ENAMEL

Developmental Stages of a Tooth

4 Layers of Cell That Make up the Enamel

Organ
Review:
1. outer enamel epithelium
 The neural crest cells in the jaws induce 2. stellate reticulum
the oral epithelium to proliferate and 3. stratum intermedium
form the DENTAL LAMINA. 4. inner enamel epithelium
o Dental Lamina - the FIRST SIGN
OF TOOTH DEVELOPMENT

Bell Stage

 As proliferation continues, the dental

Bud Stage (8th week)
organ increases in size and changes in
 A knob-like projection into the shape
underlying mesenchyme  The invagination becomes deeper until
 These downward growths are the tooth the organ assumes the shape of a bell
buds ( first sign of enamel organ
formation and the beginning of tooth
germ of a primary tooth)

Late Bell Stage

 The cells of the inner enamel epithelium

CAP STAGE
cease to divide and change from low to
 Unequal growth in different parts of the tall columnar cells
tooth bud leads to concave surface,  They increase from 12 to 40 micrometer
forming like a cap like structure. in length
 Formation of tooth germ  These tall cells are now referred to as
preameloblasts
  The preameloblasts initiate the PHYSICAL CHARACTERISTICS
peripheral cells of the dental papilla to
 Extremely hard because of high mineral
become odontoblasts
content
 The secretion of dentin matrix causes
 Forms a resistant covering of teeth,
the preameloblasts to change polarity
rendering it suitable for mastication
 With change in polarity of
 The structure and hardness of enamel
preameloblasts, these cells are now
render it brittle; therefore an
referred to as ameloblasts and ready to
underlying layer of more resilient
begin the secretion of enamel matrix
dentin is necessary to maintain its
 Amelogenesis is the formation of
integrity
enamel on teeth and begins when the
crown is forming during the advanced
bell stage of tooth development and
after dentinogenesis, forms a first layer
of dentin
 Without dentin, enamel is subject to
ENAMEL
fracture which occurs specially if the
 Hardest calcified tissue in human body supportive layer of dentin is destroyed
 Provides the shape and contour of the by either caries or improper cavity
crowns of teeth and is also a poor preparation
conductor of both heat & electricity  Tooth color is determined by the
 Glistening in appearance enamel thickness and varies yellowish
 Protects the pulp and dentin tissue white to grayish-white but appears
slightly yellow because it is translucent
 Enamel is permeable to a limited
extent, stains can enter it from both the
outside and from the pulp

