Connective Tissue

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Tooth and Mouth Anatomy
Meghan, Adam, Andrew and Kim
Fun Video
 http://www.youtube.com/watch?v=NeRblbkdBVo
Learning Objectives
 Classify different types of teeth with their structure
and function
 Develop larger understanding of mouth structure
and how teeth fit in
 Define common diseases and injuries related to the
mouth
 Summarize common methods of treatment and
prevention of disease and injury
Dontium= “Teeth”
Periodontium= “around the dontium”
Temporomandibular Joint=TMJ
Fossa= ditch or trench in a bony member VS. Process=a protrusion of boney member
Syn= “with” or “together”
Gomphis= “bolt” or “nail”
Arthro = “joint”
Condyle= “knuckle”
Ginglymus= “hinge”
Sulcus=“groove”
// to Traverse
Plane
Spine
Dental Arches
Mouth Members & Interactions
Overview:



[The TMJ]
Boney Members

Skull

Jaw

Maxilla

Mandible
Connective Tissue

Capsule

Ligaments

Stylomandibular ligament

Capsular Ligament

Sphenomandibular Ligament

Temporomandibular Ligament
Muscle Tissue

Masseter

Pterygoid

Temporalis
[The Gomphyses]
Teeth





Incisors
Canine
Premolars
Molars
Wisdom Teeth
Periodontium

Connective Tissue

Periodontal Ligaments

Soft Tissue

Gingival

Epithelial

Hemidesmosomes
Temporomandibular
Joint (TMJ)
 Function Class
(describes movement)

Ginglymoarthrodial
 Ginglymus


Hinge
Arthrodial
plane
Structural Class (describes binding


tissues)

Synovial
Bony Members
Muscle Tissue
Temporalis
Lateral Pterygoid
Masseter
Medial Pterygoid
Connective Tissue
 Stylomandibular ligament
 Capsular Ligament
 Sphenomandibular
ligament
 Temporomandibular
ligament
Articular Fossa
Articular cartilage
Synovial Fluid
Articular disk
Synovial Fluid
Articular Cartilage
Mandibular Condyle
Gomphyses
 Gomphosis “nail/bolt”

Functional Class



Synarthrosis
Peg and socket between:
• Tooth
• Alveolus
Structural Class

Fibrous
Teeth
Structure of Teeth
Crown
Enamel
Dentine/Ivory
Root
Dental Pulp
Cementum
Types of Teeth
 Incisors
Types of Teeth
 Canines
Types of Teeth
 Premolars
Types of Teeth
 Molars
Types of Teeth
 Wisdom Teeth
(3rd Molar)
Types of Teeth
 Children have 20 total
teeth

Primary or Milk teeth
 Adults have 32 total
teeth

Permanent or Adult
teeth
Adolescent Mouth
Adult Mouth
Tooth Connection to Jaw
 Alveolar bone
 Root
Periosteum
Connective Tissue
Periodontal
Ligaments(PDL’s)

Fibrous Composition


Cellular
 Osteoblasts
 Osteoclasts
 Fibroblasts
 Macrophages
 Cementoblasts
 Epithelial cell
rests of Malassez
Extracellular Matrix



Collagen
Ground Substance
Water
• ~70%
 Hemidesmosomes
 Small stud or rivet like
structures that attach
a cell to an
extracellular matrix
Soft Tissue
 Gingiva (gums) :The
mucosal tissue that
overlays the jaws
 Marginal
 Tissue that apically
borders crown of
tooth
 Attached
 Extension of the
Marginal Gingiva
apical to crown
 Interdental
 Tissue Between
Tooth-Tooth
boundaries along
the dental arch
 Oral Epithelium
 Sulcular epithelium


touches but is not
attached to tooth
non-keratinized
stratified squamous
tissue
 Junctional epithelium
 forms an attachment to
the tooth
basal lamina

Extracellular matrix secreted by epithelial
cells
• Layer on which epithelium sits
 proteoglycans
Teeth Pathologies and
Treatment
Dentistry
 Dentist
 Many specialties
 Orthodontics
 Endodontics
 Periodontics
Diagnosis
 Ask health questions
 Clinical exam
 Impressions of teeth
 Photos of face and teeth
 X-rays of mouth and head
 Decide what treatment is right
Teeth Pathologies and Treatment
Less Severe
 Alignment Issues (malocclusion)
 Tooth Sensitivity
 Bruxism (clenching and grinding)
Malocclusion of teeth
Causes:
Genetics
Pacifier, thumb sucking
Bad chewing habits
Misalignment of jaw after
fracture
• Failure of previous dental
work
•
•
•
•
Treatments:
• Functional appliances
• Surgery
Functional Appliances
 Fixed
 Braces
 Space maintainers
 Removable
 Retainers
 Splint
 Palatal expander
 Headgear
 Lip and cheek bumper
Child vs. Adult Treatment
 Benefits to treating child
 Teeth are not permanent
 Growth spurts
 Adult
 Little/no jaw growth
 Gum disease
 Surgery more likely
 Options
Lingual braces
 Invisalign

