Chapter 16: Anterior Permanent Teeth

Anterior

The following are all properties of _______ permanent teeth:

• Include incisors and canines

• Composed of four developmental lobes

• All succadaneous

• Incisal ridge (masticatory surface)

• Wider mesiodistally than labiolingually

• Height of contour in cervical third

• Greater CEJ curvature

• All lingual surfaces have a cingulum

• Usually only have single root

Mesiolabial, middle labial, distolabial, and lingual

What are the four developmental lobes that comprise all anterior teeth?

HINT: 3 labial, 1 lingual

Mesiolabial and distolabial

Where are the two developmental depressions located on permanent anterior teeth?

HINT: between two vertical labial developmental lobes…

Triangular

What is the crown outline of permanent anterior teeth when viewed from the proximal view?

Centrals and Laterals

Which teeth are included in the permanent incisor group?

Biting and Cutting

The incisors masticatory surface functions as instruments for _______ and ________ due to their Incisal ridge, triangular form, and arch positions.

Mamelons

Rounded enamel extensions on the incisal ridge of incisors from the labial or lingual views.

Attrition

Mamelons usually undergo _____ and will wear away over time. In fact, if mamelons are still present long after tooth eruption there is possible malocclusion occurring such as an anterior open bite, because the teeth are not in contact with each other.

Golden Proportions

When anterior teeth are restored or undergo orthodontic therapy, the ________ ________ can be useful to balance the size of the teeth to one another.

Maxillary lateral incisor

The crown of which tooth is most commonly be affected with dens in dente, a condition which may leave the tooth with a deep lingual pt resulting from invagination of the enamel organ into the dental papilla.

Incisal edges

High levels of attrition may alter anterior maxillary and mandibular incisors causing the incisal ridges to become…?

Hutchinson Incisors

Condition that affects the crowns of permanent incisors resulting in a screwdriver shape from the labial view and is wider cervically and narrow Incisal with a notched Incisal ridge.

Talon Cusp

A sharp small extra cusp that appears as a projection from the cingulum of incisor depth and can happen on any other within bth dentitions.

Larger

A maxillary central incisor is _____ than a maxillary lateral incisor.

More

All lingual surface features. Including marginal ridges, lingual fossa, and cingulum are _____ prominent on the maxillary incisors than on the mandibular incisors.

Clinical Considerations of Maxillary Incisors

• if this incisor has increased prominence of the lingual marginal ridges and deeper lingual fossa, it may be considered to have extreme shovel-shaped form.

• This tooth can also have an accentuated cingulum with deepened grooves.

• May have an incisal edge with severe attrition giving it lingual inclination.

• Dental biofilm and stain can collect n the prominent lingual surface concavities of these teeth, as well as in the lingual pit and linguogingival grooves.

• Clinicians must also be careful to detect for deposits in any mesial and distal root concavities.

MAXILLARY CENTRAL INCISORS

TOOTH NUMBERS: #8 and #9

ERUPTION: 7 years

CROWN FEATURES: largest of all incisors and widest tooth mesiodistally of any permanent anterior tooth.

ROOTS: single conical root, smooth and straight, usually rounded apex.

LABIAL: sharper mesial incisal angle with more rounded distal incisal angle. Usually Imbrication lines present.

LINGUAL: cingulum is well developed and off centered distally. The mesial marginal ridge is longer than the distal marginal ridge. Variations can occur with more/less prominent fossa’s, grooves and pits.

PROXIMAL: deeper mesial CEJ curvature and has the greatest depth curvature on any tooth surface i the permanent dentition

INCISAL: crown outline shape is triangular.

Avulsion

Clinical consideration in maxillary central incisors where compete displacement of the tooth from the tooth socket occurs resulting from extensive trauma.

Diastema

Clinical consideration of maxillary central incisors where there is an open contact or “gap” between the two maxillary central incisors.

Mesiodens

Clinical Consideration of maxillary central incisors where supernumerary teeth are commonly located between the two maxillary central incisors and can affect spacing in the maxillary arch.

MAXILLARY LATERAL INCISORS

TOOTH NUMBERS: #7 and #10

ERUPTION: 9 years

CROWN FEATURES: greatest degree of variation in form of any permanent tooth, besides third molars.

ROOTS: single conical root that is almost smooth and straight and has NO DEPRESSIONS on the proximal surfaces with a SHARP apex.

LABIAL: crown is smaller than central incisor and less symmetrical. The incisal angles are rounder, but the mesioincisal angle is still sharper that the distoincisal angle in this tooth. Crown outline reflects a more rounded labial surface.

LINGUAL: prominent centered cingulum with deeper lingual fossa. A lingual pit is more common in this tooth.

PROXIMAL: Deeper mesial CEJ curvature.

INCISAL: Outline of crown is round or oval.

