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BDS2 CDS Paedriatric > Primary Tooth Morphology > Flashcards

Primary Tooth Morphology Flashcards

1
Q

4 examples of early problems

A
  • gingival cysts (Epstein’s Pearls/Bohns Nodules)
  • congenital epulis
  • natal or neonatal teeth
  • eruption cyts
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2
Q

what are Gingival Cysts (Epstein’s Pearls/Bohns Nodules)?

A

name depends on location in mouth

  • White lump on gum
  • No teeth – very young
  • Keratin build up
  • No treatment as will naturally resolve
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3
Q

what is congenital epulis?

A
  • large bulbous swelling
  • Can interfere with feeding
  • Shrink as child grows
  • Sometimes need removed
  • Nothing untoward - not cancer, cant spread
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4
Q

what are natal or neonatal teeth?

A
  • tooth been in ectopic superficial position
  • Erupt early
  • Poor root support - can be mobile
  • Interfere with feeding smooth them done
  • May need extracted if too mobile
  • Usually just monitor
  • Can look hypominerlaised as not complete prior to eruption
    i. e. lower central primary incisor
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5
Q

what are eruption cysts?

A
  • Blue swelling
  • Over erupting primary teeth
  • Blood has got into follicle space
  • Can be left and resolve as tooth erupts
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6
Q

how are the quadrants numbered in FDI notation for primary teeth?

A

5, 6, 7, 8 instead of 1, 2, 3, 4

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7
Q

how are teeth numbered in FDI notation in primary teetH?

A

1, 2, 3, 4, 5

or A, B, C, D, E but never mix numbers and letters

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8
Q

when do teeth start to form?

A

week 5 of intra-uterine life

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9
Q

when does hard tissue of teeth begin to form?

A

week 13 of intra-uterine life

tooth germ can be seen on 20 week scan

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10
Q

primary maxillary central incisor calcification timeline

A
  • Start cal. 13-16 weeks i.u.l
  • Crown complete 1.5 months after birth
  • Eruption 8-12 months
  • Root Complete 33 months
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11
Q

primary maxillary second molar calcification dates

A
  • Hard tissue formation 16-23 weeks i.u.l
  • Crown formation complete at 11 months after birth
  • Eruption between 25-33 months
  • Complete root formation 47 months
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12
Q

what can lead to enamel defects in babies?

A

systemic disturbances during calcification

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13
Q

what are the 2 main causes systemic disturbances during calcification of enamel in babies?

A
  • difficult pregnancy for the mother

- complications at birth.

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14
Q

calcuication levels of crowns at birth

A
  • ½ of central incisors
  • ¹/3 of lateral incisors
  • Tip of primary canines
  • ½ of first primary molars
  • ¹/3 of second primary molars
  • Tip of cusps of first permanent molars
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15
Q

how much of the central incisor crown is calcified at birth?

A

1/2

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16
Q

how much of the lateral incisor crown is calcified at birth/

A

1/3

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17
Q

how much of the primary canines crown is calcified at birth?

A

tip

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18
Q

how much of the first primary molar crown is calcified at birth?

A

1/2

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19
Q

how much of the second primary molar crowns is calcified at birth?

A

1/3

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20
Q

how much of the permanent molar crowns are calcified at birth

A

tips

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21
Q

what is needed for tooth eruption to occur?

A

force must be generated to propel the tooth through the bone and gingival tissue for eruption to occur

and in permanent dentition the primary tooth root must also be resorbed

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22
Q

possible tooth eruption theories

A
  • Cellular proliferation at the apex of the tooth
  • Localized change in blood pressure/hydrostatic pressure
  • Metabolic activity within the PDL
  • Resorption of the overlying hard tissue

Likely to be combination of them all - unknown currently

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23
Q

what causes resorption of the overlying hard tissue (bone)?

