Lecture 6

Part 1
The incisal and middle 1/3s and the distal height of contour are in the
middle of the crown.
1. The mesial cusp ridge here is high and adjacent with cusp tip.
2. The distal cusp ridge is lower than the mesial cusp ridge ; always
remember ,similarly to the maxillary canine ,the mesial cusp ridge is
shorter than the distal cusp ridge; this feature is important in telling
the surfaces of the tooth ,when you draw any canine from the labial
aspect ,when you see a cusp sloping ridge shorter than the other
,then the short sloping ridge is the mesial
part and the longer one is the distal part .
This is simply how we can tell the side of
the tooth, which is similar to the approach
that we follow, is maxillary canine.
3. The incisal outline is 1/4 to 1/5 IC height,
the part present in the cusp tip is around
1/4 -1/5 the crown height.
4. The mesial outline is straight while distal is
convex ,both converge slightly toward the
cervix.(as we go down in the root the tooth
should be converged ,it's not straight )

So incisors and canines are wider incisally than cervically. So the two,
distal and mesial, outlines they converge cervically. The mesial height of
contour is just below MI angle; the distal height of contour is between
incisal & middle thirds. Mesial height of contour is lower than the distal
height of contour, generally it’s between the incisal third and middle third
of this tooth.

5.This tooth also is similar to incisor and maxillary canine; it's formed
by the fusion of 3 separate lobes.
• the middle lobe represents the tip of the cusp and
• mesial lobe
• and distal lobe

6. Root is conical and it's blunted ;Mesial inclination from cervix to apex
,as we go from cervix to apex we find some mesial inclination ; the
crown appears tilted distally in relation to the root long axis ;if you
draw a line through the root it looks a bit inclined, not straight .

This tooth, mandibular canine, has the longest crown of all

teeth; it measures around 11mm from the top of the root to
the cervical line...Maxillary canine is also long but still shorter
.than mandibular
The cusp tip is less pointed than maxillary canine.
  From the lingual aspect :
1) The tooth has two marginal ridges, mesial and distal, and has
two fosse, mesiolingual and distolingual; this means that we have a
ridge that separated the two fosse ,this ridge is the LINGUAL RIDGE.
2) These two fosses are shallower than the maxillary
fosses which are deeper. This is something general, if
you remember we said that fosse in maxillary teeth are
deeper than fosse in mandibular teeth, even in incisors
the lingual fossa is deeper in maxillary incisor than
mandibular ones.
3) Pits or grooves are rare.
4) Root narrower lingually than labially ,from the
lingual side we can see the sides of the tooth, because the root is
slightly narrower lingually from labial ,it means a cross section of the
root will not be symmetrical ,the labial part will be
thicker than the lingual in this cross section.
5) Distinct longitudinal depressions on the root,
clearly evident in the picture. These extend down to
reach the cervical line or the proximal surfaces.
Sometimes we might have a CENTRAL CANAL in the root,
and probability of having a central canal in the root is also
30% similar to the probability of find it in a maxillary canine.
That's why any dentist working on a root canal treatment, he
/she have to remember that there is a possibility in 30% of the population
to have two canals.

 From the mesial aspect :

1. Cusp tip with long axis of the tooth, if we draw a line dissecting
the root in the middle this line passes through the tip of the cusp.

Remember this feature is not the same in maxillary canine ,if you
remember we said : the maxillary canine if we draw a line dissecting the
root ,this line will be lingual to the tip of the cusp (or the tip of the cusp
will be labially to that line );but in mandibular canine this line pass in the
tip of the cusp and some text books say that this line pass lingual to the
cusp(completely opposite) ,but in most of cases the tip of the cusp is
exactly in line with the labiolingual dissecting line.
2. The height of contours labially and lingually is almost at same
level located, near the cervix.
3. The root is very broad labiolingually and wider mesiodistally;
that's why if we make a cross section through the root it will not be
 circular, it will be prolonged, it has the labiolingual diameter longer
than the mesiodistal diameter.

 From the distal side: is similar to mesial.

 From the incisal side :

1. The mesial and distal halves are more nearly symmetrical ,this
means that the distal and mesial parts are almost equal ;
This is not similar to maxillary canine, you remember we said that the
mesial portion is thicker labiolingually than distal, and the mesial portion
is shorter mesiodistally than the distal portion; in other words tooth halves
are not identical, they are more identical in mandibular canine.
2. Less bulky appearance of the incisal edge ,
This means the incisal part of the tooth is almost thin, but in maxillary
canine the incisal part is thick.
3. Vertical lobe grooves are less marked
If you remember we said that we have labial grooves on maxillary canines
formed by the fusion of two lobes ,so that's why we have on the maxillary
canine LABIAL GROOVE and at the side of this labial groove we have two
depressions ,these depressions are shallower in mandibular canine, more
evident.

