Dental Anatomy

Challenge 2010
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Lecture Notes
Lecture Title: Morphology of Premolars Professor Name: Dr. Ashraf AlShawesh Done By: Dental Anatomy Script Team

Morphology of Premolars
Today we will talk about the morphology of the premolars which are are part of the posterior (cheek) teeth . Posterior cheek teeth : They are the molars and premolar in permanent dentition and in deciduous dentition posterior teeth are molars only.

Q : Why we dont need to say permanent premolars ? because we dont have deciduous premolar. Usually premolar erupt from (10-12 years). As you know we have two premolars, the first erupt earlier than the second , but nearly at the same period of time. At the age of 12 all premolars must be erupted for the Jordanian population.

P.S : (Just for your information) Jordanian population is very similar to European populations but very different from African population because usually they erupt teeth much earlier than us ! Long time ago we used to call premolars bicuspid which means tooth with two cusps, but nowadays they stop to use this term and use premolar instead of it, Why? Because they found that bicuspid is not accurate for one of the premolar which is the mandibular second premolar , which In

most of the cases this tooth has three cusps instead of two, one buccal cusp and two lingual cusps.

Class traits:

Q: How can we distinguish premolars as group from the other teeth? Usually we must see at least two cusps, this means we sometime see three cusps in the case of the mandibular second premolar.

How we distinguish between the mandibular second premolar with three cusps and one of the molars like maxillary third molar which has three cusps? Its simple as this: look at the numbers of cusps buccally; premolar should have only one cusp buccally but molars at least have two cusps buccally. So if we have a case where we have a tooth with three cusps we should identify the buccal area and count the number of cusps , if you found one cusp buccally so it is premolar, two cusps buccally its molar.

Of course the other premolars (1st & 2nd maxillary & 1st mandibular premolar) its easy to distinguish it because in all of them we have two cusps only, one cusp buccally and one lingually OR two cusps lingually in the case of mandibular second premoral .

What do we mean by cusp? Cusp its an elevation on the occlusal surface of the tooth (posterior teeth ) or on the incisal surface in the case of the canine , each cusp is similar to a pyramid has four marginal ridges , each of these margins called cusp ridge, and we named these cusps according to the direction they are going to: cusp ridge goes mesially mesial cusp ridge cusp ridge goes distally distal cusp ridge cusp ridge goes buccally buccal cusp ridge cusp ridge goes lingually lingual cusp ridge. And if you remember, we said that the cusp ridge that directed toward the center of the occlusial surface we call it triangular cusp ridge and we call two triangular cusp bridges which make one continuous line transverse cusp ridge , if they make oblique line from one corner to another corner we call it oblique cusp ridge. Pit : a very small point depression at the maximum depth of the fossa. We have developmental groove running and separating the major parts( susps and marginal ridges) of the tooth ; if we found a groove that doesnt separate the major parts of the tooth we call it supplemental groove . Q ) What are the major components on the occlusal surface of any tooth? 1. Cusp 2. marginal ridges So any groove separating between cusps or separating between the cusps on marginal ridges is a developmental groove.

 Triangular fossa whish is a fossa existing inside marginal ridge . And finally in addition of triangular fossa also we have central fossa , But in premolars of course we dont see central fossa because we only have one buccal cusp and one lingual cusp .

Maxillary premolars
Arch traits :

How can we distinguish maxillary from mandibular premolars? 1. If you look at the maxillary arch you will find the first and the second premolars are much more alike while if you look at the mandibular arch you will find the two premolars different , so if you take dental arch and you see two premolars are similar then this is maxillary arch , if you see two premolars completely different then this is a mandibular arch . 2. Maxillary premolar have two major cusps that approximately equal in size and prominence , but in mandibular premolars we ca notice that the buccal cusp is bigger than the lingual. 3. Also maxilay premolar are wide buccolingualy but constricted mesodistally, but in the case of mandibular the buccolingual diameter is similar to the mesodistal diameter . 4. Inclanitaion of the crown in constrat to the root , in the case Maxillary premolar the crwon is located just on the top of the root not tilted but in the case of mandibular premolar it tends to be tilted lingually in constrat to the root , in other words, long axis of the crown and the root are coinciding in the maxillary premolar, so the long axis of the crown is in line with the long axis of the root, but in the mandibular premolar the long axis of the crown makes

