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Buccal aspect: -It’s smaller than 1st M ,but larger than the 3rd M in all dimensions, so as we go posteriorly The size of the tooth gets smaller (type trait) & it is human trait as well as others like Gorilla’s as go posteriorly ,the size gets bigger. -we have only 2B cusps which are visible from B side but in the 1st M we have 3 cusps (MB, DB & D) but in the 2nd M there are 2 cusps buccally (MB & DB) we have just 1 B groove between them, not we have (1 MB & 1 DB) groove as we have 3 cusps in the 2nd M -L cusps are more prominent from buccal aspect & it protrudes ( )يبرزabove B cusps (type trait) as amount of difference between B & L cusps is very big in this tooth but difference is very small in mandibular 1st M. Roots: -There are 2 roots & much closer to each other & distally inclined, this is (type trait) as mandibular 1st M roots are farther apart & not that distally inclined Lingual aspect: -Crown is shorter occlusocervical & little of proximal surfaces are visible.
here that’s why like 1st M as
cusps here & 2
-Why we can’t see proximal surfaces? Because this tooth is rectangular in shape not like mandibular 1st M, as in mandibular 1st M there are 3 cusps 1B& 2L which makes profile converged L, but in mandibular can’t see proximal surface as M & D profile parallel & not converged lingually. -M & D profile are less convergent cervically they tend to be more parallel (of course they converge cervically but not very much) , so neck of the tooth is less constricted but neck of mandibular 1st M is wider Mesial aspect: -1 root narrower BL with sharp apex Distal aspect: -D cusp is missing (type trait) & this tooth has 4 cusps, so if you want to distinguish between mandibular 1st M & mandibular 2nd M it is easiest way, just count the number of cusps *if u found 5 cusps, it is a mandibular 1st M *if u found 4 cusps, it is mandibular 2nd M - less of B surface is visible (not seen) because the tooth is rectangular ,so we don’t see B surface when we look from D aspect,
M, there are 2B & 2L cusps with rectangular shaped crown, so we
but in mandibular 1st M from D aspect we see part of B surface as DB line angle is obtuse because of presence of D cusp. -line angle between B surface & M or D surface is 90ْ in mandibular 2nd M, so from D aspect u can’t see B surface but in mandibular 1st M the angle between B & D are more obtuse so we can see part of B surface from D aspect. (Type trait) -D root is much narrower BL with pointed apex (type trait) as this trait not evidence in mandibular 1st M.
Occlusal aspect: -It is rectangular tooth & all angles are nearly Right angles (of course they are slightly rounded) we have 4 cusps of equal size; the shape is rectangle not trapezoidal like mandibular 1st PM & 1st M. B profile = L profile in length M profile = D profile in length, so each profile is equal in length & shape -most prominent of B profile is in region of the MB cusp-farthest point , most prominent point B is located M to B groove so it is located in region of MB cusp ,but in mandibular 1st M the prominent point is in region of DB cusp
-maximum BL dimension is just M to B groove this means slightly M half of the crown is wider BL than D half of the crown & this is not a feature in mandibular 1st M as in it maximum BL dimension is just D to MB groove. -M cusp are wider MD than D cusps slightly this means that B & L grooves are not 100% located in mid portion of crown MD & this makes M part of the tooth slightly bigger than D part *(MB & ML are slightly bigger than D part) -MRs: straight BL (not curved) Not crossed by M grooves like in mandibular 1stM -cross (+) groove pattern: this is the only tooth with this feature, this is the simplest tooth with cross groove pattern (we have B groove, L groove, M groove & D groove), M & D grooves called "central groove" So if u finds a tooth with cross pattern in the groove system, it is mandibular 2nd M. -more numerous supplemental grooves (maximum number of supplementary grooves should be in mandibular 3rd M, so as u go post. The number of supplementary grooves increases)
***Easily in the exam DR. Can bring the drawing for a groove pattern like last 2 years & ask us to identify it. Pulp: -similar to that of 1st M. -BL section, Usually 2 canals in M root & sometimes 1 canal but most commonly 2 canals, so in root canal treatment if you are dealing with mandibular 2nd M most of the time not 100% but 95% there are 2 canals in M root of mandibular 1st M & great possibility of 2 canals in 2nd M,, sometimes we have 2 canals that meet here at apical 1/3 to become 1 root canal.
-so if u are treating mandibular 2nd M & u find 1 canal it is possible, but possibility of having 2 canal in D root is very very minimum not like mandibular 1st M as there is 60% of having 2 canals in D root.
-good possibility to have 2 canals in M root & small possibility to have 1, but all the time we find 1 canal in D root. -In cross section (transverse section) u finds that M portion of pulp champers is greater than D portion.
Mandibular permanent 3rd Molar:
-Very highly variable, roots are short, fused & D inclined. -always we distinguish this M by looking on the Root,, if they are D inclined & closed to each other or sometimes fused so it is a mandibular 3rd M.
