Clinical Prof.Nattaya Asawaworaritelearning.dt.mahidol.ac.th/dtdocs/images/file/DTMS... · sides to...

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Clinical Prof.Nattaya Asawaworarit

DENTAL ANATOMY (DTMS 233,DTMS234,DTMS235)

The Form & Function of the Teeth

Introduction to

Dental Anatomy

Course Objectives (DTMS 233)

At the completion of this course, students will be able to: 1. Name the teeth and their structures, parts of a tooth, tooth surfaces and supporting tissues

2.Identify teeth in: -Palmer’s notation system -Two-digit system (the FDI World Dental Federation notation) -Universal numbering system

Course Objectives (DTMS 233)

3.Indicate the general eruption sequence of teeth

4.Demonstrate the knowledge of the morphology of each tooth

Course Contents (DTMS 233)

1. Nomenclature:Teeth and their structures, parts of a tooth, tooth surfaces and supporting structures

2.Tooth Identification systems: -Palmer’s notation system -Two-digit system -Universal numbering system

Department of Masticatory Science

3.Tooth morphology and Tooth Alignment

Course Contents

4. Chronology of Tooth Eruption

The knowledge of DA is most important to the dentist since without a complete understanding of the form of human teeth, no dentist can operate on these tissues and restore them to their correct contour and proper function.

Example of lab.& clin.practice related to DA. To carve the filling material after filling the cavity.

Fixed bridge restoration

Dental Anatomy Laboratory DTMS 234, DTMS 235

Course Objectives :

Cognitive and psychomotor skills related to the morphology and functional relationships of human dentition

(Dentition=natural teeth in the jaw)

1.Lab:Nomenclature

(name,terminology)

Course Contents (DTMS 234,235)

2. Lab. : Tooth Identification

Course Contents

Primary teeth

: Tooth Identification

Course Contents

Permanent teeth

One of the most important educational tasks for acquiring visual discrimination skills is learning to distinguish the “ideal” from its clinical important deviation from normal. The traditional method is to examine preserved human teeth

3. Practice: Wax Tooth Carving

Course Contents

Permanent teeth

Practically all teeth are aligned in their arches with varying degrees of inclination of their axial centers.

Maxilla and upper teeth as seen from anterior and lateral aspects showing average arrangement of teeth.

(more detail, later)

Mandibular teeth as seen from anterior aspects showing arrangement of teeth relative to alveolar bone.

The positioning of axial center(a) of the molar is such that the crown is inclined toward the lingual.

The hypothetical relation btw correct crown contour and gingival health. The outer and inner surfaces of the crowns contain just enough convexity so that the food is deflected away from the gingival sulcus.

Incorrect crown contour, the surfaces are too flat for the adjacent soft tissues. The result of this form is that microbial plaque and food debris become lodged in the ging.sulcus.

Incorrect crown contour, the surfaces are too ‘bulbous’ for the adjacent soft tissues. The microbial plaque and food debris tend to accumulate under the pronounced contour.

The proper relation btw crown contour and the thickness of soft tissues. This results in a continuity of crown form & tissue form and creates a sulcus area less likely to accumulate microbial plaque and food debris. .

Too flat crown contour

Evaluation:

• Practicing grade • Wax carving examination • T. ident. examination

Function of Human Teeth

2. Pronunciation

3. Facial appearance

(mastication= the process of biting or chewing food)

Form is made by Function

Form & Function of our teeth are result of Evolution

Evolutionary patterns of Tooth:

In Shape;

All the teeth are the same in form and type

In Shape

Comprised of diff types,or classes of teeth to perform diff functions in the mastication process

In Set:

1.Monophyodont

There is only one set of teeth in their lifetime.

