TOOTH IDENTIFICATION This topic accounts for about %07 of the practical exam It's very important for

you to know the steps that you have to follow all the time to identify the tooth, so what are these steps ?? 1. You have to identify the set of the tooth Regarding the set, the tooth is either permanent or deciduous Here you have to use the set traits What are the set traits that may help you distinguish permanent tooth from deciduous tooth ?? a. Size Permanent teeth are larger in size than deciduous teeth (i.e. permanent central incisor is larger than primary central incisor) b. Color Deciduous teeth are lighter in color than permanent teeth that's why they (deciduous teeth) are called milk teeth c. Cervical constriction Exists in deciduous but not in permanent d. Amount of root trunk in molars Very little in deciduous but long in permanent (the furcation begins very cervically in deciduous molars) e. Amount of root divergence The roots are very divergent and flared out in deciduous and very thin also 2. You have to identify the class of the tooth Regarding the class, the tooth is either an incisor, c-*--anine, premolar or molar

Here you have to use the class traits *** There's NO premolars in the deciduous dentition 3. You have to identify the arch of the tooth Regarding the arch, the tooth is either maxillary or mandibular Here you have to use the arch traits 4. You have to identify the type of the tooth i.e. If the tooth is a molar, then is it a first , second or a third molar? If the tooth is a premolar, then is it a first or a second premolar? If the tooth is an incisor, then is it a central or a lateral incisor? Here you have to use the type traits *** Canines have NO type traits 5. You have to identify the side of the tooth (the most important) Regarding the side, the tooth is either from the right side or the left side of the mouth ** How can we know whether the tooth is a right or a left tooth?? >>> You have to identify all the aspects of the tooth For post. teeth the occlusal aspect is the one that can tell you the most about the side of the tooth For ant. teeth the labial aspect is the one that can tell you the most about the side of the tooth

*** Questions : *** Can you identify this tooth ?? * First, you have to identify the set of the tooth >>> Regarding the size it is a permanent tooth * Second, you have to identify the class of the tooth >>> * From the labial aspect : This tooth has an incisal edge that is flattened MD * From the incisal aspect : 1. This tooth has long horizontal biting edge that is compressed LL 2. This tooth has 3 mamelons All these tell you that the tooth is an incisor * Third, you have to identify the arch of the tooth >>> 1. The crown is wide MD 2. MD dimension of the crown is slightly smaller than the IC dimension (height/width proportion is very small) 3. MD dimension of the root = LL dimension 4. The labial surface is rounded as seen from the incisal aspect So >>> The arch of this tooth is the maxillary arch * Forth, you have to identify the type of the tooth >>> Incisal aspect From the labial aspect : 1. the crown of the tooth is very wide MD 2. the MI and DI angles aren't that much rounded (MI angle is sharp) 3. the root is conical in shape From the lingual aspect :

Labial aspect

Proximal aspect

1. M and D marginal ridges, cingulum and lingual fossa all these aren't that much pronounced 2. NO lingual pit All these tell you that the tooth is a central incisor * Fifth, you have to identify the side of the tooth In maxillary central incisors : 1. the MI angle is sharp (00 degrees) while the DI angle is rounded 2. the M outline is straight while the D outline is rounded 3. the MI angle is higher (more toward the incisal edge) than the DI angle 4. you can use the M and D HOCs also (MHOC is higher than the DHOC) 5. Very very important point: always remember that the M outline is inlined with the outline of the root while the D outline isn't inlined with the outline of the root, it is located outside the outline of the root.

Stright M outline MHOC Sharp MI angle Rounded DI angle

Rounded D outline DHOC

So >>> The side of the tooth is the left one So >>>>> the tooth is maxillary left permanent central incisor (21) If you want to place it in the mouth then :

*** Can you identify this tooth ?? 1. What is the set of the tooth?? Regarding the size this tooth is a permanent tooth 2. What is the class of the tooth?? > It has only one conical pointed cusp >> It doesn't have an occlusal surface >>> As seen from the proximal aspect it's root is very thick LL >>>> It has a well developed cingulum (that's why it can't be a premolar) >>>>> It has 2 well developed depressions (Mesio-labial and Disto-labial) on the labial surface So >>>> The class of the tooth is a canine 3. What is the arch of the tooth?? > Notice the overhanging of the proximal outlines (how they are located outside the root)

>> As seen from the proximal aspect notice that the cusp tip is located labial to the LL bisecting line (this point is very important and critical in the differentiation btwn max. and mand. canines) >>> MD dimension > IC dimension of the crown >>>> As seen from the lingual aspect, the cingulum is very prominent, M and D marginal ridges are prominent also, the ML and DL fossae are very deep and the lingual pit is apparent >>>>> M and D outlines are markedly convergent toward the cervix >>>>>> You can sometimes depend on the position of HOCs which are relatively lower in maxillary than in mandibular All these tell you that this canine is from the maxillary arch 4. What is the type of the tooth?? Canines have NO type traits 5. What is the side of the tooth?? > MSR (mesial sloping ridge) is shorter than the DSR >> MI angle is higher and more rounded than the DI angle >>>You can also identify the side of the tooth from the incisal aspect, notice the amount of asymmetry btwn the M and D halves, the D half is wider than the M half (D half is thick MD and thin LL, while the M half is thin MD and thick LL) and by this you can know which is the M side and which is the D side

