1. Page 1 Tooth Anatomy drg. Fidya, M.Si Laboratorium of Anatomy and Histology Medical Faculty UB

2. Page 2 Introduction Human have heterodont dentition various type The incisors (4 pairs) cutting & shearing food The canine (2 pairs) holding & tearing PremolarCrushing &one, two, or molar Grindingthree root

3. Page 3

4. Page 4 Human diphydont (two sets) Deciduos (20 teeth) –Erupt 6 month, beginning incisors –All erupt normally by age 2½ Permanent (32 teeth) – Begins age 6 and continues until about 17 – last erupt third molar – may not be room in the jaw growth sideways impacted emerge only partially –Usually erup at the age of 17 until 25

5. Page 5 Dental formula Represent of the type, number, & position Formula for deciduous dentition: I2/2, C1/1, DM2/2 = 10x2 = 20 teeth dentition:Formula for permanent dentition: I2/2, C1/1, P2/2, M3/3 = 16x2 = 32 teeth

6. Page 6 Deciduous Teeth

7. Page 7 Permanent Teeth

8. Page 8 A tooth consist of: An exposed crown Enamel hardest substance in the body Dentine Pulppulp roof, pulp cavity, root canal, apical foramen Cementum Gingiva Periodontal Membran a connective tissue periosteum Dental alveolithe root that feet into sockets

9. Page 9

10. Page 10 Primary/ Deciduous Teeth The primary teeth are the first teeth to erupt in the child’s life They are 20 in number, 10 in each jaw Consist of: four incisors, two canines, and four molars

11. Page 11 The Crown Differences

12. Page 12 The Pulp Differences

13. Page 13 The Root Anatomy Differences

14. Page 14

15. Page 15 Tooth Eruption

16. Page 16 Movement Leading to Eruption Teeth Preeruptive Phase - preparatory to eruptive phase - consist of the movement to the developing & - growing tooth germ within the alveolar process before root formation - bodily movement & eccentric growth cause resorption bone appotition from behind - the primary teeth move in a facial occulusal direction - the permanent in lingual - upper molar develop tuberositas maxilla - lower molar develop basis ramus mandibula

17. Page 17

18. Page 18 Prefunctional Eruptive Phase - Secretory phase of amelogenesis is complete. - The intraosseus stage occur when the root formation begins. - The supraossesus begins when the erupting tooth move occlusally. - The tip of the crown enters the oral cavity by breaking throught the center of double layer epithelial cell. - The erupting tooth continues to move occlusally at maximus rate, and there is gradual exposure of more of the clinical crown.

19. Page 19

20. Page 20 Functional Eruptive Phase  Begins when the teeth reach occlision  Continues for as long as each tooth movement  in early phasethe process. alveolaris increase in hight the root continues to growth  teeth continues to move occlusally (jaw frowth, root elongation)  Establish  density of alveolar bone increase  the principle fibers of the ligament periodontal establish  gingiva, alveolar crest, and the alveolar surface separate around the root.

21. Page 21

22. Page 22 Eruption Time Primary Dentition

23. Page 23 Permanent Dentition

24. Page 24 Tooth Anomaly

25. Page 25 Anomaly Is a deviation from normal, usually related to embrionic development that may result in the absence. Dental anomalies abnormalities of teeth that most often caused by hereditary factor, developmental, and metabolic disturbance. Permanent Teeth > Primary Teeth More often in maxillary The occurance Rare (ex: 1 to 2% anodontia in population)

26. Page 26 Anomalies 1.Anodontia Total anodontia Partial anodontia (Hypodontia) 2. Supernumenery Teeth Maxillary incisors area Third Molar Area Premolar Area 3. Abnormal Tooth Morfology Abnormal Crown Morphology Abnormal Root Morphology Anomalies in Tooth Position Additional Tooth Developmental Malformations Changes in Tooth Shape due to Injury after Eruption Unusual Dentitions

