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Dental Anatomy

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.

MANDIBULAR SECOND BICUSPID

Facial: From this aspect, the tooth somewhat resembles the first, but the buccal cusp is less pronounced. The tooth is larger than the first.

Lingual: Two significant variations are seen in this view. The most common is the three-cusp form which has two lingual cusps. The mesial of those is the larger of the two. The other form is the two-cusp for with a single lingual cusp. In that variant, the lingual cusp tip is shifted to the mesial.

Proximal: The buccal cusp is shorter than the first. The lingual cusp (or cusps) are much better developed than the first and give the lingual a full, well-developed profile.

Occlusal: The two or three cusp versions become clearly evident. In the three-cusp version, the developmental grooves present a distinctive 'Y' shape and have a central pit. In the two cusp version, a single developmental groove crosses the transverse ridge from mesial to distal

Contact Points; Height of Curvature: From the facial, the mesial contact is more occlusal than the distal contact.The distal marginal ridge is lower than the mesial marginal ridge

Root Surface:-The root of the tooth is single, that is usually larger than that of the first premolar  

the lower second premolar is larger than the first, while the upper first premolar is just slightly larger than the upper second

There may be one or two lingual cusps

Compensating curvatures of the individual teeth.

- the gentle curvature of the long axes of certain posterior teeth to exhibit a gentle curvature.

-These are probably analogous to the trabecular patterns seen in the femur and therefore reflect lines of stress experienced during function.

 

Posteruptive tooth movement.

These movements occur after eruption of the teeth into function in the oral cavity. These movements, known collectively as occlusomesial forces.

A. Continuous tooth eruption eruption of teeth after coming into occlusion. This process compensates for occlusal tooth wear.. Cementum deposition and progressive remodelling of the alveolar bone are the growth processes that provide for continuous tooth movement

B. Physiological mesial drift :Tthe tendency of permanent posterior teeth to migrate mesially in the dental arch both before and after they come into occlusion. Clinically, it compensates for proximal tooth wear.

(1) It describes the tendency of posterior teeth to move anteriorly.

(2) It applies to permanent teeth, not deciduous teeth.

(3) The distal tooth have the stronger is the tendency for drift.

(4) It compensates for proximal wear.

(5) In younger persons, teeth drift bodily; in older persons, they tip and rotate.

(6) Forces that cause it include occlusal forces, PDL contraction, and soft tissue pressures. There may be other more subtle factors as well.

 

Height  of Epithelial Attachment

The height of normal gingival tissue . mesiallv and distallv on approximating teeth, is directly dependent upon the height of the epithelial attachment on these teeth. Normal attachment follows the curvature of the cementoenamel junction if the teeth are jn proper, alignment and contact.

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

MAXILLARY FIRST BICUSPID (PREMOLARS)

It is considered to be the typical bicuspid. (The word "bicuspid" means "having two cusps.")

Facial: The buccal surface is quite rounded and this tooth resembles the maxillary canine. The buccal cusp is long; from that cusp tip, the prominent buccal ridge descends to the cervical line of the tooth.

Lingual: The lingual cusp is smaller and the tip of that cusp is shifted toward the mesial. The lingual surface is rounded in all aspects.

Proximal: The mesial aspect of this tooth has a distinctive concavity in the cervical third that extends onto the root. It is called variously the mesial developmental depression, mesial concavity, or the 'canine fossa'--a misleading description since it is on the premolar. The distal aspect of the maxillary first permanent molar also has a developmental depression. The mesial marginal developmental groove is a distinctive feature of this tooth.

Occlusal: There are two well-defined cusps buccal and lingual. The larger cusp is the buccal; its cusp tip is located midway mesiodistally. The lingual cusp tip is shifted mesially. The occlusal outline presents a hexagonal appearance. On the mesial marginal ridge is a distinctive feature, the mesial marginal developmental groove.

Contact Points;The distal contact area is located more buccal than is the mesial contact area.

Root Surface:-The root is quite flat on the mesial and distal surfaces. In about 50 percent of maxillary first bicuspids, the root is divided in the apical third, and when it so divided, the tips of the facial and lingual roots are slender and finely tapered.

Histology of the Pulp

PARTICIPATING CELLS

1. Odontoblasts (body and process)
Most distinctive cells of the pulp
Single layer
The cells are columnar in the coronal portion, cuboidal in the middle portion, flat in the apical portion

Individual odontoblasts communicate with each other via junctions. The number of odontoblasts corresponds to the number of dentinal tubules.
The lifespan of an odontoblast equals the one of a vital tooth.
The morphology of the odontoblasts reflects their functional activity.
(There are three stages that reflect the functional activity of a cell: active, transitional and resting)

The odontoblastic process

2. Fibroblasts
Most numerous cells
Produce collagen fibers and ground substance
Ground substance consists of: proteoglycans and glycoproteins
Again, active and resting cells
Fibroblasts have also capability to degrade collagen

3. Undifferentiated mesenchymal cells A pool of cells from which connective tissue cells can derive.
They are reduced with age.

4. Endothelial cells, Schwann cells, pericytes and immunocompetent cells

MATRIX

It is composed of fibers and ground substance
55% of the fibers are Type I collagen. 45% of the fibers are Type III collagen.
The ground substance is gelatinous in the coronal aspect and more fibrous in the apical.

VASCULARITY

Superior and inferior alveolar arteries that derive from the external carotids
Afferent side of the circulation: arterioles
Efferent side of the circulation: venules
Lymphatics

Small, blind, thin-walled vessels in the coronal region of the pulp and exit via one or two larger vessels.
 

TOOTH MORPHOLOGY

Descriptive anatomy

  • Median sagittal plane: the imaginary plane in the center that divides right from left.
  • Median line: an imaginary line on that plane that bisects the dental arch at the center.
  • Mesial: toward the center (median) line of the dental arch.
  • Distal: away from the center (median) line of the dental arch.
  • Occlusal plane: A plane formed by the cusps of the teeth. It is often curved, as in a cylinder. We will speak often of the occlusal surface of a tooth.
  • Proximal: the surface of a tooth that is toward another tooth in the arch.
  • Mesial surface: toward the midline.
  • Distal surface: away from the midline.
  • Facial: toward the cheeks or lips.
  • Labial: facial surface of anterior teeth (toward the lips).
  • Buccal: facial surfaceof anterior teeth (toward the cheeks).
  • Lingual: toward the tongue.
  • Occlusal: the biting surface; that surface that articulates with an antagonist tooth in an opposing arch.
  • Incisal: cutting edge of anterior teeth.
  • Apical: toward the apex, the tip of the root.

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