Smaller M half Wider D half

DL fossa

ML fossa

Based on these : the side of the tooth is the right one So >>>> The tooth is maxillary right permanent canine (13) ** Can you identify this tooth?? 1. What is the set of this tooth?? (is it permanent or deciduous ??) > It is large in size >> This tooth is natural, and it isn't very white in color and this somehow excludes being deciduous >>> We don't see any cervical constriction at the area btwn the crown and the root portions of the tooth So >>> The set of this tooth is permanent 2. What is the class of the tooth?? (is it incisor, canine, premolar or molar ??) > This tooth has a biting edge that is flattened MD and compressed LL >> As seen from the incisal aspect, this tooth has 3 mamelons So >>> The class of this tooth is incisor 3. What is the arch of this tooth?? (is it max. or mand. Incisor??) > The crown is wide MD >> MD dimension of the crown is slightly smaller than the IC dimension (height/width proportion is very small) >>> MD dimension of the root = LL dimension (very important) >>>> The labial surface is rounded as seen from the incisal aspect So >>> The tooth is a maxillary incisor 4. What is the type of the tooth?? (is it max. central or max. lateral incisor??)

> The crown outlines are very rounded and the crown isn't that much wide MD >> MI and DI angles are very rounded (MI angle isn't sharp) >>> As seen from the lingual aspect, the M and D marginal ridges are very prominent, the cingulum is very convex and prominent, the lingual fossa is very deep and has a pit >>>> The root isn't 1007 conical (remember that in central incisors the root is 1007 conical) Very convex So >>> The type of the tooth is lateral incisor 5. What is the side of the tooth?? (is it a right or a left max. lateral incisor??) > DI angle is markedly rounded while the MI angle is slightly rounded >> MHOC is higher than the DHOC (MI angle is higher than the DI angle) >>> M outline is slightly rounded while the D outline is markedly rounded >>>> M outline is inlined with the outline of the root while the D outline isn't inlined with the outline of the root, it is located outside the outline of the root. So >>> The side of the tooth is the left side The tooth is maxillary left permanent lateral incisor
Slightly rounded MI angle Markedly rounded DI angle cingulum Very deep lingual fossa

*** Can you identify this tooth?? 1. This tooth is a permanent tooth 2. What is the class of the tooth??

> This tooth has 2 cusps So >>> The class of this tooth is premolar 3.What is the arch of the tooth?? > This tooth has 2 major cusps which are approximately equal in size and prominence >> As seen from the proximal aspect the buccal profile is slightly inclined lingually (the whole crown is slightly tilted lingually) >>> The occlusal table is centered over the root trunk Lingual aspect >>>> As seen from the occlusal aspect the BL dimension is greater than the MD dimension

Mesial aspect

Buccal aspect

So >>> The arch of this tooth is the maxillary arch 4. What is the type of this tooth?? > The presence of the MMRG (mesial marginal ridge groove) >> The presence of canine (inter - radicular) fossa which is deep and extends from the contact area to the bifurcation area of the root >>> It has 2 roots (use this feature to confirm that this tooth is a maxillary first premolar but don't depend on it as a 1007 clue coz in 207 of the cases this tooth has 1 root instead of 2) >>>> As seen from the occlusal aspect the M and D outlines are converging lingually (they aren't parallel to each other) >>>>> As seen from the occlusal aspect the MB and DB angles are sharp >>>>>> As seen from the occlusal aspect, the B cusp is wider MD than the L cusp (they aren't equal in width)

>>>>>>> As seen from the occlusal aspect the central groove is long and there are few supplemental grooves (or sometimes there is NO supplemental grooves at all) >>>>>>>> As seen from the buccal aspect notice the overhanging of MO and DO angles (how they are located outside the outline of the root) So >>> The type of this tooth is 1st premolar 5. What is the side of this tooth?? > The side where you have the MMRG and the canine fossa is the M side >> You can depend on the fact that in maxillary 1st premolar the MSR (mesial sloping ridge) is longer than the DSR and the MHOC is lower than the DHOC >>> look at the tooth from the occlusal aspect and notice that the MMR (mesial marginal ridge) is shorter than the DMR >>>> As seen from the occlusal aspect the lingual cusp is twisted mesially (the tip of the lingual cusp is mesial to the midline) >>>>> As seen from the buccal aspect the MSR (mesial sloping ridge) is longer than the DSR So >>> The side of this tooth is the right side >>> This tooth is maxillary right permanent 1st premolar

