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Oral embryology and histology
misc. for final: dentin, pulp, cementum, salivary glands, enamel, and inflammation
205
Dentistry
Undergraduate 3
04/29/2014

Additional Dentistry Flashcards

 


 

Cards

Term
what is the most mineral portion of enamel
Definition
calcium hydroxyapetite
Term
when talking about dentin, where are the head and tail of the odontoblasts and what do they do?
Definition

head in pulp, tail in tubule

transmits pain messages and repairs

Term
what is the main job of PMNs?
Definition
phagocytosis (most prominent are neutrophils)
Term
at the JE where are cells the thickest?
Definition
at the floor 15-30
Term
what is the main job of the JE?
Definition
seal off  between soft gingival tissues and hard tooth surface
Term
name some factors that can affect probe readings
Definition

pressure of operator

technique

inflammation, discomfort, calculus

Term
as the cells of the JE die where do they go?
Definition
dead cells from JE go into sulcus
Term
how do new cells of the JE replace old cells?
Definition

they undergo change in deep layer

 

then they enlarge and migrate to surface

 

they remain immature until they die

Term
what has the highest cell renewal rate in the whole body?
Definition
the JE has highest renewal rate in body
Term
how is the JE developed?
Definition

-ameloblast secretes basil lamina

 

-basal lamina serves as portion of primary epithelium

 

-as the tooth erupts, the fused reduced enamel epithelium and surrounding epithelial tissues peel back.

 

-the cervical portion is attached to neck of the tooth by primary  epithelial attachment

 

-happens at CEJ and is the initial attachment of primary attachment

 

it takes 3-4 yrs to create JE after the root is formed

 

then basil lamina and hemidesmomes create secondary JE

Term
where does the initial attachment of the primary epithelial attachment happen
Definition
at neck of the tooth (CEJ)
Term
what is the most common cell in lamina propria?
Definition
fibroblasts are most common cell in lamina propria
Term
period of tooth development is called?
Definition
odontogenesis
Term
what are the stages of tooth development?
Definition

initiation stage

Bud stage

cap stage

bell's stage

 

Term
when does the initiation stage begin? tooth development
Definition
initiation stage begins at 6 weeks
Term
during the initation stage what separates the ectoderm and the mesenchymal tissue?
Definition
basement membrane separates ectoderm and mesenchymal tissue
Term
what is the dental lamina?
Definition

future curved dental arches of primary dentition

 

starts from midline for both arches and progresses posteriorly

Term
supernumerary teeth and anodontia (associated with ectodermal displasia) could occur during which stage of tooth formation?
Definition
initiation stage
Term
what stage follows the initiation stage and begins at week 8> and involves proliferation of dental lamina to buds or oval masses?
Definition
bud stage
Term
what are some problems that could occur in bud stage?
Definition

macrodontia

 

microdontia

Term
what stage follows the bud stage and begins at weeks 9/10 where a cap begins to develop and is attached to dental lamina
Definition
caps stage
Term
what occurs in the caps stage
Definition
differentiation and morphogenesis occur in caps stage
Term
from what tissue is enamel derived from?
Definition
the ectoderm is the tissue that creates enamel
Term
from what cells does enamel come from
Definition
ameloblasts
Term
what will the dental papilla become>?
Definition
dentin/pulp
Term
what will the dentinal sac become>
Definition
alveolar bone and blood supply, pdls peridontium
Term
what is the tissue of origin for the enamel tissue?
Definition
the IEE inner enamel epithelium
Term
what makes the dental papilla that will eventually become dentin/pulp>? specifically what tissue?
Definition
mesenchymal tissue makes the dental papilla
Term
what is the protective layer for enamel organ?
Definition
the OEE outer enamel epithelium
Term
what is the cushion between the IEE and OEE during the caps stage?
Definition
stellate reticulum is the cushion and provides nourishment
Term
what is the future DEJ? that separates enamel and dentin?
Definition
the basement membrane is future DEJ
Term
what are the builing blocks of dentin?
Definition
odontoblasts
Term
mesenchymal tissue condenses in the caps stage to produce the dental sac what will this make?
Definition
peridontium, cementum, PDL, alveolar bone
Term
what are the 3 layers of the caps stage?
Definition

enamel organ

 

dental papilla

 

dental sac

Term
what are some things that could go wrong in caps stage?
Definition

dens in dente (enamel invaginates into dental papilla)

