NEET MDS Lessons
Dental Anatomy
Disturbances to interarch alignment are
a. Excessive overbite where the incisal edge of the maxillary incisors extend to the cervical third of the mandibular incisors
b. Excessive overjet where the maxillary teeth overjet the mandibular teeth by more than 3mm
c. End-to-end relationship: edge-to edge bite where the anterior teeth meet at there incisal edge with no overjet or overbite; cusp-to bite where the posterior teeth meet cusp to cusp with no interdigitation
d. Crossbite where the normal faciolingual relationship of the maxillary to the mandibular teeth is altered for the anterior.teeth. the mandibular tooth or teeth are facial rather than lingual to the maxillary teeth for the posterior teeth, normal inercuspaton is not seen
MAXILLARY CENTRAL INCISORS
Viewed mesially or distally, a maxillary central incisor looks like a wedge, with the point of the wedge at the incisal (cutting) edge of the tooth.
Facial Surface- The mesial margin is nearly straight and meets the incisal edge at almost a 90° angle, but the distal margin meets the incisal edge in a curve. The incisal edge is straight, but the cervical margin is curved like a half moon. Two developmental grooves are on the facial surface.
Lingual Surface:- The lingual aspect presents a distinctive lingual fossa that is bordered by mesial and distal marginal ridges, the incisal edge, and the prominent cingulum at the gingival. Sometimes a deep pit, the lingual pit, is found in conjunction with a cingulum.
Incisal: The crown is roughly triangular in outline; the incisal edge is nearly a straight line, though slightly crescent shaped
Contact Points: The mesial contact point is just about at the incisal, owing to the very sharp mesial incisal angle. The distal contact point is located at the junction of the incisal third and the middle third.
Root Surface:-As with all anterior teeth, the root of the maxillary central incisor is single. This root is from one and one-fourth to one and one-half times the length of the crown. Usually, the apex of the root is inclined slightly distally.
Formation and Eruption of Deciduous Teeth.
-Calcification begins during the fourth month of fetal life. By the end of the sixth month, all of the deciduous teeth have begun calcification.
-By the time the deciduous teeth have fully erupted (two to two and one half years of age), cacification of the crowns of permanent teeth is under way. First permanent molars have begun cacification at the time of birth. -Here are some things to know about eruption patterns:
(1) Teeth tend to erupt in pairs.
(2) Usually, lower deciduous teeth erupt first. Congenitally missing deciduous teeth is infrequent. Usually, the lower deciduous central incisors are thefirst to erupt thus initiating the deciduous dentition. The appearance of the deciduous second molars completes the deciduous dentition by 2 to 2 1/2 years of age.
- Deciduous teeth shed earlier and permanent teeth erupt earlier in girls.
- The orderly pattern of eruption and their orderly replacement by permanent teeth is important.
- order for eruption of the deciduous teeth is as follows:
(1) Central incisor.........Lower 6 ½ months, Upper 7 ½ months
(2) Lateral incisor.........Lower 7 months, Upper 8 months
(3) First deciduous molar...Lower 12-16 months, Upper 12-16 months
(4) Deciduous canine........Lower 16-20 months, Upper 16-20 months
(5) Second deciduous molar..Lower 20-30 months, Upper 20-30 months
Time for tooth development
Entire primary dentition initiated between 6 and 8 weeks of embryonic development.
Successional permanent teeth initiated between 20th week in utero and 10th month after birth Permanent molars between 20th week in utero (first molar) and 5th year of life (third molar)
MANDIBULAR FIRST BICUSPID
Facial: The outline is very nearly symmetrical bilaterally, displaying a large, pointed buccal cusp. From it descends a large, well developed buccal ridge.
Lingual: This tooth has the smallest and most ill-defined lingual cusp of any of the premolars. A distinctive feature is the mesiolingual developmental groove
Proximal: The large buccal cusp tip is centered over the root tip, about at the long axis of this tooth. The very large buccal cusp and much reduced lingual cusp are very evident. You should keep in mind that the mesial marginal ridge is more cervical than the distal contact ridge; each anticipate the shape of their respective adjacent teeth.
Occlusal: The occlusal outline is diamond-shaped. The large buccal cusp dominates the occlusal surface. Marginal ridges are well developed and the mesiolingual developmental groove is consistently present. There are mesial and distal fossae with pits,
Contact Points: When viewed from the facial, each contact area/height of curvature is at about the same height.
Root Surface:-The root of the mandibular first bicuspid is usually single, but on occasion can be bifurcated (two roots).
Enamel
Composition: 96% mineral, 4% organic material and water
Crystalline calcium phosphate, hydroxyapatite
Physical characteristics: Hardness compared to mild steel; enamel is brittle
Support from dentin is necessary
Enamel has varies in thickness
Structure of enamel
Ground sections of enamel disclose the information that we have about enamel
Enamel is composed of rods
In the past we used the term prism (do not use)
Enamel rod
The rod has a cylinder-like shape and is composed of crystals that run parallel to the longitudinal axis of the rod. At the periphery of the rod the crystals flare laterally.
Interrod region: surrounds each rod; contain more enamel protein (fish scale appearance)
Rod sheath: boundary where crystals of rods meet those of the interrod region at sharp angles (We used to describe that as a keyhole configuration)
Each ameloblast forms one rod and together with adjacent ameloblasts the interrod region Very close to dentin there is no rod structure since the Tomes' processes develop after the first enamel is formed.
Striae of Retzius and cross striations
Incremental lines
Enamel structure is altered along these lines
Cross striations are also a form of incremental lines highlighting the daily secretory activity of ameloblasts
Bands of Hunter and Schreger
Optical phenomenon produced by changes in rod direction
Gnarled enamel
Twisting of rods around each other over the cusps of teeth
Enamel tufts and lamellae
They are like geologic faults
Tufts project from the DE junction, appear branched and contain greater concentrations of enamel protein than enamel
Lamellae extend from the enamel surface
Enamel spindles
Perikymata
Shallow furrows on surface of enamel formed by the striae of Retzius
Age changes in the dentition
I. After the teeth have reached full occlusion, microscopic tooth movements occur to compensate for wear at the contact area (Mesial Drift) and occlusal surfaces (by Deposition of cementum at the root apex)
2. Attrition of incisal ridges and cusp tips may be so severe that dentin may become exposed and intrinsically stained
3. Secondary dentin may be formed in response to dental caries, trauma, and aging and result in decreased pulp size and tooth sensation