This document provides an overview of pathology of teeth and supporting structures. It discusses the anatomy of teeth, including the crown, dentin, pulp, and periodontal ligament. It also covers common dental issues like caries, gingivitis, and periodontitis. Caries is caused by bacteria and sugar fermentation, leading to tooth decay. Gingivitis is inflammation of gums from plaque buildup. Periodontitis is a progressive infection that destroys bone and tissues around teeth.
This document provides an overview of pathology of teeth and supporting structures. It discusses the anatomy of teeth, including the crown, dentin, pulp, and periodontal ligament. It also covers common dental issues like caries, gingivitis, and periodontitis. Caries is caused by bacteria and sugar fermentation, leading to tooth decay. Gingivitis is inflammation of gums from plaque buildup. Periodontitis is a progressive infection that destroys bone and tissues around teeth.
This document provides an overview of pathology of teeth and supporting structures. It discusses the anatomy of teeth, including the crown, dentin, pulp, and periodontal ligament. It also covers common dental issues like caries, gingivitis, and periodontitis. Caries is caused by bacteria and sugar fermentation, leading to tooth decay. Gingivitis is inflammation of gums from plaque buildup. Periodontitis is a progressive infection that destroys bone and tissues around teeth.
Supporting Structures Prof. Kogan E.A. 2016 Theeth Anatomy Teeth are firmly implanted in the jaw and are surrounded by the gingival mucosa . The anatomic crown of the tooth projects into the mouth and is covered by enamel, a hard, inert,acellular tissuethe most highly mineralized tissue in thebody. The enamel rests upon dentin, which is a specialized form of connective tissue that makes up most of the remaininghard-tissue portion of the tooth. Unlike enamel, dentin is cellular and contains numerous dentinal tubules, which containthe cytoplasmic extensions of odontoblasts. Cells line the interface between the dentin and the pulp and can, when properly stimulated, produce new (secondary) dentin within the interior of the tooth
The pulp chamber itself is surroundedby the
dentin and consists of loose connective tissue stroma rich in nerve bundles, lymphatics, and capillaries. Attachment In mammals, teeth are attached to the alveolar ridge of the jaws by the periodontal ligament, which provides a strong yet fl exible attachment that can withstand the forces of mastication. The periodontal ligamentattaches to the alveolar bone of the jaw on one side and to cementum, present on the roots of the teeth, which acts as a cement to anchor the periodontal ligament to the tooth. CARIES (TOOTH DECAY)
Dental caries, caused by focal degradation of the tooth structure,
is one of the most common diseases throughout the world and is the most common cause of tooth loss before age 35. Carious lesions are the result of mineral dissolution of tooth structure by acid metabolic end products from bacteria that are present in the oral cavity and are capable of fermenting sugars. Traditionally, the rate of caries has been higher in industrialized countries, where there is ready access to processed foods containing large amounts of carbohydrates. Factors influence on demographics of caries The rate of caries has markedly dropped in countries such as the United States, where improved oral hygiene and fl uoridation of the drinking water has become a standard practice. Fluoride incorporates into the crystalline structure of enamel, forming fl uoroapatite, and contributes to resistance to degradation by bacterial acids. Second, with globalization of the worlds economy, increased amounts of processed foods with high carbohydrate content are being imported into developing nations. With these trends, one can expect the rate of caries to increase dramatically in the less-developed world over the next several decades Types and stages of caries Caries classification Morphological stages of caries Base and margines of caries cavaty Early caries Superficial caries Intermediate caries Deep caries Deep caries Deep caries with pulpa penetration Reactive changes Reactive changes in pulpa Reactive changes in pulpa Acute and chronic appical pulpitis Chron sup pulpitis appicalis GINGIVITIS
Gingiva is the designation of the
squamous mucosa in between the teeth and around them. Gingivitis is inflammation of the mucosa and the associated soft tissues. Typically, the development of gingivitis is the result of a lack of proper oral hygiene, leading to an accumulation of dental plaque and calculus. Epidemiology of Gingivites Gingivitis occurs at any age but is most prevalent and severe in adolescence (ranging from 40% to 60%), after which the incidence tapers off. It is a reversible disease; Dental plaque Dental plaque is a sticky, usually colorless, biofi lm that builds in between and on the surface of the teeth. It is formed by a complex of the oral bacteria, proteins from the saliva, and desquamated epithelial cells. If plaque continues to build andis not removed, it becomes mineralized to form calculus (tartar). The bacteria in the plaque release acids from sugarrich foods, which erode the enamel surface of the tooth. Repeated erosions lead to dental caries. Plaque build-up beneath the gumline can cause gingivitis. Chronic gingivitis Chronic gingivitis is characterized by gingival erythema, edema, bleeding, Changes in contour, loss of soft-tissue adaptation to the teeth. Therapy of Gingivites
Therapy is primarily aimed at reducing the
accumulation of plaque andcalculus via brushing, fl ossing, and regular dental visit PERIODONTITIS
Periodontitis refers to an inflammatory process that
affects the supporting structures of the teeth: periodontal ligaments, alveolar bone, cementum.
With progression, periodontitis can lead to serious
sequelae, including the loss of attachment caused by complete destruction of the periodontal ligament and alveolar bone. Loosening and eventual loss of teeth are possible. Pathogenesis of Periodontitis Until the 1960s it was believed that longstanding gingivitis uniformly progressed to periodontal disease. However, this is no longer thought to be the case.
Development of periodontal disease is now considered
to be an independent process, which, for reasons that are still unclear, is associated with a marked shift in the types and proportions of bacteria along the gingiva. This shift, along with other environmental conditions such as poor oral hygiene, is believed to be important in the pathogenesis of periodontitis. Periodontal and systemic diseases Periodontal disease can also be a component of several different systemic diseases, including acquired immunodefi ciency syndrome (AIDS), leukemia, Crohns disease, diabetes mellitus, Down syndrome, sarcoidosis, and syndromes associated with polymorphonuclear defects (Chdiak-Higashi syndrome, agranulocytosis, and cyclic neutropenia).
Periodontal infections can also be etiologic factors in several
important systemic diseases. These include, for example, infective endocarditis, pulmonary and brain abscesses, and adverse pregnancy outcomes.