of enamel protein occurs in rER where
passed to Golgi complex to be condensed and packed
into membrane bound secretory granules. These granules
migrate to distal end of cells to exteriorize their content
against newly formed mantle dentine.
The hydroxyapatite crystals are randomly packed in this
first layer of enamel at the ADJ (inner structure-less
Enamel).
Some authors consider that the dentine crystals form the
nucleation sites for enamel crystals.
Life cycle of Ameloblast
III. Secretory “Formative” Stage.
Life cycle of Ameloblast
III. Secretory “Formative” Stage.
 As the first layer of enamel is formed, the ameloblast
migrate away from dentine surface which permits the
formation of Tomes’ process.
 The distinction between process and cell body is
clearly marked by distal junctional complex.
 This Tomes’ process contains primarily secretory
granules and small vesicles while cell body contains
abundant synthetic organelles.
 Secretion of enamel is confined to two sites:-
I. Adjacent to proximal part of the process close
to junctional complex; resulting in formation
of inter rod, this wall encloses a pit in which
Tomes’ process fits.
II. one surface of Tomes’ process (later on fill
these pits with matrix).
 So, the crystal orientation and direction in the wall of
pit differ from that in the pits giving the inter rod
enamel and the filling area become the enamel rods.
Life cycle of Ameloblast
III. Secretory “Formative” Stage.
Life cycle of Ameloblast
III. Secretory “Formative” Stage.
Inter rod is one step a head
before the rod.
 Withdrawal of Tomes’ processes.
 Reduction in the height of the ameloblasts and decrease in its
volume and organelle content.
During this period most probably the outer structure less enamel is
formed.
Life cycle of Ameloblast
IV. Transitional Stage.
 Enamel maturation (full mineralization) occurs
after most of the thickness of the enamel matrix
has been formed in the occlusal or incisal area.
 While at the cervical parts of the crown, enamel
matrix formation is still progressing at this time.
Life cycle of Ameloblast
V. Maturative Stage.
Ameloblasts are
 slightly reduced in length
 closely attached to enamel matrix.
 cytoplasmic vacuoles containing material
resembling enamel matrix.
 display microvilli at their distal extremities
forming a striated border “increasing
surface area”
 These structures indicate an absorptive function of
these cells.
Life cycle of Ameloblast
V. Maturative Stage.
Ameloblasts develop cycles of modulation of alternating ruffled
and smooth bordered end which is expressed like a wave.
Life cycle of Ameloblast
V. Maturative Stage.
 Associated with introduction of
inorganic materials.
 Distal tight and leaky proximal
junctions.
 Associated with removal of
protein and water.
 Distal leaky junction and
proximal tight junctions.
After complete formation and mineralization of
enamel; the ameloblasts secrete a material
between distal ends of cells and the enamel
surface identical to basal lamina
(Hemidesmosomes).
It providing a firm attachment for ameloblasts
and enamel surface which establish the
dentinogingival junction.
Life cycle of Ameloblast
VI. Protective Stage.
Ameloblasts can’t be differentiated from the
cells of the SI, SR and OEE forming a
stratified epithelial covering of the enamel,
the so called REE.
 REE protects the mature enamel by
separating it from the connective tissue until
the tooth erupts.
Life cycle of Ameloblast
VI. Protective Stage.
 If the connective tissue comes in contact with
the enamel, enamel may be either resorbed or
covered by a layer of cementum.
Life cycle of Ameloblast
VI. Protective Stage.
The REE proliferates and seems to induce atrophy of
the connective tissue separating it from the oral
epithelium as pathway for tooth eruption.
It is probable that it elaborate enzymes that are able
to destroy connective tissue fibers by desmolysis.
 Premature degeneration of the reduced enamel
epithelium may prevent the eruption of a tooth.
Life cycle of Ameloblast
VII. Desmolitic Stage.
Life cycle of Ameloblast
1. Morphogenic.
2. Organizing
3, 4. secretory.
5, 6. Maturative.
