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ENDOOO

D2 Endo

D2 endodontics final prep

Oral path soft tissue benign enlargements

Fun

I apologize for the chaos.

Yay baby teeth. More about the 5 types of peds exams

Dental public health exam, all about SDOH and insurance stuff yay

Mama there’s an orthodontist with class II occlusion behind u

:)

Non-surg perio tx

All about titanium implants

warning: lots of kitten caused ruckus

Covers the case studies that are on my first hum path lab (?) exam

Sorry i got interrupted but here’s part two of this lecture for the d2 Oral surgery midterm!

Oral surgery midterm d2

D2 oral surgery midterm

D2 Oral Surgery midterm

Second half of reading a study guide out loud

My fave unit!

(Kidding)

Strepococcous pneumoniae

Nisseria

Haemophilus influenzae

Pertussis

Etc

This is based on the D2 Intro to OMFS first lecture for our weekly quizzes. Covering CV diseases, pulmonary diseases (asthma, COPD), and renal/hepatic concerns.

Radiographic assessment categories (RL = radiolucency) RA → initial stages RA 1: RL outer ½ of enamel RA 2: RL inner ½ of enamel +/- EDJ RA 3: RL limited to outer ⅓ of dentin RB → moderate RB 4: RL reaching middle ⅓ of dentin RC → extensive RC 5: RL reaching inner ⅓ of dentin, clinically cavitated RC 6: RL into pulp, clinically cavitated Visual: Lesion Severity → ICDAS ** to eval a lesion, eval: periphery demin and shadowing 0 = sound surfaces no evidence of visible caries after air drying 1-2 = initial caries first distinct changes in enamel = white spot lesion and/or brown various discoloration no evidence of surface breakdown/underlying shadowing in dentin 3-4 = moderate White or brown spot lesion w/ localized enamel breakdown without visible dentin exposure = 3 WITH underlying dentin shadow = 4 5-6 = extensive A distinct cavity in opaque or discolored enamel without visible dentin Guiding Principles of Carious Tissue Removal to retain tooth and pulpal health as long as possible = AIM Preservation of dental tissues → non demineralized and remineralizable Avoidance of pulp exposure Provision of sound cavity margins to achieve an adequate peripheral seal Controlling the lesion and inactivating remaining bacteria Reversible vs irreversible pulpitis; pulpal inflamm/pain Reversible Pulpitis = instances where the inflammation is mild and tooth pulp reminds healthy enough to save Normal responses to: thermal tests EPT Patients may experience pain/sensitivity Irreversible pulpitis = may experience pain without action to induce pain, sensitivity, and throbbing Cause of pulpal inflammation active caries = mild/severe Cavity preps = mild/severe dental materials = mild/transient Pulpal pain Intra-pulpal pressure on nerve endings secondary to an inflammation response w/ absence of inflammation = Hydrodynamic inflammation Pulpal protection When does the pulp need protection? Full crown preps cervical dentin exposure due to erosion causing pain Presence of mechanical pulp exposure after selective Carie’s removal that have led to medium or deep cavity preps Why must we protect the pulp? Preserve pulpal vitality avoid thermal sensitivity (pain) after restos Avoid removal of sound structure to provide resistance to resto material (amalgam/gold) How to protect pulp eliminate progression of carious lesions collect appropriate information regarding pulpal health before doing restos Using appropriate cutting instruments, use water during prep, no water during caries removal selecting/applying appropriate biological and mechanically resistant dental protective materials

Class III Composite steps: Acid etch → rinse & dry Prime → air dry Adhesive → cure w/ 18J light Place composite & cure after each increment A2D = dentin A1E = enamel Pull-through = lingual → facial Cure F and L Finish and polish Finishing = shaping, contouring, and smoothing the resto Polishing = imparts the shine/surface luster Contouring Proximal Mesial surface → medium-orange SOFLEX disc @ 4500 RPM Gingival embrasures → no. 12 blade remove small amounts at a time to avoid chipping Blade dulls quickly Contouring Lingual Carbide football/egg to remove → excess and contour lingual @ FG 6000 RPM Carefully use SOFLEX disc if needed @ margins Contour, finish, and polish from composite TOWARD the tooth avoid forming flat/concave contours in resto/tooth structure Polishing cups order Green → blue → grey (no water) Green = Jiffy Polisher removes roughness left by diamond bur Blue = Gloss Plus Polisher further smooth the resto Grey = HiLuster Plus obtain high gloss

