board review dh227 dental anatomy lisa mayo, rdh, bsdh concorde career college

Board Review DH227 Dental Anatomy Lisa Mayo, RDH, BSDH Concorde Career College

Review Identify human dentition with terminology specific to: # of dentitions Types of teeth Terminology not related to man Identify component of periodontium Be able to relate eruption dates for primary and permanent teeth to clinical situations If given a picture of a dentition, identify age of pt.

How Old Is This Patient?

How old is this patient?

Review Heterodont: man is because have many diff. types teeth Homodont: all teeth the same Dispyodont: man: 2 different dentitions Monodont: 1 set of teeth Polydont: many diff. sets of teeth

Review Know key calcification times of teeth to know later in life what caused certain conditions (fluorosis, tetracycline staining, hypocalcification, etc) Know how primary roots are in relation to erupting permanent teeth Succedaneous teeth: permanent teeth that replace primary (incisors, canines, premolars) Resorption Exfoliation Non-succedaneous permanent teeth that do not replace baby tooth

Primary Teeth Also called baby, milk, temporary, deciduous, primary teeth Exfoliation = process of losing tooth Resorption = physiological removal of tissue or body products

Primary Teeth Bud = individual tooth buds/cap Bell = major amount of enamel and dentin are laid down Root development = begins when CEJ area is formed at end of the bell Root completion = 1-2yrs after eruption Ankylosed root = when primary tooth fuses to alveolar bone and will not exfoliate

Primary Tooth Eruption ERUPTION Mand Central (8-12mo) Mand Lateral (9-13mo) Max Central (8-12mo) Max Lateral (9-13mo) 0-1 years Mand 1 st Molar (13-19mo) Max 1 st Molar (13-19mo) Mand Canine (16-22mo) Max Canine (16-22mo) 1-2 years Mand 2 nd Molar (25-33mo) Max 2 nd Molars (25-33mo) 2-6 years Eruption Sequence: central, lateral, 1 st molar, canine, 2 nd molar

Permanent Tooth Eruption ERUPTIONROOT COMPLETION Man 1 st Molar Max 1 st Molar Mand Central Mand Lateral Max Central Max Lateral 6-9 years9-11 year Mand canine Mand 1 st Premolar Max 1 st Premolar Mand 1 st Premolar Max 2 nd Premolar Max Canine 9-12 year 12-15 years Mand 2 nd Molar Max 2 nd Molar 12-17 years14-16 years Mand 3 rd molar Max 3 rd Molar 17-21 years18-25 years Permanent Tooth Eruption

Primary Teeth vs Permanent Enamel is thinner and whiter Roots Same # molar-molar Mesial root wider Longer and thinner More flared No root trunks Pulp chambers large, pulp horns close to enamel Crown Shorter Wider M-D than Occlusal-Gingival

Primary Teeth vs Permanent Ant smaller than perm Post wider M-D More bulbous or bell shaped Cervical ridges are bulky/prominent Occlusal tables narrower Thin dentin layer between pulp and enamel

Review Know general differences between perm and primary teeth, know which ones resemble each other (next slide) Enamel Color Cervical ridges Size Flare of roots

Primary vs Perm PRIMARY TOOTH PERM TOOTH IT RESEMBLES ROOTS Max 1 st MolarMax 1 st Premolar3 Max 2 nd MolarMax 1 st Molar3 Mand 1 st MolarUnique crown2 Mand 2 nd MolarMand 1 st Molar2

Primary/Permanent Mixed Dentition: 6-12 years Most common congenitally missing permanent teeth Max laterals 3 rd molars Mand 2 nd premolars

Review Identify key points to teeth Angle of a tooth Types of ridges # of roots # of lobes and cusps Fossas Grooves

Review Know numbering systems Relate the size of an embrasure to contact areas of teeth Related the size of interdental papillae to the contact area between teeth, and to the curvature of the cervical line Know shapes of teeth from F and interprox Know what makes certain teeth unique Ridges Concavities/Convexities Furcations

Structures to Review Boney alveolar process surrounds each tooth Bone socket or alveolus is part of the alveolar bone in which teeth are set Crown anatomical vs clinical Root - anatomical vs clinical Enamel: 96% calcified Dentin: 70% calcified Cementum: 65% calcified Cervical line /CEJ/DEJ

Structures to Review Pulp: canal, chamber, horns Surfaces: mesial, distal, occlusal, incisal, buccal/labial, lingual Anterior teeth, posterior teeth Know which teeth have occ vs incisal edges Know which teeth have buccal or labial Lingual sometimes referred to as palatal for max. post. Contact area: where 2 adjacent teeth meet Proximal surface: surfaces in-between 2 teeth Height of the contour between 2 teeth (gets larger with age): The line encircling a tooth or other structure at its greatest bulge or diameter with respect to a selected path of insertion