7. Protective & Desmolytic.
Enamel
 Life cycle of ameloblast
I. Morphogenic.
II. Differentiation.
III. Secretory.
IV. Transitional.
V. Maturative.
VI. Protective.
VII. Desmolytic
 Amelogenesis
I. Formation of enamel
matrix.
II. Mineralization and
maturation.
 Defects of amelogenesis.
 Age changes of enamel.
Amelogenesis
 Enamel tissue formation requires
I. Good nutritive supply.
II. Plasma membrane associated enzyme as alkaline
phosphatase.
III. Cells able to synthesize and secrete organic matrix that
accept mineralization.
Amelogenesis
 Enamel mineralization doesn't a wait complete matrix formation.
 No clear cut between matrix formation and mineralization.
 Matrix formation and mineralization take place almost at the same
time.
 Crystals appear almost immediately in newly secreted matrix.
Amelogenesis
I. Formation of enamel matrix.
Synthesis of E. pr occurs in
rER, moved to Golgi for
condensation, glycation and
packing into secretory
granules
Granules secrete their content
against first formed layer of
dentine
“ mantel dentine”
Areas of un-mineralized
enamel matrix “stippled
material”; soon crystals
appear
crystals of first layer of E
interdigitate with crystals of
first formed layer of D which
act as nucleation site for E
crystals.
Ameloblasts migrate away
from E surface and Tome’s
process is formed.
Tome’s process jut into newly
formed E matrix giving it saw
tooth appearance
Amelogenesis
I. Formation of enamel matrix.
2 regions within Tome’s
process; distal end and
proximal extremities.
Proximal extremities
gives inter rod
substance; distal end
gives rod.
Crystal has a
perpendicular direction
on the membrane of
Tome’s process
Amelogenesis
I. Formation of enamel matrix.
 Stratum intermedium with ameloblasts form a functional cellular
unite responsible for E formation.
 SI plays a role in the formation of enamel itself; either through
I. The control of fluid diffusion into and out of ameloblasts.
II. The actual contribution of necessary formative elements or enzymes
“Alk. Phosphatase”.
 90% of enamel prs. is amelogenins, the remaining 10% enamelinin,
tuftllin and amelin.
Amelogenesis
I. Formation of enamel matrix.
Amelogenesis
II. Enamel mineralization.
Partial immediate
meniralization; 25-30%
Occurs before full
thickness of enamel is
formed.
Full maturation occurs
after full thickness of
enamel is formed.
 Mineralization commences from the height of the crown and
progresses cervically, depth of rod to the surface.
The actual process of mineralization involves the removal of large
quantities of A A “proline and histidine” from enamel matrix.
Amelogenesis
II. Enamel mineralization.
At the final stages of removal of organic matrix,
the ameloblasts show certain chemical and
ultrastructural features suggestive of an
absorptive function!!!
 As the crystals are deposited, a sudden change
in their orientation occurs in the prism outline
which is responsible for the presence of the rod
sheath.
Amelogenesis
II. Enamel mineralization.
Amelogenesis
II. Enamel mineralization.
Newly formed
crystals
Mature crystals
The crystals thicken rapidly and the intervening protein is
squeezed out.
Enamel
 Life cycle of ameloblast
I. Morphogenic.
II. Differentiation.
III. Secretory.
IV. Transitional.
V. Maturative.
VI. Protective.
VII. Desmolytic
 Amelogenesis
I. Formation of enamel
matrix.
II. Mineralization and
maturation.
 Defects of amelogenesis.
 Age changes of enamel.
Defects of amelogenesis.
 Febrile disease
All teeth forming in this time are affected by distinctive bands of
malformed surface enamel. On recovery, normal enamel resumed.
Defects of amelogenesis.
Tetracycline
It is an antibiotic which incorporated
in mineralizing tissues result in band
of brown pigmentation or even total
pigmentation.
 Fluoride ion
chronic ingestion of F concentration in
excess of 5 parts per million, result in
mottled enamel as patches of
hypomineralized and altered enamel.
