lntraarch relationship refers to the alignment of the teeth within an arch

1. In an ideal alignment teeth should contact at their proximal crests of curvature. A continuous arch form is observed in occlusal view

Curves of the occlusal plane (a line connecting the cusp tips of the canines, premolars, and molars) are observed from the proximal view

Curve of Spee: anterior to posterior curve; for mandibular teeth the curve is concave and for maxillary teeth it is convex

Curve of Wilson- medial to lateral curve for mandibular teeth the curve is also convex and for the maxillary it is convex

2. Contact does not always exist Some permanent dentitions have normal spacing

Primary dentitions often have developmental spacing in the anterior area: some primary den titions have a pattern of spacing called primate spaces between the primary maxillary lateral incisors and canine and between the mandibular canine and first mo1ar

Disturbances to the intraarch alignment are described as

a. Qpen contact where interproximal space exist  because of missing teeth oral habits, dental disease, or overdeveloped frena

b. where contact or position is at an unexpected area because of developmental disturbances, crowding, dental caries or periodontal ligament for their misplaced position: facial, lingual. mesial, supra(supraerupted) infra (infraerupted) and torso (rotated) version

Dental Formula, Dental Notation, Universal Numbering System

A. Dental Formula. The dental formula expresses the type and number of teeth per side

The Universal Numbering System. The rules are as follows:

1. Permanent teeth are designated by number, beginning with the last tooth on the upper right side, going on to the last tooth on the left side, then lower left to lower right

2. Deciduous teeth are designated by letter, beginning with the last tooth on the upper right side and proceeding in clockwise fashion

MAXILLARY SECOND MOLAR

The second molars are often called 12-year molars because they erupt when a child is about 12 years

Facial: The crown is shorter occluso-cervically and narrower mesiodistally whe compared to the first molar. The distobuccal cusp is visibly smaller than the mesiobuccal cusp. The two buccal roots are more nearly parallel. The roots are more parallel; the apex of the mesial root is on line with the with the buccal developmental groove. Mesial and distal roots tend to be about the same length.

Lingual: The distolingual cusp is smaller than the mesiolingual cusp. The Carabelli trait is absent.

Proximal: The crown is shorter than the first molar and the palatal root has less diverence. The roots tend to remain within the crown profile.

Occlusal: The distolingual cusp is smaller on the second than on the first molar. When it is much reduced in size, the crown outline is described as 'heart-shaped.' The Carabelli trait is usually absent. The order of cusp size, largest to smallest, is the same as the first but is more exaggerated: mesiolingual, mesiobuccal, distobuccal, and distolingual.

Contact Points; Height of Curvature: Both mesial and distal contacts tend to be centered buccolingually below the marginal ridges. Since themolars become shorter, moving from first to this molar, the contacts tend to appear more toward the center of the proximal surfaces.

Roots: There are three roots, two buccal and one lingual. The roots are less divergent than the first with their apices usually falling within the crown profile. The buccal roots tend to incline to the distal.

Note: The distolingual cusp is the most variable feature of this tooth. When it is large, the occlusal is somewhat rhomboidal; when reduced in size the crown is described as triangual or 'heart-shaped.' At times, the root may be fused.

The mixed dentition

I. Transition dentition between 6 and 12 years of age with primary tooth exfoliation and permanent tooth eruption

2. Its characteristic features have led this to be called the ugly duckling stage because of

a. Edentulated areas

b. Disproportionately sized teeth

c. Various clinical crown heights

d. Crowding

e. Enlarged and edematous gingiva

f. Different tooth colors

Formation and Eruption of Deciduous Teeth.

-Calcification begins during the fourth month of fetal life. By the end of the sixth month, all of the deciduous teeth have begun calcification.

-By the time the deciduous teeth have fully erupted (two to two and one half years of age), cacification of the crowns of permanent teeth is under way. First permanent molars have begun cacification at the time of birth. -Here are some things to know about eruption patterns:

(1) Teeth tend to erupt in pairs. 

