Final Exam Review 2024 Lecture PDF

Final Exam Review 2024 Module 1 The tongue is a thick, muscular organ that consists of two main parts: the oral tongue (or body) and the base of tongue. These two parts are separated by the circumvallate papillae, which are dome-shaped projections on the surface of the tongue that house some of th...

Final Exam Review 2024 Module 1 The tongue is a thick, muscular organ that consists of two main parts: the oral tongue (or body) and the base of tongue. These two parts are separated by the circumvallate papillae, which are dome-shaped projections on the surface of the tongue that house some of the taste bus of the tongue. The base of the tongue contains 4 different parts: 1. Tip: sometimes called apex- this is the front part of the tongue 2. Lateral Border: this is the side of the tongue, and there is one on the right and one of the left of the tongue 3. Dorsal Surface: this is the top of the tongue, which is closest to the roof of the mouth 4. Ventral Surface: this is the undersurface of the tongue, which is connected to and closest to the floor of the mouth.  Salivary Glands Submandibular Sublingual Parotid Produces 60-65% of total Smallest salivary gland. Largest major salivary Provides about 10% of saliva. Wharton's duct gland. Produces 25% of saliva through the bridges between the saliva. Stenson's duct Bartholin's duct. Located gland and oral cavity. connects the gland to below the tongue and Located just beneath the the mouth. Located just anteriorly to the mandible posterior to below and in front of ear submandibular gland sublingual. Enamel: Outer layer of anatomic crown Most densley mineralized and hardest tissue in human body. Composed of 96% inorganic matter and 4% organic matter and water Ameloblast - cells that produce enamel during tooth development Thickness and mineralization determine shade more enamel = whiter greater mineralization = greater translucency  Dentin: Makes up main portion of tooth structure Bulk of the tooth Composition is 70% inorganic, and 30% organic and water. Softer than enamel, but harder than cementum Odontoblast - dentin-producing cells Dentinal tubules extends from the pulp to the enamel or cementum. Excellent thermal conductors. Therefore, due to dentinal exposure, pain, and hot or cold sensitivity may be experienced  Dentin: Makes up main portion of tooth structure Three types of dentin: primary dentin - formed before eruption, form the bulk of tooth secondary dentin - form after eruption; continues forming, gradually narrow pulp chamber with age tertiary dentin -also reparative dentin, forms as a result of trauma or dental caries Yellow, secondary dentin explains why teeth become yellower over time Pulp composed of blood vessels, lymph vessels, nerve tissue, and odontoblasts blood vessels = provides nourishment to cells and white blood cells to fight infection lymph vessels = filter fluids in tooth nerve tissue = sensory function walls up pulp contain odontoblast. which dentin and why? pulp shrinks over time  Cementum: Bonelike, rigid connective tissue that covers root of the tooth In conjunction with periodontal ligament, protect and anchor tooth to bony socket within periodontium Comprise of 45-50% inorganic, and 50- 55% organic. Light yellow and duller in hue. Not as hard as enamel or dentin, and slightly more dense than bone Cementoblast - cells that produce cementum  Modules 2, 3 &4  Morphology  Permanent Anterior Teeth  Permanent Premolar Teeth  Permanent Molar Teeth  Mastication Chewing Incisors Canine Molars The lips, tongue, The central and The canine The premolars teeth, jaw, and lateral incisors aids in the and the molars muscles of the jaw morphological cutting of food; contribute by work collectively features allow grinding down however, its food to a more during mastication. them to cut into primarily tears, suitable size for The teeth work food. The incisal or separates ingestion. The strategically to cut, edge's sharpness the food. The wide occlusal tear, grind, and of the incisors is sharpness of square-like prepare food into a indicative of its the incisal surface along more desirable size role in the cutting edges, strength with the cusps for swallowing and action. and the makes them ingestion. thickness of the ideal for flattening food. teeth enables it to wedge into the food and rip it apart. Attributes the anterior teeth have in common Cingulum - round, raised bump on cervical third Marginal