NEET MDS Lessons
Dental Anatomy
MANDIBULAR LATERAL INCISORS
The mandibular incisor is a little wider mesiodistal than the mandibular central incisor, and the crown is slightly longer from the incisal edge to the cervical line.
Facial Surface:-The facial surface is less symmetrical than the facial surface of the mandibular central incisor. The incisal edge slopes upward toward the mesioincisal angle, which is slightly less than 90°. The distoincisal angle is rounded. The mesial border is more nearly straight than the distal border.
Lingual Surface:- The incisal portion of the lingual surface is concave. The cingulum is quite large but blends in smoothly with the rest of the surface.
Root Surface:-The root is single and extremely flattened on its mesial and distal surfaces.
Periodontal ligament development
Cells from the dental follicle give rise to the periodontal ligaments (PDL).
Formation of the periodontal ligaments begins with ligament fibroblasts from the dental follicle. These fibroblasts secrete collagen, which interacts with fibers on the surfaces of adjacent bone and cementum. This interaction leads to an attachment that develops as the tooth erupts into the mouth. The occlusion, which is the arrangement of teeth and how teeth in opposite arches come in contact with one another, continually affects the formation of periodontal ligaments. This perpetual creation of periodontal ligaments leads to the formation of groups of fibers in different orientations, such as horizontal and oblique fibers.
HISTOLOGY OF SALIVARY GLANDS
Parotid: so-called watery serous saliva rich in amylase
Submandibular gland: more mucinous
Sublingual: viscous saliva
Parotid Gland: The parotid is a serous secreting gland.
There are also fat cells in the parotid.
Submandibular Gland
This gland is serous and mucous secreting.
There are serous demilunes
This gland is more serous than mucous
Also fat cells
Sublingual Gland
Serous and mucous secreting
Serous cells in the form of demilunes on the mucous acini.
more mucous than serous cells
Minor Salivary Glands
Minor salivary glands are not found within gingiva and anterior part of the hard palate
Serous minor glands=von Ebner below the sulci of the circumvallate and folliate papillae of the tongue; palatine, glossopalatine glands are pure mucus; some lingual glands are also pure mucus
Functions
Protection: lubricant (glycoprotein); barrier against noxious stimuli; microbial toxins and minor traumas; washing non-adherent and acellular debris; calcium-binding proteins: formation of salivary pellicle
Buffering: bacteria require specific pH conditions; plaque microorganisms produce acids from sugars; phosphate ions and bicarbonate
Digestion: neutralizes esophageal contents, dilutes gastric chyme; forms food bolus; brakes starch
Taste: permits recognition of noxious substances; protein gustin necessary for growth and maturation of taste buds
Antimicrobial: lysozyme hydrolyzes cell walls of some bacteria; lactoferrin binds free iron and deprives bacteria of this essential element; IgA agglutinates microorganisms
Maintenance of tooth integrity: calcium and phosphate ions; ionic exchange with tooth surface
Tissue repair: bleeding time of oral tissues shorter than other tissues; resulting clot less solid than normal; remineralization
MAXILLARY FIRST BICUSPID (PREMOLARS)
It is considered to be the typical bicuspid. (The word "bicuspid" means "having two cusps.")
Facial: The buccal surface is quite rounded and this tooth resembles the maxillary canine. The buccal cusp is long; from that cusp tip, the prominent buccal ridge descends to the cervical line of the tooth.
Lingual: The lingual cusp is smaller and the tip of that cusp is shifted toward the mesial. The lingual surface is rounded in all aspects.
Proximal: The mesial aspect of this tooth has a distinctive concavity in the cervical third that extends onto the root. It is called variously the mesial developmental depression, mesial concavity, or the 'canine fossa'--a misleading description since it is on the premolar. The distal aspect of the maxillary first permanent molar also has a developmental depression. The mesial marginal developmental groove is a distinctive feature of this tooth.
Occlusal: There are two well-defined cusps buccal and lingual. The larger cusp is the buccal; its cusp tip is located midway mesiodistally. The lingual cusp tip is shifted mesially. The occlusal outline presents a hexagonal appearance. On the mesial marginal ridge is a distinctive feature, the mesial marginal developmental groove.
Contact Points;The distal contact area is located more buccal than is the mesial contact area.
