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  know eruption dates. 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 Loading… PALMERS 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 Cusp: top of cusp ds ms ~. Cusp tip (ct) -towards midline Mesial slope (ms) Cusp midline. ~ away from incline Distal slope (ds) - Sloptowardsa Cusp incline centre of tooth. 7 Tooth Anatomy evallys. Developmental groove: Can be found occlusally, buccally, palatally, lingually and even on roots Previously called ? fissures. Developmental grooves Image ref: pocketdentistry.com 8 Plaque retentive areas. Tooth Anatomy Fossa (plural = fossae) Pits or hollows on the tooth surface May be associated with grooves May be enclosed by ridges 9 /pulphorns Pulp Anatomy. Pulp chamber – within crown of tooth Root canals – extensions of the pulp which lie within the -Puber roots Pulp horns – extensions of - Boot the pulp chamber which canals 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  Upper Central Incisors (11;21) laid down calcium being Chronology ↑ Initial calcification 3-4 months after birth complete Crown completion 4-5 years formation Eruption 7-8 years of crown. ↓ Root completion 10 years When erupt ↓ in mouth complete formation of root. Image ref: http://dentapps.leeds.ac.uk/ Upper Central Incisors (11;21) Labial Large crown view - Bulge-outwards >. 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 Inwards. - view The palatal surface is concave cervical ↑ Distal Mesial Palatal surface has mesial & marginal marginal distal marginal ridges > raised areas ridge -. ridge Marginal ridges meet centrally near the gingival margin to form & singulum the convex cingulum m d cingul is Above the cingulum is the hollow O cingulum pit Image ref: http://dentapps.leeds.ac.uk/  Upper Central Incisors This is the Mesial headline curved view ~ Crown enamel margin undulates mesially & distally Root One single, tapering root -5 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/ Labial/Buccal Palatal Mesial Distal Upper Lateral Incisors (12;22) 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 A distal- incisal angle d m -  Upper Lateral Incisors Palatal view Pronounced mesial & distal marginal ridges palatally Palatal cingulum m > -d ingulum More marked cingulum pit than central incisor Cingulum pit 2 1 Mesial Upper Lateral Incisors view > - curved. Cervical undulation mesially and distally One tapering root One root canal with 2 pulp horns, one mesial & one distal 2 2 Greatest degree of variation. Upper right permanent lateral incisor · Occasional 2 root canals Split root · apically. (bifurcated) Labial Palatal Mesial Distal  Eye' teeth /fDl UL3UR3-Palmers. Can be Upper Canine (13;23) Impacted. Chronology Initial calcification 4-5 months after birth Crown completion 6-7 years Eruption 11-12 years Root completion 13-15 years  Slightly · Upper Canine (13;23) yellowish due to more bulk Labial view of dentine. One cusp incisally outwards. Labial surface is convex Distal bulge Distal slope of cusp is longer than mesial slope butle d m Distal surface more bulbous than Cusp mesial surface  UPPER RIGHT CANINE Convex labial Distal surface bulge Mesial cusp Distal slope (shorter) cusp slope Hunger) Cusp tip 26  · Root apex inclined distally Upper Canine Palatal. view Concave palatal surface Mesial singulum - marginal Distal Pronounced mesial & distal fossa marginal ridges ridge Large cingulum - marginal mesial -002 fossa - ridges m d Mesial & distal fossae  Distal Upper Canine view & Plaque. retentive Cervical undulation Distal root · Harbor One long, tapering root - groove bacteria O One root canal with no pulp horns Distal root groove more prominent than mesial root groove 2 variations : 9 Upper right permanent canine Exaggerated size labial - > palatal · Distal slope - extra cusp V-rane - Pointed cingulum · Inclined roof. 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  - +DI (LILRI-Palmers. Lower Central Incisor (31;41) Chronology Initial calcification 3-4 months after birth Crown completion 4-5 years Eruption 6-7 years Root completion 9 years One the 1st permanent of 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 Small cingulum cingulum. Lingual view  Lower Central Incisor Crown is wedge-shaped# from the side view Cervical undulation mesial cervical One root, one root canal and mesial & - undulation distal pulp horns variations : · Occ 2 root canals > - Buccal lingual + Mesial · occ bifurcated root at apex-split in root. view  -LL2-LR2 Lower Lateral Incisor (32;42) Chronology Initial calcification 3-4 months after birth Crown completion 4-5 years W Eruption 7-8 years Root completion 10 years Slightly later than lower Central incisor. 