NEET MDS Lessons
Dental Anatomy
ERUPTION OF THE PERMANENT TOOTH
- At the time at which the deciduous tooth erupts the tooth bud for the permanent tooth has already been building up enamel and dentin.
- When the permanent tooth starts to erupt, pressure on the root of the deciduous tooth causes resorption by the osteoclasts.
- Wolff's law states that when two hard tissues exert pressure on one another the softer of the tissues will be resorbed.
- The dentin and cementum of the root of the deciduous tooth is softer than the enamel of the permanent tooth that is why the root of the deciduous tooth is resorbed.
- Most permanent teeth have erupted and have been in use for 2 years before the root is completely formed.
MAXILLARY LATERAL INCISORS
it is shorter, narrower, and thinner.
Facial: The maxillary lateral incisor resembles the central incisor, but is narrower mesio-distally. The mesial outline resembles the adjacent central incisor; the distal outline--and particularly the distal incisal angle is more rounded than the mesial incisal angle (which resembles that of the adjacent central incisor. The distal incisal angle resembling the mesial of the adjacent canine.
Lingual: On the lingual surface, the marginal ridges are usually prominent and terminate into a prominent cingulum. There is often a deep pit where the marginal ridges converge gingivally. A developmental groove often extends across the distal of the cingulum onto the root continuing for part or all of its length.
Proximal: In proximal view, the maxillary lateral incisor resembles the central except that the root appears longer--about 1 1/2 times longer than the crown. A line through the long axis of the tooth bisects the crown.
Incisal: In incisal view, this tooth can resemble either the central or the canine to varying degrees. The tooth is narrower mesiodistally than the upper central incisor; however, it is nearly as thick labiolingually.
Contact Points: The mesial contact is at the junction of the incisal third and the middle third. The distal contact is is located at the center of the middle third of the distal surface.
Root Surface:-The root is conical (cone-shaped) but somewhat flattened mesiodistally.
Tooth development is commonly divided into the following stages: the bud stage, the cap, the bell, and finally maturation. The staging of tooth development is an attempt to categorize changes that take place along a continuum; frequently it is difficult to decide what stage should be assigned to a particular developing tooth. This determination is further complicated by the varying appearance of different histological sections of the same developing tooth, which can appear to be different stages.
Bud stage
The bud stage is characterized by the appearance of a tooth bud without a clear arrangement of cells. The stage technically begins once epithelial cells proliferate into the ectomesenchyme of the jaw. The tooth bud itself is the group of cells at the end of the dental lamina.
The periodontium consists of tissues supporting and investing the tooth and includes cementum, the periodontal ligament (PDL), and alveolar bone.
Parts of the gingiva adjacent to the tooth also give minor support, although the gingiva is Not considered to be part of the periodontium in many texts. For our purposes here, the groups Of gingival fibers related to tooth investment are discussed in this section.
Enamel
Composition: 96% mineral, 4% organic material and water
Crystalline calcium phosphate, hydroxyapatite
Physical characteristics: Hardness compared to mild steel; enamel is brittle
Support from dentin is necessary
Enamel has varies in thickness
Structure of enamel
Ground sections of enamel disclose the information that we have about enamel
Enamel is composed of rods
In the past we used the term prism (do not use)
Enamel rod
The rod has a cylinder-like shape and is composed of crystals that run parallel to the longitudinal axis of the rod. At the periphery of the rod the crystals flare laterally.
Interrod region: surrounds each rod; contain more enamel protein (fish scale appearance)
Rod sheath: boundary where crystals of rods meet those of the interrod region at sharp angles (We used to describe that as a keyhole configuration)
Each ameloblast forms one rod and together with adjacent ameloblasts the interrod region Very close to dentin there is no rod structure since the Tomes' processes develop after the first enamel is formed.
Striae of Retzius and cross striations
Incremental lines
Enamel structure is altered along these lines
Cross striations are also a form of incremental lines highlighting the daily secretory activity of ameloblasts
Bands of Hunter and Schreger
Optical phenomenon produced by changes in rod direction
Gnarled enamel
Twisting of rods around each other over the cusps of teeth
Enamel tufts and lamellae
They are like geologic faults
Tufts project from the DE junction, appear branched and contain greater concentrations of enamel protein than enamel
Lamellae extend from the enamel surface
Enamel spindles
Perikymata
Shallow furrows on surface of enamel formed by the striae of Retzius
SURFACES OF THE TEETH
Facial, Mesial, Distal, Lingual, and Incisal Surfaces
- The facial is the surface of a tooth that "faces" toward the lips or cheeks. When there is a requirement to be more specific, terms like labial and buccal are used. The labial is the surface of an anterior tooth that faces toward the lips. The buccal is the surface of a posterior tooth that faces toward the cheek.
- The mesial is the proximal surface closest to the midline of the arch. The distal is the opposite of mesial. The distal is the proximal surface oriented away from the midline of the arch.
- The lingual is the surface of an anterior or posterior tooth that faces toward the tongue. Incisal edges are narrow cutting edges found only in the anterior teeth (incisors). Incisors have one incisal edge
- Proximal Surfaces
A tooth has two proximal surfaces, one that is oriented toward the midline of the dental arch (mesial) and another that is oriented away from the midline of the arch (distal).
Permanent dentition period
-Maxillary / mandibular occlusal relationships are established when the last of the deciduous teeth are lost. The adult relationship of the first permanent molars is established at this time.
-Occlusal and proximal wear reduces crown height to the permanent dentition and the mesiodistal dimensions of the teeth
occlusal and proximal wear also changes the anatomy of teeth. As cusps are worn off, the occlusion can become virtually flat plane. -In the absence of rapid wear, overbite and overjet tend to remain stable.
-Mesio-distal jaw relationships tend to be stable,
With aging, the teeth change in color from off white to yellow. smoking and diet can accelerate staining or darkening of the teeth.
Gingival recession results in the incidence of more root caries . With gingival recession, some patients have sensitivity due to exposed dentin at the cemento-enamel junction.
Curve of Spee.
-The cusp tips and incisal edges align so that there is a smooth, linear curve when viewed from the lateral aspect. The mandibular curve of Spee is concave whereas the maxillary curve is convex.
-It was described by Von Spee as a 4" cylinder that engages the occlusal surfaces.
-It is called a compensating curve of the dental arch.
There is another: the Curve of Wilson. Clinically, it relates to the anterior overbite: the deeper the curve, the deeper the overbite.