Structures of Teeth 4

Chapter 1—Clinical Significance of Dental Anatomy, Histology, Physiology, and Occlusion 5
Enamel E
Lamella
Dentinoenamel
junction
Dentinal part
of lamella
Dentin
D
Fig. 1-9 Microscopic view through lamella that goes from enamel
surface into dentin. Note the enamel tufts (arrow). (From Bath Balogh M,
Fehrenbach MJ: Illustrated dental embryology, histology, and anatomy, ed 3,
Fig. 1-10 Microscopic view of scalloped dentinoenamel junction (DEJ)
Saunders, 2011, St Louis. Courtesy James McIntosh, PhD, Assistant Professor Emeri-
(arrow). E, enamel; D, dentin. (From Bath Balogh M, Fehrenbach MJ: Illustrated
tus, Department of Biomedical Sciences, Baylor College of Dentistry, Dallas, TX.)
dental embryology, histology, and anatomy, ed 3, Saunders, 2011, St Louis.
Courtesy James McIntosh, PhD, Assistant Professor Emeritus, Department of Bio-
medical Sciences, Baylor College of Dentistry, Dallas, TX.)
between enamel rod groups that extend from the enamel

surface toward the DEJ, sometimes extending into dentin (see
Fig. 1-9). They contain mostly organic material, which is a
weak area predisposing a tooth to the entry of bacteria and
dental caries. Enamel rods are formed linearly by successive
apposition of enamel in discrete increments. The resulting
variations in structure and mineralization are called incremen- e
tal striae of Retzius and can be considered growth rings (see f
Fig. 1-3). In horizontal sections of a tooth, the striae of Retzius c
appear as concentric circles. In vertical sections, the lines tra-
verse the cuspal and incisal areas in a symmetric arc pattern, d
descending obliquely to the cervical region and terminating at
the DEJ. When these circles are incomplete at the enamel
surface, a series of alternating grooves, called imbrication lines
of Pickerill, are formed. The elevations between the grooves are
called perikymata; these are continuous around a tooth and
Fig. 1-11 Fissure (f) at junction of lobes allows accumulation of food
usually lie parallel to the CEJ and each other.
and bacteria predisposing the tooth to dental caries (c). Enamel (e);
A structureless outer layer of enamel about 30 µm thick is dentin (d).
found most commonly toward the cervical area and less often
on cusp tips. No prism outlines are visible, and all of the
apatite crystals are parallel to one another and perpendicular
to the striae of Retzius. This layer, referred to as prismless This arrangement leaves a V-shaped escape path between the
enamel, may be more heavily mineralized. Microscopically, the cusp and its opposing groove for the movement of food during
enamel surface initially has circular depressions indicating chewing. Failure of the enamel of the developmental lobes to
where the enamel rods end. These concavities vary in depth coalesce results in a deep invagination of the enamel surface
and shape, and they may contribute to the adherence of plaque and is termed fissure. Non-coalesced enamel at the deepest
material, with a resultant caries attack, especially in young point of a fossa is termed pit. These fissures and pits act as
individuals. The dimpled surface anatomy of the enamel, food and bacterial traps that predispose the tooth to dental
however, gradually wears smooth with age. caries (Fig. 1-11).
The interface of enamel and dentin (dentinoenamel junc- Once damaged, enamel is incapable of repairing itself
tion, or DEJ) is scalloped or wavy in outline, with the crest of because the ameloblast cell degenerates after the formation of
the waves penetrating toward enamel (Fig. 1-10). The rounded the enamel rod. The final act of the ameloblast is secretion of
projections of enamel fit into the shallow depressions of a membrane covering the end of the enamel rod. This layer is
dentin. This interdigitation may contribute to the firm attach- referred to as Nasmyth’s membrane, or primary enamel cuticle.
ment between dentin and enamel. The DEJ is also a hyper- This membrane covers the newly erupted tooth and is worn
mineralized zone approximately 30 µm thick. away by mastication and cleaning. The membrane is replaced
The occlusal surfaces of premolars and molars have grooves by an organic deposit called the pellicle, which is a precipitate
and fossae that form at the junction of the developmental of salivary proteins. Microorganisms may attach to the pellicle
lobes of enamel. These allow movement of food to the facial to form bacterial plaque, which, if acidogenic in nature, can
and lingual surfaces during mastication. A functional cusp be a potential precursor to dental disease.
that opposes a groove (fossa) occludes on enamel and inclines Although enamel is a hard, dense structure, it is permeable
on each side of the groove and not in the depth of the groove. to certain ions and molecules. The route of passage may be

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Chapter 1—Clinical Significance of Dental Anatomy, Histology, Physiology, and Occlusion 5

between enamel rod groups that extend from the enamel

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