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Dental Anatomy - NEETMDS- courses
NEET MDS Lessons
Dental Anatomy

Mandibular First Deciduous Molar

-This tooth doesn't resemble any other tooth. It is unique unto itself.

-There are two roots.

-There is a strong bulbous enamel bulge buccally at the mesial.

- the mesiolingual cusps on this tooth is the highest and largest of the cusps.

Dental Terminology.

 

Cusp: a point or peak on the occlusal surface of molar and premolar teeth and on the incisal edges of canines.

 

Contact: a point or area where one tooth is in contact (touching) another tooth

 

Cingulum: a bulge or elevation on the lingual surface of incisors or canines. It makes up the bulk of the cervical third of the lingual surface. Its convexity mesiodistally resembles a girdle  encircling the lingual surface at the cervical.

 

Fissure: A linear fault that sometimes occurs in a developmental groove by incomplete or imperfect joining of the lobes. A pit is usually found at the end of a developmental groove or a place where two fissures intersect.

 

Lobe: one of the primary centers of formation in the development of the crown of the tooth.

 

Mamelon: A lobe seen on anterior teeth; any one of three rounded protuberances seen on the unworn surfaces of freshly erupted anterior teeth.

 

Ridge: Any linear elevation on the surface of a tooth. It is named according to its location or form. Examples are buccal ridges, incisal ridges, marginal ridges, and so on.

 

Marginal ridges are those rounded borders of enamel which form the margins of the surfaces of premolars and molars, mesially and distally, and the mesial and distal margins of the incisors and canines lingually.

 

Triangular ridges are those ridges which descend from the tips of the cusps of molars and premolars toward the central part of the occlusal surface. Transverse ridges are created when a buccal and lingual triangular ridge join.

 

Oblique ridges are seen on maxillary molars and are a companion to the distal oblique groove.

 

Cervical ridges are the height of contour at the gingival, on certain deciduous and permanent teeth.

 

Fossa: An irregular, rounded depression or concavity found on the surface of a tooth. A lingual fossa is found on the lingual surface of incisors. A central fossa is found on the occlusal surface of a molar. They are formed by the converging of ridges terminating at a central point in the bottom of a depression where there is a junction of grooves

 

Pit: A small pinpoint depression located at the junction of developmental grooves or at the terminals of these groops. A central pit is found in the central fossa on the occlusal surfaces of molars where developmental grooves join. A pit is often the site of the onset of Dental  caries

 

Developmental groove: A sharply defined, narrow and linear depression formed during tooth development and usually separating lobes or major portions of a tooth.

 

A supplemental groove is also a shallow linear depression but it is usually less distinct and is more variable than a developmental groove and does not mark the junction of primary parts of a tooth.

Buccal and lingual grooves are developmental grooves found on the buccal and lingual surfaces of posterior teeth.

 

Tubercle: A small elevation produced by an extra formation of enamel. These occur on the marginal ridges of posterior teeth or on the cingulum of anterior teeth. These are deviations from the typical form.

 

Interproximal space: The triangular space between the adjacent teeth cervical to the contact point. The base of the triangle is the alveolar bone; the sides are the proximal surfaces of the adjacent teeth.

 

Sulcus:-An elongated valley or depression in the surface of a tooth formed by the inclines of adjacent cusp or ridges.

 

Embrasures: When two teeth in the same arch are in contact, their curvatures adjacent to the contact areas form spillway spaces called embrasures. There are three embrasures:

(1) Facial (buccal or labial)

(2) Occlusal or incisal

(3) Lingual

(NOTE: there are three embrasures; the fourth potential space is the interproximal space ).

Crown stage

Hard tissues, including enamel and dentin, develop during the next stage of tooth development. This stage is called the crown, or maturation, stage by some researchers. Important cellular changes occur at this time. In prior stages, all of the inner enamel epithelium cells were dividing to increase the overall size of the tooth bud, but rapid dividing, called mitosis, stops during the crown stage at the location where the cusps of the teeth form. The first mineralized hard tissues form at this location. At the same time, the inner enamel epithelial cells change in shape from cuboidal to columnar. The nuclei of these cells move closer to the stratum intermedium and away from the dental papilla.

The adjacent layer of cells in the dental papilla suddenly increases in size and differentiates into odontoblasts, which are the cells that form dentin. Researchers believe that the odontoblasts would not form if it were not for the changes occurring in the inner enamel epithelium. As the changes to the inner enamel epithelium and the formation of odontoblasts continue from the tips of the cusps, the odontoblasts secrete a substance, an organic matrix, into their immediate surrounding. The organic matrix contains the material needed for dentin formation. As odontoblasts deposit organic matrix, they migrate toward the center of the dental papilla. Thus, unlike enamel, dentin starts forming in the surface closest to the outside of the tooth and proceeds inward. Cytoplasmic extensions are left behind as the odontoblasts move inward. The unique, tubular microscopic appearance of dentin is a result of the formation of dentin around these extensions.

