Permanent Dentition Tooth Morphology PDF

Permanent Dentition Tooth Morphology Module: Oral and Dental Science Tutor: Ms P Lazarou  GDC Learning Outcomes 2013: 1.1.5 Describe relevant and appropriate dental, oral, craniofacial and general anatomy and explain their application to patient management 2023: C 1.5 Identify releva...

Permanent Dentition Tooth Morphology Module: Oral and Dental Science Tutor: Ms P Lazarou  GDC Learning Outcomes 2013: 1.1.5 Describe relevant and appropriate dental, oral, craniofacial and general anatomy and explain their application to patient management 2023: C 1.5 Identify relevant and appropriate dental, oral, craniofacial, and general anatomy (recognising the diversity of anatomy across the patient population) and explain their relevance to patient management  Intended learning outcomes Revise and identify anatomical details of teeth Record the chronology and notation for the permanent dentition Identify and describe the locations/anatomy of the various tooth Loading… surfaces of the permanent dentition. Compare and discuss the anatomical differences between the permanent teeth Discuss and reflect on how you would use this knowledge within the clinical setting Assessment Formative Summative Permanent Dentitions Questions in Oral and Dental Workbook Sciences Eassessment  Review Dental notation systems FDI System Loading… Palmers System. Permanent Teeth URQ ULQ 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8 LRQ LLQ 6 Tooth Anatomy ct ds 888 Cusp: ms Cusp tip (ct) - Tip of cusp Mesial slope (ms) Towards midline Cusp incline Distal slope (ds) Away tram midline Cusp incline Slope -. towards fissure 7 Tooth Anatomy valleys. Developmental groove: Can be found occlusally, O buccally, palatally, lingually and even on j roots Previously called ?fissures Developmental grooves Image ref: pocketdentistry.com 8 Plaque retativecrea. Tooth Anatomy Fossa (plural = fossae) Pits or hollows on the tooth ⑧ surface May be associated with grooves O May be enclosed by ridges 9 nors pur Pulp Anatomy Pulp chamber – within crown of tooth ap Root canals – extensions of -namber the pulp which lie within the roots - Root Pulp horns – extensions of canals the pulp chamber which extend under cusps etc. Apex Image ref: www.inmagine.com 1 0 UPPER PERMANENT INCISORS AND CANINES Image ref: www.worldofsmiles.com 1 1 Take a picture! Can spot the characteristics mentioned on your own teeth…? Loading… Image ref: quora.com  Terms Initial calcification - calcium first being laid down Crown completion - the final step in the process of placing dental crown on a tooth. Eruption- when a developing tooth moves from it nonfunctional position within the alveolar bone to it pa final functional location within the oral cavity. Root completion - the stage when the root of a tooth is fully formed , usually occurs 2-3 years after tooth first erupts.  URI ULL Upper Central Incisors (11;21) Chronology Initial calcification 3-4 months after birth Crown completion 4-5 years Eruption 7-8 years Root completion 10 years Image ref: http://dentapps.leeds.ac.uk/ Upper Central Incisors (11;21) Labial Large crown view Smooth, slightly convex Distal Mesial labial surface incisal incisal angle angle Mesio-incisal angle is sharp Disto-incisal angle is rounded d m Mamelons often present when newly erupted Image ref: http://dentapps.leeds.ac.uk/ Mamelons on newly erupted central incisors 14  Upper Central Incisors This is the headline Palatal Dip The palatal surface is concave and view Distal Mesial Palatal surface has mesial & marginal marginal distal marginal ridges Raised ridge - ridge area -cervical - area Marginal ridges meet centrally. near the gingival margin to form the convex cingulum m cingulum - d Above the cingulum is the hollow cingulum pit Near Cevical - Area Image ref: http://dentapps.leeds.ac.uk/  Upper Central Incisors This is the Mesial headline curved view Crown enamel margin undulates mesially & distally Root undulates. One single, tapering root - --- CEJ One root canal with 2 pulp horns, one mesial & one distal Cervical Cingulum undulation Image ref: http://dentapps.leeds.ac.uk/ 1 7 Upper right permanent central incisor Image ref: http://dentapps. leeds.ac.uk/ Buccal Palatal Mesial Distal Upper Lateral Incisors (12;22) UL2 UR2 Chronology Initial calcification 10-12 months after birth Crown completion 4-5 years Eruption 8-9 years Root completion 11 years  Upper Lateral Incisors (12;22) Labial view Much less bulky and smaller than central incisor Distal Narrower cervically (gingivally) than incisal incisally angle Pronounced rounding of the distal- incisal angle d m  Upper Lateral Incisors Palatal view Pronounced mesial & distal um w marginal ridges palatally ang Palatal cingulum - Boulbous m ·d More marked cingulum pit than central incisor I Cingulum Plaque retentive pit - 2 1 Mesial Upper Lateral Incisors view Cervical undulation mesially and distally One tapering root One root canal with 2 pulp horns, one mesial & one distal 2 2 · ocassionally 2 Canals Root Upper right permanent lateral incisor · Spit Roots Labial Palatal Mesial Distal Upper Canine (13;23) Jurs un Chronology Initial calcification 4-5 months after birth Crown completion 6-7 years Eruption 11-12 years Root completion 13-15 years  · more Discared due to Upper Canine (13;23) more dentine. Labial view One cusp incisally Labial surface is convex Distal bulge Distal slope of cusp is longer than mesial slope ↳ d m Distal surface more bulbous than Cusp mesial surface  UPPER RIGHT CANINE Convex labial Distal surface bulge Mesial cusp Distal slope cusp slope Cusp tip 26  Upper Canine Palatal aired is view P Concave palatal surface Mesial marginal Distal Pronounced mesial & distal fossa marginal ridges ridge Large cingulum m d Mesial & distal fossae O-cingulum  Distal Upper Canine view Cervical undulation Distal root groove One long, tapering root retation aque Pl One root canal with no pulp horns Distal root groove more prominent than mesial root groove 2 9 Upper right permanent canine · exariation a size · Extra cusp distal · pointed Cingulum Incined · Reats Labial Palatal Mesial Distal  Distal 3 0 Comparison of 11, 12, 13 – Labial View Loading… Central Incisor Lateral Incisor Canine 3 1 Comparison of 11, 12, 13 – Palatal View Central Incisor Lateral Incisor Canine 3 2 LOWER INCISORS AND CANINES. Image ref: mapleorthodontics.co uk Lower Central Incisor (31;41) ILRILL Chronology Initial calcification 3-4 months after birth Crown completion 4-5 years Eruption 6-7 years Root completion 9 years · one of first permenal teeth to erupt. Lower Central Incisor (31;41) Flat labial surface Fairly symmetrical labial surface m d Distal incisal angle very slightly more rounded than mesial incisal angle Mamelons initially present on eruption – quickly worn Labial away view 3 5 Mamelons on lower central incisors Image ref: Oralanswers.com Lower Central Incisor Concave lingual surface Small marginal ridges m d Small cingulum - cngulum Lingual view Lower Central Incisor it ecanals Buccl/Lingual · Biocated Crown is wedge-shaped Root from the side view Cervical undulation undulation One root, one root canal and mesial & -... distal pulp horns Mesial view  Lower Lateral Incisor (32;42) LL2LR2 Chronology Initial calcification 3-4 months after birth Crown completion 4-5 years Eruption 7-8 years Root completion 10 years Lower Lateral Incisor (32;42) Looks more fan shaped than central incisor from the labial Mesio-incisal angle is sharp & disto-incisal angle is rounded d web re m than a Mesial side slightly longer than distal Labial view  Lower Lateral Incisor Concave lingual surface concavesurface Lingual - Small cingulum One root with more m d pronounced distal groove eingulum than mesial groove -_ One root canal, mesial & distal pulp horns - · variation of root and Lingual · size crown view 4 3 Comparison of 41 and 42 – Labial and Lingual View d m d m m d m d 31 Labial 32 Labial 31 Lingual 32 Lingual  LL3 LR3 Lower Canine (33;43) Less bulky than upper canine & cusp. the crown is taller than it is wide - mesial Convex labial surface, with one - cusp which inclines distally a Slope Dis d. m scope Mesial slope of cusp shorter than distal slope Distal surface more bulbous than mesial Labial view  Lower Canine cusp Chronology - neiDista ose Initial calcification 4-5 months after birth Crown completion 6-7 years ofassea Eruption 9-10 years Root completion 12-14 years  Variation Lower Canine - 2 Root canals Bifurcard Lingually there are mesial & · Roots distal marginal ridges and a cingulum