an angle with long axis of the root, why? Because the crown is tilted lingually. 5. In the maxillary premolars the lingual height of contour is in the middle third, while in mandibular the lingual height of contours is very closer to the occlusal surface not in the middle, its high. So all these 5 points are significant in distinguishing between maxillary premolars as a group and mandibular premolar as another group.

Maxillary First Premolar

Buccal aspect: It is similar to the buccal aspect of the second premolar, but its slightly larger and similar to the buccal aspect of the canine but slightly smaller . So this means: the canine should be the largest, then the first premolar and then the second premolar. So we have a decrease in size when we go posteriorly from canine to the second premolar regarding to the buccal aspect of the tooth. The tip of buccal cusp is distal to the mesiodistal (MD) midline (this feature is the opposite when you compared it with the canine because in the canine the mesial sloping ridge is shorter than the distal sloping ridge). Sloping cusp ridges: - Mesial cusp ridges is long and straight. - Distal cusp ridges is short and convex. The proximal outline and the HOCs: Mesial is slightly concave and the HOC is just occlusal to the halfway point.

 Distal is straight and the HOC is more occlusally located than the mesial HOC. The mesio-occlusal (MO) and disto-occlusal (DO) angles are overhanging. Thats mean: MO and DO bulge outside the outline of the root. We said this is a type trait, because in the case of maxillary second premolar if you draw a line for the outline of the root this line will continue through the mesio-occlusal and disto-occlusal, so we wont find these angles bulging or overhanging. A small part of the mesial margin of the lingual cusp can occasionally be seen. In buccal aspect there are 3 lobes: Middle lobe, mesial lobe and distal lobe. MB and DB depressions and labial ridge.All the time remember we have buccal ridge similar to the labial ridge of the canine.

Cervical line has a slight convexity toward root apex. Root is conical similar to that of canine but smaller.

lingual aspect : The crown is smaller, this means that the tooth buccally is wider than lingually because of that the entire buccal outline is visible (we can see buccal outline not the lingual).

The lingual cusp tip is mesial to the midline of the crown (its the opposite of the cusp tip buccally which is located distal to the mesiodistal halfway of the tooth).

 No protuberances, ridges or depressions so the lingual surface is smooth. Root : - 2 apices are visible (buccal and lingual). - There is a space between the two roots in the apical part but down we see a depression. The bifurcation of the root doesnt take place at cervical , it happen at the junction between middle third and the apical third . (but in molars the bifurcation of the roots actually happens at the junction between the cervical third and the middle third.) The mesial aspect : The buccal cusp is higher than the lingual cusp and this is a type trait , because in the maxillary second premolar the high of the two cusps are equal and they are equal in size.(thats how we can distinguish between the maxillary first and second premolar).

The triangular ridges incline at 45 degrees, thats why the two cusp ridges make 90 degrees. The mesial marginal ridge is very prominent and it has a groove which is slightly lingualto the mid portion ,this is also a type trait because in the maxillary second premolar we dont see a groove crossing the marginal ridge. The buccal HOC is within the cervical third and the lingual HOC is in the middle of the crown . The lingual outline is convex and the buccal outline is convex at the beginning and continue as a straight line.