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 - Small cingulum. One root with more m d pronounced distal groove than mesial groove One root canal, mesial & distal pulp horns 2 Lingual view 4 3 variations : Comparison of 41 and 42 – sizes and. Labial and Lingual View of crown root · d m d m m d m d 31 Labial 32 Labial 31 Lingual 32 Lingual  - fDI LR3 LL3-Palmers. Lower Canine (33;43) 4333 Less bulky than upper canine & the crown is taller than it is wide shorte a Convex labial surface, with one ~ slope. cusp which inclines distally d m Mesial slope of cusp shorter than distal slope Distal surface more bulbous than mesial Labial view  Lower Canine Shorter mesial Chronology slope Initial calcification 4-5 months after birth Crown completion 6-7 years Eruption 9-10 years Root completion 12-14 years  Lower Canine Lingually there are mesial & tose area distal marginal ridges and a cingulum as in the upper canine, but all less pronounced mesial m d Mesial & distal lingual 00 fossae of which the distal is larger Distal fossa Cingulum One root, one root canal & Cless pronounced) O 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 avitations · · Bifurcated roots m Crown size d ·. 13 43 m d  #Functions) : Central Incisors e · Bite into food/Slicing good /. Supports lips/speech/aesthetics. Lateral Incisors M Canines > - Tear-grip food. first premolars- M Chewing/tearing good start crushing of good. Second premolars with saliva create bolus. first molars > Grinding chewing of food , > - mixes to Second molars M third molars ↑ 5 0 MAXILLARY PREMOLARS  dentities. none primary in Upper First Premolar (14;24) 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 Buccal cusp is larger d m Mesial slope of buccal cusp is -longer mesial slope longer than distal slope Buccal. cusp Crown is oval – wider bucco- & palatally than mesio-distally Palatal cusp.  Upper First Premolar Palatal view Palatal cusp is smaller and narrower Tip of palatal cusp is displaced mesially when viewed from the m d palatal side displaced mesically. Palatal Hossa One central groove, and 2 cusp fossae inside the marginal ridges Marginal ridge for  Upper First Premolar This is the headline Mesial view Mesial root surface has a developmental groove between the 2 cusps Canine fossa – hollow concavity development groove on mesial root. on mesial root surface which houses the bulge distally on the canine Canine fossa Imesially) !!!  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 5 6 more mesial pronounced Upper developmental right permanent first premolar Lariation a on groove. can vary. or · one two. roots Labial Palatal Mesial Distal  fDI Upper Second Premolar (15;25) UR5 ULS-Palmers. 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) distal inclination ! Groot Buccal 2 cusps - one buccal & one palatal view Buccal cusp slightly larger than palatal cusp d m shorter mesial Mesial slope of buccal cusp shorter slope on B cosp. than distal slope - Buccal Buccal cusp > larger - cusp 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 ↓ mesially displaced Root may bend distally at apex Palatal cusp.  Distal Upper Second Premolar This is the headline view One central groove, and 2 fossae inside the marginal ridges -moreestal Root an groove groove. The root often has a more prominent groove distally --8 2 fossal. 6 1 viations : · more flared crown Upper right permanent second premolar. · Accessory cuspon distal stope · Addition hollow grooves. · Bifurcated root. DISTAL Labial Palatal Mesial  Distal 6 2 Comparison of 14 and 15 – Buccal and Occlusal View Buccal view flared more Upper Upper right right first second premolar premolar d m d m canine 1 fossa. 6 3 Comparison of 14 and 15 – palatal and Occlusal View Upper Upper right first right premolar second premolar mesial 1 - Canine fossa. 6 4 MANDIBULAR PREMOLARS  (4 LR4-Palmers. ~ _ Lower First Premolar (34;44) f Di Chronology Initial calcification 1 ¾-2 years Crown completion 5-6 years Eruption 10-12 years Root completion 12-13 years  smaller Lower First Premolar (34;44) ingual cusp. 2 cusps – one large buccal cusp and one much smaller lingual > large buccal - cusp cusp. - Angled mesially Crown is round in outline 3 d m looking occlusally, but is ‘angled off’ mesially Shorter Buccal shape is similar to lower mesial cusp canine with shorter mesial cusp Slope. slope and bulbous distal surface Buccal view Lower First Premolar Buccal Distal cusp fossa One central -Developmental developmental groove groove separates the distal cusps Larger smaller m mesial d fossa possu 2 fossae, one mesially and one distally – Short distal fossa is larger lingual cusp Lingual view  Lower First Premolar a , leangually Buccal cusp leans lingually X Lingual Buccal Lingual cusp overhangs the cusp cusp root overhangs root -curved buccal. Very curved buccal surface Surface One root, one root canal and a single pulp horn variations : missing or larger Distal - lingual cusp 2 lingual cusps · - view Bifurcated roots ·  LLS LBS Palmers - Lower second Premolar (35;45) - fDI. 