27. Page 27 Anodontia Absent of single or multiple teeth Stage: initiation stage Etiology: hereditary, endocrine disfunction, systemic disease, excess radiography expossure Cause disruption of occlusion and aesthetic problem May need partial or full denture; bridge; or implant to repalce teeth

28. Page 28 Anodontia Total Anodontia True anodontia. The total congenital absence of a set of teeth. Absence of primary and secondary teeth. Incidence is extremely rare. Associated with a generalized congenital deformation (a sex-linked genetic trait) involving the abnormal development of the ectoderm or outer embryonic cell layer. Faulty ectodermal development affect hair, nails, sebaceous, sweat, and salivary gland

29. Page 29 Partial Anodontia Congenital missing teeth Involves one or more missing teeth Not proven hereditary trait The tendency missing same teeth does run in family Radiograph are required to assure missing or unerupted Most commonly missing (permanent teeth) 1. Third Molar, maxilla often than mandibula 2. Maxillary Left Incissor (1-2% on both) 3. Mandibular second premolar (1% on both) The least likely to be absent canines

30. Page 30

31. Page 31 Supernumenary Teeth Development of one or more extra teeth Stage: initiation stage Etiology: hereditary

32. Page 32 Supernumenary Teeth Teeth that form in excess of the normal dental formula for each quadrant. Incidence 0,3 – 3,8 % in population. Found in both permanent and primary dentition. 90% in maxilla. Most frequent: - Maxillary incissor area (maxillary midline, mesiodens) - maxillary third molar area (distomolar, paramolar,or fourth molar) Twice frequently in men than women 16 month – 17 year: 20% 14% multiple 80 % in lingual position Can vary in size and shape

33. Page 33 Mesiodens In midline maxillary Supernumery teeth that have conus shape Can be seen, can be not seen (unerupted) If unerupted large diastema Prevalence in Caucasian 0,15-1,9 % Beetwen I1 & I2, I2 & C The occurent in primary dentition low

34. Page 34 Maxillary Incissor Area Third Molar Area

35. Page 35 Premolar Area

36. Page 36 Anomalies in Tooth Position 1.Unerupted (impacted teeth) Embedded teeth that fail to erupt into oral cavity A lack of eruption force The evolutionary decreasing size of modern man’s jaw The most common: maxillary and mandibulary third molar maxillary canines Incidence 10%

37. Page 37 2. Transposition Misplaced teeth The cell that form the tooth (tooth bud) seen to get out of place Teeth emerge in unusual location The most common: Maxillary canine Mandibular canine

38. Page 38 3. Tooth Rotation Rare anomaly The most common: second premolar Sometimes: maxillary incissor, first premolar, mandibular second premolar May rotate on its axis by as much as 180˚

39. Page 39 4. Ankylosis An infection or truma to the periodontal ligament that resulting in the loss of its periodontal space. The tooth root is truly fused to alveolar process or bone Fail to continue erupting as the jaw grows 2-4 mm short of occluding with an opposing teeth Most often: primary mandibular second molar.

40. Page 40 Abnormal Crown Morphology 1.Size Macrodontia Microdontia 2. Shape Gemination Fusion Concrescence Talon Cusp Dens evaginatus Dens Invaginatus Taurodontism Dilaceration 3.Structure Hiploplasia Hipomineralisasi Enamel Diysplasia

41. Page 41 Macrodontia The size of tooth larger than normal tooth Generalized is rare, may be the feature of pituary gigantism Sex: no predilection The incisors are most affected

42. Page 42 Macrodontia/ Microdontia Abnormally large/ small teeth Stage: bud stage Etiology: hereditary; endocrine dysfunction

43. Page 43 Microdontia The size of tooth smallest than normal tooth Most often affect maxillary incisors, conical shape Sex :no predilection Generalized (extremely rare) is encountered among pituary dwarft.