Structures to Review PDL: attaches tooth to bone Gingiva Gingival line Free gingiva Sulcus Epithelial attachment Gingival groove Attached gingiva Mucogingival junction Alveolar mucosa Fibers

Structures To Review Line Angles: Imaginary line formed by the junction of 2 surfaces Become more rounded as go from ant to post Point Angle: formed by the junction of 3 surfaces Cusps: less pointed or steep as go from canine to molar

Roots Named for where they are Root termination = apex Root usually/typically deflect towards the distal Concavities: 4 key areas (remember all teeth have M/D concavities!) Max 1 st premolar (M) Very prominent Max 1 st Molars (L/M/D) Max Lateral(L) Mand 1 st Premolar (M/D) Numbers Anterior: 1 Premolars: 1, except maxillary 1 st premolars (2) Maxillary molars: 3 (2F, 1L) Mandibular molars: 2 (M&D)

Lobe Primary division of a tooth 4 or 5 4- all ant and premolars except for mand molars that have 2 lingual cusps these teeth arise from 5 lobes Molars develop from 4 lobes except mand first that have 5 cusps and develop from 5 lobes Developmental depressors on labial aspect separate lobes on ant teeth and buccal of premolars, not on molars (grooves)

Shapes Trapezoidal: from F and L Triangular: Max anterior Ovoid: Canines Elliptical: Mand anterior Rhomboidal: Mand posterior Trapezoidal: Max posterior

Special/Unique Structures Max Central Lingual groove Lingual pit Mamelons Max Lateral Linguogingival groove Lingual pit Linguogingival fissure Mamelons

Special/Unique Structures Mand Central: smallest teeth in mouth Mamelons Root concavity Longitudinal groove Mand Lateral Mamelons Root concavity More prominent cingulum then #24,25 and deeper L fossa Cingulum: lingual cervical of ant teeth

Special/Unique Structures Canines: longest, strongest teeth, most stable tooth, provides guidance for occlusion Max canine Canine eminence Mesioincisal/distoincisal cusp ridge/slope Labial ridge Linguogingivial groove Lingual pit Mesio/distolingual fossa Lingual ridge

Special/Unique Structures Mand canine Canine eminence Slopes Labial ridge Mesio/distolingual fossa Lingual ridge Root concavity Narrower then maxillary

Canine Eminence

Vocabulary Ridge Marginal: found at M and D terminations of occlusal surfaces of post teeth and form the lateral borders of L surfaces ant teeth Cusp Ridge: each cusp has 4 extending from its tip (M,D,B,L) Triangular: ridge that descends from tips of cusps toward central area of occlusal surface Transverse: 2 triangular ridges merging Oblique: special type of transverse unique to MAX MOLARS from the ML to DB cusps (ML distal cusp ridge and DB triangular ridge)

Vocabulary Mamelons: small, rounded projections on incisal edges of newly erupted teeth usually worn away soon after eruption. Common on adults with malocclusion (ant open bite) Fossa: rounded depression, pit at bottom Developmental groove: One of the fine lines found in the enamel of a tooth that marks the junction of the lobes of the crown in its development Secondary groove: auxiliary groove

Individual Teeth: ANT Max incisors More developed than mand Fossa and cingulum Marginal ridges Incisal edges straight except for mand lateral twisted Max/Mand canines Max more developed Lingual ridge forms ML and DL fossas

PREMOLARS

Max Premolars General Max premolars GENERAL More similar then mand premolars 2 pointed cusps: B longer than L M marginal groove, M depression on mid-1/3 of crown down to root Single or bifrucated root (B,Palatal) and occurs apical 1/3 of root 7mm

Max 1 st premolar Max 1 st premolars: Well-developed line angles Mesial concavity extends onto root Root bifurcated Mesial marginal groove Long central groove Lingual cusp tip offset to mesial

Max 2 nd premolar More rounded line angles 1 root usually and is larger than 1 st premolar Central groove shorter with more supplemental grooves M groove absent

Max 2 nd premolar L cusp larger than L cusp on Max 1 st premolar B cusp shorter than 1 st premolar and less pointed Both cusps near same length and width Both 1 and 2 have transverse ridges

Mand 1 st Premolar Mand 1 st premolar Sharp B cusp Short nonfunctional L cusp Central groove not always present M, D fossae with pits B cusp tip centered over root

Mand 1 st premolar Transitional teeth more resemblance to canine as far as masticatory function Transverse ridge ML developmental groove separates M marginal ridge from L cusp

