Institute of Experimental Medicine, the Czech Academy of Sciences, Prague, Czech Republic.
Institute of Animal Physiology and Genetics, the Czech Academy of Sciences, Brno, Czech Republic.
J Anat. 2018 Aug;233(2):135-145. doi: 10.1111/joa.12825. Epub 2018 May 10.
In this review, classical data on the early steps in human odontogenesis are summarized and updated with specific insights into the development of the upper and lower embryonic jaws to help in understanding some oral pathologies. The initial step of human odontogenesis is classically characterized by two parallel horseshoe-shaped epithelial laminae. These originate from the oral epithelium and an ingrowth into the jaw mesenchyme: the internal dental lamina gives rise to deciduous tooth primordia, while the external vestibular lamina represents the developmental base of the oral vestibule. However, a more complex situation was revealed by recent studies combining analyses of the dental and adjacent oral epithelia on histological sections and computer-aided three-dimensional (3D) reconstructions during the 2nd month of human embryonic development. The dental epithelium forms a mound, where swellings appear later, corresponding to the individual primordia of deciduous teeth. External to the developing deciduous dentition, the 3D reconstructions do not show any continuous vestibular lamina but instead a complex of discontinuous epithelial bulges and ridges. The patterns of these epithelial structures and their relationship to the dental epithelium differ not only between the upper and lower jaws but also between the lip and cheek segments in each jaw. Knowledge of early odontogenesis may help in understanding some oral pathologies. For example, the human lateral incisor has a dual origin: it arises in the area of fusion between the medial nasal and maxillary facial processes and involves material from these two regions. Such a dual origin at the site of fusion of facial processes represents a predisposition to developmental vulnerability for the upper lateral incisor, resulting in its frequent anomalies (absence, hypoplasia, duplication), especially in patients with a cleft lip and/or jaw. Other pathologies, such as a minute supernumerary tooth, desmoplastic ameloblastoma or extraosseous odontogenic cysts are located external to the upper or lower dentition, and might be derived from structures that transiently appear during early development of the oral vestibule in humans.
在这篇综述中,总结了人类牙发生早期步骤的经典数据,并结合对上下胚胎颌发育的具体见解进行了更新,以帮助理解一些口腔病理学。人类牙发生的初始步骤经典地表现为两个平行的马蹄形上皮层。这些上皮层起源于口腔上皮和向颌骨间质的内陷:内牙板产生乳牙原基,而外前庭板代表口腔前庭的发育基础。然而,最近的研究结合了对牙和相邻口腔上皮组织的分析,在人类胚胎发育的第 2 个月,在组织学切片和计算机辅助的三维(3D)重建中揭示了更为复杂的情况。牙上皮形成一个丘状结构,随后在该处出现肿胀,对应于乳牙的各个原基。在正在发育的乳牙外部,3D 重建没有显示任何连续的前庭板,而是显示出一系列不连续的上皮隆起和嵴。这些上皮结构的模式及其与牙上皮的关系不仅在上、下颌之间有所不同,而且在上、下颌的唇和颊段之间也有所不同。对早期牙发生的认识可能有助于理解一些口腔病理学。例如,人类侧切牙具有双重起源:它起源于中鼻和上颌面突融合的区域,并涉及来自这两个区域的物质。这种在面突融合部位的双重起源代表了上颌侧切牙发育脆弱的倾向,导致其经常出现异常(缺失、发育不良、重复),尤其是在唇腭裂患者中。其他病理学,如微小的额外牙、促结缔组织形成性成釉细胞瘤或骨外牙源性囊肿,位于上颌或下颌牙列之外,可能来源于人类口腔前庭早期发育过程中短暂出现的结构。
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