MORPHOLOGY

OF
PERMANENT MOLARS
Dental Anatomy & Occlusion
Dent 202
 Permanent Molars
 Class traits

3 or more cusps

At least 2 buccal cusps

One or more lingual
cusps

In general 2 or 3 roots
Maxillary permanent molars
 Arch traits

3 roots: 2 B & 1 L

Crown: BL > MD dimension

Cusps
• 3 major cusps
– ML, MB & DB
– Arranged in a tricuspate-triangular
pattern
• Lesser-sized DL cusp & sometimes
missing

Oblique ridge: ML to DB cusp

B cusps are of unequal size

ML cusp is larger than DL
 Maxillary permanent molars
 Type trait (in general)

DL cusp reduces in size
when going posteriorly &
may be missing in 3rd molar

1st molar is the largest & shows
the least morphological variation

Cusp of Carabelli

Roots become more D inclined
& much closer when going
posteriorly
 Maxillary permanent 1st molar

 Buccal aspect

MB & DB cusps are of equal
height

MB is wider

Separated by B groove
• Terminates halfway

Slopes of DB are steeper

Tip of the ML cusp between B
cusps
 Maxillary permanent 1st molar
 Buccal aspect

M profile is highly convex in occlusal
2/3s

M HOC is ¾ the distance from CL to
MR

Cervical 1/3 is flat or concave

D profile is entirely convex

D HOC is 3/5 the distance from CL to
MR

CL is 2 slightly curved segments
separated by apical peak
Maxillary permanent 1st molar
 Buccal aspect

Buccal surface
• D surface is visible
• Cervical 1/3 is convex
• Occlusal 2/3s are flat

Roots
• The 3 roots are visible
• B bifurcation is at junction between Cervical &
middle 1/3s
• Shallow vertical groove in the midline of the B root
trunk
• MB & DB roots are narrow & incline to each other
in the apical 1/3 (type trait)
• MB root apex is in line with MB cusp tip (type trait)
• The longest L root is visible between the B roots
Maxillary permanent 1st molar
 Lingual aspect

2 cusps of unequal size

ML cusp
• Makes 3/5s of MD width of the crown
• Prominent & blunt

DL cusp
• Rounded, shorter & narrower
• Larger than those of 2nd & 3rd max.
molars
(type trait)

L groove
• Separates L cusps
• Terminates midway of L surface
 Maxillary permanent 1st molar
 Lingual aspect

M profile is convex except in the flat C 1/3

D profile is entirely convex

L surface
• Evenly convex OC
• L groove divides L surface into M & D segment
• Cusp of Carabelli on M segment (racially variant)

Roots
• The 3 roots are visible
• Proximal outline of B roots
• L root
– Tapered with blunt apex
– Shallow vertical depression from CL to 2/3s
– L root apex is in line with crown midline (type
trait)
Maxillary permanent 1st molar

 Mesial aspect

Maximum MD dimension at the
cervix of the crown

ML is higher than MB cusp

B cervical 1/3 is strongly convex

B outline continues lingually in a
straight line

L outline is uniformly convex

L HOC is at the midpoint

CL is slightly convex occlusally
 Maxillary permanent 1st molar
 Mesial aspect

Mesial surface
• M MR is marked by several tubercles &
supplementary grooves (type trait)
• Contact point is between middle & occlusal 1/3s
• Cervical 1/3 is flat or concave
• Occlusal 2/3s are convex

Roots
• MB & L roots
• MB root is broad BL
• L root is narrow & Banana-shaped,
curves L then B at the apex
• Both MB & L roots project beyond crown profile
 Maxillary permanent 1st molar
 Distal aspect

DB cusp is more prominent than DL

Only small portions of M cusps are
visible (type trait)

D MR is shorter & less
prominent than M

D MR rarely has tubercles

B & L profiles are similar to
those of M aspect

CL is nearly straight
 Maxillary permanent 1st molar

 Distal aspect

Distal surface
• Uniformly convex

Roots
• 3 roots visible
• DB root is shorter &
narrower than MB root
 Maxillary permanent 1st molar

 Occlusal aspect

Square or rhomboidal

MB & DL angles are acute

ML & DB angles are obtuse

1/3 of B surface & ½ of L
are visible

B outline: D part is more L
than M part
 Maxillary permanent 1st molar
 Occlusal table

2 distinct components
• Trigon
– Bears MB, ML & DB cusps
– Tricuspate triangle
• Talon
– Bears DL cusp & D MR
– Located DL to the tricuspate
triangle
– Well-developed in 1st molar
& undergoes reduction in size
in 2nd & 3rd molars
 Maxillary permanent 1st molar
 Occlusal table