A

enzymes in the dental follicle

- Remodelling of bone or primary tooth tissue is essential to the process of tooth eruption

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24
Q

how can the dental follicle best be seen?

A

as a dark halo around the unerupted tooth on radiographs

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25
Q

what happens when the dental follicle is activated?

A

initiate osteoclastic activity in the alveolar bone ahead of the tooth and clear a path for tooth eruption
• Don’t know what signals osteoclasts to go through bone and tooth eruption
• Leaves a trail

Once the crestal bone has been breached the follicle is likely to play a lesser role
• Just gingival tissue

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26
Q

what must occur at the base of the crypt during eruption?

A

bone growth as tooth pushes into mouth

Osteoclastic activity in front of tooth and bone deposition below tooth

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27
Q

when does the eruption process stop?

A

when the tooth comes into contact with something
- usually the tooth of the opposing arch

so continues throughout life to compensate for vertical growth of the jaws and tooth wear
- prevent anterior overbite

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28
Q

what is general role for lower and upper eruption times?

A

lower before uppers

except the lateral incisors

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29
Q

what us the general eruption sequence?

A 
A B D C E 
central incisor,
lateral incisor, 
first primary molar,
canine, 
second primary molar
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30
Q

what is the first primary tooth to erupt? and when?

A

lower central incisor

4-6 months

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31
Q

what is the second wave of primary teeth to erupt? and when?

A

lower and then upper laterals

7-16 months

32
Q

what is the third wave primary teeth to erupt? and when?

A

lower and then upper first molars

13-19 months

33
Q

what is the fourth wave primary teeth to erupt? and when?

A

lower than upper canines

16-22 months

34
Q

what is the fifth wave of primary teeth to erupt? and when

A

lower than upper second molars

15-33 months

35
Q

how do teeth of the same series erupt in respect to each other?

A

teeth of the same series tend to erupt within 3 month of their contra lateral tooth

36
Q

when is the primary dentition complete by?

A

2 and a half to 3 years

37
Q

4 differences between primary and permanent teeth crowns

A
  • The primary incisors are smaller in both their crown and root proportions.
  • The primary molars are wider mesiodistally than the permanent premolars which take their place.
  • Primary molars crowns are more bulbous.
  • The primary teeth are usually whiter in colour. (Enamel structure is slightly different)
38
Q

feature of upper and lower 1st primary molar

A

they have a prominent mesiobuccal tubercle

  • succeeding permanent premolars do not have tubercles
39
Q

feature of upper second primary molars

A

have a transverse ridge

- when doing cavity preparation cannot break this ridge

40
Q

feature of lower second primary molar

A

has 3 buccal cusps

- like first permanent molar

41
Q

3 differences between primary and permanent roots

A
  • The roots of the primary teeth tend to be narrower when compared with their permanent counterparts.
  • The roots of the primary molars are longer and more slender than the roots of the permanent molars.
  • roots tend also to flare apically to allow room in between for the developing permanent tooth crowns.
42
Q

2 differences between the pulp in primary and permanent teeth

A
  • The pulp chambers of the primary teeth are relatively large in proportion to the crowns that surround them.
  • The pulp horns of primary teeth extend high occlusally,
  • placing them closer to the enamel than the pulp horns of permanent teeth; hence pulpal exposure on cavity preparation is more likely.

primary root canals tend to be ribbon shaped, with multiple interconnecting accessory canals

43
Q

why is more care needed when carrying out restoration on primary teeth?

A

burs tend to be 2-3mm in length
- can easily breach pulp in primary teeth as thinner enamel and dentine, with a larger pulp chamber

decay is also more rapid as less enamel to penetrate

44
Q

what is the shape of primary root canals?

A

ribbon shaped, with multiple interconnecting accessory canals

  • clinically impossible to clean
  • endodotics hard
45
Q

2 hard tissue differences between primary and permanent teeth

A
  • The thickness of the coronal dentine is much thinner than in permanent teeth.
  • The enamel of the primary teeth is relatively thin and has a consistent depth.
  • Unlike permanent
  • In primary cusps and fissures are similar enamel depth
46
Q

why is some anterior spacing desired in primary dentition?