Lingual aspect: -Short crown of highly bulbous outline ( & )قصير و ناصحrounded cusps (not pointed cusps)
Mesial aspect: -B&L profile are highly convex & this makes distance between apices of M cusps (MB & ML) shorter, so occlusal table is very small in this tooth & constricted compared with mandibular 1st M. (As we don’t use it in mastication) Distal aspect: -almost entire B surface is visible & this angle between B&D surface (DB angle) is rounded & obtuse -D root is narrowest BL &shorter of all mandibular M_ pulp is similar to mandibular 2nd M.
mesial Occlusal aspect:
-ovoid in shape & as u see all angles are rounded & the crown is very constricted so occlusal surface is small & constricted. -M half is wider BL than D half (like mandibular 2nd M). -B&L profiles converge distally this makes D half of the tooth small BL than M half.
-highly constricted occlusal table in MD & BL dimensions. -4 narrow conical cusps. -highly convex MRs.
-irregular pit & groove pattern with short grooves (many supplemental grooves). -it is the most variable among teeth in morphology but maxillary 3rd M shares some features with it.
How we can distinguish between maxillary & mandibular 3rd Molar:
-all the time look at the presence of oblique ridge,, it impossible to find an oblique ridge in mandibular 3rd M,, but all the time we find an oblique ridge run obliquely from ML to DB cusps in max 3rd M & in mandibular 3rd we don’t see that the tooth look like this one>>means we can’t see acute & obtuse angels in it. - In mandibular 3rd M very variable groove pattern, very constricted occlusal table, cusps are rounded **Now I want from u to compare this with max 3rd M & here are its features (Irregular, many supplemental groove but usually u find here as u can see acute angles & obtuse ones & u find oblique ridge) **In the exam most of student’s mistakes when Dr. Asks them is this a mandibular or max 3rd M, u can look at the crown - If it rectangular in shape this is mandibular 3rd M. - If u see a crown with acute & obtuse angles with an oblique ridge it is max 3rd M.
These tables present the type trait between mandibular 1st, 2nd, & 3rd molar with difference in diameter.
By this we conclude the anatomy of molars. Now we will start the anatomy of deciduous teeth & we will continue this topic in another hall, Anatomy of deciduous teeth (deciduous dentition):
First of all, this is a picture for Melbon where dr. took his master degree. Dr. said: it looks like Irbid, isn’t it?? But we don’t have balloons in Jordan. Set trait: It is the characteristic which let us to distinguish between deciduous and permanent teeth; so it is the way that we can quickly tell is this tooth a deciduous or permanent. 1-size: smaller than permanent as teeth don’t grow we need a second set of dentition, so if the tooth is very small, it is a deciduous one. But if it is big, it is a permanent one. 2- Crown height / length: ratio is smaller in deciduous as crown is very short compared with the total length of the tooth. For example: if total length is 20 mm, in deciduous the crown is 5 or 6 mm but in permanent the crown occupy more of the tooth length. 3- crown width / height: the ratio is greater in deciduous as in permanent teeth the incisor length of the crown is greater than the
width, but in deciduous tooth, the crown is short so the width over the height will be greater but in permanent the ratio is smaller as the crown is higher. 4- More bulging B & L cervical ridges: This is an example of deciduous incisor and this is a permanent incisor, you will see the B ridge & the L ridge (the cingulum), these are bulging, this make the neck of the tooth is more constricted. 5- In molars we can distinguish between deciduous and permanent by the roots:
In deciduous more slender and relatively longer more bowed and flared outward, why these need to be bowed and flared? Because we need room for the crown of the successor premolars. To distinguish it, sorry for this example; deciduous look like females as it has a west but permanent it looks like males. Sorry for this but it is the easiest. Shorter root trunk (area before bifurcation and trifurcation), if you have more molar and this molar has root bowed and slender and the amount of root trunk is very minimum.
In permanent root trunk occupy 1/3 of the root but in deciduous it occupies just a very very short distance. 6- We also depend on the color of the tooth as deciduous teeth are whiter in color as enamel is thinner and pulp champer is large. Student who make fillings for children they enter the pulp as they forget that they should dig 1-2 mm without reaching the pulp but in permanent as it is the normal distance between external surface of tooth and the beginning of the pulp but in permanent 3-4 mm and in older people 5 mm (as they have second dentine), but students forget this fact. Some class, arch and type traits in permanent dentition are applied to deciduous dentition; only new traits will be discussed. All arch traits that dr. will not mention in this lecture are the same arch traits that are applied to deciduous teeth. For example we distinguish between maxillary central and maxillary lateral based on some features like the roundness, this feature is the same to distinguish between deciduous maxillary central incisor & deciduous maxillary lateral incisor. This will not be mentioned just the new features will be mentioned by the dr.
Deciduous incisors: Eruption: usually mandibular erupts before maxillary incisors as you know. And central erupts before lateral ones.