Sharp MB angle

MMR DMR

MHOC Tip of lingual cusp which is twisted mesially DHOC

Short DSR Overhanging MO and DO angles

Long MSR

*** Can you identify this tooth?? 1. The set of this tooth is permanent 2. What is the class of this tooth?? > It has 2 cusps So >>> The class of this tooth is premolar 3. What is the arch of this tooth?? > This tooth has 1 major cusp and 1 minor cusp (the 2 cusps aren't equal in size and prominence) >> As seen from the proximal aspect the buccal profile is markedly convergent lingually (the whole crown is completely tilted lingually) >>> The occlusal table is tilted lingually (it isn't centered over the root trunk) >>>> As seen from the occlusal aspect the MD dimension is equal to the BL dimension So >>> The arch of this tooth is the mandibular arch 4. What is the type of this tooth?? > As seen from the lingual aspect the lingual cusp is much lower than the buccal cusp (they aren't equal in height) and also the lingual cusp is much smaller than the buccal cusp (they aren't equal in size) >> The presence of a groove called the ML groove (it is situated btwn the MMR and the ML cusp ridge of the lingual cusp) >>> As seen from the occlusal aspect the MMR and the DMR are convergent lingually (they aren't parallel to each other) >>>> As seen from the proximal aspect the occlusal plane is tilted lingually >>>>> As seen from the lingual aspect the whole buccal profile is visible So >>> The type of this tooth is 1st premolar

5. What is the side of this tooth?? > Search for the ML groove to know the M side >> As seen from the occlusal aspect the MMR is shorter than the DMR >>> As seen from the buccal aspect the MSR is shorter than the DSR >>>> As seen from the proximal aspect the MMR is higher than the DMR (this feature is only seen in this tooth coz in the other premolars the MMR is lower than the DMR) >>>>> The MMR is oblique (inclined lingually and cervically) while the DMR isn't as much oblique as the MMR So >>> The side of this tooth is the right side This tooth mandibular right permanent 1st premolar (44)

Notice how the crown is markedly tilted lingually

ML groove

Question: *** How to differentiate btwn mandibular 1st premolar and a canine?? 1. Canine has only 1 cusp while mandibular 1st premolar has 2 cusps 2. Canine is the only cusped tooth with NO occlusal surface while mandibular 1st premolar has an occlusal surface 2. Canine has a prominent and convex cingulum that is very cervically located while the mandibular 1st premolar doesn't have any cingulum and lingually you can observe it's lingual cusp which is very small but more occlusally located compared with the position of the canine's

cingulum (canine's cingulum is lower than the lingual cusp of mandibular 1st premolar) *** Can you identify this tooth?? 1. The set of this tooth is permanent 2. What is the class of this tooth?? > It has 3 cusps >> 1 buccal cusp + 2 lingual cusps So >>> The class of this tooth is premolar 3. What is the arch of this tooth?? > This tooth has 1 major cusp (the B cusp) and 2 minor cusps (ML and DL cusps) (the 3 cusps aren't equal in size and prominence) >> As seen from the proximal aspect the buccal profile is markedly convergent lingually (the whole crown is completely tilted lingually) >>> As seen from the occlusal aspect the MD dimension is equal to the BL dimension So >>> The arch of this tooth is the mandibular arch 4. What is the type of this tooth?? It is for sure a mandibular 2nd premolar (the only premolar with possibility to have 3 cusps instead of 2) You can depend also on : > None of the buccal profile is visible from the lingual aspect >> B and L cusps are almost equal in size and height (when this tooth has 2 cusps like other premolars then these 2 cusps are almost equal in every thing) >>> As seen from the occlusal aspect it has NO ML groove >>>> As seen from the occlusal aspect the MMR and DMR are parallel to each other

>>>>> MMR and DMR are equal in length as seen from the occlusal aspect >>>>>> As seen from the proximal aspect the occlusal plane isn't tilted lingually (it is perpendicular on the long axis of the tooth) >>>>>>> As seen from the occlusal aspect the main grooves form the Y latter shape with a lingual groove that separates the ML and DL cusps from each other, and the central fossa has a central pit Question: *** How to differentiate btwn mandibular 2nd premolar (with 2 cusps) and : a) mandibular 1st premolar b) maxillary premolars a) compare the 2 cusps of each premolar with each other so >> 1. if they are equal in height and size then this tooth is mandibular nd 2 premolar, BUT 2. if they aren't equal in height and size then this tooth is mandibular 1st premolar b) Look at the tooth from the proximal aspect so >> 1. if the buccal profile is markedly tilted lingually then this tooth is mandibular 2nd premolar, BUT 2. if the buccal profile is approximately straight and it isn't tilted lingually then this tooth is a maxillary premolar You can use of course too many arch traits to differentiate btwn them but the one I told you can be easily noticed and it always indicates whether the tooth is maxillary or mandibular premolar 5. What is the side of this tooth?? a) If this tooth has 3 cusps ( B + ML + DL cusps) then depend on the fact that the ML cusp is wider MD and higher (it reaches the height of the buccal cusp) than the DL cusp, so what you have to do is to look at the lingual aspect of the tooth and find the higher and wider cusp of the 2 lingual cusps b) If this tooth has 2 cusps, it is somehow hard to tell which side is M and which side is D coz :

