口腔医学英语讲义

TheDevelopmentandComponentofaTooth吴堪葵广州医学院第二附属医院Unit4DevelopmentofatoothAtoothanditssurroundingsComponentsofatoothTheDevelopmentandComponentofaToothComponentofaToothDentineEnamelCementumPulpMineralizedTissue96%～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）Dentine12%waterDentinaltubulesFrompulpToenamel-dentinaljunction釉牙本质界WideinthepulpsideNarrowintheenamelsideInorganicmaterial65%Organicmaterial（collagen胶原18%CementumCementumWater12%Similartobonedifference–Novascularity(血管)–Containcementocytes（成牙骨质细胞）PulpConnectivetissue结缔组织Nerves神经Bloodvessels血管Lymphvessels淋巴管Linedbyodontoblasts成牙本质细胞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.AtoothanditssurroundingsPeriodontium牙周组织Maintainatoothinitsfunctionalposition支持牙的功能Gingiva牙龈Periodontalligament牙周膜Alveolarbone牙槽骨Gingiva牙龈MucosawhichsurroundstheteethFreegingiva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•Surroundsthetoothincollarfashion•Formsthesofttissuewallofthegingivalsulcus龈沟（0.5-3mm•平均1.8mm)Attachedgingiva附着龈ContinuouswiththefreegingivaByashallowlineardepression,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)shapePeriodontalligament牙周韧带Alsocalledperiodontalmembrane牙周膜LocatesbetweenalveolarboneandtherootSupportive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AtoothanditssurroundingsGingiva牙龈MucosawhichsurroundstheteethFreegingivaAttachedgingivaInterdentalpapillaPeriodontalligamentAlveolarbonealveolarcrestgrouphorizontalgroupobliquegroupapicalgroupinterradiculargroupAlveolarboneproperDenseboneCancellousboneDevelopmentoftoothProcessBeginningFinishEruptionReplacement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)thickenDentallamina(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）TensamlllocalizaedthickeningsofthedentallaminaThebudofprimaryteeth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）ThebudundergoesperipheralproliferationintothemensenchymeFormthetoothcap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）Furtherperipheralproliferation——resembelsabellHistodifferentiationcommences（组织分化开始）胚胎第11-12周；上皮内陷