Class IV = interproximal lesion of anterior tooth Incisal edge is involved Fracture (trauma) secondary caries rampant caries Shade selection: Clean tooth w/ flour of pumice & view patient at EYE LEVEL Proper lighting: under multiple light sources. Natural light is best Environmental factors: remove bright colors from field of view. Bright clothes, make up, gloves, neutral operators walls, etc Shade selection = made quickly to prevent eye fatigue made at BEGINNING of appt (tooth hydration) BEFORE RD placement Polychromatic technique eshethic restorative materials must blend into natural dentition by stimulating: color translucence form texture of teeth RBC come in Many shades and various opacities to match shade and translucency on both enamel and dentin Combo of optical properties from enamel and dentin provides the final appearance of normal tooth structure Optical properties are modified by: age Thickness of tooth tissue degree and quality of calcification Unworn dentition: dentin provides chroma, opacity, and fluorescence enamel modifies the appearance of dentin with translucency and opalescence Based on optical properties, RBCs contain three types of materials: Dentin-like: simulates dentin’s optical properties Enamel-like: simulates enamels optical properties Translucent-like: simulate translucent areas of the teeth As you get older = more chroma → more dentin as you age Class IV RBC Field Control R Dam: first premolar to first premolar (#5-#12) Place retainer W2A on either #5-#12 and retain other tooth w/ floss Matrices Anterior → Mylar strips Posterior → tofflemire, metal matrix bands, sectional matrix Bevel of enamel margins: Facial = 2.0-3.0 mm (esthetic bevel) lingual = 1.0 mm (partial thickness gingival = 1.0 mm (partial thickness) Settings for Bevel: Fine (red) flame-shaped diamond bur @ FG 100,000 RPM Blend w. Dark orange SOFLEX disc @ FG slow speed 4,500 Contact incisally located at HOC of adjacent tooth 1-2mm wide inciso-gingivally visual contact with adjacent tooth definitie but not excessive resistance to passage of dental floss does not shred floss If contact is slightly open → pat facial RBC into IP area with the brush to close contact Facial position = reduce with bur lingually positioned = add composite Light cure Filtek Supreme Ultra Universal = 16J to cure 1.5mm increments = ~26.6s Enamelize used for final polishing and maintenance of esthetic bonding polishing paste = aluminum oxide *** Pits in resto = took too long to cure → contour and cure quickly

Performance can be evaluated by failure mechanism

• Deformation → mechanical stress
• fracture → mechanical stress
• corrosion → chemical action
• wear → removal by solid
• erosion → removal by liquid 

To reduce local stresses:

1. Multiple simultaneous contacts
2. occlusal forces distributed over larger SA
   

Abrasion vs. attrition 

• Abrasion → shear force 
• Softer organic resin matrix = preferentially worn BEFORE harder filler particles 
• Attrition → direct contact force 
• Resin matrix and harder fillers are lost TOGETHER 
• Cracks occur in resin matrix due to occlusal stress 

Types of Stress → Deformation 

Stress (Pascal, Pa) 

• internal resistance of a material to an external load 
• resistance is dependent on the surface area which the load was delivered 
• SA = more important than the force 
• Both the applied force and stress are distributed over an area of the body 

In dentistry, Occ. forces applied over small areas (cusp tip) → produce very high stresses 

Strain 

• Deformation a body undergoes when a stress acts upon it 
• measured as a net change in the length of a material following the application of a load 
• deformation depends on the type of stress 
• you want ELASTIC deformation = not permanent (plastic) 

Modulus of Elasticity (E) 

• Ability to sustain deformation without permanent change in size or shape; stiffness of material within the elastic deformation 
• the slope of the linear region of the curve corresponding to 0-A on the Stress-strain curve 
• ratio of stress to strain (E = stress/strain) 
• Higher modulus of elasticity = more force required for deformation to happen 

• COMPOSITE MODULUS OF ELASTICITY = most similar to dentin 
  

Fracture toughness

• ability to plastically deform w/out fracture
• materials ability to resist to the propagation of a crack
• higher fracture toughness =  lower rate of bulk fracture, marginal degradation, and surface wear 
• 
  
