Introduction to

Tooth Morphology for

The Tooth
Crown: Top part of the tooth covered in enamel.
Cervix: Where the roots and crown join together. Neck of the tooth. Roots: Bottom part of the tooth covered in cementum. It may have a single root, be bifurcated into two roots or trifurcated into three parts

 Area between

two or more branches Where the roots divide

Furcation

 Root end, tip end of the tooth Where the nerve supply enters the tooth

Apex

Anatomical Crown The structural crown area covered with enamel and may not be totally visible, but will be present the entire life of the tooth.

Clinical Crown Crown surface visible only in the oral activity. It changes with age.

Throughout the life cycle of the tooth, the anatomic crown remains the same, but the clinical crown may change due to the position of the gingivae.

Enamel
Outer most layer of the crown

 The Enamel is the hardest part of the tooth It makes up the anatomical crown of the tooth

Dentin
Layer below enamel Comes down into root

 The Dentin extends almost the entire length of the tooth It is covered by the enamel of the crown and the cementum of the root

Pulp
Found in the center of the tooth Nerve of the tooth Nutrients come in thru the nerve

 Organic tooth tissue that performs four main functions: nourishment, defense, registration of sensation/pain, and dentin protection There are three parts of the pulp

3 Parts of the Pulp

Pulp horns Pulp chamber Pulp canals

3 Parts of the Pulp

Pulp horns Pulp chamber Pulp canal

3 Parts of the Pulp

Pulp horns Pulp chamber Pulp canal/s

Cementum
Thin layer that goes all the way around the root

ligaments attach to the bone and the Cementum

The Supporting Tissues

Gingiva
(the gums)
Mouth tissue, mucous tissue that surrounds the tooth Gives protection to the teeth and underlying tissues Surrounds the neck of the tooth

Peridontal Ligaments
PDL Fibers which anchor the tooth into the alveolar socket Attaches to the bone, cementum and the next tooth

Alveolar Process
Extensions of bone which support the teeth in their functional positions

Gives support to the teeth

Recap Time

The Tooth
Enamel Dentin Pulp Cementum

The Tooth
Supporting Tissues Gingiva Periodontal Ligament Alveolar Process

The Tooth
Features of a Tooth Pulp Horn Pulp Chamber Pulp Canal Cementoenamel Junction (CEJ) Furcation Apex

Time to Practice
Label the Tooth Page # 6 of your packet

Anterior and posterior teeth showing the dental tissues

(From Bath-Balogh MB, Fehrenbach MJ: Illustrated dental embryology, histology, and anatomy, ed 2, Philadelphia, 2005, Saunders.)

Vocabulary
Morphology
the

study of the form of an organ or body part

Tooth Morphology
The

study of the form and structures of the dentition

Vocabulary
Dentition
Natural

teeth in position in the dental arches

The Dental Arches

Maxilla (or maxillary arch)
The

upper arch which is fixed to the skull and non-movable

The Dental Arches

Mandible (or mandibular arch)
The

lower arch which is movable and joins the skull at the temporomandibular joint (TMJ)

The Primary Dentition

aka The Deciduous Dentition The first set of teeth to erupt in an infants mouth First teeth generally erupt at 6 months Comprised of twenty teeth Lay term - baby teeth

The Permanent Dentition

aka The Secondary Dentition Comprised of 32 teeth Begin erupting at about 6 years Third molars erupt at 1721 years

Vocabulary
Quadrant
Half

of a dental arch One quarter of the mouth

Midline
The

imaginary line which divides each arch into equal halves

Label the Quadrants

Maxillary Right Maxillary Left Mandibular Left Mandibular Right

Vocabulary
Sextant
A

section of the dental arch Three sextants make up each arch

Anterior
Toward

the front of the body the back of the body

Posterior
Toward

Label the Sextants

Maxillary Right Posterior Maxillary Anterior Maxillary Left Posterior Mandibular Left Posterior Mandibular Anterior Mandibular Right Posterior

Time to Take a Break

Good Job, you are working hard please take a 10 minute break.

Types of Teeth
Incisors
Central Incisor Lateral Incisor

Types of Teeth
Canine (Cuspid)

Types of Teeth
Premolars (Bicuspid)
First Premolar Second Premolar

Types of Teeth
Molars
First Molar Second Molar Third Molar (Wisdom Tooth) Not Shown

Permanent dentition
(From Bath-Balogh MB, Fehrenbach MJ: Illustrated dental embryology, histology, and anatomy, ed 2, St.

Louis, 2005, Saunders.)

Time to Practice
Need Set of Plastic Teeth Work Sheet

Tooth Identification
Identify a tooth by listing its Dentition Arch Side of mouth Tooth
Permanent maxillary right 1st molar mandibular left canine

Tooth Numbering Systems

Universal (ADA) FDI

Palmers

Universal (ADA) Numbering System

R 32 31 30 29

7 8 9 10 6 11 5 12 4 13 3 14 2 15 1 16

28 21 27 22 26 23 25 24

L 17 18 19 20

Permanent dentition

Time to Practice
Need Plastic Set of Teeth Work Sheet

Think about tooths crown as a box

Surfaces of the Teeth

Axial surfaces are those which parallel the tooths long axis. They are generally vertical surfaces.