After dentin formation begins, the cells of the inner enamel epithelium secrete an organic matrix against the dentin. This matrix immediately mineralizes and becomes the tooth's enamel. Outside the dentin are ameloblasts, which are cells that continue the process of enamel formation; therefore, enamel formation moves outwards, adding new material to the outer surface of the developing tooth.

AGE CHANGES

Progressive apical migration of the dentogingival junction.
Toothbrush abrasion of the area can expose dentin that can cause root caries and tooth mobility.

Histology of the alveolar bone

 

Near the end of the 2nd month of fetal life, mandible and maxilla form a groove that is opened toward the surface of the oral cavity.
As tooth germs start to develop, bony septa form gradually. The alveolar process starts developing strictly during tooth eruption.

The alveolar process is the bone that contains the sockets (alveoli) for the teeth and consists of

a) outer cortical plates
b) a central spongiosa and
c) bone lining the alveolus (bundle bone)

The alveolar crest is found 1.5-2.0 mm below the level of the CEJ.
If you draw a line connecting the CE junctions of adjacent teeth, this line should be parallel to the alveolar crest. If the line is not parallel, then there is high probability of periodontal disease.

Bundle Bone

The bundle bone provides attachment to the periodontal ligament fibers. It is perforated by many foramina that transmit nerves and vessels (cribiform plate). Embedded within the bone are the extrinsic fiber bundles of the PDL mineralized only at the periphery. Radiographically, the bundle bone is the lamina dura. The lining of the alveolus is fairly smooth in the young but rougher in the adults.

Clinical considerations

Resorption and regeneration of alveolar bone
This process can occur during orthodontic movement of teeth. Bone is resorbed on the side of pressure and opposed on the site of tension.

Osteoporosis
Osteoporosis of the alveolar process can be caused by inactivity of tooth that does not have an antagonist

 

Maxillary (upper) teeth

Primary teeth

Central
incisor

Lateral
incisor


Canine

First
molar

Second
molar

Initial calcification

14 wk

16 wk

17 wk

15.5 wk

19 wk

Crown completed

1.5 mo

2.5 mo

9 mo

6 mo

11 mo

Root completed

1.5 yr

2 yr

3.25 yr

2.5 yr

3 yr

 

 Mandibular (lower) teeth 

Initial calcification

14 wk

16 wk

17 wk

15.5 wk

18 wk

Crown completed

2.5 mo

3 mo

9 mo

5.5 mo

10 mo

Root completed

1.5 yr

1.5 yr

3.25 yr

2.5 yr

3 yr

 

 

 

 

 

 

 

Maxillary (upper) teeth

Permanent teeth

Central
incisor

Lateral
incisor


Canine

First
premolar

Second
premolar

First
molar

Second
molar

Third
molar

Initial calcification

3–4 mo

10–12 mo

4–5 mo

1.5–1.75 yr

2–2.25 yr

at birth

2.5–3 yr

7–9 yr

Crown completed

4–5 yr

4–5 yr

6–7 yr

5–6 yr

6–7 yr

2.5–3 yr

7–8 yr

12–16 yr

Root completed

10 yr

11 yr

13–15 yr

12–13 yr

12–14 yr

9–10 yr

14–16 yr

18–25 yr

 

 Mandibular (lower) teeth 

Initial calcification

3–4 mo

3–4 mo

4–5 mo

1.5–2 yr

2.25–2.5 yr

at birth

2.5–3 yr

8–10 yr

Crown completed

4–5 yr

4–5 yr

6–7 yr

5–6 yr

6–7 yr

2.5–3 yr

7–8 yr

12–16 yr

Root completed

9 yr

10 yr

12–14 yr

12–13 yr

13–14 yr

9–10 yr

14–15 yr

18–25 yr

CEMENTUM vs. BONE

Cementum simulates bone
1) Organic fibrous framework, ground substance, crystal type, development
2) Lacunae
3) Canaliculi
4) Cellular components
5) Incremental lines (also known as "resting" lines; they are produced by continuous but phasic, deposition of cementum)

Differences between cementum and bone
1) Cementum is not vascularized
2) Cementum has minor ability to remodel
3) Cementum is more resistant to resorption compared to bone
4) Cementum lacks neural component
5) Cementum contains a unique proteoglycan interfibrillar substance
6) 70% of bone is made by inorganic salts (cementum only 46%)

Relation of Cementum to Enamel at the Cementoenamel Junction (CEJ)

"OMG rule"

In 60% of the teeth cementum Overlaps enamel
In 30% of the teeth cementum just Meets enamel
In 10% of the teeth there is a small Gap between cementum and enamel

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