roger shore teeth.pdf · of raschkow cell-rich zone cell-free zone odontoblasts predentine ....

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Page 1: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as

Teeth Roger Shore

Page 2: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as

Permanent human dentition – 32 teeth

Page 3: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as
Page 4: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as
Page 5: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as

CROWN

ROOT

CUSP

Page 6: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as

Periodontium

4 Connective

tissues:

2 calcified

2 non-calcified

Calcified

1. cementum

2. alveolar bone

(lamina dura)

Non calcified

1. lamina propria

2. periodontal

ligament

Page 7: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as
Page 8: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as
Page 9: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as
Page 10: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as

A

B

C

Page 11: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as
Page 12: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as

Periodontium

4 Connective

tissues:

2 calcified

2 non-calcified

Calcified

1. cementum

2. alveolar bone

(lamina dura)

Non calcified

1. lamina propria

2. periodontal

ligament

Common element

fibrous collagen

is the bulk protein

Page 13: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as

CROWN

ROOT

Page 14: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as
Page 15: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as
Page 16: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as

ENAMEL 1

PHYSICAL PROPERTIES:

Very hard and brittle – relies on DENTINE for resilience

Colour dictated by its translucency and colour of underlying dentine

CHEMICAL COMPOSITION:

96-99% mineral by weight (hydroxyapatite) (c.f. 60% for bone)

3% water

1% organic (mainly protein but not collagen)

Page 17: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as

a. Local hypoplastic b. Pitted hypoplastic c. Rough hypoplastic d. Hypomature e. Hypocalcified

A

B C

D E

Amelogenesis imperfecta

Page 18: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as

ENAMEL 2

BASIC STRUCTURE:

Hydroxyapatite crystal 60-90nm x 25-30nm x ?

(c.f. bone crystals 40nm x 5-10nm x 50nm)

Ca10(PO4)6OH2

Crystals arranged into PRISMS (RODS) (approx 5µm diameter)

Prisms perpendicular to ADJ

Page 19: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as
Page 20: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as

Amelo-dentinal

junction Tooth surface

Page 21: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as
Page 22: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as
Page 23: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as
Page 24: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as
Page 25: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as
Page 26: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as
Page 27: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as
Page 28: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as
Page 29: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as

CROWN

ROOT

Page 30: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as
Page 31: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as
Page 32: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as

DENTINE

PHYSICAL PROPERTIES:

Slightly harder than bone

Elastic, not brittle

Yellow in colour

CHEMICAL COMPOSITION:

65% mineral (by wt), 35% organic and water

Organic mainly COLLAGEN but also

proteoglycans and glycoproteins

Page 33: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as

DENTINE 2

BASIC STRUCTURE:

Hydroxyapatite crystal

Crystals arranged mainly parallel to collagen (meshwork)

Dentinal tubules containing ODONTOBLAST process

Tubule extends from pulp to ADJ (odont. process also?)

Tubules not straight, they have –

primary curvature (resembles ‘S’ shape)

secondary curvatures (small, relatively regular

wave-like deviations superimposed on primary c.)

Tubules branched (mainly at ADJ)

Page 34: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as

Enamel Dentine

Page 35: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as
Page 36: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as
Page 37: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as

Peritubular

dentine

Intertubular

dentine

3. PERITUBULAR (hypermineralised) and INTERTUBULAR

Page 38: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as
Page 39: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as
Page 40: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as

4. IRREGULAR SECONDARY (TERTIARY or REPARATIVE)

(REACTIONARY or REPARATIVE)

Page 41: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as
Page 42: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as

Pulp

Mineralised

dentine Predentine

Odontoblasts

Cell-free zone

(of Weil)

Cell-rich zone

Calcospherites

Page 43: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as

Odontoblasts

Dentine

Pulp

Page 44: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as

Nerve plexus

of Raschkow

Cell-rich

zone

Cell-free

zone

Odontoblasts

Predentine

Page 45: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as

PROPOSED MECHANISMS OF DENTINE SENSITIVITY

1. Direct innervation

2. Odontoblasts act as sensory endings

3. Hydrodynamics (fluid flow)

Page 46: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as

Den

tine

P

re-d

en

tine

O

do

nto

bla

sts

N

erv

e p

lex

us

Direct innervation Odontoblast as ending Hydrodynamic

Page 47: Roger Shore Teeth.pdf · of Raschkow Cell-rich zone Cell-free zone Odontoblasts Predentine . PROPOSED MECHANISMS OF DENTINE SENSITIVITY 1. Direct innervation 2. Odontoblasts act as

The End