A

so no crowding in permanent dentition

47
Q

arthropoid or primate spacing

A
  • Spacing mesial to upper deciduous canine

- Spacing distal (and slightly mesial) to lower deciduous canine

48
Q

leewat space

A
  • extra mesio-distal space occupied by the primary molars which are wider than the premolars which will replace them
  • Usually equates to 1.5mm per side on the upper arch and 2.5mm per side in the lower arch
49
Q

how does the face grow?

A

downwards and forwards

impact on occlusion

50
Q

when does the mixed dentition stage occur?

A

when the first permanent tooth erupts until exfoliation of the last primary tooth

usually between 6 and 11 years

  • but variations
  • typically lasts 5 years
51
Q

upper arch permanent teeth eruption sequence

A

1st permanent molars and then front to back except canines (premolars before them)

6, 1, 2, 4, 5, 3, 7, 8

52
Q

lower arch permanent teeth eruption sequence

A

1st permanent molars and then front to back

6, 1, 2, 3, 4, 5, 7, 8

53
Q

which permanent teeth arch erupts first?

A

lowers before uppers

except second premolars

54
Q

crowding in the upper permanent arch leads to….

A

exclusion of the upper canine

55
Q

crowding in the lower permanent arch leads to…

A

lack of space for second premolar

56
Q

path of tooth eruption for permanent dentiton

A
  • proclined permanent incisors lead to an increased A-P arch length as deciduous incisors were upright
  • permanent incisors develop more palatal to primary incisors
  • risk of trauma to the permanent teeth if primary incisors are displaced towards the developing tooth.
57
Q

what is the “ugly duckling” phase? (physiological spacing)

A

Transient spacing of the upper 1’s may occur due to the close proximity of their roots to the erupting 2’s and 3’s

  • Push on root and splay it out
  • Until canine pushes its way down and closes

Physiological spacing
- changes as teeth come through

58
Q

how long does it take for complete root formation for permanent teeth?

A

from eruption it takes around 3 years for permanent tooth root to complete apexogenesis

whereas primary roots was just 1.5 years

59
Q

how many roots does a 65?

A

3 (one palatal and 2 buccal)

palatal root can be fused to buccal root

60
Q

what is the occlusal surface of 65?

A

large transverse ridge

bulbous buccal cusp

2 fissure patterns

61
Q

how many cusps does the 75 have?

A

2 lingual

3 buccal

62
Q

which buccal cusp is largest on the 75?

A

mesial

63
Q

which buccal cusps is the smallest on the 75?

A

smallest distal - round corner

64
Q

how many roots does the 75 have?

A

2 roots

splayed due to permanent tooth

65
Q

what can 61 root be like?

A

can have a distal bend

66
Q

what can 61 crown be like?

A

mesial edge of crown is straighter

67
Q

what is a difference in primary and permanent incisor?

A

more bulbous

68
Q

what is the difference in upper and lower incisors?

A

lowers more slimmer mesio-distally

69
Q

edges of 63 tend to be…..

A

mesial tends to be straighter

distal flares after ACJ

70
Q

special feature of 64

A

tubrecle

can be very prominent (like a cusp)

71
Q

occlusal surface of 64

A
  • square shaped crown
  • S/C shaped fissure
  • tubercle
72
Q

how many roots does upper first molar have? 64

A

2 roots - one buccal and one palatal

73
Q

84 occlusal surface

A
  • more retangular
  • S shaped fissure
  • mesiobuccal fissure

don’t look like premolars that replace them

74
Q

how many roots does lower 1st molars have?

A

2

one can be seem fused

75
Q

how many roots does the lower 2nd molar have?

A

3 roots

BDS2 CDS Paedriatric (7 decks)

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