Defects of amelogenesis.
Enamel
 Life cycle of ameloblast
I. Morphogenic.
II. Differentiation.
III. Secretory.
IV. Transitional.
V. Maturative.
VI. Protective.
VII. Desmolytic
 Amelogenesis
I. Formation of enamel
matrix.
II. Mineralization and
maturation.
 Defects of amelogenesis.
 Age changes of enamel.
Age changes of enamel.
Attrition
Physiologic wearing of the tooth
substance; as a result of tooth to
tooth contact.
Age changes of enamel.
Discoloration
By food substances, coffee &
smoking.
Some cases by trauma.
Modification in surface layer.
As a result of ionic exchanges with oral cavity, the composition of the
surface layer changes.
Reduction in caries incidence.
Due to increased F content by exchange; the enamel becomes harder.
Age changes of enamel.
Enamel
 Life cycle of ameloblast
I. Morphogenic.
II. Differentiation.
III. Secretory.
IV. Transitional.
V. Maturative.
VI. Protective.
VII. Desmolytic
 Amelogenesis
I. Formation of enamel
matrix.
II. Mineralization and
maturation.
 Defects of amelogenesis.
 Age changes of enamel.
Any questions??
Thank you..

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Amelogenisis

  • 3. Enamel  Life cycle of ameloblast I. Morphogenic. II. Differentiation. III. Secretory. IV. Transitional. V. Maturative. VI. Protective. VII. Desmolytic  Amelogenesis I. Formation of enamel matrix. II. Mineralization and maturation.  Defects of amelogenesis.  Age changes of enamel.
  • 4. Stages of Tooth Development
  • 5. Life cycle of Ameloblast I. Morphogenic. II. Differentiation. III. Secretory. IV. Transitional. V. Maturative. VI. Protective. VII.Desmolytic
  • 6. Life cycle of Ameloblast I. Morphogenic Stage.  Early bell stage.  IEE ; still can undergo mitosis at the cervical region.  Low cuboidal cells.  Resting on basement membrane; separating it from cell free zoon of dental papilla.  EM  Large n. filling the cytoplasm.  Golgi apparatus; less developed and centrioles are located in the proximal end of the cell (adjacent to the stratum intermedium).  mitochondria are evenly scattered throughout the cytoplasm.  Cell attachment.. Proximal junctional complex.
  • 7. Life cycle of Ameloblast II. Differentiation “organization” Stage.  Late bell stage.  Ameloblast cell; can’t undergo mitosis. Elongated up to 40 microns. Resting on basement membrane; separating it from newly formed odontoblasts.  EM  Shift of the n. to the proximal end.  Golgi apparatus; developed and condensed and centrioles are moved to the distal end.  mitochondria clustered infra nucleus.  rER increased in number.
  • 8. Life cycle of Ameloblast III. Secretory “Formative” Stage.  At late bell and developing tooth stage.  Ameloblast cell. EM  Golgi apparatus; developed and condensed occupying a major part of the central core.  mitochondria clustered in the proximal region.  rER increased in number. Cell attachment.. Proximal and distal junctional complexes.
  • 9. The synthesis of enamel protein occurs in rER where passed to Golgi complex to be condensed and packed into membrane bound secretory granules. These granules migrate to distal end of cells to exteriorize their content against newly formed mantle dentine. The hydroxyapatite crystals are randomly packed in this first layer of enamel at the ADJ (inner structure-less Enamel). Some authors consider that the dentine crystals form the nucleation sites for enamel crystals. Life cycle of Ameloblast III. Secretory “Formative” Stage.
  • 10. Life cycle of Ameloblast III. Secretory “Formative” Stage.  As the first layer of enamel is formed, the ameloblast migrate away from dentine surface which permits the formation of Tomes’ process.  The distinction between process and cell body is clearly marked by distal junctional complex.  This Tomes’ process contains primarily secretory granules and small vesicles while cell body contains abundant synthetic organelles.
