PHYSICAL CHARACTERSTICS

On the cusps of human molars and premolars the

enamel attains a maximum thickness of about 2 to
2.5mm, thinning down to almost a knife edge at the
neck of the tooth.

It is the hardest calcified tissue in the human body.

It is brittle in nature.

The specific gravity of enamel is 2.8.

The color of the enamel covered crown ranges from

yellowish white to grayish white. 2
 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: C14- labeled urea, I, etc.

The function of enamel is to form a

resistant covering of the teeth, rendering
them suitable for mastication.
3
4
 Consists mainly of inorganic
material (96%) and only a small
amount of organic substance and
water.

The relative space occupied by the

organic framework and the entire
enamel is almost equal.

Proteins have high percentages of

serine, glutamic acid and glycine. 5
 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.

From the dentinoenamel junction the rods run

somewhat tortuous courses outward to the surface of
the tooth.

The length of most rods is greater than the thickness

of enamel because of the oblique direction & the
wavy course of the rods. 6
 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.
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. 7
8
 The most common pattern is a key-hole or paddle-
shaped prism in human enamel.

The rods measure about 5 um in breadth & 9 um in

length.

The bodies of the rods are nearer occlusal & incisal

surfaces, whereas the tails point cervically.

The apatite crystals are oriented parallel to the long axes

of the rods in their bodies or heads & deviate about 65
degrees from their axes as they fan out into the tails of
the prisms.

The rods are segmented because the enamel matrix is

formed in a rhythmic manner. 9
10
11
 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.

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.

If the discs are cut in an oblique plane, the bundles of

rods seem to interwine more irregularly. This optical
appearance of enamel is called gnarled enamel. 12
13
 The more or less regular 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.

The change in the direction of rods is responsible

for the appearance of the Hunter- Schreger bands.

These are alternating dark and light strips of

varying widths seen in longitudinal ground
section.
14
 They originate at the dentinoenamel border and
pass outward, ending at some distance from the
outer enamel surface.

There are variations in calcification of the

enamel that coincide with the distribution of these
bands.

The alternate zones have slightly different

permeability.

Have slightly different content of organic

material. 15
16
 Appear as brownish bands in ground sections
of the enamel.
Illustrate the successive apposition of layers of
enamel during the formation of crown.
In longitudinal sections they surround the tip
of the dentin.
In cervical parts of the crown they run
obliquely.
From the dentinoenamel junction to the
surface they deviate occlusally.
In transverse sections of a tooth, they appear
as concentric circles. 17
18
19
 The incremental lines have been attributed to
- Periodic bending of the enamel rods,
- Variations in the basic organic structure, or to
- Physical calcification rhythm.

The rhythmic alterations of periods of enamel

matrix formation & of rest can be upset by
metabolic disturbances, causing the rest
periods to be unduly prolonged and close together.

Such an abnormal condition is responsible for the

broadening of the incremental lines of
retzius.
20
PERIKYMATA
They are transverse, wavelike grooves,
believed to be the external manifestations of
the striae of retzius.

They are continuous around a tooth & usually

lie parallel to each other & to the
cementoenamel junction.

Their course is usually fairly regular, but in the

cervical region it may be quite irregular. 21
22
23
 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.

24
 Nasmyths membrane or the primary enamel
cuticle covers the entire crown of the newly
erupted tooth.

Is probably soon removed by mastication.

Has wavy course.

Is secreted by the ameloblasts when enamel

formation is completed.

Of no major clinical significance.

25
 Formed after the tooth is in the oral cavity.

Acquired from saliva and the oral flora.

May contain factors which hinder the

attachment of bacteria to tooth surfaces.

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27
 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.

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 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. 29
30
31
 Arise at the dentinoenamel junction & reach
into the 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. 32
33
34
 The surface of the dentin at the dentinoenamel
junction is pitted.

Into the shallow depressions of the dentin fit

rounded projections of the enamel.

This relation assures the firm hold of enamel cap

on dentin.

Is scalloped.