 Thickest at the cusps of molars which

measures 2.5 mm and incisal edges
where it is 2.0 mm
 Thinner within the fissures and pit of
multicusp teeth and over the facial,  Permeability studies in 8 to 10 year old
lingual and interproximal surfaces, children showed that after eruption,
where it tapers to a minimal thickness enamel is very permeable, then
(less than 100 micrometers) at the eventually loses its porosities and
cervical margin increases in density
 Non-vital tissue and is incapable of  The texture of clinically sound enamel is
regeneration smooth and glossy
COMPOSITION 4. Protective Stage
5. Desmolytic Stage
 Inorganic material
 96% mineral content PRESECRETORY STAGE
o 90% HYDROXYAPATITE crystals
 Morphogenic Phase
(crystalline carbonate) – chief
 Inner dental epithelium begins
inorganic content
its differentiation first into
o Varying amount of carbonates
preameloblasts which induce
o Trace elements (vanadium,
adjacent dental papilla cells to
manganese, selenium,
differentiate into odontoblasts
molybdenum & strontium)
which form dentin.
 It is the Early bell stage.
 Differentiation Phase (organization
stage)
 The inner dental epithelial cells
grow into tall columnar cells
with more organelles mostly
 The high mineral content renders protein synthesizing.
enamel extremely hard; this is a  The polarity of the cells is
property that together with its complex reversed.
structural organization enables enamel
to withstand the mechanical forces SECRETORY STAGE (Formative Stage)
applied during tooth functioning.  Happens during late bell stage and
 This hardness also makes enamel developing tooth stage
brittle; therefore an underlying layer of  The pre-ameloblasts complete their
more resilient dentin is necessary to differentiation into ameloblasts which
maintain its integrity. secrete enamel.
 4 % Organic substances and water  The organelle content of secretory
o Once mature, enamel is almost ameloblasts is mainly protein
totally without the softer organic synthesizing organelles
matter  Rods and interrods formation
AMELOGENESIS (functional unit of enamel is rod)
 “Key hole” pattern
 process of enamel formation
Tomes’ Processes
Stages of enamel formation (Life Cycle of
Ameloblast)  these are finger-like projections of the
ameloblast, occurring during the
1. Presecretory Stage secretory phase of the cell during
o Morphogenic Phase amelogenesis
o Differentiation Phase
2. Secretory Stage
3. Maturation Stage
o Transitional Phase
o Maturation Proper
  Tomes' processes are a histologic  Reduction in the height of the
landmark identified on an ameloblast ameloblasts and decrease in its
 Involved in the production of tooth volume and organelle content.
enamel  The overall number of ameloblasts
 Projecttions and give the ameloblast a is reduced by programmed cell
"picket-fence" appearance under a death.
microscope.  It is estimated that by the end of
 Located on the secretory basal end of this stage the ameloblast
the ameloblast. population is reduced by as much
 During the synthesis of enamel, the as 50%.
ameloblast moves away from the b. Maturation Proper
enamel, forming a projection  the next principal activity of
surrounded by the developing enamel. ameloblast is the bulk removal of
water and organic material from
enamel and introduction of
additional inorganic material
 ameloblasts develop cycles of
MODULATION which is the cyclic
creation, loss and recreation of a
highly invaginated ruffle-ended
border or smooth border apices of
ameloblast

MATURATION STAGE Ruffled and Smooth Ameloblasts

 Maturation stage of ameloblasts o Ruffled ameloblast - Asssociated with

generally are referred to as introduction of inorganic material
postsecretory cells o Smooth ameloblast - associated with
 These cells still synthesize and secrete removal of protein and water
proteins.
 Proteins are used for the final
mineralization process.
 The noteworthy proteins involved are
amelogenins, ameloblastins,
enamelins, and tuftelins.
 During this process, amelogenins and
ameloblastins are removed after use,
leaving enamelins and tuftelin in the  The reason ruffle-ended ameloblasts
enamel. become smooth-ended periodically is
 By the end of this stage, the enamel has unknown, although this event seems to
completed its mineralization. be crucial for sustaining long-term
a. Transitional Phase crystal growth.
 Withdrawal of Tome’s processes
PROTECTIVE STAGE  Premature degeneration of the
reduced enamel epithelium may
 during this stage, ameloblasts can’t be
prevent the eruption of a tooth.
differentiated from the cells of Stratum
Intermedium, Stellate Reticulum and
Outer Enamel Epithelium, forming a
stratified epithelial covering of the
enamel, the Reduced Enamel
Epithelium (REE)
 The REE protects the mature enamel by
separating it from the connective tissue
until the tooth erupts.  Ameloblasts = the cells responsible for
the formation, are lost as the tooth
erupts into the oral cavity.
 Ameloblasts are present only during
tooth development that deposit tooth
enamel.
 When amelogenesis is complete, which
is about 3 months of age (late
apposition), the ameloblast is
 If the connective tissue comes in programed to die.
contact with the enamel, the enamel STRUCTURAL AND ORGANIZATIONAL
may either be resorbed or covered by a FEATURES OF ENAMEL
layer of cementum.
 Cementum formation Structure of enamel

 The unit structure of enamel is Enamel

Rod, enveloped with Rod Sheath, and
surrounded by Interrod Substance.

