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Dental Anatomy

Challenge 2010
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Lecture Notes

Lecture Title: Dental morphological terms Prof Name : Dr.Ashraf AlShawesh Done by : Dental Anatomy Script Team

Dental morphological terms


Grooves are shallow linear depression on the surface of a tooth, it separates between major parts of the tooth, imagine you have couple of mountain and between these mountains we have valley, the deepest point of this valley is called groove. So thats mean Grooves separate between major parts of the tooth. -There are two common types: A- Developmental grooves: their function is separating the major parts on the occlusal surface of the tooth, so for example if we look at this molar in the picture its an upper molar so here we see grooves these are called developmental grooves. For example in (figure 1) this groove (F) separates this cusp from this cusp. Another groove separates this cusp from that cusp and so on. B- Supplemental grooves: they are minor grooves that also can be found on the occlusal part of the buccal or lingual surface. So there is mesial surface, distal surface, and the occlusal surface. Figure (1)

Notice: Supplemental groove dont separate between major parts of the tooth. (In figure 1) take this line (S). This small line is a groove but it doesnt separate between major parts of tooth. Thats why it is called supplemental groove. It is not a major developmental groove. So for you to call a groove as a developmental groove it should be existing between two major parts of a tooth.

Q)What are the major parts that exist on the occlusal surface of the tooth? -They are the cusps, and the marginal ridges. Again remember that: If the groove doesnt separate between two major parts so it is not a developmental groove, but it is a supplemental groove.

Cusps

We have also a term called cusp ridge. You have to imagine the cusp as a pyramid, whose base is a square. Each pyramid has four line angles. Lets take this cusp. It has a cusp tip, and from the cusp tip we have four line angles going on different ridges. So this is the buccal cusp ridge, mesial cusp ridge, distal cusp ridge and this is the lingual cusp ridge. (Figure 2)

*P.s.
Of course you are not able to imagine these before knowing the anatomy of posterior teeth. So they will be explained again when we talk about posterior teeth. And also you will see the in the lab.

So again each cusp has four ridges and they are named according to their location. The cusp ridge that is always directed toward the center of the occlusal surface is called the triangular cusp. And thats why we have whats called triangular ridge, which is one of the cusp ridges but this is special because it directed toward the center of the occlusal surface tooth. This is the triangular ridge of the other cusp. (Figure3)

**But you only find oblique ridges on maxillary molars.

Pits, What are they ! Pits are pin point depression; at the maximum depth of a fossa. Fossa is a shallow depression. At the very bottom of any fossa we find a pit. And usually these pits are located at the junction between different grooves, developmental grooves. For example see here there is the buccal developmental groove which meets the central groove in this case, their meeting make a pin point depression and this is called a pit. In this case it's the central pit and it is so deep. We have a term called a triangular fossa. It is any fossa depression but all the time it should be located just inside marginal ridges. We have central fossa, which is located at the center of the tooth for example between this transverse ridge and this oblique ridge. We have a depression and this is called a central fossa.

Central pit

Type of Ridges ! Now when two triangle cusp ridges make one continues line , this is called a Transverse ridge. If you take the triangular ridges of this cusp which is continues ridge with that cusp making a straight line or straight ridge , this ridge will be all the time buccolingual running from buccal to lingual
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Not oblique. If this ridge running obliquely it will be called oblique ridge. So oblique ridge and transverse ridge both of these are ridges composed of triangular cusp ridges. If this ridge run obliquely, like when one cusp ridge is continues with the other cusp ridge, it will make an oblique ridge and this is because it runs obliquely but when it runs transversely from buccal to lingual then it will be known as transverse ridge.

Where can we find them?


Oblique ridges are only found on oblique molars while transverse ridges are found on all posterior teeth, so you will find transverse ridge on (premolars, upper molars or lower molars) but you will not find oblique ridges except on maxillary molars.

* P.S. We will discuss the anatomy of the posterior teeth in the next two lectures.

What should I Know about Triangular fossa !