The convexities of the scallops are directed toward

the dentin. 35
36
 Epithelial enamel organ
At the stage preceding the formation of
hard structures (dentin and enamel) the
enamel organ, originating from the
stratified epithelium of the primitive oral
cavity, consists of four distinct layers:
outer enamel epithelium,
stellate reticulum,
stratum intermedium,
inner enamel epithelium (ameloblastic layer)
 Outer enamel epithelium
In the early stages of development of the
enamel organ the outer enamel epithelium
consists of a single layer of cuboid cells,
separated from the surrounding connective
tissue of the dental sac by a delicate
basement membrane
During enamel formation, cells of the outer
enamel epithelium develop villi and
cytoplasmic vesicles and large numbers of
mitochondria, all indicating cell
specialization for the active transport of
materials.
 Stellate reticulum
In the stellate reticulum, which forms the
middle part of the enamel organ, the
neighboring cells are separated by wide
intercellular spaces filled by a large
amount of intercellular substance.
The cells are star shaped, with long
processes reaching in all directions from a
central body
 The structure of the stellate reticulum renders
it resistant and elastic. Therefore it seems
probable that it acts as a buffer against
physical forces that might distort the
conformation of the developing dentinoenamel
junction, giving rise to gross morphologic
changes.
 Stratum intermedium
The cells of the stratum intermedium are
situated between the stellate reticulum
and the inner enamel epithelium.
They are flat to cuboid in shape and are
arranged in one to three layers.
 Inner enamel epithelium
The cells of the inner enamel epithelium
are derived from the basal cell layer of
the oral epithelium.
Before enamel formation begins, these
cells assume a columnar form and
differentiate into ameloblasts that
produce the enamel matrix.
 Cervical loop
At the free border of the enamel organ
the outer and inner enamel epithelial
layers are continuous and reflected into
one another as the cervical loop
When the crown has been formed, the
cells of this portion give rise to Hertwigs
epithelial root sheath
 According to their function, can be
divided into six stages:
1. Morphogenic stage.
2. Organizing stage.
3. Formative stage.
4. Maturative stage.
5. Protective stage.
6. Desmolytic stage.
 Morphogenic stage.
React by differential growth
Produce shape of the crown
Terminal bar appears
Basal lamina separates the inner enamel
epithelium and cells of the dental papilla
Pulpal layer adjacent to the basal lamina
is a cell free zone
At cervical region cell is relatively
undifferentiated
 Organizing stage.

Inner enamel epithelium interact with

the cells of dental papilla which
differentiate into odontoblast
Cells become elongated
Proximal part contain nuclei
Distal end is nucleus free zone
Dentin formation begins
Cell free zone disappear
 As dentine is formed nutrition supply of
the inner enamel epithelium changes
from dental papilla to the capillaries
that surround the outer enamel
epithelium
Reduction and gradual disappearance
of the stellate reticulum
 Formative stage.

Formatve stage starts After the dentine

formation
Enamel matrix formation starts
Development of blunt cell process on
the ameloblast surface which penetrate
the basal lamina and enter the
predentin
 Maturative stage.

Maturation starts after most thickness

of enamel matrix formation in occlusal
and incisal area. In cervical area matrix
formation is still in progress
Ameloblast reduce in length
Cells of stratum intermedium takes
spindle shape
 Protective stage.

After enamel calcification cells on ameloblast

can no longer be differentiated from stratum
intermedium and outer enamel epithelium
These layer forms reduced enamel
epithelium
Protect the enamel from connective
tissue until the tooth erupts, if it
contacts then anomalies develop enamel
may be resorbed or cementum cover may
form (afibrillar cementum)
 Desmolytic stage.

Reduced enamel epithelium induces

atrophy of connective tissue separating
it with oral epithelium thus fusion of
the two epithelia can occur
Premature degeneration of the reduced
enamel epithelium may prevent the
eruption of he tooth
1. Organic matrix formation (follows
incremental pattern brown striae of
Retzius).

2. Mineralization.
a. Amelodentinal membrane.

b. Development of Tomes processes.

c. Distal terminal bars.

d. Ameloblasts covering maturing

enamel.
 Secretory activity of ameloblast starts
after the small dentin layer formation
Ameloblast lose their projections
separating them from predentin
Islands of enamel matrix deposit along
the dentin
This layer is known as dentino enamel
membrane
 Surface of ameloblast facing the
enamel is not smooth
The projection of ameloblast into the
enamel matrix is tomes process.
There is an interdigitation of cells of
ameloblast and enamel rod because
long axis of rods and ameloblast are
not parallel
 Picket fence arrangements
Atleast two ameloblasts are involved in
the synthesis of each enamel rod
 Appear at the distal end of the
ameloblast
Separate the tomes process from the
cell proper
They are localized condensation of
cytoplasmic substance
 These are shorter than the ameloblast
covering incompletely formed enamel
During enamel maturation 90% initially
secreted protein is lost
Organic content and water is lost in
mineralization
dpTP=distal portion of Tomes process

ppTP=proximal portion of Tomes process

Sg=secretory granules(E. protein)