Beluga whale

In Set:

2.Diphyodont

Mammals usually have 2 sets of teeth

3.Polyphyodont

In Set:

The dentitions that have an endless succession of teeth

Alligator

3. Polyphyodont

The teeth of kangaroo,a rare example of a polyphyodont mammal

Polyphyodont (Multiple sets of teeth )

In its Attachment to the jaw:

Pleurodont Having the teeth attached by their sides to the inner side of the jaw

Acrodont

Attached on the top of the jaw bone without socket

Animals collectively: especially, the animal of a particular region or time

The American Heritage Dictionary

Thecodont

Tooth attachment where the tooth is set in the socket in the bone

mammals

How to

Identify

a tooth?.....

To identify a tooth:

1. Set trait (Primary or Permanent)

2. Class trait (I,C,P,M)

3.Arch trait (Mx or Md)

4.Type trait ลกัษณะเฉพาะของ แต่ละซ่ี (1st,2nd or 3rd)

5. Right or Left?

NOMENCLATURE

SET OF TEETH

SET NUMBER erupt shed

PRIMARY 20 ½ - 2½

6-12yrs

SECONDARY 32 6-18 yrs ?

PRIMARY T.

DECIDUOUS T.

MILKY T.

1.Permanent Dentition Each Q contains 8 teeth of differing type and function.

@2 Incisors are clostest to the midline,(cutting, and incising) @1 Canine,the 3rd tooth from the midline,(tearing, piercing and holding),also called Cuspid @2 Premolars,the 4th& 5th teeth from the midline, (tearing,holding& grinding),also called Bicuspid @3 Molars,they are termed 1st ,2nd, 3rd molars

Classification of Teeth:

central incisor lateral incisor caninee 1st premolar

3rd molar 2nd molar 1st molar

2nd premolar

1 1 2 2 3

molar premolar bicuspid

canine cuspid

central lateral

incisors

Classification of Teeth:

2.Deciduous Dentition Each Q contains 5 teeth of all of which have a function similar to permanent teeth

@2 Incisors,they are termed central& lateral incisors @1 Canine @2 Molars,they are termed 1st ,2ndmolar

CLASS OF TEETH TOOTH

ANTERIOR TEETH

ฟันตดั (Incisor) ฟันเขีย้ว (Canine, Cuspid)

POSTERIOR TEETH

ฟันกรามน้อย (Premolar, Bicuspid) ฟันกราม (Molar)

DENTAL FORMULA PERMANENT DENTITION

ICPM = 2123

PRIMARY DENTITION

ICM = 212

PRIMARY DENTITION

DENTAL FORMULA

PERMANENT DENTITION

DENTAL FORMULA

Dentition Periods: Man has 2 dentitions, but 3 periods of dentition:

1. Primary Dentition Period :the period which only deciduous teeth are present(6months-6yrs of age)

2.Mixed Dentition Period :the period which both deciduous and permanent teeth are present(6-12yrs)

3.Permanent Dentition Period : only permanent teeth are present (approx. 12 yrs through the rest of life)

DENTITION AGE

1. PRIMARY D. 6 MONTHS - 6YRS

2. MIXED D. 6-12 YEARS

3. PERMANENT D. 12 YEARS

Dentition Periods:

The natural process by which deci roots are”melted away”to allow for exfoliation,is termed

resorption

For a permanent tooth to erupt in to a space where a deciduous tooth is located,

the deciduous tooth must first be shed or exfoliated.

The permanent teeth

that replaced

exfoliated deci teeth in

the mouth are called

succedaneous teeth (means”succeeding”

deciduous teeth)

How many “succedaneous”

teeth are there in your

mouth?

The permanent T, which are

also“succedaneous” teeth include

incisors and canines (replace their deciduous

counterparts) , and premolars which replace

deciduous molars

The only permanent T, which are

not“succedaneous” are Molars

All“succedaneous” teeth

are permanent T,

All The permanent T are not succedaneous T

Teeth are arranged in 2 arches( upper & lower). The teeth in the U/- arch are termed maxillary. The teeth in the -/L arch are termed mandibular.