• There is an optimal level of filler % for fracture toughness = more is not necessarily better but it is stronger up to a certain point 

Dentin = most similar in all mech. Categories when compared to RBC 

Polymerization, mech properties, and clinical performance 

• Polymerization shrinkage and stress
• de-bonding → marginal gaps → microleakage 
• cusp deflection (post-op sensitivity) or fracture
• reccurent caries 
• Incomplete polymerization
• presence of residual monomers 
• poor mech properties
• release of monomers and other components that can reach the pulp → pulpal inflammation 

Biocompatibility = ability of a material to perform with an appropriate host response in a specific situation 

Measuring biocompatibility - in Vivo/animal test 

• Animals = usage tests
• Human subjects = clinical trials 
• Material is placed in a situation identical to its intended clinical use 
• Mucous membrane irritation: material placed in contact w/ hamster cheek-pouch or rabbit oral tissue
• Skin sensitization: Material injected intradermally to test for development of skin hypersensitivity rxion 
• Implantation: materials that will contact subcutaneous tissue or bone 
• Dentistry examples:
• Dental pulp irritation tests (Class V) 
• dental implants into bone 
• Mucosa and gingival usage test (evaluate gingival inflammation in terms of resto margins, etc) 
  

Xenoestrogenic effects of RBC

• Xenoestrogenics = imitate estrogen and are toxic 
• Bis-GMA, -DMA, -EMA, and -EBDMA are monomers that are derived from BPA (bisphenol A)
• BPA = xenoestrogenic 
• In clinical conditions:
• Esterases in saliva can break ester bonds 
• Esterase → Bis-GMA = NO BPA formed
• Esterase → Bis-DMA → BPA FORMED 
• Some impurities may be present in Bis-GMA based resins 

• Concerns based on BPA
• ADA and current evidence = low levels of BPA and brief exposure → no known health risk 
• 1 time exposure of BPA from sealants = 200x lower than the daily level of safe exposure 
• Responsibilities of the dentist:
• Follow manufacturer's directions regarding placement and polymerization helps to reduce exposure 

• washing unpolymerized resin layer away/asking patients to rinse mouths following sealants 

Guiding Principles of Carious Tissue Removal 

• to retain tooth and pulpal health as long as possible = AIM
• Preservation of dental tissues → non demineralized and remineralizable 
• Avoidance of pulp exposure 
• Provision of sound cavity margins to achieve an adequate peripheral seal 
• Controlling the lesion and inactivating remaining bacteria 

Reversible vs irreversible pulpitis; pulpal inflamm/pain

Reversible Pulpitis = instances where the inflammation is mild and tooth pulp reminds healthy enough to save 

• Normal responses to:
• thermal tests
• EPT 
• Patients may experience pain/sensitivity 

Irreversible pulpitis = may experience pain without action to induce pain, sensitivity, and throbbing 

Cause of pulpal inflammation

• active caries = mild/severe
• Cavity preps = mild/severe 
• dental materials = mild/transient 

Pulpal pain

• Intra-pulpal pressure on nerve endings secondary to an inflammation response 
• w/ absence of inflammation = Hydrodynamic inflammation 

Pulpal protection

When does the pulp need protection?

1. Full crown preps 
2. cervical dentin exposure due to erosion causing pain 
3. Presence of mechanical pulp exposure 
4. after selective Caries removal that have led to medium or deep cavity preps 

Why must we protect the pulp?

1. Preserve pulpal vitality
2. avoid thermal sensitivity (pain) after restos 
3. Avoid removal of sound structure to provide resistance to resto material (amalgam/gold) 

How to protect pulp 

1. eliminate progression of carious lesions 
2. collect appropriate information regarding pulpal health before doing restos 
3. Using appropriate cutting instruments, use water during prep, no water during caries removal 
4. selecting/applying appropriate biological and mechanically resistant dental protective materials 

