Dental Anatomy 6540 6543 Manual 2011

DENTAL ANATOMY
Course Manuals

LECTURE 6540 and LABORATORY 6543

Charles J. Arcoria, D.D.S., M.B.A.
Course Director

Burt Bryan, D.D.S.
Course Co-Director

Fall 2011

Department of Restorative Sciences
1

Acknowledgments

Past Contributors

Dr. Paul E. Krupp
Dr. Damon W. Spencer
Dr. Frederick A. Shaw III
Dr. Everett Payne
Dr. Robert S. Staffanou
Dr. C. Larry Cloetta
Dr. Clarence Y. Murph

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DENTAL ANATOMY COURSES 6540 and 6543

6540 DENTAL ANATOMY Course Description:
The study of the form and function of the human primary and permanent
dentitions including but not limited to the nomenclature and development of each.
Emphasis is placed on the similarities and differences of each tooth in the human
primary and permanent dentitions.

6540 DENTAL ANATOMY Course Objective:
Students will learn to fully understand and describe the nomenclature of both
the human primary and permanent dentitions as well as describe the structural and
morphological similarities and differences of each tooth comprising the dentitions.

6543 DENTAL ANATOMY-C Course Description:
Laboratory hands-on application and creation in wax of the morphological
characteristics of each category of tooth in the human permanent dentition.

6543 DENTAL ANATOMY-C Course Objective:
By applying learned principles, students will associate and learn to create in wax
the morphological features characteristic to each tooth of the human permanent
dentition. Emphasis is given to the student developing individual skills as they correlate
the dimensional relationships of each tooths morphological features with their manual
dexterity in a progressive series of procedures.

Learning Materials

1. Textbook: Wheelers Dental Anatomy, Physiology, and Occlusion; Major M.
Ash, Jr., BS, DDS, MS, MD and Stanley J. Nelson, DDS, MS 8
th
Edition (2003)

2. Dental Anatomy Manual for Lecture & Laboratory Courses 6540 and 6543,
Department of Restorative Sciences, Baylor College of Dentistry, TAMUHSC;
2007

3. Atlas of the Human Dentition; Charles J. Goodacre, DDS, MSD; 2
nd
edition (2003)

4. Brown & Herbransons Dental Anatomy & Interactive 3-D Tooth Atlas; Version 6.0
Paul Brown, DDS, FICD, FACD; Stanford University Medical Center National
Biocomputation Center

5. Typodont anatomical model of the permanent dentition

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Course Competencies

2.2 Use, assess and integrate into practice new techniques, materials and other
findings applicable to dental practice.

2.3 Communicate professional knowledge to colleagues and patients.

4.2 Perform a physical intraoral and extraoral examination of the patient including
assessment of vital signs, radiological examination and supporting diagnostic
aids and laboratory tests.

5.4 Identify the presence and extent of diseases of the teeth and supporting
structures

5.5 Recognize and identify conditions that adversely affect the patients masticatory
functions

Course Director
Dr. Charles J. Arcoria
Associate Professor, Department of Restorative Sciences
Interim Director, Office of Continuing Education & Alumni Services
Baylor College of Dentistry
Office: Room 732-1
Office for appointments with students: Room 732-1 (please e-mail Dr. Arcoria first to schedule a time)
carcoria@bcd.tamhsc.edu
(817) 680-0239 (cell phone and voicemail)
**Dr. Arcoria has an iPhone device and is always easily reachable by e-mail or a text

IMPORTANT NOTE: Access to Information from the Course Director to D-1 Students.

A web-site has been constructed that will be used as a storehouse of files for students
throughout the semester (this is a separate location from the Colleges Public Share files,
which are typically deleted after a few days). Students should access this web-site for the
following instructional information:

1. Condensed waxing instructional videos
2. PowerPoint lecture presentation files
3. Tutorial preparation sessions for examinations
4. Various lecture or laboratory audio or video presentations
5. Preparation for taking and passing the National Board Examination

Please make a note of the web-site location (you can access this from off campus locations):

http://www.carcoria.com/bcd-d1-da-2011/dental-anatomy-2011.htm
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6540 LECTURE - Fall Semester 2011
There are four (4) examinations, including a cumulative final examination. Lecture attendance will be documented with a sign-in
sheet. Examinations are equally weighted at 24% each. Attendance is weighted at a total of 4%, meaning that if a student attends
all lectures, they will receive a 100 on the attendance weight. If a student misses 1 or more lectures, they will receive a 0 on
the attendance weight.

Lecture Exam #1 score = ____________ x .24 (weight) = _____________
Final Examination score = ___________ x .24 (weight) = _____________
Attendance score = _____________ x .04 (weight) = ______________
Final Lecture Grade = ________________

6543 LABORATORY - Fall Semester 2011
Two (2) exercises weighted at 0.5% each and twelve (12) projects that are weighted at 3% each, eleven of them waxing projects
evaluated as either pass (acceptable) or fail (unacceptable). If a student receives a passing grade from their instructor, at the end of
the appropriate laboratory period or when the project is due, they will receive full credit (grade of 100). If the student receives a
failing grade from the instructor, or if the student does not finish the project (and does not have an official excused absence), the
student will be given 1 week to finish the project (under the supervision of the Course Director) to receive a grade of 70. If the
student does not finish the project within the 1-week time frame, or make up the project because of an official excused absence, the
student will receive a grade 0 on the exercise. There are seven (7) practical examinations that are weighted at 9% each, graded on
a scale of 0 - 100. Four of the seven practical examinations involve waxing a tooth.

Project #1 (#26 cut) score = ______ x .03 (weight) = _____




Project #6 (#10 typo) score = ______ x .03 (weight) = _____




Project #10 (#14 typo) score = _____ x .03 (weight) = _____



Total Project weights = __________

Project #5a (drawings) score =_____ x .015 (weight) = ____

Project #5b (#29 typo) score =_____ x .015 (weight) = ____
Total special project weights = _________

Exercise #1 (intro) score = _____ x .005 (weight) = ____

Exercise #2 (stone) score = _____ x .005 (weight) = ____

Total exercise weights = _________

Practical #1 (Morpho) score = _____ x .09 (weight) = _____

Practical #2 (#9 typo) score = _____ x .09 (weight) = _____


Practical #4 (contours) score = _____ x .09 (weight) = _____



Practical #7 (Tooth ID) score = _____ x .09 (weight) = _____

Total Practical weights = ___________

Final Laboratory Grade (add all 4 weights) = ________________
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Evaluation (Tests & Quizzes)

A. Conversation compromises test security during examinations. Accordingly, no talking is permitted
during exams. No test questions will be interpreted on an individual basis. Any student who approaches
an instructor during a test will be expected to turn in their exam.

B. Examinations will be administered in the laboratory, to allow for sufficient time to complete an
examination. Examinations are typically 40 questions. Examination time is from 8:00 am to 8:58 pm.
The laboratory will begin promptly at 9:05 am. Students will sit in their assigned seats in the laboratory
for the examination.

C. All books, notes, backpacks, purses and all other accessories including hats are to be left in the aisles
during examinations.

D. Students are not allowed to enter or exit the laboratory once an examination begins.

E. Only students with excused absences approved by the Office of Student Services will be permitted to take
make-up exams or remediate missed lecture or laboratory sessions.

F. Under no circumstances shall an examination be taken from the testing area.

G. Under no circumstances shall a student submit for evaluation examinations or laboratory projects that are
not their own work.

H. Cheating on examination or laboratory projects will not be tolerated. Expulsion will be the
recommended punishment.

I. Stereo headphones are permitted during laboratory sessions. Due to variations in musical preferences,
please leave the boombox at home.

J. Under no circumstances shall a student sign the attendance record for another student.

K. Students cannot receive input from faculty or other students during a practical examination.

L. Students must be prepared to leave the laboratory at the time a practical examination is scheduled for
completion. Once instructed to do so, failure to leave the laboratory at the appointed time may result in a
penalty being assessed on the grade for that practical examination. Students should not return to the lab
before the grading is completed.

M. Students must not handle or have in their possession the work of another student without permission of
the owner.

N. Students will not be allowed to take lecture examinations, nor complete laboratory projects or practical
examinations early due to personal plans, commitments or circumstances.
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Attendance

Please sit in your assigned seat at every lecture. Those students who sit elsewhere will be marked
absent when the attendance is recorded. Attendance at lectures and laboratory sessions is mandatory. The
lecture is intended to be a valuable learning experience where viewing the visual aids is important. The
laboratory will start and finish required projects each day, so attendance is mandatory in order to avoid
lagging behind the rest of the class.

Students entering the lecture hall after the lecture has begun but prior to 8:10 a.m. may be seated in
the rear of the classroom in order to sign the attendance sheet once it is circulated to them. Students who
arrive for class after 8:10 a.m. will be marked absent for that day.

Those students who faithfully attend every lecture (i.e., students must initial and date next to their
name for each lecture) will receive a score of 100 on the weighted 4% portion for the lecture course.

Any student who misses four (4) or more lectures or laboratory sessions combined may have four (4)
points subtracted from their final lecture grade average as a penalty.

Excused absences will require remediation. Only absences that are excused through Ms. Moira Allen
in the Office of Student Services will be eligible for remediation. A four page typed, double-spaced paper on
an appropriate subject chosen by the course director may serve as remediation for a missed lecture.

An additional waxing assignment as determined by the course director will serve as remediation for
an excused absence from a laboratory session.

Our primary goal is to make this course a valuable and interesting learning experience for every
student. If we can make a significant contribution to your professional development and professional
satisfaction we will be gratified. Your attendance and participation is essential to your success.

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REMEDIATION POLICY 6540 AND 6543

All remediation for Dental Anatomy 6540 and 6543 must be completed during the summer following
the semester of deficiency. If remediation for a section of either course is indicated and the student fails to
accomplish the remediation requirements, the student will be required to make provisions to repeat the
course the following fall semester.

The nature of the remediation will be customized to the individual students greatest need.

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DENTAL ANATOMY SCHEDULE
D-1 STUDENTS
FALL SEMESTER - 2011

Monday, August 15
Lecture: Introduction to Dental Anatomy Dr. Arcoria

Lab: 1. Intra-oral exam 9:00 a.m. - 10:00 a.m. non-graded experience
2. Exercise #1 Intro to Waxing from 10:00 a.m. 11:50 a.m.
Have your Instructor review Exercise #1 by 11:50 a.m. for Pass/Fail grade.

Assignment: Read Wheeler, Chapter 1 in preparation for the next lecture.

Wednesday, August 17
Lecture: Nomenclature - Part I Dr. Arcoria

Lab: 1. Begin Project #1 (PJ-01) Tooth #26 Cut-away tooth.
Turn in at 11:50 a.m., finish next laboratory.


Monday, August 22
Lecture: Nomenclature - Part II Dr. Arcoria

Lab: 1. Complete Project #1 (PJ-01) Tooth #26 Cut-away
Finish by 11:50 a.m.
2. Begin Exercise #2 Stone casts.
. This group project is due at 9:00 a.m. on Wednesday, August 31


Lecture: The Development of Teeth - Part I Dr. Bryan

Lab: 1. Begin Project #2 (PJ-02) Tooth #12 Cut-away turn in at 11:30 am
2. Discuss Anatomical Features & Drawing Project (PJ-05) 11:30 11:50 am
(PowerPoint Exercise from 11:30 a.m. 11:50 a.m.) due on Wednesday,
September 14

Assignment: Read Wheeler, Chapter 2 continued for the next lecture.

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Monday, August 29
Lecture: The Development of Teeth - Part II Dr. Bryan

Lab: 1. Finish Project #2 (PJ-02) Tooth #12 Cut-away
Complete by 11:30 am.
2. At 11:30 am, review Morphological Characteristics Exercise in preparation
for Morphological Characteristics Practical (PC-01) on Wednesday,
September 7 from 11:10 am 12:00 noon

Assignment: Complete stone casts exercise for Wednesday, August 31

Lecture: Developmental Morphology Dr. Arcoria

Lab: 1. Complete Exercise #2 - Stone casts due at 9:00 a.m.
2. Begin Project #3 (PJ-03) Tooth #20 Cut-away

Assignment: Read Wheeler Chapter 5, in preparation for the next lecture.

Monday, September 5
Labor Day Holiday

Wednesday, September 7
Lecture: Physiologic Tooth Form Dr. Bryan

Lab: 1. Finish Project #3 (PJ-03) Tooth #20 - Cut-away
Complete by 11:00 a.m.
2. Practical #1 (PC-1) Morphological Characteristics Practical
(PowerPoint Practical Examination from 11:10 a.m. 12:00 noon)

Assignment: Study for Exam #1 including all notes and reading assignments.

Monday, September 12
Lecture: Lecture Exam #1 (covers lectures from August 15 September 7)

Lab: 1. Project #4 (PJ-04) Tooth #19 Cut-away
Turn in at 11:50 a.m.


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Lecture: Lobe Forms and Geometric Concepts Dr. Bryan

Lab: 1. Turn in at 9:00 a.m. Project #5a (PJ-05a) Anatomical Features & Drawing
Exercise
2. Finish Project #4 (PJ-04) Tooth #19 Cut-away
Complete by 11:50 a.m. Have typodonts available for next laboratory.


Lecture: Primary Dentition Part I Dr. York

Lab: 1. Begin Project #6 (PJ-06) Tooth #10 - Full crown wax-up
Turn in at 11:50 a.m., finish next laboratory

Assignment: Wheeler, Chapter 3 continued for the next lecture.

Lecture: Primary Dentition - Part II Dr. York

Lab: 1. Complete Project #6 (PJ-06) Tooth #10 - Full crown wax-up

Assignment: Wheeler, Chapter 4 and 5 continued for the next lecture.

Lecture: Dental Anomalies Dr. Arcoria

Lab: 1. Begin Practical #2 (PC-02) Tooth #9 - Full crown wax-up


Lecture: Permanent Maxillary Incisors Dr. York

Lab: 1. Complete Practical #2 (PC-02) Tooth #9 - Full crown wax-up
Complete and turn in at 11:00 a.m.


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Monday, October 3
Lecture: Permanent Mandibular Incisors Dr. York



Wednesday, October 5
Lecture: Permanent Canines Dr. Bryan



Monday, October 10
Lecture: Permanent Maxillary First Premolars Dr. Arcoria



Lecture: Permanent Maxillary Second Premolars Dr. Arcoria

Lab: 1. Review Contours & Embrasures Exercise to prepare for Practical #4
2. Complete Project #8 (PJ-08) Tooth #12 Complete wax-up by 11:50 am

Assignment: Study for Exam #2 including all notes and reading assignments.

Monday, October 17
Lecture: Lecture Examination #2 (covers lectures from September 14- October 12)



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Lecture: Permanent Mandibular First Premolars Dr. Arcoria



Monday, October 24
Lecture: Permanent Mandibular Second Premolars Dr. Arcoria

Lab: 1. Practical #4 (PC-04) at 9:00 am Contours & Embrasures Powerpoint
2. Project #5b (PJ-05b) - Tooth #29 Full wax-up in one lab
Complete and turn in at 11:50 a.m. (only one lab for this project)

Assignment: Read Wheeler, Chapter 11 in preparation for the next lecture

Lecture: Permanent Maxillary First Molar - Part I Dr. Arcoria

Lab: 1. Project #9 (PJ-09) Tooth #13 - Full crown wax-up
Complete by 9:00 a.m. on Dec 9 To work on outside class
2. Review placement of die lube on #13 & #14 from 9:00 to 9:15 am
3. Begin Project #10 (PJ-10) - Tooth #14 - Full crown wax-up
Note: #13 & #14 will be cast in Dental Materials in the spring


Monday, October 31

Lecture: Permanent Maxillary First Molars - Part II Dr. Arcoria

Lab: 1. Complete Project #10 (PJ-10) Tooth #14 - Complete wax-up by 11:50 a.m.


Wednesday, November 2

Lecture: Permanent Maxillary Second Molars Dr. Arcoria

Turn in at 11:50 a.m., finish next time


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Monday, November 7

Lecture: Permanent Maxillary Third Molars Dr. Bryan

Finish and turn in at 11:00 a.m.

Assignment: Study all notes & reading assignments in preparation for Exam #3.


Lecture: Lecture Exam #3 (Covers lectures from Oct. 19- Nov. 7)

Turn in at 11:50 a.m.


Monday, November 14

Lecture: Permanent Mandibular First Molars Dr. Arcoria

Lab: 1. Continue with Project #11 (PJ-11) Tooth #30 - Full crown wax-up
Complete by 11:50 am, finish next laboratory



Lecture: Permanent Mandibular Second Molars Dr. Arcoria

Finish by 10:00 a.m.
2. Begin Practical #6 (PC-06) Tooth #19 - Full crown wax-up
- from 10:15 a.m. to 11:50 a.m. Turn in at 11:50 a.m.
3. Review of Tooth Identification Exercise (11:35 a.m. to 11:50 a.m.)
In preparation for Tooth ID Practical (PC-07) on Wednesday, December 7


Monday - Friday, November 21 - 25
Thanksgiving Break

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Monday, November 28

Lecture: Permanent Mandibular Third Molars Dr. Bryan

Lab: 1. Continue with Practical #6 (PC-06) Tooth #19 - Full crown wax-up



Lecture: Pulpal and Root Morphology - Part I Dr. Arcoria

Lab: 1. Finish Practical #6 (PC-06) Tooth #19 - Full crown wax-up


Monday, December 5

Lecture: Pulpal and Root Morphology - Part II Dr. Arcoria


Assignment: Study all notes and reading assignments for the next lecture.

Wednesday, December 7

Lecture: Final Examination Review Dr. Arcoria

Lab: 1. Practical #7 (PC-07) - Tooth Identification PowerPoint
9:00 a.m. - 9:50 a.m.
2. Finish Project #12 (PJ-12) Tooth #31 - Full crown wax-up
3. Project #9 (PJ-09) - Have Instructor look and approve (10:00 am 11:50 am)
Tooth #13 full crown wax-up for Dental Materials Laboratory

Assignment: Study all notes and reading assignments in preparation for the final exam

EXAM WEEK DECEMBER 12-16

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NOMENCLATURE
Fall 2011

I. Nomenclature
A. Maxilla- (upper jaw) Maxillary arch, maxillary teeth, etc.
B. Mandible- (lower jaw) Mandibular arch, mandibular teeth, etc.
C. Temporal Bone- temporomandibular joint (TMJ) (3 axes of rotation)
D. Dentition- the natural teeth in the jawbone
1. Primary Dentition: (aka Deciduous) number = 20
2. Permanent Dentition: (aka Secondary or adult) = 32
3. Succedaneous Dentition: Permanent teeth that succeed primary teeth
4. Mixed Dentition: Transition period when both primary and permanent
teeth are present in the dental arch.

II. Human Dentition: Tooth Names:
A. Primary: per quadrant
1. Incisors (2): Central Incisor & Lateral Incisor
2. Canine (1) (aka cuspid)
3. Molars (2): 1
st
molar & 2
nd
molar
4. Total = 5 (10 per arch; 20 total)
B. Permanent: per quadrant
1. Incisors (2): Central Incisor & Lateral Incisor
2. Canine (1) (aka cuspid)
3. Premolars (2) (aka bicuspids): 1
st
Premolar & 2
nd
Premolar
4. Molars (3): 1
st
molar, 2
nd
molar, & 3
rd
molar
5. Total = 8 (16 per arch; 32 total)
C. Anterior vs. Posterior teeth
1. Anterior: canine to canine in each arch
a. typically single rooted and used to incise foods
b. important in phonetics
2. Posterior: remaining teeth in the arch (premolars & molars)
a. multirooted except for some premolars and used for chewing &
gnashing
b. have an occlusal surface

III. Tooth Numbering Systems:
A. Universal (#A-#T; #1-#32)
B. Quadrant (Zsigmondy-Palmer)
C. FDI- Federation Dentaire Internationale

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IV. Tooth Anatomy
A. Crown:
1. Anatomic crown: that portion of the tooth covered by enamel
2. Clinical crown: that portion of the tooth clinically visible
3. Coronal: pertaining to or having to do with the crown
B. Root:
1. That portion of the tooth covered with cementum
2. Radicular: pertaining to or having to do with the root
C. Cementoenamel Junction (CEJ) aka the cervical line

V. Tooth Tissues
A. Enamel (hard): outer covering of the working portion of the tooth
B. Cementum (hard): provides for a ligamentous attachment of the root to the
alveolar bone (tooth socket)
C. Dentin (hard): constitutes the bulk of the tooth
D. Pulp (soft): nerves, blood vessels, lymphatics, etc. inside the pulp chamber

VI. Surfaces of the Teeth: Each tooth has 5 surfaces or sides
A. Mesial: that surface of the tooth closest to the midline
B. Distal: that surface of the tooth farthest from the midline
C. Facial: that surface of the tooth closest to the face
1. Labial (lip): alternative term used for anterior teeth
2. Buccal (cheek): alternative term used for posterior teeth
D. Lingual: that surface of the tooth closest to the tongue (palatal term sometimes
used for maxillary posterior teeth because that surface is adjacent to the palate).
E. Occlusal: the biting surface of posterior teeth
F. Incisal: the biting surface of anterior teeth
G. Proximal: the surface of a tooth facing toward an adjacent tooth in the same arch
H. Axial: the surfaces of a tooth that are parallel to its long axis

VII: Anatomical Landmarks of Teeth (positive):
A. Cusp: an elevation or mound on the crown portion of the tooth
B. Ridge: any linear elevation on the surface of a tooth
1. Triangular: descends from the tips of the cusps of posterior teeth toward
the central part of the occlusal surface. Each cusp has only one
triangular ridge.
2. Cuspal: ridges that descend from the tips of cusps in directions other than
toward the central part of the occlusal surface
3. Oblique (unique to maxillary molars): obliquely crosses the occlusal
surface. Formed by the triangular ridge of the DF cusp & the distal
cuspal ridge of the ML cusp.
4. Transverse: formed by the union of two triangular ridges transversely
crossing the occlusal surface of a posterior tooth.
5. Marginal: the rounded borders of enamel that form the mesial & distal
margins of the occlusal surface of posterior teeth or lingual surface of
anterior teeth.

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6. Lingual: ridges that extend from the cusp tip in a lingual direction
a. Anterior teeth: Unique to the canine; run from the cusp tip to the
cingulum
b. Posterior teeth: Ridges (other than triangular ridges) that extend
lingually from the tip of a cusp
7. Incisal: ridges that extend from the incisal most portion of the mesial
& distal marginal ridges of incisors. The incisal edge is the most incisal
portion of the ridge and used to incise or tear foods
8. Cervical: the height of contour on the cervical portion of the facial or lingual
surface of a tooth. It will run in a mesiodistal direction.
a. This occurs at the cervical (neck) 1/3 of the tooth
b. Anterior teeth have a facial and a lingual cervical ridge
c. Posterior teeth have only a facial cervical ridge
C. Cingulum: the lingual lobe of an anterior tooth making up the bulk of the
cervical of the lingual portion of the tooth.
D. Tubercle: a smaller elevation of some portion of the crown produced by an extra
formation of enamel.

VIII: Anatomical Landmarks of Teeth (negative):
A. Fossa(e): an irregular depression or concavity.
1. Lingual: found on the lingual surfaces of anterior teeth (canines can have
two- a mesiolingual fossa and a distolingual fossa.
2. Central: found at the bottom of the occlusal surfaces of molars. Formed
by converging ridges ending at a central point in the bottom of the
depression where there is a junction of grooves.
3. Triangular: a triangular shaped depression found on the occlusal surface
of posterior teeth. The base of the triangle is a marginal ridge.
B. Sulcus: A depression or valley on the surface of a tooth between ridges & cusps,
the inclines of which meet at an angle. There is a developmental groove (see
below) at the junction of these inclines.
C. Groove: a definitive line on the surface of the tooth.
1. Developmental: a linear depression between the primary parts
(developmental lobes) of the tooth.
2. Supplemental: a less distinct linear depression on the surface of the tooth
that is supplemental to the developmental groove i.e. does not mark the
junction of the primary parts of the tooth.
D. Developmental Depression: A defined recessed area on the surface of a tooth
found between two primary parts of a crown or root
E. Pit: pinpoint depressions located at the junction or terminus of developmental
grooves.

IX. Gross Divisions & Junctions
A. Division into Thirds:
1. Anterior Teeth
a. Crown:
(1) facial or lingual view:
(a) mesiodistally: mesial, middle, distal
(b) incisocervically: incisal, middle, cervical
(2) proximal view: facial, middle, lingual
b. Root: cervical, middle, apical

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2. Posterior Teeth
a. Crown:
(1) facial or lingual view:
(a) mesiodistally: mesial, middle, distal
(b) occlusocervically: occlusal, middle, cervical

(2) proximal view: facial, middle, lingual
b. Root: cervical, middle, apical
B. Line Angle: an angle formed by the junction of any two of the five surfaces of
the tooth.
C. Point Angle: The point at which three of the tooths five surfaces converge.
D. Occlusal Table: An area on the chewing surface of posterior teeth bordered by
the crests of the marginal ridges mesially & distally and by the cusp tips facially
& lingually.

Identify:
1. Arch 11. Incisal surface 23. Incisal ridge 31. Supplemental groove
2. Quadrant 12. Axial surface 24. Facial ridge 32. Pit
3. Names of teeth 13. Proximal surface 25. Lingual ridge 33. Coronal
4. Universal # 14. Contact area 26. Occlusal table 34. Radicular
5. Mesial surface 15. Cusp names 27. Central fossa 35. Cervical line
6. Distal surface 16. Cuspal ridges 28. Triangular fossa 36. CEJ
7. Facial surface 17. Cingulum 29. Lingual fossa 37. Root apex
a. labial 18. Marginal ridge 30. Develop. grooves: 38. Division into thirds
b. buccal 19. Triangular ridge a. central 39. Line Angles
8. Lingual surface 20. Transverse ridge b. facial 40. Point Angles
9. Palatal surface 21. Oblique ridge c. lingual 41. Crown outline form
10. Occlusal surface 22. Cervical ridge d. other 42. Develop. depression
Location of Proximal Contact Areas
Facial View

Maxillary anterior teeth: IJ JM JM

Mandibular anterior teeth: II II IM

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The Universal Tooth Numbering System
Permanent Dentition

1. The mandibular right second premolar is tooth #_____________

2. The maxillary left first premolar is tooth #___________

3. The permanent maxillary left lateral incisor is tooth # __________

4. The permanent maxillary left second molar is tooth # ___________

5. The premolars on the right side of the mandible are tooth numbers ______ & ______

6. The permanent maxillary canines are tooth numbers ______ & ______

7. The permanent mandibular canines are tooth numbers ______ & ______

8. The permanent maxillary central incisors are tooth numbers ______ & ______

9. The permanent mandibular central incisors are tooth numbers ______ & ______

10. The mandibular third molars are tooth numbers ______ & ______

It will be easier to orient yourself throughout the dental arches if you remember some
teeth in groups:

11.One should memorize that the four permanent canines are tooth numbers:
______, ______, ______, and ______

12. The permanent maxillary first molars are tooth numbers ______ and ______

13. The permanent mandibular first molars are tooth numbers ______ and ______

14. The posterior teeth in the mandibular left quadrant are tooth numbers ______, ______, ______,
______, and ______

15. For faster orientation within the oral cavity, one should memorize the four permanent
first molars are tooth numbers ______, ______, ______, and ______

16. The permanent molars in the mandibular right quadrant are tooth numbers ______ , ______ &
_____

17. Generally speaking, the mandibular first molars are the first permanent teeth to appear
in the oral cavity. The molars are tooth numbers ______ and ______. Why are they
often called the six year molars?