1. As seen from the occlusal aspect the MMR and the DMR are equal in length 2. As seen from the buccal aspect the MSR and the DSR are equal in length also 3. As seen from the proximal aspect the MMR and the DMR are horizontal (NO one is markedly oblique than the other like in mandibular 1st premolar) 4. This tooth has NO ML groove to determine the M side You can only depend on the fact that the MMR is lower than the DMR as seen from the proximal aspect and that the DO angle is slightly lower than the MO angle as seen from the buccal aspect

Wider and higher ML cusp

Smaller and lower DL cusp

So >>> This tooth is mandibular right permanent 2nd premolar (44)

*** Can you identify this tooth?? 1. It is permanent 2. it has 2 cusps So >>> it is a premolar

3. What is the arch of this tooth?? > This tooth has 2 major cusps which are approximately equal in size and prominence >> As seen from the proximal aspect the buccal profile is slightly inclined lingually (the whole crown is slightly tilted lingually) >>> The occlusal table is centered over the root trunk >>>> As seen from the occlusal aspect the BL dimension is greater than the MD dimension So >>> The arch of this tooth is the maxillary arch 4. What is the type of this tooth?? > This tooth has NO MMR groove >> There is NO canine fossa >>> As seen from the buccal aspect the MSR and the DSR are equal in length >>>> As seen from the occlusal aspect the MMR and the DMR are equal in length and they are parallel to each other (they show NO lingual convergence) >>>>> As seen from the occlusal aspect there are too many supplemental grooves and the central groove is short >>>>>> As seen from the occlusal aspect the MB and DB angles are rounded >>>>>>> As seen from the lingual aspect the L cusp has the same MD width of the buccal cusp >>>>>>>> It has one root (again use this feature to confirm that this maxillary premolar is a 2nd one but not as it is your main clue coz in 202 of the cases you may find maxillary 2nd premolar with 2 roots) So >>> The type of this tooth is 2nd premolar 5. What is the side of this tooth?? It can be difficult to tell the side of this tooth coz:

1. As seen from the occlusal aspect the MMR and the DMR are equal in length 2. As seen from the buccal aspect the MSR and the DSR are equal in length also 3. There is NO MMR groove or canine fossa to determine the M side But you depend on the fact that the DO angle is slightly lower than the MO angle as seen from the buccal aspect So >>> The side of this tooth is the right side This tooth is the maxillary right permanent 2nd premolar (14)

*** Can you identify this tooth?? 1. The set of this tooth is permanent 2. What is the class of this tooth?? > It has 5 cusps So >>> The class of this tooth is molar 3. What is the arch of this tooth?? >This tooth has 2 roots (1 M and 1 D) >> The roots are located under the MRs >> This tooth has 4 major cusps and 1 lesser sized cusp >>> As seen from the occlusal aspect the crown is wider MD than BL >>>> MB and DB cusps are approximately equal in size, ML and DL cusps are approximately equal in size also, but the D cusp is the smallest So >>> The arch of this tooth is the mandibular arch 4. What is the type of this tooth??

> This tooth has 5 cusps >> This tooth has 3 buccal cusps >>> This tooth has 2 buccal grooves >>>> The crown of this tooth is very wide MD >>>>> The roots are widely separated from each other and show NO distal inclination >>>>>> Main grooves form " Y " pattern So >>> The type of this tooth is 1st molar 5. What is the side of this tooth?? Here you have first to orient the tooth so that it's buccal aspect is in front of you *** How can we know which side is buccal and which side is lingual?? >>> The B side has 3 cusps and 2 grooves while the L side has 2 cusps and 1 groove After you orient the tooth correctly, you have now to determine which side is M and which side is D *** How can we know which side is M and which side is D?? >>> Look at the tooth from it's occlusal aspect, identify the B and L sides in the same way I told you before, in the B side there are 3 cusps, 2 of them are of equal size and 1 is of lesser size, the 2 that are equal in size are the MB and DB cusps while the one of lesser size is the D cusp that can tell you about the D side, so that you can now know the side of this tooth in the mouth
3 MB cusp Mesial side Distal side Buccal side 2 D cusp

1 Lingual side

 1 >>> lingual developmental groove that separates the ML and DL cusps from each other 2 >>> distobuccal developmental groove that separates btwn D and DB cusps 3 >>> mesiobuccal developmental groove that separates btwn MB and DB cusps So >>> The side of this tooth is the right side >>>> This tooth is mandibular right permanent 1st molar (44) *** Note : * Tooth with 1 cusp = canine * Tooth with 2 cusps = premolar (it can be maxillary 3rd molar but this represents very small percentage) * Tooth with 3 cusps = mandibular 2nd premolar or maxillary 3rd molar How to differentiate btwn them?? >>> simply count the number of cusps buccally, so : a. 1 buccal cusp then premolar b. 2 buccal cusps then molar * Tooth with 4 cusps = maxillary molar or mandibular molar How to differentiate btwn them?? >>> simply use the arch traits like: the num of the roots (3 roots = maxillary, 2 roots = mandibular), the size of the cusps (are they approximately equal to each other or not), * Tooth with 5 cusps = mandibular 1st molar *** Can you identify this tooth?? 1. It is permanent 2. What is the class of this tooth?? > It has 4 cusps >> It has 2 buccal cusps and 2 lingual cusps So >>> The class of this tooth is molar