Protective materials = provide a protective coat for freshly cut enamel/dentin 

Cavity liners 

• Cement/resin coating of minimal thickness (<0.5mm)
• Physical barrier to bacteria and their products 
• provides therapeutic benefit = F- release, dentinal seal, and bacterial action = promoting pulpal health 
• do not place on enamel 
• RMGI (vitrebond)
• Apply after partial caries removal to → areas nearest the pulp… STAY AWAY FROM MARGINS 
• Chemical bond to tooth structure
• F- release 
• Good mechanical properties
• favorable pulpal response due to → F- release, initial low pH, physical barrier to bacterial penetration 
• RM Calcium silicates (TheraCal LC)
• Place the Ca[OH]2 liner in the deepest part of the prep covering the pulp exposure 
• place liner on moist dentin only 
• pulpal and axial walls, alway from all margins and enamel 
• Establishes a tight seal to prevent bacterial invasion 
• stimulates apatite formation and secondary dentin formation 
• Maintain an antibacterial alkaline-related biological environment 
• after placing and curing, follow w layer of → Vitrebond and/or normal bonding procedures 

Cavity sealers

• provide a protective coating to the walls of a prepared cavity and a barrier to leakage at the interface
• all walls in their entirety are coated 

• oxalates → place prior to amalgam restos 
• Superseal
• Acidic nature → demins smear layer and peritubular dentin 
• reacts with CaHydroxyapatite to form → fine granular calcium oxalate precipitate 
• Precipitate occludes → dentinal tubules 

• dental adhesives

Moderate lesions vs. extensive lesions

Moderate lesions (not reaching inner third of dentin) = restoration longevity may be more important → clinically means removing more tissue so that foundation is stronger 

Extensive-deep lesions (radiographiaclly involving inner pulpal third or quarter of dentin or with clinically assessed risk of pulpal exposure) 

• preservation of pulpal health should be prioritized → clinically means LESS tissue removed, soft area left, and cavity liner placed to prevent sensitivity that may arise from caries near pulp 
• Do NOT place cavity liners peripherally. Messes w/ RBC adhesion to enamel walls. 
• everything around lesion should stay intact to promote adhesion  
• Avoid pulp exposure, UNLESS pulpal Dx = reversible pulpitis 

CLASS V steps (summarized)

Access → 330 FG

Peripheral cavity removal w/ round #2

Round #6 or spoon excavator used for pulpal/axial walls

*** using a larger bur  = removes less tissue 

Outline form → 330 

Caries removal is first done @ periphery and along DEJ 

• do until we see clean DEJ! 

Explorer used for → assessment of surface texture only 

• be careful in deeper areas to not damage pulp 
• do not use in axial area

When material has set, excess is shaved away w/ → No. 12 surgical blade 

• Contoruing/finishing = use hand instruments as much as possible while preserving smooth surface 
• If you use rotary instruments = DO NOT DEHYRDRATE SURFACE OF RESTO 

Goals of Caries Removal in the Prep:

• Axial wall → selective removal to FIRM DENTIN
• Periphery walls (O,M,G,D) → Hard dentin DEJ 
• Occlusal and Gingival walls → parallel to slightly divergent 
• M and D walls → divergent 
• Margin (Butt joint margin) → NO bevels. Smooth margins and walls. 

Sandwich Tech Lecture

Full thickness bevel → all the way to DEJ 

Partial thickness = not entire enamel

GI or RMGI

• Dentin replacement = GIs similar thermal conductivity and coefficient of thermal expansion
• Fl release= takes place at setting rxn, the initial release is high and decreases with time
• Chemical bonding to dentin 

Why RMGI?

1. Superior mechanical properties than GI
2. Can be contoured and polished v similar to RBC 
3. Stronger in acidic environment = don’t want it to erode easily 
4. Conventional GI = poor maintenance of anatomical form 
5. Conventional GI suffers rapid surface degradation 
6. Conventional GI doesn’t present optimal esthetics = not easy to polish 

Sandwich technique = layers of GI (conventional or RM) between dentin and perm restorative material (resin composite or amalgam) 

Overall Indications of Close Sammy Technique

1. Pulp protection
1. selective Caries removal
2. preparation extends very close to pulp
3. Fl-release promotes affected dentin remin
2. Remaining enamel at the gingival margin
1. better bonding with composite than GI (GI on composite will decrease mech. Properties of resto) 
2. GI best at bonding with dentin

Anterior Resto indications for CLOSE SAMMY

• veneered w/ composite to: 