20

The Universal Tooth Numbering System
Primary Dentition

18. The primary maxillary left second molar is tooth number ______

19. The primary maxillary right second molar is tooth number _____

20. The primary mandibular left second molar is tooth number ______

21. The primary mandibular right second molar is tooth number ______

22. The primary maxillary central incisors are tooth numbers ______ and ______

23. The primary mandibular central incisors are tooth numbers ______ and ______

24. The primary mandibular left canine is tooth number ______

25. The primary maxillary right first molar is tooth number ______

Convention for Naming Teeth: dentition arch side name of tooth, i.e.:
Tooth #7 is the permanent maxillary right lateral incisor
Tooth #K is the primary mandibular left second molar

26. Tooth # 1 is the _______________________________________________________

27. Tooth # I is the _______________________________________________________

28. Tooth #12 is the ______________________________________________________

29. Tooth #18 is the ______________________________________________________

30. Tooth #B is the _______________________________________________________

31. Tooth #E is the _______________________________________________________

32. Tooth #28 is the ______________________________________________________

33. Tooth #5 is the _______________________________________________________

34. The total number of molars per arch in the permanent dentition is __________

35. The total number of molars per quadrant in the permanent dentition is _________

36. The number of premolars in the primary dentition is _______

37. The total number of incisors in the left quadrants of the mouth is _______

21
Chapter 2- The Development of Teeth
Burt Bryan, D.D.S.
Fall, 2011

I. Importance of having knowledge & understanding:
A. Clinical practice
B. Morphologic variations
C. Calcification & eruption schedule
D. Forensics
E. Anthropology
F. Paleontology & comparative anatomy

II. Chronology of Primary Tooth Development
A. Terms
1. Chronology: the time table of the development and eruption of the
teeth
2. Calcification: the process by which the tissues of the developing tooth
become hardened by the deposits of calcium salts
3. Eruption: the continuous movement of the tooth as it develops from its
bud stage until the root completely forms or it reaches occlusal contact
4. Emergence: denotes the stage of tooth development and eruption when
it emerges through the gingival tissue into the oral cavity
B. Sequence of Development within the Dental Follicle (a sac-like structure that
contains the developing tooth within the bones of the jaws).
1. Positive anatomy: cusp tips or incisal edges develop first from
developmental lobes (described below)
2. Negative anatomy: fossae & grooves develop as the centers of
calcification merge upon one another
3. Roots: develop last ending at the apex (root tip)
C. Calcification schedule of Primary Teeth
1. 13-16 weeks in utero: calcification of the primary teeth begins
2. Sequence: CI > 1
st
molar > LI > Canine > 2
nd
molar
3. 18-20 weeks in utero: all primary teeth have initiated calcification
D. Eruption & Emergence Schedule (Table 2-1, p. 32; Fig. 2-3, p. 33)
1. Mn Central incisors fist primary teeth to emerge followed by Mx CI
2. Sequence: CI > LI > 1
st
molar > Canine > 2
nd
molar
3. Mx 2
nd
molar last to emerge around 29 months of age
4. Root formation of all primary teeth completed by 39 months of age
E. Anomalies of Tooth Eruption Patterns
1. Natal teeth: baby is born with teeth (generally not well developed)
2. Neonatal teeth: teeth that emerge during the first month after birth
3. Anodontia (missing teeth): Mn CI most common primary tooth;
genetic trait
4. Supernumerary teeth: extra teeth; mesiodens forms between the
two maxillary central incisors

22
F. Neurobehavioral Mechanisms
1. Emergence of the primary teeth important for the development of oral
motor & masticating skills
2. Jaw movements & mastication skills develop concurrently with the
development of the dentition and the neuromuscular system.
3. Mature controlled neuromuscular movements of the mandible require
the teeth to come into occlusal contact
4. Proprioceptive input from the periodontium provides information for
coordinated jaw movements for chewing and tongue functions

III. Transitional Mixed Dentition Period
A. Begins with the emergence & eruption of the Permanent Mandibular 1
st
molar
distal or posterior to the primary mandibular 2
nd
molar.
B. Ends with the loss of the last primary tooth (maxillary canine) Age 11-12
C. Permanent teeth do not begin their eruptive movements until after the crown
of the tooth is formed
D. Premature loss of Primary teeth (neglect, congenital absence, or anomalies)
may lead to a lack of sufficient space to accommodate the permanent
successor

First Evidence Crown Root
of Calcification Completed Eruption Completion Exfoliated
Maxillary Tooth # (weeks in utero) (months) (age in mths) (years) (years)
i1 E, F 14 1.5 10 1.5 6.5
i2 D, G 16 2.5 11 2 7.5
C C, H 17 9 19 3.25 11
m1 B, I 15 6 16 2.5 10
m2 A, J 19 11 29 3 11

Mandibular Tooth # (weeks in utero) (months) (age in mths) (years) (years)
i1 P, O 14 2.5 8 1.5 6.5
i2 Q, N 16 3 13 1.5 7.5
C R, M 17 9 20 3.25 10.5
m1 S, L 15.5 5.5 16 2.25 10
m2 T, K 18 10 27 3 11

23
IV. The Permanent Dentition
A. Develop from 4 or more centers of calcification called developmental lobes:
1. Posterior lobes develop into cusps; posterior teeth with five cusps
developed from five developmental lobes.
2. Anterior teeth have three facial developmental lobes initiating their
development at the incisal edge known as mamelons.
a. Mamelons wear in time resulting in a smooth incisal edge.
b. Areas of coalescence on the labial surface between the
developing lobes are known as developmental depressions.
c. Imbrication lines are (negative anatomy) lines in the
enamel that are parallel to the CEJ. They are the result of an
overlapping of enamel deposits at the cervical area. The
positive anatomy is called perikymata.
3. Cingulum = the 4
th
developmental lobe of anterior teeth; raised area of
enamel located on the lingual surface of the crown occupying the
cervical one-third to one-half of the lingual surface.
B. Positioning of permanent tooth follicle:
1. Anterior teeth: lingual to the deciduous roots.
2. Premolars: within the bifurcation of the primary molar roots.
3. Molars: distal or posterior to primary molar teeth.
4. Succedaneous teeth: those permanent teeth that succeed or take the
place of primary teeth.
C. Chronology of Calcification, Eruption & Emergence of the Permanent Teeth:
1. Reliable means of determining age for anthropological or forensic
purposes.
2. Mandibular teeth generally (but not always) precede their maxillary
counterparts in the eruption process.
3. Begins with the eruption into the oral cavity of the permanent
mandibular 1
st
molar (age 6).
4. Mixed dentition phase ends with the exfoliation of the last primary
tooth (usually the maxillary canines).
5. Crowns of permanent teeth are completely formed before they emerge.
6. Roots of the permanent teeth are not completely formed (~50%) when
the teeth initially emerge into the oral cavity.
7. Schedule of calcification, emergence (eruption), and root completion
of the permanent teeth:
Arch Overall
Crown Eruption or Root Order of Order of
Maxillary Tooth # Calcification Completed Emergence Completion Eruption Eruption
Central 8, 9 3.5 months 4.5 years 7.5 years 10 years 2 5
Lateral 7, 10 1 year 4.5 years 8.5 years 11 years 3 6
Canine 6, 11 4.5 months 6.5 years 11.5 years 14 years 6 12
1st Premolar 5, 12 2 years 5.5 years 10 years 12.5 years 4 8
2nd Premolar 4, 13 2 years 6.5 years 10.5 years 13 years 5 9
1st Molar 3, 14 Birth 3 years 6 years 9 years 1 2
2nd Molar 2, 15 3 years 7.5 years 12.5 years 15 years 7 14
3rd Molar 1, 16 9 years 14 years 19 years 21.5 years 8 16

24

Arch Overall
Crown Eruption or Root Order of Order of
Mandibular Tooth # Calcification Completed Emergence Completion Eruption Eruption
Central 24, 25 3.5 months 4.5 years 6.5 years 9 years 2 3
Lateral 23, 26 3.5 months 4.5 years 7.5 years 10 years 3 4
Canine 22, 27 4.5 months 6.5 years 9.5 years 13 years 4 7
1st Premolar 21, 28 2 years 5.5 years 11 years 12.5 years 5 10
2nd Premolar 20, 29 2 years 6.5 years 11.5 years 13.5 years 6 11
1st Molar 19, 30 Birth 3 years 6 years 9 years 1 1
2nd Molar 18, 31 3 years 7.5 years 12 years 14.5 years 7 13
3rd Molar 17, 32 9 years 14 years 19 years 21.5 years 8 15

V. Anomalies of Permanent tooth development and eruption:
A. Tetracycline staining
B. Fluorosis
C. Peg-shaped lateral incisor
D. Ectopic eruption
E. Impaction
F. Supernumerary teeth
G. Anodontia or partial anodontia
H. Ankylosis (fusion of a tooth to the alveolar bone)

VI. The Dental Pulp
A. Connective tissue organ containing arteries, veins, nerves, & a lymphatic
system.
B. Large with young, newly erupted teeth, becomes smaller as tooth ages.
C. Principal function is to form the dentin of the tooth:
1. Primary Dentin: formed prior to root completion
2. Secondary Dentin: formed after root completion
3. Tertiary Dentin: formed as a reaction to injury or noxious stimuli

VII. Dental Age
A. Juvenile years: based on the stage of eruption of the permanent teeth and root
resorption of the primary teeth.
B. Development of the dentition is the best physiologic indicator of the age of
juveniles.
C. Adult, fully erupted dentition is less precise and is dependent on attrition,
wear, and other corroborating features to provide a reliable estimate.
D. During dental development, the crowns and roots of teeth are the tissues least
affected by environmental or nutritional influences.
25
Developmental Morphology

Rationale:
Compare & contrast the dentitions of other vertebrates
There are trends or commonalities regarding tooth development
Know the various tooth and cusp forms
Know the various jaw outlines and positions

Arch Form Alignment & Terminology:
Isognathous: equal-jawed or symmetrical arch alignment
Anisognathus: unequal-jawed or asymmetrical arch alignment
Humans have an arch alignment that is considered partially isognathous

Cusp Design in Vertebrates:
Bunodont: tooth-bearing conical cusps
Selenodont: crescent-shaped cusps
Humans have a primarily bunodont form that may change with age to a partially selenodont shape

Diet & Mandibular Movement in Vertebrates:
Carnivorous: meat ingesting, bunodont cusp form, and vertical mandibular movement
Herbivorous: plant ingesting, selenodont cusp form, and horizontal mandibular movement
Omnivorous: plant and animal ingesting, primarily bunodont cusp form, both vertical and horizontal
mandibular movement

Mammalian Phylogenetic Development:

<<Haplodont

<<Triconodont

<<Tritubercular

<<Tritubercular Molar

<<Quadritubercular Molar

<<Quadritubercular Molar with Talon Cusps

Maxillary First Molar Primitive Cusp Names: Mandibular 1st Molar Primitive Cusp Names:

26
The Primary Dentition
Beverly York, D.D.S.

I. Importance
A. Function (chewing & speech)
B. Appearance
C. Proper development of bone as well as the
symmetrical growth and development to the jaws
D. Maintain the space and serve as guides for the
succedaneous permanent teeth
E. Psychological well-being of the child. Must be
be maintained to avoid discomfort & mouth odors

II. Nomenclature
A. Number of teeth and names
B. Universal Numbering System
C. Eruption, Emergence & Exfoliation
D. Primary Molars replaced by permanent Premolars

III. Contrasts Between Primary & Permanent Teeth:
A. Overall size
B. Cervical ridges
C. Color
D. Anterior teeth
1. Crowns: are wider mesiodistally relative to their
crown length than are the permanent anterior teeth
2. Roots: narrower & longer when compared to respective crowns
E. Posterior teeth
1. Crowns: Primary molars larger than (permanent) premolars
2. Roots: thinner & more flared than permanent molars
F. Pulp chambers: large with high pulp horns
G. Enamel: thin with consistent depth
H. Dentin: limited thickness

IV. Chronology of calcification, eruption and emersion of Primary Teeth:

A. Maxillary Arch:

Maxillary Tooth # (weeks in utero) (months) (age in mths) (years) (years)
i1 E, F 14 1.5 10 1.5 6.5
i2 D, G 16 2.5 11 2 7.5
C C, H 17 9 19 3.25 11
m1 B, I 15 6 16 2.5 10
m2 A, J 19 11 29 3 11

27

B. Mandibular Arch:

Mandibular Tooth # (weeks in utero) (months) (age in mths) (years) (years)
i1 P, O 14 2.5 8 1.5 6.5
i2 Q, N 16 3 13 1.5 7.5
C R, M 17 9 20 3.25 10.5
m1 S, L 15.5 5.5 16 2.25 10
m2 T, K 18 10 27 3 11

V. General Considerations:

1. Primary teeth are smaller than permanent teeth.
2. The crowns of primary teeth are a smaller percentage of the
overall tooth than they are of permanent teeth, i.e., the crown-to-
root ratio is smaller.
3. Crowns of primary teeth appear not only shorter but also fatter
than those of permanent teeth.
4. Molar roots of primary teeth are long and slender with little or no
root trunk; roots themselves have a marked bowing and flaring.
5. The anterior primary teeth are constricted at the cervical line
producing conspicuous lingual and cervical bulges.
6. Primary molars have a facial bulge (cervical ridge) but lack a
conspicuous lingual bulge (ht. of contour).
7. Cervical ridges of primary teeth are more pronounced than in
permanent teeth.
8. Facial and lingual surfaces of primary teeth from the heights of
contour to the occlusal or incisal edge are flatter than those found
on permanent teeth. No mamelons are seen on primary anterior
teeth.
9. The enamel of primary teeth is thinner than that of permanent
teeth.
10. Primary teeth are considerably whiter than permanent teeth.
11. Multiple diastemas (gaps between teeth) are normally seen in the
primary arch.
12. The primary arch is more circular than the permanent arch.
13. All teeth in the primary dentition are replaced by the same teeth in
the permanent dentition except the primary molars, which are
replaced by the permanent premolars.
14. The primary teeth generally resemble the permanent teeth that
replace them except for the primary molars. The primary
maxillary and mandibular 2
nd
molars very much resemble the
permanent maxillary and mandibular 1
st
molars. The primary
maxillary and mandibular 1
st
molars do not resemble any teeth of
the permanent dentition.

28

15. Because of its prominent mesiolingual and mesiofacial cusps, the
primary maxillary first molar is the primary molar that most
resembles a premolar.
16. The primary mandibular first molar has the most unique facial
cervical ridge or bulge.
17. The primary mandibular first molar has a prominent transverse
ridge connecting the two mesial cusps.

VI. The Primary Anterior Teeth:

A. Maxillary central incisor is replaced by the permanent maxillary central
incisor and is similar in its appearance except in the following ways:

1. The labial surface is smoother and it has no mamelons
2. The cingulum may be more prominent
3. It has a significant cervical constricture with accompanying facial
and lingual cervical bulges.
4. The cervicoincisal measurement of the crown is less than the
mesiodistal measurement.

B. Maxillary lateral incisor is replaced by the permanent maxillary lateral

1. The labial surface is smoother
2. It has more distinctive lingual anatomy
3. It has a significant cervical constricture with accompanying facial
and lingual cervical bulges.

29

C. Maxillary canine is replaced by the permanent maxillary canine and is
similar in its appearance except in the following ways:

1. Facial crown outline is diamond shape rather than trapezoidal
2. The labial surface is smoother
3. It has a more prominent (almost cusp-like appearance) cingulum
4. Its mesial and distal contact areas are at the same level
5. Its mesial cuspal ridge is longer than its distal cuspal ridge
6. The OC height measures less than mesiodistal measurement

D. Mandibular central incisor is replaced by the permanent mandibular
central incisor and is similar in its appearance except in the following ways:

1. Its labial surface is smooth, unmarked and flat.
2. It has a prominent cingulum
3. It has a notable cervical constricture with accompanying facial and
lingual cervical bulges.

E. Mandibular lateral incisor is replaced by the permanent mandibular lateral

1. It has a prominent cingulum
2. It has a notable cervical constricture with accompanying facial and
lingual cervical bulges.

F. Mandibular canine is replaced by the permanent mandibular canine and is
similar in its appearance except in the following ways:

1. Facial crown outline form is arrow shaped
2. It has a smooth labial surface
3. The distal cuspal ridge is longer than the mesial cuspal ridge

30

VII. The Primary Posterior Teeth:

A. Maxillary first molar is replaced by the maxillary first premolar. It does not
resemble any teeth of the permanent dentition.

1. Most atypical of all of the molars as it has characteristics of both a
premolar and of a molar.
2. Because of its divisions on the occlusal surface and its root form,
it is classified as a molar.
3. Two major cusps, mesiolingual and mesiofacial. Smaller
distofacial cusp usually present and distolingual cusp may or may
not be discernable.
4. Occlusal crown outline is trapezoidal. Tooth converges lingually
and distally; facial surface measures longer than the lingual and
the mesial surface measures longer than the distal.
5. Occlusal table is rectangular with a facial developmental groove
separating the two facial cusps.
6. Heights of contour are prominent with a distinct cervical ridge on
the facial surface.
7. Has three roots that are very divergent.

B. Maxillary 2
nd
molar is replaced by the maxillary 2
nd
premolar. It is similar
in its appearance to the permanent maxillary 1
st
molar except in the
following ways:

1. It has a squattier and more bulbous appearance.
2. It has a more prominent cervical bulge.
3. It has very little (if any) root trunk.

C. Mandibular first molar is replaced by the mandibular first premolar. It
does not resemble any teeth in the permanent dentition.

1. It looks more like a molar than does the primary maxillary 1
st
molar
2. It generally has four cusps, two facial and two lingual. The mesio-
facial and mesiolingual cusps are the largest. Usually, a
transverse ridge can be identified between the mesiofacial and
mesiolingual cusps.
3. The mesial profile is straight and the distal profile is highly convex.

31

4. The occlusal crown outline form is rhomboidal because of the
significant cervical ridge (bulge) on the mesial half of the facial
surface.
5. The crown demonstrates lingual and distal convergence.
6. The mesial view shows a very prominent facial cervical ridge with
the cervical line moving occlusally in a faciolingual direction.
7. A facial groove separates the two facial cusps
8. Has two roots, one mesial (longer) and one distal

D. Mandibular 2
nd
molar is replaced by the mandibular 2
nd
premolar. It is
similar in its appearance to the permanent mandibular 1
st
molar except in
the following ways:

1. Its two roots are more divergent and there is no root trunk
2. Its significant cervical bulge
3. All three buccal cusps (mesiofacial, distofacial and distal) are
equal in size. The distal cusp is the smallest cusp of the
permanent mandibular 1
st
molar.

An Overview
of Each Tooth
in the

Permanent
Dentition

32

33

PERMANENT MAXILLARY CENTRAL INCISOR

1. FACIAL ASPECT - MAXILLARY CENTRAL INCISOR

a. Crown length (10.5 mm) greater than crown width
(8.5 mm).
b. Crown width at contact area greater than at cervix.
c. Crown outline said to be a trapezoid with shorter
parallel side at cervix.
d. Incisal edge relatively straight. Young tooth may
show evidence of mamelons.
e. Distal incisal angle more rounded than mesial incisal
angle. The mesial incisal angle is said to be a sharp
(almost 90) angle.
f. Mesial crown outline straighter than distal crown
outline.
g. Mesial proximal contact (greatest curvature of
mesial outline) is located nearer incisal edge than
distal proximal contact (greatest curvature of distal
outline). Mesial contact area is within the incisal 1/3
of the crown. The distal contact is at the level of the
junction of the incisal and middle thirds.
h. Cervical outline of crown is slightly concave incisally
and the arc of the curvature is said to be part of a
semicircle.
i. Facial surface is relatively flat (only slightly convex)
in its incisal two thirds.
j. Facial surface may show some evidence of shallow
vertical developmental depressions delineating lobe
structure.
k. Facial surface may show horizontal ridges at the
cervical one-third representing differing rates of
enamel formation during normal growth patterns.
The raised portions of the ridges (positive anatomy)
are termed perikymata and the horizontal grooves
(negative anatomy) are termed imbrication lines.
l. Outline of root is cone shaped with a relatively blunt
apex usually located slightly distal to center line of
tooth.

M D

34

2. LINGUAL ASPECT - MAXILLARY CENTRAL INCISOR

a. Outline of the crown and root is the reverse of the
facial outline.
b. Cervical outline of crown is more concave (toward
incisal) than on facial (not a semicircle).
c. Lingual fossa in incisal of crown surface is
described as a broad, shallow dish-shaped
depression bound by the incisal ridge, the mesial
and distal marginal ridges and the cingulum. It is
trapezoidal in shape.
d. A well developed cingulum occupies the cervical
of the crown. Its greatest curvature lingually
and the crest of the cervical line gingivally will be
slightly distal to the mesiodistal long axis bisector
of the crown.
3. MESIAL ASPECT - MAXILLARY CENTRAL INCISOR

a. Crown outline is triangular with apex at incisal.
b. Incisal ridge is centered labiolingually.
c. The cervical line viewed from the mesial aspect curves
incisally for 1/3 of total crown length. (This is the
greatest curvature of the cervical line incisally or
occlusally found on any tooth).
d. Greatest curvature of the crown outline facially and
lingually will be in the cervical 1/3 of the crown at the
crests of the facial and lingual cervical ridges. These
crests are opposite one another and at the same level.
e. The facial outline of the crown from the crest of the facial
cervical ridge to the incisal ridge is relatively flat (shows
very little convexity).
f. The lingual outline of the crown from the cingulum to
the incisal ridge is slightly concave.
g. The root is cone shaped with the blunt apex centered
faciolingually.
h. The root surface is relatively smoothly convex and has
no developmental root depressions.

D M

L F

35

4. DISTAL ASPECT - MAXILLARY CENTRAL INCISOR

a. Greatest faciolingual width is in cervical 1/3 of the
crown.
b. Incisal ridge and apex of the root are in line with each
other along the long axis of the tooth.
c. Note that convexity of the outline of the cingulum
begins approximately halfway between the incisal ridge
and the cervical line on the lingual.
d. The curvature of the cervical line incisally is less on the
distal than it is on the mesial surface.
e. The distal root surface has no developmental root
depression and is relatively smoothly convex.

5. INCISAL ASPECT - MAXILLARY CENTRAL INCISOR

a. Mesiodistal width is greater than the faciolingual
diameter.
b. Interproximal contact areas (greatest curvature mesially
and distally) are centered faciolingually.
c. Incisal edge (ridge) is relatively straight and
perpendicular (at a 90 angle) to the mesiodistal
bisecting plane. It is positioned along (parallel to) the
faciolingual bisecting plane.
d. Crest (greatest curvature lingually) of the cingulum is
slightly distal to the afore mentioned mesiodistal
bisecting plane of the crown.
e. Crown outline converges lingually.
f. Mesiofacial and distofacial line angels are relatively
prominent and the surface outline between them
relatively straight.

F L

D M

36
DENTAL ANATOMY
PRINCIPLE CHARACTERISTICS OF A
PERMANENT MAXILLARY LEFT CENTRAL INCISOR

1. INCISAL ASPECT
a. incisal ridge centered faciolingually
b. incisal ridge perpendicular to the mesiodistal bisector

2. FACIAL ASPECT
a. conical shaped root
b. mesioincisal line angle square
c. distoincisal line angle rounded
d. crown outline trapezoidal

3. LINGUAL ASPECT
a. trapezoidal shaped lingual fossa
b. cingulum well developed and occupies cervical half of the crown
c. crown outline trapezoidal

4. MESIAL ASPECT
a. contact area at incisal 1/3 and centered faciolingually
b. curvature of cervical line toward incisal greatest of any tooth
c. crown outline triangular

37

F L
5. DISTAL ASPECT
a. distal contact area at junction of middle and incisal third
b. crown outline triangular

Notes:
1. Hutchinsons Incisor: An anomaly associated with congenital syphilis
resulting in the crown portion of this tooth being screwdriver shaped.

2. Dimensions: CI (10.5 mm) > MD ( 8.5 mm) > FL (7.0 mm)

3. Facial surface is straight to slightly convex from cervical ridge to the incisal
ridge

4. MI lineangle is sharper than the DI lineangle

5. Root is conical, straight and generally round on cross section. It may
however show a slight convergence toward the lingual, with the mesial
dimension being wider faciolingually than the distal.

6. Curvature of cervical line toward the incisal on the mesial surface is the
greatest cervical line curvature of any tooth

7. Cervical line height of curvature on the facial surface canted very slightly
toward the distal.

38
DENTAL ANATOMY
PERMANENT MAXILLARY LATERAL INCISOR

1. FACIAL ASPECT - MAXILLARY LATERAL INCISOR

a. Crown length is 1.0 -1.5 mm shorter than the maxillary
central incisor. Crown width is 2.0 mm less than the
maxillary central incisor. This gives impression that the
maxillary lateral incisor is relatively long and narrow.
b. Crown outline is trapezoidal with the shorter parallel
side at the cervix.
c. Incisal edge is relatively more rounded (curved) than the
maxillary central incisor.
d. Both mesial and distal incisal line angles are said to be
rounded and each is more rounded than the
corresponding incisal line angle of the maxillary central
incisor. The distoincisal line angel is more rounded than
the mesioincisal angle.
e. The mesial proximal contact is at the level of the junction
of the incisal and middle thirds of the crown.
f. The distal contact is at a level near the middle of the
middle 1/3 of the crown.
g. The curvature of the cervical line incisally is elliptical
and not as broad as that of the maxillary central incisor.
The highest point of the curve is likely to be slightly
distal to mesiodistal bisector of the crown.
h. The facial surface is said to be convex in all directions.
i. The root converges evenly toward the apex for the
cervical two thirds of its length. There is usually a
characteristic curve of the root toward the distal in its
apical third.

M D

39

2. LINGUAL ASPECT - MAXILLARY LATERAL INCISOR

a. The lingual outline of the crown and root is the reverse
of the labial outline.
b. The lingual fossa is relatively deep, triangular in shape
and also cup-shaped. It occupies the incisal two
thirds of the lingual surface of the crown.
c. The anatomical features serving as boundaries for the
fossa are the same as those for the maxillary central
incisor; however, the cingulum of the maxillary lateral
incisor is limited to the cervical 1/3 of the crown and
the mesial and distal marginal ridges form a V as
they meld into the cingulum. There is often a very
deep depression or even a pit, deep in the fossa behind
the cingulum at the point of the V.
d. Occasionally there will be a developmental groove
extending out of the lingual fossa between a marginal
ridge and the cingulum, usually on the distal side of
the cingulum. This groove may be quite deep and may
even extend across the cementoenamel junction onto
the root. It is termed the linguogingival groove and is
unique to the maxillary lateral incisor.
3. MESIAL ASPECT - MAXILLARY LATERAL INCISOR

a. Greatest curvature of both the facial and lingual crown
outlines is in the cervical 1/3 and each is identified as a
cervical ridge.
b. Incisal ridge is in line with mid-point of the faciolingual
diameter.
c. Facial crown outline is convex from facial cervical ridge
crest to incisal ridge.
d. Lingual crown outline is slightly concave from lingual
cervical ridge to the incisal ridge.
e. Curve of the cervical line toward the incisal is greater
on the mesial surface than on the distal surface. It
extends for 1/3 of the crown length but not as great of
a distance as on the maxillary central incisor since the
lateral incisor has a shorter crown length.
f. Apex of the root is usually facial to the faciolingual
long axis bisector.
g. If there is any evidence of a root depression, it will be
slight.

D M

L F

40

5. INCISAL ASPECT - MAXILLARY LATERAL INCISOR

a. Crown is wider mesiodistally than it is faciolingually
by only 0.5 mm (6.5 mm vs 6.0 mm).
b. Incisal ridge crosses approximately midway between
the facial and lingual outline; however, it usually
shows some curvature with the convexity toward the
facial.
c. The facial outline is more continuously convex than
that of the maxillary central incisor and the
mesiofacial and distofacial line angles are more
rounded (less prominent).
d. The crown outline converges sharply toward the
lingual. The crest of the lingual outline of the
cingulum will be slightly to the distal of the
mesiodistal bisector (all cinguli incline or point
slightly toward the distal).
4. DISTAL ASPECT - MAXILLARY LATERAL INCISOR

a. As noted, the incisal ridge and root apex will not be in
line with one another, but the incisal ridge is centered
faciolingually.
b. Facial outline of root will be straighter and shorter than
the lingual outline when measured from cervical line to
apex of root.
c. Cervical line curves for a shorter distance incisally on the
distal surface.

F L

M D

41
DENTAL ANATOMY
PERMANENT MAXILLARY LEFT LATERAL INCISOR

1. INCISAL ASPECT
a. Incisal ridge centered faciolingually
b. Crown outline demonstrates significant lingual conversion

2. FACIAL ASPECT
a. Features of the maxillary lateral incisor are more rounded than those of the
maxillary central incisor
b. Root length can be as long or longer than the maxillary central incisor
c. CI crown length (9.0 mm) less than CI crown length of maxillary central
incisor (10.5 mm)

3. LINGUAL ASPECT
a. Triangular shaped lingual fossa
b. Lingual pit often found at apex of triangular fossa
c. Linguogingival developmental groove

L F
4. MESIAL ASPECT
a. Mesial contact area at junction of the middle & incisal thirds and
centered faciolingually
b. Crown outline triangular

42

Anomalies: (The maxillary lateral incisor is the permanent tooth most likely to
have anomalies)

1. Often missing (anodontia)
2. Microdontia (abnormally small teeth)
3. Peg lateral
4. Dens in dente
5. Supernumerary (teeth in addition to normal number in the dentition)

Notes:

1. Root: may be more ovoid in cross section than the root of the maxillary
central incisor but it is still comparatively round
2. Root often has a distal curvature in the apical
3. Root length is generally the same as the maxillary central incisor (13.0
mm) or can be longer.
4. Crown size: CI (9.0 mm) > MD (6.5 mm) > FL (6.0 mm)
5. Has more distinct lingual anatomy than the maxillary central incisor
6. Linguogingival groove extends from lingual pit gingivally, usually in a
distal direction. Can cross the CEJ onto the root surface and is prone
to decay because hygiene is difficult.
7. Because of its lingual pit, the maxillary lateral incisor is the most likely
of all the incisors to require a lingual restoration
8. Mamelons (if present) are not as prominent as those of the maxillary
central incisor

F L
5. DISTAL ASPECT
a. Contact area located in middle third and centered faciolingually
b. Crown outline triangular

PERMANENT MAXILLARY INCISORS

I. Permanent Incisors (General)

Class Traits (Permanent incisors)

1. The incisal two-thirds of the crown appears flattened or
compressed faciolingually, providing a long horizontal biting
edge or margin.
2. Distinct and rounded protuberances termed mamelons
representing developmental lobes surmount the incisal margins
of all newly erupted incisors.
3. The marginal ridges of all incisors are located on the mesial and
distal borders of the lingual surfaces.

II. Permanent Maxillary Incisors

Arch Traits (Permanent Maxillary Incisors)

1. Maxillary incisors are wider than the corresponding mandibular
incisors.
2. The central incisor is larger than the lateral incisor.
3. Lingual morphology (marginal ridges and cinguli) is more
prominent on maxillary incisors than on mandibular incisors.
4. Lingual fossae are deeper on maxillary incisors because
marginal and incisal ridges are more prominent.
5. Roots are rounded or triangular in cross section with equal
faciolingual and mesiodistal widths.
6. Facial surfaces are more rounded when viewed from the incisal
aspect.
7. Crowns are wider mesiodistally than faciolingually.

43

44

B. Type Traits (Permanent maxillary incisors)

CENTRAL LATERAL
1. Facial Aspect
a. Mesiodistally
b. Mesioincisal
line angle
c. Distoincisal line
angle
d. Mesial profile
e. Distal profile
f. Mesial contact

a. Facial surface
b. Distal contact

Wide
Sharp (90 degrees)

Slightly rounded

Straight
Rounded
Incisal third

Relatively flat
Junction of incisal
and middle thirds

Narrower than central
Slightly rounded

Distinctly rounded

Slightly rounded
Highly rounded
Junction of incisal and
middle thirds
Rounded
Middle third
2. Lingual aspect
a. Marginal ridges
and cingulum

b. Lingual fossa

Moderately
pronounced

Trapezoidal;
Moderately deep

More prominent

Triangular; Deep
3. Mesial aspect
a. Cementoenamel
junction
b. Contact area

c. Cingulum

Moderately curved

Within incisal third

Moderately convex

Less curved

Junction of incisal and
middle thirds
Convex
4. Incisal aspect
a. Outline
b. Labial surface
c. Lobes
d. Mesiofacial and
distofacial line
angles

Triangular
Slightly convex
Visible facially
Prominent

Ovoid
Highly convex
Slightly visible to absent
Rounded

45
Trauma to Maxillary Incisors:

People in general and children in particular are subject to accidents that damage
their teeth. The most likely teeth to be damaged are the maxillary central
incisors. Due to their position in the mouth and their conical roots, they often fall
victim to blunt traumatic injuries. An incisor in labioversion is particularly
susceptible to this sort of injury.

If an injury occurs:

75% will involve only the enamel and are usually easily repaired with a bonded
composite restoration or by simply smoothing the enamel.

24% involve the dentin and enamel and are repaired with a bonded composite
restoration.

1% will involve the pulp of the tooth and require endodontic (root canal) treatment
and the placement of a crown.