3. What is the arch of this tooth?? > This tooth has 3 roots (2 B and 1 L) >> The roots are located under the cusps >>> This tooth has 3 major cusps (that are arranged in tricuspate triangular pattern) and 1 lesser sized cusp >>>> As seen from the occlusal aspect the crown is wider BL than MD >>>>> The 2 lingual cusps are of unequal size (ML cusp is larger than DL cusp) >>>>>> The 2 buccal cusps aren't 1002 equal in size, actually the MB cusp is slightly bigger than the DB cusp So >>> The arch of this tooth is the maxillary arch 4. What is the type of this tooth?? > The roots are widely separated from each other and they show NO distal inclination >> The size of DL cusp is large >>> The 2 B cusps are equal in height as seen from the buccal aspect >>>> The presence of cusp of carabelli (remember that the presence of this cusp doesn't tell you 1002 that this tooth is maxillary 1st molar coz in 102 of the cases you may find maxillary 1st molar without cusp of carabelli and maxillary 2nd molar with cusp of carabelli, so it isn't an accurate clue but it can help in confirming that this tooth is maxillary 1st molar) So >>> The type of this tooth is 1st molar 5. What is the side of the tooth?? Again orient the tooth so that it's buccal aspect is in front of you *** How to know the buccal side??

Simply the B side is the side where the 2 cusps (MB and DB cusps) are equal in height and it is the side where we have 2 roots (MB and DB roots) Then, you have to determine which side is mesial and which side is distal *** How to know that?? There are 5 ways: 1. look at the tooth from the occlusal aspect and look for the smallest cusp which is the DL cusp to know the D side 2. look at the tooth from the occlusal aspect and look for the largest cusp which is the ML cusp to know the M side 3. search for cusp of carabelli which is situated on the lingual aspect of the ML cusp to know the M side again 4. look at the tooth from the occlusal aspect the MMR is longer than the DMR so that you can know the M and D sides 5. look at the tooth from the buccal aspect the MB cusp is wider MD than the DB cusp (it is the easiest way coz the tooth here is oriented correctly and that exclude getting confused in determining the side of the tooth) So >>> The side of this tooth is the right side >>> This tooth is maxillary right permanent 1st molar (14) *** Note : The Dr. can bring a tooth with missing root and ask you about the reason why this root is missing, so how are you going to answer this question??? 1. if the apical foramina are widely opening (they are large) and they have very thin edge of dentine lining them from inside then this root is still developing and it isn't complete yet 2. if the apical foramina are small and narrow and lined with thick layer of dentine then the root was broken while the tooth was extracted out of the mouth

*** Can you identify this tooth?? 1. It is permanent 2. What is the class of this tooth?? > It has 4 cusps >> it has 2 B and 2 L cusps So >>> The class of this tooth is molar 3. What is the arch of this tooth?? > It has 3 roots (2 B and 1 L) >> The roots are located over the cusps >>> The crown is wider BL than MD >>>> The 2 lingual cusps are of unequal size (ML cusp is much larger than DL cusp) >>>>> The 2 buccal cusps aren't 1002 equal in size also (MB cusp is slightly larger than DB cusp) >>>>>> This tooth has 3 major cusps (that are arranged in tricuspate triangular pattern) and 1 lesser sized cusp So >>> The arch of this tooth is the maxillary arch 4. What is the type of this tooth?? > The roots of this tooth are close to each other and they show distal inclination >> The size of DL cusp is small >>> The 2 B cusps aren't equal in height (DB is shorter than MB) as seen from the buccal aspect >>>> You can depend on the appearance of the oblique ridge (if it is long and prominent then this tooth is 1st molar but if it is short and less prominent then this tooth is 2nd molar) >>>>> Many supplemental grooves So >>> The type of this tooth is 2nd molar

5. What is the side of this tooth?? First >>> orient the maxillary tooth so that it's buccal aspect is in front of you (look for the side with 2 roots) Second >>> determine the M and D sides (look for the smallest cusp which is the DL cusp to know the D side or look for the largest cusp which is the ML cusp to know the M side or look at the tooth from the buccal aspect and look for the wider cusp MD which is the MB cusp or look at the tooth from the occlusal aspect and look for the longer marginal ridge which is the MMR or use cusp of carabelli if it is present) So >>> The side of this tooth is the left side >>> This tooth is the maxillary left permanent 2nd molar (22) *** Can you identify this tooth?? 1. It is permanent 2. What is the class of this tooth?? > It has 4 cusps >> It has 2 buccal and 2 lingual cusps So >>> The class of this tooth is molar

3. What is the arch of this tooth?? > This tooth has 2 roots (1 M and 1 D) >> The roots are located under the marginal ridges not the cusps >>> This tooth has 4 major cusps >>>> As seen from the occlusal aspect the crown is wider MD than BL

