Philias R. Garant - Oral Cells and Tissues

Oral Cells and Tissues

Philias R. Garant, DMDProfessor Department of Periodontics School of Dental Medicine State University of New York at Stony Brook Stony Brook, New York

Library of Congress Cataloging-in-Publication Data

Garant, Philias R.

Oral cells and tissues / Philias R. Garant.

p. ; cm.

Includes bibliographical references.

ISBN 0-86715-429-2

1. Teeth—Cytology. 2. Mouth—Cytology. 3. Oral mucosa—Cytology.

[DNLM: 1. Stomatognathic System—anatomy & histology. 2.

Stomatognathic System—embryology. WU 101 G212o 2003] I. Title.

QP88.6.G37 2003

611'.0181—dc21

2003006003

© 2003 Quintessence Publishing Co, Inc

Quintessence Publishing Co, Inc

551 Kimberly Drive

Carol Stream, Illinois 60188

www.quintpub.com

Editor: Arinne Dickson

Internal design and production: Patrick Penney

Cover design: Dawn Hartman

All rights reserved. This book or any part thereof may not be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, or otherwise, without prior written permission of the publisher.

Printed in Canada

To my wife, Jeanne

Table of Contents

Preface Preface Since the deciphering of the genetic code, scientists have gained enormous insight into how cells and tissues function. It is now evident that our understanding of the structure and function of oral cells and tissues must be based on knowledge of subcellular mechanisms common to most cell types. More than ever, the basic sciences are essential in oral biology, helping us to understand the nature of oral cells and tissues in health and disease. This book seeks to bring our understanding of the basic biology of the oral cavity to bear on the daily clinical practice of dentistry. To accomplish this, whenever possible, the chapters conclude with sections on the basic science and clinical correlations of the information presented. It is my hope that individuals seeking an overview of the cellular components of the oral cavity, whether they are dental students or researchers new to the biology of the oral cavity, will find this book to be a useful framework for their studies. Keeping up with the flood of new information and defining the book’s boundaries were constant challenges. Nevertheless, I have made every effort to make the text as comprehensive and as straightforward as possible for students at any level. I was inspired to write this book because of the pleasure I get from learning about new discoveries and from knowing that there are students who, although anxious to study the purely clinical aspects of their education, see and appreciate the profound beauty of the cells and tissues of the oral cavity. Several individuals deserve acknowledgment for their inspiration and assistance during preparation of this book. My teachers at the Harvard School of Dental Medicine, especially Drs Paul Goldhaber, George Szabo, and the late John Nalbandian, were instrumental in setting me on the path of academic dentistry and making study, research, and discovery a major part of my adult life. Without the encouragement and support of Dean Barry Rifkin, along with the generous resources of Stony Brook University, writing this book would have been impossible. I must also thank Drs James Sciubba and Moon-II Cho for their encouragement and continued insistence that I not give up this project. I am also grateful to all the scientists and publishers who graciously permitted me to adapt and/or reproduce their illustrations for this book. Finally, I am most grateful to my spouse and best friend, Jeanne. Without her help and support I would not have been able to complete my professional education, nor lead a life in academia. I am also grateful to my six children for the love they have shown me.

1Early Tooth Development

Role of the Neural Crest

Development of the Dental Lamina, Enamel Organ, and Dental Papilla

Epithelial-Ectomesenchymal Morphogenetic Regulation of Odontogenesis

Growth and Differentiation Factors That Regulate Tooth Formation

Establishing Coronal Form (Cusp Formation)

Basic Science Correlations

Clinical Correlation: The Human Dentition

2Dentin

Differentiation of Odontoblasts

Secretion of Dentin Matrix

Structure of Mature Secretory Odontoblasts

Composition of the Dentin Matrix

Mineralization of Mantle and Circumpulpal Dentin

Structure of the Odontoblastic Process and Dentinal Tubules

Formation of Intertubular and Peritubular Dentin

Transport Across the Odontoblastic Layer

Innervation of Dentin and Mechanisms of Pain Sensation

Supply of Blood to the Pulp

Cells and Extracellular Matrix of the Dental Pulp

Basic Science Correlation: The Secretory Pathway

Clinical Correlations

3Enamel

Differentiation of the Enamel Organ

Structure of Secretion-Stage Ameloblasts

Biology of the Enamel Matrix

Location and Expression of Amelogenin, Ameloblastin, and Tuftelin Genes

Mineralization of the Enamel Matrix

Structure of Transition-Stage Ameloblasts

Formation of the Papillary Layer

Structure of Maturation-Stage Ameloblasts

Structure of Postmaturation-Stage Ameloblasts

Basic Science Correlations

Clinical Correlations

4Oral Mucosa

Cell Proliferation and Differentiation in Stratified Squamous Epithelia

Structure and Function of the Cornified (Orthokeratinizing) Epithelium: The Epidermal Model

Differentiation of the Oral Mucosa

Basic Science Correlations

Clinical Correlations

5Gingiva

Epithelial Components of the Gingiva

Expression of Keratins in Gingiva

Expression of Cell Surface Adhesion Molecules in Gingiva

Formation of Dental Cuticles

Organization of Gingival Connective Tissue

Supply of Blood to the Gingiva

Innervation of the Gingiva

Flow and Composition of Gingival Crevicular Fluid

Basic Science Correlations

Clinical Correlations

6Periodontal Ligament

Development and General Structure of the Periodontal Ligament

Components of the Extracellular Matrix

Supply of Blood to the Periodontal Ligament

Innervation of the Periodontal Ligament