NEET MDS Lessons
Dental Anatomy
THE DECIDUOUS DENTITION
I. The Deciduous Dentition
-It is also known as the primary, baby, milk or lacteal dentition.
diphyodont, that is, with two sets of teeth. The term deciduous means literally 'to fall off.'
There are twenty deciduous teeth that are classified into three classes. There are ten maxillary teeth and ten mandibular teeth. The dentition consists of incisors, canines and molars.
ARTICULAR SURFACES COVERED BY FIBROUS TISSUE
TMJ is an exception form other synovial joints. Two other joints, the acromio- and sternoclavicular joints are similar to the TMJ. Mandible & clavicle derive from intramembranous ossificiation.
Histologic
- Fibrous layer: collagen type I, avascular (self-contained and replicating)
- Proliferating zone that formes condylar cartilage
- Condylar cartilage is fibrocartilage that does not play role in articulation nor has formal function
- Capsule: dense collagenous tissue (includes the articular eminence)
- Synovial membrane: lines capsule (does not cover disk except posterior region); contains folds (increase in pathologic conditions) and villi
Two layers: a cellular intima (synovial cells in fiber-free matrix) and a vascular subintima
Synovial cells: A (macrophage-like) syntesize hyaluronate
B (fibroblast-like) add protein in the fluid
Synovial fluid: plasma with mucin and proteins, cells
Liquid environment: lubrication, ?nutrition - Disk: separates the cavity into two comprartments, type I collagen
anterior and posterior portions
anetiorly it divides into two lamellae one towards the capsule, the other towards the condyle
vascular in the preiphery, avascular in the center - Ligaments: nonelastic collagenous structures. One ligament worth mentioning is the lateral or temporomandibular ligament. Also there are the spheno- and stylomandibular with debatable functional role.
Innervations
|
Ruffini |
Posture |
Dynamic and static balance |
|
Pacini |
Dynamic mechanoreception |
Movement accelerator |
|
Golgi |
Static mechanoreception |
Protection (ligament) |
|
Free |
Pain |
Protection joint |
MANDIBULAR THIRD MOLAR
Facial: The crown is often short and has a rounded outline.
Lingual: Similarly, the crown is short and the crown is bulbous.
Proximal: Mesially and distally, this tooth resembles the first and second molars. The crown of the third molar, however, is shorter than either of the other molars
Occlusal: Four or five cusps may be present. Occlusal surface is a same as of the first or second molar, or poorly developed with many accessory grooves. The occlusal outline is often ovoid and the occlusal surface is constricted. Occasionally, the surface has so many grooves that it is described as crenulated--a condition seen in the great apes
Contact Points; The rounded mesial surface has its contact area more cervical than any other lower molar. There is no tooth distal to the third molar..
Roots:-The roots, two in number, are shorter in length and tend to be fused together. they show a distinct distal curve
MAXILLARY SECOND BICUSPID
smaller in dimensions. The cusps are not as sharp as the maxillary first bicuspid and have only one root.
Facial: This tooth closely resembles the maxillary first premolar but is a less defined copy of its companion to the mesial. The buccal cusp is shorter, less pointed, and more rounded than the first.
Lingual: Again, this tooth resembles the first. The lingual cusp, however, is more nearly as large as the buccal cusp.
Proximal: Mesial and distal surfaces are rounded. The mesial developmental depression and mesial marginal ridge are not present on the second premolar.
Occlusal: The crown outline is rounded, ovoid, and is less clearly defined than is the first.
Contact Points; When viewed from the facial, the distal contact area is located more cervically than is the mesial contact area.
PULP
Coronal
Occupies and resembles the crown,
Contains the pulp horns
It decreases in size with age
Radicular
Occupies roots
Contains the apical foramen
It decreases in size with age
Accessory apical canals
PULP FUNCTIONS
Inductive: The pulp anlage initiates tooth formation and probably induces the dental organ to become a particular type of tooth.
Formative: Pulp odontoblasts develop the organic matrix and function in its calcification.
Nutritive: Nourishment of dentin through the odontoblasts.
Protective: Sensory nerves in the tooth respond almost always with PAIN to all stimuli (heat, cold, pressure, operative procedures, chamical agents).
Defensive or reparative: It responds to irritation by producing reparative dentin. The response to stimuli is inflammation.
Histologically the pulp consists of delicate collagen fibers, blood vessels, lymphatics, nerves and cells. A histologic section of the pulp reveals four cellular zones:
Odontoblastic
Cell-free (Weil)
Cell-rich
Pulp core
Cementum & Cementogenesis
Cementum formation is called cementogenesis and occurs late in the development of teeth. Cementoblasts are the cells responsible for cementogenesis. Two types of cementum form: cellular and acellular.
Acellular cementum forms first. The cementoblasts differentiate from follicular cells, which can only reach the surface of the tooth's root once Hertwig's Epithelial Root Sheath (HERS) has begun to deteriorate. The cementoblasts secrete fine collagen fibrils along the root surface at right angles before migrating away from the tooth. As the cementoblasts move, more collagen is deposited to lengthen and thicken the bundles of fibers. Noncollagenous proteins, such as bone sialoprotein and osteocalcin, are also secreted. Acellular cementum contains a secreted matrix of proteins and fibers. As mineralization takes place, the cementoblasts move away from the cementum, and the fibers left along the surface eventually join the forming periodontal ligmaments.
Cellular cementum develops after most of the tooth formation is complete and after the tooth occludes (in contact) with a tooth in the opposite arch. This type of cementum forms around the fiber bundles of the periodontal ligaments. The cementoblasts forming cellular cementum become trapped in the cementum they produce.
The origin of the formative cementoblasts is believed to be different for cellular cementum and acellular cementum. One of the major current hypotheses is that cells producing cellular cementum migrate from the adjacent area of bone, while cells producing acellular cementum arise from the dental follicle. Nonetheless, it is known that cellular cementum is usually not found in teeth with one root. In premolars and molars, cellular cementum is found only in the part of the root closest to the apex and in interradicular areas between multiple roots.
TYPES OF TEETH
The human permanent dentition is divided into four classes of teeth based on appearance and function or position.
Incisors, Canines, Premolars & Molars