Triangular fossa which is a depression but in this case it should be bordering the marginal ridges .So when we look to the marginal ridge that locate on the margin and we find a fossa that locate there so we consider it as Triangular fossa. We can describe the triangular fossa in more details when we mention a fossa that locate between mesial ridge and transverse ridge. Central Fossa that will be found in the center of the tooth, for example , when we have one oblique ridge and another transverse ridge and we find a depression , so we define it with the phrase Central fossa.

**Central fossa : is a normal fossa locate between oblique and transverse ridge .

* P.S : - We discussed Division into thirds last time, so you should study it because we will use these terms in the practical work.

All orientation terms are important . For example: -Axial : is any surface located at the long surface of the tooth . -Facial : it's known as Liable for anterior teeth and Buccal for posterior teeth . But the general term is Facial . -Fissure : it is the same as the term developmental groove .

Wiki: The term "contact area" rather than "contact point" is preferred because the amount of contact is greater than that of a point. By means of the contact area, the teeth help to support each other when force is exerted.

**Contact area : is the region on the mesial or distal surface of any tooth which is on a contact with another area of the adjacent tooth. The Contact area is located at the maximum convexity of the surface .

Imagine it with us ! For example the mesial surface is not linear but it's convex surface so at the top of this convexity when it meets with the adjacent convexity of the adjacent tooth this is where we define the Contact area.

- An embrasure: is a V-shaped space between the proximal surfaces of two adjacent teeth which are in contact.

Embrasures!
Let's imagine that we have two teeth, the surfaces that are in contact between these two teeth are not necessarily flat surfaces. Usually they have some convexity so they meet at certain area. Because they meet only at a small area they leave a space above or below that area, and also they leave a space buccal and lingual to those areas, and these are the embrasures.

when two teeth are in contact at certain point, this means that we have areas buccal to the contact area and areas lingual to the contact area and these spaces are not in contact .So this V-shaped spaces located buccal and lingual to the contact area are called embrasures.

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Types of embrasures ! In a similar way we have something called occlusal embrasure and cervical or gingival embrasure, also if you look at two teeth they make contact only in certain point so they leave a V-shaped space below the contact and this is related to the gingiva thats why we call it the gingival embrasure, they also leave a space above the contact point or occlusal to the contact point that is called the occlusal embrasure.

Q) How many embrasures do we have per tooth? -Four embrasures .


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If we imagine our teeth as boxes, this means that the proximal surfaces are 100% flat then the amount of embrasures is zero. But we should have full embrasure when the contact point becomes very small, so the larger the contact point the smaller the embrasure.

Note here !
Large contact point gives small embrasure . If our teeth are spherical then the two spherical teeth would meet at a very small area, the contact point instead of the contact area, so this makes the embrasure the maximum. This means that the embrasure tends to be maximized when the contact area is very small and vice versa.

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Once again : -Small contact area -big contact area

More embrasure space. less embrasure space.

So, if our teeth are spherical, that mean that our tooth will contact in appoint so , it give us that maximum embrasure . -Embrasure is very important because its the area where we can use our tongue to wash out the food. -The only area that cannot clean by tongue is gingival embrasure. So it lead to food accumulation and caused proximal caries. So it's important area for decay formation and spread below the contact area.

Do not forget to floss your teeth! -The only way to remove food from gingival embrasure is by using dental floss. The height of contour "HOC" ! -The maximum convexity of the surface of one tooth come on contact with the maximum convexity of the a joining surface of adjacent tooth .

*P.S
1-"The doctor will deter this term in details in the practical part ". 2-" When we said that the tooth is higher that mean it is more incisal."

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-HOC are not always in the same level of all teeth .

- Incisal edge is the higher tooth for any anterior teeth . - The cusp tip is the higher tooth for any posterior teeth .

-When we said the mesial HOC is height than distal HOC are more insical

. Morphology of permanent incisors ! -Eruption sequence:


41/31:mandibular central incisor . 11/21: maxillary central incisor. 42/32:mandibular lateral incisor. 12/22: maxillary lateral incisor.

-Functions:
1-Cutting :it function for incisor so, some animal like goat can't cut because they havent incisor. 2-Esthetics : its science of beauty. 3-Speech :contact between upper lip and lower incisor (say F,V, )

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Class traits:

Q)How we and molar ?

can

distinguish

incisor

from

canine

,premolar

-The incisal two thirds are flattened mesiodistaly as you see ,so if you want to see the mesiodistal dimension you have to look at the facial or the labial view and as you see in the picture , the incisal two thirds are flat or wide but if you look at the incisal two thirds

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from the mesial or distal aspect they tend to be very narrow, This is the only feature found in incisors.

