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Tooth Variations

Suruedee Chinthakanan

Tooth variations

• Dental anomalies

• Cause :

– hereditary factor

– Developmental disturbances of teeth

www.ectodermaldysplsia.org

Tooth variations

• Enamel is formed from the ectodermal components.

• Dentin, pulp, cementum, the supporting PDL, and bone

are all derived from ectomesenchyme

http://www.uic.edu/classes/orla/orla312/VariationInToothMorphology.htm

Developmental disturbances of teeth

• Disturbances in Size

• Disturbances in Shape

• Disturbances in Structure

• Disturbances in Number

• Disturbances in Eruption

R.Rajendran, B.Sivapathasundharam,2007

Developmental alterations in size of teeth

• Race , systemic disease , syndromes ,etc.

• Microdontia

– Hypodontia

– maxillary lateral incisors , permanent third molars

– “peg-shaped”

• Macrodontia

– mandibular third molar

www.medical-dictionary.thefreedictionary.com

Developmental alterations in shape of teeth

• Alterations in crown shape

• Alterations in root shape

Alterations in crown shape

• shovel-shaped incisors

– permanent Maxillary lateral incisors

– permanent Maxillary central incisors

• Mamelons

– newly erupted teeth

www.nature.comB.S.Kraus, R.E.Jordan, L.Abrums,1969

Alterations in crown shape

• Dens invaginatus (dens in dente)

– lingual pit

– Radiographic feature

– permanent maxillary lateral incisors ; bilateral involvement

– Dental caries

J.A.Regezi, J.J.Sciubba,

R.C.K.Jordan,2008grabpage.info www.studyblue.com

Alterations in crown shape

• Palatogingival groove– permanent incisors

– Dental caries & periodontal disease

pocketdentistry.com www.ijds.in www.slideshare.net

Alterations in crown shape• Accessory lingual ridges

– permanent maxillary incisors : esp. central incisor

– Vary in number & size

• Talon cusps– lingual surface three-pronged pattern as eagle’s talon

– Composes of : enamel, dentin and pulp

– permanent maxillary incisors

www.ascro.net www.ejournalofdentistry.com

Alterations in crown shape

• Accessory cusps– permanent premolars and molars

www.jaypeejournals.com

Alterations in crown shape• Dens evaginatus

– tubercle or cusp : central groove , lingual ridge of buccal cusp

– permanent premolars , molars

– premolars > molars , mandible > maxilla

– Composes of : enamel, dentin and pulp

– Exposes pulp

blog.xuite.netwww.uniondentalsurgery.comwww.studyblue.com

Alterations in crown shape

• Variation of cusp of carabelli

– Vary in size ; may be absent

– Vary in location

www.dimensionsofdentalhygiene.com

Alterations in crown shape

• cervical enamel extension (cervical enamel

projection)– mandibular molars > maxillary molars

– Periodontal disease

www.studyblue.com

Alterations in crown shape

• Taurodontism– Large pulp chamber , apically bifurcation

Oral Maxillofacial pathology,2004.

Alterations in crown shape

• Hutchinson’s incisor / mulberry molar– congenital syphilis

www.sfmedia.dental.pacific.edu

medical-dictionary.thefreedictionary.com

Alterations in root shape

Alterations in root shape

• Dilaceration

– permanent maxillary incisors

– Root canal treatment , extraction

J.A.Regezi, J.J.Sciubba, R.C.K.Jordan,2008

www.researchgate.net

www.studyblue.com

Alterations in root shape

• Accessory roots (supernumerary roots)– third molars , mandibular canines , premolars