Avulsion: The total dislodgement of the tooth from its socket. Usually such a
tooth can be successfully re-implanted in the socket if certain procedures are
followed. Most importantly, successful re-implantation of an avulsed tooth is
time dependent.
< 30 minutes = 90% success rate
30 90 minutes = 40% success rate
> 90 minutes = 7% success rate

How to Re-Implant an avulsed Tooth:

1. Reassure the child and the occasionally frantic parent.
2. Wash the tooth gently with water to remove any loose debris. Do not
scrub the tooth. Remnants of the periodontal ligament and the cementum
should not be disturbed.
3. Have the parent replace the tooth in the socket if possible.
4. Have the patient brought to the dental office immediately. A dentist can
stabilize the tooth by splinting (affixing it to a stable adjacent tooth or
teeth).

If the tooth cannot be re-implanted prior to arrival at the dental office, the tooth
should be kept moist in milk, water, or saliva (last choice).

The tooth will require root canal therapy once it is stabilized.

46

PERMANENT MANDIBULAR CENTRAL INCISOR

1. FACIAL ASPECT - MANDIBULAR CENTRAL INCISOR

a. Crown outline trapezoidal with longer parallel side at incisal edge.
b. Incisal edge straight and at right angle to (perpendicular to) the
long axis line of the tooth.
c. Mesial and distal incisal line angles are both said to be sharp
almost 90 angles. However, the distal incisal line angle slightly
more rounded than the mesial incisal line angle.
d. The mesial and distal proximal contacts are at the same level and
are within the incisal 1/3 of the crown (after incisal wear the
contacts may be very near the incisal edge).
e. The incisal 1/3 of the crown surface is relatively flat. The cervical
two thirds of the surface is convex.
f. The mesial outline may be slightly straighter than the distal
outline.
g. The crest of the curve of the cervical line may be ever so slightly to
the distal of the mesiodistal long axis bisector.
h. However when viewing the facial aspect of this crown, it is
considered to be bilaterally symmetrical.
i. The root converges evenly to a relatively pointed apex. The apex
may be slightly to the distal of the mesiodistal long axis bisector
but it will rarely if ever be curved to any great extent.
2. LINGUAL ASPECT - MANDIBULAR CENTRAL INCISOR

a. The lingual outline is the reverse of the facial outline.
b. The anatomical features found on the lingual surfaces of all
incisors (marginal ridges and cinguli) are present but
relatively muted and not conspicuous on mandibular
incisors.
c. The lingual fossa is trapezoidal in shape, will be very
shallow and limited to the incisal 1/3 of the crown.
d. The cingulum will be smoothly rounded and not as
prominent as the cinguli of the maxillary incisors.

M D
D M

47

3. MESIAL ASPECT - MANDIBULAR CENTRAL INCISOR

a. The incisal ridge will be lingual to the faciolingual long
axis bisector.
b. The enamel on the lingual surface will extend apically
about 0.5 mm farther than it does on the facial. This
makes the measurement of the anatomical crown 0.5 mm
greater on the lingual surface than on the facial surface.
c. The crests of the cervical ridges (greatest curvatures) will
not be at the same level facially and lingually (the crests
of these ridges are about 1 mm incisal to the cervical line).
d. Cervical ridges are not as well developed on mandibular
anterior teeth. Their crests extend beyond the
labiolingual diameter of the root at the cervix less than
the 0.5 mm. When compared to most other permanent
teeth, this is quite small.
e. The cervical line curves incisally more on the mesial
surface than on the distal surface.
f. The root converges apically, evenly toward a relatively
blunt (rounded) root end.
g. A broad longitudinal root depression is usually found for
most of the length of the root.
4. DISTAL ASPECT - MANDIBULAR CENTRAL INCISOR

a. The distal outline is a reverse image of the mesial outline.
b. It should be noted that in spite of the fact that the incisal
ridge is lingually placed relative to the faciolingual long
axis bisector, the proximal contact areas are at a level
cervical to the incisal ridge and are near the mid-point of
the tooth faciolingually.
c. The cervical line curves incisally for a relatively shorter
distance on the distal than on the mesial surface.
d. The broad root depression may be deeper on the distal
surface of the root than on its mesial. The apex of the root
will be even with the faciolingual long axis bisector.
L F

F L

48

NOTES:
1. Incisal ridge slightly lingual of the faciolingual bisector
2. The lingual fossa is trapezoidal in shape
3. When compared to the maxillary central incisor, the tooth is much narrower
with the crown having more squared incisal line angles. The mandibular
central incisor is the narrowest (M-D) of all teeth
4. Crown is considered to be bilaterally symmetrical
5. Mesial & distal proximal contacts are high on the incisal third of the crown
6. The root is wider in a faciolingual dimension and is narrow mesiodistally
7. The root has developmental depressions on both the mesial and distal
surfaces and a tendency for two canals
8. May on rare occasion have two roots

5. INCISAL ASPECT - MANDIBULAR CENTRAL INCISOR

a. The faciolingual diameter is greater than the mesiodistal
width.
b. The greatest curvature mesially and distally (proximal
contact areas) are equidistant between the facial and
lingual outlines.
c. The incisal ridge runs straight across the tooth
mesiodistally parallel to but slightly lingual to the
faciolingual bisector of the crown.
d. Mesiofacial and distofacial line angles are more distinct
(less rounded) than those of a maxillary lateral incisor
because of the relative flatness of the incisal 1/3 of the
facial surface.
e. The crest of the cingulum lingually is usually slightly to
the distal of the mesiodistal bisector of the crown.
f. In spite of this, the outline of the mandibular central
incisor crown from the incisal view is said to be bilaterally
symmetrical.
D M

49

PERMANENT MANDIBULAR LATERAL INCISOR

M D
1. FACIAL ASPECT- MANDIBULAR LATERAL INCISOR

a. The mandibular lateral incisor is larger than the mandibular
central incisor in all dimensions.
b. The incisal edge is straight but it may appear slanted toward
the distal.
c. The mesial incisal line angle is said to be a sharp 90 angle;
the distal incisal line angle usually appears a little more
rounded.
d. Proximal contacts are both within the incisal 1/3 of the
crown and are considered to be at essentially the same level.
e. There is often more curvature in the distal crown outline;
therefore, the crown is not considered symmetrical from the
facial view.
f. The crest of the gingival curvature of the cervical line will be
slightly distal to the mesiodistal long axis bisector.
g. The root tapers to a pointed apex. It may curve slightly to
the distal or remain straight.
2. LINGUAL ASPECT- MANDIBULAR LATERAL INCISOR

a. The lingual outline is the reverse of the labial outline.
b. Anatomical features are not as prominent as they are on
maxillary incisors.
c. The lingual fossa is trapezoidal in shape, shallow and limited
to the incisal 1/3 of the crown.
d. The cingulum is smoothly rounded and not well delineated.
D M

50

4. DISTAL ASPECT- MANDIBULAR LATERAL INCISOR

a. The distal outline of this tooth resembles the distal of the
mandibular central incisor. It is not a reverse image of the
mesial view of the mandibular lateral incisor. From the
distal aspect the mesial marginal ridge cannot be seen
protruding to the lingual as it is hidden by the outline of
the distal marginal ridge.
b. The cervical line curves less incisally than on the mesial.
c. The root outline and root depression are similar to that of
the distal surface of the root of a mandibular central incisor.
d. The apex of the root will be in line with the faciolingual
long axis bisector.
L F
3. MESIAL ASPECT- MANDIBULAR LATERAL INCISOR

a. The incisal ridge will be lingual to the faciolingual long axis
bisector of the tooth.
b. When measured, the anatomical crown is longer from the
incisal ridge to the cervical line on the lingual surface.
Enamel extends apically 0.5 mm more on the lingual than on
the facial surface.
c. The crest of the facial cervical ridge will be at a higher level
incisally than the crest of the lingual cervical ridge.
d. The height of contour of the crown beyond the root facially
and lingually will be less than 0.5 mm on either surface.
e. The cervical line curves incisally to a higher level on the
mesial surface than on the distal.
f. Since the crown of this tooth is slightly twisted on its
root and the distal end of the incisal ridge is more inclined
to the lingual, a part of the distal marginal ridge can be
seen beyond the lingual outline of the mesial marginal
ridge. This is a distinctive characteristic of this tooth from
the mesial view.
g. The mesial surface of the root will be similar in outline to
that of the mandibular central incisor. A broad root
depression will exist for most of the root length.
F L
DMR

51

NOTES:
1. Of all of the incisors, the mandibular lateral incisor has the strongest tendency to
have two canals, one facial and one lingual.
2. Also most likely incisor to have two roots
3. Lingual fossa shallow and trapezoidal in shape
4. Both mesial and distal proximal contacts at the incisal 1/3 of the crown
5. Tooth is not bilaterally symmetrical
6. Incisal ridge lingual to the faciolingual bisector
7. Distal portion of the crown more inclined toward the lingual giving it a twisted
appearance. This characteristic is best seen from either a mesial or incisal view.
8. Root is ovoid, wider faciolingually and narrower mesiodistally
9. Larger tooth than the mandibular central incisor

5. INCISAL ASPECT- MANDIBULAR LATERAL INCISOR

a. The faciolingual measurement is greater than the mesiodistal.
b. The mesial contact area is centered faciolingually but the distal
proximal contact will be slightly to the lingual of the
faciolingual bisector.
c. The incisal ridge will be lingual to the faciolingual bisector of
the crown outline in its entirety; however, the distal end of the
ridge will be more toward the lingual than the mesial end.
d. The incisal ridge will be relatively straight but it is not straight
across the tooth mesiodistally. It slants to the lingual at its distal
end and is not parallel to the faciolingual bisector.
e. The crest of the cingulum lingually will be slightly distal to the
mesiodistal bisector.
f. The crown of the mandibular lateral incisor from the incisal
view is said to look twisted or rotated on its axis, not at all
symmetrical.
D M

52
DENTAL ANATOMY
PRINCIPAL CHARACTERISTICS OF THE
PERMANENT MANDIBULAR LATERAL INCISOR

1. INCISAL ASPECT
a. Crown twisted (distal portion more lingual than mesial portion)
b. FL (6.5 mm) > MD (5.5 mm)
c. Incisal ridge lingual to the faciolingual bisector

2. FACIAL ASPECT
a. Wider mesiodistally (5.5 mm) than the mandibular central
incisor (5.0 mm)
b. MI line angle sharp; DI line angle more rounded
3. LINGUAL ASPECT
a. Anatomical features not as prominent as maxillary incisors
b. Lingual fossa shallow and trapezoidal in shape
c. Cingulum smoothly rounded and not well defined
4. MESIAL ASPECT
a. Because of twisted crown, the DMR is seen from this view
b. Incisal ridge lingual to the faciolingual bisector
c. DMR visible from mesial aspect

L F

53

5. DISTAL ASPECT
a. Cervical ridges extend facially & lingually only 0.5 mm beyond the cervical line
b. Incisal ridge is lingual to the faciolingual long axis bisector

F L
Additional Notes:

54
PERMANENT MAXILLARY CANINE

1. FACIAL ASPECT - MAXILLARY CANINE

a. Although canines have a cusp that keeps the facial outline
from being a true trapezoid, the outline is still said to be a
trapezoid with the shorter parallel side at the cervix.
b. The tip of the cusp may be centered or it may be slightly to
the mesial of the mesiodistal long axis bisector.
c. In either case, the mesial cuspal ridge will be shorter than
the distal cuspal ridge because there is a difference in the
level of the mesial and distal proximal contact areas.
d. The mesial contact is said to be at the level of the junction of
the incisal and middle 1/3 of the crown.
e. The distal contact is usually near the middle of the middle
1/3 of the crown.
f. The mesial crown outline from the contact to the cervical
line is slightly convex.
g. Although the distal outline in the contact area is definitely
convex (almost semicircular), there is a concave segment
between the distal contact area and the cervical line.
h. The crest of the arc of the cervical line apically will usually
be slightly distal to the mesiodistal long axis bisector.
i. The crown converges evenly (at the same rate, mesially and
distally) from the contact areas to the cervical line. This
gives the feeling that the crown is balanced under its root
(this will contrast with the description of a mandibular
canine).
j. The crest of the facial ridge (greatest facial curvature of this
surface in an incisocervical direction) will curve slightly
toward the mesial. The curvature mesially will be at the
mid-point of the crest.
k. The crown surface mesial to the crest of the facial ridge will
be convex in all respects.
l. The crown surface distal to the crest of the labial ridge is
convex in the incisal ; however, the distocervical quadrant
of the surface is slightly concave. The concavity is manifest
in the distal outline of the crown.
m. There may be some evidence of vertical developmental
depressions between lobes particularly between the middle
facial and the distal lobes.
n. The root is conical in form. It is the longest of all roots of
human teeth. The root may remain straight or it may curve
in its apical 1/3, usually toward the distal.

M D

55

2. LINGUAL ASPECT - MAXILLARY CANINE

a. The lingual outline will be the reverse of the facial
outline.
b. Anatomical features on the maxillary canine are well
developed.
c. There are two lingual fossae. They are termed the
mesiolingual fossa and the distolingual fossa.
d. The two lingual fossae are separated by the lingual
ridge which connects the cusp tip and the cingulum.
The crest of this ridge curves with the mid-part of the
curve slightly mesial to the mesiodistal long axis
bisector. This makes the distolingual fossa a little
larger than the narrower mesiolingual fossa.
e. The cingulum is smooth but well developed and
occupies the cervical of the lingual surface.
f. The crest of the cingulum lingually and the crest of the
curve of the cervical line cervically are both slightly
distal to the mesiodistal long axis bisector.
g. The root tapers lingually, i.e. the ligual root surface is
more narrow than the facial.
3. MESIAL ASPECT - MAXILLARY CANINE

a. The outline of the crown from a mesial aspect is
triangular.
b. The tip of the cusp may be centered faciolingually but it
is usually slightly facial to the faciolingual long axis
bisector. The cusp tip is never lingual.
c. The facial and lingual cervical ridges are well
developed and their crests oppose one another at the
same level.
d. The facial outline between the cervical ridge and cusp
tip is smoothly convex.
e. The lingual outline will be that of the convex cingulum
and the crest of the lingual ridge which is slightly
concave. This is sometimes referred to as an S shaped
lingual outline.
f. The outline of the mesial marginal ridge will follow
somewhat the same curvature but a little to the facial of
the lingual outline.
g. The cervical line on the mesial aspect will not extend as
far incisally as on the incisors, but will extend incisally
more on the mesial surface than on the distal surface.
D M
L F

56
g. The root from the mesial aspect remains broad and
converges gradually to a relatively blunt tip that is
usually facial to the faciolingual long axis bisector.
Note that both the apex of the root and the cusp tip
are usually facial to this line and therefore are more or
less in line with one another vertically.
h. A shallow developmental depression is normally
found for part of the root length.

4. DISTAL ASPECT - MAXILLARY CANINE

a. The outline is the reverse of the mesial outline.

b. The distal marginal ridge crest is farther to the
lingual and its crest will more closely follow the
lingual outline of the lingual ridge.

c. The cervical line curves less incisally on the distal
surface than it does on the mesial surface.

d. The root depression is likely to be deeper than the
depression on the mesial surface of the root.
F L

57

d. The facial outline is full and rounded in its mesial and
middle thirds but there is definitely a concave area in
the outline where the middle facial and distal lobes
have joined.

e. The lingual outline is also fuller and continuously
convex from the mesial contact area to the crest of the
cingulum than it is between the cingulum and the
distal contact area. The relative thinness of the distal
lobe causes a concavity in the lingual outline of this
area. Therefore, the crown from this view looks
wider faciolingually in its mesial half.

f. The crest of the lingual outline will be slightly distal
to the mesiodistal bisector.

5. INCISAL ASPECT - MAXILLARY CANINE

a. The incisal outline is described as diamond shaped. It
measures wider faciolingually than mesiodistally.
(Note that this differs from maxillary incisors).

b. From the incisal view, the cusp tip will usually be
slightly facial to the faciolingual bisector of the crown
and slightly mesial to the mesiodistal bisector.
However, it may be centered within the crown outline.

c. The cuspal ridges are generally in line with one another
across the tooth mesiodistally; but not necessarily
straight across the tooth. The distal end of the distal
cuspal ridge is likely to be a little lingual to the mesial
end of the mesial cuspal ridge. (Both cuspal ridges
comprise the incisal ridge.) There is some compensation
in this tooth form that contributes to the curvature of
the maxillary dental arch. The maxillary arch presents a
wider arch than does the mandibular arch; therefore,
the curving effect is less dramatic in the maxillary
canine than that observed in the mandibular canine and
lateral incisor.

M D

58
PERMANENT MAXILLARY CANINE

1. INCISAL ASPECT
a. diamond shaped
b. cusp tip centered or slightly facial of FL bisector
c. cingulum offset to the distal
d. wider FL (8.0 mm) than MD (7.5 mm)

2. FACIAL ASPECT
a. Cusp tip will be centered or slightly mesial to the MD long axis bisector
b. Mesial cuspal ridge shorter than the distal cuspal ridge due to the relative
positioning of the proximal contacts
c. The crown outline cervical to the mesial contact area is convex
d. The crown outline cervical to the distal contact area is concave
e. Root form is conical
f. Longest root of any tooth (17.0 mm)
g. Mesial contact area: Junction of middle & incisal thirds
h. Distal contact area: Middle (area of greatest convexity)

3. LINGUAL ASPECT
a. Prominent mesial and distal marginal ridges
b. Prominent lingual ridge and cingulum
c. Mesiolingual (smaller) and distolingual (larger) fossae

59

NOTES:
1. Due to its facial positioning, the maxillary canine gives rise to canine eminence or
prominence in the maxillary dental arch.
2. The canines are considered to be transitional teeth between anterior and posterior
teeth and contain features of both.
3. Canines are extremely important teeth in esthetics and occlusal function
4. Of all the teeth (maxillary & mandibular), the maxillary canine has the longest root
5. The maxillary canine crown has asymmetrical anatomy. The distal portion of the
crown is not as well developed as the mesial portion.
6. The maxillary canine is the widest (faciolingually) of all the anterior teeth (8.0 mm).
7. The maxillary canine has the longest root of any tooth (17.0 mm)
8. The middle-facial lobe is the most developed of all the lobes and gives rise to the
facial ridge.
9. From a proximal viewpoint, the cusp tip of the maxillary canine is lined up with the
root tip. It may be centered or slightly facial of the faciolingual long axis bisector. It
is never lingual.
10. The cingulum is well developed and smooth.
L F
4. MESIAL ASPECT
a. Crown outline triangular
b. Cusp tip centered or slightly facial (never lingual)
c. Facial & Lingual cervical ridges at the same level
d. Facial outline smoothly convex
e. Lingual outline extending from the convex cingulum and
slightly concave crest of the lingual ridge is said to resemble
an S
f. Cusp tip and root apex are aligned
g. Shallow developmental root depression
h. Cervical line slumps significantly toward the incisal
F L
5. DISTAL ASPECT
a. Distal marginal ridge more lingual than mesial marginal ridge
b. Distal marginal ridge follows the outline of the lingual ridge
c. Root depression deeper than that found on the mesial surface
d. Cervical line slump is not as severe

60

PERMANENT MANDIBULAR CANINE

1. FACIAL ASPECT - MANDIBULAR CANINE

a. The mandibular canine is narrower mesio-
distally and the crown is longer (inciso-
gingivally) than that of the maxillary canine.
b. The mesial proximal contact is at the incisal 1/3
and the distal proximal contact is at the middle
1/3 of the crown.
c. The average root length of the mandibular
canine is 16.0 mm which is only 1.0 mm shorter
than that of the maxillary canine (17.0 mm).
d. The cusp tip will appear less pointed than the
cusp tip of the maxillary canine. The proximal
contact areas are nearer the incisal outline and
the cuspal ridges meet at a wide obtuse angle.
The tip will be mesial to the mesiodistal long
axis bisector and the mesial cuspal ridge will
always be shorter than the distal cuspal ridge.
e. The mesial contact area is in the incisal 1/3 of
the crown. The distal contact is within the
middle 1/3 of the crown but is more incisally
placed than is the distal contact of the maxillary
canine.
f. The mesial outline of the crown, from contact
area to cervical line is straight. There is little or
no change in direction between the crown and
root outlines.
g. The distal outline of the crown, from the contact
area to the cervical line, reflects a concavity in
the tooth surface. There is a change of direction
between the crown and root outlines.
h. The cervical outline of the crown is described as
the arc of a semicircle. The cervical crest of the
arc will fall slightly distal to the mesiodistal long
axis bisector.
i. The crown does not look balanced over its root
but rather looks tipped to the distal.

M D

61
j. As was true for the maxillary canine, the
crest of the facial ridge curves slightly so
that the middle segment of the curve is
slightly mesial to the mesiodistal long axis
bisector.
k. The crown surface mesial to this crest is
convex. The crown surface distal to the crest
of the facial ridge is convex in its incisal
but slightly concave in its cervical . (The
morphology of the facial surface of the
maxillary canine was similarly described).
l. The root outline tapers evenly from the
cervical line for 2/3 of the root length and
usually curves distally in its apical 1/3.
The root may curve mesially or remain
straight. Occasionally this root may
bifurcate into a facial and lingual root. This
is the only anterior tooth that does bifurcate
often enough that the fact is noted in
textbooks.

2. LINGUAL ASPECT - MANDIBULAR CANINE

a. The lingual outline will be the reverse of the labial
outline.
b. As was true when comparing the lingual anatomy of
maxillary and mandibular incisors, it is noted that the
anatomical features of mandibular canines (while
present and identifiable) are more poorly developed
when compared to those of the maxillary canine. The
mesial and distal lingual fossae are shallow. The
borders of each fossa are their respective marginal
ridges and cuspal ridges, the lingual ridge and the
cingulum.
c. The crest of the cervical line apically will be distal to
the mesiodistal long axis bisector.
D M

62

3. MESIAL ASPECT - MANDIBULAR CANINE

a. As is true of the mandibular incisors, the incisal
ridge (mesial and distal cuspal ridges referred to
collectively) will be lingual to the faciolingual
long axis bisector.
b. The cusp tip of the mandibular canine is lingual
to the faciolingual long axis bisector.
c. Unlike the mandibular incisors, the facial and
lingual extent of the enamel apically is at the
same level and the crests of the facial and lingual
cervical ridges are also at the same level across
the tooth surface.
d. Like the mandibular incisors, the apex of the root
is in line with the faciolingual long axis bisector.
e. The mesial contact area is centered faciolingually
and within the incisal 1/3 of the crown.
f. The facial outline from the facial cervical ridge to
the cusp tip is slightly convex. The lingual
outline from the cingulum to the lingual roll-
over of the cusp tip is slightly concave.
g. A separate outline marking the crest of the
mesial marginal ridge may also be seen from the
mesial aspect.
h. The cervical line curves incisally more on the
mesial surface than on the distal but not as much
in respect to the total crown length as is seen on
incisors.
i. The root outline usually tapers evenly to a
relatively pointed apex that is centered
faciolingually. As previously noted, the
mandibular canine is the anterior tooth most
likely to have a bifurcated root. There may be a
true bifurcation into a facial and lingual root for
as much as the root length; or there may be a
deep mesial and distal root depression in the
apical of the root suggesting two root canals
and two apical foramina.

L F

63

4. DISTAL ASPECT - MANDIBULAR CANINE

a. The distal outline will be the reverse of the mesial
outline.
b. The distal contact area will be just cervical to the
junction of the incisal and middle thirds of the
crown.
c. The cervical line curves less toward the incisal than
it did on the mesial surface.
d. The morphological characteristics of the root
surface will be similar to the mesial surface of the
same root.
5. INCISAL ASPECT - MANDIBULAR CANINE

a. The incisal outline measures wider faciolingually
than it does mesiodistally. The general shape of the
outline is similar to that of the maxillary canine,
including the slight facial concavity at the junction of
the middle facial and distal lobes.
b. The lingual crest of the outline of the cingulum will
be slightly distal to the mesiodistal bisector.
c. The primary distinguishing characteristic of a
mandibular canine from the incisal view is the
location of the cusp tip and cuspal ridges. The cusp
tip will always be lingual to the faciolingual bisector
of the tooth.
d. As is true of the maxillary canine, the distal end of
the distal cuspal ridge may be a little more lingual
than the mesial end of the mesial cuspal ridge. Both
cuspal ridges combine to form the incisal ridge. Most
of the curve in the mandibular arch is compensated
for in the directional curve of the incisal ridge of the
lateral incisor; however, in some instances there will
be additional evidence of compensation in the
mandibular canine as well.

F L
D M

64
PERMANENT MANDIBULAR LEFT CANINE

D M
1. INCISAL ASPECT
a. Narrower mesiodistally (7.0 mm) than the maxillary canine
(7.5 mm)
b. Wider FL (7.5 mm) than MD (7.0 mm)
c. Asymetrical diamond outline
d. Cusp tip and ridges lingual to the faciolingual bisector
e. Cusp tip slightly mesial to the mesiodistal bisector

M D
2. FACIAL ASPECT
a. Crown is longer (IC) (11.0 mm) than the crown of the maxillary
canine (10.0 mm)
b. IC crown length (11.0 mm) longest of any tooth
c. Mesial outline straight, distal outline concave
d. Cervical outline arc of a semicircle
e. Crown does not look balanced over the root but tipped to the distal
f. Mesial cuspal ridge shorter than the distal cuspal ridge
g. Mesial contact area: Incisal
h. Distal contact area: Middle
D M
3. LINGUAL ASPECT
a. Anatomical features less prominent than those of the maxillary
canine
b. ML & DL fossae are separated by the lingual ridge

65

F L
4. MESIAL ASPECT
a. Cusp tip and ridges lingual to the faciolingual bisector
b. Prominent developmental root depression. Anterior tooth
most likely to have two roots, facial & lingual
c. Mesial contact area centered faciolingually within the
incisal third of the crown
L

F
5. DISTAL ASPECT
a. Distal contact area slightly cervical to the junction of the
incisal and middle thirds of the crown
b. Prominent developmental root depression
NOTES:
1. Mandibular canine crown is slightly smaller M-D & F-L than the crown of the
maxillary canine but is longer IC.
2. When viewed from the facial aspect, cervical line is semicircular in appearance
3. Mesial cuspal ridge significantly shorter than the distal cuspal ridge
4. Mesial contour straight and continuous between crown and root, distal contour
presents a concavity in the cervical area
5. MF line angle more angular than DF line angle which is more rounded
6. Cusp tip lingual to the faciolingual long axis bisector
7. Mandibular canine is the anterior tooth most likely to have a root bifurcation one
facial & one lingual).

66
PERMANENT CANINES
(aka Cuspids)

I. Permanent Canines (General)

Class Traits:

1. Canines are the only teeth in the dentition possessing a single
conical cusp.
2. Canines have the longest single root of all the teeth.
3. Canines are the only cusped teeth that feature a functional
lingual surface. Typically, the functional surface of a tooth is
the occlusal (posterior) or the incisal (anterior) surface.

II. Permanent Maxillary Canines

1. Overall, the crown of the maxillary canine is larger than the
mandibular canine (of the same dentition) however the actual
crown length of the mandibular canine (measured
incisocervically) is slightly longer.
2. The mesial and distal marginal ridges converge markedly
toward the cervix.
3. The incisal portion of the crown (as measured from the contact
areas to the tip of the cusp) occupies at least one-third of the
crown height (often as much as one-half).
4. The mesial and distal marginal ridges, the lingual ridge, and the
cingulum are more prominent than those of the mandibular
canine.
5. A lingual pit and/or grooves are a common feature.
6. The faciolingual diameter of the crown near the cervix is greater
than that of the mandibular canine.
7. There is a marked asymmetry of the mesial and distal halves of
the crown when viewed from the incisal aspect.
8. The crown appears to be more centered over the root.
9. The cusp tip is centered over the root tip or is slightly facial to
the faciolingual long axis bisector. It is never lingual to it.

67

III. Permanent Mandibular Canines

1. The crown is slightly smaller than the maxillary canine.
2. The mesial outline (when viewed from the facial aspect) is
straight from the contact area to the cervical line. There is little
or no change in direction between the crown and root outlines.
3. The distal outline of the crown is concave from the contact area
to the cervical line. There is a change in direction between the
crown and root outlines.
4. The crown appears tipped off center toward the distal.
5. The incisal portion of the crown occupies only the incisal one-
fourth or one-fifth of the crown, giving the tooth a long, narrow
appearance when compared to the maxillary canine.
6. The entire lingual surface is flatter than the maxillary canine,
with much less prominence of marginal ridges, lingual ridge,
and cingulum.
7. There are no lingual pits or grooves.
8. The faciolingual diameter of the crown near the cervix is less
than that of the maxillary canine.
9. The mesial and distal halves of the crown, when viewed from
the incisal aspect, are more symmetrical than the maxillary
canine.
10. The cusp tip is lingual to the faciolingual long axis bisector.

NOTES:

68
MAXILLARY FIRST PREMOLAR
(aka maxillary 1
st
bicuspid)

1. FACIAL (BUCCAL) ASPECT - MAXILLARY FIRST PREMOLAR

a. Facial outline of the crown is a trapezoid with the shorter parallel
side at the cervix.
b. The tooth is broad shouldered when viewed from this aspect with
markedly convex mesial and distal contours.
c. The cusp tip is relatively pointed and will be slightly distal to the
mesiodistal long axis bisector. (This is a distinctive characteristic
since this is the only permanent tooth where the mesial cuspal
ridge of the facial cusp is longer than the distal cuspal ridge).
d. The mesial proximal contact is slightly more cervically placed than
the distal proximal contact. (This is a characteristic of both
maxillary and mandibular first premolars and would be expected
since the mesial contact meets the distal contact of a canine and
both maxillary and mandibular canines have their distal contact
areas in the middle 1/3 of the crown incisogingivally).
e. The mesial outline of the crown between the mesial contact area
and the cervical line is slightly concave. This is principally due to
the developmental root depression on the mesial surface that
extends over the CEJ onto the crown surface better described from
the mesial aspect. Although not visible from the facial aspect, this
outline is said by one text to be a mirror image of the distal contour
of the adjacent canine.
f. The distal outline of the crown between the contact area and the
cervical line is slightly convex.
g. The apical crest of curvature of the cervical line on premolar
crowns will usually be centered but may be slightly distal to the
mesiodistal long axis bisector.
h. The root of this tooth is usually bifurcated into a facial and a
lingual root. Since the facial root is usually wider than the lingual
root, the lingual root will not always be visible from the facial
aspect. However, dental charts depicting a drawing of this tooth
from a facial view will usually show the apices of both roots on the
drawing.
i. The apices of both the facial and lingual roots will usually be
slightly distal to the mesiodistal long axis bisector.
j. There is a tendency for the facial surface of the crown to show
evidence of lobe formation by having a prominent facial ridge
running axially from the facial cusp that is bordered by noticeable
developmental depressions mesial and distal to it.