(arrow=cell membrane, p=Tomes process, s=incomplete
septum)
a. Partial mineralization (25-30%).

b. Maturation (gradual completion of

mineralization).
 Maturation seems to begin at the
dentinal end of the rod
Each rod mature from the depth to the
surface
The sequence of maturing rod is from
cusps or incisal edge toward the cervical
line
Incisal and occlusal region reach
maturity ahead of the cervical region
 Original ribbon shaped crystal increase
in thickness more rapidly than in width
RECENTLY FORMED CRYSTALS MATURE CRYSTALS
 Interference during E. matrix 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 HYPOCALCIFICATION ENAMEL HYPOPLASIA
 two-step process
first step produces a partially mineralized
enamel approximately 30% mineralized
second step involves an influx of
additional mineral content coincident
with the removal of organic material and
water results in 96% mineralization
the influx of mineral results in growth of
the crystals in width and thickness
 ameloblasts derived from
the inner dental epithelium
secrete matrix proteins that
are responsible for creating
and maintaining and
extracellular environment
favorable to mineral
deposition
possess a unique life cycle
each stage reflects its primary
activity during enamel stages
can be divided into
three main stages
presecretory,
secretory,
maturation stages
Figure 7-14 Representative
micrographs of amelogenesis in the
cat. A, Tooth formation shows an
occlusal-to-cervical developmental
gradient so that on some crowns
finding most of the stages of the
ameloblast life cycle is possible.
The panels on the right (B
corresponds with B1 and C with B2)
are enlargements of the boxed
areas: B, Secretory stage, initial
enamel formation; C, secretory
stage, inner enamel formation. D
and E are from the incisal tip of the
tooth (see Fig. 7-15). D,
Midmaturation stage, smooth-ended
ameloblasts; and E, late maturation
stage, ruffle-ended ameloblasts.
Am, Ameloblasts; D, dentin; E,
enamel; N, nucleus; Od,
odontoblasts; PL, papillary layer;
RB, ruffled border; SB, smooth
border; SI, stratum intermedium.
 morphogenetic phase
during the cell stage DEJ and shape of
the crown is determined
cells of the inner dental epithelium are
cuboidal or low columnar with large centrally
located nuclei and poorly developed Golgi
separated from the dental papilla by a
basement membrane
Organizing and differentiation phase
as the cells of the IDE differentiate into
ameloblasts they elongate and their
nuclei shift toward the stratum
intermedium
the basement membrane fragments by the
cytoplasmic projections of the ameloblasts
during the formation of predentin
this allows contact between the pre-
ameloblasts and pre-odontoblasts
the Golgi complex increases in volume and
migrates distally to occupy a major portion
of the cytoplasm
the amount of RER increases significantly
and most of the mitochondria clusters in the
proximal region of the cell
-therefore the cell becomes polarized
with most of the organelles distal to the
nucleus
 at the distal end of the cell extensions form called Tomes
processes - against which enamel forms
research now shows the these differentiating ABs
secrete enamel proteins at the early stage even
before the basement membrane disintegrates
pre-ameloblasts also express dentin sialoprotein
transiently which is also an odontoblast product
adjacent ABs align closely with each other form junctional
complexes between them keeps them aligned
these complexes encircle the cells at the distal end of the
cell (adjacent to the stratum intermedium)
formed of fine actin filaments radiating from these
complexes into the cytoplasm
 cells acquire intense synthetic
and secretory activity
enamel proteins are translated
by the RER, modified by the
Golgi and packaged into
secretory granules
migrate to the distal
Tomes processes
secretion is constitutive the
secretory granules are not
stored for long within the cells
the contents of the
secretory granules are
released against the newly
formed dentin along the
surface of the Tomes
process
little time elapses between the
secretion of enamel and its
mineralization
 as the initial enamel layer forms the ABs migrate away
from the dentin surface and develop a distal portion of Tomes
process extension from the existing proximal portion of Tomes
process
the pTP extends from the distal junctional complex to the surface
of the enamel layer
the dTP interdigitates into the enamel beyond the initial layer
the cytoplasm of both processes is continuous with that of the
body of the AB
so once the initial enamel layer forms the AB only has a
pTP
the dTP forms once the enamel forms into rods
when the dTP forms the enamel proteins are secreted at two
sites located at defined ports along the dTP
the dTP lengthens as the enamel layer thickens
it also becomes thinner as the rod grows in diameter
eventuallyu squeezed out of existence
Figure 7-31 In three dimensions,
interrod (IR) enamel surrounds
the forming rod (R) and the distal
portion of Tomes process (dpTP);
this portion is the continuation of