as in the upper · Crown/Root canine, but all less Size. pronounced m d Mesial & distal lingual fossae of which the distal is larger aDistal Cingulum / fossa One root, one root canal & no pulp horns Lingual view 4 8 Comparison of 13 and 43- labial view d m 13 43 d m 4 9 Comparison of 13 and 43 – palatal/lingual view m d 13 43 m d 5 0 MAXILLARY PREMOLARS Upper First Premolar (14;24) UR4/U24 Chronology Initial calcification 18-21 months after birth Crown completion 5-6 years Eruption 10-11 years Root completion 12-13 years  Upper First Premolar (14;24) Buccal view 2 cusps – one buccal & one palatal e mesial · Buccal cusp is larger d m Mesial slope of buccal cusp is longer than distal slope Buccal cusp Crown is oval – wider bucco- palatally than mesio-distally 9 Palatal uSp.  Upper First Premolar Palatal view Palatal cusp is smaller and narrower Tip of palatal cusp is displaced a m d mesially when viewed from the palatal side Displace zossae & Palatal One central groove, and 2 cusp fossae inside the marginal ridges Marginal & ridge O  Upper First Premolar This is the headline Mesial o view Mesial root surface has a developmental groove between developmen 9 o the 2 cusps Canine fossa – hollow concavity on mesial root surface which O houses the bulge distally on the canine Canine fossa ↑ Where Canine sits.  Upper First Premolar 2 roots – one buccal & one palatal soDistal view Sometimes the 2 roots are partly fused 2 root canals (buccal & palatal) and 2 pulp horns 5 6 Upper right permanent first premolar Labial Palatal Mesial Distal Upper Second Premolar (15;25) URS/unS Chronology Initial calcification 2-2.5 years Crown completion 6-7 years Eruption 10-12 years Root completion 12-14 years  Upper Second Premolar (15;25) Buccal includally 2 cusps - one buccal & one palatal ~ view Buccal cusp slightly larger than palatal cusp d m Mesial slope of buccal cusp shorter than distal slope Buccal cusp esp. Palatal Crown is oval – wider bucco- palatally than mesio-distally  Upper Second Premolar This isPalatal the headline view Palatal cusp displaced mesially as in the first premolar Single root, flattened mesio- m d distally Palatal One or two root canals, and two cusp tip pulp horns Root may bend distally at apex  Distal Upper Second Premolar This is the headline view One central groove, and 2 & Root fossae inside the marginal ridges groove Distal. The root often has a more prominent groove distally variations flared crown fossae- dentral · cusp · Extra · additional graves Bifurcated Root groove. ·. 6 1 Upper right permanent second premolar Labial Palatal Mesial Distal  Distal 6 2 Comparison of 14 and 15 – Buccal and Occlusal View Buccal view Upper Upper right right first second premolar premolar d m d m 6 3 Comparison of 14 and 15 – palatal and Occlusal View Upper Upper right first right premolar second premolar No · canine mesial Fossa on - URS/475 contessa &. 6 4 MANDIBULAR PREMOLARS  LL4/CR4 Lower First Premolar (34;44) Chronology Initial calcification 1 ¾-2 years Crown completion 5-6 years Eruption 10-12 years Root completion 12-13 years Lower First Premolar (34;44) Lingual cusps. 2 cusps – one large buccal cusp and one much smaller lingual O cusp Buccal Crown is round in outline m looking occlusally, but is ‘angled d off’ mesially Buccal shape is similar to lower canine with shorter mesial cusp slope and bulbous distal surface inclined Buccal Distally view - Lower First Premolar Buccal Distal cusp fossa cus - One central lingual developmental On groove separates the Fossa cusps - mmesiadi d central 2 fossae, one mesially and one distally – Short development groove. distal fossa is larger lingual cusp Lingual view  Lower First Premolar s effect Poo - Buccal cusp leans lingually Lingual Buccal Lingual cusp overhangs the cusp cusp root Very curved buccal surface One root, one root canal and a single pulp horn variations : val cusp missinger Larger · Ling cusp Distal cusp/2 lingual · Extra view · Bifurcatia Roots..  