NEET MDS Lessons
Dental Anatomy
Mandibular Second Deciduous Molar.
-This tooth resembles the lower first permanent molar that is d
istal to it in the dental arch.
-There are two roots and five cusps. The three buccal cusps are all about the same size. This is in contrast to the lower first molar where the 'distal' cusp is smaller that the mesiobuccal and distobuccal cusps.
-The distal of the three buccal cusps may be shifted of onto the distal marginal ridge.
NOTE
-Upper molars have three roots, lowers have two roots.
-Upper and lower second deciduous molars resemble first permanent molars in the same quadrant.
-Upper first deciduous molars vaguely resemble upper premolars. -Lower first deciduous molars are odd and unique unto themselves.
-First deciduous molars (upper and lower) have a prominent bulge of enamel on the buccal at the mesial. These help in determining right and left.
The very first histological evidence of tooth development appear during the second month of intrauterine life. Calcification of deciduous incisors begins at 3-4 months in utero.
MANDIBULAR FIRST MOLAR
It is the first permanent tooth to erupt.
Facial Surface:- The lower first permanent molar has the widest mesiodistal diameter of all of the molar teeth. Three cusps cusps separated by developmental grooves make on the occlusal outline The mesiobuccal cusp is usually the widest of the cusps. The mesiobuccal cusp is generally considered the largest of the five cusps. The distal root is usually less curved than the mesial root.
Lingual: Three cusps make up the occlusal profile in this view: the mesiolingual, the distolingual, and the distal cusp which is somewhat lower in profile. The mesiobuccal cusp is usually the widest and highest of the three. A short lingual developmental groove separates the two lingual cusps
Proximal: The distinctive height of curvature seen in the cervical third of the buccal surface is called the cervical ridge. The mesial surface may be flat or concave in its cervical third . It is highly convex in its middle and occlusal thirds. The occlusal profile is marked by the mesiobuccal cusp, mesiolingual cusp, and the mesial marginal ridge that connects them. The mesial root is the broadest buccolingually of any of the lower molar roots. The distal surface of the crown is narrower buccolingually than the mesial surface. Three cusps are seen from the distal aspect: the distobuccal cusp, the distal cusp, and the distolingual cusp.
Occlusal There are five cusps. Of them, the mesiobuccal cusp is the largest, the distal cusp is the smallest. The two buccal grooves and the single lingual groove form the "Y" patern distinctive for this tooth
Roots :-The tooth has two roots, a mesial and a distal.
Contact Points; The mesial contact is centered buccolingually just below the marginal ridge. The distal contact is centered over the distal root, but is buccal to the center point of the distal marginal ridge.
Roots: Lower molars have mesial and distal roots. In the first, molar, the mesial root is the largest. It has a distal curvature. The distal root has little curvature and projects distally.
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
Genetics and Environment: Introduction
The size of the teeth and the timing of the developing dentition and its eruption are genetically determined. Teeth are highly independent in their development. Also, teeth tend to develop along a genetically predetermined course.: tooth development and general physical development are rather independent of one another. Serious illness, nutritional deprivation, and trauma can significantly impact development of the teeth. This genetic independence (and their durability) gives teeth special importance in the study of evolution.
Teeth erupt full size and are ideal for study throughout life. Most important, age and sex can be recorded.
When teeth erupt into the oral cavity, a new set of factors influence tooth position. As the teeth come into function, genetic and environment determine tooth position.
In real life, however, girls shed deciduous teeth and receive their permanent teeth slightly earlier than boys, possibly reflecting the earlier physical maturation achieved by girls. Teeth are slightly larger in boys that in girls
Histology of the Pulp
PARTICIPATING CELLS
1. Odontoblasts (body and process)
Most distinctive cells of the pulp
Single layer
The cells are columnar in the coronal portion, cuboidal in the middle portion, flat in the apical portion
Individual odontoblasts communicate with each other via junctions. The number of odontoblasts corresponds to the number of dentinal tubules.
The lifespan of an odontoblast equals the one of a vital tooth.
The morphology of the odontoblasts reflects their functional activity.
(There are three stages that reflect the functional activity of a cell: active, transitional and resting)
The odontoblastic process
2. Fibroblasts
Most numerous cells
Produce collagen fibers and ground substance
Ground substance consists of: proteoglycans and glycoproteins
Again, active and resting cells
Fibroblasts have also capability to degrade collagen
3. Undifferentiated mesenchymal cells A pool of cells from which connective tissue cells can derive.
They are reduced with age.
4. Endothelial cells, Schwann cells, pericytes and immunocompetent cells
MATRIX
It is composed of fibers and ground substance
55% of the fibers are Type I collagen. 45% of the fibers are Type III collagen.
The ground substance is gelatinous in the coronal aspect and more fibrous in the apical.
VASCULARITY
Superior and inferior alveolar arteries that derive from the external carotids
Afferent side of the circulation: arterioles
Efferent side of the circulation: venules
Lymphatics
Small, blind, thin-walled vessels in the coronal region of the pulp and exit via one or two larger vessels.
MORPHOLOGY OF THE DECIDUOUS TEETH
Deciduous Anterior Teeth.
-The primary anteriors are morphologically similar to the permanent anteriors.
-The incisors are relatively simple in their morphology.
-The roots are long and narrow.
-When compared to the permanent incisors, the mesiodistal dimension is relatively larger when compared to axial crown length
-At the time of eruption, mamelons are not present in deciduous incisors
-They are narrower mesiodistally than their permanent successors.