 

germination- single tooth unsucessfully tries to divide into two

 

fusion-union of 2 tooth germs

 

tubercles-extra cusps

 

Term
during weeks 11 and 12 of the tooth formation stages layers begin to form, the IEE, OEE, Stellate reticulum and stratum reticulum.  what stage is this
Definition
Bell's stage
Term
what type of cells make up the OEE
Definition
cuboidal cella or low columnar cells of enamel organ, it creates a protective layer
Term
what cells are the enamel secreting cells of the IEE?
Definition
ameloblasts, they are cuboidal
Term
what separatest the IEE and the OEE from the dental papilla during the bells stage?
Definition
basement membrane separates the IEE and OEE from the dental papilla.
Term
what is made first, dentin or enamel?
Definition
dentin is made first
Term
what is found in the structure for both enamel and dentin?
Definition
hydroxyapetite crystals that are calcified are found in both enamel and dentin
Term
where do cementoblasts come from?
Definition
cementoblasts come from PDLs
Term
what outlines the enamel rod?
Definition
the enamel sheath outlines the enamel rod
Term
what lays down the enamel in layers perpendicular to cell membrane?
Definition
tomes process
Term
what happens during the mineralization stage
Definition

ameloblasts lay down hydroxyapetite and calcify

 

every 4th day the rod changes

 

lines are created (the pattern around the tooth called stria of retzium)

Term
which direction do the lines of retzius go?
Definition

curve outward and occlusally from the DEJ

 

 

Term
imbrication lines and perikymata come from what lines?
Definition
lines of retzius produce these types of lines
Term
nasmyths membrane
Definition
primary enamel cuticle it is last thing made by ameloblasts stains easily
Term
what is created after nasmyths membrane is produced and flattened and blend with IEE and OEE?
Definition
reduced enamel epithelium
Term
hypocalcified enamel would appear as
Definition

spots white to yellow

 

from insufficient growth of enamel, or crystals not packed together tight enough

Term
what enamel appears normal but thin and can be yellow to gray?
Definition
hypoplastic enamel
Term
cracks in enamel due to development problems are called
Definition
enamel lamellae
Term
enamel tuft
Definition
enamel extends into dentin
Term
enamel spindle
Definition
odontoblasts (that make dentin) migrated to the enamel side
Term
what is formed first the root or the crown?
Definition
crown develops first
Term
what is the 1st step in root development?
Definition
cervical loop - a bilayer rim of IEE and OEE grows deep into mesenchymal tissue of dentinal sac.
Term
what does the cervical loop create that ultimately designs the root?
Definition
Hertwigs sheath
Term
the hertwigs sheath surrounds the
Definition
dental papilla (dentin/pulp)
Term

what material makes up most of the tooth?

enamel, dentin, cementum?

Definition
dentin is most prominent in tooth
Term
what happens on the outside of the herwigs sheath
Definition
odontoblasts secrete dentin
Term
what is important about stellate reticulum of root formation
Definition

there is no stellate reticulum in root.

 

without it enamel cannot form

Term
what can happen if the hertwigs sheath does not dissinigrate?
Definition
rests of malssez could become a cyst around 3rd molars, and mandibular canines, must remove all cells and could cause fractured jaw.
Term
what do you call a lost ameloblast on the root?
Definition
enamel pearl
Term
what are mature cementum cells
Definition
cementocytes.
Term
what do you call where cementum meets dentin?
Definition
dentinocemental junction
Term
what are some developmental disturbances of the cementum?
Definition

concrescence-union of roots (common in maxillary molars) 