Surfaces of the Teeth

Axial surfaces
include the following

Labial

Facial

Buccal Labial

Buccal

Surfaces of the Teeth

Non-Axial surfaces include

the following

Occlusal Incisal

Tooth Surfaces
Facial
Buccal Labial

Incisal / Occlusal Lingual Mesial Distal

Surfaces of the teeth

(From Bath-Balogh MB, Fehrenbach MJ: Illustrated dental embryology, histology, and anatomy, ed 2, St. Louis, 2005, Saunders.)

Time to Practice
Boxes Markers

Lunch Time

Indication for Root Canal Therapy(RCT)

Endodontics
Clinical Examination

Palpation
Percussion Mobility Transillumination

Endodontics
Clinical Examination
Thermal Anesthesia Direct Dentin Stimulation Electric Pulp Testing Radiograph

Endodontics
Lateral Condensation
Endodontics

Endodontics Part of the Root Canal Treatment

Isolation Extirpation Debridement Irrigation Obturation Desiccant Medicament Curettage Restoration

HEMISECTION

HEMISECTION

Apicectomy Apicectomy illustration

APICECTOMY WITH LASER

10 minutes break!!!

IMPLANT Educational Implant Video Implant surgery lateral insicor

Dental Implants
Artificial teeth are anchored to surgically embedded tissue or bone. This specialty incorporates principles from both fixed and removable prosthodontics in conjunction with the use of bone-anchored implants.

Two single endosseous units were placed for tooth #18 and tooth #19.

Indications for Dental Implants

Increase the support, stability, and patient satisfaction for a full lower denture Increase the patient's comfort in chewing Increase the patient's confidence in smiling and speaking Increase the patient's overall psychological health Replace one or more teeth as single units with crowns Esthetics Provide support for a partial denture

Contraindication for Dental Implants

The financial investment is greater Treatment can take up to 9 months Risk of infection and other complications An implant may loosen and require replacement Implant procedure may be challenging for some patients Bruxism is a significant component of failed implants Patients with certain medical complications

Preliminary Evaluations for Implants

Psychological Evaluation
Dentist assesses the patient's attitude, ability to cooperate during complex procedures, and overall outlook on dental treatment

Dental Evaluation
Dentist evaluates the condition of the teeth, soft tissues, areas of attached and unattached tissue, and the height and width of the edentulous alveolar bone ridge

Preliminary Evaluations for Implants-contd

Medical Evaluation
Assess any existing medical conditions that could worsen as a result of the stress of implant surgery

Radiographs
Panoramic, cephalometric radiographs, and tomograms are needed to evaluate the height, width, and quality of bone

Preliminary impressions
Surgical stent

Assisting in an Endosteal Implant Surgery

Copyright 2005 by Elsevier Inc. All rights

Copyright 2005 by Elsevier Inc. All rights reserved.

Endosteal Implants
Also known as Osseointegrated Implants, are surgically placed into the bone Three components of endosteal implants
1. Titanium implant 2. Titanium abutment screw 3. Abutment post or cylinder

Osseointegration
The process by which the living jawbone naturally grows around the implanted dental supports.

Copyright 2005 by Elsevier Inc. All rights reserved.

Procedure Process of an Endosteal Implant

First Surgery
Implant fixture placed in receptor sites in the jawbone at predetermined locations Mucosa is sutured over the fixtures A period of 3 to 6 months is required to permit the fixture to osseointegrate or bond to the bone

Procedure Process of an Endosteal Implant-contd

Second Surgery
Implant fixture is exposed and the abutment screw is connected to the anchor Implant protrudes through the mucosa and connects the fixture to the prosthesis Patient begins the restorative phase

Subperiosteal Implants
This type of implant places a metal frame under the periosteum but on top of the bone.

Copyright 2005 by Elsevier Inc. All rights reserved.

Fig. 53-5 Example of subperiosteal implant

Procedure Process of a Subperiosteal Implant

First Surgery
Alveolar ridge is exposed and impressions taken Tissue is repositioned over the ridge and sutured back into place Impression sent to laboratory where metal frame with posts is fabricated

Procedure Process of a Subperiosteal Implant-contd

Second Surgery
Alveolar ridge is surgically exposed Metal frame is placed over the ridge With frame in place, the tissues are repositioned and sutured into place

Transosteal Implants
Primarily used on patients with severely resorbed ridges. The implant is inserted through the inferior border of the mandible and into the edentulous area.

Preoperative Guidelines
Consent form should advise:
Background information on implants Complications of implant surgery Prognosis Time frame Home care Follow-up appointments

Maintenance of Dental Implants

Home Care Devices
Toothbrushes (manual or electric) Single-tufted toothbrushes Partial denture clasp brushes Interproximal brushes Dental implant floss Floss

Recall Appointments
Patients should be scheduled at regular intervals for:
Examinations Radiographs Prophylaxis Removal of fixed components Replacement of components Relines and remakes as recommended

QUAESTIONS ????

We are what we repeatedly do. Excellence, therefore, is not an act but a habit. Aristotle