Also we have a long horizontal incisal edge usually we see two or more mammelons that are only found in incisors .

* P.S -If you want to look to the tooth mesio-distaly , you should look to the tooth from facial surface .

Wiki: remember.. Mammelons are usually found as three small bumps on the incisal edges of anterior teeth. They are the remnants of three lobes of formation of these teeth, the fourth lobe represented by the cingulum. Since this surface of the tooth is the first to wear away from attrition, mammelons may not be visible on teeth of older people. Instead, the best chance to see this characteristic is soon after eruption of the tooth into the mouth. Note, the presence of mammelons in adults is an indication of malocclusion.

Marginal ridges are parallel to the long axis of the tooth , if you want to see the marginal ridges on incisors you have to look at the tooth from inside (from lingual surface) .

So this is the lingual surface , here we see the cingulum , fossa

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and we have one marginal ridge and another marginal ridge , notice that marginal ridges are running along with the long axis of the tooth and are not perpendicular as in molars. Once again!

Q)How we can distinguish between upper and lower incisors ? - We can use : 1-The crown. 2- The root. Now Let's start with the crown ! 1-The crown in upper incisor is wider mesiodistally than in lower incisor.

*P.S The distance between the mesial and the distal is wider in upper incisors than in lower incisors.

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Height over width proportion! -You bring the height of the crown and divided it by the width of the crown .

The height of the crown for the upper incisors is ten mm , and the width of the crown is eight mm so ten over eight equal 1.25 mm remember this number , let's do the same for the mandibular incisors the height is ten mm divided by the width which is five mm so this is equal two mm , that is why the "height/ width proportion " tends to be very much smaller in the maxillary incisors compared to the mandibular incisors . Mesiodistal width divided by the labiolingual width !
Take the mesiodistal width of maxillary incisor which is eight mm and divided it by labiolingual width of the same tooth which is seven so 8 / 7 very close to one .

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Let's do the same for the mandibular incisor , the mesiodistal width is five and the labiolingual is seven so 5/7 =0.7 So the mesiodistal width / the labiolingual width proportion tend to be greater in upper incisors . The root is the same , The mesiodistaly width over the labiolingualy width in the maxillary incisors is close to one , but in the mandibular teeth; the mesiodistal width which is three mm over the labiolingual width which is eight mm so three over eight =.037 which is a very small proportion. So, the mesiodistal over labiolingual proportion in the root is greater in maxillary incisors.

Also roots tend to be conical ( )in maxillary incisors which means if you make a cross section through these roots you will get a circle but if you make a cross section of the mandibular teeth you will get a rectangular so the cross section or the shape of the root is different.

Q) How we can distinguish between the maxillary central incisor and the maxillary lateral incisor ?

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1-Size: the central incisor is bigger than in the lateral incisor. 2- The height/ width proportion is higher in lateral incisor than in central incisor because the lateral incisor is narrow than central incisor. 3- The mesiodistal / labiolingual proportion is different and it tends all the time to be greater in central incisor and smaller in lateral incisor. 4- The angles ,the angles in the central incisor are sharper than in the lateral incisor , so the angles in the lateral incisor tend to be rounded. Also the cingulum in the central incisor is less prominent than the cingulum in the lateral incisor. 5- Fossa in the central incisor tends to be shallower than the fossa in lateral incisor.

1-If we get the central incisor height and width and divide them , the ratio will be close to one . 2- If we get the lateral incisor height and width and divide them the ratio will be more than one. 3- The MD over labialing of proportion is different as well , it tends to be greater in central than lateral incisor.

The anatomy of the tooth!


Let's start from the labial aspect this tooth is the widest mesiodistally of all incisors , which is a type train because we can use it distinguish between this tooth and maxillary lateral incisor .

This tooth erupts with 3 mammelons :


1-middle mammelon the smaller in width . 2-mesial mammelon has a raised shoulder. 3-distal mammelon has a low shoulder. But, as I said these 3 mammelon, after using the tooth for a while ,they get worn out ,leaving a strength incisor edge.