>>>>> MB and DB cusps are approximately equal in size, ML and DL cusps are approximately equal in size also So >>> The arch of this tooth is the mandibular arch 4. What is the type of this tooth?? > This tooth has 4 cusps >> This tooth has 2 buccal cusps >>> This tooth has 1 buccal groove >>>> The roots are close to each other and show distal inclination >>>>>> Main grooves form " + " pattern >>>>>>> numerous nom of supplemental grooves So >>> The type of this tooth is 2nd molar 5. What is the side of this tooth?? The roots are always distally inclined so that the side that has NO root under it is the M side, you can also use the MHOC and DHOC (the MHOC is higher than the DHOC)

M side

D side

Distal inclination

So >>> The side of this tooth is the left side

>>> This tooth is the mandibular left permanent 2nd molar (72) *** Can you identify this tooth?? 1. It is permanent 2. What is the class of this tooth?? * From the labial aspect : This tooth has an incisal edge that is flattened MD * From the incisal aspect : 1. This tooth has long horizontal biting edge that is compressed LL 2. This tooth has 3 mamelons So >>> The class of this tooth is an incisor 3. What is the arch of this tooth?? > The crown is narrow MD >> MD dimension of the crown is much smaller than the IC dimension (height/width proportion is much greater than 1 it is approximately equals to 2) >>> The root is narrow MD and thick (bulky) LL (very important) >>>> The labial surface is flat as seen from the incisal aspect So >>> The arch of this tooth is the mandibular arch 4. What is the type of this tooth?? We have many clues to identify the side, among them > As seen from the incisal aspect the incisal ridge (not edge) is perpendicular on the long axis of the tooth which is the LL line (this one is the most important clue) >> As seen from the labial aspect the MI and DI angles are sharp (09 degrees) >>> The crown of the tooth is bilaterally symmetrical

>>>> The crown of the tooth is very narrow MD So >>> The type of this tooth is central incisor 5. What is the side of this tooth?? It is somehow difficult to tell the side of this tooth but you can depend on the fact that the MI angle is slightly higher than the DI angle as seen from the labial aspect or depend on the fact that the MI angle is sharper than the DI angle

Flat labial surface DI angle

Incisal ridge

MI angle

So >>> The side of this tooth is the right side >>> The tooth is the mandibular right permanent central incisor (11)

*** Can you identify this tooth?? 1. It is permanent 2. What is the class of this tooth?? * From the labial aspect : This tooth has an incisal edge that is flattened MD * From the incisal aspect : 1. This tooth has long horizontal biting edge that is compressed LL

2. This tooth has 3 mamelons So >>> The class of this tooth is an incisor 3. What is the arch of this tooth?? > The crown is narrow MD >> MD dimension of the crown is much smaller than the IC dimension (height / width proportion is much greater than 1 it is approximately equals to 2) >>> The root is narrow MD and thick LL (important) >>>> The labial surface is flat as seen from the incisal aspect So >>> The arch of this tooth is the mandibular arch 4. What is the type of this tooth?? > As seen from the incisal aspect the incisal ridge (not edge) isn't perpendicular on the long axis of the tooth which is the LL line, it tends to be oblique (this one is the most important clue) >> As seen from the labial aspect the MI and DI angles are rounded >>> The crown of the tooth is bilaterally asymmetrical So >>> The type of this tooth is lateral incisor 5. What is the side of this tooth?? > As I said before the incisal ridge isn't perpendicular on the LL line, it tends to incline lingually as we go distally

M side

D side

So >>> The side of this tooth is the right side >>> This tooth is the mandibular right permanent lateral incisor (12)

*** Can you identify this tooth?? 1. It is permanent 2. What is the class of this tooth?? > It has only one conical pointed cusp >> It doesn't have an occlusal surface >>> As seen from the proximal aspect it's root is very thick LL >>>> It has a well developed cingulum (that's why it can't be a premolar) >>>>> It has 2 well developed depressions (Mesio-labial and Disto-labial) on the labial surface So >>> The class of the tooth is a canine 3. What is the arch of this tooth?? > The proximal outlines are inlined with the outline of the root (they aren't overhanging) >> As seen from the proximal aspect notice that the cusp tip is located on the LL bisecting line (this point is very important and critical in the differentiation btwn max. and mand. canines) >>> IC dimension > MD dimension of the crown >>>> As seen from the lingual aspect, the cingulum isn't very prominent, M and D marginal ridges aren't prominent also, the ML and DL fossae are very shallow and there is NO lingual pit (the entire L surface is flat) >>>>> M and D outlines are almost parallel to each other >>>>>> You can sometimes depend on the position of HOCs which are relatively higher in mandibular than in maxillary

So >>> The arch of this tooth is the mandibular arch 4. What is the side of this tooth?? > MSR (mesial sloping ridge) is shorter than the DSR >> MI angle is higher and more rounded than the DI angle >>> MHOC is higher than the DHOC So >>> The side of this tooth is the right side >>> This tooth is the mandibular right permanent canine (43) *** Notes : * The widest tooth BL is the maxillary 1st molar * The widest tooth MD is the mandibular 1st molar * The longest tooth IC is the mandibular canine * The narrowest tooth MD is the mandibular central incisor * The tooth with the longest root is the maxillary canine * The tooth with the highest M and D HOCs is the mandibular canine (it's M and D HOCs are the closest to the top of the tooth)