(2) Usually, lower deciduous teeth erupt first. Congenitally missing deciduous teeth is infrequent. Usually, the lower deciduous central incisors are thefirst to erupt thus initiating the deciduous dentition. The appearance of the deciduous second molars completes the deciduous dentition by 2 to 2 1/2 years of age.

- Deciduous teeth shed earlier and permanent teeth erupt earlier in girls.

- The orderly pattern of eruption and their orderly replacement by permanent teeth is important.

- order for eruption of the deciduous teeth is as follows:

(1) Central incisor.........Lower 6 ½ months,         Upper 7 ½ months

(2) Lateral incisor.........Lower 7 months,   Upper 8 months

(3) First deciduous molar...Lower 12-16 months, Upper 12-16 months

(4) Deciduous canine........Lower 16-20 months, Upper 16-20 months

(5) Second deciduous molar..Lower 20-30 months, Upper 20-30 months

Periodontal ligament

Composition

a. Consists mostly of collagenous (alveolodental) fibers.
Note: the portions of the fibers embedded in cementum and the alveolar bone proper are known as Sharpey’s fibers.

b. Oxytalan fibers (a type of elastic fiber) are also present. Although their function is unknown, they may play a role in the regulation of vascular flow.

c. Contains mostly type I collagen, although smaller amounts of type III and XII collagen are also present.

d. Has a rich vascular and nerve supply.

Both sensory and autonomic nerves are present.

(1) The sensory nerves in the PDL differ from pulpal nerves in that PDL nerve endings can detect both proprioception (via mechanoreceptors) and pain (via nociceptors).

(2) The autonomic nerve fibers are associated with the regulation of periodontal vascular flow.

(3) Nerve fibers may be myelinated (sensory) or unmyelinated (sensory or autonomic).

Cells

a. Cells present in the PDL include fibroblasts; epithelial cells; cementoblasts and cementoclasts; osteoblasts and osteoclasts; and immune cells such as macrophages, mast cells, or eosinophils.

b. These cells play a role in forming or destroying cementum, alveolar bone, or PDL.

c. Epithelial cells often appear in clusters, known as rests of Malassez.

Types of alveolodental fibers

a. Alveolar crest fibers—radiate downward from cementum, just below the cementoenamel junction (CEJ), to the crest of alveolar bone.

b. Horizontal fibers—radiate perpendicular to the tooth surface from cementum to alveolar bone, just below the alveolar crest.

c. Oblique fibers

(1) Radiate downward from the alveolar bone to cementum.

(2) The most numerous type of PDL fiber.

(3) Resist occlusal forces that occur along the long axis of the tooth.

d. Apical fibers

(1) Radiate from the cementum at the apex of the tooth into the alveolar bone.

(2) Resist forces that pull the tooth in an occlusal direction (i.e., forces that try to pull the tooth from its socket).

e. Interradicular fibers

(1) Only found in the furcal area of multi-rooted teeth.

(2) Resist forces that pull the tooth in an occlusal direction.

Gingival fibers

a. The fibers of the gingival ligament are not strictly part of the PDL, but they play a role in the maintainence of the periodontium.

b. Gingival fibers are packed in groups and are found in the lamina propria of gingiva

c. Gingival fiber groups:

(1) Transseptal (interdental) fibers

(a) Extend from the cementum of one tooth (just apical to the junctional epithelium), over the alveolar crest, to the corresponding area of the cementum of the adjacent tooth.

(b) Collectively, these fibers form the interdental ligament , which functions to resist rotational forces and retain adjacent teeth in interproximal contact.

(c) These fibers have been implicated as a major cause of postretention relapse of teeth that have undergone orthodontic treatment.

(2) Circular (circumferential) fibers

(a) Extend around tooth near the CEJ.

(b) Function in binding free gingiva to the tooth and resisting rotational forces.

(3) Alveologingival fibers—extend from the alveolar crest to lamina propria of free and attached gingiva.

(4) Dentogingival fibers—extend from cervical cementum to the lamina propria of free and attached gingiva.

(5) Dentoperiosteal fibers—extend from cervical cementum, over the alveolar crest, to the periosteum of the alveolar bone.