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You have to be able to distinguish between the incisor ridge and edge . Because the mesial mammelon has a raise shoulder that distal mammelon. The two angles of the tooth are different see this angle, it is the right angle. this is important because when you see a tooth from the labial surface ,you will be able to till this is mesial side or distal side ,because you already know that the medial side has a right angle. But the distal side has a rounded angle. So the mesio incisal angle is 90 degrees . the diltoincisal angle is rounded, also the mesial outline is straightly , but the distal out line is slightly convexes .

The HOC is also different mesialy .The HOC is located in the middle of the incisor third but, distally it is located in the junction between the middle third and the incisor third.

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Q) Which high of contours is highest mesialy or distally? - Mesialy.

* P.S -Highest means that it is located more toward the incisor edge.

So, we have discussed everything but, we still have the cingulum enamel
junction. Which is a cervical line and convex, and the convexity of the line is toward the convex of the tooth or the root. The root is conical and inclined distally. The 90 degree mesioincisor line angle, this is a type trait, because in the lateral incisor it is not going to be 90, it will be more rounded. That's why it is a type trait that allows you to distinguish between the maxillary central incisor and lateral incisor.

The root is conical and slightly inclined distally!


From the lingual aspect , the tooth is spoon like, which means that we have a concavity . this concavity is caused by a convexity and two razed bridges. These bridges are located as a margin , that's why we called marginal bridge.

Q) Why do we need fossa in upper incisor ? - Because this fossa is the area where the incisor edges of lower incisor may contact in normal occlusion .

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For this reason the fossy for lower incisor are very shallow because nothing is going to come in contact to the fossy of lower incisor , but of course the incisor edge of lower incisor will be in contact with the fossy of the upper incisor. The lingual fossa is boarded by the mesial and distal marginal bridge and the cingulum as we discussed .This tend to be very prominent in maxillary lateral incisor followed by maxillary central incisor and finally followed by mandibular incisor. The cingulum is very prominent.

Q) The marginal bridge is very prominent in which tooth? -The maxillary central incisor followed by the mandibular incisor. You can touch that by your tongue. If you put your tongue against the lateral incisor you can feel the prominent of the lateral incisor which is more prominent that the maxillary central incisor. You can also put your tongue on the surface of the mandibular incisor and feel that the fossy are not prominent . The same in the enamel junction lingual, is also convex towards the root but, it is more convex than the labial and the summit tends to be toward distal slightly.

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The root looks narrower when seen from the lingual this mean it is slightly wider labial than lingual. Now, this tooth from mesial aspect, it is looks like chisel shape, so the labial HOC here it is located within the cervical third, and it is located nearly as the same level as a lingual height of contour. The cervical line tends to be convex. But notice that the convexity is reversed the convexity tend to be toward the incisal edge and tends to be more convex mesialy than distally .

The incisal edge with the long axis!


If you make a long axis running through the long axis of the root , if you continue this line it should pass through incisal edge , this is a feature in maxillary incisors but it is not a feature in mandibular incisors. In mandibular incisors, the crown tend to be inclined lingual, this means that the incisal edge tend to be slightly lingual to the by the secting line. If we draw a line passes in the middle of the Incisal edge it should also pass through the middle of the root edge and this for the maxillary teeth not mandible teeth.

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Q) The incisal edge in the mandibular incisors tend to be lingual to secting line , why ? - Because the crowns of the mandibular incisors tend to be slightly lingual. Also, if you see the root from the mesial aspect, it tend to be conical from the distal aspect, the morphology is similar to the morphology from the mesial aspect with one exception , the cervical line is less curved .

Now, we will talk about the incisal aspect ,if you look at the tooth from the incisal edge, it is going to look like this and this is important, because many students when they do tooth carving they ignore to evaluate the carving from the incisal view , so they produce very nice work if you look to their work from labial,mesial,distal and lingual. But when you look from incisal, it is rubbish, so why? Because they ignore to see the incisal view of the tooth.