ridges - round, raised borders on mesial and distal surfaces Fossa - wide, shallow depression Root - all have a single root Function in cutting food 4 Developmental lobes - 3 labial (mamelons) and 1 lingual (cingulum) Maxillary Central Incisors - Lingual View - Crown ◼ The Lingual fossa is a depression on lingual surface Maxillary Lateral Incisor Anomalies Dens in Dente Abnormal development of tooth within a tooth. Also termed Dens Invaginatus Peg Laterals Abnormal development resulting in small, often pointed teeth Parts of a Tooth That part of the tooth Apex that separates the anatomical crown from the anatomical root is called the Cervical Line. It is located where the enamel meets the cementum. It is also Cervical known as the Line Cementoenamel Junction (CEJ). The end of the root is known as the Apex. Types of Teeth - Incisors There are 8 incisors in the complete adult dentition: 4 in the maxilla and 4 in the mandible. The incisors are located toward the front of the oral cavity (mouth).The crowns of incisors are shaped for cutting. The cutting edge of an incisor tooth is called the Incisal Edge or Surface. Incisal Edge Types of Teeth - Canines There are 4 canines in the complete adult dentition: 2 in the maxilla and 2 in the mandible. The canines are located toward the front of the oral cavity (mouth).The crown of the canine is pointed. This pointed area is called a Cusp. The canine's shape is adapted for piercing, holding, tearing and breaking food. Cusp  Root Canals Mandibular premolars Maxillary premolars  Usually one canal  Often have two canals (first premolar is bifurcated with 2 roots, but the second premolar has 2 canals but is single-rooted) 19  Proximal Surface The surface of a tooth that is between adjacent teeth in the same arch (jaw) is called the Proximal surface of the tooth. The arrow is pointing to proximal surface of teeth. Summary of Parts of a Tooth Fossa Cusp Enamel Dentino-enamel junction Dentin Pulp Cemento-enamel Chamber Junction Pulp Cementum Pulp Apex Canal  Universal Numbering System 7 8 9 10 6 1 5 4 112 13 In addition to naming 3 14 teeth by arch, side and 2 15 type, a more convenient 1 16 method of identifying 3 1 teeth is the universal 2 7 31 18 numbering system. This 30 19 system assigns a specific number from 1-32 for 29 2 2 20 each tooth in the oral 8 1 27 2 26 25 24 2 2 3 cavity. The maxillary right 3rd molar is assigned the number 1 Palmer Numbering System FDI Numbering System Universal, Palmer, & FDI Numbering System Other General Concepts – Height of Contour (Crest of Curvature) The Height of Contour, also known as the Crest of Curvature, is that area of the surface outline that has the maximum curvature (convexity). The height of contour on the lingual surface of this view of this tooth is depicted by the arrow. (Where the tooth bulges out the most) Height of Contour Division of Teeth Into Thirds To facilitate descibing areas of teeth, it is convenient to divide the tooth into thirds occluso-cervically and mesio-distally. The figures illustrate this with appropriate names. Apical Third Middle Mesial Distal Third Middle Third Third Third Cervical Mesial Middle Distal Third Third Third Third Cervical Third Cervical Third Middle Third Middle Third Apical Third Incisal Third  Maxillary Central Incisors  mesioincisal angle sharper than distoincisal  Incisal edge is straight.  Characteristics of Maxillary Lateral Incisor - Crown There is a wide variety in form and teeth are often malformed (e.g. "peg lateral"). One of the most commonly misshaped teeth common tooth to be missing With Permission from Dr. Robert Kanas, DDS Maxillary Lateral Incisors - Lingual View - Crown  Marginal ridges and cingulum (same anatomical features as on central incisor) are prominent  Lingual fossa is more concave than central incisor Maxillary Lateral Incisors - Lingual View - Crown May have deep developmental pit and/or groove that extends onto root General Characteristics of Canines  Canines have the longest roots of all teeth and, therefore, are quite stable. Usually one of the last teeth to be lost.  Maxillary Canines – Lingual View  Large cingulum  Lingual ridge separating mesial and distal fossae (plural of fossa)-maxillary incisors only had one lingual fossa  Mesial and distal marginal ridges form boundaries of mesial and distal fossae  Contact Areas Notice the teeth are divided into thirds Maxillary Lateral Incisors Hight of Contour (crest of curvature) Where the tooth “bulges out” the most (greatest curvature or convexity and this circles the tooth) Forms the Contact areas Mesial Contact = Incisal 1/3 Distal Contact = Junction of Incisal & Middle 1/3 Gingival embrasures Incisal embrasures How many roots? How Many Roots?  