Disadvantages
 Incorrect fitting
 Unpleasant to wear
 Removable
 Need cooperation of patient
Tooth Sensitivity
Causes:
•
•
•
•
Enamel wear
Dentin exposure
Tooth/Gum disease
Chipped or fractured tooth
Treatments:
• Desensitizing toothpaste
• Sealant to cover exposed roots
• Root Canal
Bruxism
Causes:
• Stress and Anxiety
• Abnormal bite
Treatments:
• Relax, massage and
stretch jaw muscles
• Ice
• Avoid hard foods
• Splints and mouth
guards
• Surgery
Teeth Pathologies and Treatment
More Severe
 Fracture
 Decay
 Infection
 Misalignment of Jaw
 Oral caner
Fracture
o Minor-chipping of the
outer layers
o Crack through tooth to
center
o Severe vertical, diagnol,
horizontal fractures of
roots
Causes
 Impact/trauma
 Tooth decay
 Tooth infection
 Failure of previous
dental work
Treatment
o Minor (outer layer)
o crown
o Center of tooth
o Dental pulp infected
o Root canal
o Crown
o Split root
o Tooth extraction
Tooth Decay
Causes:
• Acid and plaque build up
Symptoms:
• Tooth pain
• Visible pits or holes in teeth
Results in:
• Cavities
• Tooth abscess
• Infection
Treatment
o Mild
o
o
Fluoride
Filling if cavity has formed
o Severe
o
o
o
Crown
Root canal
Extraction
http://www.youtube.com/watch?v=jHHn52KhBkQ
Tooth and Gum Infection
Infection of gums:
Ex. Gingivitis, Periodontitis
Causes:
• Accumulation of bacteria or
plaque
• Tooth decay
Symptoms:
• Bad breath
• Red, swollen gums
• Painful chewing
Treatment
o Mild
o Antibiotics -- medicine, gel
o Cut open abscess -- drain
o Severe
o Root canal
o Tooth extraction
o Surgery
o
o
Bone and tissue grafts
Growth factors
Bone and Tissue Grafts
 Grafting
 Gum
 Soft tissue
 Connective tissue
 Tunnel grafting
 Bone
 Autogenous
 Allograft
 Xenograft
Jaw Problems
o Mandibular fracture
o Dislocation
o Cause: Typically
impact
Symptoms
 Mandibular
 Bleeding and bruising
 Limited movement
 Swelling
 Stiffness
 Abnormal appearance
 Dislocation
 Crocked bite
 Drooling
 Pain
 Difficulty speaking
Treatment
o Mandibular
o Minor
o
o
o
Medication
Liquid diet
Severe
o
Surgery
o Dislocation
o Place back
o Anesthetics and muscle relaxants
o Surgery
Temporomandibular Joint Disorder (TMJ)
Causes:
• Disk erodes or moves out of proper alignment
• impact
• Cartilage damage due to
arthritis
Symptoms:
• Locking of jaw
• Difficulty chewing
• Pain of jaw or around ear
Treatment
• Noninvasive:
• Acupuncture
• Jaw exercises
• Medication
• Surgery:
• Arthrocentesis or joint
irregation
• Arthroplasty
• Total Joint Replacement
Dental Implants
Endosseous Implant
Transosteal Implant
Subperiosteal
Implant
Implant Process
• Immediate Load Implants
• Implants Loaded in Phases
• http://www.youtube.com/watch?v=yZY_WrR4dEI&
feature=endscreen
Oral Cancer
Most common in:
• Lips or tongues
• Also found in cheek lining, gums, and floor or roof of mouth
Risk Factors:
•
•
•
•
•
Smoking and other tobacco use
Poor dental hygiene
Chronic irritation
Family history
Sun exposure
Symptoms
o Sore, lump, ulcer
o Difficulty chewing and swallowing
o Swollen lymph nodes in neck
Treatment
 Depends on stage
 Surgery
 Radiation therapy
 Chemotherapy
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