1. The document discusses dentinogenesis, the process of dentin formation, outlining the key stages and cells involved. It describes how odontoblasts differentiate and deposit an organic matrix that becomes mineralized to form dentin layers including mantle dentin and circumpulpal dentin.
2. Dentin hypersensitivity is then discussed, including potential causes, treatments using agents like potassium nitrate and newer therapies involving casein phosphopeptide-amorphous calcium phosphate. Laser therapy, iontophoresis, and minimally invasive techniques are also summarized.
3. Future therapies explored include gene therapy to block nerve growth factors and herbal treatments, with several references provided for further reading.
5. 5
DENTINOGENESIS content at a glimpse……
Introduction
Stages of Dentinogenesis
1-Odontoblast and its differentiation.
2- Deposition of organic matrix
3-Mineralization modification of organic
matrix.
4- MantL dentin formation
5-Circumpulpal dentin formation
6-Peritubular dentin formation
6. 6
Introduction…..
Dentinogenesis = the process of dentine formation
Starts after tooth germ has reached the
bell stage
EARLY BELL STAGE LATE BELL STAGE
HISTO
DIFFERENTIATION
MORPHO
DIFFERENTIATION
7. 7
Odontoblast and its differentiation…
Dentin forming cell
Origin- ectomesenchymal LIFE CYCLE OF
ODONTOBLAST
QUIESCENT STAGE
Decreased in size Decreased dentin formation
FORMATIVE STAGE
Odontoblast process Increase length
DIFFERENTIATION STAGE
Form Preodontoblast Attached to BM
TGF,
BMP,
IGF
MAP 1B
13. 13
FORMATION OF PERITUBULAR DENTIN…….
New dentin formed changed the previous dentin
Diameter of odontoblast process
Create a space
More mineralized dentin deposited
PERITUBUAR DENTIN
14. 14
2.MINERALIZATION OF DENTIN
MATRIX FORMATION
MATRIX VESICLE
RUPTURE OF VESICLE
DEPOSITION OF Ca2 and PO4
MINERALIZATION OF DENTIN
ODONTOBLAST
MOVE
TO CENTER
17. 17
CONTROL OF MINERALIZATION………
• INITIATIONCACLIUM
• INHIBIT GROWTH OF HYDROXY APPETITE
• PROMOT BINDING OF Ca2 &Po4OSTEONECTIN
• MINERALIZATIONOSTEOPECTIN
• PREVENT PREMATURE CALCIFICATIONPROTEOGYCAN
• Transport of ca,
• Aggregation of fiber,stabilization of crysytalDPP
• ATTRACT AND CONCENTRATE CALCIUMGLA PRTEIN
18. 18
GENES & REGULATION OF DENTINOGENESIS…..
• REGULATE
SIALOPHOSPHOPROTEIN mRNA.Wnt10a
• REGULATE DENTIN MATRIX
PROTEINM06-G3
• REGULATE SIGNALING AND
DEVELOPMENT
HEPARAN
SULPHATE
• MINERALIZATIONTGF,BSP
29. 29
OTHER METHOD
Fluoride varnishes
Oxalic acid and resin
Glass ionomer cements
Composites
Dentin bonding agents
DENTIN ADHESIVE
Dentin bonding agent are used
Micro mechanical bonding through
formation of an interdiffusion hybrid layer
30. 30
NOVAMIN in DH
It is Bio active glass ceramic
MOA
Calcium sodium phosphosilicate
Aqueous medium
Release calcium and phosphate ion
Form hydroxy-carbonate appetite
SEAL DT
31. 31
Recaldent
Is a complex of Casein Phosphopeptide (CPP) and Amorphous
Calcium Phosphate (ACP)
MAO
Binds readily to surfaces within the oral cavity
Delivers calcium and phosphate ions to the enamel and into the
oral environment
Works with fluoride in toothpaste (for MI Paste & MI Paste Plus
users)
32. 32
Laser in DH
Example- Nd:YAG laser, CO2 LASER
MOA- 1-Coagulation and precipitation of plasma
protein in dentinal tubules (Goodies et al 1994)
2-thermal energy liberated alter intra-dental nerve
activity (Orcharelous et al 1998)
33. 33
IONTOPHORESIS…
Electrical potential is used to transfer the ion into body
for therapeutic purpose
Used sodium fluoride.
MOA-
Current may
produce reparative
dentin or nerve
paresthesia.
Fluoride ion
precipitation may
occlude by calcium
fluoride formation.
Method…
Place a negative electrode on
the dentin & positive Electrode
on the patients arm
Chemical is applied to tooth
surface & current is
passed through –ve electrode
using 0.5mA current
34. 34
Advanced THERAPY FOR DH
The PILP system-
The polymer-induced liquid precursor
(PILP) system created by Laurie Gower, PhD, an
associate professor in the department of materials
science and engineering at the University of Florida
in Gainesville.(June 2, 2011)
(study performed at the University of
California, San Francisco (UCSF))
35. 35
MOA…
Poly- L-aspartic acid delivers calcium phosphate to the
fibrils and releases it inside the collagen fibril so
minerals form within them.