– Root canal treatment , extraction

www.forp.usp.br medind.nic.in quizlet.com

Alterations in root shape

• Enamel pearls

– maxillary molars > mandibular molars

– furcation , cemento-enamel junction

– Periodontal disease

www.studyblue.com www.methuenperio.com

gallerily.com

Alterations in root shape

• fused root

• Dwarfed roots

www.doctoruldedinti.infowww.studyblue.com

Alterations in root shape

• Concrescence– Fused of root surface by

cementum

– Permanent maxillary molars

www.studyblue.com

drmohitmangla.blogspot.com

Alterations in root shape

• Hypercementosis – Permanent premolars & molars

www.scielo.brmedicine.academic.ru

Developmental disturbances of teeth

• Disturbances in Size

• Disturbances in Shape

• Disturbances in Structure

• Disturbances in Number

• Disturbances in Eruption

R.Rajendran, B.Sivapathasundharam,2007

Disturbances in Number

• Supernumerary tooth

• Congenital missing

• Fusion

• Gemination

www.studyblue.com

www.scienceopen.com

Disturbances in Number

• Fusion

www.ijdr.inwww.studyblue.com

www.studyblue.com

Disturbances in Number • Gemination

www.dentalaegis.com

www.contempclindent.org

forum.dentalxp.com

www.studyblue.com

Tooth variations

• Permanent Incisors

• Permanent Canines

• Permanent Premolars

• Permanent molars

• Deciduous teeth

Permanent Incisors

• Permanent Maxillary Incisors– Permanent Maxillary Central Incisors

– Permanent Maxillary Lateral Incisors

• Permanent Mandibular Incisors – Permanent Mandibular Central Incisors

– Permanent Mandibular Lateral Incisors

Permanent Maxillary Central Incisors

Labial Lingual Incisal Mesial Distal

Variations of 11,21

• Shape : Ovoid, Taper, Square

• La grooves

B.S.Kraus, R.E.Jordan, L.Abrums,1969

www.habdcprostho.com/Prosthodontics

/Veneers3.htmblog.drnormanhuefner.comwww1.nobelbiocare.com

Variations of 11,21

• La profile; convex

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Variations of 11, 21

• Mammelons

• Pit/groove at cingulum

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Variations of 11, 21

• Shovel-shaped incisor

• Hutchinson’s incisors

www.fossa-medical-

dictionary.thedictionary.com

www.sfmedia.dental.pacific.edu

www.nature.com

Variations of 11, 21• Accessory lingual ridges

• Extremely long root & short root

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Permanent Maxillary Lateral Incisors

Labial Lingual Incisal Mesial Distal

Variations of 12, 22

• Peg shape

www.dental.mu.edu/oralpath/lesions

/densindente/densindente.htm

• Congenital missing

www.blledental.com.edu

Variations of 12, 22

• Prominence in the distal lobe

– Slight prominence

– Moderate prominence

– Pronounced prominence

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Variations of 12, 22

• Talons cusp

• Lingual pit / deep lingual fossa

B.S.Kraus, R.E.Jordan, L.Abrums,1969

ipj.quintessenz.de.1jpg.jpgwww.ascro.net

Variations of 12, 22

• Dens invaginatus

www.mndental.org Oral Maxillofacial pathology,2004.

www.jaypeejournals.com

Variations of 12, 22

• Palato-gingival groove / Palato-radicular

groove

• Curvature of root

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Permanent Mandibular Central Incisors

Labial Lingual Incisal Mesial Distal

Labial Lingual Incisal Mesial Distal

Permanent Mandibular Lateral Incisors

Variations of 31, 41 & 32, 42

• La surface inclination

• Mammelons

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Variations of 31, 41 & 32, 42

• Root:

– Curvature

– Longitudinal grooves

– 2 roots

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Permanent Canines

• Permanent Maxillary Canines

• Permanent Mandibular Canines

Permanent Maxillary Canines

Labial Lingual Incisal Mesial Distal

Variations of 13, 23

• Cusp tip:

– blunted

– nippled apex

• Cusp ridge:

– vertical pitch

– shoulder

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Variation of 13, 23

• Lingual tubercle or cingulum

• Root; long, short, hook

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Permanent Mandibular Canines

Labial Lingual Incisal Mesial Distal

Variations of 33, 43

• Shoulder

• Inclination of

crown : root

“bending”

