DEVELOPMENT OF THE ROOT & PDL

Oral Histology Dent 206

Root development
Some time after enamel completion Interaction between

Dental follicle Epithelial root sheath (of Hertwig)

structure derived from cervical loop region of enamel organ

Dental papilla

Onset coincides with axial phase of tooth eruption

Epithelial root sheath (ERS)

Forms at the late bell stage Amelogenesis and dentinogenesis are welladvanced Double-layered

Internal enamel epithelium External enamel epithelium

No SR or SI Apical proliferation Mapping out the shape of the root Never a continuous sheath disintegration

Enamel Pearl
Localized areas of enamel on root surface Usually in inter-radicular regions of molars Retention of SR & SI inside the doublelayered ERS

ERS in mutli-rooted teeth

Primary apical foramen subdivide into a number of secondary apical foramina Ingrowth of epithelial shelves from the margins of ERS Fuse near the center of the root Number & location of shelves

Corresponds to the number of roots May be under inductive role of dental papilla

Ingrowth is believed to occur along paths of low vascularity

Primary apical foramen

While the root is being formed

Apex is wide open, surrounded by: Thin regular knife edge of dentine Erupts with about 2/3s of formed root Needs 3 or more years before root completion

A permanent tooth

By root completion, the wide apical foramen becomes very narrow Only wide to transmit the neurovascular bundle

Growth of ERS

Occurs apically Encloses dental papilla

Except at primary apical foramen

Margin of ERS is angled internally to form

Root diaphragm Lies external to ERS Forms cementum, PDL & alveolar bone

Dental follicle

Root diaphragm
The angled edge of ERS A circular band Sandwiched between the undifferentiated mesenchyme of

Dental papilla Dental follicle

Commencement of root dentinogenesis

Cells of internal layer of ERS

Induce peripheral cells of dental papilla Differentiate into odontoblasts Root dentine is deposited

Commencement of cementogenesis
Root dentine is deposited ERS cells lose continuity

Form epithelial rests (of Malassez) in PDL

Root dentine is exposed to the undifferentiated cells of the dental follicle Differentiate into cementoblasts Cementogenesis

Dental follicle near the diaphragm

3 layers

Inner investing layer

Ectomesenchymal neural crest Cells differentiate into cementoblasts Cuboidal cells on root dentine surface Mesodermal origin Cells differentiate into fibroblasts Forming PDL Mesodermal origin Cells differentiate into osteoblasts Forming alveolar bone

Intermediate layer

Outer layer

DF after commencement of cementogensis

Follicular cells are obliquely oriented along the root surface Become the fibroblasts of PDL Fibroblasts secrete collagen which become embedded in developing cementum and alveolar bone (Sharpys fibers)

Root completion

When the final root length is achieved, the proliferation of epithelium in the diaphragm lags behind that of the pulp or connective tissue The wide apical foramen is reduced first

to the width of the diaphragmatic opening itself further narrowed by apposition of dentine and cementum at the apex of the root

Accessory root canals

If continuity of root sheath is broken or not established prior to dentine formation a defect in the dentinal wall of the pulp occurs

Root elongation & tooth eruption

Root growth theory of eruption

Changes in apical connective tissue Old view - cushion hammock ligament

Fibrous with fluid filled interstices Attachment on either sides to alveolar bone Resistant base prevents bone resorption eruptive force

Root growth theory of eruption

Current view pulp limiting membrane

No attachment to alveolar bone But merges with developing PDL Surgical removal no effect on eruption Changes in vascular permeability Dense accumulation of tissue fluid Fluid force bone and root apart Contribution to eruption