M D

69

2. LINGUAL ASPECT - MAXILLARY FIRST PREMOLAR

a. The entire tooth converges toward the lingual and the lingual cusp
is shorter than the facial cusp. The outline is a reverse image of the
facial outline.
b. The lingual cusp tip is less pointed and about 1.0 mm shorter than
the facial cusp.
c. The lingual cusp tip is slightly mesial to the mesiodistal long axis
bisector; therefore, the mesial cuspal ridge will be shorter than the
distal cuspal ridge. It is characteristic of the lingual cusps of both
maxillary premolars to swing or point to the mesial.
d. The mesial and distal outlines of the lingual cusp will both be
slightly convex.
e. A small amount of both the mesial and distal surfaces of the crown
will be visible.
f. The fact that the tip of the facial cusp is distal and the tip of the
lingual cusp is mesial to the mesiodistal long axis bisector is very
significant in distinguishing between the lingual views of
maxillary premolars.
3. MESIAL ASPECT - MAXILLARY FIRST PREMOLAR

a. The outline of this tooth crown is said to be trapezoidal with the
longer parallel side at the cervix and the shorter parallel side at
the occlusal. (This is true for the proximal view of all maxillary
posterior teeth.)
b. The greatest contour facially will be the crest of the cervical
ridge at a level within the cervical 1/3 of the crown.
c. The greatest contour lingually will be the crest of the wide
convex arc of the lingual outline of the crown. This will occur
at the middle 1/3 of the lingual outline of the crown. Note that
there is NO ridge (elevation along a line) of enamel at this level.
Posterior teeth do not have cervical ridges on their lingual
surfaces.
d. The faciolingual width of the occlusal table is about that of
the total faciolingual width of the tooth crown. This places the
cusp tips well within the confines of the root trunk.
e. The facial outline of the crown is slightly convex from the facial
cusp tip to the crest of the cervical ridge.
f. The lingual outline is evenly convex from the lingual cusp tip to
the cervical line.
g. The occlusal outline between cusps reflects the outline of the
triangular ridges which meet at a point hidden by the outline of
the mesial marginal ridge. This will be slightly lingual to the
faciolingual long axis bisector. Triangular ridges on maxillary
premolars tend to be approximately the same length. Their
slope toward the central groove is said to be steeper than for
any other tooth.

D M

L F

70

h. The mesial cuspal ridges of the facial and lingual cusps
converge cervically from their respective cusp tips to meet the
facial and lingual segments of the mesial marginal ridge. The
crest of this mesial marginal ridge is almost perpendicular to
the faciolingual long axis bisector. It is divided into a facial
and a lingual segment by the MESIAL MARGINAL
DEVELOPMENTAL GROOVE which crosses the ridge from
the occlusal surface and extends onto the mesial surface. The
maxillary first premolar is the only tooth that has such a
groove. This is, therefore, a distinguishing characteristic of the
tooth.
i. The cervical line curves occlusally in its middle segment
approximately 1 .0 mm. This occlusal curvature of the
cervical line on the mesial surface of 1.0 mm or less remains
generally constant on all posterior teeth, maxillary and
mandibular according to Wheeler.
j. The mesial proximal contact area is located just cervical to the
facial segment of the mesial marginal ridge, facial to the mesial
marginal developmental groove.
k. The area of this crown cervical to the mesial contact area will
be slightly concave.
l. The faciolingual measurement of the root trunk at the cervical
line is about 1.0 mm less than the overall faciolingual crown
measurement (0.5 mm overhang facially and 0.5 mm overhang
lingually).
m. The length of the root trunk will vary but usually the apical
will definitely present a facial and lingual root. This tooth
may present a single root but if it does, it will almost always
have two root canals and two apical foramina.
n. All forms will have a relatively deep root depression that
increases in width occlusally from the point of bifurcation to
the cervical line.
o. This MESIAL DEVELOPMENTAL (ROOT) DEPRESSION
crosses the cervical line and extends to the level of the junction
of the cervical and middle thirds of the crown. At the level of
the cervical line, the tooth surface will be convex in its facial
and lingual thirds and concave in its middle 1/3. After
crossing the cervical line onto the crown, the depression
continues to become wider faciolingually as it progresses
occlusally. The entire MESIAL DEVELOPMENTAL
DEPRESION is triangular in outline with the base of the
triangle at the junction of the middle and cervical thirds of the
crown and its apex at the root bifurcation. For this reason, this
mesial developmental depression must always be of concern
to the dentist during restorative and periodontal treatment
procedures.

71

4. DISTAL ASPECT - MAXILLARY FIRST PREMOLAR

a. The distal outline of both the crown and root will be the
reverse of the mesial outline.
b. The crest of the distal marginal ridge will be more cervically
positioned (relative to the MMR) and it will be uninterrupted.
There is no groove crossing the distal marginal ridge.
c. The distal contact area will still be facial to the faciolingual
long axis bisector but it will be slightly higher on the tooth
occlusally than the mesial contact and a little wider
faciolingually since it contacts a wider tooth.
d. The crown surface cervical to the level of the contact area will
be smoothly convex.
e. The root depression will not likely be as broad nor as deep as
seen on the mesial surface and it does not extend across the
cervical line. In fact, the root trunk in the cervical 1/3 is
usually convex.
f. The cervical line crosses the surface with very little or no
curvature toward the occlusal (your text lists a zero for the
curvature of the cervical line on the distal surface of all
permanent posterior teeth).
g. Cervical ridge extends facially 0.5 mm relative to the CEJ
h. The distal proximal contact is located in the middle 1/3 of the
crown occlusogingivally.
5. OCCLUSAL ASPECT - MAXILLARY FIRST PREMOLAR

a. Occlusal outline is described in your text as a hexagon with
unequal sides.
b. The facial outline will show evidence of the three lobes that
make up the facial half of the tooth. There will be slight
indentations in the outline corresponding to the developmental
depressions between the lobes.
c. The mesial contact area will be closer to the faciolingual bisector
than the distal contact area will be. This is logical since the
tooth is near the curve of the arch and the distal contact of the
canine is centered faciolingually.
d. The mesiofacial and distofacial line angles are both prominent
(more angular than rounded).
e. The mesial segment of the outline measures less faciolingually
than the distal outline. The mesial outline is said to reflect the
contour of a figure 3 (or a reverse figure 3 for the maxillary
left first premolar illustrated). This is due to the presence of the
MESIAL MARGINAL RIDGE DEVELOPMENTAL GROOVE.
f. The distal segment of the outline is slightly convex, and blends
smoothly into the arc of the lingual segment.
g. The crest of the lingual segment lingually will be well to the
mesial of the mesiodistal bisector of the crown.
F L

M D

72
h. The mesiolingual and distolingual line angles are
relatively round.
i. The mesial and distal cuspal ridges of the facial cusp
are almost in line with one another but they do angle
across the tooth surface. The mesial end of the
connected cuspal ridge line will be more to the lingual
than the distal end.
j. The cusp tip of the facial cusp is positioned distal to the
mesiodistal bisector. The tip is about half the distance
from the facial outline to the faciolingual bisector of the
crown.
k. The mesial marginal ridge is crossed near its center by
the mesial marginal ridge developmental groove and is
divided into two segments by the groove.
l. The distal marginal ridge is longer, uninterrupted and
is slightly curved.
m. The mesial marginal ridge is said to meet the mesial
cuspal ridge of the facial cusp at a 90 angle while the
distal marginal ridge meets the distal cuspal ridge of
the facial cusp at an acute angle.
n. The mesial and distal cuspal ridges of the lingual cusp
meet at the cusp tip forming a continuous curve.
o. The tip of the lingual cusp will be mesial to the
mesiodistal bisector of the crown. Lingual cusps of
maxillary premolars swing mesially. The tip of the
lingual cusp will be nearer the lingual outline of the
crown than the facial cusp tip is to the facial outline.
p. The mesial cuspal ridge of the lingual cusp will be
shorter than its distal cuspal ridge.
q. Triangular ridges from the facial and lingual cusps
meet near the center of the occlusal table but slightly
lingual to the faciolingual bisector of the crown. There
is the potential for them to form a true transverse
ridge. Although the crests of the two triangular ridges
are in line with one another, they are almost always
separated by a deep central groove. The alignment of
the crests of the two triangular ridges will not be
parallel to the mesiodistal bisector.
r. The central groove crosses the occlusal table
mesiodistally, parallel to but slightly lingual to the
faciolingual bisector of the occlusal table. The central
groove more or less bisects the occlusal table into facial
and lingual halves. It connects the mesial and distal
triangular fossae and extends over the mesial marginal
ridge as the mesial marginal ridge developmental groove. It
is considered to be long when compared to the central
groove of the maxillary second premolar. This also

73
places the mesial and distal triangular fossae farther
apart and closer to the mesial and distal occlusal
outlines than the triangular fossae of the maxillary
second premolar. It also means that the marginal
ridges of the first premolar will be narrower
mesiodistally than marginal ridges of the maxillary
second premolar.
s. There is less likelihood for the maxillary first premolar
to have supplemental grooves.
t. The overall effect of the shortness of the mesial surface
versus the distal surface measurement and the position
of the facial and lingual cusp tips cause one authority
to describe the crown from this view as appearing
twisted or rotated around its long axis. Another
authority describes the crown appearing as though the
mesial half had been pinched together with pliers
applied facially and lingually.

NOTES:
1. The maxillary first premolar typically has two roots, one facial and one lingual. It
always has (at least) two canals. If a third canal is present, it will be in the facial
root.

2. Rarely, the maxillary 1
st
premolar will present with 3 roots. These teeth will have
two roots situated facially (MF & DF) and one root situated lingually.

3. The lingual cusp is typically 1.0 mm shorter than the facial cusp
.
4. The mesial marginal ridge is taller than the distal marginal ridge (the DMR is
more cervical than the MMR).

5. The middle facial lobe is the most developed of the facial lobes and gives rise to
a prominent facial ridge.

6. The maxillary first premolar emerges into the oral cavity after the permanent
maxillary lateral incisor but before the permanent maxillary canine.

74
MAXILLARY FIRST PREMOLAR

1. OCCLUSAL ASPECT
a. Crown outline hexagonal; occlusal table trapezoidal
b. The angle formed by the convergence of the MF cusp ridge and the M
marginal ridge approaches a 90 angle.
c. The angle formed by the convergence of the DF cusp ridge and the D
marginal ridge is acute.
d. M & D triangular fossae connected by central groove that
extends over MMR and onto the mesial surface as the mesial
marginal ridge developmental groove or mesial marginal groove
e. F cusp is distal & L cusp is mesial to the mesiodistal bisector

2. LINGUAL ASPECT
a. Lingual cusp is 1.0 mm shorter than the facial cusp
b. Lingual cusp is mesial to the mesiodistal long axis bisector

3. FACIAL ASPECT
a. Prominent facial ridge running axially from the cusp tip
b. M & D developmental depressions border facial ridge
c. Facial cusp distal of mesiodistal long axis bisector
d. Broad-shouldered with markedly convex mesial & distal
contours

75

5. DISTAL ASPECT
a. Developmental root depression does not extend over the cervical
line
b. DMR more cervical than MMR
c. Facial & lingual heights of curvature extend approx. 0.5 mm
beyond the cervical line

4. MESIAL ASPECT
a.. Mesial developmental root depression crosses cervical line onto the
crown surface. It is triangular in shape with the apex at the root
bifurcation
b. Mesial marginal ridge developmental groove extends over the MMR as
an extension of the central groove
c. Facial root slightly longer than lingual root
d. Lingual cusp approx. 1.0 mm shorter than facial cusp

76
MAXILLARY SECOND PREMOLAR
(aka maxillary 2
nd
bicuspid)

1. FACIAL ASPECT - MAXILLARY SECOND PREMOLAR

a. It should be noted that the AVERAGE measurements
(given in your text for all maxillary premolars Wheeler
measured) suggest that maxillary first and second
premolars are essentially the same in every dimension.
However, when maxillary first and second premolars are
compared from the same dentition, the maxillary second
premolars will measure slightly smaller than the maxillary
first premolars. It is important to remember that the
outlines of the teeth will differ considerably from every
visual aspect.
b. The facial cusp tip will usually be slightly mesial to the
mesiodistal long axis bisector. The mesial cuspal ridge is
shorter than the distal cuspal ridge.
c. The facial cusp tip will be more rounded (less pointed)
than the facial cusp tip of the maxillary first premolar.
d. Both proximal contact areas are at a level occlusally high in
the middle 1/3 of the crown and at the same level across
the tooth.
e. The outlines of the crown surfaces between contact areas
and cervical line are both smooth convex curves.
f. The cervical outline of the crown is also smoothly (evenly)
convex.
g. The total effect of these flowing rounded curves make the
outline of the crown essentially oval from the facial
aspect.
h. There is less evidence of the lobe structure on the facial
surface of the maxillary second premolar crown as the
developmental depressions are less defined than they are
on the maxillary first premolar.
i. The root outline converges evenly toward a relatively blunt
apex which may be centered or slightly distal to the
mesiodistal long axis bisector. The maxillary second
premolar has a single root.

M D

77

2. LINGUAL ASPECT - MAXILLARY SECOND PREMOLAR

a. The outline of the lingual surface will be a reverse image of
the facial outline.
b. Occlusally the outline of both cusps will be visible. The tip
of the lingual cusp will be in line with the tip of the facial
cusp. It will be nearly equal in height and a little more
rounded (less pointed) than the facial cusp. The cuspal
ridges of the lingual cusp will not be as high occlusally as
those of the facial cusp and will present the same angle of
slant from the tip of the cusp.
c. The mesial, distal and cervical outlines are such that an
outline of the entire lingual surface is described as being
oval in appearance.
d. The lingual surface of the root is not quite as wide as the
facial surface of the root.
e. The apex of the single root is relatively blunt and will
usually be distal to the mesiodistal long axis bisector.
3. MESIAL ASPECT - MAXILLARY SECOND PREMOLAR

a. The outline from the mesial aspect is described as a trapezoid
with the shorter parallel side at the occlusal and the longer
parallel side at the cervix.
b. The facial cusp tip is more pointed than the lingual cusp tip and
is located about half way between vertical lines that mark the
greatest facial curvature and the faciolingual long axis bisector of
the crown.
c. The lingual cusp tip is more rounded than the facial cusp tip and
the tip will be closer to the vertical line marking the greatest
lingual curvature than it is to the faciolingual long axis bisector.
d. The slants of the triangular ridges are not as steep as those seen
on maxillary first premolar. The mesial marginal ridge is almost
horizontal across the tooth and is continuous (not divided into
two segments by a groove).
e. The greatest curvature facially is the crest of the cervical ridge on
the cervical 1/3 of the crown outline.
f. The greatest curvature lingually will occur about the level of the
middle of the middle 1/3 of the crown outline.
g. The contact area is about 1.0 mm cervical to the crest of the
mesial marginal ridge and will be slightly facial to the facio-
lingual long axis bisector.
h. The mesial surface between the contact area and the cervical line
is evenly convex (not at all like that of the maxillary first
premolar). The cervical line curves occlusally about 1.0 mm.
i. The root converges evenly to a blunt tip which is usually slightly
facial to the faciolingual long axis bisector.
j. There is a longitudinal root depression that is limited to the root
(it does not cross the cervical line onto the crown).

D M

L F

78

4. DISTAL ASPECT - MAXILLARY SECOND PREMOLAR

a. The distal outline will be the reverse of the mesial outline.
b. The surface is very similar in all respects to the mesial
surface except that the cervical line curves a little less
occlusally and may even be relatively straight.
c. The root has a longitudinal depression on the distal aspect
that is confined to the root.
d. Although root depressions are found on both the mesial
and distal surfaces, the root does not bifurcate.
e. Distal contact area is centered faciolingually.

F L

M D
5. OCCLUSAL ASPECT - MAXILLARY SECOND PREMOLAR

a. Although the measurements of an average maxillary second
premolar are essentially the same as that of the maxillary first
premolar, the second premolar from the same dentition will usually
measure slightly smaller.
b. The line angles of the maxillary second premolar are more rounded
and there is less evidence of the lobe structure in the facial outline.
The overall effect is that the crown outline is said to be oval
however the occlusal table outline is rectangular. There is a
balanced look about the tooth from the occlusal aspect.
c. Both facial and lingual cusp tips are slightly mesial to the mesio-
distal bisector. The cusp tips are in line with each other. The facial
cusp tip is farther from the facial outline than the lingual cusp tip is
from the lingual outline.
d. The triangular ridges are approximately the same length and the
point at which they meet will be located slightly lingual to the
faciolingual bisector of the crown. Rarely will there be a true
transverse ridge since the two triangular ridges will be separated by
a central groove.
e. The mesial and distal cuspal ridges of the facial cusp are relatively
straight and will meet at the facial cusp at an obtuse angle. They
are not aligned with one another as they are on the maxillary first
premolar.
f. The mesial and distal cuspal ridges of the lingual cusp present a
continuous elliptical arc.
g. Mesial and distal marginal ridges converge slightly toward the
lingual. They join the cuspal ridges at relatively rounded line
angles but the occlusal table is said to be rectangular in outline.
h. This tooth has mesial and distal irregular triangular fossae that are
nearer the center of the tooth when compared to the maxillary first
premolar. Therefore, this tooth is described as having a relatively
short central groove and relatively wide marginal ridges.
i. There may be several supplemental grooves extending facially and
lingually along the central groove giving the occlusal table a
wrinkled appearance.

79

MAXILLARY SECOND PREMOLAR

1. OCCLUSAL ASPECT
a. Ovoid crown outline with MMR & DMR parallel to one another
b. Rounded facial line angles (compared to maxillary 1
st
premolar)
c. Many supplemental grooves (wrinkled appearance)
d. Short pit-like central groove
2. FACIAL ASPECT
a. Trapezoidal crown outline
b. Middle facial lobe most developed of three facial lobes but less prominent
than that found on the maxillary 1
st
premolar.
c. Developmental depressions found on either side to the facial ridge more
subtle as well
3. LINGUAL ASPECT
a. Crown does have lingual convergence but not as conspicuous as that found
on maxillary 1
st
premolar
b. Lingual cusp in line with the facial cusp and very nearly the same height
4. MESIAL ASPECT
a. Contact area located in the high middle 1/3 (OG) of the tooth and
facial to the faciolingual long axis bisector of the crown
b. Trapezoidal crown outline with the longer parallel side at the cervical
c. Developmental root depression present but does not extend over the
cervical line onto the crown

80

NOTES:

1. The maxillary 2
nd
premolar has two cusps (facial & lingual) of nearly
equal size and height
2. The distal cuspal ridges of both cusps are longer than the mesial
cuspal ridges
3. This tooth typically has one root with 2 pulp canals. There is however
an extreme variation in pulp morphology.
4. Overall, this is a smaller tooth than the maxillary 1
st
premolar
5. Root length for this tooth will be as great (14.0 mm) or occasionally
even longer than the root of the maxillary 1
st
premolar.
6. The facial ridge is not as prominent as that of the maxillary 1
st

premolar.
7. When compared to the maxillary 1
st
premolar, this tooth will usually
present with more supplemental occlusal anatomy (secondary ridges
and grooves).

5. DISTAL ASPECT
a. Very little (if any) curvature of the cervical line occlusally
b. Developmental root depression that is confined to the root
c. Distal contact area is centered faciolingually.

81
PERMANENT MAXILLARY PREMOLARS

I. PERMANENT PREMOLARS (GENERAL)

CLASS TRAITS:

1. Premolars generally have two cusps (facial & lingual) but may
have additional cusps or cusplets.
2. Premolars in general have a single facial cusp with one or more
lingual cusps. For this reason, the preferred nomenclature for
these teeth is premolar rather than bicuspid which implies
the tooth has two and only two cusps. Although used with
decreasing frequency, the term bicuspid is parlance still
commonly used in dental literature and offices.

II. PERMANENT MAXILLARY PREMOLARS

KEY CONSIDERATIONS:

1. There are two major cusps, facial and lingual, that are
approximately equal in size and prominence however the
maxillary first premolar presents a lingual cusp that is
approximately 1.0 mm shorter than the facial cusp.
2. The crowns, from the occlusal aspect, are relatively much wider
(2.0 mm) faciolingually than they are mesiodistally. This
characteristic is true of all maxillary posterior teeth.
3. Facial profiles viewed from the proximal aspect, are only
slightly inclined lingually from height of contour to cusp apex.
4. Lingual height of contour is situated approximately midway
between cervical line and the cusp tip in the middle 1/3 of the
crown.
5. There is, overall, a much greater morphological similarity
between the two maxillary premolars than between the two
mandibular premolars.

82
B. TYPE TRAITS (Maxillary premolars)

FIRST PREMOLAR SECOND PREMOLAR

Facial aspect Prominent, broad shoulders
Facial cusp tip distal of
center
Prominent facial lobes
Narrow shoulders
Facial cusp tip mesial of
center
Facial lobes not prominent

Lingual aspect Entire facial profile of crown
visible
Little or none of the facial
profile visible.

Mesial aspect Mesial marginal ridge
developmental groove
interrupts mesial marginal
ridge.
Usually two roots, facial and
lingual.
Mesial developmental
depression extends from
bifurcation of root across the
cervical line and well onto
crown almost to contact
area.
No mesial marginal ridge
developmental groove.
Single root.
Mesial depression restricted
to root surface.
Occlusal aspect Crown profile hexagonal.
Mesiofacial and distofacial
line angles are sharp.
Mesial and distal profiles
converge lingually.
Occlusal table outline
trapezoidal.
Facial cusp ridge has a slight
mesial cant, giving the
crown a twisted appearance.
Facial cusp wider than
lingual cusp.
Central groove long.
Supplemental grooves rare.
Facial ridge, developmental
depressions and lobes
visible.
Crown profile ovoid.
Mesiofacial and distofacial
line angles more rounded.
Little lingual convergence;
mesial and distal marginal
ridges parallel.
Occlusal table outline
rectangular.
Crown not twisted in
appearance.
Short central groove & wide
marginal ridges
Many supplemental grooves
giving a wrinkled
appearance

Cross section of
root
Outline is kidney shaped
with concavity on mesial.
One root canal at cervix, two
root canals as root bifurcates
Outline is ovoid.
One root with one or two
root canals with varied pulp
morphology

83
MANDIBULAR FIRST PREMOLAR
(aka mandibular first bicuspid)

1. FACIAL ASPECT:

a. Nearly symmetrical bilaterally.
b. Large, pointed facial cusp with mesial cuspal ridge shorter than
distal cuspal ridge (cusp tip positioned slightly mesial of mesiodistal
long axis bisector).
c. Contact areas broad occlusogingivally.
d. Note slight vertical developmental depressions between lobes.

2. LINGUAL ASPECT:

a. Crown and root both taper lingually.
b. Occlusal table slants (slopes) cervically in a lingual direction.
c. It is possible to see much of the occlusal, mesial and distal surfaces
of this tooth when viewed from the lingual aspect.
d. Lingual cusp is small (almost like a cingulum at times).
e. Measurement from lingual cusp tip to cervical line is approximately
2/3 the total occlusogingival crown measurement.
f. Lingual cusp tip is pointed and is in line with facial cusp tip.
g. The mesiolingual groove crosses between the mesial cuspal ridge of
the lingual cusp and the mesial marginal ridge. It extends
gingivally at the mesiolingual line angle of the tooth.
h. Horizontal depressions are seen bilaterally on either side of the
lingual ridge just occlusal to the cervical line.

3. MESIAL ASPECT:

a. Note rhomboid form of crown outline (typical of all mandibular
posterior teeth).
b. Tip of facial cusp centered over root or may be slightly facial to the
faciolingual long axis bisector.
c. Tip of lingual cusp in line with lingual outline of root.

M D

D M
L F

84
d. Greatest curvature of facial outline in cervical 1/3 identifiable as a
facial cervical ridge.
e. Greatest curvature of the lingual portion of the crown outline
is at the middle 1/3 (of the entire occlusocervical measurement of
the crown).
f. Facial outline convex to facial cusp tip.
g. Triangular ridge of facial cusp relatively long.
h. Triangular ridge of lingual cusp relatively short.
i. Triangular ridges meet at a point well to the lingual of the
faciolingual long axis bisector to form a transverse ridge.
j. The mesial marginal ridge slants lingually and gingivally at an angle
almost parallel to the crest of the triangular ridge of the facial cusp
(approximately at a 45 angle to long axis of tooth).
k. The mesiolingual groove crosses between the mesial marginal ridge
and the mesial cuspal ridge of the lingual cusp.
l. The contact area is in line with tip of the facial cusp.
m. The cervical line curves occlusally approximately 1.0 mm.

4. DISTAL ASPECT:

a. Reverse of the mesial outline (with certain exceptions)
b. Cervical line shows less curvature (or none)
c. Distal marginal ridge is usually a little higher, curved and more
horizontal than the mesial marginal ridge.
d. There is no groove crossing between the distal cuspal ridge of the
lingual cusp and the distal marginal ridge.
e. The contact area is centered both faciolingually and
occlusogingivally.

5. OCCLUSAL ASPECT:

a. Outline said to be diamond shaped.
b. Occlusal table said to be triangular with the base at the cuspal ridges
of the facial cusp and the apex at tip of the lingual cusp.
c. Facial cusp triangular ridge long.
d. Lingual cusp triangular ridge short.
e. Facial and lingual triangular ridges meet to form a transverse ridge.
f. Mesial fossa presents a linear mesial groove that becomes
continuous with the mesiolingual groove. This groove crosses
between the mesial marginal ridge and the mesial cuspal ridge of
the lingual cusp onto the lingual surface near the line angle.
g. The distal fossa usually presents a comma shaped curved groove.

F L

D M

85

MANDIBULAR FIRST PREMOLAR

1. OCCLUSAL ASPECT
a. Diamond shaped crown outline
b. Triangular shaped occlusal table
c. Facial & lingual triangular ridges form a transverse ridge
d. Mesial developmental groove continues onto the lingual surface at the ML line
angle as the mesiolingual developmental groove.
2. FACIAL (BUCCAL) ASPECT
a. Characteristic mesial bulge
b. Large pointed cusp slightly mesial to the mesiodistal long axis bisector
3. LINGUAL ASPECT
a. Crown has characteristic lingual conversion
b. Occlusal table slants cervically in a lingual direction
c. Lingual cusp small (almost cingulum-like)
d. Mesiolingual groove at about the area of the mesiolingual line angle
4. MESIAL ASPECT
a. Characteristic rhomboid crown outline
b. Tip of facial root centered over the root
c. Greatest curvature of facial outline at cervical third of crown (cervical ridge)
d. Greatest curvature of lingual outline at middle third of entire occlusocervical
measurement of the crown

86

NOTES:

1. The mandibular 1
st
premolar is viewed as a transitional tooth resembling
the mandibular canine but with two cusps. The facial cusp is much larger
than the lingual cusp which may even resemble a cingulum.

2. The occlusal table slopes cervically in a lingual direction. It is the only
posterior tooth with this trait.

3. When viewed from the facial aspect, the tooth has near symmetrical mesial
& distal profiles. However, there is a prominent mesial bulge.

4. The mesiolingual groove produces a slight concavity at about the
mesiolingual line angle of the tooth.

5. The occlusal crown outline is diamond shaped. The occlusal table is
triangular.

6. There is a prominent transverse ridge from the facial cusp tip to the lingual
cusp.

7. The MMR is less distinct than the DMR and slopes lingually at or about a
45 angle (approximates the DMR of the abutting mandibular canine).

5. DISTAL ASPECT
a. DMR higher and more horizontal than MMR
b. Contact area centered faciolingually and occlusogingivally

87
MANDIBULAR SECOND PREMOLAR
(aka mandibular second bicuspid)

Drawings of Mandibular Second Premolar (3 cusp variety):

1. FACIAL ASPECT:

a. Facial cusp shorter and blunter than the facial cusp of mandibular first
premolar.
b. Contacts are broad occlusogingivally and are located nearer the occlusal
outline than the contacts of the mandibular first premolar.
c. Crown does not converge as much toward the cervix as does the
mandibular 1
st
premolar.
d. Mesial cuspal ridge of the facial cusp is shorter than distal cuspal ridge.
(Cusp tip is located slightly to the mesial of the mesio-distal long axis
bisector.)
e. The distal cuspal ridge presents a characteristic notch.

2. LINGUAL ASPECT:

a. Has two lingual cusps (3-cusp variety) separated by a lingual groove.
Mesiolingual cusp is approximately 1 mm shorter than facial cusp.
Distolingual cusp is approximately 2.0 mm shorter than facial cusp.
b. The mesiolingual cusp is usually slightly wider than the distolingual
cusp.
c. The lingual surface below the cuspal ridges is spheroidal.
d. The lingual surface at the cervical line is almost as wide as the surface at
the cervical line on the facial surface (crown does not converge as much
toward the lingual as does the crown of the mandibular first premolar).

3. MESIAL ASPECT

a. Facial outline crests in the cervical 1/3 as a cervical ridge.
b. Greatest lingual curvature is located rather high (occlusally) in the
middle 1/3.
c. Facial cusp tip is slightly facial to the center of the root measured
faciolingually.
d. The mesiolingual cusp tip is very near the lingual outline and more or
less in line with the lingual outline of the root.
e. The mesial marginal ridge is relatively high (occlusally) and much more
nearly horizontal than was observed on the mandibular first premolar.
f. The cervical line curves occlusally about 1.0 mm.
M D

L F

88

4. DISTAL ASPECT

a. The distal surface outline is the reverse of the mesial outline.
b. The distal marginal ridge is slightly lower than the mesial marginal
ridge thus allowing more of the occlusal surface to be visible.
c. Since the distolingual cusp is mm shorter than the mesiolingual cusp,
the outline of the shorter cusp is superimposed over the outline of the
taller mesiolingual cusp.
d. The cervical line curves less toward the occlusal and is often almost flat.
e. Lingual height of contour described to be at the occlusal

5. OCCLUSAL ASPECT

a. Contact areas are located slightly facial to the faciolingual bisector and are
fairly wide faciolingually.
b. The facial outline is fairly rounded and may not present the usual three lobe
appearance.
c. The occlusal crown outline form is described as being nearly square. There
is no dramatic lingual convergence as seen on the mandibular first premolar.
The lingual mesiodistal measurement may actually be wider than the facial
mesiodistal measurement. This is the only mandibular tooth (3-cusp variety
only) that has the potential to exhibit lingual divergence.
d. The lingual outline is fairly straight presenting a slight indentation in the
lingual groove area.
e. There are three distinct cusps (listed according to size: facial, mesiolingual and
distolingual).
f. The facial cusp tip is located slightly to the facial of the faciolingual bisector
and slightly mesial to the mesiodistal bisector.
g. The tips of the lingual cusps are located quite near the lingual outline.
h. The mesiolingual cusp is slightly wider than the distolingual cusp.
i. Cuspal ridges extend mesially and distally from the cusp tips to join relatively
straight almost parallel marginal ridges.
j. None of the triangular ridges meet to form transverse ridges.
k. There is a central fossa that is generally located midway between the facial
and lingual outlines of the occlusal table (3-cusp variety only).
l. From the central pit in the central fossa radiate the lingual, mesial and distal
grooves, forming a Y shaped pattern.
m. The mesial and distal grooves end respectively in their mesial and distal
triangular fossa.