 Pulp is similar to maxillary canine.:

• Double convex lens shape
• Very narrow MD
• But wide labiolingually

This is a cross section of root canal .it is elongated and in case of having
two canals you will see two separates canals.

From slide 10-13 show the arch traits of canines... This is a summary of
what we've talked about … it's very important, read it and know it.

Canine relationship:
In the last lecture we talked about the incisal relationship, we said we
have Class I, class II and class III. And we discussed what we mean by
overjet and overbite.

We'll talk about the three classes of canine relationship: class I, class II
and class III.
** Remember something: the maxillary incisors are wider than
mandibular, for this reason you should imagine than mandibular teeth all
come under maxillary,
Look at the picture: we have maxillary incisor, wide; and the mandibular
incisor, more narrower, you can notice there's a space between the two
teeth while occluding .Because of that in any apposition of any teeth, the
mandibular will be more mesial than the same tooth in the maxilla, thus
forming a space; for example if you take the mandibular first premolar,
this should be more mesial than maxillary first premolar, why? because we
have a difference in the incisal teeth; because the incisal in the upper jaw
are wider than in the lower jaw, so all the posterior teeth will be nearer to
the middline than maxilla.

Because of this we have class I, class II Maxillary

and class III. canine
1) in class I relationship :
Notice that the mandibular canine is
located between the maxillary canine
and lateral incisor;
In other words: the set of the maxillary
canine is located between the
mandibular canine and the mandibular
first premolar.
Mandibular Canine
2) Now, if the tip on mandibular canine is located more
anterior to this position, it’s
class II.
3) If it's located more
posterior to this position, it’s
class III.

See here, for example, the tip of the

maxillary canine should be exactly
between the mandibular canine and
first premolar, but because it's
located more anterior to the original
position, we call it CLASS II.
If it was located more posterior, like
in the third picture, you can see the
tip of the canine is located posterior,
so it's CLASS III.
So simply, we actually can give the canine relationship based on the
location of the canine tip in relation to the mandibular teeth.

Morphology of Premolars (Lecture

6 pt2)

Introduction (slide 1):

• Now we talk about premolars. Premolars are the first teeth among the posterior
teeth, the anterior teeth are the incisors and canine, the premolars are posterior
teeth. They're also called cheek teeth. Premolars start to irrupt at the age of 10,
and end irrupting at the age of 12, the duration of time were premolars and canine
irrupt is called the second phase of mixed dentition, the first phase of mixed
dentition is actually indicated by the emergence or irruption of the first molar and
the incisors.

• Sometimes and in some text books we call premolars "bicuspids", but this term
is no longer used, why? Because it's possible that sometimes we
may have a premolar with three cusps! So a bicuspid is a
tooth with two cusps, and this situation is not appropriate cusps 2
because there's a possibility of having three cusps in one of the
premolars like the mandibular second premolar, so premolar is
actually a more appropriate term than bicuspid. What are the
class traits? How can we distinguish between premolars, canines
and molars? Simply, in premolars we should have at least two
cusps and we should have at most three cusps, molars on the
other hand should have at least three cusps. How can I
distinguish between one premolar with three cusps and
one molar with three cusps? Simply premolars should
have only one cusp buccully; it is impossible for any
premolar to have more than one buccal cusp. Molars should
have at least two cusps buccully. So count the number of cusps
buccully and count on it to distinguish! The premolar with two
cusps lingually is the mandibular second premolar. We have four
premolars, two upper and two lower, each of the two upper premolars has two
cusps and the two lower premolars, the first premolar has two cusps but the second
premolar may have two cusps lingually the chance of that is about "60%".
Landmarks related to posterior teeth (Slide2-6)
• Each cusp has four ridges; the mesial, the distant, the triangular and the
buccal ridges. For two cusp ridges on one side located at each corner of the
tooth, and joined by a continuous line; we call this an oblique ridge, but if cusp
ridges are located at the same side of the tooth, meaning at the distal or mesial
side, we call it a transverse groove. The developmental groove is any groove
that separates the major parts of the tooth which are the cusps and marginal
ridges. Grooves that do not separate major parts of the tooth are called
supplemental grooves. Central fossa is located in the center, but the fossae
located at the margins of the tooth are called triangular fossae.