could have been cause by trauma

Term
what type of tissue forms the pdls
Definition
mesenchymal tissue forms PDLs
Term
what is responsible for differentiation in roots (splits)
Definition
hertwigs sheath is responsible for roots dividing into multi rooted tooth
Term
dilaceration
Definition
distortion of hertwigs sheath due to pressure or trauma
Term
what is the inflammatory response as a result of tissue disinigration in primary tooth eruption?
Definition
teething
Term
eruption
Definition
when a tooth erupts coronal to the portion of fused tissue peels ack of the crown but fuses at the CEJ which will later become functional epithelium
Term
exfoliation
Definition
osteoclasts absorb the alveolar bone between teeth (primary and permanent) with causes resorption and the osteoblasts produce new bone.
Term
what does the REE fuse with to form erupt permanent teeth?
Definition
oral epithelum
Term
are newly erupted teeth anchored in bone?
Definition
no it takes years for the root to complete until then they are not anchored to bone.
Term
what type of cyst can form if hertwigs sheath does not dissinigrate and could cause pain, jaw fractures, and neoplastic issues (cancer)
Definition
dentigerous cyst
Term
what type of epithelium is found in oral mucosa
Definition

stratified squamous epithelium

 

 and overlying lamina propria (connective tissue)

Term
what are the 3 main tissues of oral mucosa>
Definition

lining mucosa

masticatory mucosa

specialized mucosa

Term
what are some qualities of lining mucosa?
Definition

softer surface texture

moist

can stretch and compress

Term
what are some things in the mouth that are keratinized?
Definition
tongue, attached tissue, and hard palate
Term
what is responsible for stippling?
Definition
lamina propria
Term
name the specific areas that are lining mucosa in the mouth?
Definition

-buccal

-labial

-alveolar below MG line

-lining of floor of mouth

-ventral surface of tongue

-soft palate

Term
is lining mucosa keratinized?
Definition

no lining mucosa is not keratinized.

 

 the interface between lamina propria is smoother (fewer, less pronounced rete ridges)

Term
what are yellowish elevations found on lining mucosa such as the buccal or labial mucosa?
Definition

fordyce spots

 

from deposits of sebum in sebaceous glands

Term
describe masticatory mucosa ? features
Definition

rubber surface texture

and resilient

Term
what are the specific areas that are considered masticatory mucosa?
Definition

attached gingiva

hard palate

dorsal surface of tongue

 

ALL ARE KERATINIZED

Term
would you find rete pegs in masticatory mucosa
Definition
absolutely keratinized tissue tends to have more rete pegs
Term
what are considered specialized mucosa?
Definition
dorsal and lateral surfaces of tongeue in the form of lateral papillae
Term
what oral mucosa is considered orthokeratinized?
Definition
masticatory mucosa
Term
where would you find parakeratinized tissue?
Definition
on lateral sides of tongue
Term
what happens at the basal layer (deepest) of stratified squamous epithelium?
Definition
mitosis where new cells form
Term
what happens at the intermediate layer of stratified squamous epithelium?
Definition
mature cells
Term
what happens at the superficial layer of stratified squamous epithelium?
Definition
cells shed
Term
what is the least common form of epithelium
Definition
orthokeratinized stratified squamous epithelium: includes tongue, hard palate, and attached gingival
Term
the orthokeratinized stratified squamous epithelium consists of 4 layers what are they?
Definition

-basal layer-mitosis is deepest

 

-prickle layer or stratum spinosum

 

-granular layer or stratum granulosum (flat and stacked 3-5 cells thick)

 

-keratin layer or stratum corneum (this goes away in disease bleeds easily and looks shiny but can come back)

Term
what is keratin?
Definition
cytoplasm filled with keratin, a soft white waterproof material
Term
how many layers are in parakeratinized stratified squamous epithelium.
Definition

4 same layers as orthokeratinized.

 

basal

prickle

granular

keratin

Term
what is the main difference between parakeratinized and orthokeratinized.
Definition
keratin layer of parakeratinized epithelium the cells get shed or lost.
Term
what is the main fiber of lamina propria
Definition
collagen fibers
Term
what are the 2 layers of lamina propria?
Definition
papillary and dense
Term
what is the blood supply to the lamina propria
Definition
capillary plexus it is found between the papillary and dense layers
Term
describe attached gingiva
Definition

masticatory mucosa

keratinized

opaque, could have melanin

dull, firm, immobile

stippling

Term
where are lingual papillae found?
Definition

on surfaces of the tongue

 

filiform

fungiform

follate

circumvallate

Term
what lingual papillae are associated with taste
Definition

-fungiform

-foliate

-circumvallate

 

taste buds extend from basement membrane to epithelial surface of lingual papillae. there are 30-80 spindle shaped cells.  