the proximal portion (ppTP) into
the enamel layer. The interrod
(IGS) and rod (RGS) growth sites
are associated with membrane
infoldings (im) on the proximal
and distal portions of Tomes
process, respectively. These
infoldings represent the sites
where secretory granules (sg)
release enamel proteins
extracellularly for growth in length
of enamel crystals and,
consequently, the thickening of
interrod and rod enamel.
 both tooth eruption the enamel hardens
change in the physiochemical properties of the
enamel
actually because the pre-existing HA crystals
of the enamel grow in width and thickness
and NOT because new crystals are made
Tomes processes are not apparent at this
stage
the ABs are generally referred to as post-
secretory cells at this stage
although they still secrete proteins
made up of a transitional phase and the
maturation proper phase
transitional phase after the full
thickness of the enamel has formed
the ABs undergo significant
morphological changes that prepares
them for the maturation of the
enamel
reduction of AB height and a
decrease in their volume and
organelle content
 Maturation Proper Phase ABs become involved in the removal of
water and organic material
also undergo apoptosis so that approximately 25% of the ABs die
during the transitional phase and an additional 25% die during the
MP phase
characterized by the modulation of the cells cyclic creation, loss and
recreation of a highly ruffled apical surface and a smooth surface
occurs in waves traveling across the crown of the developing tooth
from least mature to most mature enamel regions
can happen every 8 hours in some species
significance is unknown could be related to calcium transport and
completion of enamel mineralization
the calcium ions are required for active crystal growth because the
cellular junctions at the ruffled end are more leaky
these ABs show enhanced endocytic activity and numerous
lysosomes for the withdrawl of enamel proteins from the
maturing enamel matrix
BUT the main mechanism for organic matrix removal is the
production of bulk-degrading enzymes into fragments small
enough to be able to leave the enamel layer and be taken up by the AB
 amelogenin accumulate during the secretory stage
undergo minor short-term and major long-term
processing to form smaller fragments
these fragments form the bulk of the final organic matrix
of maturing enamel
prevents crystals from fusing during their
formation and must be removed to permit crystal
growth
least concentrated at positions where the interrod and
rod crystals grow in length = enamel growth sites
form aggregates called nanospheres that surround the
enamel crystals along their long axis
Non amelogenins
enamalin small degredation during the secretory stage
which decreases in the deeper zones of the enamel
crystal nucleation and growth
ameloblastin undergoes rapid degredation the
intact protein is found near the enamel-forming surface
while the fragmented forms are found in the deeper zones
of the enamel
promotes mineral formation and crystal elongation
also known as amelin and sheathlin
highest concentration can be found at the enamel
growth sites
secreted together with amelogenins
 sulfated glycoproteins short half life in the enamel
tuftelin localizes specifically at the DEJ and participates in its
establishment
not specific to enamel
enzymes: metalloproteinases e.g. MMP20 or enamelysin
(short-term breakdown), serine proteinases (bulk degredation),
phosphatases
dentin sialoprotein transiently expressed
 introduction of minerals span the secretory and maturation
phases
calcium moves from the blood supply through the
enamel organ to reach the enamel
a smooth tubular network has been described that is found in
ABs and opens onto the enamel
this network is similar to the ER/sarcoplasmic reticulum
calcium is likely to be routed from high-capacity stores
associated with the ER
no matrix vesicle are associated with mineralization as is the
basis for collagen-based mineralized tissues like bone
almost an immediate formation of crystallites within the
enamel secreted against the dentin so there is no pre-enamel
 Striae of Retzius in longitudinal
sections they are a series of dark lines
extending from the DEJ toward the
tooth surface
forms becuase of a weekly rhythm of
enamel production resulting in structural
alterations of the rods
OR could be due to appositional
deposition of successive layers of enamel
Cross striations forms at 4um
intervals across the rods
rhythmicity??
Bands of Hunter and Schreger optical
phenomenon produced by the changing
orientations of adjacent groups of rod
Gnarled enamel
Enamel tufts and lamellae no clinical
significance
like geological faults
project from the DEJ for a short distance
into the enamel
branched and contain greater
concentrations of enamel that the rest of
the enamel
abrupt changes in the directions of the
rods arising from the DEJ
 Ameloblasts are lost after the enamel
has been laid down.

Hypoplasia and Hypocalcification.

Developmental disturbances like

amelogenesis imperfecta.

85