NEET MDS Lessons
Dental Anatomy
Embryonic development
The parotid derives from ectoderm
The sublingual-submandibular glands thought to derive from endoderm
Differentiation of the ectomesenchyme
Development of fibrous capsule
Formation of septa that divide the gland into lobes and lobules
The parotid develops around 4-6 weeks of embryonic lofe
The submandibular gland develops around the 6th week
The sublingual and the minor glands develop around the 8-12 week
Abnormalities
There are a number of tooth abnormalities relating to development.
Anodontia is a complete lack of tooth development, and hypodontia is a lack of some tooth development. Anodontia is rare, most often occurring in a condition called hipohidrotic ectodermal dysplasia, while hypodontia is one of the most common developmental abnormalities, affecting 3.5–8.0% of the population (not including third molars). The absence of third molars is very common, occurring in 20–23% of the population, followed in prevalence by the second premolar and lateral incisor. Hypodontia is often associated with the absence of a dental lamina, which is vulnerable to environmental forces, such as infection and chemotherapy medications, and is also associated with many syndromes, such as Down syndrome and Crouzon syndrome.
Hyperdontia is the development of extraneous teeth. It occurs in 1–3% of Caucasians and is more frequent in Asians. About 86% of these cases involve a single extra tooth in the mouth, most commonly found in the maxilla, where the incisors are located. Hyperdontia is believed to be associated with an excess of dental lamina.
Dilaceration is an abnormal bend found on a tooth, and is nearly always associated with trauma that moves the developing tooth bud. As a tooth is forming, a force can move the tooth from its original position, leaving the rest of the tooth to form at an abnormal angle. Cysts or tumors adjacent to a tooth bud are forces known to cause dilaceration, as are primary (baby) teeth pushed upward by trauma into the gingiva where it moves the tooth bud of the permanent tooth.
Regional odontodysplasia is rare, but is most likely to occur in the maxilla and anterior teeth. The cause is unknown; a number of causes have been postulated, including a disturbance in the neural crest cells, infection, radiation therapy, and a decrease in vascular supply (the most widely held hypothesis).Teeth affected by regional odontodysplasia never erupt into the mouth, have small crowns, are yellow-brown, and have irregular shapes. The appearance of these teeth in radiographs is translucent and "wispy," resulting in the nickname "ghost teeth"
Dental Terminology.
Cusp: a point or peak on the occlusal surface of molar and premolar teeth and on the incisal edges of canines.
Contact: a point or area where one tooth is in contact (touching) another tooth
Cingulum: a bulge or elevation on the lingual surface of incisors or canines. It makes up the bulk of the cervical third of the lingual surface. Its convexity mesiodistally resembles a girdle encircling the lingual surface at the cervical.
Fissure: A linear fault that sometimes occurs in a developmental groove by incomplete or imperfect joining of the lobes. A pit is usually found at the end of a developmental groove or a place where two fissures intersect.
Lobe: one of the primary centers of formation in the development of the crown of the tooth.
Mamelon: A lobe seen on anterior teeth; any one of three rounded protuberances seen on the unworn surfaces of freshly erupted anterior teeth.
Ridge: Any linear elevation on the surface of a tooth. It is named according to its location or form. Examples are buccal ridges, incisal ridges, marginal ridges, and so on.
Marginal ridges are those rounded borders of enamel which form the margins of the surfaces of premolars and molars, mesially and distally, and the mesial and distal margins of the incisors and canines lingually.
Triangular ridges are those ridges which descend from the tips of the cusps of molars and premolars toward the central part of the occlusal surface. Transverse ridges are created when a buccal and lingual triangular ridge join.
Oblique ridges are seen on maxillary molars and are a companion to the distal oblique groove.
Cervical ridges are the height of contour at the gingival, on certain deciduous and permanent teeth.
Fossa: An irregular, rounded depression or concavity found on the surface of a tooth. A lingual fossa is found on the lingual surface of incisors. A central fossa is found on the occlusal surface of a molar. They are formed by the converging of ridges terminating at a central point in the bottom of a depression where there is a junction of grooves
Pit: A small pinpoint depression located at the junction of developmental grooves or at the terminals of these groops. A central pit is found in the central fossa on the occlusal surfaces of molars where developmental grooves join. A pit is often the site of the onset of Dental caries
Developmental groove: A sharply defined, narrow and linear depression formed during tooth development and usually separating lobes or major portions of a tooth.
A supplemental groove is also a shallow linear depression but it is usually less distinct and is more variable than a developmental groove and does not mark the junction of primary parts of a tooth.
Buccal and lingual grooves are developmental grooves found on the buccal and lingual surfaces of posterior teeth.
Tubercle: A small elevation produced by an extra formation of enamel. These occur on the marginal ridges of posterior teeth or on the cingulum of anterior teeth. These are deviations from the typical form.
Interproximal space: The triangular space between the adjacent teeth cervical to the contact point. The base of the triangle is the alveolar bone; the sides are the proximal surfaces of the adjacent teeth.
Sulcus:-An elongated valley or depression in the surface of a tooth formed by the inclines of adjacent cusp or ridges.
Embrasures: When two teeth in the same arch are in contact, their curvatures adjacent to the contact areas form spillway spaces called embrasures. There are three embrasures:
(1) Facial (buccal or labial)
(2) Occlusal or incisal
(3) Lingual
(NOTE: there are three embrasures; the fourth potential space is the interproximal space ).
FUNCTIONS OF PERIODONTIUM
Tooth support
Shock absorber
Sensory (vibrations appreciated in the middle ear/reflex jaw opening)
Mandibular First Deciduous Molar
-This tooth doesn't resemble any other tooth. It is unique unto itself.
-There are two roots.
-There is a strong bulbous enamel bulge buccally at the mesial.
- the mesiolingual cusps on this tooth is the highest and largest of the cusps.
1. Errors in development. These are usually genetic.
a. Variability of the individual teeth. In general, the teeth most distal in any class are the most variable.
b. Partial or total anodontia. missing teeth in children,
c. Supernumerary teeth.
d. Microdontia
e. Macrodontia
F. Microdontia
2. Errors in skeletal alignment. Malpositioned jaws disrupt normal tooth relationships.
3. Soft tissue problems.
-Ocasionally, the proper eruption of a tooth is prevented by fibrous connective tissue over the crown of the tooth.
-In the mixed dentition, the deciduous second molars have a special importance for the integrity of the permanent dentition. Consider this: The first permanent molars at age six years erupt distal to the second deciduous molars.
-Permanent posterior teeth exhibit physiological mesial drift, the tendency to drift mesially when space is available. If the deciduous second molars are lost prematurely, the first permanent molars drift anteriorly and block out the second premolars.
An incisor diastema may be present. The plural for diastema is diastemata.
-Important: The deciduous anteriors--incisors and canines are narrower than their permanent successors mesiodistally.
-Important: The deciduous molars are wider that their permanent successors mesiodistally.
-This size difference has clinical significance. The difference is called the leeway space.
The leeway space in the lower arch is approximately 3.4 mm.
-The leeway space in the upper arch is approximately 1.8 mm. In normal development, the leeway space is taken up by the mesial migration of the first permanent molars.
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.