• Now what are the arch traits of the maxillary premolars? If you take any
premolar and you wanted to know if it's upper or lower; There are 5 features to
differentiate between them:

o 1st of all in the maxillary arch the first and second premolars are
much more alike.

o In the 2nd feature notice that the maxillary premolar's two major
cusps are approximately equal in size and prominent, but in the
mandibular you can notice that one cusp (buccal) is big and the lingual is
small.

o 3rd is the buccolingual and mesiodistal diameters of the tooth. Look

at the tooth from the occlusal view and notice that the buccolingual line is
much bigger than the mesiodistal, the tooth is wider buccolingually than
mesiodistally, and this is for the maxillary premolars. In Mandibular
premolars, the buccolingual width is similar to the mesiodistal width, in
other words the maxillary premolar is almost rectangular but the
mandibular premolar is square or round.

o The 4th feature which is also important in the arch traits; we could
see a slight lingual intonation of the crown, meaning; see the mandibular
premolar, draw a line through the root, and draw a line through the crown,
notice that the line that bisects the root passes also through the crown,
but if you do the same here for this tooth; draw a line that passes through
the root it will actually not pass through the root cusp, in other words the
crown of the mandibular premolar appears to be lingually central; so we
have a slight lingual inclination of the crown in relation to the root for the
maxillary premolar but for the mandibular premolar the inclination is much
more prominent (‫)اوضح‬

o The 5th feature is the lingual high of contour; in Maxillary premolars

it is in the middle third (1\3) while in the mandibular premolars it is in the
occlusal third (1\3).
Refer to the picture below; notice the HOC on the lingual outline of the
maxillary, it is approximately in the middle of the outline but the
mandibular HOC is very close to the surface this is because of the
inclination of the crown.
 Maxillary Mandibular
premolar premolar

Maxillary 1st premolar (slide7-10)

• The Buccal aspect

o From the buccal aspect it is similar to that of the maxillary canine

but slightly smaller. To distinguish between the maxillary canine and
premolar we look at them from the lingual aspect where the maxillary
premolar has two cusps. Sometimes a procedure known as canination is
performed on the maxillary premolar that has its occlusal cusp defected;
the tooth is shaped into a canine as a preservation method to the tooth.

o It is also similar to the buccal aspect of the 2nd premolar but slightly
larger

o The tip of the buccal cusp is distally located to the mesiodistal (MD)
midline; if you draw a line through the roots it will not pass through the
 middle of the crown and that is because the buccal cusps has two sloping
ridges the mesial sloping ridge is longer and more straight that the distal
sloping ridge which is shorter and a bit convex

o Proximal outlines: The mesial outline starts concave then convexes

but the distal outline is convex

o Height of contour: The mesial HOC is just (slightly) occlusal to the

halfway point but the distal HOC is more occlusal to the halfway point. In
other words the distal HOC is higher than the mesial HOC which is the
exact opposite of the canine and incisal HOC’s

o There are also overhanging mesio-occlusal and disto-occlusal angles;

{ (to explain the meaning of overhanging) to those who have filings in
their teeth, some of those fillings are overhanging ( ‫زز زز زززز‬ ‫ )ززز ز‬and is
not in sync ( ‫ )زززززز‬with the contour of the tooth, which is due to a dental
error caused by a dentist,} so these overhanging angles are seen over the
root level (‫)خارجين عن مستوى الرووت‬. If you draw a line continuous from the
root outline you will find that these angles are overhanging.
So is basically a type trait i.e. in canines and the maxillary second
premolars they are not overhanging it’s only in the maxillary 1st premolar.

o A small part of the M margin of the L cusp can occasionally be seen;

this is because the buccal cusp is not centered exactly in the center of the
tooth

o From the buccal aspect we can see that the buccal cusp is formed
from three lobes fused together that is why we commonly see the buccal
ridge, the mesio-buccal, the disto-buccal depressions and the labial ridge

o The cervical line has a slight convexity towards the apex of the root

o The root is conical and similar to that of the canine but is smaller

• The Lingual aspect

o From the lingual aspect we can see that the root is much narrower
that’s why we can see the sides of the tooth, as in the mesial and distal
side.

o Regarding the crown the lingual cusp is much

smaller than the buccal cusp that’s why the entire
buccal outline is visible. Again this is a type trait (‫صفة‬
‫ )محددة‬i.e. you will not see this in the maxillary second
premolar

o The lingual cusp tip is smaller and is mesial to

the midline of the crown.

o What is the possibility of finding 2 roots in this

tooth (maxillary 1st premolar)? 90% of the cases leaving
only 10% for cases with 1 root. This is the opposite in
regard to the maxillary 2nd premolar where the possibility of having 2 roots
is 10% and the possibility of having 1 root is 90%.

o What is the possibility of having 2 roots for the mandibular

premolars? Its less than 1%

o As we have 2 roots of a different size, the 2 apices and the

interradicular groove are visible

Fin
Done by:
Sara Ibdiwi
Hadeel Jarrar &
Mohamed Harun B. Sanoh