F L

D M

89

MANDIBULAR SECOND PREMOLAR

2. FACIAL ASPECT
a. Occlusocervical crown dimension is greater than the mesiodistal crown
dimension
b. Crown outline form described as trapezoidal or pentagonal
c. Tendency for distal curvature of root tip

3. LINGUAL ASPECT
a. Of the two lingual cusps, the ML is the larger occupying 2/3 of the
mesiodistal crown dimension
b. Less lingual convergence than found on mandibular 1
st
premolar
c. 3-cusp variety likely to have lingual divergence

4. MESIAL ASPECT
a. Crown outline rhomboidal
b. MMR horizontally positioned at a rt. angle to the faciolingual long-
axis bisector of the tooth
c. Facial cusp tip slightly facial to the FL long axis bisector
d. ML cusp in line with the lingual outline of the root
e. Mesial contact area oval shaped (FL direction) and is facial to the
faciolingual long axis bisector
f. Lingual height of contour located at the occlusal
5. DISTAL ASPECT
a. 3-cusp variety: all 3 cusps are visible from this aspect
b. DMR cervical to MMR showing more of the occlusal surface
c. Distal contact area ovoid (FL direction) and is facial to the
faciolingual long axis bisector
d. Lingual height of contour located at the occlusal
1. OCCLUSAL ASPECT
a. May present with two or three cusps. 2-cusp variety may have H or
U shaped grove pattern; 3-cusp variety will have a Y shaped occlusal
groove pattern
b. No transverse ridges extending between facial and lingual cusps
c. 3-cusp variety only mandibular tooth to exhibit lingual divergence

90

MANDIBULAR SECOND PREMOLAR: 2-CUSP VARIETY

1. Crown outline described as round or oval
2. Occlusal groove pattern resembles a U or an H
3. Has a central developmental groove connecting the mesial and
distal fossae
4. Has a transverse ridge connecting the facial and lingual cusps
5. Occlusal crown outline will exhibit lingual convergence unlike the
3-cusp variety mandibular 2
nd
premolar which may exhibit lingual
divergence

PERMANENT MANDIBULAR PREMOLARS
(general traits)

1. Have a single, well-developed facial cusp, however the lingual cusp or
cusps may vary in size and development and are never as well
developed as the facial cusp.
2. The crowns, from the occlusal aspect, are more nearly the same
diameter faciolingually and mesiodistally (the faciolingual
measurement is greater than mesiodistal measurement by only 1.0 mm
or less).
3. Facial profiles, viewed from the proximal aspect, are significantly
inclined lingually from the height of contour (cervical ridge) to the tip
of the facial cusp.
4. Lingual height of contour is situated more occlusally much nearer the
tip(s) of the lingual cusp(s). This is still considered to be the middle
third of the crown when compared to the crowns overall
occlusocervical measurement. However some text books reference the
lingual height of contour as being in the occlusal 1/3 of the crown
because it is referencing an OC measurement from the tip(s) of the
lingual cusp(s) to the cervical line.
5. The mandibular first premolar and the 3-cusp variety mandibular
second premolar do not share a great deal of morphological similarity.
The mandibular 1
st
premolar and the 2-cusp variety mandibular 2
nd

premolar demonstrate significant lingual convergence. The 3-cusp
variety mandibular 2
nd
premolar may demonstrate lingual divergence,
that is to say the mesiodistal measurement of the lingual surface may be
greater than that of the facial surface.

91
TYPE TRAITS (Mandibular premolars)

FIRST PREMOLAR SECOND PREMOLAR

1. Facial aspect Crown not as
bilaterally symmetrical

Crown bilaterally
symmetrical

2. Lingual aspect

Entire facial profile
visible
Almost entire occlusal
surface visible
Lingual cusp much
smaller and lower than
facial cusp
None of facial profile
visible
Little if any of occlusal
surface visible
Facial and lingual
cusps almost equal in
height

3. Mesial aspect

Occlusal plane tilted
lingually
Transverse ridge links
tips of the facial and
lingual cusps
Mesial marginal ridge
inclines cervically
about 45
Mesiolingual groove

Occlusal plane
horizontal
No transverse ridge
(except 2-cusp variety)
is horizontal
Lingual groove
separating lingual
cusps (3-cusp variety)

4. Occlusal aspect Occlusal crown outline
diamond shaped
Mesial and distal
profiles converge
lingually
Occlusal table
triangular in outline
Facial cusp more than
twice the size of lingual
cusp
shorter and less
prominent than distal
marginal ridge
Absence of Y pattern
formed by grooves
No pit
Occlusal crown outline
square or oval
Mesial and distal
profiles straight and
parallel
Occlusal table square in
outline
Facial and lingual
cusps nearly equal in
size
Mesial and distal
marginal ridges about
same length and
prominence
Main grooves form Y
pattern (3-cusp)
Central pit

92
PERMANENT MAXILLARY FIRST MOLAR

1. OCCLUSAL ASPECT MAXILLARY FIRST MOLAR

a. Average mesiodistal diameter - 10.0 mm
b. Average faciolingual diameter 11.0 mm
c. Somewhat rhomboidal crown outline.
d. Crown wider mesially than distally (distal convergence)
and wider lingually than facially (unique feature of this
tooth).
e. Four well developed cusps. One minor fifth cusp
(Carabellis) on the lingual of and augmenting the
mesiolingual cusp.
f. Cusp size: very large mesiolingual cusp followed in size by
mesiofacial, distolingual, distofacial and fifth (Carabellis)
in that order. The maxillary first molar has a well
developed distolingual cusp.
g. Mesial contact area is facial to the faciolingual bisector.
Distal contact area is centered faciolingually.
h. The oblique ridge (characteristic of all maxillary molars)
extends from the tip of the mesiolingual cusp diagonally
across the tooth to the tip of the distofacial cusp. The
oblique ridge is produced by the meeting of (1) the
triangular ridge of the distofacial cusp and (2) the distal
cuspal ridge of the mesiolingual cusp. The low point of the
ridge (where the two ridges meet) is at the same level as the
mesial and distal marginal ridges.
i. Each major cusp has a triangular ridge that extends from
the cusp tip down into the central portion of the occlusal
surface
j. Each cusp has cuspal ridges that extend laterally (mesially
and distally) from the tip of the cusp.
k. The mesial marginal ridge and distal marginal ridge
mark the mesial and distal margins of the occlusal
table. They are confluent with the mesial and distal cusp
ridges of the major mesial and distal cusps. Each marginal
ridge typically has a marginal groove, a supplemental
groove emanating from the pit in their respective triangular
fossae (see 1.m below).
l. There are two major fossae located on either side of the
mid-point of the oblique ridge. They are named the central
fossa (in the center of the occlusal surface) and the distal
fossa (on the distal side of the oblique ridge)

M D

93
m. There are two minor fossae located toward the center of
the tooth from the mid-points of the marginal ridges.
These are named the mesial triangular fossa and the distal
triangular fossa. There are four fossae on the occlusal
surface of the maxillary first molar, 2 major & 2 minor.
n. The central groove runs from the central pit in the central
fossa to the mesial pit in the mesial triangular fossa. The
facial groove runs from the central pit straight to and then
onto the facial surface of the tooth. The distal oblique
groove runs from the pit in the distal triangular fossa
through the distal fossa and continues diagonally toward
the lingual surface where it meets and becomes
continuous with the lingual groove. The lingual groove
crosses over onto the lingual surface of the crown
separating the mesiolingual and distolingual cusps. It
terminates near the center of the lingual surface in a
lingual fossa or pit. Sometimes, there is a groove which
crosses the oblique ridge. This groove, when present, is
called the transverse groove of the oblique ridge. There are
usually shallow, short supplemental grooves running
toward the corners of the tooth from the mesial and distal
triangular fossae.

2. FACIAL ASPECT MAXILLARY FIRST MOLAR

a. The crown outline of facial surface is trapezoidal.
b. Typically, maxillary molar facial cusps are taller than
lingual cusps and mesial cusps are taller than distal
cusps. The MF & DF cusps of the maxillary 1
st
molar are
very nearly the same height. On occasion, the DF cusp
will even be taller than the MF cusp.
c. Facial cusps are more pointed than lingual cusps.
d. Cuspal ridges of the mesiofacial cusp meet at an obtuse
angle.
e. The cuspal ridges of the distofacial cusp meet at a 90 or
right angle making it a sharper cusp than the MF cusp.
f. Usually the crown is longer in the mesial half, but
occasionally the distofacial cusp will be as tall as or taller
than the mesiofacial cusp.
g. The facial groove extends occlusocervically between the
mesiofacial and distofacial cusps to a point near the
center of the facial surface.

M D

94
h. The facial surface shows a slight depression
extending laterally (both mesially and distally)
from the cervical limit of the facial groove. This
depression is just occlusal to and parallel to the
cervical ridge.
i. The facial surface demonstrates vertical facial
ridges extending cervically from the cusp tip of
each facial cusp. The cervical ridge runs
mesiodistally just above the cervical line but only
in the mesial two-thirds of the cervical third of the
crown.
j. The cervical line curves apically and may come to
a definite point near the center, in alignment with
the furcation between the mesiofacial and disto-
facial roots.
k. The mesiofacial root extends in a mesial direction
for two-thirds of its length. It then curves slightly
to the distal. Its apex is said to be in alignment
with the tip of the mesiofacial cusp.
l. The distofacial root is generally straighter and
slightly shorter than the mesiofacial root. Its apex
is usually in line with the distal outline of the
crown.
m. The root trunk (the root portion that extends from
the cervical line to where it bifurcates) on the facial
aspect of the tooth averages 4 mm in length.
There is a broad concave area between the roots
extending from the cervical line into the furcation
area.
n. The lingual (or palatal) root may also be seen from
the facial view of this tooth. It is the longest of the
three roots by about 1.0 mm. Its apex is in line
with the facial groove when viewed from this
aspect.

95

3. LINGUAL ASPECT MAXILLARY FIRST MOLAR

a. Usually, only the lingual cusps will be seen from this
aspect since they are larger and block the facial cusps
from view unless the tooth is tipped slightly.
b. The mesiolingual cusp is very wide mesiodistally and
is said to occupy about three-fifths of the total mesio-
distal measurement of the crown. Its cuspal ridges
meet at a rather wide obtuse angle at the cusp tip. Its
mesial cuspal ridge meets the relatively straight
mesial outline of the crown at a 90 right angle.
c. The distolingual cusp is well developed. It takes up
the remaining two-fifths of the total mesiodistal width
of the crown. Its tip is so rounded that it is sometimes
described as spheroidal. The occlusal outline of this
cusp joins the distal outline of the crown in an arc that
is almost that of a semicircle.
d. The fifth (or Carabellis) cusp is located on the lingual
aspect of the mesiolingual cusp. Its cuspal ridges are
parallel to, and about 2.0 mm cervical to the occlusal
outline of the mesiolingual cusp. Sometimes this cusp
can be so well developed that the cusp angle will be
90, i.e sharper and less obtuse than the mesiolingual
cusp. Other times this cusp will be hardly
distinguishable at all. As with all cusps, the fifth cusp
is considered to have four cuspal ridges, albeit at
times they may be difficult to define.
e. The lingual groove begins at the lingual border of the
occlusal table as an extension of the distal oblique
groove. From this origin between the mesiolingual
and distolingual cusps, it slants cervically and
diagonally across the lingual surface until it reaches a
position near the center of the mesiodistal width of the
surface then it turns more parallel with the long axis
of the tooth. It ends in a fossa (sometimes a pit) near
the center of the lingual surface.
f. All three roots will be visible from a lingual view. The
apex of the lingual (palatal) root will be in line with
the occlusal end of the lingual groove as it crosses
between the mesiolingual and distolingual cusps to
join the distal oblique groove.
g. There is a shallow developmental depression in the
middle one third of the lingual (palatal) root that
extends occlusally on the root and across the cervical
line onto the cervical third of the crown.

D M

96

4. MESIAL ASPECT - MAXILLARY FIRST MOLAR

a. The crown outline from the mesial view is trapezoidal
with the shorter parallel side at the occlusal and the
longer parallel side at the cervix.
b. The greatest curvature of the facial outline is within the
cervical third of the crown.
c. The greatest curvature of the lingual outline is near the
middle third of the crown.
d. Since the ML cusp is taller than the DL cusp and the
MF cusp is taller than the DF cusp and the mesial
marginal ridge is higher than the distal marginal ridge,
little if any of the occlusal anatomy is visible from this
view.
e. The lingual outline of the crown will reflect the
position of the fifth (Carabellis) cusp by showing a
slight indentation about 2.0 mm cervical to the
mesiolingual cusp tip.
f. The cervical line curves occlusally about 1.0 mm. The
crest of this curvature will reach its highest position
occlusally at a point slightly facial to the faciolingual
long axis bisector.
g. Only two of the three roots of this tooth are visible
from the mesial view since the mesiofacial root is much
wider faciolingually and slightly longer than the
distofacial root.
h. The root trunk is shorter on the mesial aspect than on
the facial, however the mesial surface shows a similar
concavity between the trifurcation area and the cervical
line.
i. The mesiofacial root is broad and flattened on its
mesial aspect. Its width faciolingually from facial
outline to the area of furcation is approximately two-
thirds of the cervical measurement of the crown.
j. The mesiofacial root presents a relatively wide but
shallow depression for almost its entire length. This
root depression extends occlusally across the root trunk
area and cervical line onto the cervical one-third of the
crown.
k. The facial outline of the mesiofacial root often extends
facially in its middle one-third a little beyond the
greatest projection of the crown and then curves
lingually to a relatively blunt apex that is more or less
in line with the tip of the mesiofacial cusp. The lingual
outline is relatively straight to the area of trifurcation.

L F

97
l. The lingual (palatal) root is the longest of the three
roots. It is said to be banana shaped. From the
mesial view the facial outline of this root is
concave while the lingual outline is convex. The
lingual outline of this root in its middle and even
its apical third may extend lingually beyond the
greatest lingual projection of the crown.

5. DISTAL ASPECT - MAXILLARY FIRST MOLAR

a. From the distal view the crown outline is also
trapezoidal. The greatest facial curvature of the outline
will crest in its cervical third; lingually the greatest
curvature will crest in middle third of the crown length.
b. Since the crown of this tooth is shorter in its distal half,
it is possible to see quite a bit of the occlusal anatomy
from the distal aspect. The occlusal outlines of the
mesiofacial and mesiolingual cusps will be seen
extending occlusally beyond the outlines of the shorter
distofacial and distolingual cusps.
c. Like all molars, the crown of this tooth is narrower in
its distal half. Most of this convergence to the distal
takes place because the facial cervical ridge flattens out
in the distal half of the tooth. It is therefore possible to
see much of the facial surface when viewing the tooth
from the distal aspect.
d. The cervical line across the distal surface is relatively
straight and presents little or no curve occlusally.
e. All three roots will be visible from a distal view.
f. The distofacial root is narrower at its base than the
other roots and is normally the shortest of the three
roots. It continues to be relatively narrow facio-
lingually and its outline will be superimposed over the
outline of the wider mesiofacial root. The distal surface
of the root trunk is likely to show a shallow root
depression that extends occlusally to the cervical line.
The distofacial portion of the depression (above the DF
root) will extend occlusally over the cervical line onto
the cervical of the crown surface. The outline of the
lingual (palatal) root will be similar to that seen from a
mesial view (banana shaped).
F L

98
g. The distal surface of the root trunk is generally
smoothly rounded and convex. There is a small,
shallow depression in the root trunk over the
distofacial root that extends across the cervical line
onto the cervical third of the crown surface.
However, there is little or no depression between the
furcation area and the cervical line as was described
on the facial and mesial aspects.
h. The root trunk on the distal aspect is longer than its
measurement on the facial aspect by about 1.0 mm.
Its total length will average about 5.0 mm.

NOTES:

1. Primary Cusp Triangle: Formed by the three major cusps (mesiofacial,
distofacial and mesiolingual). Characteristic of all maxillary molars.

2. The permanent maxillary 1
st
molar measures a wider lingual surface
mesiodistally than it does on its facial surface. This makes this permanent
tooth unique (along with the 3-cusp variety mandibular 2
nd
premolar) in
that it does not exhibit lingual convergence.

3. Anomalies: Mulberry molar is a developmental anomaly associated with
congenital syphilis and Hutchinsons Incisor. Otherwise there are few as
this tooth is very consistent in its size and form as it develops.

4. MF root has a 50% probability of having two root canals. If it does, one
will be facial and one will be lingual.

5. Root lengths: L > MF > DF

6. Facial & lingual heights of contour extend approx. 0.5 mm beyond the
cervical line.

7. Facial roots are wider in a faciolingual direction; lingual root is wider in a
mesiodistal direction

8. Root Depressions: On all three roots (always on widest surface). The
mesial, distal and lingual root depressions cross the CEJ onto crown
surface. The facial root (trunk) depression does not cross onto the facial
surface.

99
DENTAL ANATOMY
PERMANENT MAXILLARY RIGHT FIRST MOLAR

1. OCCLUSAL ASPECT
a. Rhomboidal crown outline; ML & DF line angles obtuse
b. Crown dimension wider lingually than facially
c. Mesial contact facial to the FL bisector; distal contact is centered
d. Two major fossae: central & distal; two minor: M & D triangular fossae
e. Central groove runs from central pit (central fossa) to mesial pit (MTF)
f. Primary cusp triangle (all maxillary molars): MF, DF, ML cusps
2. BUCCAL ASPECT
a. Facial cusps more pointed than lingual cusps
b. Facial groove separates MF & DF cusps
c. M & D cuspal ridges of MF cusp meet at an obtuse angle; M & D cuspal
ridges of DF cusp meet at a 90 angle
d. MF root is the 2
nd
longest root supporting the 2
nd
largest cusp
e. MF root tip lines up with MF cusp; DF root tip lines up with DF cusp
f. L root tip lines up with F groove
3. LINGUAL ASPECT
a. ML cusp the largest of all cusps and occupies 60% of the MD measurement
b. DL cusp well-developed and occupies remaining 40% of MD measurement
c. 5
th
(Carabelli) is on the lingual surface of and augments the ML cusp
d. Lingual (extension of distal oblique) groove separates the ML & DL cusps
e. Developmental root depression that crosses over the cervical line onto the
lingual surface of the crown
4. MESIAL ASPECT
a. Trapezoidal crown outline
b. MF root is broad faciolingually and occupies of the FL measurement
c. Developmental root depression extends over the cervical line onto the crown
d. Facial ht. of curvature at cervical (cervical ridge); lingual ht. of curvature
in middle of crown
e. 5
th
(Carabelli) cusp approx 2.0 mm cervical to ML cusp tip
5. DISTAL ASPECT
a. Measurement of crown is narrower & shorter than on mesial
b. Cervical ridge flattens and is not evident on distal half of crown
c. Shallow developmental root depression that crosses over the cervical line
onto the crown surface

100
PERMANENT MAXILLARY SECOND MOLAR

1. OCCLUSAL ASPECT - MAXILLARY SECOND MOLAR

a. Average mesiodistal diameter - 9.0 mm.
b. Average faciolingual diameter - 11.0 mm.
c. Crown outline from this view will usually be that of a
rhomboid. The mesiolingual line angle and distofacial line
angle are obtuse. The distofacial line angle and mesiolingual
line angle are obtuse. This rhomboidal form presents four
well developed functional cusps on its occlusal surface.
d. The central groove extends mesially from the central pit in the
central fossa to the mesial pit in the mesial triangular fossa.
e. The distal oblique groove extends from the distal pit in the distal
triangular fossa in a lingual direction parallel to the oblique
ridge. It continues onto the lingual surface as the lingual
groove.
f. The maxillary 2
nd
molar has similar occlusal anatomy to the
maxillary 1
st
molar with the following exceptions:
1. Rarely has fifth or Carabellis Cusp.
2. The distolingual cusp is smaller. In some specimens, it
is quite small giving this tooth a heart shaped
appearance which is more characteristic of a third
molar crown. The primary cusp triangle characteristic
of all maxillary molars is identifiable since it does not
include the distolingual cusp.
3. This heart type is still considered to have four cusps
although at least one textbook considers this tooth to
have only three functional cusps.
4. When the distolingual cusp is small in size, the oblique
ridge and the distal marginal ridge often become
difficult to distinguish as separate landmarks.
5. In some specimens, the triangular ridge of the
distofacial cusp and the distal cuspal ridge of the
mesiolingual cusp do not exactly meet and the
transverse groove of the oblique ridge is quite deep.
6. When compared to the first molar, the maxillary second
molar usually has more secondary grooves.
g. The mesial contact area is located facial to the faciolingual
bisector. The distal contact area is centered faciolingually.

M D

101

2. FACIAL ASPECT - MAXILLARY SECOND MOLAR

The permanent maxillary second molar from the facial
view is similar to the first molar with the following
exceptions:
1. The difference in cusp height of the two facial cusps
is greater. The distofacial cusp of this tooth is
always shorter than the mesiofacial cusp. The
maxillary second molar is positioned in the arch
such that the facial cusp tips maintain the convex
arc of the Curve of Spee.
2. The facial groove is shorter.
3. The lateral depression described for the first molar
is not present or is very shallow on the second.
4. The root trunk is longer than that of the 1
st
molar.
5. The overall root lengths (as measured from the
cervical line to the apices of the root tips) may be as
long or even longer than the roots of the maxillary
1
st
molar. The actual roots (as measured from the
bifurcation to the root tip apices) are shorter and
less divergent. In fact, in a few instances they will
be very close together or even fused. They are
much more likely to curve distally.
3. LINGUAL ASPECT - MAXILLARY SECOND MOLAR

The permanent maxillary second molar is similar in
outline and anatomical morphology to the maxillary first
molar with the following exceptions:
1. The mesiolingual cusp is more nearly centered.
2. The distolingual cusp is shorter and much less
developed.
3. Very rarely is there a fifth (Carabellis) cusp.
4. No root depression extending onto the crown is
described.
5. Roots curve to the distal so that the lingual
(palatal) root apex is in line with the distolingual
cusp.
M D

D M

102

NOTES:
1. Root lengths: L > MF > DF
2. Roots are less divergent than those of the maxillary 1
st
molar
3. Developmental depressions on roots are limited
4. Facial roots wider faciolingually; lingual root wider mesiodistally
5. More supplemental grooves and wrinkled occlusal anatomy than
maxillary 1
st
molar
6. Develops from four lobes unless 5
th
cusp present which is very rare
4. MESIAL ASPECT - MAXILLARY SECOND MOLAR

The mesial view of a permanent maxillary second
molar is similar to that of the first molar with the
following exceptions:
1. There is no fifth (Carabellis) cusp
2. The roots, though similar in number, shape
and distribution are closer together and are
never wider in total faciolingual measurement
than the crown. They are described as being
within the confines of the crown.
3. No root depression area is described
extending onto the crown. The root
depressions found on the mesiofacial root
surface are confined to the root.
5. DISTAL ASPECT - MAXILLARY SECOND MOLAR

This view of the permanent maxillary second molar
is also similar to that of the first molar with these
exceptions:
1. More of the occlusal anatomy is visible
because the distal cusps are significantly
shorter than the mesial cusps.
2. All three roots are visible but they are
shorter and less divergent.
3. There is no developmental depression
extending from the root trunk onto the distal
portion of the crown.

L F
F L

103

MAXILLARY RIGHT SECOND MOLAR

1. OCCLUSAL ASPECT
a. Four cusps: ML > MF > DF > DL
b. Wrinkled occlusal anatomy due to more supplemental grooves
c. Rhomboid crown outline
d. Primary cusp triangle
e. DL cusp may be quite small
2. BUCCAL ASPECT
a. MF cusp taller than DF cusp (Curve of Spee)
b. Short facial groove
c. Roots have a distal cant and remain within the confines of the crown outline
3. LINGUAL ASPECT
a. 5
th
(Carabelli) cusp rarely seen
b. DL cusp may be quite small
c. Root depression does not cross CEJ onto crown surface
4. MESIAL ASPECT
a. Root depression on MF root confined to the root
b. Roots confined within the outline of the crown
c. M contact area facial of central groove
5. DISTAL ASPECT
a. All four cusps are visible
b. All three roots are visible
c. D contact area centered faciolingually

104
PERMANENT MAXILLARY THIRD MOLAR

1. OCCLUSAL ASPECT- MAXILLARY THIRD MOLAR

a. Average mesiodistal crown diameter - 8.0 mm.
b. Average faciolingual crown diameter - 10.0 mm.
c. Generally, this tooth has the greatest variation in morphology
of any tooth in the permanent dentition.
d. From the occlusal view, the crown outline is described as
heart shaped.
e. The occlusal anatomy is similar to that of other maxillary
molars. This is particularly true of the Primary Cusp
Triangle (Trigon) area. The distolingual cusp and distal
marginal ridge will be dissimilar in the following ways:
1. The distolingual cusp will be shorter and narrower
(mesiodistally).
2. The distal outline will be more rounded.
3. It is often difficult to distinguish definite, separate
cuspal and triangular ridges on the distolingual cusp.
4. Often, the distolingual cusp is seen as only a minor
elevation or Talon.
5. Often, the distal marginal ridge is hardly discernible.
6. Likewise, definite lingual, distal oblique and
distolingual grooves are hard to distinguish.
7. Often, this whole area of the crown becomes a single
convex roll of enamel from the crest of the oblique
ridge onto the distal surface.
2. FACIAL ASPECT - MAXILLARY THIRD MOLAR

The maxillary third molar from the facial view is very
similar to that view of the permanent second maxillary
molar with the following (expected) exceptions:
1. Crown length is shorter.
2. There is more evidence of the Curve of Spee.
3. Mesiofacial cusp width mesiodistally is
proportionately wider when compared to the
width of distofacial cusp.
4. Root structure will vary from tooth to tooth. Roots
are the same in name, number and arrangement
but they are usually more curved to the distal,
closer together and are often fused.

M D

M D

105

3. LINGUAL ASPECT - MAXILLARY THIRD MOLAR

The maxillary third molar from the lingual view is also
similar to that view of a permanent maxillary second
molar with some exceptions:
1. The mesiolingual cusp tip is more centered
mesiodistally.
2. The mesiolingual cusp dominates the
mesiodistal width of the crown.
3. Often the distolingual cusp is so short,
narrow and rounded that the lingual groove
is evident as a mere fold in the enamel and
the cusp seems to have little height at all.
4. Difference in root curvature and divergence
as described above.
4. MESIAL ASPECT - MAXILLARY THIRD MOLAR

The maxillary third molar from the mesial view is
probably more like the mesial view of the permanent
maxillary second molar than from any other visual
aspect of the tooth. There are hardly any exceptions
or differences other than the fact that roots may be
closer together or even fused.

5. DISTAL ASPECT - MAXILLARY THIRD MOLAR

The same statement concerning similarities to a permanent
maxillary second molar may be made when the distal view
is considered. Perhaps a little more of the facial and occlusal
surfaces are in sight because the crown converges
proportionately more so than does the second molar crown
(toward the distal in both mesiodistal and occlusogingival
measurements). All three roots are usually discernible
although they may be fused.

D M

L F
F L

106
DENTAL ANATOMY
MAXILLARY RIGHT THIRD MOLAR

1. OCCLUSAL ASPECT
a. Type I: 3 cusps, heart shaped, vestigial or no distolingual cusp
b. Type II: 4 cusps, rhomboid shaped (less common than Type I)
c. Shallow central groove
d. Many supplemental grooves
2. BUCCAL ASPECT
a. Shortest OC crown height of all the maxillary molars
b. DF cusp shorter than MF cusp, i.e. more evidence of the Curve of Spee
c. MF cusp wider than DF cusp
d. Roots vary but will have a distal cant, are close together and often fused
3. LINGUAL ASPECT
a. ML cusp is centered mesiodistally
b. ML cusp dominates the lingual width of the crown
c. Depending on Type, DL cusp may be present, vestigial or absent
d. Roots close together and often fused
4. MESIAL ASPECT
a. Most resembles maxillary 2
nd
molar from this aspect
b. Any developmental root depressions will not cross cervical line onto the
crown surface
5. DISTAL ASPECT
a. Significant distal convergence both in a mesiodistal and occlusocervical
direction
b. From this aspect, more of the occlusal and facial surfaces can been seen
than were visible on the maxillary 2
nd
molar.

107
PERMANENT MAXILLARY MOLARS

I. Permanent Molars (General)

Class Traits:

1. Molars have the largest occlusal surfaces of any teeth in the arch.
2. Molars have 3 to 5 major cusps.
3. Molars are the only teeth that have at least two facial cusps.
4. Molars have multiple large roots (usually two or three).

II. Permanent Maxillary Molars

Arch Traits:

1. There are generally three roots, two facial and one lingual.
2. As a general rule, mesial cusps will be taller than distal cusps and facial cusps
will be taller than lingual cusps. The DF cusp of the maxillary 1
st
molar may be
as long as or sometimes even longer than the MF cusp.
3. The mesiolingual cusp as the supporting or centric cusp will be the largest cusp
in size. The second largest cusp is typically the mesiofacial cusp. The third
largest cusp of the permanent maxillary 1
st
molar is the distolingual cusp
followed by the distofacial cusp. The maxillary 2
nd
and 3
rd
molars third largest
cusp is the DF cusp as the DL cusp is much smaller in size and can sometimes
be only a minor elevation (talon).
4. The mesiofacial, distofacial and mesiolingual cusps are arranged in a tricuspate
triangular pattern (trigon) more commonly termed the primary cusp triangle.
5. Generally there are these three major cusps (primary cusp triangle) and a fourth
cusp (distolingual) of lesser size. As noted above, an exception may be the
maxillary 1
st
molar. Wheeler describes the distolingual cusp as being the third
largest of the five cusps. Nevertheless, the MF, DF and ML cusps constitute the
primary cusp triangle of the maxillary first molar.
6. These crowns are always wider faciolingually than mesiodistally.
7. The distofacial and mesiolingual cusps are, with few exceptions, connected by
the oblique ridge.

