College of Dentistry

Pedodontic I
Morphological Differences Between the
Primary and Permanent teeth
Dr. Hazem El Ajrami

 There are twenty primary teeth; a central

incisor, a lateral incisor, a canine, a first molar
and a second molar in each quadrant. These
teeth are exfoliated and replaced by the
permanent central and lateral incisors, canines
and first and second premolars.
Considerable morphological differences exist
between the primary and permanent teeth both
in size and color of the teeth and in their general
external and internal morphology.

I.

Size:
1. Primary teeth are smaller in all dimensions
than the corresponding permanent teeth.
2. The mesiodistal width of primary incisors
and canines is less than their permanent
successors, while the mesiodistal width of
primary molars is wider than their successors
(premolars).
3. The thickness of enamel and dentine in
primary teeth is approximately half its
thickness in permanent teeth. Therefore an
occlusal cavity must be shallower than in
permanent teeth to avoid pulp exposures.

II. Color:
The color of primary teeth is bluish white,
while that of permanent teeth ranges from
grayish white to yellowish white.
III. Crown:
1. The crowns of primary teeth are wider in
their mesiodistal diameter in relation to
their cervico-occlusal height than those of
permanent teeth. This gives the primary
anterior teeth a cup shaped appearance and
the primary molars a squat shape.

2. The crowns of primary molars are bulbous due

to their markedly constricted necks and
pronounced cervical ridges on the buccal aspect
especially in the first primary molar. This
bulbous shape and the pronounced cervical
bulge in primary molars make it difficult to
apply the matrix band. The constriction at the
neck calls for special care in the placement of
the gingival floor during cavity preparation.

3. The buccal and lingual surfaces of primary

molars, converge sharply toward the occlusal
surface, forming a narrow occlusal table.
This characteristic is especially evident in the
first primary molar, making the isthmus
portion of a Class II amalgam filling very
narrow and liable to fracture.
4. The buccal and lingual inclines in primary
molars are relatively flatter above the
cervical bulge than those in permanent
molars.

5. The enamel cap in primary teeth is thinner

and has nearly a constant depth throughout
the crown.
6. The enamel cap in primary molars ends
abruptly at the cementoenamel junction,

while in permanent teeth it tapers off to a

feather edge.

7. The enamel rods at the cervix slope occlusally

in primary teeth instead of being oriented
gingivally as in permanent teeth. This
characteristic does not necessitate beveling of
the gingival floor in Class II cavity
preparations in primary molars.
8. The interproximal contact between primary
molars is not a small round area as in
permanent molars, but tends to be a large
ellipsoid and flattened area.

IV. Roots:
1. The roots of the primary anterior teeth are
narrower mesiodistally than permanent
anterior teeth.
2. The roots of primary teeth are longer and
more slender in comparison to the crown
size than in permanent teeth.

3. The roots of primary molars flare out near

the cervix leaving no root trunk.
4. The roots of primary molars diverge as they
reach the apex to envelope the underlying
permanent teeth buds. Special care must be

employed in the extraction of primary molars

with unresorbed root to avoid the permanent
buds being removed at the same time.

Primary Tooth

Permanent Tooth

V.

Pulp:
1. The pulp outline follows the dentinoenamel
junction more closely in primary than in
permanent teeth.
2. The pulp horns are higher in primary
molars, especially the mesial pulp horn.
The pulp chambers are proportionately
larger than permanent teeth, hence there is
less tooth structure protecting the pulp in
primary teeth which requires special
attention when establishing the depth of
cavities in primary teeth.

3. The root canals of primary molars show

more lateral branching and apical
ramifications than permanent molars. This
characteristic makes it impossible to remove
all pulp tissue in the root canals during root
canal therapy.
4. The apical foramina in primary teeth are
relatively wider than in permanent teeth.

Thank You