Dentinogenesis | I neeD moRe Medicine

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Dentinogenesis The odontoblasts that form dentin are differentiated from the ectomesenchymal cells of the dental papilla under the organizing influence of the inner dental epithelium. Dentinogenesis begins at the incisal edge or cusp tips then spreads down the cuspal slopes, toward the cervical region. In multi-cusped teeth, dentin formation begins independently at the sites of each future cusp in a genetically determined pattern, spreads down the cusp slopes, and fuses with adjacent formative centers. Primary dentin formation continues until the external form of the tooth has been completed (till the completion of the root). Dentin formation does not cease however after the normal anatomy of the tooth has been established but continues, although at a much slower rate. This dentin formed after root formation is known as Secondary dentin. Dentinogenesis takes place in two phases: 1) Organic matrix formation : It is the elaboration of the fibers and the ground substance forming the predentin. 2) Mineralization : It involves the calcificatin of the predentin. It begins when a fairly wide band of predentin has been laid down 1) Organic matix formation: After the differentiation of the odontoblasts, the next step in the production of dentin is the formation of the organic matrix. A- Formation of Mantle Dentin: Collagen first appears as very distinct large diameter fibrils-The Von Korff fibrils- (0.1 to 0.2 um in diameter) which aggregate in the structureless ground substance immediately below the basal lamina supporting the inner dental epithelium. The fibrils are aligned at right angles to the basement membrane. In addition to the large diameter fibrils there are small diameter fibrils (of 0.05 urn diameter) formed by the newly differentiated odontoblasts and running randomly between them. These collagen fibrils, together with the ground substance in which they aggregate, constitute the organic matrix of the first formed dentin or mantle dentin. It has been shown that collagen formation begins at the ribosomal sites related to the cisternae of the rough endoplasmic reticulum. Pro-collagen molecules are then passed, via transport vesicles, to the Golgi complex where they are glycosylated and then, in turn, passed to the secretory pole of the cell in distinct transport vesicles. Once secreted, the pro-collagen is aggregated into the visibly banded collagen outside the cell. The ground substance follows a similar synthetic pathway within the odontoblast. The odontoblasts, as they secrete the collagen, are still increasing in size, obliterating the extracellular compartment between them and bringing adjacent odontoblasts into contact. Extensive junctional complexes develop where such contact is made to form a distinct row, or layer, of odotoblasts. The odontoblasts also develop alkaline phosphatase activity along their plasma membranes at this time, an activity probably associated with the transport of calcium into the cell. As the first collagen of the dentin matrix is being deposited, the plasma membranes of the odontoblasts adjacent to the inner enamel epithelium push out several short stubby processes. On occasion, one of these processes may penetrate the basal lamina and interpose itself between the cells of the inner enamel epithelium to form what will later be an enamel spindle. As the odontoblast forms these processes, it also buds off a series of small, membrane-bound vesicles known as matrix vesicles, which come to lie between the large diameter collagen fibrils. As the matrix is formed, the odontoblast begins to move towards the center of the pulp. As it does, one of the short stubby processes becomes accentuated and is left behind to form the principal extension of the cell, the odontoblastic process. It is into this site that apatite crystallites are introduced. They first appear within matrix vesicles as single crystals which grow rapidly and rupture from the confines of the vesicle to spread as a cluster of crystallites until they fuse with adjacent clusters to form small islands that subsequently fuse and form a continuous calcified layer. As the apatite crystallites are deposited, they obscure the collagen fibrils of the matrix. In this way mantle dentin is formed. B-Formation of Circumpulpal Dentin: After mantle dentin has formed, the remaining primary dentin is deposited. This dentin forms the bulk of the tooth and its formation is essentially similar to that of mantle dentin with three notable exceptions. First, the collagen fibrils forming the matrix are much smaller in diameter (0.05 um), are more closely packed and interwoven with each other, and are generally aligned at right angles to the tubules. Second, the ground substance is now an exclusive product of the odontoblast. The organic matrix of the mantle dentin incorporates some preexisting ground substance of the dental papilla. But, because of the close packing of the odontoblast layer, all the ground substance for circumpulpal dentin must originate from these odontoblasts and not from the ground substance of the dental papilla. Third, the pattern of mineralization is slightly different. No matrix vesicles are present as circumpulpal dentin forms. Instead, mineralization spreads from the preexisting mineralized mantle dentin. Organic matrix must always formed before mineral salts can be deposited within it, hence there is always a band of unmineralized dentin, predentin, between the odontoblasts and mineralized dentin. C-Formation of the Peritubular Dentin. The rate of coronal dentin deposition is about 4 to 8 um per day and occurs in a regular or incremental manner. As new dentin is formed, further changes occur within the previously formed dentin. The odontoblastic process diminishes in diameter and is responsible for the deposition of a collar of more highly mineralized dentin around itself in the space so created. This collar of hypermineralized dentin is the peritubular dentin. 2) Mineralization of dentin The initial mineralization of dentin via matrix vesicles has already been described. Continued mineralization of the dentin intertubular matrix results from the deposition of apatite crystallites around and within the collagen fibrils. The crystals are arranged with their long axis paralleling the fibril axes. It has been shown that dentin mineralization follows three different patterns, namely a linear pattern, a globular pattern, and a combination of the two. A- Linear Calcification Linear calcification indicates the deposition of crystals along an uninterrupted front and is the principal pattern of mineralization found in the mantle dentin. B- Globular Calcification. Globular, or calcospheric calcification refers to the deposition of crystals in several areas of the matrix at one time. With continued mineralization, globular masses develop which enlarge and eventually fuse to form a single calcified mass. This type of mineralization is seen principally in the circumpulpal dentin formed just below mantle dentin. C- Combination pattern. In the rest of the circumpulpal dentin a combined pattern of calcification occurs with a globular phase alternating with a linear phase.

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4/10/2012 10:51:48 PM