Lesson 1

Permanent Maxillary Molars

● Non-succeedaneous teeth – no predecessor

● Differ in design from any of the anterior teeth

Permanent and premolar.
1st Maxillary Molars
● Together with mandibular molars, they perform
the major function of teeth, mastication of food

Permanent Maxillary Molars

Permanent Maxillary Molars
● Largest and strongest maxillary teeth
● Roots are shorter than premolars, but
molars presents 3 well-developed
● Crowns are shorter than premolars, but over all
roots.
dimension are greater.

● Have large crowns with four well-formed cusps. ● Root is broader at the base in all
directions and is trifurcated into 3 well-
● Outlines & curvatures of all max molars are similar developed roots.
 Maxillary First Molar Maxillary First Molars
● Usually emerge/erupt when child is 6 year old
● Largest tooth in the maxillary arch

– Deciduous teeth are still intact and functioning ● Crown is wider BL than MD (varies)

● Occlusally, crown is relatively shorter but broad MD and BL

– Facial bones develop downward and forward, ● Development rarely deviates from accepted normal.
providing sufficient space at age 6 yr. to
accommodate first molar.

Maxillary First Molars Maxillary First Molars

● Develops from four lobes; 2 buccal & 2 lingual ● Three well-developed, separated roots
– MB lobe , DB lobe , ML lobe , DL lobe ● (MB, DB, Lingual)
● Lingual root is the longest

● MB root not as long but broader

● 4 well-developed , functioning cusps
● DB root smallest
● (MLc, MBc, DLc, DBc)

● Supplemental cusp ● Arrangement and placement of roots gives

● (cusp or tubercle of Carabelli) tooth maximum anchorage
 Max. Left First Molar
Maxillary First Molar Buccal Aspect
crown is trapezoidal
-4 cusps visible:
First evidence of calcification At birth - Mesiobuccal cusp
- Distobuccal cusp
Enamel completed 3 to 4 years - Mesiolingual cusp
- Distolingual cusp
Eruption 6 years -3 roots visible:
- Mesiobuccal root
Root completed 9 to 10 years - Distobuccal root
- Lingual root

Max. Left First Molar Max. Left First Molar

Buccal Aspect Buccal Aspect
Mesiobuccal cusp:
- broader than DBc Buccal Dev’tal Groove
- MCR meets DCR at an –divides the two buccal cusps
obtuse angle -approx. equidistant between
MB & DB line angles
Distobuccal cusp:
- MCR meets DCR at - slants occlusoapically
approx right angle parallel to the long axis of DB
- more sharper, maybe root
as long or longer than - terminates in a pin-point
MBc depression (Buccal Dev’tal Pit)
Max. Left First Molar
Buccal Aspect Max. Left First Molar
Buccal Aspect
-CEJ generally convex
towards the roots -all 3 roots are visible ;
originate from a common root
-Mesial outline base (trunk)
* nearly straight
* MCA –approx at the
junc.of middle & occlusal -axes of roots inclined distally;
3rd. roots not straight
-Distal outline
*convex, surface is -buccal roots shows inclination
spheroidal halfway bet. bifucation area
*DCA – middle of middle and apices
3rd

Max. Left First Molar

Max. Left First Molar Lingual Aspect
Buccal Aspect
* Mesiolingual cusp:
-point of bifurcation is approx
4mm above cervical line - MD width is about 3/5 of the
(varies) MD width of the crown
- angle formed by mesial
-deep dev’tal groove/ outline and mesial slope is
depression on the root trunk almost 90°
terminates at CEJ extends - angle formed by MCR &
slightly onto enamel DCR is obtuse
*Distolingual cusp:
-roots are about twice as long
as the crown.
- spheroidal and smooth,
rounded, cusp ridges are
semicircular
-
Max. Left First Molar Max. Left First Molar
Lingual Aspect Lingual Aspect
Supplemental Cusp / 5th Cusp:
- Mesial outline is straight
- Distal outline is a smooth * Cusp or tubercle of Carabelli
curve * named from Austrian dentist,
Georg von Carabelli
- Lingual Dev’tal Groove: *attached to MLc; outlined by an
*between two lingual cusps irreg. groove- fifth cusp groove (FCG)
*start at the center MD *cusp ridges is approx. 2mm
*continues on to occlusal cervical from cusp ridges of MLc
surface