Maxillary Second Premolar Comparisons with Maxillary First Premolar (Buccal View) Similar to maxillary first premolar in facial view Maxillary second premolar generally has one root. Maxillary first premolar usually has two  Mandibular Second Premolar Variations in Mandibular Second Premolar In 3-cusped versions, the mesiolingual cusp is longer and larger Mesial than distolingual cusp. Helps distinguish mesial from distal Lingual  Mandibular Second Premolar Variations in Mandibular Second Premolar  The 3 - cusped version of the second premolar is most common type  Three types of groove configurations are possible; Y-shaped (3 cusps), H-shaped (2 cusps) and U-shaped (2 cusps) Y-Shaped H-Shaped U-Shaped Dental Morphology Maxillary Molars Maxillary Molars - General Characteristics Maxillary molars have 3 roots; mesiobuccal, distobuccal, and lingual (palatal) They are the largest and strongest of teeth in the mouth Function is primarily crushing and grinding Maxillary First Molar – Occlusal View  The crown is Buccal rhomboidal in shape  Five cusps are visible: mesiolingual, mesiobuccal, distobuccal, distolingual and fifth cusp (cusp of Distal Mesial Carabelli  1 oblique ridge. Seen only in permanent maxillary molars in adults Lingual  3RD 2ND 1ST cusp of Carabelli  Module 6 & 7  Stages and development of the teeth  Eruption sequence  Primary dentition  Dental anomalies Primary Dentition  Primary Dentition E F G D C H  There are 20 teeth in the B I primary dentition. In the A J Universal numbering 3 14 system, they are designated as letters of the 30 19 alphabet, starting with "A" T K and ending in "T" S L R M Q P O N  Primary Dentition  The eruption of the primary dentition is usually complete by the age of 3-4 years.  By the age of 5 years some of the primary tooth roots are beginning to resorb because of eruption of the permanent dentition. With permission from Dr. Margot Van Dis, DDS  Primary Dentition  The permanent teeth that replace the primary teeth are called succedaneou s teeth.  The primary teeth that are replaced are With permission from Dr. Margot Van Dis, DDS called predecessors.  Primary Dentition  Resorbing primary roots provide a pathway of least resistance to "guide" the permanent tooth into proper position.  Primary teeth maintain space to allow room for the erupting With permission from Dr. permanent Margot Van Dis, DDS tooth.  Primary Dentition  If a primary tooth is lost prematurely, teeth can drift mesially, closing off the pathway for the erupting permanent tooth. This can lead to improper occlusion, impacted permanent teeth and extensive orthodontic treatment.  Primary Dentition  When a primary tooth is lost prematurely, space maintainers can be fabricated and inserted to prevent teeth from drifting mesially. (See figure). In this figure the appliance is attached to the primary 2nd molar to provide space for the eruption of the permanent first premolar. With Permission from Dr. Robert Kanas, DDS  Primary Dentition  This figure is a radiograph showing how an appliance attached to a primary second molar is maintaining space to allow for normal eruption of a permanent first premolar. With Permission from Dr. Robert Kanas, DDS  The Primary Dentition Compared to the Permanent Dentition  In general, the primary dentition is lighter in shade than the permanent dentition. Permanent Primary Molar Molar With permission from Dr. Lewellyn Powell, DDS  The Primary Dentition Compared to the Permanent Dentition  In general, the primary dentition has roots that are more widely flared, proportionately longer and narrower than the corresponding permanent teeth. The flared roots provide room for the developing permanent crowns beneath the roots. Permanent Primary Maxillary 1st Maxillary molar 2nd Molar With permission from Dr. Lewellyn Powell, DDS Development of the Dentition and Eruption Development of the Dentition and Eruption Notice that permanent 1st, 2nd and 3rd molars do not have a predecessor. Therefore, they are NOT succedaneous teeth.  