 The distance between the tips of the cusps is greater in the maxillary first premolar compared to the maxillary second premolar. Cervical line is convex towards the occlusal. Mesial interradicular groove (interradicular : between the roots ). It is also called the canine fossa , because this groove is occupied by the disto-incisal angle of the canine (which is very prominent ) . it makes the groove at the root area not occlusaly because the maxillary first premolar erupts before the maxillary canine . The Occlusal table is centered over the root trunk. And this is an arch trait because in the mandibular premolar the crown is titled lingually ,thats why is occlusal table is not centered in the mandibular premolar . (Centered means if you draw a line through the root, it will pass through the middle portion of the crown ) Roots: We see commonly two roots, bifurcate at the junction between middle and apical thirds.

Q : What is the percentage of seeing two roots in this tooth? Its 90% and in the 10% of the cases we will see one root but still with two canals (because there is a depression in the root its possible to have two canals) Q: What is the percentage of seeing two canals in this tooth? I Its almost 100% ! VIP: Remember that we have two root canal for this tooth .

Distal aspect: Similar to the mesial aspect except that we dont see marginal ridge groove and we dont see a concavity in the crown .

In the mesial interradicular groove it's start between the root and continue and also continue to involve part of the crown .So the cervical part of the crown is also involve in this concavity ,But from the Distal aspect this groove is only confined to the root so we don't see it crossing the crown. More of the occlusal surface may be seen because the distal marginal ridge is low while the mesial marginal ridge as we said is high and thats why I cannot see part of the occlusal surface . The distal interradicular groove is shallower than the mesial one.

Occlusal aspect :

The 1 premolar is hexagonal in shape and

st

this is a type trait and the buccal profile is "V " in shape.

We have very sharp MB and DB angle and this also type trait because in the maxillary 2nd premolar they tend to be rounded .

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 We have slightly convergent mesial and distal profile they are not parallel they are converging because the buccal part of the tooth is wider than the lingual part of the tooth, and this is a type trait because in the maxillary 2nd premolar the mesial and distal outline seen from the occlusal view tend to be parallel. The lingual profile is strongly convex .And also we can see the buccal ridge and two depressions. The occlusal table formed by cusps and marginal ridges, we have the buccal cusp ,lingual cusp , mesial marginal ridge and distal marginal ridge. The apex of the lingual cusp is located slightly mesial to the bisecting line buccolingully. Triangular ridges, of course we see triangular ridge for the buccal cusp and another one for the lingual cusp they are making a continues ridge called the "Transverse ridge" . So the transverse ridge made by the two triangular ridges, these two ridges are separated by the central groove. The central groove terminate mesially and distally in the mesial triangular fossa and the distal triangular fossa and these are bounded by the fossa here ,for example the mesial fossa is bounded by the mesial marginal ridge and the transvers ridge . The mesial marginal ridge is shorter than the distal marginal rdidge. Pulp : - cross section : its look like kidney shape , because buccally wider than lingually - longtidual section : the pulp constitricted mesodistally, but in buccolingually section it is wide. - In most of the cases we have two roots and two canals and lets say in less than 10% of the cases we see one root but still we see two canals , sometimes we see one canal that bifurcate into two .

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][Sum it up][

On the occlusal surface of the premolar, we can find some grooves, some ridges and some fossae:

Developmental grooves

Grooves
Supplemental grooves

Tringular fossa Fossae Central fossa

Ridges

Tringular ridge Transverse ridge

Occlusal table is centered over root trunk. 1st & 2nd are much more a like while they are different in mandibular.

arch traits

Have 2 major cusps approximately equal in size & prominence. Wider BL than MD while in mandibular BL = MD. Slight lingual inclination of the crown while mandibular have strongly lingually inclined crowns. In maxillary, lingual Height Of Contour (HOC) is in the middle 1/3, while it is in the occlusal 1/3 in mandibular. Overhanging MO & DO angles. In the Lingual aspect : the Entire buccal outline is visible. in oclussal aspect : Hexagonal in shape - Sharp MB & DB - Slightly convergent M & D profile.

type traits

class traits

At least 2 cusps. Single buccal cusp with one or more lingual cusps. Molars must have at least 2 buccal cusps.