  • 11.  Secretion of enamel is confined to two sites:- I. Adjacent to proximal part of the process close to junctional complex; resulting in formation of inter rod, this wall encloses a pit in which Tomes’ process fits. II. one surface of Tomes’ process (later on fill these pits with matrix).  So, the crystal orientation and direction in the wall of pit differ from that in the pits giving the inter rod enamel and the filling area become the enamel rods. Life cycle of Ameloblast III. Secretory “Formative” Stage.
  • 12. Life cycle of Ameloblast III. Secretory “Formative” Stage. Inter rod is one step a head before the rod.
  • 13.  Withdrawal of Tomes’ processes.  Reduction in the height of the ameloblasts and decrease in its volume and organelle content. During this period most probably the outer structure less enamel is formed. Life cycle of Ameloblast IV. Transitional Stage.
  • 14.  Enamel maturation (full mineralization) occurs after most of the thickness of the enamel matrix has been formed in the occlusal or incisal area.  While at the cervical parts of the crown, enamel matrix formation is still progressing at this time. Life cycle of Ameloblast V. Maturative Stage.
  • 15. Ameloblasts are  slightly reduced in length  closely attached to enamel matrix.  cytoplasmic vacuoles containing material resembling enamel matrix.  display microvilli at their distal extremities forming a striated border “increasing surface area”  These structures indicate an absorptive function of these cells. Life cycle of Ameloblast V. Maturative Stage.
  • 16. Ameloblasts develop cycles of modulation of alternating ruffled and smooth bordered end which is expressed like a wave. Life cycle of Ameloblast V. Maturative Stage.  Associated with introduction of inorganic materials.  Distal tight and leaky proximal junctions.  Associated with removal of protein and water.  Distal leaky junction and proximal tight junctions.
  • 17. After complete formation and mineralization of enamel; the ameloblasts secrete a material between distal ends of cells and the enamel surface identical to basal lamina (Hemidesmosomes). It providing a firm attachment for ameloblasts and enamel surface which establish the dentinogingival junction. Life cycle of Ameloblast VI. Protective Stage.
  • 18. Ameloblasts can’t be differentiated from the cells of the SI, SR and OEE forming a stratified epithelial covering of the enamel, the so called REE.  REE protects the mature enamel by separating it from the connective tissue until the tooth erupts. Life cycle of Ameloblast VI. Protective Stage.
  • 19.  If the connective tissue comes in contact with the enamel, enamel may be either resorbed or covered by a layer of cementum. Life cycle of Ameloblast VI. Protective Stage.
  • 20. The REE proliferates and seems to induce atrophy of the connective tissue separating it from the oral epithelium as pathway for tooth eruption. It is probable that it elaborate enzymes that are able to destroy connective tissue fibers by desmolysis.  Premature degeneration of the reduced enamel epithelium may prevent the eruption of a tooth. Life cycle of Ameloblast VII. Desmolitic Stage.
  • 21. Life cycle of Ameloblast 1. Morphogenic. 2. Organizing 3, 4. secretory. 5, 6. Maturative. 7. Protective & Desmolytic.
  • 22. Enamel  Life cycle of ameloblast I. Morphogenic. II. Differentiation. III. Secretory. IV. Transitional. V. Maturative. VI. Protective. VII. Desmolytic  Amelogenesis I. Formation of enamel matrix. II. Mineralization and maturation.  Defects of amelogenesis.  Age changes of enamel.
  • 23. Amelogenesis  Enamel tissue formation requires I. Good nutritive supply. II. Plasma membrane associated enzyme as alkaline phosphatase. III. Cells able to synthesize and secrete organic matrix that accept mineralization.
  • 24. Amelogenesis  Enamel mineralization doesn't a wait complete matrix formation.  No clear cut between matrix formation and mineralization.  Matrix formation and mineralization take place almost at the same time.  Crystals appear almost immediately in newly secreted matrix.
