tooth and pulp anatomy - semmelweis egyetem · dentin structure • dentin is a calcified...
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Tooth and Pulp
Anatomy
Dr. Zsuzsanna Tóth Ph.D.
Semmelweis University
Dept. of Conservative Dentistry
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decidous permanent
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Deciduous teeth
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Permanent teeth
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Schmelz
Dentintubuli
Pulpakammer
Pulpa
Zementum
enamel
dentintubuli
pulpchamber
pulp
cement
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MORPHOLOGY of the PULP
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ameloblasts
enamel
dentin
odontoblasts
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Dentin Structure
• dentin is a calcified connective tissue
penetrated by millions of tubules;
• their density varies from 40,000 to 70,000
tubules per square mm
• tubules are from 1 μm in diameter at the
dentinoenamel junction to 3 μm at their pulpal
surface and contain fluid that has a composition
similar to extracellular fluid
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FUNCTION of the PULP The pulp lives for the dentin and
the dentin lives by the grace of the pulp
• Nutrition of the dentin
• Innervation of the pulp and dentin
• Formation of the dentin
• Defense of the tooth and the pulp
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PULP TISSUE • connective tissue
• obviously rich in fluid
• highly vascularized
• cells
• collagen fibres
• vessels
• nerves
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Supportive Elements • Pulpal Blood Supply. • pulp blood vessels do not reach a large size.
• At the apex and extending through the central pulp, one or more arterioles branch into smaller terminal arterioles or metarterioles that are
• directed peripherally
• Before the arterioles break up into capillary beds, arteriovenous anastomoses
• often arise to connect the arteriole directly to a venule. These arteriole-venule shunts are identified by the presence of irregularly oriented myoepithelium-
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PULP TISSUE
• principal support system for the peripheral pulp, which includes the large vessels and nerves from which branches extend to supply
• Plexuses of capillaries and small nerve fibers ramify in
this subodontoblastic layer
• pulp showing major support systems, including arterioles with a muscular wall, thin-walled lymphatics , venules , and nerve bundles containing myelinated and unmyelinated nerve
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The development of dentin
• Primer
• Secunder
• Tertier
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The development of dentin
• Primer
• Secunder
• Tertier/irritation dentin
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Reserve Cells
The pulp contains a pool of reserve cells, descendants of undifferentiated cells in the primitive dental papilla. These multipotential cells are likely a fibroblast type that retains the capability of dedifferentiating and then redifferentiating on demand into many of the mature cell types.
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Fibroblasts
Most of the cells of the pulp are
fibroblasts. Pulpal fibroblasts are
spindle-shaped cells with ovoid nuclei.
These cells exhibit wide variation in
their degree of differentiation.
Principal producers of collagen
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Defense Cells
• histiocytes and Macrophages
• undifferentiated mesenchymal cells
• polymorphonuclear Leukocytes.
• lymphocytes and Plasma Cells
• mast cells
• odontoblasts
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Odontoblasts
• In the puplchamber
50 000 cells / mm2
• In the root
significant less
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Caries media
localized irregular
irritative dentin
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Denticulus
Denticulus
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Tooth notation
• Zsigmondy-Palmer, Chevron,
Set-Square system
• The FDI two-digit system (international method)
• European, Scandinavian,
Haderup system
• American (universal) system
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FDI Federation Dentaire Internationale
WHO World Health Organization
IADR International Association for Dental Research
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8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8
8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8
V IV III II I I II III IV V
V IV III II I I II III IV V
Zsigmondy-Palmer, Chevron, Set-Square system
Right Left
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FDI
18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28
48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38
Right Left
55 54 53 52 51 61 62 63 64 65
85 84 83 82 81 71 72 73 74 75
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European, Scandinavian,
Haderup system
8+ 7+ 6+ 5+ 4+ 3+ 2+ 1++1 +2 +3 +4 +5 +6 +7 +8
Right Left
8- 7- 6- 5- 4- 3- 2- 1- -1 -2 -3 -4 -5 -6 -7 -8
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USA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
32 31 30 29 28 27 26 25 24 23 22 21 20 19 18 17
Right Left