DH 122 - Oral Histology and Embryology

1. Demonstrate understanding of the salivary glands.
   1. Compare an exocrine gland and an endocrine gland. 
   2. Compare and contrast the location, type of secretion, amount of secretion, and duct location of the three major saliva glands.
   3. Identify the location of the minor salivary glands including VonEbners, the amount and type of saliva produced.
   4. Compare and contrast the etiology and description of a mucocele and ranula.
   5. Describe the histological components of a salivary gland.
   6. Determine the flow of saliva from the salivary gland to the oral cavity.
   7. Identify the major components of saliva and the effect the components have on the oral cavity and caries rate.
   8. Describe the major functions of saliva.
   9. Describe how to assess the flow of saliva for a patient.
   10. Describe why the salivary flow test is necessary and explain the procedure to a patient.
   11. Utilizing the medical history and clinical observations analyze if a salivary flow test is necessary for the patient.
2. Describe the histological characteristics and functions of the lymph tissue.
   1. Determine the functions of the lymph system within the body.
   2. Describe the parts of a lymph node.
   3. Describe the flow of the lymph fluid within the body.
   4. Compare and contrast the drainage of lymph fluid into the various nodes from the structures of the head and neck.
   5. Compare the location of the palatine tonsils, pharyngeal tonsil and lingual tonsils.
3. Describe the caries process, Caries Risk Assessment and Caries Management
   1. Summarize the process of cavitation, demineralization and remineralization.
   2. Describe the use of CAMBRA to assess dental caries risk
   3. Assess the caries risk and determine caries prevention strategies.
4. Describe how to manage oral malodor for the dental patient.
   1. Determine assessments utilized to identify the etiology of oral malodor.
   2. Categorize various etiologies of oral malodor.
   3. Explain to a patient the relationship between oral malodor and periodontal disease.
   4. Determine methods to discuss oral malodor with patients.
   5. Create a treatment plan to manage oral malodor.
5. Demonstrate understanding of cells.
   1. Describe the structure and contents of an individual cell.
   2. Identify and describe the four basic types of tissues.
6. Distinguish between the two basic types of oral tissue and three types of mucosa in the oral cavity.
   1. Identify the location of non-keratinized and keratinized tissue within the oral cavity.
   2. Identify the location and describe the three types of mucosa in that oral cavity.
7. Identify terms related to embryology and histology
   1. Define the following terms: histology, embryology, prenatal development.
   2. Compare and contrast cell, cell membrane, tissue, organ, and organ systems.
   3. Utilize histological terminology to describe the development of the embryo.
8. Determine the development of the embryo during weeks one through four.  
   1. Illustrate and describe the development during week one pre-implantation.
   2. Identify the tissues of the blastocyst at the end of week one and what each tissue will become.
   3. Describe the changes of the embryo that occur between week one and two.
   4. Identify the tissues during week two and determine what those tissues will become.
   5. Describe how the bilaminar disc develops into a trilaminar disc during week three. 
   6. Identify and describe the notochord
   7. Summarize the development of the neural tube. 
   8. Determine where the neural crest cells originate.
   9. Describe why the neural crests cells are critical to the development of the head and neck.
   10. Identify the time period for the development of the spinal cord.
   11. Describe the somites and determine what the somites develop.
   12. Define and give examples of teratogens.
   13. Discuss five teratogens and the defects the teratogens may cause.
   14. Determine if all birth defects are caused by teratogens.
   15. Determine how Down syndrome occurs.
   16. Identify characteristics of Down syndrome.
   17. Describe how Down syndrome may affect the physical characteristics of the oral cavity.
   18. Describe how and when an ectopic pregnancy occurs.
   19. Summarize why week four of pregnancy is a critical time period in development.
9. Describe the embryonic development of the upper, mid and lower face.
   1. Describe the stomodeum, development of the stomodeum and timeframe.
   2. Identify the location of the oropharyngeal membrane and the significance of the tissue involved.
   3. Describe what occurs during week four to the oropharyngeal membrane.
   4. Describe how and when the mandibular and maxillary arches develop.
   5. Discuss what parts of face the frontonasal develops.
   6. Summarize the movement of the medial nasal processes, lateral nasal processes, eyes and ears during development.
   7. Describe the formation of the upper lip including timeframe of development.
   8. Compare and contrast the degrees of severity related to a cleft lip.
10. Describe the embryonic development of the palate.
    1. Summarize the three stages of the development of the palate.
    2. Identify the timeframe for the development of the palate.
    3. Identify the teeth located in the primary palate and the palatal shelves.
    4. Draw and label the hard and soft palate.
    5. Compare and contrast the degrees of severity related to cleft palate.
11. Describe the embryonic development of the tongue.
    1. Identify the timeframe for tongue development.
    2. Determine the branchial arches that are involved in the formation of the tongue.
    3. Summarize the formation of the tongue.
    4. Describe three landmarks of the tongue and indicate why the landmark is present.
    5. Draw the tongue identifying the body of the tongue, base of the tongue, and the four different papilla located on the tongue.