We don’t have mamelons or labial grooves or lobes in deciduous teeth. The day before the lecture the dr. went to Karak for his searches with another dr. This dr. asked Dr. Ashraf about a child tooth: is this tooth deciduous or permanent?? As it was a big incisor and he can’t determine is it deciduous or permanent. Dr. Ashraf asked him: does it have mamelons? Dr. said no. So Dr. Ashraf told him that it is a deciduous tooth because a newly erupted incisor should have mamelons but incisor without mamelons in children which is usually small in size is a deciduous incisor.
Permanent Maxillary deciduous central incisor:
The only incisor with MD width is greater than crown height; it is the only incisor (including deciduous & permanent) with a width greater than the height of the crown.
M & D profiles are overhanging (located outside the root outline) but in permanent teeth D & M profiles are continuous with the root profile.
No labial grooves, no depressions and no lobes, so you don’t feel that this tooth is made of 3 lobes fused together; as there is no mamelons. The cingulum is very prominent & more incisally located, but in permanent just the cervical 1/3 is occupied by cingulum but here in deciduous cingulum occupy the cervical half & usually it has an extension that extends toward the incisal edge. Sometime this extension may reach the incisal edge dividing the labial aspect into 2 portions; ML & DL fossa so in this case we call it lingual ridge (impossible to find it in permanent central incisor). Unmarked by pits & grooves (impossible to find them here in deciduous) Marginal ridges are clearly evidence and very common. This is a maxillary central incisor, as you can see it is very constricted from all aspect, cervical part is constricted. In proximal surfaces, the cervical line is convex incisally
Conical root with rounded apex and incisal surface is diamond in shape. Mistakes in practical exams when the dr. bring us a question to identify a deciduous central incisor usually students think that this tooth is permanent incisor, how we can distinguish? All the time look at the constriction, if the cervix is constricted this tooth is deciduous but if the cervix is not constricted, this tooth is permanent but of course we look at the size of the tooth. Always mistakes in mandibular central permanent incisor as it is small in size so we have to look at the constriction Maxillary lateral incisor: Smaller than deciduous central incisor, M & B profiles are more in line with root profile not overhanging. DI angle more rounded than MI same feature of maxillary permanent lateral incisor Labial aspect is more convex MD but in permanent it was a flat. L fossa is deeper, mesial marginal ridges are more prominent, cervical line is similar to that of central incisor and the tooth is rounded from all of incisal aspect. Regarding to mandibular central deciduous incisor: This tooth is bilaterally symmetrical to mandibular permanent central incisor, MI & DI angles are 90 degree (incisal margin or ridge is horizontal).
Prominent cingulum with lingual margin extending incisally but in mandibular permanent central incisor the cingulum was not prominent like this. So in deciduous mandibular central incisor the cingulum is more prominent and the marginal ridges are more prominent too. Marginal ridges are less marked than in maxillary deciduous, DI & lingual fossa is shallower. But all of these features are more prominent in mandibular deciduous than the permanent so if you want to tell is this tooth a deciduous or permanent just look at the prominence of these features with the size and color. But if less prominence and there is no constriction of cervix so it is maxillary. The mandibular central incisor the labial surface is flat MD, not constricted and not convex & cervical line is similar to that of maxillary incisor. The root is 3x the height of the crown.
Now how we distinguish between mandibular deciduous and permanent incisor? 1- Compare height of crown to the height of the root (small in deciduous) 2- Root is narrow conical with pointed apex
Mandibular lateral incisor:
Incisal edge slopes distally, this makes the MI angle, more acute or more 90 degree than the DI as DI the shoulder is lower & the angle is more rounded. D profile is more rounded then M profile; we have greater crown height/ MD ratio than mandibular central deciduous incisor as this tooth is not wide MD LL > MD dimensions. We have cingulum, fossa, MRs which is similar to those of mandibular central incisor. Roots are narrow & conical, apex has D inclination. D surface has narrow vertical depression. But how we can distinguish between a mandibular deciduous central & mandibular deciduous lateral again similar to the way we use to distinguish between permanent and deciduous.
Look at the tooth from incisal view; if you see incisal edge is perpendicular to BL line, it is a central. If you see cervical ridge inclined D&L this is mandibular lateral. Now let’s go to middle hall to complete this lecture there!!!
EnD Of LeCtuRe Forgive us for any mistake, we wish u best of luck in your final exams & don’t forget we are dentists of the future Please ma t5arb60 been el mesial and the molar both e5tesaron M We indicate this job to: Abeer al-hamarneh (my sweet bob corn), Haneen aqle (elnoom sol6aan, our DJ), Haneen mohsen (fedeetk, arf3lik el8ob3h oo an7nilk e7tram^_*), Sara al-7ffar ( lek yaaaaaaaaaa salam), Ethar Salameh (nutella),
Sanaa Maali (7beeet), Rowyda al-m2ani (CNN eldof3a), Hanan al-kateeb (NASCAFE..97 97) WDeena (sho mshan, wa5 mneek ya happy girl) Wbsara7a big thanks lyali wafarlna mo7adaret 2007 thanks dr. W6b3an ma bnnsa our football team
DONE BY: HANAN.O.AL-KHATEEB & DEENA.N.RAMADAN Allah y36eena el3afyh
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