The imaginary vertical line which divides each arch is the midline (mid-sagittal plane)

The 2 portions of each arch divided by the midline are termed quadrants

There are 4 Q in the mouth as a whole:

Type trait:

Canine (Cuspid) Premolar

(Bicuspi

Lateral Central

ฟันกรามน้อยบนซ้ายซี่ที่หน่ึง

ฟันกรามแท้ล่างซ้ายซี่ที่สอง (Mandibular left permanent

2nd molar)

Mandibular right permanent lateral

incisor Maxillary right permanent third molar

(Maxillary left permanent1st

premolar)

ฟันเขีย้วนํา้นมล่างขวา

(Mandibular right deciduous canine)

Maxillary left deciduous canine Mandibular right deciduous 1st molar

ฟันกรามนํา้นมบนขวาซี่ที่สอง (Maxillary right deciduous 2nd molar)

Tooth Numbering Systems

In clinical practice, some “shorthand” of tooth notation is necessary for recording data. Several systems are in use around the world, but only a few are considered here.

PALMER’s system

INTERNATIONAL SYSTEM (TWO- DIGIT)

AMERICAN OR UNIVERSAL SYSTEM

(Numbering system)

The symbolic system is most often referred to as the Palmer notation system

A= central incisor B= lateral incisor C= canine D= 1st molar E= 2nd molar

the Palmer notation system

For the permanent dentition beginning with the central incisors, the teeth are numbered 1 through 8 in each Q.

8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8

However, because of difficulties with keyboard notation of the symbolic notation system, the ADA in 1968 officially recommended the “universal” numbering system.

The universal numbering system for the primary dentition uses uppercase letters for each of the primary teeth:

• For the maxillary teeth, beginning with the right 2nd molar, letters A through J, • For the mandibular teeth, letters K through T, from the left mandibular 2nd molar

In the universal notation system for the permanent dentition

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

32 31 30 29 28 27 26 25 24 23 22 21 20 19 18 17

• The maxillary teeth are numbered from 1 through 16, beginning with the right 3rd molar.

• Beginning with the mandibular left 3rd molar, the teeth are numbered 17 through 32.

Thus the right mandibular 3rd molar is #32

The universal numberring system is acceptable to computer language, whereas the Palmer notation is generally incompatible with computers and word processing systems. Each tooth in the universal system is designated with a unique number, which leads to less confusion than with the Palmer notation.

Two-digit system proposed by Federation Dentaire Internationale (FDI) has been adopted by the WHO and accepted by other organizations

For the permanent teeth:

Upper Right Upper Left

18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28

48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38

Lower Right Lower Left

Two-digit system

For the permanent teeth:

18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28

48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38

The 1st digit indicates the Q (1-4 for permanent), The 2nd digit indicates the tooth within a Q. (1-8 for permanent teeth,1-5 for primary teeth)

For the primary teeth:

55 54 53 52 51 61 62 63 64 65

85 84 83 82 81 71 72 73 74 75

5 indicates U/ Rt side, 6 indicates U/ Lt side, 7 indicates /L Lt side, 8 indicates /L Rt side

• ASH MM, Ramfjord S. Occlusion 4th.ed. Philadephia : Saunders, 1995

• Dawson PE. Evaluation,Diagnosis,and Treatment of Occlusal Problems. St.Louis : Mosby, 1974.

• Junge D. Oral Sensorimotor Function.Medico Dental Media Interntl Inc.1998

• Okeson JP. Management of Temporomandibular Disorders and Occlusion, 6th.ed. St Louis : Mosby year book,2008.

• Mc Neill C (ed.) Science and Practice of Occlusion. Chicago : Quintessence, 1997

• Mohl ND, Zarb GA, Carlsson G E, Rugh JA. A Textbook of Occlusion. Chicago: Quintessence, 1988.

• Rufenacht C R. Fundamental of Esthetics. Chicago : Quintessence, 1990.

• Smukler H. Equilibration in the Natural and Restored Dentition. Chicato: Quintessence, 1991.

Reference

Clinical Prof.Nattaya Asawaworaritelearning.dt.mahidol.ac.th/dtdocs/images/file/DTMS... · sides to...

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