 

sensory neurons send info to CNS

Term
what is the most common form of lingual papillae?
Definition

filiform is most common. found on dorsal of tongue.

 

shaped like fine point cones (look spiky on microscope)

Term
on what form of lingual papillae are taste buds not present?
Definition
filiform no taste buds
Term
what is mushroom shaped and appears as reddish dots on tongue?
Definition
fungiform
Term
what are leaf shaped lingual papillae that are 4-11 verticle ridges parallel to each other on lateral surface of tongue?
Definition
foliate lingual papillae
Term
which are large mushroom shaped raised lingual papillae that form and inverted V shape facing pharynx?
Definition
circumvallate papillae
Term
what are the salivary glands that are just behind the circumvallate papillae that flush saliva ?
Definition
von ebners
Term
geographic tongue involves mostly what papillae
Definition
filiform papillae are changing in geographic tongue
Term
what are the renewal rates of repair in oral mucosa?
Definition

-4-6 days in sulcus

 

-10-14 days in buccal mucosa

Term
what happens during the repair process
Definition

blood clots inflammatory response

 

WBC triggers

 

clots act as guide to form new surfaces

 

fibroblasts migrate to produce new immature connective tissue

 

granulation is immature connective tissue

 

less fibroblasts more blood vessels in granulation

 

scar tissue gets more fibroblasts and less blood vessels

Term
what are some things that affect oral mucosa with age
Definition

-dry

-less rete ridges

-less fibroblasts

-recession

-less definition with lamina propria

-low collagen turnover

-increase in fordyce spots

-less taste bud

Term
col
Definition
concave gingiva between buccal and lingual, it is always nonkeratinized!!
Term
how is the col affected if there is no contact area?
Definition
attached gingiva extends uninterupted from facial to lingual
Term
what extends from the marginal gingiva to the JE?
Definition
free gingival crest, it is what we measure when probing
Term
characteristics of attached gingiva
Definition

-attach to bone

-pink when healthy

-dull when dry

-firm

-immobile

Term
the interdental papillae of anterior vs. posterior?
Definition

anterior-cone shaped

 

posterior-blunted

Term
what separates the attached and free gingiva with slight depression?
Definition

free gingival groove

 

it can be translucent

Term
characteristics of free marginal gingiva
Definition

-pink when healthy

-dull

-firm

-lacks stippling

-mobile

Term
what is the histological description of attached gingiva?
Definition
parakeratinized, stratified squamous epithelium
Term
what are some drugs that can cause gingival overgrowth?
Definition

dilantin

cyclosporin

calcium channel blockers (verapmil, diltiazem, nifedipin)

 

nifedipin or procardia is the worst offender!!!!

Term
the tissue that faces the tooth is called?
Definition
dentogingival junction it is in the sulcus JE
Term
where does gingival fluid come from
Definition
epithelial cells and seeps into sulcus
Term
what does gingival fluid do?
Definition
allows WBC to reach sulcus and allows antibodies in
Term
after crevicular fluid goes in sulcus, where does it go?
Definition
oral cavity
Term
what are some characteristics of the dentogingival tissue?
Definition

stratified squamous epithelium

nonkeratinized

tight packed cells

no rete ridges

Term
what are the stages of secondary attachment of the JE?
Definition

stage 1 JE on enamel

 

Stage 2 JE enamel and a bit of cementum (long stage)

 

stage 3 JE on CEJ (long stage)

 

stage 4 JE apical to CEJ (pathological ginigival recession)

Term
what are some signs of acute inflammation?
Definition

ulcerations of JE

 

thinning of JE

 

lamina propria breakdown of collagen fibers

 

BOP

Term
when inflammation is increased what changes can occur in lamina propria?
Definition

increase blood vessels (PMNs for phagocytosis)

 

increase crevicular fluid (antibodies and WBCs)