And now let's identify some deciduous teeth Regarding the deciduous incisors and canines actually you have to follow the same path you followed in identifying the permanent incisors and canines, the same class, arch and type traits *** How can we differentiate btwn permanent and deciduous ant. teeth in general ?? You have to remember all set traits like for example : > size (permanent larger than deciduous) >> color (permanent darker than deciduous) >>> cervical constriction (pronounced constriction in the area btwn the crown and the root in deciduous teeth but it isn't existing in permanent teeth)

>>>> more bulging of labial and lingual surfaces near the cervix of the tooth as seen from the proximal aspect (this feature is seen in deciduous but not in permanent) *** How to differentiate btwn permanent maxillary central incisor and deciduous maxillary central incisor ?? Use the set traits and : > the labial surface of deciduous is flat and it doesn't have any lobes or any labial grooves or any mamelons >> MI and DI angles in deciduous are markedly overhanging the outline of the root >>> the cingulum in deciduous is very big and more incisally located than in permanent and has a ridge that extends toward the incisal edge >>>> the MD dimension of the crown is greater than the IC dimension in deciduous (while in permanent the IC dimension of the crown is slightly greater than the MD dimension) this point is very important While other features are the same like for example : sharp MI angle and rounded DI angle, the MHOC is higher than the DHOC, the root is conical, *** How to differentiate btwn permanent canines and deciduous canines?? Follow the set traits and : > the labial surface of deciduous is flat and it doesn't have any lobes or any labial grooves >> the M and D HOCs in deciduous are more cervically located (more toward the cervix of the tooth) than in permanent ** Deciduous molars ** *** Can you identify this tooth?? 1. What is the set of this tooth??

Follow the set traits and : > notice how the roots are widely separated from each other (more flared outward and more divergent and very thin) >> very little root trunk >>> the presence of cervical buccal ridge So >>> The set of this tooth is the deciduous dentition 2. What is the class of this tooth?? > It has 4 cusps So >>> The class of this tooth is molar 3. What is the arch of this tooth?? > It has 3 roots (2 B and 1 L roots) >> The roots are located under the cusps >>> As seen from the occlusal aspect the BL dimension of the crown is greater than the MD dimension >>>> This tooth has 3 major cusps (that are arranged in tricuspate triangular pattern) and 1 lesser sized cusp >>>>> The 2 lingual cusps are of unequal size (ML cusp is much larger than DL cusp) >>>>>> The 2 buccal cusps aren't 1002 equal in size, actually the MB cusp is slightly bigger than the DB cusp So >>> The arch of this tooth is the maxillary arch 4. What is the type of this tooth?? Follow this role : The last deciduous tooth looks like the permanent tooth behind it The deciduous 2nd molars look exactly like the permanent 1st molars

Based on this role if the deciduous molar looks like the permanent 1st molar behind it then it's type is 2nd molar, BUT if it doesn't look like the permanent 1st molar then it's type is 1st molar i.e. if you have mandibular deciduous molar and you find that it looks exactly like the mandibular permanent 1st molar behind it then it's type is 2nd molar, but if it doesn't then it's type is 1st molar *** Do you think that this maxillary deciduous molar looks exactly like the maxillary permanent 1st molar?? Yes, so it is a typical maxillary deciduous molar and it's type is 2nd molar *** How to differentiate btwn maxillary permanent 1st molar and maxillary deciduous 2nd molar ?? Simply use the set traits, like: > Size (deciduous smaller) >> Color (deciduous lighter) >>> Amount of root trunk (very little in deciduous) >>>> Amount of root divergence and their thickness (very flared outward and divergent and thin in deciduous) >>>>> Cervical constriction (exists in deciduous but not in permanent) >>>>>> The presence of buccal cervical ridge (exists in deciduous) 5. What is the side of this tooth?? orient the tooth so that it's buccal aspect is in front of you *** How to know the buccal side?? Simply the B side is the side where the 2 cusps (MB and DB cusps) are equal in height and it is the side where we have 2 roots (MB and DB roots) and it's the side with a ridge cervically (BCR) and if you view the tooth from the proximal aspect you will find that the buccal aspect is the side where you have very prominent bulging

Then, you have to determine which side is mesial and which side is distal *** How to know that?? There are 5 ways: 1. look at the tooth from the occlusal aspect and look for the smallest cusp which is the DL cusp to know the D side 2. look at the tooth from the occlusal aspect and look for the largest cusp which is the ML cusp to know the M side 3. search for cusp of carabelli which is situated on the lingual aspect of the ML cusp to know the M side again 4. look at the tooth from the occlusal aspect the MMR is longer than the DMR so that you can know the M and D sides 5. look at the tooth from the buccal aspect the MB cusp is wider MD than the DB cusp (it is the easiest way coz the tooth here is oriented correctly and that exclude getting confused in determining the side of the tooth) So >>> The side of this tooth is the right side >>> This tooth is maxillary right deciduous 2nd molar (44)

