ENAMEL and AMELOGENESIS

Gt-s3792

SHARON ISIDRO-ALVAREZ, DMD, Ph.D.

Our Lady of Fatima University
College of Dentistry
Amelogenesis
 Oral
epithelium
IDE =
ameloblasts =
enamel

Dental
lamina
Dental
organ Tooth
bud
Differentiation of ameloblasts
• Epithelial product – IDE
• From cusp tips and
incisal edges
• Dentinogenesis must
occur first
• Amelogenesis, 2 steps:
o Formation of organic
matrix
o Maturation of matrix
Epithelial product - IDE
Inner dental epithelial cells before enamel
formation
• Low columnar cells
• Nuclei at center of cells
• Nutrition is from the
blood vessels in the
dental sac and dental
papilla
The dental organ

• ODE, SR, SI:

form a stratified layer adjacent to

ameloblasts
Nutritional status of ameloblasts
during enamel formation
• There is poor nutritive supply
• Stored glycogen is used for nourishing cells of
IDE
• Cells of stratum intermedium exhibit intense
alkaline phosphatase activity
Formation of enamel matrix
• Organic + inorganic component
• Organic = enamel protein
 Enamel Protein
1. Amelogenin 2. Non-Amelogenins
22-30 kDa Enamelin, ameloblastin, tuftelin
Hydrophobic 48-70kDa
Rich in proline, histidine and Acidic
glutamine
Glutamic acid, aspartic acid,
Flows under pressure
serine
(thixotrophy)
90% of enamel protein
Single gene on X chromosome
codes for it
Contins TRAP
 Amelogenesis
1. Morphogenetic Stage
– Bell stage
– IDE are low columnar cells
or cuboidal
– Nuclei are centrally located
– Golgi elements are in
proximal part of cells (near
SI)
– Mitochondria and other
cell elements are scattered
throughout the cells
 Amelogenesis
2. Differentiation stage
– IDE ------ ameloblasts (polarized cell)
– Cells elongate
– Nuclei shifts proximally
– GI complex increase in number and
migrate centrally
– RER – increases
– Mitochondria – proximal region
– (+) junctional complexes
– Basal lamina disintergrates
 Amelogenesis
3. Secretory stage
– Tomes process forms as the first
layer of enamel is deposited on
dentin surface
– Secretion: first site – proximal part
of process (enamel matrix wall is
formed)
– Second site- on the pit where
tomes process fits
 Amelogenesis
3. Secretory stage
– Protein syntheis in RER
– Protein is passed to Golgi complex
– IN golgi complex, protein is
condensed, and packaged into
membrane bound secretory granules
– Packed protein migrate to distal end
of cell
– Contents are released
 Amelogenesis
4. Maturation stage
– Ameloblasts with ruffled border
– Ameloblasts with smooth
border
Mineralization and Maturation
• The secreted enamel protein is almost
instantly becomes mineralized
• Enamel protein is directly deposited onto
mineralized dentin
• Initial mineralization : nucleation from the
apatite crystals located within the dentin
Mineralization and Maturation
• Initial mineralization : nucleation from the
apatite crystals located within the dentin
• Crystal growth progresses rapidly and and
matrix becomes 30% mineralized.
• Influx of mineral and removal of protein
 Amelogenesis
5. Protective stage
– Hemidesmosomes
Postsecretory ameloblasts
• Shortens
• Lose their Tomes
process
• Becomes involved in
enamel maturation
• After enamel
maturation, it joins
the stratified layer to
form REDUCED
ENAMEL EPITHELIUM
 Reduced enamel epithelium
• Protects enamel before tooth eruption
• If it breaks, cells of dental sac will come in
contact with the enamel, and cementum will
form on enamel surface
 Amelogenesis
5. Desmolytic stage
• The reduced enamel epithelium proliferates and
induce atrophy of the connective tissue
separating it from the oral epithelium, so that
fusion of the two epithelia can occur (
• the epithelial cells elaborate enzymes that are
able to destroy connective
tissue fibers by desmolysis.
 PHYSICAL CHARACTERSTICS
THICKNESS
• cusps of human molars and
premolars: thickness of
about 2 to 2.5mm,
• thinning down to almost a
knife edge at the neck of
the tooth.
 PHYSICAL CHARACTERSTICS
THICKNESS
• thicker in the lingual
surfaces of maxillary molars
and in the buccal surfaces
of mandibular
molars(supporting cusps)
 PHYSICAL CHARACTERSTICS
• It is the hardest calcified tissue
in the human body.

• It is brittle in nature.

• specific gravity : 2.8.

• Khn: 343

• color: white to grayish white,

Translucent enamel
• Incisal areas may have a
bluish tinge where the
thin edge consists only of
a double layer of enamel.

• Acts like a
semipermeable
membrane, permitting
complete or partial
passage of certain
molecules:

29
• The function of enamel is to form a resistant
covering of the teeth, rendering them suitable
for mastication.