Development of the Dentition and Eruption Permanent and Primary teeth tend to erupt in a certain order known as an eruption sequence. The table below illustrates the most common order of tooth eruption in the primary dentition. Mandibular eruption normally precedes maxillary eruption. Central Incisor Lateral Incisor Canines First Molar Second Molar Maxillary Third (7.5 MO) Fourth (9 MO) Eighth (18 MO) Sixth (14 MO) Tenth (24 MO) Mandibular First (6 MO) Second (7 MO) Seventh (16 MO) Fifth (12 MO) Ninth (20 MO) Information from Woelfel’s Dental Anatomy, eighth edition, Rickne C. Scheid, Gabriela Weiss, Lippincott, Williams & Wilkins, 2012  Development of the Dentition and Eruption The table below illustrates the most common order of tooth eruption in the permanent dentition. Mandibular eruption normally precedes maxillary eruption. Central Incisor Lateral Incisor Canine First Premolar Second First Molar Second Molar Third Molar Premolar Maxillary Second (7-8 Third (8-9 Sixth (11-12 Fifth (10-11 Fifth (10-12 First (6-7 years) Seventh (12-15 Eighth (17-21 years) years) years) years) years) years) years) Mandibular First (6-7 years) Second (7-8 Fourth (9-10 Fifth (10-12 Sixth (11-12 First (6-7 years) Seventh (11-13 Eight (17-21 years) years) years) years) years) years) Information from Woelfel’s Dental Anatomy, eighth edition, Rickne C. Scheid, Gabriela Weiss, Lippincott, Williams & Wilkins, 2012  Development of the Dentition and Eruption All of the primary teeth are not exfoliated at once. The first permanent teeth to erupt are the mandibular and maxillary permanent molars, followed by the mandibular incisors. This means that after age 6 the patient is in the mixed dentition stage. The last primary tooth is exfoliated at age 12, so the period between 6-12 is known as the mixed dentition stage. Development of the Dentition and Eruption From this information we would estimate the patient's age to be between 7-8 years since this about the time that these teeth erupt.  Mixed Dentition  Mixed dentition generally occurs between the ages of 6 and 12 years  Both primary and permanent teeth are present during this transitional period  The mixed dentition period begins with the eruption of the first permanent tooth, which is a permanent mandibular first molar  This period ends with shedding of the last primary tooth Mixed Dentition- eruption ages  Module 8  Development of the Face and Neck Bones of the Head and Neck  Cranial bones and the facial skeleton Frontal bone Parietal bone Sphenoid Nasal bone bone Ethmoid bone Zygomatic bone Lacrimal bone Maxilla Inferior nasal Alveolar process concha Mandible Vomer bone Alveolar process Mental foramen Symphysis  Mandibular Bones Know Condyle Know mental foramen  Tempromandibular Joint  TMJ  Glenoid fossa of temporal bone  Articular eminence of temporal bone  Condyloid process of mandible  Module 9  Muscles of the Head and Neck Innervation of the Head and Neck Muscles of the Mastication Temporal muscles Masseter muscles Internal pterygoid muscles External pterygoid muscles Trigeminal Nerve The largest cranial nerve and the most important to dental auxiliaries is the trigeminal nerve This cranial nerve innervates the maxilla and the mandible.  Module 10 & 11  Circulation of the head and neck Glands, lymphatic system, paranasal sinuses  Histology of Oral Mucous Membrane & The Tongue  Arteries and Veins  Veins typically bring oxygen-depleted blood to the heart  Arteries transport oxygenated blood from the heart to the rest of the body. Major Salivary Glands  The three large paired salivary glands are the parotid, submandibular, and sublingual glands. Minor Salivary Glands The minor salivary glands are smaller and more numerous than the major salivary glands. The minor glands are scattered in the tissues of the buccal, labial, and lingual mucosa; the soft palate; the lateral portions of the hard palate; and the floor of the mouth. Von Ebner's salivary gland is associated with the circumvallate lingual papillae on the dorsal surface of the tongue.  Papillae—elevated structures scattered throughout the dorsum  Four types  Circumvallate or vallate papillae  Fungiform papillae  Filiform papillae  Foliate Papillae. 