III. Maxillary Third Molars

1. Extremely variant in size and can be very small
2. Have more rounded features than do the other maxillary molars
3. Roots have a distal cant and are often fused
4. Are frequently missing
5. Type I: Three cusps (no DL cusp) and heart shaped occlusal crown outline
6. Type II: Four cusps and rhomboid shaped occlusal crown outline
7. An oblique ridge is said to be present in both Type I and Type II maxillary third
molars although in Type I it may be difficult to differentiate it from the distal
marginal ridge.

108

Type traits (Maxillary molars)

First Molar Second Molar Third Molar
Facial
aspect
a. Widest (FL) of the
three molars
b. Facial cusps
equal in height.
c. Apex of MF root
directly in line
with tip of MF
cusp.

a. Intermediate in
width
b. DF cusp slightly
shorter than MF
c. MF root apex in
line with center
of crown.
a. Smallest
b. DF cusp much
shorter than MF.
c. Roots show
pronounced
distal inclination
and are often
fused
Lingual
aspect
a. DL cusp largest
of the three
molars.

a. DL cusp smaller
in width and height.
a. DL cusp usually
vestigial or
missing.

Mesial
aspect
a. Lingual root wide
mesiodistally.
b. MF and lingual
roots project
beyond crown
profiles.
a. Lingual root
narrower.
b. MF and lingual
roots much less
divergent.
a. Lingual root
narrowest.
b. MF and lingual
roots often fused.

Occlusal
aspect

a. Crown outline
square to
rhomboidal.
b. Oblique ridge
prominent.
c. Large talon
(distolingual
cusp).

a. Rhomboidal form
more pronounced
in crown outline.
b. Oblique ridge
smaller.
c. Medium talon
(DL cusp)

a. Heart shaped (I)
or rhomboid (II)
crown outline.
b. Oblique ridge
barely discern-
able or absent.
c. Talon vestigial.

109

DENTAL ANATOMY LABORATORY
PERMANENT MANDIBULAR FIRST MOLAR

n. There are four major developmental grooves.
The central groove runs irregularly mesio-
distally across the occlusal surface from the
1. OCCLUSAL ASPECT - MANDIBULAR FIRST MOLAR

a. Average mesiodistal diameter - 11.0 mm.
b. Average faciolingual diameter - 10.5 mm.
c. Occlusal crown outline said to be hexagonal (Wheeler)
or pentagonal (Kraus)
d. Faciolingual measurement is greatest in mesial half of
crown (because of cervical ridge).
e. Tooth converges toward lingual. The facial half of the
crown is much wider than lingual half.
f. Mesial contact area is located slightly facial to the
faciolingual bisector and about 1.0 mm cervical to
mesial marginal ridge.
g. Distal contact area is also located facial to the
faciolingual bisector and about 1 .0 mm cervical to the
distal cuspal ridge of the distal cusp.
h. Crown has five cusps. Three cusps are located on the
facial half of the crown and two cusps are located on
the lingual half.
i. The most distally located cusp on the facial half is
located far enough around on the corner of the crown
to be called the distal cusp.
j. The other cusps are named according to their general
location as mesiofacial, distofacial, mesiolingual and
distolingual.
k. In order of greatest size development, the cusps are
listed: 1) mesiofacial; 2 and 3) (similar in development)
mesiolingual and distolingual; 4) distofacial and 5)
distal (or fifth) cusp.
l. In order of cusp height: 1) mesiolingual; 2) distolingual
(both presenting rather pointed cusps); 3) mesiofacial,
4) distofacial, and 5) distal all presenting rather
rounded cusps.
m. There is one major fossa - the central fossa and two
minor fossae - the mesial triangular fossa and the distal
triangular fossa.
M D

110

mesial pit in the mesial triangular fossa through
the central fossa to the distal pit in the distal
triangular fossa. The mesiofacial groove
extends facially (or slightly in a mesiofacial
direction) at the deepest part of the sulcus
between the mesiofacial and distofacial cusps.
The distofacial groove extends from the central
groove in a distofacial direction at the deepest
part of the sulcus between the distofacial and
distal cusps.
n. The mesiofacial groove and the distofacial groove
extend over onto the facial surface of the crown.
o. The groove pattern of this tooth is described by
various authors as shaped like a W or M or
Y. The M or W configuration best describes
the wanderings of the central groove (depending
on the perspective of the viewer). The Y
comparison considers the paths of the mesiofacial,
distofacial and lingual grooves and that segment
of the central groove between them. It ignores the
mesial and distal extensions of the central groove.
p. Note that each cusp has a definite triangular ridge,
but also note that none of them meet. This
produces an occlusal surface that has no
transverse ridges.

2. FACIAL ASPECT - MANDIBULAR FIRST MOLAR

a. Outline of the facial surface is trapezoidal with the
longer parallel side at occlusal.
b. All cusps are visible since the lingual cusps are taller
than facial cusps.
c. As previously noted, the lingual cusps are more pointed
while facial cusps (even before wear) are more rounded.
d. The mesiofacial cusp is the widest of the three facial
cusps. Its cuspal ridges meet at an angle that is almost
flat. The distofacial cusp is almost as wide as the
mesiofacial cusp but its cuspal ridges meet more at an
angle, yet the cusp tip is still considered rounded. The
distal cusp makes up a very small part of the total
mesiodistal width of the facial surface because most

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of the cusp is lingual to the distofacial line angle
placing it on the distal aspect of the tooth. The
distal cusp is also very rounded occlusally but
more pointed than either the mesiofacial or
distofacial cusp.
e. There are two facial grooves seen from the facial
view. The mesiofacial groove separates the
mesiofacial and the distofacial cusps. The
distofacial groove separates the distofacial and
distal cusps.
f. The mesiofacial groove is the shorter of the two. It
extends from the occlusal margin of the facial
surface and terminates about half way to the
cervical line. It often ends in a slight depression
that extends laterally from the terminus of the
groove. Also, there is often a pit present at the
terminus that frequently requires restoration.
Clinically these are termed facial or buccal
pits that are considered simple yet necessary
restorations.
g. The facial cervical ridge occupies the area cervical
to the lateral depression described above for
approximately the mesial 2/3 of the mesiodistal
width of the tooth.
h. The distofacial groove is somewhat longer and
extends onto the more flattened area on the
cervical 1/3 of the surface distal to the cervical
ridge. This groove rarely ends in a pit but it may
be fissured along its length.
i. The cervical line usually dips apically in its center
pointing slightly toward the bifurcation of the two
roots.
j. The mesial outline of the crown is somewhat
concave in its cervical 1/3. The distal outline is
straighter or slightly convex.
k. The root trunk on the facial aspect measures 3.0
mm on the average. There is a deep depression
between the roots that becomes progressively
more shallow as it extends occlusally from the
bifurcation to the cervical line. Occasionally, there
is a slight concave area extending across the
cervical line onto the crown surface of the tooth.

112

l. The two roots are positioned mesially and distally.
The roots of the mandibular first molar are usually
longer and more divergent than those of the
mandibular second or third molar.
m. The mesial root is usually a little longer than the
distal root. The mesial root usually curves
mesially for its cervical half then curves distally to
a tapered apex. The mesial outline of the mesial
root is convex. The distal outline of the root is
concave.
n. The distal root is usually a little shorter, less
curved and more pointed at its apex. It usually
curves distally in its apical 1/3 but it may be
straight or even curve slightly to the mesial.
o. Both roots are wider mesiodistally in their facial
measurement than their lingual measurement.
Both roots have root depressions on their mesial
and distal aspects that are not seen from this view.

e. It should be noted that the anatomical crown
length is the same when measured facially or
lingually although the lingual cusps are taller.
The cervical line is positioned occlusally approx.
3. LINGUAL ASPECT - MANDIBULAR FIRST MOLAR

a. From a lingual view the two taller more pointed
lingual cusps will be seen. Since this tooth
converges toward the lingual, a part of the outline of
the distal cusp will be visible as well.
b. The mesiolingual cusp will usually be somewhat
taller and a little wider than the distolingual cusp.
c. The lingual developmental groove extends a short
distance onto this surface separating the two cusps
but rarely if ever is deep enough to require
restoration (i.e., not fissured).
d. The lingual surface of each cusp (lobe) is generally
spheroidal in the occlusal half. The cervical half of
the entire lingual surface is relatively smooth and
flat.

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1.0 mm more so on the lingual surface than on the
facial surface. Therefore, the root trunk measure-
ment will also be 1 mm longer (average 4.0 mm)
from cervical line to bifurcation on the lingual
aspect of the tooth. It can also be said that when
measured on the lingual, the total root length is
greater because the roots are measured from the
cervical line to the apex.
f. The surface of the root trunk is comparatively
flatter than on the facial aspect. The
developmental depression is deep at the
bifurcation; however it quickly becomes
progressively more shallow and fades out entirely
before it reaches the cervical line.

4. MESIAL ASPECT - MANDIBULAR FIRST MOLAR

a. The crown outline from the mesial view is
rhomboidal.
b. The greatest curvature of the facial outline is at the
cervical third of the crown and is termed the
cervical ridge. The crest is somewhat higher
occlusally when compared to the cervical ridges
found on maxillary molars but it is still in the
cervical one-third.
c. The greatest curvature of the lingual outline is
higher (occlusally) in the middle third of the crown.
d. Since mesial cusps are taller than the distal cusps of
the tooth, only the mesiofacial and mesiolingual
cusps will be visible from this view.
e. The fact that anatomical crown length measures the
same facially and lingually is because of a slant in
the level of the cervical line (it is higher occlusally at
its lingual end). This also accounts for a longer root
measurement along its lingual outline from the
cervical line to apex.
f. The cervical line curves occlusally about 1.0 mm
near the center of its mesial segment.
g. Only the mesial root is visible since it is wider
faciolingually than the distal root and is usually a
little longer.

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h. The mesial root apex is located directly below the
mesiofacial cusp slightly facial to the faciolingual
long axis bisector of the crown. This also
contributes to a shorter, straighter facial root
outline compared to a longer more slanted lingual
outline.
i. The mesial root presents a rather wide develop-
mental root depression extending the full length of
the root. A similar depression will be found on
the distal side of this same root as well. From both
mesial and distal aspects, this root is convex at its
facial and lingual borders with this broad
concavity in between.

5. DISTAL ASPECT -MANDIBULAR FIRST MOLAR

a. From the distal view the crown outline is also
rhomboidal.
b. It has already been noted that the distal cusp is located
far enough around the distofacial line angle of the tooth
to be considered partly on the distal surface. It is also
obvious from the occlusal view that the facial surface
converges to the lingual as it nears the distofacial line
angle.
c. Therefore, from a distal view, the outline of the distal
cusp will be seen superimposed on the distofacial cusp.
Also, part of the facial surface of the crown will be
visible.
d. The cervical line across the distal surface is relatively
straight with little or no curve occlusally.
e. Both the mesial and distal roots will be visible from this
view.
f. The distal root is narrower and shorter and the apex is
more pointed than the mesial root; therefore, the outline
of the mesial root will be evident beyond the outline of
the distal root along at least one border.
g. There may be longitudinal root depressions on the
mesial and distal aspects of the distal root. However,
they are narrower faciolingually and not as deep as those
found on the mesial root.

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115

NOTES:

1. Two roots (mesial & distal) that are wider in a faciolingual direction
2. Five cusps (three facial and two lingual)
3. MF groove separates the MF & DF cusps; DF groove separates the DF
and distal cusps
4. MF grooves terminates at the facial (buccal) pit
5. Mesial surface of the crown is concave in the cervical third and highly
convex at the upper two-thirds; the distal surface is convex throughout
6. Facial surface wider mesiodistally than the lingual surface (lingual
convergence)
7. Lingual groove separates two lingual cusps
8. Both mesial marginal ridge (longer) and distal marginal ridge (shorter) are
interrupted by developmental grooves
9. Crown outline is pentagonal (Wheeler describes it as hexagonal)
10. Three occlusal fossae: Central with central pit; extending from this pit are
the mesiofacial and lingual grooves and through it runs the central
groove. The MTF and the DTF contain their respective mesial and distal
pits which are termini for the central groove. The distofacial groove
originates from the central groove, distal to the central pit.
11. Mesial and distal roots are joined at a common root trunk; both roots
curve slightly to the distal and are blunt. The mesial root is the broadest
(FL) of any root in the arch.
12. The mesial root is slightly larger than the distal root and has a distinct
developmental root depression on its mesial and distal surfaces. This
root has two pulp canals, one facial and one lingual.

116
PERMANENT MANDIBULAR SECOND MOLAR

1. OCCLUSAL ASPECT - MANDIBULAR SECOND MOLAR

a. Average measurements:
1. Average mesiodistal diameter - 10.5 mm
2. Average buccolingual diameter - 10.0 mm
3. Average cervicoocclusal length of crown - 7.0 mm

b. All mandibular molars are wider in their mesiodistal
dimension.
c. Greatest faciolingual measurement is usually in the
mesial half of crown. This is because the cervical ridge is
usually more prominent on the mesiofacial lobe.
d. Although the crown outline is said to be rectangular, the
crown tends to converge toward the distal. The distal
outline is rather rounded (semi-circular) compared with
a more square mesial outline.
e. The crown has four well developed cusps: two facial
and two lingual. All four are of nearly equal size. The
tips of the facial cusps (especially the mesiofacial cusp)
are usually located farther lingually from the facial
outline than is true of the tips of the lingual cusps in
relation to the lingual outline.
f. The central groove crosses the occlusal surface
mesiodistally slightly lingual to the faciolingual bisector.
The facial groove and the lingual groove cross the central
groove at right angles dividing the occlusal surface into
mesial and distal halves. These three major grooves
present a groove structure which is said to be a + or
cross design. One author calls this a 4+ arrangement
because there are 4 cusps of approximately equal size
with a + sign dividing them.
g. There is usually a suggestion (if not a presence) of a
mesiofacial & mesiolingual as well as a distofacial &
distolingual groove at the proximal ends of the central
groove. Also, there are often many supplemental
grooves associated with the occlusal surface of this
tooth.

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117
h. The central pit forms where the facial, lingual and
central grooves meet and this is within the central
fossa. The terminal ends of the central groove are
in the mesial triangular fossa and the distal triangular
fossa and each end has its respective mesial and
distal pit.
i. Each cusp has its mesial and distal cuspal ridges
as well as a triangular ridge that extends toward
the central fossa. On most specimens the
triangular ridges meet in such a way as to form
two transverse ridges.
j. The mesial border of the occlusal table is the
mesial marginal ridge and the distal border is the
distal marginal ridge. The occlusal table is said to
be rectangular.

g. The two roots are termed the mesial and distal
roots. They vary greatly in length and divergence,
but generally it may be said that (1) the mesial root
will be longer than the distal root, (2) the roots are
usually closer together than those of the first
molar, (3) the roots may be fused together for all
or part of their length; (4) the roots incline distally
2. FACIAL ASPECT - MANDIBULAR SECOND MOLAR

a. The crown is narrower mesiodistally and shorter
occlusocervically than that of a mandibular first molar.
b. All four cusps will be visible since the lingual cusps are
taller than facial cusps. Mesial cusps will be a little
taller than distal cusps.
c. Lingual cusps are sharper and more pointed than facial
cusps which are flatter and more rounded.
d. There is only one facial groove. It is simply called the
facial (or buccal) groove. It separates the mesiofacial
and distofacial cusps and extends only a short distance
onto the facial surface. There is rarely a facial (buccal)
pit at the termination of this groove.
e. The two facial cusps are about equal in mesiodistal
width.
f. The cervical ridge is more prominent on the mesial half
of the crown surface.
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118
more than those of the first molar, and (5) the
root trunk will be shorter than that of the first
molar.

3. LINGUAL ASPECT - MANDIBULAR SECOND MOLAR

a. The lingual convergence of the mandibular second
molar is considerably less than that of the first molar;
the lingual width measurement of the mandibular
second molar may actually be wider than the lingual
width measurement of the mandibular first molar of
the same dentition.
b. Very little of the mesial or distal surfaces will be seen
from a lingual view.
c. As was noted on the mandibular first molar, the crown
length when measured from cusp tip to cervical line is
about the same on both the facial and lingual surfaces.
With the lingual cusps being taller, this is because the
cervical line is higher (occlusally) on the lingual surface
thereby producing equal measurements. This also
makes the measurement of the length of both the root
trunk and the total root length greater on the lingual
aspect as measured from the cervical line.
4. MESIAL ASPECT - MANDIBULAR SECOND MOLAR

a. The greatest facial curvature is in the cervical one-
third and is termed the cervical ridge.
b. The greatest lingual curvature is in the middle one-
third.
c. The tips of the facial cusps are nearer the
faciolingual long axis bisector than are the tips of
the lingual cusps.
d. The facial cusps are shorter and more rounded.
e. The lingual cusps are longer and more pointed.
f. The mesial root is very similar in shape to the
mesial root of the mandibular first molar. The root
depression and surface contour is also the same.
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119

NOTES:
1. Two roots, one mesial and one distal
2. Roots are wider in a faciolingual direction
3. Smaller than the mandibular 1
st
molar with four cusps (no distal cusp).
4. Only one facial groove separating the mesiofacial & distofacial cusps
5. Crown outline rectangular as is the occlusal table
6. Central pit located in the central fossa. The central groove, facial
groove and lingual groove all radiate from the central pit and form a
characteristic + sign.
7. Central groove terminates mesially at the mesial pit, located in the
MTF and distally at the distal pit located in the DTF.
8. There are no developmental grooves interrupting the marginal ridges
9. Roots are more distally inclined and closer together than the roots of
the mandibular 1
st
molar.
10. Mesial contact area with mandibular 1
st
molar: Middle of the crown,
occlusocervically and faciolingually.
11. Distal contact area: Because the molars become progressively shorter
from the first to the third, the centers of the contact areas also drop
cervically. A line bisecting the contact areas of the second and third
molars is located approximately at the center of the middle thirds of the
crowns. (Wheeler)

5. DISTAL ASPECT - MANDIBULAR SECOND MOLAR

a. The distal view of a mandibular second molar differs
primarily from that view of a mandibular first molar
in that the second molar has no distal cusp.
b. Otherwise, the contours of the crown and roots will
be very similar. The lack of curvature in and the
slanted position of the cervical line can be described
the same as it was for the mandibular first molar.
c. The distal surface of the crown of the mandibular
second molar is likely to be more rounded (convex)
than that of the mandibular first molar. This often
places the distal contact area (with the third molar)
almost centered, both faciolingually and
occlusocervically.
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120

MANDIBULAR LEFT SECOND MOLAR

1. OCCLUSAL ASPECT
a. Greatest faciolingual measurement at mesial half of crown because of
cervical ridge
b. Four cusps of near equal size separated by + developmental grooves
c. Three fossae: Central, MTF and DTF
2. BUCCAL ASPECT
a. All four cusps visible (lingual cusps taller than facial cusps)
b. Facial groove separates MF & DF cusps
c. Cervical ridge is more prominent on mesial half of crown surface
3. LINGUAL ASPECT
a. Taller more pointed lingual cusps
b. Lingual convergence not a pronounced as that of mandibular 1
st
molar
4. MESIAL ASPECT
a. Cervical ridge greatest facial curvature
b. Greatest lingual curvature at middle third
c. Facial cusps shorter and more rounded
5. DISTAL ASPECT
a. Distal root slightly shorter than mesial root
b. Distal contact centered occlusocervically and faciolingually

121

PERMANENT MANDIBULAR THIRD MOLAR

1. OCCLUSAL ASPECT - MANDIBULAR THIRD MOLAR

a. Average mesiodistal crown diameter - 10 mm.
b. Average faciolingual crown diameter - 9.5 mm.
c. This tooth varies greatly in morphology and is second only
to the maxillary third molar in this respect.
d. Most mandibular third molars crowns conform to the
characteristics of a mandibular second molar in the
number and arrangement of the four cusps (Type I). They
also present a 4+ groove pattern. Other mandibular
third molars (Type II) will have five cusps and a groove
pattern similar to a mandibular first molar. Both types
will usually have a more rounded and narrower distal
outline than either a mandibular first or second molar.
e. The occlusal anatomy often presents many supplemental
grooves radiating from the basic developmental grooves.
f. Mesial conatact area: Center of the middle 1/3
2. FACIAL ASPECT - MANDIBULAR THIRD MOLAR

a. The crown from the facial aspect will present either
two facial cusps (similar in relative size and placement
to those of the mandibular second molar) or three
cusps (similar in relative size and placement to those of
the mandibular first molar).
b. Facial and lingual cusps are likely to be more nearly
the same height on third molars.
c. Facial (buccal) grooves are not likely to be deep or
fissured.
d. The typical third molar will have two roots (mesial and
distal). These will usually be shorter and curved more
toward the distal with a higher degree of inclination
relative to the occlusal plane. The roots may be
separated or fused for all or part of their length.
e. Mesial contact area: Center of the middle 1/3

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122

3. LINGUAL ASPECT - MANDIBULAR THIRD MOLAR

From the lingual aspect it will be noted that the lingual
cusps are likely to be more pointed than facial cusps.
Otherwise, this surface presents a relatively smooth and
convex contour.

4. MESIAL ASPECT - MANDIBULAR THIRD MOLAR

a. The mesial view resembles that of the mandibular
second molar except that the facial and lingual cusps
are more nearly the same height. Accordingly, the
cervical line crosses the surface more horizontally.
b. The roots are shorter; therefore, the facial and lingual
outlines converge at a faster rate toward the apex.
The root apex is more pointed.

5. DISTAL ASPECT - MANDIBULAR THIRD MOLAR

The anatomical appearance from the distal aspect will
be somewhat similar to the distal view of either a
mandibular second molar or a mandibular first molar
except for the size and length of the root. Also,
variations will occur depending on whether the tooth
has four or five cusps.

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123

6. SPECIAL NOTATIONS REGARDING THIRD MOLARS

a. Third molars, because of their late development
and position in the dental arch, often become
trapped in the bone or have their normal eruption
pathway impeded by other teeth. The general
term for this situation is impaction. Because of
this, the pressure on the developing tooth follicle
may lead to rather bizarre variations in the third
molars shape and size.
b. It is not uncommon to see a disproportion in the
size of third molar crowns and the sizes of their
roots. When crowns and/or roots are so out of
proportion as to be considered malformed, it is
more likely to see a mandibular third molar with
an exceptionally large crown associated with very
small, short, and fused roots while on the other
hand, a maxillary third molar under similar
circumstances will present an exceptionally small
crown that will have normal size, well developed,
and divergent roots.

NOTES:
1. Mandibular third molars are highly variable in their morphology
2. They may resemble mandibular 1
st
or 2
nd
molars but are usually
much shorter and more bulbous
3. Crown outline and occlusal table are ovoid
4. Roots are short, sometimes fused and distally inclined
5. Because the molars become progressively shorter from the first to
the third, the centers of the contact areas also drop cervically. A
line bisecting the contact areas of the second and third molars is
located approximately at the center of the middle thirds of the
crowns. (Wheeler)

124

MANDIBULAR LEFT THIRD MOLAR

OCCLUSAL ASPECT
a. Ovoid shape
b. Type I: 4+ groove pattern
c. Type II: 5 cusps resembling mandibular 1
st
molar
BUCCAL ASPECT
a. Single facial groove
b. Cusps equal in height
c. Short, distally inclined roots
LINGUAL ASPECT
a. Lingual surface relatively smooth with a convex contour
b. Short, distally inclined roots
MESIAL ASPECT
a. Facial & lingual cusps essentially the same height
b. Short root with facial & lingual aspects rapidly converging
toward the apex
DISTAL ASPECT
a. Facial & lingual cusps essentially the same height
b. Short root with facial & lingual aspects rapidly converging
toward the apex

125
NUMBER OF ROOTS PERMANENT DENTITION

One Maxillary and mandibular central incisors
Maxillary and mandibular lateral incisors
Maxillary and mandibular canines
Sometimes maxillary first premolar
Maxillary second premolar
Mandibular first and second premolars
Sometimes maxillary and mandibular third molars (when fused)

Two Usually maxillary first premolar
Sometimes maxillary third molars
Mandibular first and second molars
Generally mandibular third molars (when not fused)

Three Maxillary first and second molars
Generally maxillary third molars
Sometimes mandibular third molars which can have up to
eight terminal roots.

NUMBER OF CUSPS PERMANENT DENTITION

One cusp Maxillary and mandibular canines
Usually mandibular first premolar has only one
functioning cusp

Two cusps Maxillary first and second premolars
Mandibular first premolar
Sometimes mandibular second premolar (2-cusp variety)

Three cusps Sometimes mandibular second premolar (3-cusp variety)
Sometimes maxillary third molars

Four cusps Maxillary and mandibular second molars
Sometimes maxillary and mandibular third molars

Five cusps Maxillary* and mandibular first molars
Sometimes maxillary second molars*
Sometimes mandibular third molars

*The fifth cusp, which is also known as the cusp of Carabelli or perhaps more properly as Carabellis
tubercle, is found on the lingual surface in the mesial portion of the permanent maxillary 1
st
molar
augmenting the mesiolingual cusp. It is rarely but sometimes found on the permanent maxillary 2
nd
molar
as well.

NOTE:
The permanent tooth with the greatest overall average length is the maxillary canine.
126
DENTAL ANATOMY
Compendium of Key Points

1. The formula for the primary dentition per maxillary/mandibular quadrant:
i 2/2; c 1/1; m 2/2

2. The formula for the permanent dentition per maxillary/mandibular quadrant:
I 2/2; C 1/1; P 2/2; M 3/3

3. Contact areas:
A. Anterior teeth (incisocervically):

Maxillary Mesial Distal
Central incisor Incisal Junction of Incisal & Middle
Lateral incisor Junction of Incisal & Middle Middle
Canine Junction of Incisal & Middle Middle

Mandibular

Central incisor Incisal Incisal
Lateral incisor Incisal Incisal
Canine Incisal Middle

Maxillary anterior teeth: IJ JM JM
Mandibular anterior teeth: II II IM

B. Posterior teeth (occlusocervically):
1. As a generality, the proximal contact areas of all posterior teeth are
positioned in the middle of the crown occlusocervically. The
mesial contact area is typically positioned more occlusally than the
distal. The contact areas are ovoid, slightly wider in a faciolingual
dimension.
2. EXCEPTIONS:
(a) The mesial contact area of the mandibular 1
st
premolar is
positioned more cervically (sloped MMR) than the distal.
(b) The contact areas on the mesial surfaces of maxillary &
mandibular molars are located at the junction of the occlusal
& middle
C. Faciolingual: All teeth have faciolingual proximal contact areas located
in the middle of the crown however the posterior teeth tend to have
theirs positioned slightly more toward the facial.

127
4. Heights of Contour:
A. All teeth generally have facial heights of contour at the cervical of
the crown although the mandibular molars are more correctly
described as being at the junction of the cervical and middle .
B. Facial heights of contour are also termed cervical ridges and extend
in a mesiodistal direction parallel to the cervical line (CEJ).
C. Facial heights of contour are most prominent on mandibular posterior
teeth. They are least prominent on mandibular anterior teeth.
D. Anterior teeth have lingual heights of contour at the cervical of the
crown, also termed cervical ridges
E. Posterior teeth have lingual heights of contour at the middle of the
crown. EXCEPTION: Mandibular 2
nd
premolar- the lingual ht. of
contour is said to be at the occlusal (due to the diminished lingual
crown height and cusp size).

5. CEJ (cementoenamel junction aka the cervical line):
A. Dips incisally/occlusally on the proximal surfaces of teeth.
B. Dips more so on anterior teeth than posterior teeth.
C. Dips more so on the mesial proximal surface than on the distal.
D. Dips more so on maxillary teeth than on mandibular.
E. Based on the above criteria, the most severe curvature would be
found on the mesial surface of the maxillary central incisor and the least
would be on the distal surface of the mandibular 3
rd
molar.

6. Embrasures:
A. There are 4 V-shaped spaces (embrasures) around every tooth
contact area: occlusal (incisal), lingual, gingival and facial.
B. Lingual embrasures are wider than facial embrasures on all permanent
teeth because of faciolingual convergence (generally teeth are wider
facially than they are lingually). There are three exceptions: (1) the
maxillary 1
st
molar and (2) the 3-cusp variety mandibular 2
nd
premolar
because the lingual calibration on these two teeth is greater than it is on
the facial. (3) The mandibular central incisors are the other exception
where the facial and lingual embrasures are described as being the
same size.
C. Incisal embrasure:
(1) largest is between maxillary lateral incisor & canine
(2) 2
nd
largest: between mandibular lateral incisor & canine
(3) 3
rd
: between maxillary central & lateral incisors
(4) 4
th
: between maxillary central incisors
(5) 5
th
: between mandibular central & lateral incisors
(6) 6
th
(smallest) incisal embrasure is between the mandibular
central incisors.
D. Largest overall occlusal embrasure: between maxillary canine and 1
st

premolar.

128
7. Calcification & Eruption dates:
A. Primary teeth:
(1) show first evidence of calcification in utero during the 2
nd

trimester (~14 weeks).
(2) calcification of crowns complete by 11 months (maxillary 2
nd

molars)
(3) mandibular teeth usually erupt before their maxillary
counterparts
(4) mandibular central incisors first to erupt (10 months), maxillary
2
nd
molars are last (29 months)
(5) all roots have completed formation by 39 months (maxillary
canines)
(6) see Calcification and Eruption charts (pp. 26-27) for
chronologies

B. Permanent teeth:
(1) 1
st
molars are the first permanent teeth to initiate calcification
and do so after birth.
(2) mandibular teeth usually erupt before their maxillary
counterparts except the maxillary 2
nd
premolar which may
erupt at the same time or before the mandibular 1
st
premolar
(3) 1
st
molars are the first permanent teeth to erupt (6 yrs. of age).
This initiates the mixed dentition phase of development.
(4) mandibular central incisors are the first succedaneous
permanent teeth to erupt (6-7 yrs. of age)
(5) maxillary canines are the last succedaneous permanent teeth
to erupt
(6) 3
rd
molars last teeth to initiate calcification (9 yrs.), also last to
complete crown formation and erupt
(7) see Calcification & Eruption charts (p. 23) for chronologies

8. Geometric Forms of Teeth:
A. Facial or Lingual view: All teeth TRAPEZOIDAL with the shorter
parallel side oriented cervically (gingivally).
B. Proximal view:
(1) Anterior teeth: TRIANGULAR with the apex oriented incisally
(2) Maxillary posterior teeth: TRAPEZOIDAL with the shorter
parallel side oriented occlusally
(3) Mandibular posterior teeth: RHOMBOIDAL

9. Anterior teeth incisal edge orientation (proximal view):
A. Maxillary:
(1) Incisors: centered over the long-axis bisector of the tooth
(2) Canines: cusp tip is centered over or slightly facial to the long
axis bisector of the tooth (never lingual)

129
B. Mandibular:
(1) Incisors: lingual to the long-axis bisector of the tooth
(2) Canines: lingual to the long-axis bisector of the tooth

10. Teeth with one facial cusp: the mesial cusp ridge is slightly shorter than the
distal cusp ridge. EXCEPTIONS: (1) maxillary 1
st
premolar and (2) primary
maxillary canine.

