《口腔医学英语讲义》PPT课件

TheDevelopmentandComponentofaTooth,吴堪葵广州医学院第二附属医院,Unit4,TheDevelopmentandComponentofaTooth,ComponentofaTooth,Dentine,Enamel,Cementum,Pulp,MineralizedTissue,96%97%inorganicmaterial无机物（chieflyhydroxyapatite羟基磷灰石）,1%organicmaterial有机物釉原蛋白、非釉原蛋白、蛋白酶和脂类引导釉质晶体生长、粘结晶体和釉质作用,Enamel（Thehardestandmosthighlycalcifiedbiologicaltissueknown）,EnamelEctodermalorigin来源于外胚层,3%4%water结合水和游离水,Enamel,Millionsofrods/prisms釉柱EnamelrodsFromenamel-dentinaljunction釉牙本质界Totoothsurface,向窝沟底部集中，呈放射状,在牙颈部排列成水平状,Enamelrods,Composedofapatitecrystals磷灰石晶体Mainlyhydroxyapatite羟基磷灰石Rodsheath釉柱鞘Controversial有争议的Highercontentoforganicmaterial有机物Differentcrystalorientation晶体排列方向,球拍样,70%inorganicmaterial磷灰石晶体、微量元素,18%organicmaterialI型胶原蛋白、非胶原蛋白,Dentine（The2ndmosthighlymineralizedtissue）,Dentine,12%water,Dentinaltubules,FrompulpToenamel-dentinaljunction釉牙本质界WideinthepulpsideNarrowintheenamelside,Inorganicmaterial65%,Organicmaterial（collagen胶原18%,Cementum,Cementum,Water12%,SimilartobonedifferenceNovascularity(血管)Containcementocytes（成牙骨质细胞）,Pulp,Odontoblast成牙本质细胞,位于牙髓周围，呈柱状紧接前期牙本质排列成一层主要功能：形成牙本质,小结,Eachtoothhasfourmainparts,includingthefollowing:enamel-theouterlayerofthetooth.dentin-theinnerlayerandthemainpartofthetooth.cementum-onlyfoundontheundersideofthetooth.pulp-partoftheinsideofthetooththatcontainsthenerveandotherdelicatetissue.,Atoothanditssurroundings,Periodontium牙周组织Maintainatoothinitsfunctionalposition支持牙的功能,Gingiva牙龈,MucosawhichsurroundstheteethFreegingiva游离龈Attachedgingiva附着龈Interdentalpapilla龈乳头牙龈上皮gingivalepithelium龈沟上皮salcularepithelium结合上皮junctionalepithelium龈谷上皮固有层:胶原纤维神经、血管,Freegingiva游离龈,Terminaledgeofgingiva牙龈边缘SurroundsthetoothincollarfashionFormsthesofttissuewallofthegingivalsulcus龈沟（0.5-3mm平均1.8mm),Attachedgingiva附着龈,ContinuouswiththefreegingivaByashallowlineardepression,thefreegingivagroove游离龈沟Tightlybound(紧密附着)totheunderlyingperiosteumofalveolarbone(牙槽骨骨膜),Surfacestippling点彩:increaseabrasiveresistance增强对机械摩擦的抵抗,Interdentalgingiva,Occupiestheinterproximalspacebeneathareaofteethcontact牙间隙Pyramidal(锥)orcol(谷)shape,Periodontalligament牙周韧带,Alsocalledperiodontalmembrane牙周膜LocatesbetweenalveolarboneandtherootSupportive支持功能主要纤维一端埋入牙骨质，一端埋入牙槽骨将牙固定在牙槽窝中组成：纤维、基质、细胞、血管,Periodontalligament牙周韧带,主纤维：牙槽嵴组alveolarcrestgroup起于牙槽嵴顶，止于釉牙骨质界下方的牙骨质将牙向牙槽窝内牵引，对抗侧方力，保持牙直立,水平组horizontalgroup维持牙直立的主要力量与牙槽嵴纤维共同对抗侧方力，防止牙侧方移动,斜行组obliquegroup牙周膜中数量最多、力量最强的一组纤维向根方倾斜约45度这种结构可均匀分散咀嚼压力到牙槽骨上限制牙的转动,根尖组apicalgroup固定牙根尖，保护进出根尖孔的血管和神经根间组interradiculargroup只存在于多根牙防止牙根向冠方移动,Periodontalligament牙周韧带功能,Sensory感觉动能丰富的神经和末梢感受器对疼痛和压力、轻叩和震动有敏锐的感觉通过神经系统的传导和反射调节和缓冲咀嚼力,Nutrition营养作用营养牙周膜本身，也营养牙骨质和牙槽骨Homeostatic形成功能不断更新改建牙周膜保证牙和牙周膜的正常附着联系,Alveolarbone,Alsocalledalveolarprocess牙槽突Alveolarboneproper固有牙槽骨Densebone密质骨Cancellousbone松质骨,Alveolarboneproper固有牙槽骨,Containsmanysmallperforations多孔throughwhichbloodvesselsandnervesreachtheperiodontalspace血管和神经进入牙周膜Knownascribriformplate筛状板,密质骨,牙槽骨的外表部分，即颌骨内、外骨板的延伸部分厚度不一上颌牙槽骨唇面密质骨很薄，舌侧厚下颌牙槽骨密质骨比上颌厚,松质骨,位于密质骨和固有牙槽骨之间由骨小梁trabecular和骨髓marrow组成骨小梁的粗细、数量和排列方向与所承担的咀嚼力相关承受较大咀嚼力的区域，骨小梁粗大致密无功能的牙或承担咀嚼力小的牙，骨小梁细小,牙槽骨的生物学特性,高度可塑性人体骨骼最活跃的部分受压力被吸收，受牵引力增生正畸治疗Orthodontictreatment牵张成骨DistractionOsteogenesis,小结,Atoothanditssurroundings,Gingiva牙龈,MucosawhichsurroundstheteethFreegingivaAttachedgingivaInterdentalpapilla,Periodontalligament,Alveolarbone,alveolarcrestgroup,horizontalgroup,obliquegroup,apicalgroup,interradiculargroup,AlveolarboneproperDenseboneCancellousbone,Developmentoftooth,Process,BeginningFinishEruptionReplacement胚胎第7周20岁Growthstage:（牙胚的形成和发育）Calcification:（牙体硬组织的形成）Eruptionstage:（牙的萌出）,牙发育过程,Growthstage:（牙胚的形成和发育）Calcification:（牙体硬组织的形成）Eruptionstage:（牙的萌出）,Complexcellularandbiochemicalprocess复杂的细胞作用和生物化学作用过程,Growthstage:（牙胚的形成和发育）,Theepithelium(上皮)thickensinaU-shapebandintheareaofthefuturealveolarprocesses(牙槽突）Formprimaryepitheliumband(原发性上皮带)DifferentiateintoVestibularlamina(前庭板)andDentallamina(牙板)thickenDentallamina(牙板)牙胚,Duringthe7thweekofintra-uterinelifeEpithelium(上皮)thickensinaU-shapedbandPrimaryepithelialband原发性上皮带,primaryepithelialband（原发性上皮带）（前庭板）vestibularlaminaanddentallamina（牙板）thevestibuleoftheoralcavitydeciduousteethand（形成口腔前庭）permanentdentallamina（乳牙胚、恒牙牙板）permanentteeth（恒牙）,牙胚是发育形成牙的胚胎性组织牙胚的组成：成釉器（enamelorgan）:源于外胚层牙乳头（dentalpapilla）:源于外胚层间充质牙囊（dentalfollicle）:源于外胚层间充质,蕾状期（Budstage）：上皮细胞在形态上、功能上的变化是极微小的。帽状期(Capstage)：上皮细胞开始有组织分化和形态分化，形成外釉上皮、內釉上皮和星网状层细胞。钟状期(Bellstage)：既有组织分化又有形态分化，最显著的特点是出现了中间层,它是确定钟状期的标志。,Developmentoftheenamelorgan（成釉器）,蕾状期（Budstage）,TensamlllocalizaedthickeningsofthedentallaminaThebudofprimaryteeth胚胎第八周；牙板末端膨大，似花蕾；细胞立方或矮柱状，增生，无分化。,帽状期（capstage）,ThebudundergoesperipheralproliferationintothemensenchymeFormthetoothcap胚胎第9-10周；细胞增生并发生分化；似帽状。分化为三层细胞外釉上皮（outerenamelepithelium）内釉上皮（innerenamelepithelium）星网状层（stellatereticulum）,钟状期（bellstage）,FurtherperipheralproliferationresembelsabellHistodifferentiationcommences（组织分化开始）胚胎第11-12周；上皮内陷，周缘生长，形似吊钟。分化为四层细胞外釉上皮（outerenamelepithelium）内釉上皮（innerenamelepithelium）星网状层（stellatereticulum）中间层（stratumintermedium）,Basalcellinnerenamelepithelium（内釉上皮）outerenamelepithelium（外釉上皮）Assumeastar-shapedappearancestellatereticulum（星网状层）flattensquamous-type（鳞状）cellstratumintermedium（中间层）,dentalpapilla（牙乳头）,Intheinvagination(内陷）ofthedeepspaceoftheepithelialorganSurroudingtheouterenamalepithelium,theenamelorgan（成釉器）,Theepithelialorganconstitutestheenamelorganconnectedtotheoralepithielium(口腔上皮）byathinneddentallamina(牙板),Calcification（牙体硬组织的形成）,Componentsofthetoothgerm（牙胚）：enamelorgan（成釉器）:giverisetoenamel(牙釉质)dentalpapilla（牙乳头）:giverisetopulpanddentine（牙本质、牙髓）dentalfollicle（牙囊）:giverisetocementum，theperiodontalligamentandalveolarbone（牙骨质、牙周膜、牙槽骨）,(Root)牙根的形成,Arisefromthecervicalloop(颈环）stellatereticulum（星网状层）andintermediatecellcombine（中间层）anepithelialmebraneFormHertwigsepithelialrootsheath（上皮根鞘）Proliferation（单根牙及多根牙的形成）,(Dentine)牙本质的形成,Cellontheperiphery（外周）ofthedentalpapilla(牙乳头）Differentiateintoodontoblast（成牙本质细胞）Dentinefomationdentalpapillachangestodentalpulp（牙髓),（Enamel）牙釉质形成,Predentine(前期牙本质）inducethecellbecometheameloblast(成牙釉质细胞）formtheenamel,（cementum）牙骨质的形成,Formtheamelocementaljunction(釉牙骨质界）Cementumforminassociationwiththerootsheath（根鞘）therootsheathpersistasthecellofMalassez(Malassez上皮剩余）,（Periodontaltissue)牙周形成,Periodontalligamentfiber(牙周膜纤维）attachthecememtumtothealveolarbone（牙槽骨）,牙的萌出（tootheruption）,Aftercompletionofthecrown,总结,牙体的组织来源：成釉器牙釉质牙胚牙乳头牙本质、牙髓牙骨质（內层）牙囊牙周韧带（中层）牙槽骨（外层）,总结,牙的发育过程：acomplexcellularandbiochemicalprocessGrowthstage:Formationofdentallamina（牙胚）DevelopmentoftoothbudCalcification:Formationofhardtissue（