Clinical Considerations for Maxillary Lateral Incisors

• one of the most common teeth in the dentition to exhibit partial microdontia. This disturbance leads to a smaller one of these teeth or a peg …

• Also common in partial anodontia and this may be congenitally missing

• May have one or more tubercles or accessory cusps on the cingulum

False

TRUE/FALSE: mandibular laterals are similar to maxillary laterals in that they are both smaller than the centrals?

Mandibular incisors

Excessive attrition of ______ _____ can drastically change the tooth as it becomes an incisal edge and can sometimes even create a bow-shaped wear pattern on the incisal edge, exposing the underlying dentin.

MANDIBULAR CENTRAL INCISORS

TOOTH NUMBERS: #24 and #25

ERUPTION: 6 years

CROWN FEATURES: smallest and simplest teeth of entire dentition.

ROOTS: single root which is widest labiolingually and shape is a narrow oval. Pronounced proximal root concavities.

LABIAL: crown is very symmetrical. No Imbrication lines or developmental depressions. Mesioincisal angle is slightly sharper.

LINGUAL: outline of crown is most symmetrical of all incisors. Less pronounced lingual surface and small centered cingulum.

PROXIMAL: Higher mesial CEJ curvature.

INCISAL: notable symmetry.

Accessory or Bifurcated root

What is the only major clinical consideration mentioned with Mandiublar Central AND Lateral Incisors?

MANDIBULAR LATERAL INCISORS

TOOTH NUMBERS: #23 and # 26

ERUPTION: 8 years

CROWN FEATURES: crown appears tilted or twisted distally.

ROOTS: single straight root that is slightly longer and wider than central. Pronounced proximal root concavities, especially on the distal surface.

LABIAL: sharper mesioincisal angle.

LINGUAL: lacks bilateral symmetry. More prominent features than central, and small cingulum that lies more distally. A single lingual fossa is also present but a lingual pit is rarely present.

PROXIMAL: higher mesial CEJ curvature.

INCISAL: rounder crown outline than cetral and notable distally displaced cingulum.

Eyeteeth

Patients also refer to their canines as what?

Slightly deeper yellow color

As a result of canines increased thickness and opacity, patients often complain of what?

Pearce and Tear

Because of their overall tapered shape and prominent cusp, canines function to ______ and ___ during mastication.

Most

Canines are the ____ stable teeth in the dentition, because of their long root length and position in the arches which serve as stabilizing anchors.

HINT: guideposts

True

TRUE/FALSE: canines are not usually involved in dental caries.

Wider

Canines are _____ labiolingually than the incisors and even more so than maxillary incisors.

Cusp slopes

The unique cusp tip of canines divides the incisal edge into two ____ _____ rather than being straight across. Also, the mesial of this is usually shorter than the distal.

Labial ridge

Canines are the only teeth in the dentition with a centrally placed vertical ______ _______.

Canine Eminence

The long and large root of canines is externally manifested in the jaws by the vertically oriented and labially placed bony ridge of the alveolar process called the…?

PERMANENT MAXILLARY CANINES

TOOTH NUMBERS: #6 and #11

ERUPTION: 11 years

CROWN FEATURES: similar in length or shorter than maxillary central incisor.

ROOTS: long single root with blunt apex. Longest root in maxillary arch. Prominent proximal developmental depressions.

LABIAL: mesial half resembles nearby incisor, distal half resembles nearby premolar. Usually both Imbrication lines and perikymata are present.

LINGUAL: large centered cingulum. Prominent lingual surface features.

PROXIMAL: higher mesial CEJ curvature.

INCISAL: asymmetrical crown outline

Impacted canines

Eruption order may cause canines to erupt after maxillary incisor or possibly even canines, resulting in _______ if there is no space left for them.

Dentigerous cyst

Impacted canines may result in formation of ______ ______.

Dilaceration

Because of its long root length, maxillary canines may also undergo distorted angulations or _________ and there may be several curvatures along its length.

MANDIBULAR CANINES

TOOTH NUMBERS: #22 and #27

ERUPTION: 10 years

CROWN FEATURES: closely resemble maxilary but narrower labiolingually and mesiodistally.

ROOTS: single root with slight mesial inclination and more pointed apex. Longest mandibular root. More pronounced mesial developmental depression.

LABIAL: not as rounded as maxillary. Imbrication lines not usually present. Distal outline is shorter and rounder. Shorter mesial cusp slope than distal.

LINGUAL: less developed cingulum and two marginal ridges. Rarely any ligual pits or grooves.

PROXIMAL: n/a

INCISAL: slightly more symmetrical than maxillary. Less developed cingulum distally offset.

Manidibular

_____ canines are more likely to have an accessory root or bifurcated root of the anterior teeth, but this is still rare.