76  Parotid salivary gland The parotid salivary gland is the largest of the major salivary glands, but it provides only 25% of the total volume of saliva. It is located in an area just below and in front of the ear. Saliva passes from the parotid gland into the mouth through the parotid duct, also known as Stensen's duct. Its opening is near the buccal surface of the maxillary 2nd molars  Submandibular salivary gland The submandibular salivary gland, about the size of a walnut, is the second largest salivary gland. This gland provides 60% to 65% of the total volume of saliva. It lies beneath the mandible in the submandibular fossa, posterior to the sublingual salivary gland. The gland releases saliva into the oral cavity through the submandibular duct, also known as Wharton's duct, which ends in the sublingual caruncles. Sublingual Salivary Gland  The sublingual salivary gland is the smallest of the three major salivary glands. It provides only 10% of the total salivary volume. This gland releases saliva into the oral cavity through the sublingual duct, also known as Bartholin's duct. Other smaller ducts of the sublingual gland open along the sublingual fold.  A stone, or sialolith, may block the salivary glands in the duct opening, preventing saliva from flowing into the mouth. Salivary stones may be removed surgically  Lymph Nodes of the Head and Neck  Dental professionals must examine and palpate the lymph nodes of the head and neck very carefully during an extraoral examination. Enlarged lymph nodes could indicate infection or cancer. Lymph nodes for the oral cavity drain intraoral structures such as the teeth, as well as the eyes, ears, nasal cavity, and deeper areas of the throat. A patient needs a referral to a physician when lymph nodes are palpable because of a disease process in these other regions. Lymph Nodes Lymph nodes are small round or oval structures that are located in lymph vessels. They fight disease by producing antibodies; this is part of the immune reaction. In acute infection, lymph nodes become swollen and tender as a result of the collection of lymphocytes gathered to destroy invading substances. Sinuses The sinuses are named for the bones in which they are located Maxillary sinuses—the largest of the paranasal sinuses Frontal sinuses—located within the forehead just above the left and right eyes Ethmoid sinuses—irregularly shaped air cells separated from the orbital cavity by a very thin layer of bone Sphenoid sinuses—located close to the optic nerves, where an infection may damage vision Module 11  -Introduction to histology -Histology of epithelial tissue, connective tissue, muscle and nerve -Histology of the tooth and surrounding structure  Enamel  Enamel rod  Head and tail  Their location in the enamel is such that the head is surrounded by the tails of two other enamel rods.  The substance surrounding the inner portion, the rod core, of each enamel rod is the interprismatic substance.  the enamel rods are hardest and the interprismatic substance is the weakest.  The enamel matrix is produced by the ameloblast cells.  Tome’s process  guides the enamel matrix into place. As the second layer is laid down, the first becomes more mineralized and this process follows until the last layer is © engage Learning 2013 placed.  Enamel  Perikymata (pear-ee-KIGH-mah- tah) AKA Imbrication lines incremental growth lines that appear on the surface of tooth enamel as a series of linear grooves. each perikyma takes approximately 6–12 days to form. External manifestation of the lines (striae) of Retzius  Dentin  Dentin, which makes up the main portion of the tooth structure, extends almost the entire length of the tooth  It is covered by enamel on the crown and by cementum on the root  There are three major types of dentin  Primary dentin  Secondary dentin  Tertiary dentin (reparative dentin) 86  Cementum  Softer and grainy  No regeneration  Allows for orthodontic treatment  Movement without destruction  Sharpey’s fibers (anchor between bone and tooth)  Pulp  Pulp is made up of blood vessels and nerves that enter the pulp chamber through the apical foramen  The blood supply is derived from branches of the dental arteries and from the periodontal ligament  Coronal pulp  Radicular pulp 88 Divisions of Mucous Membrane Oral mucosa or oral mucous membrane categories Specialized mucosa On upper surface of tongue Masticatory mucosa Gingiva and hard palatal tissue Lining mucosa All other areas of oral mucosa 89  Papillae—Filiform  Cover the remaining anterior two thirds  Pointed  Parakeratinized to keratinized  No taste function  Likely provide only tactile sensation. 90  Module 13  TMJ and Occlusion  TMJ Disease Signs and symptoms:  Crepitus or tinnitus  Limited movement of mandible  Trismus/Popping and clicking noise when opening and closing mouth  Headaches or neckaches  Pain around ear  Tenderness of masticatory muscles