*** Can you identify this tooth?? 1. It is deciduous 2. What is the class of this tooth?? > It has 5 cusps So >>> The class of this tooth is molar 3. What is the arch of this tooth?? >This tooth has 2 roots (1 M and 1 D) >> The roots are located under the MRs not the cusps

>> This tooth has 4 major cusps and 1 lesser sized cusp >>> As seen from the occlusal aspect the crown is wider MD than BL >>>> MB and DB cusps are approximately equal in size, ML and DL cusps are approximately equal in size also, but the D cusp is the smallest So >>> The arch of this tooth is the mandibular arch 4. What is the type of this tooth?? This tooth looks exactly like mandibular permanent 1st molar this tooth is mandibular deciduous 2nd molar *** How to differentiate btwn the 2 teeth (permanent 1st molar and deciduous 2nd molar) ?? in the same way I told you before 5. What is the side of this tooth?? Here you have first to orient the tooth so that it's buccal aspect is in front of you *** How can we know which side is buccal and which side is lingual?? >>> The B side has 3 cusps and 2 grooves while the L side has 2 cusps and 1 groove After you orient the tooth correctly, you have now to determine which side is M and which side is D *** How can we know which side is M and which side is D?? >>> Look at the tooth from it's occlusal aspect, identify the B and L sides in the same way I told you before, in the B side there are 3 cusps, 2 of them are of equal size and 1 is of lesser size, the 2 that are equal in size are the MB and DB cusps while the one of lesser size is the D cusp that can tell you about the D side, so that you can now know the side of this tooth in the mouth

So >>> The side of this tooth is the right side >>> This tooth is the mandibular right deciduous 2nd molar (54)

*** Can you identify this tooth?? 1. It is deciduous 2. What is the class of this tooth?? > it is a cusped tooth with occlusal surface So >>> the class of this tooth is molar 3. What is the arch of this tooth?? > This tooth has 3 roots (2 B and 1 L) >> The roots are located under the cusps >>> As seen from the occlusal aspect the crown is wider BL than MD So >>> The arch of this tooth is the maxillary arch 4. What is the type of this tooth?? ** Do you think that this tooth look exactly like the maxillary permanent 1st molar??? NO, so it is an atypical maxillary deciduous molar and it's type is 1st molar You can confirm your decision depending on many clues, like: > this tooth has 2 major cusps (MB and ML) and 2 minor cusps (DB and DL)

>> as seen from the buccal aspect the cervical line isn't straight (uniform), it is lower M and higher D that's why the OC dimension M is larger than that D >>> This tooth is intermediate btwn premolar and molar So >>> The type of this tooth is 1st molar 5. What is the side of this tooth?? > Look at the tooth from the occlusal aspect, the M cusps are wider MD than the D cusps >> Look at the tooth from the buccal aspect, the M side is longer OC than the D side (as we go mesially the cervical line goes cervically) So >>> The side of this tooth is the right side >>> This tooth is the maxillary right deciduous 1st molar (44)

*** Can you identify this tooth?? 1. It is deciduous 2. What is the class of this tooth?? > cusped tooth with occlusal surface >> It has 4 cusps So >>> The class of this tooth is molar 3. What is the arch of this tooth?? > This tooth has 2 roots (1 M and 1 D) >> The roots are located under the MRs not the cusps >>> As seen from the occlusal aspect the crown is wider MD than BL

So >>> The arch of this tooth is the mandibular arch 4. What is the type of this tooth?? *** Does this mandibular deciduous molar look like mandibular permanent 1st molar?? NO, so it is the atypical mandibular molar and it's type is 1st molar How to confirm that?? > This tooth has 4 cusps only >>> The cervical line isn't uniform (straight), it inclines cervically as we go mesially that's why the M side is longer OC than the D side >>>> This tooth is intermediate btwn premolar and molar So >>> The type of this tooth is 1st molar 5. What is the side of this tooth?? > Look at the buccal aspect of the tooth, the M side is longer OC than the D side (the cervical line is lower M than D) >> Look at the occlusal aspect of the tooth, the largest cusp is the MB cusp that tells you about the M side So >>> The side of this tooth is the right side >>> This tooth is the mandibular right deciduous 1st molar (54) *** NOTE : If you are sure that the tooth you are looking at is a deciduous molar then you have 4 choices : 1. if the deciduous molar looks exactly like the maxillary permanent 1st molar then the tooth you have is maxillary deciduous 2nd molar 2. if the deciduous molar looks exactly like the mandibular permanent 1st molar then the tooth you have is mandibular deciduous 2nd molar

3. if the deciduous molar doesn't look like any permanent 1st molar then it is deciduous 1st molar (atypical molar) *** How to differentiate btwn the 2 atypical deciduous molars?? Use the arch traits : > Number of roots (2 roots = mandibular, 3 roots = maxillary) >> Location of roots (under the MRs = mandibular, under the cusps = maxillary) >>> Dimensions of the crown as seen from the occlusal aspect (MD>BL = mandibular, BL>MD = maxillary)