NEET MDS Lessons
Dental Anatomy
FUNCTIONS OF PERIODONTIUM
Tooth support
Shock absorber
Sensory (vibrations appreciated in the middle ear/reflex jaw opening)
Cementum
Composition
a. Inorganic (50%)—calcium hydroxyapatite crystals.
b. Organic (50%)—water, proteins, and type I collagen.
c. Note: Compared to the other dental tissues, the composition of cementum is most similar to bone; however, unlike bone, cementum is avascular (i.e., no Haversian systems or other vessels are present).
Main function of cementum is to attach PDL fibers to the root surface.
Cementum is generally thickest at the root apex and in interradicular areas of multirooted
Types of cementum
a. Acellular (primary) cementum
(1) A thin layer of cementum that surrounds the root, adjacent to the dentin.
(2) May be covered by a layer of cellular cementum, which most often occurs in the middle and apical root.
(3) It does not contain any cells.
b. Cellular (secondary) cementum
(1) A thicker, less-mineralized layer of cementum that is most prevalent along the apical root and in interradicular (furcal) areas of multirooted teeth.
(2) Contains cementocytes.
(3) Lacunae and canaliculi:
(a) Cementocytes (cementoblasts that become trapped in the extracellular matrix during cementogenesis) are observed in their entrapped spaces, known as lacunae.
(b) The processes of cementocytes extend through narrow channels called canaliculi.
(4) Microscopically, the best way to differentiate between acellular and cellular cementum is the presence of lacunae in cellular cementum.
lntraarch relationship refers to the alignment of the teeth within an arch
1. In an ideal alignment teeth should contact at their proximal crests of curvature. A continuous arch form is observed in occlusal view
Curves of the occlusal plane (a line connecting the cusp tips of the canines, premolars, and molars) are observed from the proximal view
Curve of Spee: anterior to posterior curve; for mandibular teeth the curve is concave and for maxillary teeth it is convex
Curve of Wilson- medial to lateral curve for mandibular teeth the curve is also convex and for the maxillary it is convex
2. Contact does not always exist Some permanent dentitions have normal spacing
Primary dentitions often have developmental spacing in the anterior area: some primary den titions have a pattern of spacing called primate spaces between the primary maxillary lateral incisors and canine and between the mandibular canine and first mo1ar
Disturbances to the intraarch alignment are described as
a. Qpen contact where interproximal space exist because of missing teeth oral habits, dental disease, or overdeveloped frena
b. where contact or position is at an unexpected area because of developmental disturbances, crowding, dental caries or periodontal ligament for their misplaced position: facial, lingual. mesial, supra(supraerupted) infra (infraerupted) and torso (rotated) version
MANDIBULAR CUSPIDS
Mandibular canines are those lower teeth that articulate with the mesial aspect of the upper canine.
Facial: The mandibular canine is noticeably narrower mesidistally than the upper, but the root may be as long as that of the upper canine. In an individual person,the lower canine is often shorter than that of the upper canine. The mandibular canine is wider mesiodistally than either lower incisor. A distinctive feature is the nearly straight outline of the mesial aspect of the crown and root. When the tooth is unworn, the mesial cusp ridge appears as a sort of 'shoulder' on the tooth. The mesial cusp ridge is much shorter than the distal cusp ridge.
Lingual: The marginal ridges and cingulum are less prominent than those of the maxillary canine. The lingual surface is smooth and regular. The lingual ridge, if present, is usually rather subtle in its expression.
Proximal: The mesial and distal aspects present a triangular outline. The cingulum as noted is less well developed. When the crown and root are viewed from the proximal, this tooth uniquely presents a crescent-like profile similar to a cashew nut.
Incisal: The mesiodistal dimension is clearly less than the labiolingual dimension. The mesial and distal 'halves' of the tooth are more identical than the upper canine from this perspective. In the mandibular canine, the unworn incisal edge is on the line through the long axis of this tooth.
Embryonic development
The parotid derives from ectoderm
The sublingual-submandibular glands thought to derive from endoderm
Differentiation of the ectomesenchyme
Development of fibrous capsule
Formation of septa that divide the gland into lobes and lobules
The parotid develops around 4-6 weeks of embryonic lofe
The submandibular gland develops around the 6th week
The sublingual and the minor glands develop around the 8-12 week
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Maxillary (upper) teeth |
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Primary teeth |
Central |
Lateral |
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First |
Second |
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Initial calcification |
14 wk |
16 wk |
17 wk |
15.5 wk |
19 wk |
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Crown completed |
1.5 mo |
2.5 mo |
9 mo |
6 mo |
11 mo |
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Root completed |
1.5 yr |
2 yr |
3.25 yr |
2.5 yr |
3 yr |
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Mandibular (lower) teeth |
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Initial calcification |
14 wk |
16 wk |
17 wk |
15.5 wk |
18 wk |
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Crown completed |
2.5 mo |
3 mo |
9 mo |
5.5 mo |
10 mo |
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Root completed |
1.5 yr |
1.5 yr |
3.25 yr |
2.5 yr |
3 yr |
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PULP
Coronal
Occupies and resembles the crown,
Contains the pulp horns
It decreases in size with age
Radicular
Occupies roots
Contains the apical foramen
It decreases in size with age
Accessory apical canals
PULP FUNCTIONS
Inductive: The pulp anlage initiates tooth formation and probably induces the dental organ to become a particular type of tooth.
Formative: Pulp odontoblasts develop the organic matrix and function in its calcification.
Nutritive: Nourishment of dentin through the odontoblasts.
Protective: Sensory nerves in the tooth respond almost always with PAIN to all stimuli (heat, cold, pressure, operative procedures, chamical agents).
Defensive or reparative: It responds to irritation by producing reparative dentin. The response to stimuli is inflammation.
Histologically the pulp consists of delicate collagen fibers, blood vessels, lymphatics, nerves and cells. A histologic section of the pulp reveals four cellular zones:
Odontoblastic
Cell-free (Weil)
Cell-rich
Pulp core