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) Xlarger cusp than disto-lingual dl 0 G ml ⑨ 3 cusps – one buccal, 2 ! lingual ocusps Larger in comparison to shorter mesial lower first premolar Buccal - slope on buccal cusp 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– cosp. square in outline - Buccal - >2 lingual cusps ml dl Single root with a & > - Disto-lingual tendency to curve distally Mesio- cusp m d. at the apex lingual cusp O One root canal, 2 – 3 Distal Inclination pulp horns Lingual - view 7 4 Lateral comparison of 44 & 45 44 – 45 – note the note the very lingual- 2 lingual short cusps cusps. / lingual - lingual Lingua are Lingu cusp cusp al cusp l cusps much higher 7 5 Variations : more flared crown · Additional shallow grooves. · Bifurcated. root - Comparison 44 and 45 – Buccal and Lingual View 44 Buccal 45 Buccal 44 Lingual 45 Lingual 7 6 MAXILLARY MOLARS  URG UL6-Palmers Upper First Molar (16;26) - fDI Chronology Initial calcification Birth or slightly before Crown completion 2 ½ -3 years Eruption 6-7 years Root completion 9-10 years Frupts behind deciduous.  large occlusal Surfacee. Upper First Molar (16;26) Buccal view 4 cusps: 2 furcations 1. Mesio-buccal (mb) 2. Disto-buccal (db) 3. Mesio-palatal (mp) d m 4. Disto-palatal (dp) Simular 2 buccal cusps of similar size sizes. mb Mesio-palatal cusp the largest db Disto-palatal cusp the smallest > - largest cusp dp mp E smallest cusp.  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 Carabelli m d Y Extra cusp. Upper First Molar Buccal angled square view The crown is an equilateral rhomboid, with the mesio-distal dimension being roughly equal to the bucco-palatal dimension  Upper First Molar ridge. Goblique Ridge of enamel running from the disto-buccal cusp to the mesio-palatal cusp called the oblique ridge db mb Oblique ridge divides the & occlusal surface into 2, often with distinct, separate groove patterns Distal to the oblique ridge is a mp deep groove running from dp 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 > - Palatal cuspmone b p occlusal surface.  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 8 4 Variations : partially · fused roots -Simular cusp of Caribelli · · Enamel pearls. /cusp sizes db my d m. · DP cusp underdeveloped shallow m concavity · /mp do / Mesio-buccal and Largest Single large palatal cusp disto-buccal roots root.  UR7 UL7-Palmer Upper Second Molar (17;27) - fDI. 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 smaller 16 17 db - mb abcrsp It moleus than. dp mp Upper Second Molar The smaller disto-palatal cusp makes the rhomboidal shape of the occlusal surface more squashed and angled – it is O no longer equilateral  variations : Do missing · Upper Second Molar roof fusion · · 4 pulp horns. 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 more together (can be fured) 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) Chronology Initial calcification Birth or slightly before Crown completion 2 ½ -3 years Eruption 6-7 years Root completion 9-10 years  main job in eating -. Lower First Molar (36;46) 5 cusps – 3 buccal & 2 dl ml lingual: d 1. Mesio-lingual (ml) mb db 2. Disto-lingual (dl) Distal cusp 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 largest cusp. The distal cusp is the smallest cusp mb d db developmental smallest - groove There are 2 developmental d m grooves buccally between the cuspa, S of which the mesial is deeper & longer Buccal view  Lower First Molar Mesio-lingual cusp larger than mb db disto-lingual cusp d m/ dl Small Occlusally the cusps Lingual 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 Lingual wall much more straight 2 roots, mesial & distal b l 3 or 4 root canals,⑧ 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 Very short marginal ridge to the lingual side of the distal cusp l b Distal root is narrower and usually without a groove S Fossae o o o Distal view  LL7 LR7-Palmers Lower Second Molar (37;47) - fDI 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 -Higher cusp. db 4. Disto-lingual Mesio-buccal cusp -higher than disto-buccal cusp Buccal view Lower Second Molar Mesio-lingual cusp ↓ central groove higher than disto-lingual cusp m d Overall occlusal shape even- is rectangular ml dl Buccal & lingual cusp tips are opposite each other 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 > Straight b l lingual surface curved Buccal surface is curved buccal surface Lingual surface is straighter Mesial view  Lower Second Molar Distal root is narrower - deeper Lingual Buccal groove groove 3 – 4 root canals & ⑧ 4 pulp horns l b Buccal groove (deeper) and lingual groove 3 Fossae - Distal view 1 0 Bigger 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 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