Term
what is the technical name for crevicular fluid? qualities?
Definition

supperative fluid

 

dead and alive pmns

 

and dead cells

Term
what is a rinse used to diminish inflammation
Definition

periostat/doxycyline/ tetracylinel low dose

 works by attacking enzymes in inflammation

Term
what is an anti inflammatory rinse mixed chairside and delivered into sulcus?
Definition
atridox
Term
what is a minocyline that is time released over 21 days and patients should not floss after placement?
Definition
arestin
Term
according to the book je should heal in
Definition
1 week
Term
according to book patient should come back for a re-eval in
Definition
10-14 days
Term
standard of care requires re eval for class IV patients when
Definition
3-4 weeks
Term
what is the main difference between endocrine glands and exocrine glands?
Definition
exocrine has ducts
Term
is thyroid endocrine or exocrine?
Definition
thyroid is and endocrine gland
Term
for endocrine glands (ductless) where does secretion go??
Definition
in blood
Term
for exocrine gland, where does secretion go
Definition
where it will be used example parotid, stensons duct salive
Term
functions of saliva
Definition

-lubricates

-cleanses

-buffers

-enzyme activity for digestion

-antibacterial

-integrity

-pellicl formation (glycoprotiens provide nidus for bacteria)

Term
what are the 2 types of saliva?
Definition

serous: protien enzymes

 

mucus : mainly carbohydrate fluid

 

 

Term
what controls the serous and mucous saliva?
Definition
autonomic nervous system
Term
contents in saliva
Definition

-minerals

-enzymes

-buffers

-electrolytes

-IGA (make more when laugh)

metabolic waste

Term
what are the 3 major salivary glands
Definition

parotid

submandibular

sublingual

Term
what type of saliva is secreted and how much in the largest of all the salivary glands?
Definition

serous saliva

 

25%  in parotid the largest salivary gland

Term
what is the 2nd largest salivary gland, % volume and type of saliva
Definition
submandibular: 60-65% beneath mandible and submandibular fossa, a mix of serous and mucous saliva.
Term
what is the submandibular duct?
Definition
whartons
Term
what is the smallest salivary gland % volume and type of saliva
Definition

sublingual: 10% 

mix of serous and mucous

found in sublingual fossa

Term
what is the duct for sublingual gland?
Definition
bartholins duct
Term
the von ebners is located where, and contain  what type of saliva?
Definition
behind cirvumvallate papillae and is serous
Term
what is the appearance of mucous salivary glands
Definition
cloudy cytoplasm
Term
serous has what color cytoplasm
Definition
clear cytoplasm
Term
xerostomia can happen because of
Definition

radiation

 

age

 

drugs

Term
what are some treatments for xerostomia
Definition

flouride

 

artificial lubricant

 

avoid alcohol

 

frequent recall

Term
a blocked saliva gland due to a stone
Definition
mucocele
Term
swelling due to retention of saliva that cannot flow out (most common in submandibular and sublingual glands)
Definition
ranula
Term
inflammation of duct due to smoking it looks like red dots on palate
Definition
nicotine stomatitis
Term
what is the largest endocrine gland?
Definition
thyroid is the largest endocrine gland
Term
thyroid secretes what
Definition
thyroxin
Term
what does thyroid control
Definition

metabolic rate

 

when underproducting it is hypothyroid

 

when overproducing it is hyperthyroid

Term
location of thyroidd
Definition

anterior portion of neck two lateral lobes connected by isthmus.

 

develops from mesenchymal tissue at the 24th day and originates from the foramen cecum

Term
what is shaped like a bean, and forms in clusters and filters toxins to prevent entry in blood stream
Definition
lymphatic system
Term
what do tonsils contain
Definition
lymphocytes that remove toxins
Term
goblet cells
Definition

found in epithelium

 

surrounded by mucous and serous glands

 

rest on basement membrane

 

keep surface moist and provide humidity

 

they trap foreign materials

Term
what are some problems with sinuses?
Definition

abcess with maxillary molars

 

sinusitis

 

nitrous oxide

 

extracted molars

Term
characteristics of enamel
Definition

avascular

 

no nerves

 

hardest calcified tissue

 

 if lost then lost forever!!!

