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

Amelogenesis and Enamel

Enamel is highly mineralized: 85% hydroxyapatite crystals
Enamel formation is a two-step process
The first step produces partially mineralized enamel: 30% (secretory)
The second step: Influx of minerals, removal of water and organic matrix (maturative)
Again, dentin is the prerequisite of enamel formation (reciprocal induction)
Stratum intermedium: high alkaline phosphatase activity
Differentiation of ameloblasts: Increase in glycogen contents

Formation of the enamel matrix
Enamel proteins, enzymes, metalloproteinases, phosphatases, etc.
Enamel proteins: amelogenins (90%), enamelin, tuftelin, and amelin
Amelogenins: bulk of organic matrix
Tuftelin: secreted at the early stages of amelogenesis (area of the DE junction)
Enamelin: binds to mineral
Amelin

Mineralization of enamel
 No matrix vesicles
Immediate formation of crystallites
Intermingling of enamel crystallites with dentin
"Soft" enamel is formed

Histologic changes

Differentiation of inner enamel epithelium cells. They become ameloblasts
Tomes' processes: saw-toothed appearance
Collapse of dental organ
Formation of the reduced enamel epithelium

Hard tissue formation (Amelogenesis )

Enamel formation is called amelogenesis and occurs in the crown stage of tooth development. "Reciprocal induction" governs the relationship between the formation of dentin and enamel; dentin formation must always occur before enamel formation. Generally, enamel formation occurs in two stages: the secretory and maturation stages. Proteins and an organic matrix form a partially mineralized enamel in the secretory stage; the maturation stage completes enamel mineralization.

In the secretory stage, ameloblasts release enamel proteins that contribute to the enamel matrix, which is then partially mineralized by the enzyme alkaline phosphatase. The appearance of this mineralized tissue, which occurs usually around the third or fourth month of pregnancy, marks the first appearance of enamel in the body. Ameloblasts deposit enamel at the location of what become cusps of teeth alongside dentin. Enamel formation then continues outward, away from the center of the tooth.

In the maturation stage, the ameloblasts transport some of the substances used in enamel formation out of the enamel. Thus, the function of ameloblasts changes from enamel production, as occurs in the secretory stage, to transportation of substances. Most of the materials transported by ameloblasts in this stage are proteins used to complete mineralization. The important proteins involved are amelogenins, ameloblastins, enamelins, and tuftelins. By the end of this stage, the enamel has completed its mineralization.

Permanent dentition period  

-Maxillary / mandibular occlusal relationships are established when the last of the deciduous teeth are lost. The adult relationship of the first permanent molars is established at this time.

-Occlusal and proximal wear reduces crown height to the permanent dentition and the mesiodistal dimensions of the teeth

occlusal and proximal wear also changes the anatomy of teeth. As cusps are worn off, the occlusion can become virtually flat plane. -In the absence of rapid wear, overbite and overjet tend to remain stable.

-Mesio-distal jaw relationships tend to be stable,

With aging, the teeth change in color from off white to yellow. smoking and diet can accelerate staining or darkening of the teeth.

Gingival recession results in the incidence of more root caries . With gingival recession, some patients have sensitivity due to exposed dentin at the cemento-enamel junction.

Curve of Spee.

-The cusp tips and incisal edges align so that there is a smooth, linear curve when viewed from the lateral aspect. The mandibular curve of Spee is concave whereas the maxillary curve is convex.

-It was described by Von Spee as a 4" cylinder that engages the occlusal surfaces.

-It is called a compensating curve of the dental arch.

There is another: the Curve of Wilson. Clinically, it relates to the anterior overbite: the deeper the curve, the deeper the overbite.