NEET MDS Lessons
Dental Anatomy
ERUPTION
. Root completion (approximately 50% of the root is formed when eruption begins)
Generally mandibular teeth erupt before maxillary teeth,
Primary teeth
I. Emerge into the oral cavity as follows:
Maxillary Mandibular
Central Incisor 7½ months 6 months
Lateral incisor 9 months 7 months
Canine 18 months 16 months
First Molar 14 months 12 months
Second Molar 24months 20 months
The sequence of primary tooth development is central incisor, lateral incisor, first molar, second molar
3. Hard tissue formation begins between 4 and 6 months in utero
4. Crowns completed between 1½ and 10 months of age
5. Roots are completed between I½ and3 yearsof age 6 to 18 months after eruption
6. By age 3 years all of the primary and permanent teeth (except for the third molars) are in some stage of development
7. Root resorption of primary teeth is triggered by the pressure exerted by the developing permanent tooth; it is followed by primary tooth exfoliation in sequential patterns
8. The primary dentition ends when the first permanent tooth erupts
LOCATION OF THE TEETH
Normally, a human receives two sets of teeth during a lifetime.
The first (deciduous or primary) set consists of 20 teeth ("baby" teeth).
The second (permanent) set usually consists of 32 teeth. In each quadrant, there are eight permanent teeth: two incisors, one cuspid, two bicuspids, and three molars
The tooth positioned immediately to the side of the midline is the central incisor, so called because it occupies a central location in the arch.
To the side of the central incisor is the lateral incisor. Next is the cuspid, then the two bicuspids (the first bicuspid, followed by the second bicuspid). The last teeth are three molars. After the second bicuspid comes the first molar, followed by the second molar, followed by the third molar or more commonly called the "wisdom tooth."
Another method of describing the location of teeth is to refer to them as anterior or posterior teeth .
Anterior teeth are those located in the front of the mouth, the incisors, and the cuspids. Normally, these are the teeth that are visible when a person smiles.
The posterior teeth are those located in the back of the mouth-the bicuspids and molars.
THE DECIDUOUS DENTITION
I. The Deciduous Dentition
-It is also known as the primary, baby, milk or lacteal dentition.
diphyodont, that is, with two sets of teeth. The term deciduous means literally 'to fall off.'
There are twenty deciduous teeth that are classified into three classes. There are ten maxillary teeth and ten mandibular teeth. The dentition consists of incisors, canines and molars.
MAXILLARY SECOND MOLAR
The second molars are often called 12-year molars because they erupt when a child is about 12 years
Facial: The crown is shorter occluso-cervically and narrower mesiodistally whe compared to the first molar. The distobuccal cusp is visibly smaller than the mesiobuccal cusp. The two buccal roots are more nearly parallel. The roots are more parallel; the apex of the mesial root is on line with the with the buccal developmental groove. Mesial and distal roots tend to be about the same length.
Lingual: The distolingual cusp is smaller than the mesiolingual cusp. The Carabelli trait is absent.
Proximal: The crown is shorter than the first molar and the palatal root has less diverence. The roots tend to remain within the crown profile.
Occlusal: The distolingual cusp is smaller on the second than on the first molar. When it is much reduced in size, the crown outline is described as 'heart-shaped.' The Carabelli trait is usually absent. The order of cusp size, largest to smallest, is the same as the first but is more exaggerated: mesiolingual, mesiobuccal, distobuccal, and distolingual.
Contact Points; Height of Curvature: Both mesial and distal contacts tend to be centered buccolingually below the marginal ridges. Since themolars become shorter, moving from first to this molar, the contacts tend to appear more toward the center of the proximal surfaces.
Roots: There are three roots, two buccal and one lingual. The roots are less divergent than the first with their apices usually falling within the crown profile. The buccal roots tend to incline to the distal.
Note: The distolingual cusp is the most variable feature of this tooth. When it is large, the occlusal is somewhat rhomboidal; when reduced in size the crown is described as triangual or 'heart-shaped.' At times, the root may be fused.
Time for tooth development
Entire primary dentition initiated between 6 and 8 weeks of embryonic development.
Successional permanent teeth initiated between 20th week in utero and 10th month after birth Permanent molars between 20th week in utero (first molar) and 5th year of life (third molar)
MAXILLARY SECOND BICUSPID
smaller in dimensions. The cusps are not as sharp as the maxillary first bicuspid and have only one root.
Facial: This tooth closely resembles the maxillary first premolar but is a less defined copy of its companion to the mesial. The buccal cusp is shorter, less pointed, and more rounded than the first.
Lingual: Again, this tooth resembles the first. The lingual cusp, however, is more nearly as large as the buccal cusp.
Proximal: Mesial and distal surfaces are rounded. The mesial developmental depression and mesial marginal ridge are not present on the second premolar.
Occlusal: The crown outline is rounded, ovoid, and is less clearly defined than is the first.
Contact Points; When viewed from the facial, the distal contact area is located more cervically than is the mesial contact area.
ARTICULAR SURFACES COVERED BY FIBROUS TISSUE
TMJ is an exception form other synovial joints. Two other joints, the acromio- and sternoclavicular joints are similar to the TMJ. Mandible & clavicle derive from intramembranous ossificiation.
Histologic
- Fibrous layer: collagen type I, avascular (self-contained and replicating)
- Proliferating zone that formes condylar cartilage
- Condylar cartilage is fibrocartilage that does not play role in articulation nor has formal function
- Capsule: dense collagenous tissue (includes the articular eminence)
- Synovial membrane: lines capsule (does not cover disk except posterior region); contains folds (increase in pathologic conditions) and villi
Two layers: a cellular intima (synovial cells in fiber-free matrix) and a vascular subintima
Synovial cells: A (macrophage-like) syntesize hyaluronate
B (fibroblast-like) add protein in the fluid
Synovial fluid: plasma with mucin and proteins, cells
Liquid environment: lubrication, ?nutrition - Disk: separates the cavity into two comprartments, type I collagen
anterior and posterior portions
anetiorly it divides into two lamellae one towards the capsule, the other towards the condyle
vascular in the preiphery, avascular in the center - Ligaments: nonelastic collagenous structures. One ligament worth mentioning is the lateral or temporomandibular ligament. Also there are the spheno- and stylomandibular with debatable functional role.
Innervations
|
Ruffini |
Posture |
Dynamic and static balance |
|
Pacini |
Dynamic mechanoreception |
Movement accelerator |
|
Golgi |
Static mechanoreception |
Protection (ligament) |
|
Free |
Pain |
Protection joint |