Term
where does the tomes process start laying enamel down on tooth
Definition
starts at incisal edge
Term
how many ameloblast make the head and tail of enamel (keyhole, fish shape)
Definition
3 make tail, one makes head
Term
the enamel side of matrix in concave, so the dentin side is
Definition
convex
Term
the line found on all primary teeth formed during birth process?
Definition
neonatal line
Term
too much flouride cause
Definition

flourosis

 

enamel dysplasia

 

appears mottled

Term
how much flouride is in water?
Definition
0.7-1 parts per million
Term
tooth tissues hardest to softest
Definition

enamel

 

dentin

 

bone 

 

cementum

Term
when is secondary dentin formed
Definition
after completion of apices
Term
what is the job of the odontoblasts
Definition

provide nutrition

 

pain sensation

 

nucleus of odontoblasts in pulp

 

hydrodynamic theory

Term
circumpulpal dentin
Definition
layer of dentin around pulpal wall
Term
mantle dentin
Definition
1st predentin that forms and matures with tooth very dense
Term
interglobular layer
Definition
unmineralized spots short distances in DEJ
Term
where is tomes granular layer found?
Definition

in root it is a band of minut unmineralized spots beneath cementum

 

Term
reparative dentin
Definition

next to pulpal wall of older teeth

 

less tubules, irregular

Term
what happens to odontoblast of older teeth
Definition

 odontoblasts are shrunk up

 

they are in pulp only

 

 not much sensation transmitted

Term
reparative or secondary dentin happens during
Definition

attrition

caries

operative procedures

damaging stimuli

Term
what is a common spot for reparative dentin to lay
Definition

next to pulp chamber and pulp horns in posteriors

 

incisal edge in anteriors with heavy attrition

Term
tertiary dentin is a response to injury where does it form
Definition

under exposed dentinal tubules

 

caries, cavity prep, attrition, recession

Term
what can happen to odontoblasts in tertiary dentin
Definition
can die and new ones come in from pulp (pulp sends in mesenchymal tissue to become odontoblasts
Term
dentin filled with calciulm salts and no odontoblasts are called
Definition
sclerotic dentin
Term
calcium salts is used as
Definition
defense mechanism
Term
dead tracts
Definition
dentinal tubules with no odontoblasts and no calcium salts
Term
what is the only non mineralized portion of the tooth?
Definition
pulp
Term
what is in pulp
Definition

soft connective tissue (cells, intercellular substance, and tissue fluid)

 

collagen fibers (small)

blood vessels

nerves

denticles (pulp stones)

fibroblasts 

Term
where do nerves enter pulp?
Definition
apical foramen
Term
what are the zones of the pulp?
Definition

-odontoblast zone: outermost layer next to predentin layer, it interprets information.

 

-cell free zone: toward pulp core: acts as buffer

 

cell rich zone: high number of cells, the reservoir that makes new cells

Term
pulp functions
Definition

formative:

 

odontoblasts 

ground subsance

 

Sensory: pain/pressure

 

Nutritive:blood supply 

Defensive: inflamatory, sclerosis of dentin, reparative dentin

 

Term
what are age related changes to pulp?
Definition

reparative dentin makes pulp chamber smaller

 

root canals narrower

 

endo is harder

 

fibrous intercellular changes

 

blood and nerve supply decrease with age

 

denticles larger and more numerous

Term
when cementum meets enamel exactly at CEJ
Definition
30%
Term
when it does not quite meet enamel at CEJ
Definition
10%
Term
when cementum slightly overlaps enamel at CEJ
Definition
60% this is best
Term
when does cementum form
Definition
after dissinigration of hertwigs sheath
Term
what are the functions of cementum
Definition

protect dentin

 

medium for pdl attachment

 

mending tissue @ fracture site

 

forms furcation at apical to compensate for attrition

Term
what are the 2 types of cementum, where are they and which is layed down 1st.
Definition

acellular is 1st

 

cellular is after acellular and at apical 1/3

Term
entrapped cementoblastast are called
Definition
cementocytes
Term
the organic matrix produced by cementoblasts are located
Definition
in pdls
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