Cusps in order of decreasing size:
ML, MB, DB & DL

M MR is longer & more prominent
than D MR

Oblique ridge

Major Fossae
• Central fossa
– Central pit
– B & D grooves
– Central groove
• Distal fossa
– D pit
– DL groove which continues as the L groove
Maxillary permanent 1st molar
 Occlusal table

Minor fossae
• M triangular fossa
– M pit
– MB & ML supplementary
grooves
• D triangular fossa
– Distal pit
– DB & DL supplementary
grooves
 Maxillary permanent 1st molar
 Pulp

MD section
• 2 horns, MB is higher
• Pulp chamber, roof & floor
• Canals, narrow
• Canal orifice

BL section
• Pulp chamber is wider
• 2 horns of equal height

X-section
• 3 canals
Maxillary permanent 2nd molar
 Buccal aspect (type traits)

Smaller crown size

Less prominent DB cusp & narrower
MD

Distally inclined B roots
 Lingual aspect

DL cusp is smaller in width & height

L root is narrower MD & slightly D
inclined

No cusp of Carabelli?
 Maxillary permanent 2nd molar

 Mesial aspect

Less numerous MR tubercles

MB & L roots are less divergent
 Distal aspect

Smaller D cusps

A greater portion of the occlusal
aspect is visible
Maxillary permanent 2nd molar
 Occlusal aspect
• MB & DL angles are more acute
• ML & DB angles are more obtuse
• Talon is more reduced in size
• More variable pit/groove pattern
• More numerous supplementary
groove
• Crown is more constricted MD
 Pulp

Similar to that of 1st molar
Maxillary 3rd molar
 Buccal aspect (type traits)

Crown is smallest in all dimensions

Roots are much short & commonly
fused

Shows a pronounced distal
inclination
 Lingual aspect (type traits)

DL cusp is usually missing

L root is commonly fused with the B
roots
Maxillary 3 molar rd

 Mesial aspect

Crown profile is irregular

Fused roots
 Distal aspect

DL cusp is absent

More of the occlusal surface is
visible compared with 1st & 2nd
Maxillary 3 molar rd

 Occlusal aspect (type traits)


Triangular or heart-shaped
outline

DB cusp is of minimal size

Oblique ridge is barely visible

Pit/groove pattern is variable

Numerous supplementary
grooves
Maxillary 3 molarrd

 Pulp

MD section
• Large MB horn &
small DB horn

BL section
• MB & L horns are
of equal prominence

X- section
• Ovoid
• Narrow MD
Maxillary 3rd molar

Anatomic variation
Mandibular permanent molars
 Upper & lower molars show
progressive reduction posteriorly
(human trait)
 The 1st to appear of permanent
dentition (6 yrs)
 Arch traits

2 roots; M & D

4 major cusps & 1 lesser-sized 5th cusp
(in 1st molars)

Crowns broader MD than BL

The 2 L cusps are of equal size

MB & DB cusps are of equal size
Mandibular permanent 1st molar

 Buccal aspect

Widest MD (type trait)

MB, DB & D cusps

MB cusp is the widest then DB & D

MB & DB are of equal height

D cusp is conical located in the DB
corner

MB & DB grooves
Mandibular permanent 1st molar

 Buccal aspect

M profile
• C 1/3 is straight or concave
• Occlusal 2/3s are convex

D profile is entirely convex

M & D profiles are convergent cervically

CL is similar to that of upper 1st molar
 Buccal surface

Buccal cervical ridge in C 1/3

MB groove ends halfway

DB groove extends most of B surface
length
 Mandibular permanent 1st molar
 Buccal surface

Roots
• 2 roots; M & D
• Widely separated (type trait)
• Share a common trunk that has
a shallow vertical depression
• Apical half of M root is distally
inclined
• D root projects distally without
curvature
 Mandibular permanent 1st molar

 Lingual aspect

ML & DL cusps
• Of equal size
• Higher & more conical than B cusps

Lingual groove

Narrower MD than B profile

M & D profiles
• Generally convex except in the
straight or concave C 1/3
• Convergent cervically
 Mandibular permanent 1st molar

 Lingual surface

Occlusal 2/3s are convex in both
H & V planes

Cervical 1/3 is flat or concave
 Roots

Vertical shallow depression on
the midline of the root trunk

Proximal surfaces of roots are
visible
 Mandibular permanent 1st molar
 Mesial aspect

ML cusp is slightly higher than MB

MR is higher & has mesial marginal groove

From buccal cervical ridge, B outline curves
sharply lingually (arch trait)