11. Crowns of teeth when measured occlusocervically tend to get shorter from
the canine to the 3
rd
molar.

12. Developmental lobes: All teeth develop from 4 lobes. EXCEPTIONS: (1)
permanent maxillary 1
st
molar, (2) permanent mandibular 1
st
molar, and (3) 3-
cusp mandibular 2
nd
premolar (all exceptions develop from 5 lobes).

13. Generally, the mesial portion of a tooth is better developed and measures
more occlusocervically as well as cervicoapically than does the distal portion

14. When comparing like classifications of teeth (i.e. molars or premolars) the more
posterior the tooth, there is the likelihood for it to have more supplemental
anatomy, sometimes termed tertiary anatomy (supplemental ridges, grooves,
etc.).

15. The largest cusp on molars will be the mesial supporting cusp (maxillary:
ML; mandibular: MF

16. Roots, canals and pulps:
A. The roots of all teeth are inclined distally.
B. If a single root has two canals, they will be oriented one facial and one
lingual
C. Teeth erupt with as many pulp horns as they have cusps. The pulp
chamber follows the overall outline of the crown so its widest portion
will correlate to the widest portion of the crown.
D. Single molar roots with more than one canal:
(1) Maxillary 1
st
molar (MF root)
(2) Mandibular 1
st
molar ( M root)
(3) Mandibular 2
nd
molar (M root)
(4) Distal roots of Mandibular 1
st
(31.6%) & 2
nd
(14.9%) molars
E. Single anterior roots with tendencies for more than one canal:
(1) Mandibular canine (most likely anterior tooth); has M & D root
depressions and is also the anterior tooth most likely to have a
bifurcated root
(2) Mandibular lateral incisor (next most likely, has M & D root
depressions)
(3) Mandibular central incisor (rarely & least likely, has M & D root
depressions)
130
(4) NOTE: Maxillary anterior teeth do not have multiple canals
F. Maxillary premolars:
(1) 1
st
: Two canals (always) and two roots (usually); F & L, rarely
3 but if so, MF, DF & L
(2) 2
nd
: Variant pulp morphology can have 2 canals and
occasionally 2 roots.
G. Premolar most likely to have one root and one canal: Mandibular 2
nd
H. Only tooth with a pulp wider mesiodistally than faciolingually: maxillary
central incisor
I. Maxillary central & lateral incisors: Significant faciolingual taper, hence
the pulp chambers are triangular when viewed incisally in cross section.

17. Individual Tooth Morphology Unique Characteristics:
A. Maxillary Central Incisor
(1) M-D crown dimension greatest of any anterior tooth
(2) M curvature of cervical line toward the incisal greatest of any
tooth
(3) Incisal ridge centered labiolingually

B. Maxillary Lateral Incisor
(1) M-D crown dimension smallest of any maxillary tooth
(2) Tooth with most developmental anomalies (exempting 3
rd

molars)
(3) Most cervically located contact area of any incisor (centered
distal contact area)
(4) M-D (6.5 mm) and F-L (6.0 mm) dimensions closer than any
other anterior tooth
(5) Incisal ridge centered labiolingually

C. Mandibular Central Incisor
(1) Crown dimensions smallest of any tooth
(2) Bilaterally symmetric crown
(3) Proximoincisal line angles sharpest of any tooth (shared with
MI line angle of maxillary lateral incisor)
(4) Proximal contact areas at the same level (incisal )
(5) Incisal edge lingual to faciolingual bisector (shared with all
mandibular anterior teeth)
(6) Unique characteristics shared with mandibular lateral incisor:
(a) fewest facial developmental depressions, lines & grooves
(b) smoothest lingual surface contours
(c) least developed cingulum

D. Mandibular Lateral Incisor
(1) Crown twisted on root; seen from two views:
(a) Mesial: can see lingual portion of DMR
(b) Incisal: from mesial distal, incisal ridge curves lingually
131
(2) Shared unique characteristics with mandibular central incisor:
See C-5 and C-6 above
(3) MI line angle sharp; DI less so

E. Maxillary Canine
(1) Greatest (along with mandibular canine) overall tooth length
(2) Longest root length of any tooth
(3) F-L dimensions greatest of any anterior tooth
(4) Distal bulge (pinched or stretched distally)
(5) Cusp tip centered with or facial to faciolingual bisector (never
lingual)
(6) Greatest cervical prominence of any anterior tooth
(7) Facial ridge prominence greatest of any anterior tooth
(8) Distal contact area centered F-L and C-I

F. Mandibular Canine
(1) Greatest (along with maxillary canine) overall tooth length
(2) Longest root length of any mandibular tooth
(3) I-C crown length greatest of any tooth
(4) Mesial crown & root surfaces aligned in a straight line
(5) From proximal view: facial crown and root curvature C
shaped
(6) Cusp tip/incisal edge lingual to faciolingual bisector (shared
with all mandibular anterior teeth
(7) ML & DL fossae each have distinct boundaries with the lingual
ridge being common to both and the cingulum being the most
cervical boundary of each

G. Maxillary 1
st
Premolar
(1) Only premolar with mesial cusp ridge longer than distal cusp
ridge (facial cusp)
(2) Mesial marginal ridge (developmental) groove
(3) Mesial crown concavity
(4) Mesial root depression
(5) L cusp 1.0 mm shorter than F cusp
(6) Deep central developmental groove

H. Maxillary 2
nd
Premolar
(1) More bilaterally symmetrical than any other posterior tooth
(2) Cusp heights closer than any other premolar
(3) M and D fossae closer to one another than any other posterior
tooth

132
I. Mandibular 1
st
Premolar
(1) Presence of ML groove (unique, only tooth to have this
developmental groove)
(2) F-L crown dimension smallest of any posterior tooth and the
same as the mandibular canine (7.5 mm)
(3) FL (7.5 mm) MD (7.0 mm) crown dimensions closer than any
other mandibular tooth hence occlusal crown form is said to be
diamond shaped
(4) M contact area cervical to D contact area
(5) Sloped occlusal surface visible from lingual aspect
(6) M marginal ridge slopes lingually (45) and is cervical to D
marginal ridge
(7) L cusp is small, non-functional and almost cingulum-like

J. Mandibular 2
nd
Premolar
(1) Two varieties:
(a) 2-cusp: U or H occlusal groove pattern
(b) 3-cusp: Y occlusal groove pattern & more common
(2) 3-cusp only premolar with multiple lingual cusps and develops
from five lobes
(3) 3-cusp only premolar with a lingual groove
(4) 3-cusp only premolar with a central fossa
(5) 3-cusp premolar and maxillary 1
st
molar only permanent teeth
where the lingual calibration measures greater than facial, i.e.
the crown does not taper faciolingually
(6) 3-cusp premolar L height of contour in occlusal of crown
(7) 3-cusp premolar most likely premolar to be congenitally missing

K. Maxillary 1
st
Molar
(1) This tooth and the 3-cusp variety mandibular 2
nd
premolar are
the only permanent teeth where the mesiodistal lingual
calibration is greater than on the facial
(2) 5
th
cusp (Carabelli) augments lingual surface of the ML cusp
(3) Oblique ridge (all maxillary molars) formed by the distal cusp
ridge of the ML cusp and the triangular ridge of the DF cusp
(4) Primary cusp triangle (all maxillary molars): MF, DF & ML
cusps
(5) Centered distal contact area

L. Maxillary 2
nd
Molar
(1) 4 primary cusps, rarely a 5
th
cusp
(2) Diminished DL cusp size, primary cusp triangle remains
(3) Centered distal contact area
(4) Oblique ridge (all maxillary molars)

133
M. Maxillary 3
rd
Molar
(1) Smallest OC crown dimension of any tooth
(2) Shortest root(s) of any maxillary tooth
(3) More distal inclination of roots of any maxillary tooth
(4) Primary cusp triangle present (heart shaped crown) or may
have vestige of DL cusp (talon)
(5) Multiple supplemental ridges & grooves
(6) Oblique ridge (all maxillary molars)

N. Mandibular 1
st
Molar
(1) Largest M-D crown dimension of any tooth (11.0 mm)
(2) Largest F-L crown dimension of any mandibular tooth (10.5
mm)
(3) Largest O-C crown dimension of any mandibular molar
(4) Longest root length of any molar (14.0 mm)
(5) Greatest mesiodistal root separation of any tooth
(6) M root has greatest F-L dimension of any root
(7) Only tooth with two facial developmental grooves

O. Mandibular 2
nd
Molar
(1) Characteristic MF crown prominence
(2) Characteristic + shaped occlusal groove pattern
(3) All cusps of near equal size
(4) Centered distal proximal contact (along with maxillary lateral
incisor, canine, 1
st
molar and 2
nd
molar)

P. Mandibular 3
rd
molar
(1) Smallest OC crown dimension of any mandibular tooth
(2) More bulbous crown form than any other mandibular tooth
(3) More distal root inclination than any other mandibular tooth
(4) Shortest root(s) of any mandibular teeth
(5) Multiple supplemental ridges & grooves

18. Widest, narrowest, tallest, longest, etc;
A. Widest tooth mesiodistally: mandibular 1
st
molar
B. Widest primary tooth mesiodistally: mandibular 2
nd
molar
C. Widest anterior tooth mesiodistally: maxillary central incisor
D. Widest tooth faciolingually: maxillary 1
st
molar
E. Widest primary tooth faciolingually: maxillary 2
nd
molar
F. Widest anterior tooth faciolingually: maxillary canine
G. Only tooth with a pulp chamber wider mesiodistally than faciolingually:
maxillary central incisor
H. Only teeth to measure wider lingually than facially:
(1) primary maxillary 2
nd
molar
(2) permanent maxillary 1
st
molar
(3) 3-cusp variety mandibular 2
nd
premolar
134
19. Longest teeth (from cusp tip to root tip):
(1) maxillary canine &
(2) mandibular canine (both 27.0 mm)

20. Longest root (CEJ to apex): maxillary canine (17.0 mm)

21. Tallest crown incisogingivally:
(1) mandibular canine (11.0 mm) >
(2) maxillary central incisor (10.5 mm) >
(3) maxillary canine (10.0 mm)

22. Anomalies:
A. Maxillary lateral incisor (other than the 3
rd
molars, most common
permanent tooth to have anomalies)
(1) dens in dente
(2) congenitally missing (2
nd
most common tooth)
(3) microdontia
(4) peg lateral
(5) supernumerary
B. Mesiodens: most common incident of a supernumerary tooth (between
maxillary central incisors)
C. Mandibular 2
nd
premolar: most likely premolar to be congenitally
missing
D. 3
rd
molars: most common teeth to be congenitally missing or
malformed.

23. Tooth with the smallest anatomical crown: mandibular central incisor

24. Anterior tooth with the most symmetrical anatomical crown: mandibular central
incisor

25. Posterior tooth with the most symmetrical anatomical crown: maxillary 2
nd

premolar

26. Tooth with the narrowest M-D measurement: mandibular central incisor

27. Tooth with the best developed lingual anatomy: maxillary lateral incisor

28. Only tooth with a linguogingival groove: maxillary lateral incisor

29. Only tooth with a mesiolingual groove: mandibular 1
st
premolar

30. Only tooth with a mesial marginal developmental groove: maxillary 1
st
premolar
(maxillary molars may have supplemental marginal grooves)

135
31. Smallest facial embrasure in the mouth or the smallest lingual embrasure in
the mouth is between the two mandibular central incisors. It should be noted
that they are essentially of equal size.

32. Concrescence: The cementum of two proximal teeth is fused together. When
seen, usually associated with 2
nd
& 3
rd
molars as well as anterior teeth.

33. Impacted teeth: Most frequently seen in (1) 3
rd
molars, (2) maxillary canines
and (3) mandibular 2
nd
premolars

Intraoral Exam on Student Partners

The goal of this introductory exercise is to gain familiarity with basic structures
and landmarks within the oral cavity. Label the provided diagram for reference. Students
should pair up as assigned. Perhaps you will make a new friend.
As you proceed with the exercise, please make sure that everyone has an
opportunity to benefit from being both the doctor and the patient.
It is important to observe guidelines for infection control and patient con-
sideration when performing the examination. Wash your hands and put on latex gloves
for the exam. Use a sterile exam package for the examination.
The doctor should stand for this exam, while the patient should be seated.

Even with the mouth closed, the vermilion border of the lips and the labial
commissures may be observed.

When the patient opens their mouth, identify the maxillary (upper) and the
mandibular (lower) dental arches.

Identify the right side and the left side of both arches. Note that this refers to the
patients right or left side, not the observers. Identify the midline of both arches. This
is an imaginary line between the central incisor teeth and it divides each arch into a left
quadrant and a right quadrant.

Label on the diagram the four quadrants of the oral cavity. (maxillary right
quadrant, mandibular left quadrant, etc.)

Identify the incisor teeth. (Centrals and laterals)
Identify the canine teeth.
Identify the premolar teeth (sometimes referred to as bicuspids)
Identify the molar teeth.

How many of each type of teeth are present in the complete adult dentition?

Incisors_____ Canines_____ Premolars_____ Molars_____

On the diagram provided, place an X through any missing teeth. Sketch in any
restorations (completed dental procedures), which are present.

The vestibule is the space adjacent to the cheeks near the roots of the teeth that
surrounds the maxillary and mandibular arches. Essentially this space is formed where
the cheeks meet the maxilla or mandible. Located within the vestibule are the frena (pl)
(sing. = frenum). They are muscle attachments that also aid in facial expression. Find
them near the midline and near the premolars.
L-1

Notice the mucosa that lines the oral cavity. This is a moist and slippery tissue as
compared to the vermillion border of the lips.

On the mucosa that lines the patients cheek, notice the opening of the parotid
salivary duct located near the maxillary molars. What are some possible advantages and
disadvantages of salivary flow? Also located on the buccal mucosa is a demarcation
called the linea alba (white line). This whitish line parallels the plane of the biting
surfaces of the molars and premolars. Had you noticed this prior to today? Do you have
any ideas as to how this line originated?

The mucosa gives way to gingiva (gum tissue) along the lateral portions of the
mandible and the maxilla. Take note of the mucogingival junction that demarcates these
two distinctive types of tissue. What is the major change in the tissue that is responsible
for this obvious change in color?

Located on the gingiva near each tooth is a more subtle line or depression called
the free gingival groove. What does it delineate?

The gingiva located immediately adjacent to the teeth has special names reflective
of its location. Can you differentiate between marginal and interdental gingiva?

Just behind the mandibular molars notice the retromolar pad. This is soft,
depressible tissue.

Now looking towards the throat, attempt to locate the palatine tonsils. There
may be great variation in the amount of this tissue that is present. Your patient has
possibly had this tissue removed. Do you know the function of this tissue?

The roof of the mouth is referred to as the palate. Near the maxillary central
incisors is a landmark called the incisive papilla. Behind this are several rough folds of
tissue called rugae. The rugae are important because the tongue moves across this area
during the pronunciation of many different syllables. Near the back end of the palate is a
curious structure called the uvula. Do you know the function of this structure?

In the floor of the mouth, find the sublingual caruncle which is the opening for
the mandibular salivary duct. It is located in the midline behind the mandibular incisors.
Be careful when viewing this structure as you might get gleeked.

Finally, take a closer look at the tongue. The tongue shows a great deal of
variation from one person to the next. Notice that it fills whatever space is available.
Perhaps the tongue is scalloped and conforms to the shapes of the teeth surrounding it.
This powerful muscle can be deeply fissured, or may be quite smooth.

This concludes todays tour of the oral cavity!

L-2

L-3
L-4
Linea Alba
L-5
L-6

L-7
Lecture Seat No. _________

Name: ______________________________________

LABORATORY EXERCISE #1
INTRODUCTORY WAXING EXERCISE

KNOW YOUR WAXING INSTRUMENTS

1. SHAW1: Large wax dropper. Double-ended (one end slightly larger). Once heated, used to carry
wax from its source to the carving. Also used to coalesce wax from multiple applications into a
homogenous conflux.

2. SHAW-2: Small wax dropper. Same as above, only with smaller amounts of wax.

3. SHAW-4: Spatula/Carver. Once heated, one end can be used to carry larger amounts of wax from
its
source to the carving. The pointed end of the spatula allows this instrument to also be used as a
carving tool for certain applications. The other end is designed to carve the wax in gentle pulling
strokes.

4. SHAW-7: Double-ended spatula. The smaller end is very similar to the spatula end of the SHAW-4.
The larger end, once heated, can carry larger amounts of wax from its source to the carving.

5. PKT-4: Double ended carver. Each end is set at 90 degrees to the other. One end has a noticeable
bow to allow access for unique applications. This carving instrument has sharper edges and will
il d t h k th l h dl d d li t l

IMPORTANT

Begin to develop good hand skills and techniques early that will serve you now and
throughout your professional career. The first skill to learn is the finger-rest. Have your
instructor demonstrate to you the proper way to stabilize your hands as you heat, transfer and
apply wax as well as carve your wax patterns. These skills will soon become automatic to you,
give you much more control with your hands, and provide you an easier means of placing your
instruments exactly where you want them to go.

Excellent Good Needs minor
improvement
Unacceptable
Creativity

Enthusiasm

Finish and
Polish

Neatness of
project

Project
complete & on
time

FINAL GRADE: Pass Fail

INSTRUCTOR _________________________

Suggested Exercises

1. Write your name in wax

2. Create three standard
geometric forms (square,
circle, triangle) in wax.
Try using different colors
of wax.

3. Be creative with the
waxes. Draw a picture,
write a poem, etc. Extra
credit for 3 dimensional
forms!

L-8
Name __________________________________ Lecture Seat No. __________
LABORATORY EXERCISE #2
Stone Casts

Identify the following Morphological Characteristics on the stone casts provided. Using an
identifying characteristic color, mark the crests of ridges, the depths of grooves or outline of a
specific area. The same color may be used to identify more than one non-related characteristic (i.e.,
red may be used to identify one of the grooves as well as one of the ridges or one of the line angles.)

A. On the teeth in the maxillary right and mandibular left quadrants identify the
following negative anatomical characteristics:

Name of Morphological Characteristic Sample of Color Used

1. CENTRAL fossa ________________________

2. MESIAL TRIANGULAR fossa ________________________

3. DISTAL TRIANGULAR fossa ________________________

4. MESIAL LINGUAL fossa ________________________

5. DISTAL LINGUAL fossa ________________________

6. LINGUAL fossa ________________________

7. CENTRAL groove ________________________

8. FACIAL (Buccal) groove ________________________

9. LINGUAL groove ________________________

B. On the teeth in the maxillary left and mandibular right quadrants identify the
following positive anatomical characteristics:

Name of Morphological Characteristic Sample of Color Used

1. Tip of each CUSP ________________________

2. Each INCISAL RIDGE and EDGE ________________________

3. Each MESIAL CUSPAL RIDGE ________________________

4. Each DISTAL CUSPAL RIDGE ________________________

5. Each MESIAL MARGINAL RIDGE ________________________

6. Each DISTAL MARGINAL RIDGE ________________________

7. Each TRIANGULAR RIDGE ________________________

8. Each CERVICAL RIDGE ________________________

9. Each BUCCAL (Facial) RIDGE ________________________

10. Each LINGUAL RIDGE ________________________

11. Each LABIAL (Facial) RIDGE ________________________

12. Each CINGULUM ________________________

13. Each TRANSVERSE RIDGE ________________________

14. Each OBLIQUE RIDGE ________________________

L-9
Instructor: _________
Grade:_________
Name __________________________________ Lecture Seat No. __________

L-10

C. As briefly as possible answer the following questions:

1. Which teeth have a central fossa?

2. Which teeth have mesial and distal triangular fossae?

3. Which teeth have mesial and distal lingual fossae?

4. Which teeth have a single lingual fossa?

5. Which teeth have lingual grooves?

6. Which teeth have facial (buccal) grooves?

7. Which teeth have central grooves?

8. Which teeth have incisal ridges? What is an incisal edge?

9. Which teeth have cuspal ridges?

10. Which teeth have facial ridges?

11. Which teeth have lingual ridges?

12. Which teeth have marginal ridges?

13. Which teeth have triangular ridges?

14. Which teeth have transverse ridges?

15. Which teeth have oblique ridges?

16. What are the boundaries of an occlusal table?

17. Which teeth have an occlusal table?

18. What are the boundaries of the lingual fossa on an incisor?

19. What are the boundaries of the distal lingual fossa on a canine?

20. Which teeth have a cingulum (pl = cinguli)?

21. Which teeth have a cervical ridge? Which teeth have more than one cervical
ridge? Where are they located?

Lecture Seat # __________________

Laboratory Project: PJ-01
Tooth # 26- Cut-Out

1. Incisal Anatomy
a. Incisal ridge (edge):
(1) Distal portion tapers or slants
cervically from mesial to distal
(2) Distal portion also curves lingually,
i.e. the distal end of the ridge is
more lingual than the mesial. This
view gives the crown a twisted
or rotated appearance
b. Line angles
(1) MI is more square
(2) DI is slightly rounded
c. M & D proximal contacts are within
incisal 1/3 of crown

2. Facial (Labial) Anatomy
a. Incisal edge has a subtle slope from M-D
b. Developmental depressions (denoting
formative lobes) are faint but present
c. Line angles: see above
d. Proximal contacts are both within the
incisal 1/3 of the crown

3. Lingual Anatomy
a. Marginal ridges: subtle but present
b. Lingual fossa: shallow & limited to
incisal 1/3
c. Cingulum smoothly rounded and not
prominent or well defined

4. Mesial:
a. Incisal ridge lingual to faciolingual long-axis
bisector
b. Part of the distal marginal ridge is visible
because of its lingual twist

5. Distal:
a. Incisal ridge well lingual to faciolingual
long-axis bisector
b. Mesial marginal ridge is not visible

F L F
D D

F L

M D

F

M D

L

L-11
Lecture Seat # _________________

Tooth #12- Cut-Out

M D
L F L

F

M D

L

M M

F L

1. Occlusal Anatomy
a. Crown outline is hexagonal
b. MF & DF line angles are relatively square
c. Line angles mirror line angles of abutting teeth
d. ML & DL line angles more rounded
e. Central groove: crosses occlusal table mesiodistally
parallel to but slightly lingual to the crowns
faciolingual bisecting line.
f. Central groove connects M & D triangular fossae
g. Crest of lingual ridge well mesial of M-D bisector
h. Facial cusp:
1) is distal to M-D bisector, i.e mesial cuspal
ridge is longer than the distal cuspal ridge
2) The mesial end of the mesial cuspal ridge is more
lingual than the distal end of the distal cuspal ridge.
i. Lingual cusp:
1) Is mesial to the M-D bisector, i.e the mesial
cuspal ridge is shorter than the distal cuspal ridge
2) Cuspal ridges meet at cusp tip as a continuous
curve

2. Triangular Ridges
a. From facial cusp & lingual cusp meet near center of
occlusal table but slightly lingual of a FL bisector of
the crown
b. Although separated by a deep central groove,
potential for a true transverse ridge to form

3. Marginal Ridges:
a. Mesial:
1) Meets the mesial cuspal ridge of the facial cusp at
at a near 90 degree angle
2) Mesial marginal developmental groove crosses
ridge at its center
3) Crest is almost perpendicular to the faciolingual
long axis bisector
b. Distal:
1) Longer than mesial and uninterrupted by a groove
2) Meets the distal cuspal ridge of the facial cusp at
an acute angle

4. Mesial Aspect:
a. Crown outline is trapezoidal
b. Can see height of contour:
1) Facial: cervical 1/3 (cervical ridge)
2) Lingual: middle 1/3

c. Mesial marginal developmental groove
is evident as it crosses thru the mesial
marginal ridge
d. The cervical line curves occlusally in
its middle segment approx.1.0 mm.
e. Proximal Contact: located just cervical
to the mesial segment of the mesial
marginal ridge, facial to the mesial
f. Mesial developmental root depression:
1) Crosses the cervical line and
extends to the level of the
junction of the cervical & middle
thirds of the crown.
2) At the level of the cervical line,
the tooth surface will be convex in
its facial and lingual thirds and
concave in its middle third.

L-12
Lecture Seat # ____________________

Tooth #19- Cut-Out

1. Occlusal Anatomy
a. Cusps:
1) MB (largest), DB, ML (tallest), DL (2
nd

tallest)
2) Distal cusp: smallest cusp and is located at
or slightly lingual to the DB line angle
3) Buccal cusps are more rounded, lingual
cusps more pointed
b. Triangular ridges: each cusp has one but none
meet, i.e. no transverse ridges
c. Cuspal ridges: flow into the marginal ridges
at the perimeters
d. Fossae:
1) Central
2) Mesial triangular
3) Distal triangular
e. Developmental grooves:
1) Central
2) Mesiobuccal
3) Distobuccal
4) Lingual
f. Crown converges lingually, i.e. buccal half is
wider than lingual half
g. Contact areas: both mesial & distal located
buccal to a line bisecting the crown into
buccal & lingual halves.
1) Mesial: 1 mm cervical to the marginal
ridge
2) Distal: 1 mm cervical to the distal
cuspal ridge of the distal cusp
3) Line angles mirror line angles of
abutting tooth

2. Buccal aspect:
a. Trapezoidal with parallel sides at occlusal &
cervical
b. All cusps visible (lingual cusps taller)
c. MB cusp widest of the buccal cusps and its
cuspal ridges meet at very obtuse (almost
flat) angle.
d. DB cusp almost as wide as MB cusp & cuspal
ridges meet at a more significant angle
e. Distal cusp is the smallest and although
rounded, is more pointed than the other buccal
cusps.
f. Two buccal grooves: MB & DB (longer of two)
g. Cervical ridge at the cervical third of the buccal
surface of the crown (mesial 2/3 only)

3. Lingual Aspect:
a. ML cusp slightly taller & wider than DL cusp
b. Lingual developmental groove visible
c. Height of curvature will be at the middle 1/3

4. Mesial aspect:
a. Crown outline is rhomboidal
b. Can see the height of contour:
1) Buccal- cervical 1/3 (cervical ridge)
2) Lingual- middle 1/3
c. Proximal contacts: 1 mm cervical to the
marginal ridge on the buccal of the crown

5. Distal aspect:
b. Distal cusp position may be slightly lingual to
the DF line angle, i.e., the distal contact is 1
mm below the distal cuspal ridge of the distal
cusp.

M D D M

M D
L F L

B

D M

L
B L

L-13

Tooth #20- Cut-Out
1. CONTACT AREAS
Both are broad and buccal to the faciolingual
bisector (a plane bisecting the buccal & lingual
halves of the crown)

2. Occlusal table:
a. outline is square with a slight
lingual convergence (Wheeler). (Note: some
textbooks describe the 3-cusp variety
mandibular 2
nd
premolar as having a slight
lingual divergence)
b. line angles, although rounded, demonstrate
a definitive change in direction and will
mirror the line angles of the abutting teeth.

3. Three distinct cusps in order of size:
a. Buccal (mesial cuspal ridge shorter than
distal) cusp tip is slightly buccal to the facio-
lingual bisector
b. ML: slightly wider than DL cusp
c. DL: approx. 2 mm. shorter than buccal cusp
d. Tips of lingual cusps near lingual outline

4. Cuspal ridges run laterally from cusp tips to join
relatively straight (almost parallel) marginal ridges

5. Triangular Ridges: none meet

6. Central Fossa:
a. Lingual, mesial and distal developmental
grooves radiate forming a Y as they
separate the 3 cusps
b. Lingual groove separates ML & DL cusps
c. Mesial & distal grooves end in their
respective mesial & distal triangular fossae
d. Central pit is where all 3 grooves converge

7. Triangular fossae:
a. Each has their respective marginal ridge as
the base of a triangle
b. Mesial & distal grooves end at pits in their
respective triangular fossa

L F L

M D

B

D M

L

B L

M M
L-14

Tooth #10 Full Wax-Up

M D
L F L

M M
M D

F

L
F L 1. Proximal Views:
a. Facial outline relatively convex
compared to the central incisor
b. Cervical ridge prominent on the lingual
but understated on the facial
c. Triangular crown outline with the
incisal ridge centered over the root

2. Facial View:
a. This tooth is narrower mesiodistally
relative to its incisal-gingival length
giving it an oblong appearance
b. Developmental depressions delineate
the facial lobes
c. Mesioincisal line angle is rounded but
relatively square compared to DI
d. Distoincisal line angle is distinctly
rounded compared to MI line angle
e. From mesial to distal, the incisal ridge
slopes cervically
f. Distal contact area located slightly
more cervical (middle 1/3) than the
mesial contact area (junction of middle
& incisal thirds)
g. Mesial and distal outlines mildly
convex

3. Lingual Anatomy:
a. Prominent marginal ridges
b. Triangular shaped lingual fossa that is
relatively deep & cup-shaped
c. Convex cingulum

4. Incisal View:
a. Crown is wider M-D than it is F-L
b. Labial outline is more continuously
convex than that of the central incisor
c. Outline converges sharply toward the
lingual
L-15

Laboratory Project/Practical: PJ-05 & PC-01
Anatomical Features & Drawing Exercise (PJ-05)
Morphological Characteristics Practical (PC-01)

Laboratory Practical: PC-07
Tooth Identification Practical
1. Anatomical Features and Drawing Exercise

Dental Anatomy Laboratory PJ-04 Begin on August 24, 2011
Finish on September 14, 2011

Instructions and Guidelines:
1. Understanding detailed anatomical features
2. Drawing from memory
3. Master diagram on the left; Cut-out on the right
4. Vector lines
5. Use #2 pencil with an eraser
6. Restore missing anatomical features
7. Accuracy & Precision
8. Pay attention to details
9. Evaluation

2. Dental Anatomy Morphological Characteristics Practical:

Administered on September 7, , 2 20 00 11

This is a practical exam
There are 50 slides each with a question relating to an associated model or photograph.
There will be 5 multiple choice answers, choose your best answer.

