Developing tooth is called tooth germ, which appeared in developing jaws within the manner of proper location, proper number and proper morphology. During the developmental stages of tooth germ, i.e., initial, bud, cap, early bell and late bell stages, the simple and small tooth germ transformed to ones having complex and larger morphology, and the tooth crown is performed. For the tooth-specific feature is observed in early bell stage but not in cap stage, tooth malformation of the shape is thought to be the result in partial alteration before early bell stage. Tooth malformation is classified into five categories, i.e., the tooth matrix, the shape of the tooth outline, the tooth size, the tooth numbers and the surface morphology. The shape, size, and number of tooth are thought to be determined in the cap stage, and the surface morphology is in the early bell stage. HGF and BMP4 are proposed as the candidates that control the morphological features. The surface morphology of the tooth is formed by many components, but the cusp formation was thought to have two important steps, i.e. the definition of the summit position by secondary enamel knot and role of the groove between cusps by growth factors such as HGF.
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