44. Page 44 Gemination Incomplete splitting into two teeth resulting in a bifid crown with a single root. Stage: cap stage Etiology: hereditary Only one pulp chamber and root canal are evident. Almost same with fusion A full complement of teeth indicated gemination, while one tooth less than normal indicated to fusion

45. Page 45

46. Page 46 Fusion Union of two adjescent tooth germ Stage: cap stage Etiology: pressure on area Implicated factors are evolution, hereditary, trauma, and environment Males and females might be equally affected More often present in deciduous teeth Mostly present in anterior mandible (90& fusion between incisivus and canine)

47. Page 47

48. Page 48 Concresence A union of the root of two adjacent teeth via their cementum only. Stage: maturation and apposition stage Etiology: traumatic injury or crowding of teeth True concresence: union in odontogenesis False concresence: union in post development Two teeth or more

49. Page 49 Talon Cusp/ Tubercle Extra cusp from affect enamel organ Stage: cap stage Etiology: truma; pressure; or metabolic disease An accesories cusp that arises from the cingulum area of an incisor or canine tooth. Commonly found on permanent molar or cingulum anterior teeth.

50. Page 50 Enamel Pearl Sphere on enamel on root Stage: apposition and maturation stage Etiology: displacement of ameloblast to root Maybe confused as calculus on root

51. Page 51 Dens evaginatus An abnormal proliferation and folding of inner portion of enamel epithelium Subjacent ectomesenchymal cells of the dental papilla into the stellate reticulum of the enamel organ. Stage: bell stage. The resultant formation: defined as a tubercle, or supplemental solid elevation on some portion of the crown surface.

52. Page 52

53. Page 53 Dens Invaginatus/ Dens in Dente Enamel organ invaginatus into dental papilla Stage: cap stage Etiology: hereditary Coronal enamel and dentine become inverted into pulp chamber Generally localized ta a single tooth Occasionally involve multiple teeth Frequently involve the same tooth bilaterally The coronal on may be limited to the crown region, or it may exten deeptly into radiculary pulp

54. Page 54

55. Page 55 Taurodontism Elongated pulp chamber Observable only in dental radiography Molars are affected ang look “strecth” May be encounterred in patient with developmental craniofacial deformities Ex: trichodento osseous syndrome. No treatment Must be attention in endodontic treatment

56. Page 56 Dilaceration A developmental tooth anomaly Caused by mechanical trauma that tears away the calcified part of a tooth from uncalcified part. Shows an abrupt labial change in the axial inclination between the crown and root. Primay teeth are seldom

57. Page 57 Enamel Dysplasia Faulty development of enamel from interference involving ameloblast. Stage: apposition and maturation stage. Etiology: local or systemic; hereditary. Pitting and intrinsic color change. Possible change in enamel thickness of enamel. Problems in function and estethic

58. Page 58 Amelogenesis Imperfekta Abnormal formation of tooth enamel Due to the malfunction of the proteins in the enamel: ameloblastin, enamelin, tuftelin and amelogenin. ameloblastinenamelintuftelinamelogenin Abnormal color: yellow, brown, grey The teeth have a higher risk for dental cavities and are hypersensitive to temperature changes.dental cavities Can afflict any number of teeth.

59. Page 59

60. Page 60 Dentinogenesis Imperfecta A disorder of tooth development by abnormal dentin formation Etiology: hereditary. Causes the teeth to be discolored (most often a blue- gray or yellow-brown color) and translucent. Teeth are also weaker than normal. Making them prone to rapid wear, breakage, and loss. These problems can affect both primary (baby) teeth and permanent teeth.

61. Page 61

62. Page 62 Reference Avery, J.K. 2001. Oral Development and Histology. 3rd ed. New York Van De Graff. 2001. Human Anatomy. 6th ed. Shield, R and Weiss,G. 2011. Dental Anatomy Wheller. 6th ed

63. Page 63 Thank You