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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.