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The incisal view it is triangular. The labial outlines as you see it is convex, but see the lingual outline it is very convex. So the convexity of the lingual is much much more than the convexity of the labial outline. The mesial and distal outlines, usually they meet the labial outline at sharp angle, but when they meet the lingual outline they do not meet at sharp angle. The mesial outline is slightly longer than the distal outline; the labial grooves can be seen.

The pulp of the tooth!


The pulp looks like the external configuration of the tooth, all the time the shape of the dental pulp reflect the external shape of the tooth. So this is the central incisor, see the pulp ,the part of the pulp located in the root canal or in the root is called the root canal. And the part of the pulp located in the crown or inside the crown is called the pulp chamber or pulp cavity. We do not have an area where we can see that this is the end of the pulp cavity and the beginning of the root canal, because it is all continuous, but in the posterior teeth it is easy to say that this is the root canal and this is the pulp chamber, we have an area where you can see this is the end of the pulp chamber and the beginning of the root canal but in anterior teeth they are continuous.

Pulp canals tend to be wide mesiodistaly, but very narrow labiolingualy as you see in the picture above. And we see two extentions,one toward each

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of the angles , so here we have an extension that goes to the mesioincisal,and another extension goes to the diso incisal angles, these are called pulp horns. These are cavities, areas extension that goes toward the angles of the tooth. When you do root canal treatment, it is very important to remove all pulp tissue from the tooth, many dentists unfortunately, they failed to remove the pulp here at the pulp horns. So what are the sequels of leaving pulp tissues after making root canal treatment? If you failed to remove the pulp tissue from that area, after doing root canal treatment, the tooth will be stained ( the pulp tissue will spread in the dentin and stain the tooth). Many people who they have trauma in one of the incisors if you leave the trauma without treatment, the tooth will look darker, why? Because the pulp tissue was not removed and started to be composed and penetrated through the tubules of dentin. So the good dentist is the one that remembers that in the anatomy of the pulp of this tooth we have two pulp horns these need to be exposed and all the pulp tissue inside the pulp horn need to be cleared. The pulp canal is conical because it looks like the root of the tooth.

KEEP IN MIND.. The top 5 point :


1-To describe posterior teeth we use those terms: (cusp ridge vs transverse ridge & oblique ridge) (development groove vs supplement groove) (triangular fossa vs central fossa) (pit).

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2-Each tooth contact with adjunct tooth by "contact area" & constitutes a V shape structure called "Embrasures' ". 3-The Maxillary central incisor have many functions (cutting, esthetics, speech). 4-Arch trait vs type trait on the central incisors. 5-Special characteristics of central incisor, which are :

Labial aspect: -Wide MD,Hoc -Three mamelons,two lobe groove.

Lingual aspect :

Mesial aspect :

Distal aspect :

-Lingual fossa -Chisel shape, -Less curved CEJ ,convex CEJ convex CEJ from mesial. -Narrow root. - Conical root .

Test yourself ..
Questions 1- The Embrasures are V shape structure forms as a result of tooth fractions? a) True b) False 2- One of the following is a class trait of incisors: A) Incisal 2/3 flattened MD & compressed LL B) Long horizontal MD biting edge C) Marginal ridges parallel to long axis D) all of the above
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3- All of these are type traits for incisors except? A) Size. B) Height / width proportion in crown. C) Wider MD. D) MD / LL proportion in crown and root. 4- On mesial aspect of CEJ : A) Curved cervicaly. B) Curved incisally. C) Convex incisally. D) Convex cervically.

5- The pulp of the central incisor ? A) Have 2 horns B) Mirror the internal configuration C) Chisel in shape D) Non of the above

Answers: 1 2 3 4 5 B D B C A

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Quote of the Day : We are all in one boat equally ,Responsible, for everything
Ahmed AlShamary Hebah Ramadnah Rmz Rabbadi

A9eel Ghawanmeh

Russia Al Shboul Salam Bataineh Abeer M. Dirawi Sundos Abu Zaid Eman Idkaidek Eman Nazzal Hibah Jarrah Sawsan Z. Jwaied Noha Mohamad Rawda Najjar GaYda'a Kana'an Hadeel Sumrien

Thanks For Alaa Mahany Dalya Machadi Abeer Dirawi For their efforts

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