Section Iii: A. Four Tissues of A Tooth

Chapter 1 | Basic Terminology for Understanding Tooth Morphology 11
SECTION III TERMINOLOGY USED TO DESCRIBE THE PARTS OF A TOOTH
A. FOUR TISSUES OF A TOOTH of cementum is about 50%.) Cementum is about as

hard as bone but considerably softer than enamel.
The tooth is made up of four tissues: enamel, dentin,
It develops from the dental sac (mesoderm), and is
cementum, and pulp. The first three of these (enamel,
produced by cells called cementoblasts [se MEN toe
dentin, and cementum) are relatively hard since they
blasts].
contain considerable mineral content, especially cal-
The cementoenamel [se MEN toe ehn AM el] junc-
cium (so these tissues can also be described as calci-
tion (also called the CEJ) separates the enamel of the
fied). Only two of these tissues are normally visible in
crown from the cementum of the anatomic root. This
an intact extracted tooth: enamel and cementum. The
junction is also known as the cervical [SER vi kal] line,
other two tissues (dentin and pulp) are usually not vis-
denoting that it surrounds the neck or cervix [SER
ible on an intact tooth. Refer to Figure 1-6 while read-
viks] of the tooth.
ing about each tissue.
Dentin [DEN tin] is the hard yellowish tissue under-
Enamel [ee NAM el] is the white, protective external
lying the enamel and cementum, and makes up the
surface layer of the anatomic crown. It is highly cal-
major bulk of the inner portion of each tooth crown
cified or mineralized, and is the hardest substance in
and root. It extends from the pulp cavity in the center
the body. Its mineral content is 95% calcium hydroxy-
of the tooth outward to the inner surface of the enamel
apatite (which is calcified). The remaining substances
(on the crown) or cementum (on the root). Dentin is
include 5% water and enamel matrix. It develops from
not normally visible except on a dental radiograph,
the enamel organ (ectoderm) and is a product of spe-
or when the enamel or cementum have been worn
cialized epithelial cells called ameloblasts [ah MEL o
away, or cut away when preparing a tooth with a bur,
blasts].
or destroyed by decay. Mature dentin is composed of
Cementum [se MEN tum] is the dull yellow exter-
about 70% calcium hydroxyapatite, 18% organic mat-
nal layer of the tooth root. The cementum is very thin,
ter (collagen fibers), and 12% water, making it harder
especially next to the cervical line, similar in thickness
than cementum but softer and less brittle than enamel.
to a page in this text (only 50–100 mm thick where one
Dentin develops from the embryonic dental papilla
mm is one millionth of a meter). It is composed of 65%
(mesoderm). The cells that form dentin, called odon-
calcium hydroxyapatite (mineralized and calcified),
toblasts [o DON toe blasts], are located at the junction
35% organic matter (collagen fibers), and 12% water.
between pulp and dentin.
(Another author, Melfi, states that the mineral content
Apical foramen
Root canal
Anatomic Root
Cementum
Dentin
Cementodentinal
junction FIGURE 1-6.
A maxillary anterior
Pulp chamber
tooth sectioned longitudinally through
the middle to show the distribution of
Cementoenamel junction the tooth tissues and the shape of the
pulp cavity (made up of pulp chamber
Anatomic Crown
Enamel and root canal). On the right is a

close-up of the apical portion depicting
Dentinoenamel junction the usual expected constriction of the
root canal near the apical foramen. The
Lingual surface of crown layer of cementum covering the root of
an actual tooth is proportionately much
thinner than seen in these drawings.
12 Part 1 | Comparative Tooth Anatomy
Dentinoenamel junction
FIGURE 1-7.
Radiographs (x-rays) showing
tooth crowns covered with enamel, and the
Enamel
tooth roots embedded within the alveolar
Dentin bone. You can distinguish the whiter outer
enamel shape from the darker inner dentin,
Pulp and the darkest pulp chamber in the middle of
Periodontal ligament the tooth. The very thin, dark periodontal
(dark line) ligament can also be seen between the root and
Alveolar bone the bone, but the cementum cannot be seen.
The dentinoenamel [DEN tin o ehn AM el] junction • Defensive or protective: Pulp responds to injury
is the inner surface of the enamel cap where enamel or decay by forming reparative dentin (by the
joins dentin. This junction can be best seen on a radio- odontoblasts).
graph (Fig. 1-7). The cementodentinal [se MEN toe
DEN tin al] (or dentinocemental) junction is the inner
surface of cementum where cementum joins dentin.
B. ANATOMIC VERSUS CLINICAL
Cementum is so thin that it is difficult to identify this CROWN AND ROOT
junction on a radiograph. 1. ANATOMIC CROWN AND ROOT
Pulp is the soft (not calcified or mineralized) tissue DEFINITION
in the cavity or space in the center of the crown and
root called the pulp cavity. The pulp cavity has a coro- The anatomic crown is that part of the tooth (in the
nal portion (pulp chamber) and a root portion (pulp mouth or handheld) normally covered by an enamel
canal or root canal). The pulp cavity is surrounded layer, and the anatomic root is the part of a tooth cov-
by dentin, except at a hole (or holes) near the root tip ered by cementum (Fig. 1-6). A cervical line (or cemen-
(apex) called an apical [APE i kal] foramen [fo RAY toenamel junction) separates the anatomic crown from
men] (plural foramina [fo RAM i na]). Nerves and the anatomic root. This relationship does not change
blood vessels enter the pulp through apical foramina. over a patient’s lifetime.
Like dentin, the pulp is normally not visible, except on a
dental radiograph (x-ray) or sectioned tooth (Fig. 1-7). 2. CLINICAL CROWN AND ROOT (ONLY
It develops from the dental papilla (mesoderm). Pulp is APPLIES WHEN THE TOOTH IS IN THE
soft connective tissue containing a rich supply of blood MOUTH AND AT LEAST PARTIALLY
vessels and nerves. Functions of the dental pulp are as ERUPTED)
follows:
The clinical crown refers specifically to the amount
• Formative: Dentin-producing cells (odontoblasts) of tooth visible in the oral cavity, and the clinical root
produce dentin throughout the life of a tooth. This is refers to the amount of tooth that is not visible since it
called secondary dentin. is covered with gingiva (gum tissue). Clinically, the gin-
• Sensory: Nerve endings relay the sense of pain caused gival margin in a 25-year-old patient with healthy gin-
from heat, cold, drilling, sweet foods, decay, trauma, giva approximately follows the curvature of the cervical
or infection to the brain, so we feel it. However, the line, and under these conditions, the clinical crown is
nerve fibers in a dental pulp are unable to distin- essentially the same as the anatomic crown. However,
guish the cause of the pain. the gingival margin is not always at the level of the cer-
• Nutritive: Blood vessels transport nutrients from vical line because of the eruption process early in life or
the bloodstream to cells of the pulp and the odon- due to recession of the gingiva later in life. For example,
toblasts that produce dentin. (Surprisingly, blood in the gingiva on a partially erupted tooth of a 10-year-old
the tooth pulp had passed through the heart only covers much of the enamel of the anatomic crown of
6 seconds previously.) the tooth, resulting in a clinical crown (exposed in the

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Chapter 1 | Basic Terminology for Understanding Tooth Morphology 11

SECTION III TERMINOLOGY USED TO DESCRIBE THE PARTS OF A TOOTH

A. FOUR TISSUES OF A TOOTH of cementum is about 50%.) Cementum is about as

Enamel and root canal). On the right is a

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