L profile is convex

L HOC between middle & occlusal 1/3s

M surface is flat or concave in the C 1/3
& convex in the occlusal 2/3s

Roots
• Broad BL (type trait)
• Blunt apex
• Proximal root concavity
 Mandibular permanent 1st molar
 Distal aspect

3 cusps
• DL, DB & D (order of decreasing size)
• D cusp is L to DB cusp
• DB groove
• D MR is shorter than M & has a distal
marginal groove
• 1/2 of B surface is visible
• CL is straight
• Narrower BL than M surface
• Root
– Broad BL, but narrower than M root
– Blunt apex
– may have shallow depression
 Mandibular permanent 1st molar
 Occlusal aspect

Crown is pentagonal (type trait)

B profile is longer than L

M profile is longer than D

B profile
• 3 regions
• DB is the most prominent
• Maximum BL diameter is just D
to MB groove (type trait)
 Mandibular permanent 1st molar
 Occlusal aspect

MB angle is sharp

DB angle is rounded

M & D profiles are convergent
L (type trait)

L profile 2 regions

2/3s of buccal surface are
visible (arch trait)

L profile: only occlusal 1/3 is
visible
 Mandibular permanent 1st molar
 Occlusal table

5 cusps (type trait)

2L cusps, MB, DB & distal (order of
decreasing size)

L cusps are more pointed & conical

M & D MRs converge L (type trait)

M MR is higher and longer

Marginal grooves
 Mandibular permanent 1st molar
 Occlusal table

Fossae
• Central fossa
• 2 M & D triangular fossae

Grooves
• Central
• MB & L terminate in the
central pit
• DB (y-shape with MB & L
[type trait])

Pits
• M, D & central
Mandibular permanent 1st molar
 Pulp

MD section
• 2 horns
– MB > DB
• Narrow canals

BL section
• 2 horns
– ML > MB
• 2 canals in M root

Transverse section
• Rectangular
Mandibular permanent 2nd molar
 Buccal aspect

Smaller than 1st but larger than
3rd in all dimensions (type traits)

Only 2 B cusps & 1 B groove
(type trait)

L cusps are more prominent
from B aspect (type trait)

Roots (type traits)
• Much closer together
• D inclined
Mandibular permanent 2nd molar

 Lingual aspect

Crown is shorter OC

Little of proximal surfaces is visible

M & D profiles are less convergent
cervically
 Mesial aspect

Root is narrower BL with sharp apex
 Mandibular permanent 2nd molar

 Distal aspect

D cusp is missing (type trait)

Less of B surface is visible (type
trait)

D root is much narrower BL with
a pointed apex (type trait)
Mandibular permanent 2nd molar

 Occlusal aspect (type traits)


Crown is rectangular

B profile = L in length

M profile = D in length

Most prominent of B profile
is in the region of the MB cusp

Maximum BL dimension is
just M to B groove

M cusps are wider MD than D cusps
 Mandibular permanent 2nd molar

 Occlusal aspect

MRs
• Straight BL
• Not crossed by marginal grooves

“+” groove pattern

More numerous Supplementary
grooves
 Mandibular permanent 2nd molar

 Pulp

Similar to that of 1st

BL section
• Usually 2 canals in M root
• Sometimes 1 canal in M
root

T-section
• M dimension > D
 Mandibular 3rd molar

 Buccal aspect

Highly variable

Roots are short, fused & D inclined
 Lingual aspect

Short crown of highly bulbous
outline

Rounded cusps
 Mandibular 3rd molar
 Mesial

B & L profiles are highly convex

Distance between apices of M cusps is
shorter
 Distal

Almost entire B surface is visible

D root is the narrowest BL & shortest
of all mandibular molars
 Pulp is similar to mandibular 2nd molar
Mandibular 3rd molar
 Occlusal aspect

Ovoid in outline

M half is wider BL than D half

B & L Profiles converge D

Highly restricted occlusal table in
MD & BL dimensions (type trait)

4 narrow conical cusps

Highly convex MRs

Irregular pit/groove pattern

Shorter grooves
 Permanent Molar - size & eruption

Tooth Crown MD crown BL crown Tooth Age at

height diameter diameter length eruption
16 or 26 7.5 mm 10.0 mm 11.0 mm 19.5 mm 6 yrs
17 or 27 7.0 mm 9.0 mm 11.0 mm 18.0 mm 12 yrs
18 or 28 6.5 mm 8.5 mm 10.0 mm 17.5 mm 18+yrs
36 or46 7.5 mm 11.0 mm 10.5 mm 21.5 mm 6 yrs
37 or47 7.0 mm 10.5 mm 10.5 mm 20.0 mm 12 yrs
38 or 48 7.0 mm 10.0 mm 9.5 mm 18.0 mm 18+yrs