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Tertiary dentin (including reparative dentin or sclerotic dentin) is a form of dentin, one of the main component materials of teeth. It forms as a reaction to stimulation, including caries , wear and fractures . [ 1 ]
Reactionary dentin is formed by odontoblasts when the injury does not damage the odontoblast layer. Reparative dentin is formed by replacement odontoblasts when the injury is so severe that it damages a part of the primary odontoblast layer. Thus a type of tertiary dentin forms in reaction to stimuli, such as attrition or dental caries.
Dentin formation, known as dentinogenesis, is the first identifiable feature in the crown stage of tooth development. The formation of dentin must always occur before the formation of enamel. The different stages of dentin formation result in different types of dentin: mantle dentin, primary dentin, secondary dentin, and tertiary dentin. [31]
Tertiary dentin is dentin formed as a reaction to external stimulation such as cavities and wear. [27] It is of two types, either reactionary, where dentin is formed from a pre-existing odontoblast, or reparative, where newly differentiated odontoblast-like cells are formed due to the death of the original odontoblasts, from a pulpal progenitor ...
These materials protect the pulp from noxious agents (heat, cold, bacteria) and stimulate the cell-rich zone of the pulp to lay down a bridge of reparative dentin. Dentin formation usually starts within 30 days of the pulp capping (there can be a delay in onset of dentin formation if the odontoblasts of the pulp are injured during cavity ...
On the other hand, dentin is produced continuously throughout life by odontoblasts, which reside at the border between the pulp and dentin. Since odontoblasts are present, a stimulus, such as caries, can trigger a biologic response. These defense mechanisms include the formation of sclerotic and tertiary dentin. [80]
Odontoblasts also secrete tertiary dentin when irritated. Tertiary dentin secreted by odontoblasts is often due to chemical attack, either by chemicals diffusing through the dentin and insulting the odontoblasts, or by diffusion of toxic bacterial metabolites down the dentinal tubules in the instance of a carious attack with dental decay. This ...
Pulp acts as a security and alarm system. Slight decay in tooth structure not extending to the dentin may not alarm the pulp, but as the dentin gets exposed, due either to dental caries or trauma, sensitivity starts. The dentinal tubules pass the stimulus to the pulp's odontoblastic layer, triggering the response. This mainly responds to cold.