Theory

Formation of principal PDL fibers

Stage 1 before eruption

PDL loosely structured collagenous elements Permanent molars

Dentogingival

& oblique fibers are organized

Premaloars
Only

dentogingival fibers are well-developed

Formation of principal PDL fibers

Stage 2 tooth penetration

PDL fibers developed but not spanning PDL space Permanent molars

PDL

well-differentiated Oblique fibers

Premolars
Only

alveolar crest fibers are organized

Formation of principal PDL fibers

Stage 3 reaching occlusion

Permanent molars
Fibers

in cervical region are organized

Premolars
Prominent

cervical fibers Undeveloped in apical part of the root

Stage 4 functional

Classical organization of principal fibers

Additional notes on formation of principal PDL fibers

Collagen fibers are only organized in function

Eruptive force caused by traction of collagen in PDL development is debatable

Change in obliquity & thickness of fibers as the tooth reaches the functional position
Inclination decreases Thickness with function

Additional notes on formation of principal PDL fibers

During eruption resorption of the bone in the base of the socket is predominant
Bone deposition is not accepted as a cause of eruption However, species differ (deposition in dogs) Bone activity is related to the distance the tooth has to erupt Distance greater than root length deposition

Cementogenesis

Primary (acellular) cementum

Cervical portion of the root

Secondary (cellular) cementum

Apical region of the root Furcation areas

Formation of acellular cementum

Starts cervically and proceeds apically Cells of ERS

Do not enlarge as in enamel organ Separated by a basal lamina on both sides

Induction of root dentinogenesis Odontoblasts retreat inwards Form first-formed root predentine

No odontoblastic process yet Structureless Hyaline layer when fully mineralized

Formation of acellular cementum

ERS in contact with predentine Disintegration of ERS cells Exposure of follicular cells to unmineralized hyaline layer Differentiation into cementoblasts Cementoblasts secrete collagen fibrils

Deep parts of fibrils intermingle with those of the hyaline layer strong union Peripheral parts extend into PDL (fibrous fringe)

Formation of acellular cementum

Mineralization of
Hyaline layer Fibrous fringe

Thus, first formed acellular cementum are firmly attached to root dentine Fibers of PDL are still parallel to root surface & not yet attached to fibrous fringe

Formation of primary (acellular) cementum

Slow increase in thickness of acellular cementum Establishment of continuity between fibrous fringe and PDL fibers Continued slow mineralization of collagen

Types of acellular cementum

Acellular intrinsic fiber cementum

Acellular cementum lining the root before its fringe fibers are linked with those of PDL In permanent teeth, exist until tooth erupts into the mouth

Acellular extrinsic fiber cementum

Acellular cementum lining the root after its fringe fibers are linked with those of PDL Increases in thickness slowly & evenly throughout life

Mineralization in acellular cementum

Presence of crystals is adjacent dentine is believed to initiate mineralization in cementum Adjacent PDL fibroblasts may play a role Very slow process No calcospherites No layer of unmineralized precementum Incremental lines

High content of ground substance Low content of collagen Closer together than in cellular cementum slow formation

Bisphosphonate

Bisphosphonate inhibit cementogenesis

Interferes with mineralization of initial root dentine No mineralization of the hyaline layer No cementogenesis

Acellular afibrillar cementum

A thin layer overlying cervical margin enamel Damaged reduced enamel epithelium Follicle cells contact enamel Differentiation into cementoblasts Cementoblasts secrete afibrillar matrix that calcifies

Secondary (cellular) cementum

Appears at the time of eruption Reflects increase in rate of cementogenesis Early inductive changes are similar to those in acellular cementum Cells of forming cellular cementum

Appear as a distinct layer of basophilic cells (RER active protein synthesis) More cytoplasmic processes

Cellular cementum

Effect of high rate of cementogenesis in cellular cementum

High rate of formation appearance of precementum Less mineralized than acellular cementum Multipolar mode of mineralization cells incorporated within matix cellular appearance of cementum Cementoblasts beomce cementocytes Generation of new cementoblasts at surface Incremental lines more widely spaced

What Can Go Wrong

Cementum will not form if epithelial cells are in contact with dentine

Acellular cementum
Fibres of Periodontal Ligament Epithelial Rests Cementum

Root dentine

Cellular cementum