DESMOLYTIC STAGE
ENAMEL RODS
 The REE proliferates and seems to
induce atrophy of the connective tissue  Basic structural unit of enamel
separating it from the oral epithelium  First described as hexagonal, and
as pathway for tooth eruption prism-like; the term enamel prism was
 frequently used since the basic unit Enamel Rods’ direction
does not have a regular geometry.
 Generally perpendicular to the surface
or the dentin (or at right angle to the
dentino-enamel junction), with a slight
inclination toward the cusp as they pass
outward
 Near the cusp tip, run more vertically
 Under pits and fissures, the enamel
rods are arranged in tent-like manner,
that is, rods converge toward each
CHARACTERISTICS OF ENAMEL ROD/PRISM other to the bottom of the pit or fissure
 On the proximal areas or sides, the
 Number: 5 – 12 millions
rods are horizontal.
 Direction: Run in oblique direction and  As they approach the cusp or incisal,
wavy course the rods are in vertical direction
 Length: greater than its thickness  In cervical enamel, the rods run mainly
 Diameter average: 4 µm horizontal or obliquely inclined (apically
 Cross-section: hexagonal, round, oval or for permanent teeth and coronally for
fish scales deciduous)
 The head of enamel rod is formed by  The arrangement of rod rows has a
one ameloblast and tail is formed by clinical importance because enamel
three ameloblasts fractures occur between adjacent rows
 Thus, each rod is formed by four
ameloblasts.
 The head is directed towards the
occlusal aspect and tail towards the
cervical region of the tooth

SUBMICROSCOPIC STRUCTURE OF ENAMEL

RODS

 Keyhole or paddle-shaped
 Separated by interrod substance
Enamel Rods: Basic Structural Unit  About 5 µm in breadth and 9 µm in
length
 The bodies are near the occlusal or
incisal surface
 the tails point cervically
 The crystals: parallel to the long axis of
the prism heads
Enamel Rod’s Shape INTERROD ENAMEL / INTERPRISMATIC
SUBSTANCE

BANDS OF HUNTER-SCHREGER

 Alternating dark and light strips

 Have varying width
 Originate from DEJ (dentino-enamel
Junction)
 optical phenomenon seen in reflected
light
 Seen in ground longitudinal section
Rod sheath

 the boundary between the enamel rod

and interrod is delimited by a narrow
space containing organic material
 a thin peripheral layer
 darker than the enamel rod
 acid resistant
 less calcified and contains more organic This is due to:
matter than the enamel rod itself
1. Abrupt change in the direction of the
enamel rods
2. Variation in calcification of enamel
3. Alternate zones having different
permeability and organic material

INTERROD ENAMEL / INTERPRISMATIC

SUBSTANCE

 Is the substance that cements the rods

together
 This is an area surrounding each rod in
which crystals are oriented in a
different direction from those making
up the rod
GNARLED ENAMEL (GNARLED ENAMEL ROD) hypomineralization) that occur during
growth of the enamel
 These rods that form enamel are woven
during formation into a mass that
resists an average masticatory impact of
20 to 30 pounds per tooth
 Enamel is thickest over the areas of
greatest impact

 In a cross or transverse sections, the

lines of Retzius appear as concentric
rings (an arrangement similar to the
annual rings of a tree)

 Generally, enamel rods are not straight

throughout their length
 In the cuspal region, the rods are very
wavy
 The rods that are wavy are referred to
as gnarled enamel
 In longitudinal section, they are seen as
Legend:
a series of dark bands reflecting
A. Gnarled enamel successive enamel-forming fronts or
B. Enamel spindle (end of successive apposition of layers of
an odontoblastic process enamel during formation of the crown
penetrating the enamel just (compared to growth rings in a cross
past the dentino-enamel section of a tree)
junction (DEJ)

INCREMENTAL LINES OF RETZIUS (Band of

Retzius or Striae of Retzius)

 Incremental lines of growth

 Concentric growth rings
 Originate from DEJ to outer surface of
enamel
 Where they end as shallow furrows and PERIKYMATA or IMBRICATION LINES OF
be known as perikymata PICKERILL
 “Incremental lines” reflect variations in  These grooves represent the lines of
structure and mineralization Retzius as they meet the surface
(hypermineralization or enamel
 Where the margin of each enamel layer therefore most primary teeth and
reaches the free surface of the enamel, permanent central incisors have these
a fine ridge is seen in recently erupted
teeth. The ridges are called perikymata
(imbrication lines of Pickerill)