1. Enhance esthetics 
2. enhance polishability 
3. increase abrasion resistance 

Posterior Restos for CLOSE SAMMY

• veneered w/ composite or Amalgam for increased fracture and wear resistance 

Open Sammy Technique

• layering of two directly placed materials where both exposed to saliva 
• AKA: Bonded-base technique (summit) 
• helps w/ fl- release to oral environment 

Open Sammy indications:

1. Restoration of deep cervical lesions w/ dentin or cementum margins (severely damaged teeth w/ no enamel on the margins)
2. Need material that contains Fl to reduce potential recurrent Caries ( = high risk pts)
3. The selective material for open sandwich technique is RMGI

Closed Sammy Technique 

• layering of two directly placed materials, one covering the other
• Dentin is covered by RMGI/GI 
• GI/RMGI = completely covered by the overlaying Resto (RC or amalgam)
• Liner/base = GI is placed internally (on dentin) and completely surrounded with a second material (Amalgam or RBC)
• NO GI is exposed to saliva 

Closed Sandwich Technique Steps 

1. Prep → NO BEVEL. Butt joint only 
2. Rinse and dry → DON’T DESICATE, leave dentin moist (GIC needs water for Rxn) 
3. Apply GI/RMGI → place GI over pulpal and/or axial wall 
4. Check margins → do not place GI over any margins/on enamel 
5. Etch and rinse
6. Prime → Prime remaining exposed dentin- no primer on GI 
7. Final Resto 

Open Sandwich Steps

1. Prep → NO BEVEL on cementum. Butt joint only. 
2. Rinse and dry
3. Apply RMGI → place RMGI over PULPAL/AXIAL walls 
4. Light Cure
5. Etch and rinse 
6. Prime
7. Final Resto 

Technique

Indication

Contact w/ saliva?

Surfaces

Material

Closed sammy

Pulp protection (enamel on margins) 

No

Axial and pulpal walls

GI or RMGI

Open sammy

Deep cervical lesions w/ dentin or cementum margins 

Yes = Fl- release to oral einvronemnt 

ANY (except surfaces under occlusal forces) 

RMGI

Occlusal Curvatures and axial positions 

• Curve of spee: 2d curvature = buccal cusp tips of premolars and molars posteriorly, curvature begins @ tip of canines and curves upwards from anterior → posterior 

• Max molar roots = inclined MESIALLY

• Mandi molar roots = inclined DISTALLY 

• Curve of Wilson: the medio-lateral curvature of the occlusal plane of posterior teeth → complements the paths of the condoles during mandible movement 

• Also 2d 

• Crowns of MANDI posterior teeth incline to the lingual (Lingual Lower)

• Crowns of MAX posterior teeth incline toward buccal (Buccal Upper) 

• Molars have greater inclination bc the curve  → deeper posterior 

• Sphere of Monson AKA compensating occlusal curvature = 3d sphere shaped curvature for occlusal plane Concave curve for mandi, convex for maxillary = combo of curve and spee and curve of Wilson

Axial position/Root inclination

• Axial position = the inclination of a tooth from vertical axis 

• Normally described in mesiodistal and faciolingual direction (but a combo of the two) = opposite of BULL

• Crown is normally inclined in the OPPOSITE direction = BULL

Crown surface form 

• From facial/lingual aspects ALL permanent teeth = rougly trapezoidal 

Tooth 

Shape of Crown

Info

Anterior

Tringular 

• Proximal view → triangular 

• Base = cervical 3rd

• Apex = incisal 3rd

• Apex = wedge in tearing, biting, and incising food

Max posteriors

Trapezoidal 

• Proximal view → trapezoidal 

• Base = cervical 

• Wedge → aids in distribution of forces during mastication and self-cleaning process

Mandi posteriors

Rhomboidal 

• Proximal → rhomboidal 

• Crowns = inclined toward the lingual  = proper interlocking of the Mandi and max posterior teeth during mastication 

Contact areas

• Increase in size with age = Abrasive contact in proximals broaden the area 

• Mesiodistal length of dental arches = get shorter = as teeth become narrower mesiodistally, they are moving closer to midline 

• Proper contact location = stabilizes dental arch and prevents food packing 

• Contact areas become more cervically located from anterior → posterior in each quad (basically just move down towards cervical 3rd from midline to molars) 

