NEET MDS Lessons
Dental Anatomy
As root and cementum formation begin, bone is created in the adjacent area. Throughout the body, cells that form bone are called osteoblasts. In the case of alveolar bone, these osteoblast cells form from the dental follicle. Similar to the formation of primary cementum, collagen fibers are created on the surface nearest the tooth, and they remain there until attaching to periodontal ligaments.
Like any other bone in the human body, alveolar bone is modified throughout life. Osteoblasts create bone and osteoclasts destroy it, especially if force is placed on a tooth. As is the case when movement of teeth is attempted through orthodontics, an area of bone under compressive force from a tooth moving toward it has a high osteoclast level, resulting in bone resorption. An area of bone receiving tension from periodontal ligaments attached to a tooth moving away from it has a high number of osteoblasts, resulting in bone formation.
Cap stage
The first signs of an arrangement of cells in the tooth bud occur in the cap stage. A small group of ectomesenchymal cells stops producing extracellular substances, which results in an aggregation of these cells called the dental papilla. At this point, the tooth bud grows around the ectomesenchymal aggregation, taking on the appearance of a cap, and becomes the enamel (or dental) organ. A condensation of ectomesenchymal cells called the dental follicle surrounds the enamel organ and limits the dental papilla. Eventually, the enamel organ will produce enamel, the dental papilla will produce dentin and pulp, and the dental follicle will produce all the supporting structures of a tooth
Gingiva
The connection between the gingiva and the tooth is called the dentogingival junction. This junction has three epithelial types: gingival, sulcular, and junctional epithelium. These three types form from a mass of epithelial cells known as the epithelial cuff between the tooth and the mouth.
Much about gingival formation is not fully understood, but it is known that hemidesmosomes form between the gingival epithelium and the tooth and are responsible for the primary epithelial attachment. Hemidesmosomes provide anchorage between cells through small filament-like structures provided by the remnants of ameloblasts. Once this occurs, junctional epithelium forms from reduced enamel epithelium, one of the products of the enamel organ, and divides rapidly. This results in the perpetually increasing size of the junctional epithelial layer and the isolation of the remenants of ameloblasts from any source of nutrition. As the ameloblasts degenerate, a gingival sulcus is created.
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
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.
The mixed dentition
I. Transition dentition between 6 and 12 years of age with primary tooth exfoliation and permanent tooth eruption
2. Its characteristic features have led this to be called the ugly duckling stage because of
a. Edentulated areas
b. Disproportionately sized teeth
c. Various clinical crown heights
d. Crowding
e. Enlarged and edematous gingiva
f. Different tooth colors
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