ORAL ANATOMY

Dental Anatomy
>Relationship of the teeth to each other by way of shape
>Development
>Morphology (Form/Shape)
>Function
>Identification of the teeth in human dentition

Landmarks
>Face
>Oral Cavity

Landmarks of the Face

 Ala of the Nose
>The wing of the nose or outer edge of the nostrils
 Nasolabial Groove
>Groove from the ala of the nose to the corner of the mouth
>Connects nose and lips
 Philtrum
>Shallow V-shaped depression between the bottom of the nose and
the middle of the upper lip
 Vermillion Border
>Where skin meets the vermillion zone and forms a line around the
lips
>Lip line
 Vermillion Zone
>The reddish portion of the lips
>Lips
 Tubercle of the Lip
>Small elevation at the middle of the upper lip
 Labial Commisure
>Angle of the mouth / Corners of the Mouth
  Labiomental Groove
>Between lips and chin
>Found below the lower lip
>Runs horizontally and it separates the lip from the chin

Landmarks of the Oral Cavity

 Oral Vestibule
>Also known as mucobuccal fold
>Pocket formed by the soft tissue of the cheeks and gingiva
 Vestibular Fornix
>Deepest point of the vestibule
>Forms a U-shaped pocket that is continuous through the anterior
and posterior area
 Mucosa
>Tissue that lines the inner surface of the cheeks and lips
>Labial Mucosa – inner surface of the lips
>Buccal Mucosa – inner surface of the cheeks
>Alveolar Mucosa – covers the alveolar bone that supports the teeth
 Frenum / Freni
>Raised lines of mucosal tissue that extend from the alveolar mucosa
through the vestibule to the labial and buccal mucosa
 Gingiva
>Dense, fibrous, highly vascularized connective tissue that surrounds
and protects the teeth
>Pinkish, firm, does not bleed easily
>Gingival pocket – 2mm
>Gingivitis – inflamed gingiva
>Periodontitis – gum disease
 Linea Alba
>Raised white line on the buccal mucosa that runs parallel to the
biting plane
Palatal Area of the Oral Cavity
 Hard Palate
>Anterior portion of the palate
>Bony plate covered with soft pinkish to brownish keratinized tissue
 Soft Palate
>Posterior portion of the palate
>Covers muscle tissue and is darker pink or yellowish
*Relevance of palates – making of dentures

Hard Palate Landmarks

 Incisive Papilla
>Raised area of soft tissue lying behind the incisors
 Palatine Raphe
>Separates left and right palate
>Slightly raised line that extends down the middle of the hard palate
>”Median Palatine Raphe” ; Significant in Surgery
>Behind the anterior teeth
 Palatine Rugae
>Ridges that run horizontally across the hard palate behind the
incisive papilla
 Torus
>Excessive bone formation or bone prominence
>Torus Palatinus
>Torus Mandibularis
>Can be surgically removed

Soft Palate Landmarks

 Uvula
>Projection that extends off the back of the soft palate
>2 uvulas = bifid uvula
  Anterior Tonsillar Pillars
>Soft tissue folds that extend horizontally from the uvula to the base
of the tongue
 Posterior Tonsillar Pillars
>Found at the back of the throat
 Palatine Tonsils
>Depressed area between 2 sets of pillars
>Marked with deep grooves and red and inflamed due to infection
>Clinical Conditions: Open palate and inflamed tonsils
 Fauces
>Space in the back of the oral cavity where food passes into pharynx
>Bounded superiorly by the soft palate
>Bounded laterally by the palatoglossal arches
>Bounded inferiorly by the tongue
 Tongue
>Main organ for the sense of taste
>Clinical Conditions: Strawberry tongue, geographical tongue, hairy
tongue, ankyloglossia
 Papilla
>Small raised projections where taste buds are located
 Tastebuds
>Taste receptors
>Located at the dorsum of the tongue
>Bitter (posterior), sweet (anterior), salty, sour

Landmarks of the Tongue

 Sulcus Terminalis
>Shallow, V-shaped groove
>Posterior portion of the tongue
 Circumvallate Papillae
>Largest papilla (wall shaped)
>Located anterior to the sulcus terminalis (bitter taste)
  Filiform Papillae
>Hair-like projections
>Covers dorsal side of the tongue
>Anterior to the circumvallate papillae
 Fungiform Papillae
>Mushroom-like papillae that give the tongue the strawberry effect
 Foliate Papillae
>Slight elevation near the base of the tongue
 Median Sulcus
>Line of division or groove that runs from the base to the tip of the
tongue