ENAMEL TUFTS

 Originate at the dentino-enamel

junction and reach into the enamel (1/5
 PERIKYMATA ( IMBRICATION LINES of to 1/3 of the thickness of the entire
PICKERILL are external manifestations enamel)
of Incremental lines of Retzius  They resemble tufts of grass growing
out of a root, form garlands running in
an occlusocervical direction
 They are composed of hypomineralized
enamel rods, interrod enamel and
organic material—enamelin

NEONATAL LINE

 Part of the enamel of deciduous teeth is

formed both before and after birth
 Caused by abrupt change in
environment and nutrition at birth, it is
recorded in the enamel as a more
pronounced incremental or brownish
line, termed NEONATAL LINE

ENAMEL LAMELLAE
 The neonatal line is an accentuated line  thin, leaf like structures
that apparently reflects the marked  extends from enamel surface towards
physiologic changes occurring at birth, DEJ
 develop in planes of tension
 extends in longitudinal and radial ENAMEL SPINDLE
direction
 Extensions from dentinal tubules that
 represent site of weakness in the tooth
penetrate the dentino-enamel junction
 Confused with cracks
into the enamel
 Seen as black or dark irregular or spiral-
shaped or club-shaped structures and
are normally filled with dentinal fluid
 Their dark appearance is due to the
presence of air and debris resulting
from the preparation of the section
 In this ground cross-section of tooth,
you can see enamel lamellae, enamel
tufts, and neonatal line
 What do these three structures have in
common? Answer : They are all
hypocalcified

Legend:
Legend:
A. Enamel lamella
B. Enamel tuft A. Enamel Spindle
C. Neonatal line B. Odontoblast
Process

 Cracks may also appear in enamel

because enamel is a highly mineralized  Enamel spindles are:
tissue > stress from breathing cold air a. Odontoblast proesses that cross
or drinking cold beverages especially the DEJ
when enamel is weakened by b. Remnants of ameloblasts
underlying caries c. Enamel rods develop in planes of
 Lamellae are not tubular defects > they tension
are leaf-like structures extending
Important: It makes the area hypersensitive to
around the crown
pain, particularly during dental procedures such
 Lamellae are important as a pathway as tooth preparation.
through enamel and function as a
possible avenue for dental caries
DENTINO-ENAMEL JUNCTION (DEJ) AGE CHANGES

 It is the junction between the enamel  Result of age changes:

and dentin o Teeth may become darker due
 It is established as these two hard to:
tissues begin to form and is seen as a  addition of organic
scalloped profile in cross-section material to enamel
 Convexities of scallops are directed  attrition of enamel
towards the dentin (that would show the
 Preformed even before the underlying dentin)
development of hard tissues

 Most apparent: attrition or wear of the

occlusal surfaces and proximal contact
points as a result of mastication

 Evidence n Loss of vertical dimension of

the crown
 Flattening of the proximal contour

 Structure loss (rods and

perikymata)
o Facial and lingual surfaces: lose
their structure much more
rapidly (than proximal surfaces)
o Anterior teeth: lose their
structure more rapidly (than
posterior teeth)
  Superficial enamel layers (older AMELOGENESIS IMPERFECTA
teeth): localized increase of
 Abnormal formation of the enamel due
nitrogen and fluoride
to the malfunction of the proteins in the
enamel
 People afflicted with amelogenesis
imperfecta have teeth that has
abnormal color; yellow, brown or grey.
 Teeth have a higher risk for dental
Abnormalities caries and are hypersensitive to
temperature changes
 Interference during Enamel matrix
 May affect several teeth per patient
formation may cause Enamel
hypoplasia
 Interference during Enamel
maturation may cause Enamel
hypocalcification
 Each condition may be caused by
systemic, local, or hereditary
factors.

ENAMEL HYPOPLASIA

 Defect of the teeth in which the tooth

enamel is hard but thin and deficient in
amount.
 Caused by defective enamel matrix
formation with deficiency in the
cementing substance

ENAMEL HYPOCALCIFICATION

 Refers to the lack of complete

deposition of calcium into the
developing tooth enamel.
 Hypocalcification is actually a form of
hypoplasia.