30
31
 CHEMICAL PROPERTIES
• Highly mineralized
crystalline structure 95-98%
inorganic matter by weight;
hydroxyapatite (HA) is
largest mineral constituent
(in hexagonal
configuration).
• 4% by weight organic
content and water .
• Proteins have high
percentages of serine,
glutamic acid and glycine.
 STRUCTURE
• The enamel is composed
of enamel rods or prisms,
rod sheaths, and in some
regions a cementing
interprismatic substance.

• The number of enamel

rods ranges from 5 million
in the lower lateral
incisors to 12 million in
the upper first molars.
33
 ROD SHEATH
• A NARROW SPACE THAT
CONTAINS ORGANIC MATTER,
FOUND AROUND THE
PERIPHERY OF THE ROD AND
IN BETWEEN ROD AND
INTERROD SUBSTANCE

• DARKER THAN THE ROD

• ACID-RESISTANT

• LESS CALCIFIED THE ROD

34
Enamel rods
 Direction of rods
Ò From the dentinoenamel junction the rods run somewhat
tortuous courses outward to the surface of the tooth.

Ò The length of most rods is greater than the thickness of enamel

because of the oblique direction & the wavy course of the rods.

36
• The rods located in the cusps, the thickest part of the enamel, are
longer than those at the cervical areas of the teeth.

• THE diameter of the rod averages 4 um.

• The diameter of the rods increases from the dentinoenamel
junction toward the surface of the enamel at a ratio of about 1:2.

37
• Have a clear crystalline
appearance.

• In cross section under

light microscope they
occasionally appear
hexagonal.

• In cross sections of
human enamel, many
rods resemble fish
scales.
Histological slide prepared and provided by
the Department of Biomedical Sciences,
38
University of Maryland, Dental School.
• During amelogenesis,
each head is formed by a
single ameloblast and
three other ameloblasts
participate in the
formation of the tail.

• The head is believed to

be the actual enamel
rod, whereas the tail is
considered to be
interrod enamel.

Histological slide prepared and provided by

the Department of Biomedical Sciences,
39
University of Maryland, Dental School.
40
 SUBMICROSCOPIC STRUCTURE
Ò The most common
pattern is a key-hole or
paddle-shaped prism in
human enamel.

Ò The rods measure about 5

um in breadth & 9 um in
length.

Ò The bodies of the rods are

near to the occlusal &
incisal surfaces, whereas
the tails point cervically. 41
KEY HOLE SHAPED ENAMEL ROD

42
 CROSS STRIATIONS
• Each enamel rod is built up of
segments separated by dark lines
that give it a striated appearance
• THEY demarcate rod segments
and become more visible by the
action of mild acids.
• more pronounced in enamel that
is insufficiently calcified. The rods
are segmented because the
enamel matrix is formed in a
rhythmic manner.
• these segments seem to be a
uniform length of about 4 μm.
43
 LAYER OF PRISMLESS ENAMEL,
2O-40MM THICK
• Found in 70% of permanent teeth and all deciduous teeth.
• structureless enamel is found least often over the cusp tips and most
commonly toward the cervical areas of the enamel surface.
• surface layer
• no prism outlines are visible
• all of the apatite crystals are parallel to one another and
perpendicular to the striae of Retzius
• more heavily mineralized

44
 DIRECTION OF RODS
• The rods are oriented at right angles to the dentin surface.

• In the cervical & central parts of the crown of a deciduous

tooth, they are approximately horizontal.

45
 DIRECTION OF RODS
• Near the incisal edge or tip of cusps they change gradually
to an increasingly oblique direction until they are almost
vertical in the region of the edge or tip of the cusps.

46
 GNARLED ENAMEL

Under cusp tips and incisal edges, the bundles of rods seem
to intertwine more irregularly, forming the GNARLED
ENAMEL.
• An adaptation for functional demands.
47
 HUNTER- SCHREGER BANDS

• These are alternating dark and

light strips of varying widths
seen in longitudinal ground
section.
1. DARK ZONE – diazones
(rods that are cut longitudinally)

2. LIGHT ZONE –parazones

(rods that are cut transverselly)
48
 HUNTER- SCHREGER BANDS
žregular change in the
direction of rods may be
regarded as a functional
adaptation, minimizing the
risk of cleavage in the axial
direction under the influence
of occlusal masticatory forces.

žThe change in the direction

of rods is responsible for the
appearance of the Hunter-
Schreger bands. 49
 INCREMENTAL LINES OF RETZIUS
• Appear as brownish bands in
ground sections of the enamel.

• Illustrate the successive

apposition of layers of enamel
during the formation of crown.

50
 INCREMENTAL
INCREMENTAL LINES OFRETZIUS
LINES OF RETZIUS
žIn longitudinal sections
they surround the tip of the
dentin.
žIn cervical parts of the
crown they run obliquely.
žFrom the dentinoenamel
junction to the surface they
deviate occlusally.
žIn transverse sections of a
tooth, they appear as
concentric circles.
51
INCREMENTAL LINES OF RETZIUS
 PERIKYMATA
PERIKYMATA
žThey are transverse, wavelike
grooves, believed to be the external
manifestations of the striae of retzius.