Floor of the Mouth

 Sublingual Caruncles
>2 raised small folds of tissue attached to the lingual frenum and
floor of the mouth
 Fimbrinted Folds
>Folds of tissue lateral to lingual veins
 Sublingual Folds
>Run backwards to the base of the tongue
 Sublingual Sulcus
>Horseshoe shaped groove
>Follows the curve of the dental arch

The Dentition

Types of Teeth
 Primary Teeth
>Deciduous Teeth
>Temporary Teeth
>Milk Teeth
>Baby Teeth
  Permanent Teeth
>Secondary Teeth
>Succedaneous Teeth
 Natal Teeth
>Present at birth
 Neonatal Teeth
>Present within the first 30 days after birth

Some Diseases of the Teeth

 Cellulitis due to carious teeth
 Misaligned teeth
 Tooth Discoloration

Functions of the Primary Teeth

 Help provide nutrition
 Help make speech possible
 Aid in the normal development of the jaw bones and facial muscles
 Add to an attractive appearance
 Reserve space for the permanent teeth and help guide them into position
(mesiodistal width)

Functions of the Teeth

 Mastication
 Speech
 Esthetics

Types of Teeth and their Functions

 Incisors
>To cut food
>For Speech
>Supports the face and the lips and maintains esthetic appearance
  Canines
>To support the lips and facial muscles
>To cut, pierce or shear / tear food morsels
>Contributes to a person’s appearance
 Premolars
>Chewing or mastication
>Maintains the vertical dimension of the face
>Assist the canines in shearing or cutting food morsels
>Support the corners of the mouth and cheeks
 Molars
>Chewing or mastication
>Maintains the vertical dimension of the face
>Important in maintaining continuity within the dental arches

Anatomical Differences between Deciduous and Permanent Teeth

 M-D diameter of the crowns of primary teeth are wider compared to their
crown length than secondary teeth
 Roots of primary anterior teeth are narrower and longer in relation to their
crowns than the permanent teeth
 The roots of the primary molars and longer and more slender and flare
more
 The cervical ridges of deciduous teeth are more pronounced
 The cervical portions of the crowns and roots of primary molars are more
slender mesiodistally
 The buccal and lingual surfaces of primary molars are flatter above the
cervical curvatures which narrows the occlusal table
 Primary teeth are whiter in appearance

Deciduous Tooth Eruption (Months) Exfoliation (Years) Maxillary Order

Central Incisor 6-10 6-7 #1
Lateral Incisor 9-12 7-8 #2
Canine 16-22 10-12 #4
1st Molar 12-18 9-11 #3
2nd Molar 24-32 10-12 #5
Deciduous Tooth Eruption (Months) Exfoliation (Years) Mandibular Order
Central Incisor 6-10 6-7 #1
Lateral Incisor 7-10 7-8 #2
Canine 16-22 9-12 #4
1st Molar 12-18 9-11 #3
2nd Molar 20-32 10-12 #5

Permanent Teeth Eruption (Years) Maxillary Order

Central Incisor 7-8 #2
Lateral Incisor 8-9 #3
Canine 11-12 #6
st
1 Premolar 10-11 #4
2nd Premolar 11-12 #5
1st Molar 6-7 #1
2nd Molar 12-13 #7
3rd Molar 17-21 #8

Permanent Teeth Eruption (Years) Maxillary Order

Central Incisor 6-7 #2
Lateral Incisor 7-8 #3
Canine 9-10 #4
st
1 Premolar 10-11 #5
2nd Premolar 11-12 #6
1st Molar 6-7 #1
2nd Molar 11-13 #7
3rd Molar 17-21 #8
Tooth Notation Systems
1. Palmer Notation System
2. Universal Notation System
3. FDI System (Federation Dentaire Internationale)

Quadrants
 Tooth-bearing region of the jaw
 Can be divided into 4 quadrants
>Right Maxillary (1 or 5)
>Left Maxillary (2 or 6)
>Left Mandibular (3 or 7)
>Right Mandibular (4 or 8)

Deciduous (20 teeth) Permanent (32 teeth)

5 6 1 2

8 7 4 3

Palmer Notation System

 Old name: Symbolic System
 Introduced by Adolph Zsigmondy of Vienna in 1861
 Originally for permanent dentition
 Modified for the primary dentition in 1874
 Commonly referred to as the Palmer Notation System or Zsigmondy System
 Deciduous Teeth Permanent Teeth
EDCBA ABCDE 87654321 12345678

EDCBA ABCDE 87654321 12345678

Universal Notation System
 ADA officially recommended the system in 1968
 Utilizes upper case letters for primary dentition
 Maxillary teeth are numbered through 1 to 16
 Mandibular teeth are numbered through 17 to 32
 Uses “#” sign
 Deciduous Teeth Permanent Teeth
ABCDE FGHIJ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

