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 relevant...

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 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 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 Tooth Anatomy c Cusp: t ds m Cusp tip (ct) s Mesial slope (ms) Cusp incline Distal slope (ds) Cusp incline Tooth Anatomy Developmental groove: Can be found occlusally, buccally, palatally, lingually and even on roots Previously called ? Development al grooves Image ref: pocketdentistry.com Tooth Anatomy Fossa (plural = fossae) Pits or hollows on the tooth surface May be associated with grooves May be enclosed by ridges Pulp Anatomy Pulp chamber – within crown of tooth Root canals – extensions of the pulp which lie within the roots Pulp horns – extensions of the pulp chamber which extend under cusps etc. Image ref: www.inmagine.com UPPER PERMANENT INCISORS AND CANINES Image ref:  Take a picture! Can spot the characteristics mentioned on your own teeth…? Image ref: quora.com Upper Central Incisors (11;21) Chronology Initial 3-4 months after calcification birth Crown 4-5 years completion Eruption 7-8 years Root 10 years completion Image ref: http://dentapps.leeds.ac.uk/ Upper Central Incisors (11;21) Labial Large crown view Smooth, slightly convex Mesi Dista labial surface al l incis incis Mesio-incisal angle is sharp al al angle angle 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 ThisPalata is the Incisors headline l view The palatal surface is concave Distal Mesial Palatal surface has mesial & margin margin distal marginal ridges al al ridge ridge Marginal ridges meet centrally near the gingival margin to form the convex cingulum m d Above the cingulum is the hollow cingulum pit Image ref: http://dentapps.leeds.ac.uk/  Upper Central This Mesial is the Incisors headline view Crown enamel margin undulates mesially & distally Root One single, tapering root One root canal with 2 pulp horns, one mesial & one distal Cervical Cingulum undulation Image ref: http://dentapps.leeds.ac.uk/ Upper right permanent central incisor Image ref: http://denta pps.leeds.ac Buccal Palatal Mesial Distal.uk/ Upper Lateral Incisors (12;22) Chronology Initial 10-12 months after calcification birth Crown 4-5 years completion Eruption 8-9 years Root 11 years completion Upper Lateral Incisors (12;22) Labial view Much less bulky and smaller than central incisor Distal Narrower cervically (gingivally) than incisa incisally l angle Pronounced rounding of the distal- m d incisal angle Upper Lateral Incisors Palata l view Pronounced mesial & distal marginal ridges palatally Palatal cingulum m d More marked cingulum pit than central incisor Cingulu m pit  Mesia Upper Lateral Incisors l view Cervical undulation mesially and distally One tapering root One root canal with 2 pulp horns, one mesial & one distal  Upper right permanent lateral incisor Labial Palatal Upper Canine (13;23) Chronology Initial 4-5 months after calcification birth Crown 6-7 years completion Eruption 11-12 years Root 13-15 years completion Upper Canine (13;23) 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 Cus mesial surface p  UPPER RIGHT CANINE Convex labial Distal surface bulge Mesial Distal cusp cusp slope slope Cusp tip 26 Upper Canine Palata l view Concave palatal surface Mesial Dista Pronounced mesial & distal margin al ridge l marginal ridges fossa Large cingulum m d Mesial & distal fossae Upper Canine Distal view Cervical undulation Distal root groov One long, tapering root e One root canal with no pulp horns Distal root groove more prominent than mesial root groove  Upper right permanent canine Labial Palatal Mesial Distal Comparison of 11, 12, 13 – Labial View Central Incisor Lateral Incisor  Comparison of 11, 12, 13 – Palatal View Central Incisor Lateral Incisor LOWER INCISORS AND CANINES Image ref:. mapleorthodontics.co uk Lower Central Incisor (31;41) Chronology Initial 3-4 months after calcification birth Crown 4-5 years completion Eruption 6-7 years Root 9 years completion Lower Central Incisor (31;41) Flat labial surface Fairly symmetrical labial surface d m Distal incisal angle very slightly more rounded than mesial incisal angle Mamelons initially present on eruption – quickly worn Labi away al view Mamelons on lower central incisors Image ref: Oralanswers.com Lower Central Incisor Concave lingual surface Small marginal ridges m d Small cingulum Lingual view Lower Central Incisor Crown is wedge- shaped from the side view Cervical undulation One root, one root canal and mesial & distal pulp horns Mesial view  Lower Lateral Incisor (32;42) Chronology Initial 3-4 months after calcification birth Crown 4-5 years completion Eruption 7-8 years Root 10 years completion Lower