Its occurs too shortly
Full recovery will occurs.
36. 36
ICON DMG…..
Features and Benefits
Micro invasive technique
No drilling or anesthesia required
Prevents lesion progression
Treated lesions lose whitish appearance and look like
healthy enamel
Easy treatment
only one visit
44. 44
REFERENCE
JOURNA F CONSERVATIVE
DENTISTRY 2010 OCT-DEC
Dentin hypersensitivity: Recent
trends in management
Sanjay Miglani, Vivek
Aggarwal, and Bhoomika Ahuja
International Journal of Dentistry
Volume 2009 (2009), Article
ID 464280, 12 pages
http://dx.doi.org/10.1155/2009/4642
80Review Article Reparative
Dentinogenesis Induced by Mineral
Trioxide Aggregate: A Review from
the Biological and Physicochemical
Points of View
Takashi Okiji and Kunihiko Yoshiba
Orban’s Oral histology and
Embryology
Ten cate’s oral histology
Shafer’s Text book of oral
pathology
45. 45
REFERENCE…….
1.Shen P, Cai F, Nowicki A, Vincent J, Reynolds EC. Remineralization of
enamel subsurface lesions by sugar–free chewing gum containing casein
phosphopeptideamorphous calcium phosphate. J Dent Res. 2001
Dec;80(12):2066–70.
2.Morgan MV, Adams GG, Bailey DL, Tsao CE, Reynolds EC. CPP–ACP
gum slows progression and enhances regression of dental caries. J Dent
Res 2006; 85 (Sp. Iss. B): 2445.
3.Walsh LJ. Tooth Mousse: Anthology of Applications. GC Asia Dental, 2007.
4.Cochrane NJ, Cai F, Reynolds EC. QLF and TMR analysis of CPP–ACFP
remineralized enamel in vitro. J Dent Res 2006; 85 (Sp. Iss. B): 0192.
46. 46
“I will apply, for the benefit of the sick, all measures
[that] are required, avoiding those twin traps of
overtreatment and therapeutic nihilism”.
(Hippocratic Oath)
Upcoming Seminar ………..
TOOTH MORPHOLOGY
(the architect……..)
Editor's Notes
GF- TGF ,IGF,BMP found in IEE induced differentiatio of odontoblast.
MAP 1B GENE
Reciprocal cell and matrix interactions are
believed to play a key role for the terminal differentiation
of odontoblasts and ameloblasts
Collagen fibril small dm 0.05 micro m
Closedly packed
Rate of coronal dentin4-8micro m/day
3 theory are there
1- booster mechanism
2- seeding mechanism
3-matrix vehicle theory
Schematic drawing of the odontoblast-predentin region during
dentinogenesis (Linde, 1989). Macromolecules are synthesized within the
odontoblast cell bodies. The constituents of predentin, primarily collagen
and proteoglycan (PG), are secreted close to the odontoblast cell bodies
(lower set of arrows) to form the extracellular, nonmineralized predentin
matrix; some of this PG is metabolized in predentin. Uptake into the cells
of degradation products from such metabolism in predentin seems to occur
along the odontoblast process membrane (arrows). Several noncollagenous
components are transported within the odontoblast process and secreted
at the mineralization front, i.e., in predentin, just before the advancing
mineralized dentin, where mineral formation is initiated. Among these are
the highly phosphorylated phosphoprotein (PP-H), y-carboxyglutamatecontaining
proteins of the osteocalcin type (Gla-protein), as well as a
second pool of PG.
Schematic representation, showing different calcium ion
transport pathways in dentinogenically active odontoblasts. Ca2+ ions
are transferred from the blood across the odontoblast cell layer, either
through the cells, between the cells, or by both pathways (left). If the
Ca2+ ions migrate between the cells by diffusion, they would have to
penetrate through the intercellular junctions between the odontoblasts
and into the predentin layer (arrows). If, on the other hand, Ca2+ ions
are actively transported by intracellular pathways, some extrusion
mechanism from the odontoblast process and into the predentin space
has to be postulated (arrows upper left). The cell to the right illustrates
the transmembraneous Ca2+-transporting mechanisms shown to be
present in odontoblasts. (From Linde and Lundgren, 1990.)
The PILP remineralization solutions were prepared following a slightly modified procedure [9]. Poly-L-aspartic acid (Pasp) with a molecular weight of 27 KDa was used as the polymeric process-directing agent. Calcium chloride dihydrate was dissolved in Tris buffered saline (TBS) at a 9mM concentration and Pasp was added to a final concentration of 100 μg/mL. An equal volume of dipotassium phosphate solution was added to the calcium-polymer mix, resulting in a calcium-to-phosphate ratio of 2.14 (mol/mol). Specimens were incubated at 37°C under continuous stirring for 7, 14, or 28 days. pH of the PILP system was 7.4 at the start of mineralization experiments and at the end of experiments was typically 7.1–7.2.