Mand 2 nd premolar 2 or 3 cusps, no transverse ridges, more supplemental grooves than 1 st premolar Larger than 1 st premolar B cusp shorter than 1 st premolar ML cusp is larger than DL Root wider than 1 st premolar with a blunt apex Y-shape to central and lingual groove If 2 cusps can have a U-shape or an H-shape to central groove

MOLARS

Maxillary 1 st Molars Max 1 st Molars 1 st rhomboid occlusal pattern to cusp tip alignment Cusp of carabelli that is non-functional Largest tooth in the mouth in regards to overall bulk/ surface area Crown is wider F-L than M-D Roots trifurcated: 2B, 1 palatal (DB is the narrowest)

Max 1 st molar cusps

Max 2 nd Molars Max 2 nd molars Smaller than the 1 st No 5 th cusp Rhomboid shape to occlusal is more accentuated Can have a heart shaped form like 3 rd molar For both L root is largest then MB then DB 2 roots: MB root tip curves distally

Mandibular Molars First Second Third

Mand 1 st molar Mand 1 st Molars 1 st pentagon/rectangular wider M-D than B-L Largest tooth of mand arch Bifuracted roots: roots twice as long as crown, M root longer/stronger, root apex of M turns toward D

Mand 1 st molar Mand 1 st Molars 5 Cusps D, 2B grooves, B and DB. (D smallest. MB cusp wider than DB No transverse ridges 4 developmental grooves: Central, B, DB, L Central groove

Mand 2 nd molar Mand 2 nd Molars Rectangle for both distal roots are straighter, M are widest B-L than D Roots: shorter than 1 st molar, closer together, M root less broad then on 1 st molars

2 transverse ridges: 1 st molar has NONE!

Contact Areas Become more cervical as go from ant to post Distal usually more cervical then mesial Size from ant to post Ant teeth contacts centered F-L Post teeth contacts slightly B of center

Interprox Space Triangular and filled with interdental papillae Triangle is formed by proximal surfaces of adjacent teeth, the apex is the contact of adjacent teeth and the base is the alveolar bone Shape changes ant to post

Embrasures Named for location: F, L, Cervical, Occlusal For protection and stimulation of the periodontium Form directly related to contact areas: ie. post teeth the lingual embrasures are larger than the F because the contact is to the Facial/Buccal of center

Heights of Contour For anterior: height on the labial and lingual is in the cervical third Posterior: the B is in the cervical third Posterior: the L is in the middle to occlusal thirds Thirds of crowns and roots: horz and vert thirds Cervical lines always steeper on M and D

Comparing ant-post Proximal curvature of CEJ flattens M/D CEJ curvatures of an individual tooth: M curvature D curvature Lingual height of contours shift from cervical to middle 1/3 Contact areas shift from incisal 1/3 to middle 1/3

Anomalies Max Central 1.Dwarfed root 2.Hutchinsons incisors 3.Talon cusp 4.Supernumerary Max Lateral 1.Peg lateral 2.Cingulum may have tubercle 3.Congenitally missing (agenesis) 4.Dens in dente Mand Central 1.Bifurcated root Mand Lateral 1.Bifurcated root

Anomalies Max Canine 1.Tubercle on lingual surface Mand Canine 1.Bifurcated root

Anomalies Max 1 st Premolar 1.3 roots 2.Antrum (root penetrating max. sinus) Max 2 nd Premolar 1.Absent central groove 2.Antrum Mand 1 st Premolar 1.ML developmental groove absent 2.Bifurcated root Mand 2 nd Premolar 1.Congenitally missing 2.Bifurcated root 3.Supernumerary

Anomalies Max 1 st molar 1.Mulberry molar 2.Root variations (fusion, length) 3.Carabelli Max 2 nd molar 1.Heart-shaped occlusal 2.Tubercle on B 3.Root fusion Max 3 rd molar 1.Peg 3 rd molar 2.Everything!

Mulberry Molars

Anomalies Abnormal # Adontia: any missing teeth total or partial Supernumerary: mesodens most common supernumerary tooth followed by maxillary molar areas Abnormal Size Macrodontia: true assoc. with gigantism, more commonly see large teeth Microdontia True: pituitary dwarfs False=more common, see Max laterals, peg laterals, max 3 rd molars

Development of two maxilla together- Genetic Malformation

Anomalies Abnormal Shape Dens in Dente: external structures become reversed in pulp chamber. Tooth Within A Tooth Dilaceration: linear distortion (bend) in root/crown from trauma Flexion: dilaceration root only Gemination: splitting of single tooth germ single root but looks like 2 crowns Fusion: union of 2 tooth buds only involving crowns