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Maxillary 1st Premolar

Buccal
1) similiar to the max.canine ( slightly smaller ) and similar to 2nd premolar ( slightly larger ) 2) Tip of the buccal cusp is distal to the MD midline. 3) Sloping ridges: M is long and straight, D is short and convex. 4)Proximal outlines and HOCs 5) Overhanging MO & DO angles (type traits) 6)A small part of the M margin of the L cusp can occasionally be seen 7) 3 lobes (MB, DB and a labial ridge). 8) Cervical line is convex toward the root. 9) Root is conical (similar to the caniens but smaller).

Lingual
1) Entire buccal outline is visible (type trait) 2) L cusp tip is mesial to the midline of the crown 3) No protuberances, ridges or depressions 4) Root * 2 apices are visible *Interradicular groove is visible

Mesial
1) Buccal cusp is higher than lingual 2)Triangular ridges incline at 45 degrees 3)Mesial Marginal ridge 4)Buccal HOC within cervical 1/3 from which a slight lingual inclination toward cusp apex 5)Lingual outline is convex with HOC within middle 1/3 6)Cervical line CL is convex toward occlusal 7) Mesial interradicular groove 8) Occlusal table is centered over root trunk (arch trait) 9) Roots : * Commonly 2 roots * bifurcate at the junction between middle & apical 1/3s )

Distal
1) Similar to mesial except: *more of O. surface can be seen. No marginal grooves. *No concavity in C. 1/3.

Occlusal
1) Hexagonal. 2) Sharp MB and DB.

Pulp
1) X-section : kidney shape, wide BL narrow MD.

3) M and D are 2) BL. slightly convergent. Section : 2 pulp horns, 4) L is strongly buccal is convex. larger. 5) Apex of L. cusp is mesial to the midline. 3) MD. Section: Similar to canine.

* Distal interradicular 6)Triangular groove is shallower ridges

7) Central groove terminates M & D in Triangular fossae 8)Mesial MR is shorter & interrupterd by marginal groove

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Test yourself

1) One of the following is true about the supplemental grooves found in posterior teeth: a) They could be the margins of an old restoration. b) Irregular, indistinct linear depressions that separate the major parts of the tooth. c) They are the same developmental grooves, just another synonym for it. d) Irregular, indistinct linear depressions that dont separate the major parts of the tooth. 2) Only one of the following can be used to distinguish between the maxillary and that mandibular premolars: a) 1st and 2nd maxillary premolars are alike, while the mandibular premolars are not. b) 1st and 2nd maxillary premolars are different, while the mandibular premolars are alike. c) Maxillary premolars cusps are different; the buccal cusp is larger than the lingual cusp while the Mandibular premolars cusps are equal in size. d) Maxillary premolars have a strong inclination of the roots toward the lingual side while the mandibular premolars have a slight inclination toward the labial side. 3) On the lingual surface of the maxillary 1 st premolar: a) There are 2 depressions and a ridge. b) A marginal groove can be seen. c) The Interradicular groove can be seen. d) 1 lobe or more could be present. 4) The pulp in a Bucculingual section of the Maxillary 1st premolar: a) is a cigar-shaped. b) is similar to the exterior of a maxillary canine. c) is kidney-shaped. d) 2 pulp horns could be seen.

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5) Each fossa of the triangular fossae that are present on the occlusal surface of the maxillary 1st premolar contain only a pit and buccal grooves. a) True. b) False. 6) Fill in the space: In the maxillary first premolar the mesial cusp ridge is _____ than the distal cusp ridge.

1 d 2 a 3 c 4 d 5 b 6 longer

Noha Ghazal Rawda Najjar Hadeel Jaradat Baraah Alslamat Hebah Ramadnah A9eel Ghawanmeh Sundos Abu Zaid Ahmed Al Shamary Salam Bataineh Eman Idkaidek Eman Nazzal Hibah Jarrah Asmaa Almawas Hadeel Sumrian Abeer M. Dirawi

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