žThey are continuous around a tooth

& usually lie parallel to each other &
to the cementoenamel junction.

žTheir course is usually fairly regular,

but in the cervical region it may be
quite irregular.
53
The surface of the enamel
appears very uneven:

• Pits: (depression) of about 1–

1.5 μm in diameter
– represent the ends of ameloblast

• enamel caps : elevations of

about 10–15 μm
– due to enamel deposition
onnonmineralizable debris.

enamel brochs: Larger enamel

elevations 54
• The enamel of the deciduous tooth develops partly before & partly after
birth.

• The boundary between the two portions of enamel in the deciduous teeth
is marked by an accentuated incremental line of retzius, the neonatal line
or neonatal ring.

• Because of the undisturbed & even development of the enamel prior to

birth, perikymata are absent in the occlusal parts of the deciduous teeth,
whereas they are present in the postnatal cervical parts.

55
Histology of Enamel

**A Striae of Retzius is located

between the two arrows.

Histological slide prepared and provided by

the Department of Biomedical Sciences,
University of Maryland, Dental School.
 Dentinoenamel Junction (DEJ)
• The DEJ is scalloped
so that the
convexity of the
enamel fits into the
concavity of dentin.
• Several structures
are evident at the
DEJ: enamel
spindles, enamel Histological slide prepared and provided by the
tufts, and enamel Department of Biomedical Sciences, University
of Maryland, Dental School.

lamellae.
 Tufts and Enamel Lamella
– Enamel spindles are short spindle-like structures that are the ends of dentinal
tubules that are trapped in enamel.
– Enamel tufts are hypocalcified enamel rods that resemble tufts of grass.
– Enamel lamellae, hypocalcified enamel rods, are of two types, false and true.
• False enamel lamellae are cracks in enamel and frequently extend into the
dentin.
• True enamel lamellae are hypocalcified enamel rods that are poorly
calcified or uncalcified due to developmental disturbances affecting the
ameloblasts.

Enamel
Spindle
Enamel
Tuft

Histological slide prepared and

provided by the Department of
Biomedical Sciences, University of
Maryland, Dental School.
 ENAMEL LAMELLAE
• Thin leaf like structures that extend
from the enamel surface toward the
dentinoenamel junction.

• May sometimes extend to dentin.

• Consist of organic material, with but

little mineral content.

• Develop in planes of tension.

60
• Three types of lamella are :-

- Type A: lamellae composed of poorly calcified rod

segments.

- Type B: lamellae consisting of degenerated cells.

- Type C: lamellae arising in erupted teeth where the cracks

are filled with organic matter, presumably originating from
saliva.

• May be a site of weakness in a tooth & may form a road of

entry for bacteria that initiate caries. 61
62
 Tufts and Enamel Lamella

Image reprinted from the Leeds University: The Virtual Oral Histology
Laboratory
 Enamel Lamellae

False Enamel Lamella True Enamel Lamella

 ENAMEL TUFTS
• Arise at the dentinoenamel junction &
reach into the enamel (1/5-1/3 of the
thickness of enamel)

• Resemble tufts of grass when viewed in

ground sections.

• Is a narrow, ribbon like structure.

• Consists of hypocalcified enamel rods &

interprismatic substance.

• Act to prevent enamel fractures, stress-

shielding to increase compliance with
dentin.
65
66
ENAMEL SPINDLES

Club-shaped, short,
stubby processes that
form as odontoblastic
processes pass across the
dentinoenamel junction
into the enamel

67
 DENTINOENAMEL JUNCTION
žThe surface of the dentin at the dentinoenamel
junction is pitted.

žInto the shallow depressions of the dentin fit rounded

projections of the enamel.

žThis relation assures the firm hold of enamel cap on

dentin.

žIs scalloped.

žThe convexities of the scallops are directed toward the

dentin. 68
69
 Clinical considerations
• Ameloblasts are lost after the enamel has
been laid down.

• Hypoplasia and Hypocalcification.

• Developmental disturbances like

amelogenesis imperfecta.

70
 Clinical Significance of Fluoride:
Benefit vs. Risk

• When the fluoride ion is

incorporated into the
hydroxyapatite crystals during
mineralization the resulting
enamel is more resistant to acid.
This is one aspect of the role of
Fluoride in caries prevention.
• However, ameloblasts are very
sensitive to Fluoride ions and
high (above 5 parts/
million=Fluorosis) levels of
fluoride can disturb or kill
ameloblasts causing malformed
enamel or “mottled” enamel.

Images complements of Dr. Glen Minah

 Clinical Significance: Trauma and High Fever
During Enamel Formation
• Trauma to primary teeth can cause damage to the developing permanent tooth
and result in an enamel defect.
• Childhood diseases causing high temperatures can disturb amelogenesis for the
period of illness and cause a band of poorly formed enamel known as
chronologic enamel hypoplasia.

**Note line of
hypoplasia
across anterior
teeth, esp.
noticeable on
maxillary lateral
incisors and
mandibular
canines.
 Age changes
• Discoloration
• Reduced permeability
• Toothwear
• Thinning