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

FDI System (Federation Dentaire Internationale)

 2 digit system that has been adopted by WHO and also IADR
 The 1st digit indicates the quadrant
>1st digit = 1 to 4 = Permanent
>1st digit = 5 to 8 = Deciduous
 The 2nd digit indicates the tooth within the quadrant
>2nd digit = 1 to 8 = Permanent
>2nd digit = 1 to 5 = Deciduous
 Deciduous Teeth

55 54 53 52 51 61 62 63 64 65

85 84 83 82 81 71 72 73 74 75

 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
Tooth Surfaces
 Proximal
>A tooth has 2 proximal surfaces
>Mesial – proximal surface closest to the midline of the arch
>Distal – proximal surface farthest from the midline of the arch
 Facial
>Surface of a tooth that faces towards the lips or cheeks
 Labial
>Surface of an anterior tooth that faces towards the lips
 Buccal
>Surface of a posterior tooth that faces towards the cheek
 Lingual
>Surface of a tooth facing toward the tongue
 Incisal
>Surface towards the cutting edge of an anterior tooth
 Occlusal
>Towards the chewing surface of a posterior tooth
 Long Axis and Axial Surface
>The long axis of the tooth is an imaginary line that goes through the
crown and root around which the substance of a tooth is most
symmetrically distributed

Divisions into Thirds, Line Angles and Point Angles

Horizontal Division Longitudinal Division

>Cervical 3rd >Facial 3rd
>Middle 3rd >Middle 3rd
>Occlusal 3rd >Lingual 3rd
>Incisal 3rd >Mesial 3rd
>Middle 3rd
>Distal 3rd
Line Angles
 Formed by the junction of two surfaces and derives its name from the
combination of two surfaces that join

Line Angles of Anterior Teeth

>Labioincisal >Linguoincisal
>Mesiolingual >Distolingual
>Mesiolabial >Distolabial

Line Angles of Posterior Teeth

>Mesioocclusal >Linguoocclusal
>Mesiolingual >Distolingual
>Mesiobuccal >Distobuccal
>Buccoocclusal >Distoocclusal

Point Angles
 Formed by the junction of three surfaces

Point Angles of Anterior Teeth

>Mesiolabioincisal >Distolabioincisal
>Mesiolinguoincisal >Distolinguoincisal

Point Angles of Posterior Teeth

>Mesiolinguoocclusal >Distolinguoocclusal
>Mesiobuccoocclusal >Distobuccoocclusal

Distinctive Crown Convexities and Concavities

 Lobe
>One of the primary anatomical divisions of a crown
>Mesial, distal, labial, lingual lobes
>Distobuccal, messiobuccal, distolingual, mesiolingual lobes
 Mamelons
>Small, rounded projections of enamel from the incisal edges of
newly erupted anterior teeth
>Disappear due to abrasion or grinding
 Cingulum
>A convex mount of enamel localized to the cervical 1/3 of the crown
>Found on the lingual aspect of an anterior tooth
 Cusp
>Pointed or rounded elevation of enamel found on cuspids and on
the chewing surfaces of bicuspids and molars
 Marginal Ridge
>Is a linear, rounded border of enamel that forms the mesial and
distal borders of occlusal surfaces on posterior tooth
 Lingual Ridge
>The ridge of enamel that extends from the cingulum to the cusp tip
on the lingual surface of most cuspids
 Cusp Ridge
>Each cusp has four cusp ridges radiating from the tip
>They are named according to the direction they take away from the
cusp tip (mesial, distal, facial or lingual)
>MBCR, DBCR, DLCR, MLCR
 Cusp Inclines / inclined Plane
>Is the sloping area found on the cusp ridges
 Oblique Ridge
>Consists of a union between the triangular ridge of the distobuccal
cusp and the distal cusp ridge of the mesiolingual cusp
>Seen in maxillary 1st and 2nd molars
 Transverse Ridge
>is the union of a buccal and lingual triangular ridge that crosses the
surface of a posterior tooth transversely
>Seen in mandibular premolars
 Lingual Fossa
>Is an irregular, rounded concavity bound by the mesial marginal
ridge, distal marginal ridge, cingulum and mesial edge of the lingual surface
of an incisor tooth
 Triangular Fossa
>Are located adjacent to marginal ridges on the occlusal surfaces of
posterior teeth
 Central Fossa
>Is a centrally located depression or concavity found on the occlusal
surface of molars and mandibular second bicuspids
>Found on occlusal surface of molars
 Sulcus
>Is an elongated valley or depression in the surface of a tooth formed
by the inclines of adjacent cusps / ridges
 Developmental Groove
>Is the junction line between the inclined walls of a sulcus
>Represent lines of union between lobes of the crown during its
formation
>These grooves appear on labial, occlusal, buccal and lingual surfaces
and are least apparent on the labial aspect of anterior teeth
 Supplemental Groove
>Minor, auxiliary groove that branches off from a much more
prominent developmental groove
 Fissure
>A linear fault that sometimes occurs in a developmental groove
>Represents a lack of union between the inclined walls of a sulcus
 Pit
>A small, pinpoint fault on the surface of a tooth
>Usually found at the end of a developmental groove or at a place
where two fissures intersect
Fundamental Curvatures