  • 25. Amelogenesis I. Formation of enamel matrix. Synthesis of E. pr occurs in rER, moved to Golgi for condensation, glycation and packing into secretory granules Granules secrete their content against first formed layer of dentine “ mantel dentine” Areas of un-mineralized enamel matrix “stippled material”; soon crystals appear crystals of first layer of E interdigitate with crystals of first formed layer of D which act as nucleation site for E crystals. Ameloblasts migrate away from E surface and Tome’s process is formed. Tome’s process jut into newly formed E matrix giving it saw tooth appearance
  • 26. Amelogenesis I. Formation of enamel matrix. 2 regions within Tome’s process; distal end and proximal extremities. Proximal extremities gives inter rod substance; distal end gives rod. Crystal has a perpendicular direction on the membrane of Tome’s process
  • 27. Amelogenesis I. Formation of enamel matrix.  Stratum intermedium with ameloblasts form a functional cellular unite responsible for E formation.  SI plays a role in the formation of enamel itself; either through I. The control of fluid diffusion into and out of ameloblasts. II. The actual contribution of necessary formative elements or enzymes “Alk. Phosphatase”.  90% of enamel prs. is amelogenins, the remaining 10% enamelinin, tuftllin and amelin.
  • 29. Amelogenesis II. Enamel mineralization. Partial immediate meniralization; 25-30% Occurs before full thickness of enamel is formed. Full maturation occurs after full thickness of enamel is formed.
  • 30.  Mineralization commences from the height of the crown and progresses cervically, depth of rod to the surface. The actual process of mineralization involves the removal of large quantities of A A “proline and histidine” from enamel matrix. Amelogenesis II. Enamel mineralization.
  • 31. At the final stages of removal of organic matrix, the ameloblasts show certain chemical and ultrastructural features suggestive of an absorptive function!!!  As the crystals are deposited, a sudden change in their orientation occurs in the prism outline which is responsible for the presence of the rod sheath. Amelogenesis II. Enamel mineralization.
  • 32. Amelogenesis II. Enamel mineralization. Newly formed crystals Mature crystals The crystals thicken rapidly and the intervening protein is squeezed out.
  • 33. Enamel  Life cycle of ameloblast I. Morphogenic. II. Differentiation. III. Secretory. IV. Transitional. V. Maturative. VI. Protective. VII. Desmolytic  Amelogenesis I. Formation of enamel matrix. II. Mineralization and maturation.  Defects of amelogenesis.  Age changes of enamel.
  • 34. Defects of amelogenesis.  Febrile disease All teeth forming in this time are affected by distinctive bands of malformed surface enamel. On recovery, normal enamel resumed.
  • 35. Defects of amelogenesis. Tetracycline It is an antibiotic which incorporated in mineralizing tissues result in band of brown pigmentation or even total pigmentation.
  • 36.  Fluoride ion chronic ingestion of F concentration in excess of 5 parts per million, result in mottled enamel as patches of hypomineralized and altered enamel. Defects of amelogenesis.
  • 37. Enamel  Life cycle of ameloblast I. Morphogenic. II. Differentiation. III. Secretory. IV. Transitional. V. Maturative. VI. Protective. VII. Desmolytic  Amelogenesis I. Formation of enamel matrix. II. Mineralization and maturation.  Defects of amelogenesis.  Age changes of enamel.
  • 38. Age changes of enamel. Attrition Physiologic wearing of the tooth substance; as a result of tooth to tooth contact.
  • 39. Age changes of enamel. Discoloration By food substances, coffee & smoking. Some cases by trauma.
  • 40. Modification in surface layer. As a result of ionic exchanges with oral cavity, the composition of the surface layer changes. Reduction in caries incidence. Due to increased F content by exchange; the enamel becomes harder. Age changes of enamel.
  • 41. Enamel  Life cycle of ameloblast I. Morphogenic. II. Differentiation. III. Secretory. IV. Transitional. V. Maturative. VI. Protective. VII. Desmolytic  Amelogenesis I. Formation of enamel matrix. II. Mineralization and maturation.  Defects of amelogenesis.  Age changes of enamel.