Max. Left First Molar Max. Left First Molar

Lingual Aspect Mesial Aspect
crown is trapezoidal,
-- all three roots are visible shortest of uneven is
occlusal
--lingualportion of root trunk is
continuous with entire cervical
portion of crown Cusps in sight are
MBc; MLc and 5th cusp
--largelingual root is conical,
terminates in bluntly rounded Lingual outline curves
apex outward; same with
buccal
-MB and DB roots outline and
apex are visible
-
 Max. Left First Molar
Max. Left First Molar Mesial Aspect
Mesial Aspect
Mesiobuccal root
-MLc is on a line with the long axis of *broad and flattened
lingual root
*exhibits smooth flutings for
-MBc and 5th cusp – tip is witihin part of its length
projected outline of the root base.
*width is approx 2/3 of crown
-MMR measurement BL at cervix
- * confluent with MB and ML cusp *
ridges
*level of bifurcation is a little
- * irregular, curves cervically about closer to CEJ
1/5 the crown length
- *may at time presents tubercles
*may partly or completely
hides DB root

Max. Left First Molar Max. Left First Molar

Mesial Aspect Distal Aspect

-crown is trapezoidal
Lingual root
*longer than MB root but -crown taper distally on the
narrower buccal surface
* extends lingually and is
banana in shaped -BL measurement of
* apex is rounded, however, crown mesially is greater than
it appears more pointed than distally
MB root.
-DMR dips sharply toward
Note: two bifurcation areas are cervix exposing more of the
visible, one more apical than triangular ridges, no tubercles
the other
 Max. Left First Molar
Distal Aspect Max. Right First Molar
Distal Aspect
-DLc and DBc are visible
-cusp tips within the confines
of the root trunk
MMR is more occlusal
-crown surface is convex DMR is more cervical,
exposing more of the
triangular ridges
-DB root is narrower than MB

-bifurcation is more apical,

approx. 5mm or more from
CEJ to bifurcation

Max. Right First Molar Max. Right First Molar

Occusal Aspect Occusal Aspect

crown outline is rhomboidal Four major cusps-

* 2 acute angles arranged accdg to size:
MB and DL 1. ML cusp is largest
* 2 obtuse angles 2. MB cusp
ML and DB 3. DL cusp
4. DB cusp
Crown is :
wider mesially than distally 5th cusp – considered as
wider lingually than secondary cusp
buccally
Max. Right First Molar Max. Right First Molar
Occusal Aspect Occusal Aspect

Only 3 major cusps are OCCLUSAL ANATOMY

considered primary cusp:
MLc; MBc; DBc
Cusp and Cusp Ridges
Triangular arrangement of 1. ML cusp: MCR, DCR
cusps reflect the outline of root 2. MB cusp: MCR, DCR
trunk.
MAXILLARY MOLAR 3. DL cusp: MCR , DCR
PRIMARY CUSP TRIANGLE 4. DB cusp: MCR, DCR

- DLc and 5th cusp considered

as secondary 5th cusp – considered as
secondary cusp

Max. Right First Molar Max. Right First Molar

Occusal Aspect Occusal Aspect

OOCLUSAL ANATOMY: OOCLUSAL ANATOMY:

Triangular Ridges: Ridges:

MBTR
DBTR MBTR + MTR of MLc =
DLTR Transverse ridge
ML cusp:
MTR of MLc DBTR + DTR of MLc =
DTR of MLc Oblique ridge
Marginal Ridges:
MMR ; DMR
 Max. Right First Molar Max. Right First Molar
Occusal Aspect Occusal Aspect

OCCLUSAL ANATOMY OCCLUSAL ANATOMY

-Fossae: -Grooves:
2 major fossae Major grooves:
central fossa – roughly triangular, CDG- central dev’tal g.
located mesial to the OR BDG- buccal dev’tal g.
LDG- lingual dev;’tal g.
distal fossa –roughly linear, DOG- distal oblique g.
located distal to the OR
Minor grooves:
2 minor fossae FCG- fifth cusp g.
MTF- immediately distal to MMR TGOR-transverse groove of the
DTF- immediately mesial to DMR oblique ridge
SG – stuart groove

Max. Right First Molar Max. Right First Molar

Occusal Aspect Occusal Aspect

-OCCLUSAL ANATOMY -OCCLUSAL ANATOMY

Pits Pits
central pit central pit
mesial pit mesial pit
distal pit distal pit
Max. Right First Molar
Occusal Aspect Maxillary Second Molar
SUMMARY OF HE
OCCLUSAL ANATOMY ● Supplement max first molar in function
CUSPS ● -shorter than max first molar cervico-
RIDGES
occlusally, narrower mesiodistally
CUSP RIDGES
MARGINAL RIDGES ● -DB cusp is not as large or as well-
TRIANGULAR RIDGES developed
TRANSEVRSE RIDGE
OBLIQUE RIDGE ● -DL cusp is smaller
FOSSAE
GROOVES
● No fifth cusp
PITS

Maxillary Second Molar

● has two types (occlusal):
– 1. resembles first molar – extreme
rhomboidal outline occlusally (most
common)
– 2. resembles 3rd molar – DL cusp poorly
developed , heart-shaped occlusally

● Roots are as long, if not longer than 1st molar