Lateral Incisor (32;42) Looks more fan shaped than central incisor from the labial Mesio-incisal angle is d m sharp & disto-incisal angle is rounded Mesial side slightly longer than distal Labial view Lower Lateral Incisor Concave lingual surface Small cingulum One root with more m d pronounced distal groove than mesial groove One root canal, mesial & distal pulp horns Lingua l view  Comparison of 41 and 42 – Labial and Lingual View d m d m m d m d 31 Labial 32 Labial 31 Lingual Lower Canine (33;43) Less bulky than upper canine & the crown is taller than it is wide Convex labial surface, with one cusp which inclines distally d m Mesial slope of cusp shorter than distal slope Distal surface more bulbous than mesial Labi al view  Lower Canine Chronology Initial 4-5 months after birth calcification Crown 6-7 years completion Eruption 9-10 years Root 12-14 years completion Lower Canine Lingually there are mesial & distal marginal ridges and a cingulum as in the upper canine, but all less pronounced m d Mesial & distal lingual fossae of which the distal is larger Dist al Cingulu foss One root, one root canal & m a no pulp horns Lingual view Comparison of 13 and 43- labial view d m 13 43 d m Comparison of 13 and 43 – palatal/lingual view m d 13 43 m d MAXILLARY PREMOLARS Upper First Premolar (14;24) Chronology Initial 18-21 months after calcification birth Crown 5-6 years completion Eruption 10-11 years Root completion 12-13 years Upper First Premolar (14;24) Bucca l view 2 cusps – one buccal & one palatal Buccal cusp is larger d m Mesial slope of buccal cusp is Bucca longer than distal slope l cusp Crown is oval – wider bucco- palatally than mesio-distally Upper First Premolar Palata l view Palatal cusp is smaller and narrower Tip of palatal cusp is displaced mesially when viewed from the m d palatal side Palatal One central groove, and 2 cusp fossae inside the marginal ridges Margin al ridge  Upper First Premolar This is the Mesial headline view Mesial root surface has a developmental groove between the 2 cusps Canine fossa – hollow concavity on mesial root surface which houses the bulge distally on the canine Canin e fossa Upper First Premolar Distal view 2 roots – one buccal & one palatal Sometimes the 2 roots are partly fused 2 root canals (buccal & palatal) and 2 pulp horns Upper right permanent first premolar Labial Palatal Mesial Distal Upper Second Premolar (15;25) Chronology Initial 2-2.5 years calcification Crown 6-7 years completion Eruption 10-12 years Root completion 12-14 years Upper Second Premolar (15;25) Bucca 2 cusps - one buccal & one palatal l view Buccal cusp slightly larger than palatal cusp d m Mesial slope of buccal cusp shorter than distal slope Bucca l cusp Crown is oval – wider bucco- palatally than mesio-distally  Upper Second Premolar This is the Palat headline al Palatal cusp displaced mesially view as in the first premolar Single root, flattened mesio- m d distally One or two root canals, and two Palata pulp horns l cusp tip Root may bend distally at apex  Dista Upper Second Premolar This is the l headline view One central groove, and 2 Root fossae inside the marginal ridges groov e The root often has a more prominent groove distally Upper right permanent second premolar Labial Palatal Comparison of 14 and 15 – Buccal and Occlusal View Bucc al view Upper Upper right right first second premola premolar r d m d m Comparison of 14 and 15 – palatal and Occlusal View Upper Upper right right first second premol premola ar r MANDIBULAR PREMOLARS Lower First Premolar (34;44) Chronology Initial 1 ¾-2 years calcification Crown 5-6 years completion Eruption 10-12 years Root completion 12-13 years Lower First Premolar (34;44) 2 cusps – one large buccal cusp and one much smaller lingual cusp Crown is round in outline d m looking occlusally, but is ‘angled off’ mesially Buccal shape is similar to lower canine with shorter mesial cusp slope and bulbous distal surface Buccal view Lower First Premolar Buccal Distal cusp fossa One central developmental groove separates the cusps m d 2 fossae, one mesially and one distally – Short distal fossa is larger lingual cusp Lingual view Lower First Premolar 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 Distal view  Lower second Premolar (35;45) Chronology Initial 2 ¼ -2 ½ years calcification Crown 6-7 years completion Eruption 11-12 years Root completion 13-14 years Lower second Premolar (35;45) dl ml 3 cusps – one buccal, 2 lingual Larger in comparison to lower first premolar Buccal cusp The mesio-lingual cusp d m (ml) is larger than the disto-lingual (dl) cusp Mesial slope of buccal cusp is shorter than the distal slope Buccal view Lower Second Premolar The crown viewed from the occlusal is round– square