LLS LRS Lower second Premolar (35;45) Chronology Initial calcification 2 ¼ -2 ½ years Crown completion 6-7 years Eruption 11-12 years Root completion 13-14 years Lower second Premolar (35;45) mustenter 0 Acusp dl 00 ml 3 cusps – one buccal, 2 lingual O-Buccal Larger in comparison to lower first premolar Buccal cusp - S mesial Shorter Dissenger The mesio-lingual cusp d m Slope (ml) is larger than the disto-lingual (dl) cusp S Mesial slope of buccal cusp is shorter than the distal slope Buccal view  variation - Lower Second Premolar -additional Shallow grooves · Bifurcated Reets The crown viewed from the occlusal is round– · more flaired square in outline Gown ml dl Single root with a tendency to curve distally at the apex m d One root canal, 2 – 3 pulp horns Distal ~ Lingual incline view 7 4 side- Lateral comparison of 44 & 45 44 – 45 – note the ------ ----- note the very ------ - ----- lingual short cusps lingual Lingua are Lingu cusp al cusp l cusps much higher I lingual 2 Lingual cusp cusp. 7 5 Comparison 44 and 45 – Buccal and Lingual View 44 Buccal 45 Buccal 44 Lingual 45 Lingual 7 6 MAXILLARY MOLARS Upper First Molar (16;26) URGluLG Chronology Initial calcification Birth or slightly before Crown completion 2 ½ -3 years Eruption 6-7 years Root completion 9-10 years  Upper First Molar (16;26) Buccal so view 1. 4 cusps: Mesio-buccal (mb) o R 2. Disto-buccal (db) 3 3. Mesio-palatal (mp) d m 4. Disto-palatal (dp) 2 buccal cusps of similar size mb cusp Mesio-palatal cusp the largest db o O cusp Disto-palatal cusp the smallest G dpO mp cusp cusp Largest smallest  Palatal Upper First Molar view Sometimes an additional cusp is present on the palatal surface of the mesio-palatal cusp called the Cusp of Carabelli Cusp of cusp Carabelli. m d Extra Upper First Molar Buccal view The crown is an equilateral rhomboid, with the mesio-distal dimension being roughly equal to the bucco-palatal dimension aid Rhomb pe  Upper First Molar Ridge of enamel running from the disto-buccal cusp to the mesio-palatal cusp called the oblique ridge Oblique ridge divides the dedb mb occlusal surface into 2, often with distinct, separate groove patterns · Distal to the oblique ridge is a i mp deep groove running from dp Y occlusal to palatal surfaces, which separates off the disto- palatal cusp  Upper First Molar This is the headline Palatal groove Central groove which may be divided into 2 by oblique ridge Palatal groove Palatal wall more curved than buccal wall, such that palatal cusp tips lie further onto occlusal surface than buccal cusp tips b p  inside turcation · Upper First Molar 9 furcation 3 roots: 1. Large single palatal root 2. Mesio-buccal 3. Disto-buccal p b 3 or 4 root canals (extra one is mesio-buccal) and 4 pulp horns (one per cusp) Distal view 8 4 Fariations · Fused Roots · Enamel Pearls. · under developed cusps · Exra Rock d m m Mesio-buccal and Single large palatal disto-buccal roots root Upper Second Molar (17;27) URT U27 Chronology Initial calcification 2 ½ -3 years Crown completion 7-8years Eruption 12-13 years Root completion 14-16 years  Upper Second Molar (17;27) Buccal view As with upper first molar, there are 4 cusps – mesio-buccal, disto-buccal, mesio-palatal and disto-palatal Disto-palatal cusp is smaller than in the first molar m d db mb 16 17 00 0 O dp mp Upper Second Molar The smaller disto-palatal cusp makes the rhomboidal shape of the occlusal surface more squashed and angled – it is no longer equilateral oidal R homb shape.  horrs 4 pulpal. Upper Second Molar · The fissure pattern occlusally is very similar to the first molar, with an oblique ridge and palatal fissure There are the same 3 roots, one palatal, a mesio-buccal and a disto-buccal, but less divergent -Less splayed Roots-closer sometimes fused. Upper Third Molar (18;28) Chronology Initial calcification Crown completion 7-9 years 12-16 years Loading… Eruption 17-21 years Root completion 18-25 years  b Upper Third Molar (18;28) The occlusal shape is triangular, m d with the disto-palatal cusp lost or very small p Often only 3 cusps – palatal, mesio-buccal & disto-buccal Often 3 fused roots with 3 root canals, & roots often curve distally d m Can be very varied in shape, 9 cusp form and number of 3 16 17 18 9 4 MANDIBULAR MOLARS  Lower First Molar (36;46) LLG LRG Chronology Initial calcification Birth or slightly before Crown completion 2 ½ -3 years Eruption 6-7 years Root completion 9-10 years Lower First Molar (36;46) 5 cusps – 3 buccal & 2 00 dl ml lingual: 1. 