• Distal contact area normally = more cervical location than mesial contact 

• Relative size increases from anterior to posterior in each quad

• Posterior teeth → contact areas = normally located to the buccal of center in the faciolingual dimension 

Cervical Line: Curvatures

• CEJ = cervical line = line around the tooth where enamel and cementum meet 

• Separates anatomical crown and root → only visible when not covered by soft tissue

• It is stable (unlike gingival line → everchanging)

• Gingival line = gingival margin/crest → imaginary line which marks the level of termination of nonattached soft tissue surrounding the tooth 

• Separates the clinical crown and root → is always visible 

• Epithelial attachment = actual attachment of the soft tissue of the mouth to the tooth 

• Can be distinguished From the PDL 

• Connection for soft gingival tissue 

• PDL = attachment of the hard tissue (bone_ to the tooths root structure 

• Usually a sulcus between gingival Marin and epithelial attachment 

Cervical Line Countour Rules

• Cervical line normally curved (convex) or bulges TOWARD the apical on the → lingual and facial teeth surfaces

• CL is normally convex toward the incisal/occlusal on → the mesial and distal surfaces

• The amount (depth) of cervical line curvature on any tooth is normally GREATER on the MESIAL compared to distal 

• Cervical lines on adjacent prox. Surfaces of adj. teeth have → approx same depth of curvature

• Depth of curvature on all surfaces = greatest on → central incisors and decreases POSTERIORLY 

Dental formula 

• A dental formula = indicates the dentiiton of only 1 side of the mouth but includes both MAX and MAND. Quadrants. 

  • Must be multiplied by 2 to provide the number of teeth in entire dentition 

• PERM DENTAL FORMULA: I 2/2: C 1/1 : P 2/2; M3/ 3 = 32 TEETH TOTAL 

• BABY DENTAL FORMULA: I 2/2: C 1/1: M 2/2 = 10 TEETH TOTAL 

 

General Eruption Pattern  

• Deciduous:  

  1. MAND Central incisor  

  2. MAND Lat incisor 

  3. MAX Central incisor  

  4. MAX Lat incisor 

  5. MAND 1st molar  

  6. MAX 1st molar 

  7. MAND canine 

  8. MAX canine 

  9. MAND 2nd molar 

  10. MAX 2nd molar  

 

Decid. Eruption Ages in Months 

1. Central incisor mand = 6 

2. Central incisor max = 7.5 

3. Lat incsor mand = 7 

4. Lat incisor max = 9 

5. Mand canine = 16 

6. Max canine = 14 

7. Mand 2nd molar = 20 

8. MAX 2nd molar = 24  

 

 

Perm dentition erupt sequence: with ages in years 

1. Mandibular 1st molar = 6-7 

2. Max 1st molar = 6-7 

3. Mand C. incisor = 6-7 

4. Mand L. incisor = 7-8 

5. Max C. incisor = 7-8 

6. Max L. incisor = 8-9 

7. Mand canine = 9-10 

8. Mand 1st premolar = 10-11 

9. Max 1st premolar = 10-11 

10. Mand second premolar = 11-12 

11. Max second premolar = 11-12 

12. Max canine = 11-12 

13. Mand 2nd molar = 11-13 

14. Max 2nd molar = 12-13 

15. Mand 3rd molar =17-21 

16. Max 3rd molar = 17-21 

 

 

Numbering systems 

• Universal numbering system  

  • Perm = Upper right third molar is #1 and then you go all the way to number 16. Start the next arch off at lower left 3rd molar = #17 and then lower right third molar = #32 

  • Deciduous teeth = Numbered 1-20 in the same fashion as perm teeth but lowercase "d" is added after the number. Most common, just use letters to address baby teeth, A-T retrospectively.  