12. Describe each stage of tooth development.
    1. Describe the initiation stage, the dental lamina and its age of appearance embryologically.
    2. Define terms related to tooth development.
    3. Identify and describe two developmental problems that may occur during initiation.
    4. Determine how the two abnormalities will affect the patient's treatment plan.
    5. Describe the bud stage and determine what occurs during this stage.
    6. Identify the time frame for the bud stage.
    7. Draw and label a picture of the bud stage
    8. Identify two abnormalities that may develop during the bud stage.
    9. Determine how the two abnormalities may affect the patient’s treatment plan.
    10. Identify the time frame for development during the cap stage.
    11. Identify what occurs during the cap stage.
    12.  Draw and label a picture of the cap stage.
    13. Identify the three parts of the tooth germ.
    14. Indicate what each part of the tooth germ will develop.
    15. Identify three abnormalities that may develop during the cap stage.
    16. Determine how the three abnormalities will affect the patient’s treatment plan.
    17. Describe the timeframe that the bell stage occurs.
    18. Describe what occurs during the bell stage.
    19. Draw a picture of the bell stage and label all the different types of cells.
    20. Determine what each type of cell is responsible to create during the bell stage.
    21. Describe the apposition stage.
    22. Determine what is occurring during the apposition stage.
    23. Describe the maturation stage.
    24. Determine what is occurring during the maturation stage.
13. Explain the development of the root.
    1. Relate the cervical loop to crown development and root development.     
    2. Relate the role of Hertwig’s epithelial root sheath (HERS) to root formation of single, bifurcated and trifurcated roots.
    3. Describe the relation of HERS to root dentin formation.
    4. Describe the epithelial rests of malassaz related to root development.
14.  Explain the stages of tooth eruption.
    1. Identify the eruption dates of primary and permanent teeth.
    2. Compare the position of the permanent teeth in relation to their primary predecessors.
    3. Compare and contrast active and passive eruption.
    4. Summarize the bell stage related to the reduced enamel epithelium (REE).
    5. Describe the process of root resorption and subsequent exfoliation of a primary tooth.
    6. Describe the eruption of a permanent tooth. 
    7. Describe deviations that may occur in relation to eruption patterns. 
15. Explain the morphological and histological structures of dentin.
    1. Describe the embryological process involved in producing dentin.
    2. Describe the chemical composition of dentin.
    3. Compare and contrast primary, secondary, reparative/reactive, and sclerotic, dentin.
    4. Compare and contrast the various types of dentin: peritubular, intertubular, mantle, circumpulpal, interglobular, and Tomes granular layer.
    5. Determine the etiology of the following: Imbrication Lines of Von Ebner, Contour Lines of Owen, and neonatal line.
    6. Describe dead tract and korff’s fibers found within the dentin.
    7. Discuss the effects on dentin due to taking tetracyline during tooth development.
    8. Describe dentinal sensitivity related to the contents of dentinal tubule and stimulation.
    9. Create a treatment plan to address a patient’s complaint related to dental sensitivity.
    10. Compare the width of the dentinal tubule at the DEJ and near the pulp.
16. Explain the morphological and histological structures of pulp.
    1. Describe the embryonic origin of the pulp.
    2. Explain the functions of the pulp
    3. Describe the components of the pulp and subsequent age changes of the pulp.
    4. Label and describe the pulp horns, apical foramen, coronal and radicular pulp.
    5. Determine how accessory canals are developed.
    6. Identify where accessory canals are located.
    7. Describe innervation and vascularization of the pulp.
    8. Describe the cells, fibrous matrix, ground substance within the pulp.
    9. Compare and contrast true and false denticles
    10. Discuss the various diseases of the pulp tissue.
    11. Communicate to your patient how an abscessed tooth can be life threatening.      
17. Describe the various characteristics of enamel including the histological characteristics.
    1. Determine the chemical formula of enamel.
    2. Identify the name of the crystal found in enamel.
    3. Identify the percent of inorganic and organic matter within enamel.
    4. Determine why the DEJ is scalloped.
    5. Compare and contrast the ameloblast to an odontoblast.
    6. Compare and contrast the preameloblast and ameloblast.
    7. Discuss the theory of Enamel Prisms, Prism Sheaths and the orientation of the enamel prisms.
    8. Identify where gnarled enamel is located.
    9. Compare and contrast gnarled enamel and enamel.
    10. Compare and contrast the incremental lines of retzius and neonatal lines.
    11. Determine how perikymata are developed.
    12. Compare and contrast enamel spindles, tufts, and lamellae
18. Describe the various histological characteristics of cementum, periodontal ligament and alveolar bone.
    1. Discuss the development of cementum
    2. Compare and contrast cementum and cementoid
    3. Compare and contrast acellular cementum and cellular cementum
    4. Describe how cementocytes, lacunae, and canaliculi are related.
    5. Describe the role and location of cementoblasts
    6. Compare and contrasts reversal and arrest lines
    7. Compare and contrast free and attached cementicles
    8. Describe the role of Sharpey’s Fibers
    9. Describe the development of alveolar bone.
    10. Differentiate between the different types and location of bone.
    11. Describe the osteocytes within the bone.
    12. Describe osteoid and bone.
    13. Compare and contrast the osteoblasts and osteoclasts
    14. Compare and contrast the components of cementum and alveolar bone.
    15. Compare and contrast the chemical composition and percent of inorganic and organic material in bone and cementum.
    16. Describe the collagen fibers embedded in cementum and in alveolar bone.
    17. Compare and contrast the components of cementum and alveolar bone.
    18. Identify the name and purpose of the various periodontal fibers.