Root Surface:-The root is quite flat on the mesial and distal surfaces. In about 50 percent of maxillary first bicuspids, the root is divided in the apical third, and when it so divided, the tips of the facial and lingual roots are slender and finely tapered.
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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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Dentin
Composition: 70% inorganic, 20% organic, 10% water by weight and 45%, 33%, and 22% in volume respectively
Hydroxyapatite crystals and collagen type I
Physical characteristics: Harder than bone and softer than enamel
Yellow in color in normal teeth
Radiographic appearance: More radiolucent than enamel
Primary (circumpulpal) dentin: forms most of the tooth
Mantle dentin: first dentin to form; forms the outline of dentin in the adult tooth
Predentin: lines the innermost portion of dentin (faces the pulp)
Secondary dentin: after root formation dentin continues to form, continuous to primary dentin but with structural irregularities
Tertiary dentin: reactive or reparative dentin; may or may not have characteristics of primary dentin; produced in the area of an external stimulus; osteodentin
Dentin is formed by cells called odontoblasts.
These cells derive from the ectomesenchyme and produce the organic matrix that will calcify and become the dentin.
Formation of dentin initiates formation of enamel.
The formation of dentin starts during late bell-stage in the area of the future cusp.
First coronal dentin and then root dentin.
Completion of dentin does not occur until about 18 months after eruption of primary and 2-3 years after eruption of permanent teeth.
The rate of dentin development varies.
The role of the internal (inner) dental (enamel) epithelium
Cuboidal - Columnar (reverse polarization)
Ectomesenchymal cells of the dental papilla become preodontoblasts - odontoblasts
Acellular zone disappears
Histologic features of dentin
Odontoblasts
Dentinal tubules
Extend through the entire thickness of dentin
S-shaped (primary curvatures) path in the crown, less S-shaped in the root, almost straight in the cervical aspect
Secondary curvatures
Tubular microbranches
Presence of fluid
Intratubular dentin
Dentin in the tubule that is hypermineralized
The term peritubular dentin should not be used
Sclerotic dentin
Dentinal tubules that are occluded with calcified material
Most likely a physiologic response
Reduction of permeability of dentin
Intertubular dentin
Dentin between the tubules
Interglobular dentin
Areas of unmineralized or hypomineralized dentin
The defect affects mineralization and not the architecture of dentin
Incremental lines
Lines of von Ebner: lines associated with 5-day rythmic pattern of dentin deposition
Contour lines of Owen: Originally described by Owen they result from a coincidence of the secondary curvatures between neighboring dentinal tubules.
Granular Layer of Tomes
Seen only in ground sections in the root area covered by cementum
Originally, they were thought to be areas of hypomineralization
They are true spaces obtained by sections going through the looped terminal portions dentinal tubules
DE junction :Scalloped area
Enamel tissue with incremental lines of Retzius and dentin tissue with parallel, curved dentinal tubules are in contact at the irregular dentino-enamel junction. The junction often has a scalloped-shaped morphology
DC junction Dentin Cemental Junction
MAXILLARY FIRST MOLAR
The first molars are also known as 6-year molars, because they erupt when a child is about 6 years
Facial Surface:-The facial surface has a facial groove that continues over from the occlusal surface, and runs down to the middle third of the facial surface.
Lingual Surface:-In a great many instances, there is a cusp on the lingual surface of the mesiolingual cusp. This is a fifth cusp called the cusp of Carabelli, which is in addition to the four cusps on the occlusal surface.
Proximal: In mesial perspective the mesiolingual cusp, mesial marginal ridge, and mesiobuccal cusp comprise the occlusal outline. In its distal aspect, the two distal cusps are clearly seen; however, the distal marginal ridge is somewhat shorter than the mesial one.
Occlusal Surface:- The tooth outline is somewhat rhomboidal with four distinct cusps. The cusp order according to size is: mesiolingual, mesiobuccal, distobuccal, and distolingual. The tips of the mesiolingual, mesiobuccal, and distobuccal cusps form the trigon, Cusp of Carabelli located on the mesiolingual cusp.
Contact Points; The mesial contact is above, but close to, the mesial marginal ridge. It is somewhat buccal to the center of the crown mesiodistally. The distal contact is similarly above the distal marginal ridge but is centered buccolingually.
Roots:-The maxillary first molar has three roots, which are named according to their locations mesiofacial, distofacial, and lingual (or palatal root). The lingual root is the largest.