3. Tooth Identification Practical
Wednesday, December 7, 2011

Instructions:
1. Each question has 5 possible answers
2. Pick the BEST answer, for each question
3. Each question is displayed for only 60 seconds
4. There are 40 questions on the examination
5. All photos display the crown at the top of the screen and root oriented below it
6. Place tooth # charting diagram on paper and use it to answer questions
7. Each view is standardized on the screen as follows:

Mesial
Distal
Occlusal
Facial
Lingual
L-16
Lecture Seat # ______________

Laboratory Project #PJ-07
Tooth #11- Full Wax-Up

M D
L F L

M M

M D
F

L

F L
1. Facial aspect:
a. Distal cuspal ridge longer than mesial cuspal
ridge
b. Developmental depressions define facial
lobes
c. Concavity cervical to distal contact is a
distinct feature of this tooth
d. Mesial contour, by comparison, is straighter
than the distal contour which is more
rounded
e. Proximal contacts:
1) Mesial: at the junction of the middle &
incisal thirds
2) Distal: near the middle 1/3 of crown (more
cervical than mesial)

2. Mesial aspect:
a. Crown outline is triangular
b. Tip of the cusp centered faciolingually or
slightly facial (never lingual)
c. Facial & lingual cervical ridges are well
developed & crests oppose one another at the
same level in the cervical 1/3 of the crown.

3. Distal aspect:
Very similar to the mesial aspect except the
distal marginal ridge is slightly more lingual and
the distal contact (middle 1/3) area is more
cervical than the mesial contact area (junction of
incisal & middle thirds).

4. Lingual aspect:
a. Marginal ridges are well developed
b. Lingual ridge extends from the cusp tip to the
cingulum dividing the lingual fossa into ML &
DL fossae
c. Cingulum is well developed and occupies the
cervical 1/3 of the lingual surface

5. Incisal aspect:
a. Incisal outline measures wider faciolingually
than it does mesiodistally (opposite of maxillary
incisors)
b. Line angles mirror abutting teeth

Notes:

L-17
Lecture Seat # _________________

Tooth #12- Full Wax-up

M D
L F L

F

M D

L

M M

F L

1. Occlusal Anatomy
parallel to but slightly lingual to the faciolingual
bisector of the crown.
g. Crest of lingual ridge well mesial of M-D bisector
h. Facial cusp:
1) is distal to M-D bisector, i.e mesial cuspal
i. Lingual cusp:
1) is mesial to the M-D bisector, i.e the mesial
curve
3) Lingual cusp is 1.0 mm lower than the facial cusp

occlusal table but slightly lingual to the FL bisector of
the crown
b. Although separated by a deep central groove, there is
potential for a true transverse ridge

3. Marginal Ridges:
a. Mesial:
1) meets the mesial cuspal ridge of the facial cusp at
ridge at its center
long axis bisector
b. Distal:
an acute angle

4. Mesial Aspect:

c. Mesial marginal developmental groove
is evident as it crosses thru the mesial
marginal ridge
d. The cervical line curves occlusally in
its middle segment approx. 1.0 mm.
e. Proximal Contact: located just cervical
to the mesial segment of the mesial
marginal ridge, facial to the mesial
1) Crosses the cervical line and
extends to the level of the
junction of the cervical & middle
thirds of the crown.
2) At the level of the cervical line,
the tooth surface will be convex in
its facial and lingual thirds and
concave in its middle third.

L-18
Lecture Seat # _________________

LABORATORY PRACTICAL: PC-03
Tooth #5- Full Crown Wax-Up

1. Occlusal Anatomy
parallel to but slightly lingual to the crowns
faciolingual bisector.
g. Crest of lingual ridge well mesial of the M-D bisector
h. Facial cusp:
1) is distal to M-D bisector, i.e the mesial cuspal
i. Lingual cusp:
1) Is mesial to the M-D bisector, i.e the mesial
curve

occlusal table but slightly lingual of a FL bisector of
the crown
b. Although separated by a deep central groove, there
is potential for a true transverse ridge to form

3. Marginal Ridges:
a. Mesial:
1) Meets the mesial cuspal ridge of the facial cusp at
ridge at its center
long-axis bisector
b. Distal:
an acute angle

4. Mesial Aspect:
c. Mesial marginal developmental groove is evident as
it crosses thru the mesial marginal ridge
F L F

M D

F

D M

L

D D

F L

d. The cervical line curves occlusally in its
middle segment approx.1.0 mm.
e. Proximal Contact: located just cervical to
the mesial segment of the mesial marginal
ridge, facial to the mesial marginal
developmental groove.
1) Crosses the cervical line and extends
to the level of the junction of the
cervical & middle thirds of the crown.
2) At the level of the cervical line, the
tooth surface will be convex in its
facial and lingual thirds and concave
in its middle third.

L-19

Tooth #13- Full Crown Wax-Up
Retain for Dental Materials Casting
Spring Semester

A. Contact Areas
1) Mesial contact is located facial to the
central groove
2) Distal contact is centered
3) Both contact areas are 2-3 mm wide FL
and 1 mm wide occlusogingivally

B. Line Angles & Embrasures
1) MF & DF line angles are relatively squared
2) ML & DL line angles are rounded

C. Cusp Placement & Size
1) Occlusal table width is comparable to the
maxillary first premolar
2) Facial cusp tip is located mesial to the
mesiodistal bisector of the crown
3) Lingual cusp tip is also located mesial to
the mesiodistal bisector
4) Cusps are very nearly equal in height

D. Marginal ridges
1) Marginal ridges are parallel relative to those
of the maxillary first premolar
2) Marginal ridges approximate the same
height as adjacent teeth
3) Marginal ridges are wide relative to the
maxillary first premolar

E. General
1) The occlusal outline of this tooth is ovoid
2) The central groove is short relative to the
first premolar
3) The occlusal surface has a wrinkled
appearance due to a number of
supplemental grooves
4) Triangular ridges are essentially of equal
length and are separated by a the central
groove

M D
L M L

F

M D

L
M M
F L
L-20
Lecture Seat # ____________________

Laboratory Project: PJ-05b

B L B

M D
D D

B

M D

L
B L

1. Occlusal Anatomy
a. Overall crown outline is pentagonal although the
occlusal table is said to be square
b. Cusps: (three-cusp variety)
1) Buccal (largest) located mesial to the mesio-
distal bisector of the crown & over the buccal
half of the tooth
2) ML: slightly wider than the DL cusp
3) DL: smallest of the three cusps
4) Both lingual cusps located near lingual outline
c. Triangular ridges: each cusp has one but none
d. Cuspal ridges: run laterally from cusp tips to join
straight (almost parallel) marginal ridges
e. Fossae:
1) Central
f. Developmental grooves:
1) Lingual }
2) Mesial }
3) Distal }
4) M & D grooves end in their respective
triangular fossae
g. Contact areas:
1) are fairly wide buccolingually
2) both mesial & distal contact areas are located
buccal to the faciolingual long axis bisector of
the tooth
h. Line angles mirror line angles of abutting
teeth

2. Buccal aspect:
a. Buccal cusp tip shorter than that of 1
st
premolar
b. Contacts broad occlusogingivally
c. Mesial cuspal ridge shorter than distal cuspal ridge,
i.e. buccal cusp is located slightly mesial
d. Height of contour (cervical ridge) located at the
cervical 1/3 of the buccal surface

3. Lingual aspect:
a. ML cusp: approx. 1 mm. shorter than the buccal
cusp & slightly wider than the DL cusp
b. DL cusp: approx. 2 mm. shorter than buccal cusp
c. Lingual surface below the cuspal ridges is spherical
d. Height of contour is at the middle 1/3 of lingual
surface

Radiate from within the
central fossa to form a Y
4. Mesial aspect:
a. Can see the height of contour:
b. Proximal contacts: cervical to the marginal
ridge on the buccal of the crown
c. Buccal cusp tip slightly buccal to the faciolingual
long axis bisector of the root
d. Marginal ridge relatively high (occlusally) and
nearly horizontal

5. Distal aspect:
a. Distal marginal ridge slightly lower (more
cervical) that mesial marginal ridge
b. The DL cusp is superimposed on the ML cusp
since the DL cusp is shorter
c. Proximal contact is on the buccal of the crown

6. Occlusion
a. Buccal cusp occludes on the opposing mesial
marginal ridge of tooth #4
b. Lingual cusp of #4 occludes with the distal
marginal ridge of this tooth (#29)

L-21

Tooth #14-Full Crown Wax-Up
Retain for Dental Materials Casting
Spring Semester

A. Buccal Aspect:
1) Crown outline is trapezoidal
2) Buccal cusps more pointed than lingual cusps
3) Buccal groove extends facially between MB &
DB cusps

B. Lingual Aspect:
1) Lingual cusps slightly longer than buccal cusps
2) ML cusp very wide mesiodistally (3/5 of the
mesiodistal measurement of the crown)
3) 5
th
cusp (Carabellis) located on the lingual
aspect of the mesiolingual cusp
4) Lingual groove separates ML & DL cusps

C. Mesial Aspect:
2) Cervical ridge visible on facial (cervical 1/3)
3) Greatest lingual curvature at middle 1/3
4) Contact is located buccal to the central groove
& is 2-3 mm wide buccolingually, 1 mm wide
occlusocervically

D. Distal Aspect:
2) Greatest buccal & lingual curvatures are the
same as stated above
3) Buccolingual dimension of the crown is slightly
smaller than that of mesial (true of all molars)
4) Contact area is centered, 2-3 mm wide bucco-
lingually & 1 mm wide occlusocervically

E. Occlusal Aspect:
1) Outline is somewhat rhomboidal; ML and DF
line angles are obtuse
2) Crown is wider mesially than it is distally
3) Crown is wider lingually than it is buccally
4) Four well-developed cusps. One minor 5
th
cusp
5) Cusp sizes: ML>MB>DL>DB>5
th
(Wheeler)
6) Each major cusp has a triangular ridge; those of
the mesial cusps often form a transverse ridge
7) Oblique Ridge: Distal cuspal ridge of the ML
cusp meets the triangular ridge of the DB cusp
8) The low point of the oblique ridge is the same
height as the mesial and distal marginal ridges
9) The marginal ridges should be the same height
as those of each adjacent crown
10) There are two major fossae (central & distal)
and two minor fossae (mesial triangular & distal
triangular).

M D

L B L

B

M D

L

M M

B L
F. Embrasures/Line Angles
1) Facial line angles relatively square
2) Lingual line angles more rounded
3) Each line angle & embrasure
mirrors those of its abutting tooth

G. Cusp Placement & Size
1) Width of occlusal table- maxillary
molar crowns are wider bucco-
lingually than they are mesiodistally
2) ML cusp tip occludes in the
opposing central fossa of the
mandibular 1st molar
3) DL cusp tip occludes on the
opposing mandibular 1
st
molar distal
marginal ridge
4) Facial cusps are positioned in the
facial grooves of the mandibular
first molar
5) Mesial cusps are wider mesio-
distally than the distal cusps
6) MB, DB, ML cusps form the
primary cusp triangle

L-22
Lecture Seat # ____________________


D M M D

M D

B L B

B

M D

L

B L

1. Occlusal Anatomy
a. Cusps:
nd

tallest), and D (smallest)
cusps more pointed
at the perimeters
d. Fossae:
1) Central
1) Central
2) Mesiobuccal
3) Distobuccal
4) Lingual
buccal to the faciolingual bisector (a line
bisecting the crown into buccal & lingual
halves)
ridge
abutting teeth

2. Buccal aspect:
cervical
cuspal ridges meet at nearly a flat angle.
cusps.

3. Lingual Aspect:

4. Mesial aspect:

5. Distal aspect:
cusp.

L-23

M D

B L B

B

D M

L

D D

B L
Tooth #3-Full Crown Wax-Up
A. Buccal Aspect:
2) Buccal cusps more pointed than lingual cusps
3) Buccal groove extends facially between MB &
DB cusps

B. Lingual Aspect:
1) Lingual cusps slightly longer than buccal cusps
2) ML cusp very wide mesiodistally (3/5 of the
mesiodistal measurement of the crown)
3) 5
th
cusp (Carabellis) located on the lingual
aspect of the mesiolingual cusp
4) Lingual groove separates ML & DL cusps

C. Mesial Aspect:
2) Cervical ridge visible on facial (cervical 1/3)
3) Greatest lingual curvature at middle 1/3
4) Contact is located buccal to the central groove
& is 2-3 mm wide buccolingually, 1 mm wide
occlusocervically

D. Distal Aspect:
2) Greatest buccal & lingual curvatures are the
same as stated above
3) Buccolingual dimension of the crown is slightly
smaller than that of mesial (true of all molars)
4) Contact area is centered, 2-3 mm wide bucco-
lingually & 1 mm wide occlusocervically

E. Occlusal Aspect:
1) Outline is somewhat rhomboidal
2) Crown is wider mesially than it is distally
3) Crown is wider lingually than it is bucally
4) Four well-developed cusps. One minor 5
th
cusp
5) Cusp sizes: ML>MB>DL>DB>5
th
(Wheeler)
6) Each major cusp has a triangular ridge; those of
the mesial cusps often form a transverse ridge
7) Oblique Ridge: Distal cusp ridge of the ML cusp
meets the triangular ridge of the DB cusp
8) The low point of the oblique ridge is the same
height as the mesial and distal marginal ridges
9) The marginal ridges should be the same height
as those of each adjacent crown
10) There are two major fossae (central & distal)
and two minor fossae (mesial triangular & distal
triangular).

F. Embrasures/Line Angles
1) Facial line angles relatively square
2) Lingual line angles more rounded
3) Each line angle & embrasure
mirrors those of its abutting tooth

G. Cusp Placement & Size
1) Width of occlusal table- maxillary
molar crowns are wider bucco-
lingually than they are mesiodistally
2) ML cusp tip occludes in the
opposing central fossa of the
mandibular 1st molar
3) DL cusp tip occludes on the
opposing mandibular 1
st
molar distal
marginal ridge
4) Facial cusps are positioned in the
facial grooves of the mandibular
first molar
5) Mesial cusps are wider mesio-
distally than the distal cusps
6) MB, DB, ML cusps form the
primary cusp triangle

L-24
Lecture Seat # ____________________

Tooth #19- Full Crown Wax-up

M D D M

M D
L F L

B

D M

L
B L

1. Occlusal Anatomy
a. Cusps:
nd

tallest), and D (smallest)
cusps more pointed
at the perimeters
d. Fossae:
1) Central
1) Central
2) Mesiobuccal
3) Distobuccal
4) Lingual
buccal to the faciolingual bisector (a line
bisecting the crown into buccal & lingual
halves)
ridge
abutting teeth

2. Buccal aspect:
cervical
cuspal ridges meet at nearly a flat angle.
cusps.
3. Lingual Aspect:

4. Mesial aspect:

5. Distal aspect:
cusp.

L-25
Lecture Seat # ____________________

Laboratory Project: PJ-12 2
Tooth #31- Full Crown Wax-up

B L B

D M M D

B

M D

L
D

B L
M

1. Occlusal Anatomy
a. Cusps:
1) Four: MB, DB, ML, & DL
2) All are of relative equal size
b. Triangular ridges: each cusp has one
1) MB & ML meet to form a transverse ridge
2) DB & DL meet to form a transverse ridge
at the perimeters
d. Fossae:
1) Central
1) Central: runs mesiodistally, slightly lingual
to the faciolingual bisector
2) Buccal
3) Lingual
NOTE: Both B & L grooves cross the central
groove at right angles dividing occlusal surface
into mesial and distal halves forming a + sign
f. Supplemental grooves:
1) Usually many
2) MB, ML, DB, DL at respective ends of the
central groove & within their triangular fossae
g. Although the occlusal surface of the crown is said to
be rectangular, there is a slight distal convergence
h. Crown slightly wider M-D than B-L
1) Greatest B-L meas. in mesial of crown
2) Cervical ridge prominent only on MB lobe
i. Line angles mirror the line angles of the
abutting teeth

2. Buccal aspect:
a. All cusps are visible (lingual cusps are modestly
taller)
b. MB cusp slightly taller than DB
c. Buccal groove separates the two buccal cusps
d. Both buccal cusps have equal width mesiodistally
e. Cervical ridge is evident on the cervical 1/3 of the
buccal surface but more prominent on the mesial
f. Mesial & Distal walls taper from the contact areas
toward the CEJ

3. Lingual aspect:
a. Although there is a lingual convergence of the mesial
& distal walls, it is very slight, i.e. little (if any) of the
mesial or distal surface can be seen
b. Both lingual cusps are modestly taller than the buccal
cusps
c. Lingual developmental groove separates the ML &
DL cusps
d. Height of curvature is at the middle 1/3

4. Mesial aspect:
c. Proximal contact: Middle 1/3
(occlusocervically) and buccal of center
(central groove)
d. Buccal cusps closer to the faciolingual
bisector line than are the lingual cusps.
e. Buccal cusps are modestly shorter and
more rounded, lingual more pointed

5. Distal aspect:
a. Crown narrower distally than it is
mesially (distal convergence)
b. Contact area (with 3
rd
molar) more in the
center

6. Occlusion:
a. MB cusp: Opposing mesial marginal
ridge of tooth #2
b. DB cusp: Opposing central fossa of
tooth #2

L-26
DENTAL ANATOMY 6543 Tooth #26 Cut-Out Teeth Laboratory Project Quality Assessment Form
Student Name:

Last First
Lab Seat # Lec Seat # Tooth #
26
Project # PJ-01
Finish Date:
/ /
Grading Instructor: Grade:
Anterior Anatomical Waxing Standard Instructions: 1) Students will study all categories below and place a check mark next to each after
understanding the specific criteria, 2) Instructor will indicate a status for the applicable categories (A, G, or E), 3) Instructor will signify approval of
the 5 Item Category Summaries by signing and dating, and 4) Instructor will place a P (Pass) of F (Fail) grade in the upper box at end of exercise.
1
CONTACTS & HEIGHT
Applicable
to Project?

Instructor Comments, Approval & Date

Acceptable

Good

Excellent
A Mesial Incisal Angle Height

B Distal Incisal Angle Height

C Incisal Ridge/Edge Angulation

D Incisal Ridge/Edge Thickness

E Facial Incisal Edge Contour

F Lingual Incisal Edge Contour

Contacts & Height Summary

2
FACIAL SURFACE
Applicable
to Project?


Acceptable

Good

Excellent
A Facial Crown Outline

B Mesial Facial Line Angle

C Distal Facial Line Angle

D Facial Incisal Edge Contour

E Incisal Ridge/Edge Angulation

F Width at Contact Areas

Facial Surface Summary

3
LINGUAL SURFACE
Applicable
to Project?


Acceptable

Good

Excellent
A Lingual Incisal Edge

B Mesial Marginal Ridge

C Distal Marginal Ridge

D Lingual Fossa

Lingual Surface Summary

4
PROXIMAL SURFACE
Applicable
to Project?


Acceptable

Good

Excellent
A Mesial Surface Contour

B Distal Surface Contour

C Mesial Incisal Angle

D Distal Incisal Angle

Proximal Surface Summary

5
WAXING SKILLS
Applicable
to Project?


Acceptable

Good

Excellent
A Marginal Adaptation

B Smoothness of Wax

C Polish of wax-up

D Neatness of Project

Waxing Skills Summary

Additional Instructor Comments:
DENTAL ANATOMY 6543 Tooth #12 Cut-out Teeth Laboratory Project Quality Assessment Form
Student Name:

Last First
Lab Seat # Lecture Seat # Tooth #
12
Project # PJ-02
Finish Date:
/ /

Posterior Anatomical Waxing Standard Instructions: 1) Students will study all categories below and place a check mark next to each after
understanding the specific criteria, 2) Instructor will indicate a status for the applicable categories (A, G, or E), 3) Instructor will signify approval of
the 4 Item Category Summaries by signing and dating, and 4) Instructor will place a P (Pass) of F (Fail) grade in the upper box at end of exercise.

1
CONTACTS & HEIGHT
Applicable
to Project?


Acceptable

Good

Excellent
A Mesial Proximal Contact
B Mesial Marginal Ridge


2
MESIAL SURFACE
Applicable
to Project?


Acceptable

Good

Excellent
A Marginal Ridge Height
B Marginal Groove Placement
C Proximal Contact Placement
D Root Surface Depression
E Cervical Line Placement
F Mesial Lingual Surface Contour
G Facial Lingual Surface Contour


3
OCCLUSAL SURFACE
Applicable
to Project?


Acceptable

Good

Excellent
A Mesial Marginal Ridge Outline
B Triangular Ridge Height
C Triangular Ridge Width
D Central Groove Placement
E Mesial Marginal Ridge Groove
F Mesial Triangular Fossa
G Distal Triangular Fossa
H Presence of Secondary Anatomy
I Depth of Developmental Pits &
Groove


4
WAXING SKILLS
Applicable
to Project?


Acceptable

Good

Excellent
A Marginal Adaptation
B Smoothness of Wax
C Polish of wax-up
D Neatness of Project


DENTAL ANATOMY 6543 Posterior Cut-out Teeth Laboratory Project Quality Assessment Form
Student Name:

Last First
19
Project # PJ-
Finish Date:
/ /
Posterior Anatomical Waxing Standard Instructions: 1) Students will check categories applicable to this project, 2) Instructor will indicate
a status for the applicable categories (A, G, or E), 3) Instructor will signify approval of the 6 Item Category Summaries by signing and dating, 4)
Instructor will place a P (Pass) of F (Fail) grade in the upper box, and 4) an unacceptable proximal contact will ALWAYS result in a failing grade.
1
CONTACTS & HEIGHT
Applicable
to Project?


Acceptable

Good

Excellent
A
Mesial Proximal Contact

B
Distal Proximal Contact

C
Cusp Tip Heights & Placements

D
Marginal Ridge Heights

E
Cuspal Ridge Placements

F
Mesial & Distal Occlusal Embrasure


2
FACIAL SURFACE
Applicable
to Project?


Acceptable

Good

Excellent
A
Facial Crown Outline

B
Cusp Tip Placement(s)

C
Mesial & Distal Facial Line Angles

D
Mesial & Distal Facial Embrasures

E
Facial Cervical Ridge

F
Facial Ridge

G
Developmental Groove Placement(s)


3
LINGUAL SURFACE
Applicable
to Project?


Acceptable

Good

Excellent
A
Lingual Crown Outline

B

C
Mesial & Distal Lingual Embrasures

D
Lingual Height of Contour

E
Lingual Ridge(s)


4
OCCLUSAL SURFACE
Applicable
to Project?


Acceptable

Good

Excellent
A
Triangular Ridge Placement(s)

B
Developmental Groove Placements

C
Presence of Secondary Anatomy

D
Depth of Developmental Pit(s) & Groove(s)

E
Occlusal Crown Outline

Occlusal Surface Summary

5
PROXIMAL SURFACE
Applicable
to Project?


Acceptable

Good

Excellent
A
Mesial & Distal Contact Contours

B
Cervical Interproximal Forms

C
Mesial & Distal Cervical Embrasures

D
Proximal Crown Outline


6 WAXING SKILLS
Applicable
to Project?


Acceptable

Good

Excellent
A
Marginal Adaptation

B
Smoothness of Wax

C
Polish of wax-up

D
Neatness of Project


DENTAL ANATOMY 6543 Anterior Typodont Teeth Laboratory Project Quality Assessment Form
Student Name:

Last First
Project # PJ-
Finish Date:
/ /
Anterior Anatomical Waxing Standard Instructions: 1) Students will check categories applicable to this project, 2) Instructor will indicate
1
CONTACTS & HEIGHT
Applicable
to Project?


Acceptable

Good

Excellent
A

B

C
Incisal Ridge/Edge Height

D
Incisal Ridge/Edge Anatomy

E
Cusp Tip Placement

F
Cuspal Ridges

G
Mesial Incisal Embrasure

H
Distal Incisal Embrasure


2
FACIAL SURFACE
Applicable
to Project?


Acceptable

Good

Excellent
A
Facial Crown Form & Anatomy

B
Mesial Facial Line Angle

C
Distal Facial Line Angle

D
Mesial Facial Embrasure

E
Distal Facial Embrasure

F

G
Developmental Depressions

H
Facial Ridge


3
LINGUAL SURFACE
Applicable
to Project?


Acceptable

Good

Excellent
A
Lingual Crown Form & Anatomy

B
Mesial Marginal Ridge

C
Distal Marginal Ridge

D
Lingual Fossa(e)

E
Lingual Ridge

F
Cingulum

G
Mesial Lingual Embrasure

H
Distal Lingual Embrasure

I
Lingual Cervical Ridge


4
PROXIMAL SURFACE
Applicable
to Project?


Acceptable

Good

Excellent
A
Mesial Contact Contour

B
Distal Contact Contour

C
Cervical Interproximal Form

D
Mesial Cervical Embrasure

E
Distal Cervical Embrasure


5
WAXING SKILLS
Applicable
to Project?


Acceptable

Good

Excellent
A
Marginal Adaptation

B
Smoothness of Wax

C
Polish of wax-up

D
Neatness of Project


DENTAL ANATOMY 6543 Anterior Typodont Teeth Laboratory Practical Quality Assessment Form
Student Name:

Last First
Practical # PC-
Finish Date:
/ /
Anterior Anatomical Waxing Standard Instructions: 1) Students will check categories applicable to this project, 2) Student will evaluate
their pattern for each category, 3) Instructor will check 1 of 3 evaluation points (Unacceptable, Acceptable, or Excellent) for each item and deduct
points, if indicated, 4) Instructor will add up deductions for each of the categories then subtract total from 100 and place this numerical grade in the
upper box, and 5) an unacceptable proximal contact will ALWAYS result in a failing grade.
1
CONTACTS & HEIGHT
Potential
Point
Deductions

Deductions?

Unacceptable?

Acceptable?

Excellent?

Student Evaluation & Comments
A
2
B
2
C
Incisal Ridge/Edge Height
2
D
Incisal Ridge/Edge Anatomy
2
E
Cusp Tip Placement
1
F
Cuspal Ridges
1
G
Mesial Incisal Embrasure
1
H
Distal Incisal Embrasure
1

12

2
FACIAL SURFACE
Potential
Point
Deductions

Deductions?

Unacceptable?

Acceptable?

Excellent?

A
Facial Crown Form/Anatomy
2
B
Mesial Facial Line Angle
2
C
Distal Facial Line Angle
2
D
Mesial Facial Embrasure
2
E
Distal Facial Embrasure
2
F
1
G
Developmental Depressions
1
H
Facial Ridge
1

13

3
LINGUAL SURFACE
Potential
Point
Deductions

Deductions?

Unacceptable?

Acceptable?

Excellent?

A
Lingual Crown Form/Anatomy
1
B
Mesial Marginal Ridge
2
C
Distal Marginal Ridge
2
D
Lingual Fossa(e)
1
E
Lingual Ridge
1
F
Cingulum
1
G
Mesial Lingual Embrasure
2
H
Distal Lingual Embrasure
2
I
Lingual Cervical Ridge
1

13

4
PROXIMAL SURFACE
Potential
Point
Deductions

Deductions?

Unacceptable?

Acceptable?

Excellent?

A
Mesial Contact Contour
1
B
Distal Contact Contour
1
C
Cervical Interproximal Form
2
D
Mesial Cervical Embrasure
1
E
Distal Cervical Embrasure
1

6

5
WAXING SKILLS
Potential
Point
Deductions

Deductions?

Unacceptable?

Acceptable?

Excellent?

A
Marginal Adaptation
2
B
Smoothness of Wax
2
C
Polish of wax-up
1
D
Neatness of Project
1

6

DENTAL ANATOMY 6543 Posterior Typodont Teeth Laboratory Project Quality Assessment Form
Student Name:

Last First
Project # PJ-
Finish Date:
/ /
Posterior Anatomical Waxing Standard Instructions: 1) Students will check categories applicable to this project, 2) Instructor will indicate
1
CONTACTS & HEIGHT
Applicable
to Project?


Acceptable

Good

Excellent
A

B

C

D

E

F
Mesial & Distal Occlusal Embrasure


2
FACIAL SURFACE
Applicable
to Project?


Acceptable

Good

Excellent
A

B

C
Mesial & Distal Facial Line Angles

D

E

F
Facial Ridge

G
Developmental Groove Placement(s)


3
LINGUAL SURFACE
Applicable
to Project?


Acceptable

Good

Excellent
A

B

C

D

E
Lingual Ridge(s)


4
OCCLUSAL SURFACE
Applicable
to Project?


Acceptable

Good

Excellent
A

B
Developmental Groove Placements

C
Presence of Secondary Anatomy

D

E


5
PROXIMAL SURFACE
Applicable
to Project?


Acceptable

Good

Excellent
A
Mesial & Distal Contact Contours

B

C
Mesial & Distal Cervical Embrasures

D


6 WAXING SKILLS
Applicable
to Project?


Acceptable

Good

Excellent
A
Marginal Adaptation

B
Smoothness of Wax

C
Polish of wax-up

D
Neatness of Project


DENTAL ANATOMY 6543 Posterior Typodont Teeth Laboratory Practical Quality Assessment Form
Student Name:

Last First
Practical # PC-
Finish Date:
/ /
Posterior Anatomical Waxing Standard Instructions: 1) Students will check categories applicable to this project, 2) Student will evaluate
their pattern for each category, 3) Instructor will check 1 of 3 evaluation points (Unacceptable, Acceptable, or Excellent) for each item and deduct
points, if indicated, 4) Instructor will add up deductions for each of the categories then subtract total from 100 and place this numerical grade in the
upper box, and 5) an unacceptable proximal contact will ALWAYS result in a failing grade.
1
CONTACTS & HEIGHT
Potential
Point
Deductions

Deductions?

Unacceptable?

Acceptable?

Excellent?

A
2
B
2
C
2
D
2
E
2
F Mesial & Distal Occlusal Embrasure 2

12

2
FACIAL SURFACE
Potential
Point
Deductions

Deductions?

Unacceptable?

Acceptable?

Excellent?

A
2
B
2
C Mesial & Distal Facial Line Angles 2
D Mesial & Distal Facial Embrasures 2
E
2
F
Facial Ridge
1
G Developmental Groove Placement(s) 1

12

3
LINGUAL SURFACE
Potential
Point
Deductions

Deductions?

Unacceptable?

Acceptable?

Excellent?

A
1
B
2
C Mesial & Distal Facial Embrasures 2
D
1
E
Lingual Ridge(s)
1

7

4
OCCLUSAL SURFACE
Potential
Point
Deductions

Deductions?

Unacceptable?

Acceptable?

Excellent?

A
2
B Developmental Groove Placements 2
C Presence of Secondary Anatomy 2
D
1
E
1

8

5
PROXIMAL SURFACE
Potential
Point
Deductions

Deductions?

Unacceptable?

Acceptable?

Excellent?

A Mesial & Distal Contact Contours 1
B
1
C Mesial & Distal Cervical Embrasures 2
D
1

5

6
WAXING SKILLS
Potential
Point
Deductions

Deductions?

Unacceptable?

Acceptable?

Excellent?

A
Marginal Adaptation
2
B
Smoothness of Wax
2
C
Polish of wax-up
1
D
Neatness of Project
1

6


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