• Palmer notation method 

  • Breaks mouths into 4 quadrants of 8 teeth 

    • 1 = C.incis 

    • 2 = Lat.incis 

    • 3 = canine DDA 

    • 4 = 1st PM 

    • 5 = 2nd PM 

    • 6-8 = 1-3rd molars  

    • Use letters A-E for baby teeth  

    • Signs tell the quadrants  

• FDI system  

  • Binomial system = the first number = quadrant and second number = tooth # (1-8) 

  • PERM = 1 at top right, two, 3 = LL, 4 = LR 

  • BABY = 5,6,7,8  

Intro 

• Teeth are seperated into upper and lower arches 

• upper arch = maxillary and lower arch = mandible 

• Mandible = lower jar = movable 

• Midline = imaginary verticle line that divides the mouth into halves 

• The mouth = further divided into quadrants: 

  • Maxillary upper right 

  • Maxillary upper left 

  • Mandibular lower right 

  • Mandibular lower left  

• It's improtant to remember that the left is actually the patients right and patients left is actually our right  

• Occulsion = the action of the mandibular bottom teeth contacting the max. Upper teeth 

• The process of biting and chewing food = mastication 

 

 

1. Classification of Dentitions 

• Humans = heterodont = meaning we have different types of teeth that have different functions while masticating. A homodont would instead have all one same set of teeth.  

• Humans are also diphyodonts which means they have two sets of teeth 

  • Deciduous 

  • Permanent 

• Polyphyodonts = 2+ sets of teeth develop throughout life 

• Humans have two dentition phases. Deciduous and permnant 

  Decid = primary dentiton. Erupt around 6 mos till around 2 years old. 

  • 20 of them 10 on top 10 on bottom 

  • Perm = 32 perm teeth. 16 on top and 16 on bottom. 

    •  and they erupt from 6 yrs old to 21 years old. 

 

 

1. Classification of Teeth 

• Humans have 8 different types of teeth in the perm dentition  

  • 2 incisors = closest to ML  

    • Central and lateral incisors 

    • Biting, cutting, incising, and shearing. 

    • 4 per arch = 8 total in mouth 

  • 1 canine AKA cuspid 

    • 3rd tooth from midline 

    • Cutting, tearing, piercing, and holding 

    • 2 per arch = 4 total in mouth 

  • 2 premolars AKA bicuspids 

    • 4th and 5th teeth from ML 

    • 1st and second premolars = their names 

    • Tearing, holding, grinding 

    • 4 per arch = 8 total per moutn 

  • 3 molars 

    • 6th, 7th, 8  

    • First, 2nd, and 3rd molars 

    • First molar = 6 year old jmolar 

    • Second molar = 12 year old molar 

    • 3rd molar = wisdom tooth 

    • GRINDING 

    • 6 per arch, 12 per mouth  

• Decidious dentiion: 

  • 2 incisors = central and lateral incsicors 

    • Biting, cutting, incising, and shearing 

  • 1 canine = cuspid 

    • Cutting, tearing, piercing, holding 

  • 2 molars = first and second molars 

    • GRINDING 

  • NO PRE MOLARS, one less molar per quadrant. 

• 5 teeth per quadrant, 10 per arch = 20 total teeth  

 

1.  Dentition periods and succedaneous teeth 

 

• Humans = 2 dentition types but THREE dentition PERIODS 

  • Bc decidouus and perm periods interlap, which makes the middle mixed periods. 

1. Primary= mostly Decidious 

2. Mixed 

3. Perm 

 

1. Primary period 

   1. Only baby teeth 

   2. 6 mos to 6 years 

   3. At 6 years the 1st mandibular molar will erupt. = lower 1st molar = 6 year old molar 

2. Mixed dentiition period 

   1. Both baby and perm teeth 

   2. 6 years to 12 years old. 

   3. Starts at 6 years old with eruption of 6 year old molar = lower 1st molar = mandibular molar 

   4. Ends at age 12 when the last tooth efoliates / falls out = maxillary second molar = upper 12 year old moalr = second molar 

3. Permnant dentiion period 

   • Begins at 12 years old when the maxillary 2nd molar falls out of the upper arch 

   • Continues till we die basically 

• In order for a permanent tooth to erupt a baby tooth must exfoliate, or fall out. This happens through resorption, which is a natural process of the roots melting away or eating themselves  

• Succedaneous (sucks-uh-daneous) teeth = perm teeth that replace the exfoliated baby teeth  

  • Means succeeding teeth, teeth that come after the baby teeth.  

  • There are 20 since they are replacing 20 baby teeth.  

  • Inciscors, canines replace their counter parts and premolars replace baby molars. 

  • Since the PreMs are replacing the baby molars the PERMMolars have nothing to replace therefore they are NOT succedaneous teeth.