 Proximal Contact Areas

>Positive relation of one tooth with another is established mesially
and distally when the teeth are erupted
>Importance:
>Serves to keep food from packing between teeth
>Helps stabilize the dental arch
 Interproximal Spaces
>Triangular spaces between the teeth
>Filled by gingival papilla
 Embrassures
>Spillways
>Curvatures adjacent to the contact areas
>Functions:
>Provide spillway for food during mastication
>Prevents food from being forced through the contact area
 Labial and Buccal Contours at the Cervical 3rds of the Crown
 Curvatures of the Cervical Lines
 Contours at the middle 3rds of the crowns
Tooth Tissues
Parts of a Tooth

 Crown
>Topmost part of the tooth
>Anatomical – Part of the tooth that is covered with enamel
>Clinical – Exposed in the oral cavity
 Root
>Bottom half of the tooth
>Anatomical – Part of tooth that is covered in cementum
>Clinical – Exposed in the oral cavity
 Enamel
>Hardest of the parts of the tooth and also the hardest of all the
tissues of the human body
>Protective tooth structure that covers the exposed part of a tooth,
the crown
>96% inorganic , 4% organic substance
 Dentin
>Gives the teeth the yellowish colour
>Tissue below the tooth enamel that forms the main mass of a tooth
>Supports the tooth enamel and absorbs the pressure of eating
>Has the ability to restore itself
>Reparative / Secondary Dentin
>CaOH (Calcium Hydroxide)
>Response to carious lesions
>Coronal Dentin (Crown)
>Radicular Dentin (Root)
 Cementum
>Part of tooth anatomy that covers the dentin outside of the root
and is attached to the bone of the jaw with little elastic fibers
>Hard as bone but not as hard as the dentin nor enamel
 Pulp
>Soft connective tissue containing nerves and blood vessels that
nourish the tooth
>Most internal structure of a tooth, surrounded by dentin
>Found in the soft center of the tooth, inside the pulp chamber and
the root canal
>Has blood vessels
>Large in young children
>Constricts as you grow older
>Coronal Pulp
>Radicular Pulp
Supporting Structures of the Teeth
 Collectively called periodontium
 Periodontium consists of:
>Alveolar Process
>Periodontal Ligament
>Cementum
>Gingiva

Alveolar Process

 Portion of the maxillae or mandible in which the roots of the teeth are
embedded and by which the tooth roots are supported
 Consists of 3 kinds of bones:
>Outer Cortical Plate
>Is a compact layer of bone on the bones surface
>Lamina Dura
>Thin, dense layer of bone that lines tooth sockets
>Spongy Bone
>Less dense, cancellous bone representing the alveolar process
central mass

Periodontal Ligament

 Thin, fibrous ligament connecting a tooth to the lamina dura of the bony
socket
 Fibers act as a shock absorber to cushion the force of chewing impacts

Cementum

 Considered as both a basic part of the teeth and a component of the

periodontium
 A thin, calcified layer of tissue that completely covers the dentin of a
tooth’s root
 Formed during the development of the root
 Functions as an area of attachment for periodontal ligament fibers
Gingiva

 Specialized mucous membrane covering the alveolar processes and

encircling the necks of the teeth
 Aids in the support of the teeth and protects the alveolar process and
periodontal ligament from bacterial invasion
 Healthy gingiva is pale pink, firm and resilient
 2 types of gingiva: Free and Attached Gingiva

Free Gingiva

 “Free” to the extent that it can be displaced

 Not tightly bound to anything underneath it
 Extends from the gingival crest to the bottom of the gingival sulcus
 At the bottom of the sulcus, an epithelial attachment joins the free gingiva
to the tooth surface
 Interdental Papilla fills the proximal space below the contact area of
adjacent teeth
 Function: To help prevent food from packing between the teeth

Attached Gingiva

 Covers the labial cortical plate of the alveolar process

 Firmly fixed to underlying bone