in outline ml dl Single root with a tendency to curve distally at the apex m d One root canal, 2 – 3 pulp horns Lingual view  Lateral comparison of 44 & 45 44 – 45 – note note the the very lingua short l Ling Lingu lingua ual al cusps l cusp cusp cusp are s much higher  Comparison 44 and 45 – Buccal and Lingual View 44 Buccal 45 Buccal 44 Lingual 45 Lingual MAXILLARY MOLARS Upper First Molar (16;26) Chronology Initial Birth or slightly calcification before Crown 2 ½ -3 years completion Eruption 6-7 years Root completion 9-10 years Upper First Molar (16;26) Buccal view 4 cusps: 1. Mesio-buccal (mb) 2. Disto-buccal (db) 3. Mesio-palatal (mp) d m 4. Disto-palatal (dp) 2 buccal cusps of similar size mb Mesio-palatal cusp the largest d Disto-palatal cusp the b smallest d mp p  Palata Upper First Molar l view Sometimes an additional cusp is present on the palatal surface of the Cusp mesio-palatal cusp of called the Cusp of Carabelli Carabel li m d Upper First Molar Buccal view The crown is an equilateral rhomboid, with the mesio- distal dimension being roughly equal to the bucco-palatal dimension  Upper First Molar Ridge of enamel running from the disto-buccal cusp to the mesio-palatal cusp called the oblique ridge d m Oblique ridge divides the b occlusal surface into 2, often b with distinct, separate groove patterns Distal to the oblique ridge is a m dp p deep groove running from occlusal to palatal surfaces, which separates off the disto- palatal cusp  Upper First Molar This is the headline Palata Central groove which may be l divided into 2 by oblique ridge groov e 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 Upper First Molar 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 d m m Mesio-buccal and Single large disto-buccal roots palatal root Upper Second Molar (17;27) Chronology Initial 2 ½ -3 years calcification Crown 7-8years completion 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 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 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 3-4 root canals Upper Third Molar (18;28) Chronology Initial 7-9 years calcification Crown 12-16 years completion Eruption 17-21 years Root completion 18-25 years Upper Third Molar (18;28) b The occlusal shape is triangular, with m the disto-palatal cusp lost or very d small Often only 3 cusps – palatal, mesio- p buccal & disto-buccal Often 3 fused roots with 3 root canals, & roots often curve distally Can be very varied in shape, cusp form and number of roots d m 16 17 18 MANDIBULAR MOLARS  Lower First Molar (36;46) Chronology Initial Birth or slightly calcification before Crown 2 ½ -3 years completion Eruption 6-7 years Root completion 9-10 years Lower First Molar (36;46) 5 cusps – 3 buccal & 2 dl ml lingual: d 1. Mesio-lingual (ml) m d 2. Disto-lingual (dl) Distal b b cusp 3. Mesio-buccal (mb) 4. Disto-buccal (db) 5. Distal (d) d m Distal cusp displaced onto distal surface Bucca l view Lower First Molar The mesio-buccal cusp is larger than the disto-buccal cusp Developmental grooves The distal cusp is the smallest cusp db mb d d m There are 2 developmental grooves buccally between the cuspa, of which the mesial is deeper & longer Buccal view Lower First Molar Mesio-lingual cusp larger than disto-lingual cusp Occlusally the cusps Lingual interdigitate, and the central groove groove zig-zags between ml dl them m d Overall crown shape viewed occlusally is oval Small lingual groove Lingual view Lower First Molar Buccal wall curved 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 Wide has a marked central groove mesial Mesial Developmental grooves ----- root view  Lower First Molar Distally the distal cusp is visible 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 Distal view  Lower Second Molar (37;47) Chronology Initial 2 ½ -3 years calcification Crown 7-8 years completion 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 Overall occlusal shape is rectangular m d ml dl Buccal & lingual cusp tips are opposite each other Cross–shaped groove pattern Lingual view 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 view Lower Second Molar Distal root is narrower Lingual Buccal groove groove 3 – 4 root canals & 4 pulp horns l b Buccal groove (deeper) and lingual groove Fossae - Distal view Comparison of 46 and 47 – Buccal and Lingual View 46 Buccal 47 Buccal 46 Lingual 47 Lingual 16 and 17 Buccal and Palatal / Lingual Views 46 and 47  Mandibular Third Molar (38;48) Chronology Initial 8-10 years calcification Crown 12-16 years completion 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 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 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 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