2. Mesio-lingual (ml) Disto-lingual (dl) Distal cusp 800 d db mb 3. Mesio-buccal (mb) 4. Disto-buccal (db) 5. Distal (d) d m Distal cusp displaced onto distal surface Further - back Buccal view Lower First Molar The mesio-buccal cusp is larger than the disto-buccal cusp Developmental grooves The distal cusp is the smallest cusp mb d db There are 2 developmental d m grooves buccally between the cuspa, of which the mesial is deeper & longer Buccal view & Lower First Molar Mesio-lingual cusp larger than roore disto-lingual cusp 9 Occlusally the cusps centralLingual small interdigitate, and the central groove groove zig-zags between ml them dl m d Overall crown shape viewed occlusally is oval Small lingual groove Lingual view  Lower First Molar Buccal wall curved fore entral Lingual wall much more straight 2 roots, mesial & distal b l 3 or 4 root canals, 5 pulp horns Mesial root is wider and often has a marked central groove # Wide Developmental grooves ----- mesial Mesial root view  Lower First Molar Distally the distal cusp is visible ~ pitsIswet Very short marginal ridge to the lingual side of the distal cusp l b Distal root is narrower and usually without a groove Fossae o o o Distan Distal view  IRZ Lower Second Molar (37;47) LL7 Chronology Initial calcification 2 ½ -3 years Crown completion 7-8 years Eruption 11-13 years Root completion 14-15 years Lower Second Molar (37;47) 4 cusps – 2 buccal &2 db mb lingual: 1. Mesio-buccal dl ml 2. Disto-buccal d m 3. Mesio-lingual mb db 4. Disto-lingual Mesio-buccal cusp higher than disto-buccal cusp Buccal view Lower Second Molar Mesio-lingual cusp higher than disto-lingual cusp retastcoand grow m d Overall occlusal shape is rectangular ml dl Buccal & lingual cusp Yower the ngual tips are opposite each other mesialesp. Cross–shaped groove Lingual view pattern  Lower Second Molar Wider mesially than distally d 2 roots, one mesial & one distal m Mesial root is wider and often grooved b l Buccal surface is curved Lingual surface is straighter * mesial Mesial Root view  Lower Second Molar Distal root is narrower Lingual Buccal groove groove 3 – 4 root canals & 4 Deeper pulp horns lingual than l b groove. Buccal groove (deeper) and lingual groove Fossae - Distal view 1 0 larger. 6 Comparison of 46 and 47 – Buccal and Lingual View 46 Buccal 47 Buccal 46 Lingual 47 Lingual 1 0 8 16 and 17 Buccal and Palatal / Lingual Views 46 and 47  Mandibular Third Molar (38;48) Chronology Initial calcification 8-10 years Crown completion 12-16 years Eruption 17-21 years Root completion 18-25 years Mandibular Third Molar (38;48) Very variable size & form 4, 5 or 6 cusps Roots – variable number, may be fused & often have a marked distal inclination d m Buccal view Mandibular Third Molar Very curved, convex buccal b l wall Mesial view Bulbous crown Broader mesial root l b Narrower distal root Distal view  functions of teeth. Central Incisors Slice - 6 through foodWhen eatings, Supports ups , aids in speech gestetics , · masticatina Incisos-cuttiof foduring Lateral Canines-Ripping/tearing of food. pre-molars - Tear , crush , grind food into smaller Pieces. 2nd molars - grinding and chewing food. Eruption Dates. References and further reading Beek, G.C.v (1983) Dental Morphology, An illustrated Guide. 2nd Edition. Bristol: John Wright & Sons Ltd. Leeds University (2014) Tooth Morphology Lab. [online] Available at: http://www.dentistry.leeds.ac.uk/students/vlab/morphology/ [Accessed 20 March 2021]. University of Dundee (2015) Dundee Tooth Morphology. [online] Available at: https://sketchfab.com/DundeeDental/collections/dundee-tooth-morphology [Accessed 20 March 2021]. 112 1 1 3 Resources Maxillary Lateral Incisor Anatomy: https://www.youtube.com/watch?v=GD1rQcW5Lzk Mandibular Central Incisor Anatomy https://www.youtube.com/watch?v=avu0NraMgcA Mandibular Lateral Incisor Anatomy https://www.youtube.com/watch?v=cI9PGFcKrB8 Mandibular Canine Anatomy https://www.youtube.com/watch?v=G8sgEh3qU8o 1 1 4 Resources cont. Maxillary First molar Anatomy https://www.youtube.com/watch?v=7RuWpHGnWo4 Maxillary Second Molar Anatomy https://www.youtube.com/watch?v=z0zv4tlwpcU Mandibular First Premolar Anatomy https://www.youtube.com/watch?v=N3do-BBk0dM Mandibular Second Premolar Anatomy https://www.youtube.com/watch?v=qNmM0xYigdA Mandibular molar Anatomy https://www.youtube.com/watch?v=DuPwsfuTr5o