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Variations of 33, 43

• Root

– Deep longitudinal groove

– Juxta-positional root

– 2 roots

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Permanent Premolars

• Permanent Maxillary Premolars– Permanent Maxillary First Premolars

– Permanent Maxillary Second Premolars

• Permanent Mandibular Premolars– Permanent Mandibular First Premolars

– Permanent Mandibular Second Premolars

Permanent Maxillary First Premolars

Buccal Lingual Occlusal Mesial Distal

Variations of 14, 24

B.S.Kraus, R.E.Jordan, L.Abrums,1969

•Conical cusp

•Blunted cusp

• Intercuspal width

Variations of 14, 24

B.S.Kraus, R.E.Jordan, L.Abrums,1969

• Bell shaped premolar

• Deep buccal groove

•Mesiobuccal groove

Variations of 14, 24

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Bifurcation

point

Irregular

curvature of root

Convergence of

root profile

Permanent Maxillary Second Premolars

Buccal Lingual Occlusal Mesial Distal

Variations of 15, 25

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Distal tranverse ridgeStrongly developed styles

Deep pitIrregular pattern of

supplemental

grooves

Variations of 15, 25

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Cusplet Rounded buccal cusp

&

Conical buccal cusp

Irregular curvature

of root

Permanent Mandibular First Premolars

Buccal Lingual Occlusal Mesial Distal

Variations of 34, 44

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Transverse ridge

• Mesiolingual groove

•number

•depth

Variations of 34, 44

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Lingual cusp

Distal style

of

buccal cusp

•2 roots

•Deep longitudinal

groove

Root

Permanent Mandibular Second Premolars

Buccal Lingual Occlusal Mesial Distal

Variations of 35, 45

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Pit & groove pattern

2 cusped mandibular premolar

Variations of 35, 45

B.S.Kraus, R.E.Jordan, L.Abrums,1969

M&D styles of buccal cusp Root curvature

Permanent Molars

• Permanent Maxillary Molars– Permanent Maxillary First Molars

– Permanent Maxillary Second Molars

– Permanent Maxillary Third Molars

• Permanent Mandibular Molars– Permanent Mandibular First Molars

– Permanent Mandibular Second Molars

– Permanent Mandibular Third Molars

Permanent Maxillary First Molars

Buccal Lingual Occlusal Mesial Distal

Variations of 16, 26

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Oblique ridge

Cusp of Carabelli

Variations of 16, 26

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Styles on MB cusp

Variations of the

Carabelli trait

Variations of 16, 26

B.S.Kraus, R.E.Jordan, L.Abrums,1969

small & large

Oblique ridge

Anterior transverse

ridge on MB cusp

Variations of 16, 26

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Board MB rootStraight linual

root

Curvature of root

Permanent Maxillary Second Molars

Buccal Lingual Occlusal Mesial Distal

Variations of 17, 27

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Pit-groove patterns

Variations of 17, 27

B.S.Kraus, R.E.Jordan, L.Abrums,1969

DL cusp

2 MB root Fused MB & L root

Permanent Mandibular First Molars

Buccal Lingual Occlusal Mesial Distal

Variations of 36, 46

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Distal cusp

Pit & groove pattern

Variations of 36, 46

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Roots !!

Permanent Mandibular Second Molars

Buccal Lingual Occlusal Mesial Distal

Variations of 37, 47

B.S.Kraus, R.E.Jordan, L.Abrums,1969

First and Second molar

Roots !!

Permanent Maxillary Third Molars

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Permanent Mandibular Third Molars

B.S.Kraus, R.E.Jordan, L.Abrums,1969

Thank You for your attention!!

References

• B.S.Kraus, R.E.Jordan, L.Abrums. Dental anatomy and occlusion. The Williams and Wikins; Maryland. 1969.

• M.M.Ash, S.J.Nelson. Wheeler’s Dental Anatomy Physiology, and Occlusion. Saunders; St.Louis. 2003.

• R.Rajendran, B.Sivapathasundharam. Shafer’s textbook of oral pathology. 5th. Elsevier; New Dheli. 2007.