Dens in Dente

Dilaceration

Anomalies Concrescence: union of 2 teeth at roots Molars most common Segmented roots Dwarfed roots Hypercementosis: excessive cementum Enamel Pearls (Ectopic enamel): on root surface furcation areas, developmental issue Hutchinsons Teeth: prenatal syphilis, incisor may be screwdriver Mulberry: notch-shaped in incisal edge and molars

Enamel Pearl

Anomalies Attrition: Mechanical wearing. Abrasive tp, oral habit, improper tb technique Erosion: Chemical wearing. Acid or low-pH, acidic foods, drinks

HELPFUL LINK http://dentistry.umkc.edu/Practicing_Communities/asset /AbnormalitiesofTeeth.pdf

Anomalies Abnormal calcification and apposition: Both may be local, systemic, hereditary factors Enamel Dysplasia / Hypoplasia Disturbance occurs during enamel matrix formation Dentiogenesis Imperfecta Affects mesodermal formation, enamel normal, tooth opalescent, gray to blue color, obliteration of pulp chambers and root canals, root shorter Genetic Amelogenesis Imperfecta Malfunction of tooth germ Enamel appears pitted, aplasia, yellow/dark brown, unusual wearing, enamel thin, hypocalcification Genetic Hypocalcification Later stage during maturation Rickets, birth trauma, idiopathic factors, congenital syphilis, fluoride

What is this?

Answer: Dentiogenesis Imperfecta

What is this?

Answer: Amelogenesis Imperfecta

Amelogenesis Imperfecta

Anomalies Abnormal calcification and apposition Fluorosis: chalky white or brown, mottled teeth Focal hypomaturation: chalky white, circular, soft enamel Turners Teeth: injury to follicle during extraction of baby tooth or from abscess Tetracycline staining: o Minocycline: blue/gray o Tetracycline: yellow/brown Taurodontism: large pulp chamber, location of the furcation is more apical, elongated crown, Downs syndrome, Bulls tooth

What Is This?

What is this?

Answer: Taurodontism

Functions Incisors 1.Biting 2.Cutting 3.Esthetics 4.Phonetics Canines 1.Tearing 2.Piercing 3.Facial Support 4.Cosmetics 5.Phonetics

Functions Premolars 1.Grinding 2.Esthetics 3.Phonetics Molars 1.Grinding 2.Esthetics 3.Phonetics

A&P: Mand Tooth Innervation MolarsPremolarsAnterior PulpInferior Alveolar B/F gingivaBuccalBuccal/MentalMental L gingivaLingual

A&P: Max Tooth Innervations 2,3 Molars 1st MolarPremolarCanineIncisors PulpPost Superior Alveolar Post & Middle Superior Alveolar Middle Superior Alveolar Anterior Superior Alveolar B/F Gingiva Post Superior Alveolar Middle Superior Alveolar Anterior Superior Alveolar Palate Gingiva Greater Palatine Nasopalatine

A&P: Muscles of Mastication Innervation: Mandibular Division of the Trigeminal Nerve (V3) Blood Supply: Maxillary Artery (Branch of the external carotid artery) Medial pterygoid & masseter have similar functions & positions Medial pterygoid is internal Masseter external Temporalis, medial pterygoid, masseter muscles all close the mouth (elevate the mandible) Lateral pterygoid opens the mouth

A&P: Muscles of Mastication TemporalisMasseterMedial Pterygoid Lateral Pterygoid OriginTemporal fossa Zygomatic arch Medial surface lateral pterygoid plate, max tuberosity Lateral surface lateral pterygoid plate, infratemporal surface sphenoid bone InsertionCoronoid process & mand post to 3 rd molar Outer surface of the mand, angle of the mandible Inner surface angle of the mandible TMJ disc, neck mand condyle FunctionRetract, elevate mandible Elevate the mandible Elevate & protrude mandible Protrude & depress mand, lateral shift of mand

A&P: TMJ Components Temporal Bone Mandibular fossa, glenoid fossa, articular fossa Articular eminence just ant to the fossa Mandible Condyle Articular Disc Fibrous pad of dense collagen tissue Prevents bone to bone contact Divides joint into upper and lower synovial joints Thickest at the posterior, thinner in center Moves with condyle under normal function Capsule Thick, fibrous tissue surrounding joint Reinforced by the temporomandibular ligament Inner lining secretes synovial fluid

A&P: TMJ Movement 1.Rotation Condyle rotates in the fossa 2.Translation Condyle slides forward along the articular fossa to the articular eminence Disc moves with condyle in health 3.Trismus Hypomobility from trauma, disease, bruxism

board review dh227 dental anatomy lisa mayo, rdh, bsdh concorde career college

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