Oral Anatomy Lecture #1: Tooth Anatomy & Notation Systems

Palmer Notation System Universal Notation System FDI (ISO) Notation System Victor Haderup System Anatomical and Clinical Crown/Root Tooth Structures: Enamel, Dentin, Cementum, Pulp Pulp Cavity and Its Parts Tooth Junctions: CEJ, DEJ, Cementodentinal Junction Periodontium: PDL, Alveolar Bone, Gingiva Alveolar Process and Alveolus Tooth Anatomy Terms: Apex, Furcation, Root Trunk

shorthand -

Tooth numbering or “_____” system of tooth notation is necessary in clinical practice for recording data and communication.

Palmer Notation System

AKA: 8 Tooth Quadrant or Symbolic System.

Palmer Notation System

1861 - Developed by Adolph Zsigmondy.

Adolph Zsigmondy

Born in Hungary, practiced in Austria.  

1870 and Ohio, USA

When and where did Corydon Palmer modified the Palmer Notation System?

ADA

Presented the Palmer Notation in the ___Grid Sign meeting. 

Grid Sign

• Named and added by Palmer. 

1947

Roman numerals were used previously in naming teeth but were changed to an alphabet system by ADA because they were one that recommended the symbolic system as a numbering of choice particularly by the orthodontists, pedodontists, and other dental schools.

Roman numerals

were used previously in naming teeth but were changed to an alphabet system by ADA because they were one that recommended the symbolic system as a numbering of choice particularly by the orthodontists, pedodontists, and other dental schools.

Pedodontists and orthodontics of USA and Canada

What kind of dentists and which countries use Universal Notation System?

Advantages of PNS

• System is easy to use.

• Easier for beginners due to less confusion as permanent and deciduous teeth are indicated differently.

Disadvantages of PNS

• Doesn’t include the maxillary and mandibular arch.

• Hard to input in the computer since there’s no grid.

• No provisions to identify supernumerary teeth (excess tooth).

• Segments have only one number and are used to designate a particular tooth.

• Difficult for verbal transmission.

Universal Notation System

Developed by Julius Parreidt (1882) and Cunningham (1883). 

1882 and 1883

When did Julius Parreidt and Cunningham developed the UNS?

Universal Notation System

What notation system did the ADA for USA and Canadian dentists adopted in the year of 1968?

Advantages of UNS

• Separate number/alphabet is given for individual tooth. 

• Easy to visualize.

• Easy to communicate.

Disadvantages of UNS

• Confusing when comparing with Palmer Notation System.

• Confusing with FDI and difficult to remember.

• Doesn’t clearly show jaw quadrants, similar teeth

• numbered differently in each quadrant.

Two - digit system, ISO - 3950 Notation

What are the other terms for FDI System?

1966

When FDI developed by the Berlin dentist, Dr. Jochen Viohl. 

Dr. Jochen Viohl

Who developed FDI in 1966?

1970

When did FDI get accepted by WHO and IADR as the notation system in dentistry?

FDI System

What notation system got accepted at 1970 by WHO and IADR?

Advantages of FDI

• It is very simple, accurate, and easy to memorize.

• It is user friendly, and prevents errors in differentiating left and right, upper and lower arches and tooth type.

• Simple to teach and easy to understand.

• Simple to translate into computer input.

• Simple in conversation and direction.

• Readily communicable in print.

Disadvantages of FDI

• In the case of deciduous teeth, there can be confusion and it is difficult to memorize.

• For specialists other than pedodontists, it can be difficult to understand or to define teeth.

• It is difficult to enter multiple teeth in different arches and it would be too long to use routinely.

Victor Haderup System

European (Denmark) system of identifying teeth by use of a number for each permanent tooth and a + or - sign to indicate the position of each tooth. 

Advantages of VHS

• This system is computer friendly. 

• Easy to understand.

Disadvantages of VHS

• It can be very confusing for recording mixed dentitions.

• It is very difficult to dictate, so it can’t be used routinely.

Clinical Crown

Portion of tooth which is visible in mouth. Clinical crown may, or may not correspond to anatomical crown, depending on level of soft tissue & may also include a portion of the anatomical root.

Anatomical Crown

Portion of tooth which is covered by enamel.

Clinical Root

• Portion of tooth which is not visible in mouth.

• An ever changing entity

• May or may not correspond to the anatomical root.

Clinical Crown

If may konting root na visible na sa mouth, part na ng ____? Kasi wala ng cementum.

Anatomical Root

Portion of tooth which is covered by the cementum.

Clinical root

Anything that is covered by the gum is still considered as part of ____.

Cervical line (Neck)

It is a thin line which separates the anatomical crown and the anatomical root

CEJ

Divides the crown and root of the tooth. It is a constant entity.

Root trunk

It is that part of the root which starts from the cervical line to the furcation area of multirooted teeth (posterior teeth only).

Furcation

It is the junction of roots in multirooted teeth mainly in posterior. (Plural - Furca)

Apex

It is the tapered end of the root tip of a tooth.

Apical Foramen

It is communicating channel or opening between the periodontal membrane and the pulp. It is usually present at the apex of the root. (Plural

Apical Foramen

Kung saan lumalabas yung nerves ng ngipin and where the nutrient of the tooth comes from.

Cementum

Layer of hard, bonelike tissue which covers dentin of anatomical root of a tooth. 

Enamel

Hard, mineralized tissue which covers dentin of anatomical crown of a tooth & hardest living body tissue. 

Dentin

Hard tissue which forms the main body of tooth and surrounds pulp cavity & is covered by enamel in anatomical crown and by cementum in anatomical root.

Enamel

Substantia Adamantina

Enamel has a hardness of 5-8 on the Mohs scale, making it harder than bone.

What is the hardness of enamel on the Mohs scale?

The enamel is 2-3 mm thick on incisors' incisal edges and 3-4 mm thick on cusps.

How thick is the enamel on incisors’ incisal edges and cusps?

The specific gravity of enamel is 2.8.

What is the specific gravity of enamel?

Varies according to the thickness. 

Thin = Yellow white

Thick opaque = Blue - ish white /Grayish

How does the thickness of enamel affect its color?

Semi-translucent and soluble in acid media.

(Kaya mabilis makapitan ng caries.)

Is enamel translucent?

Enamel is selectively permeable because of enamel rods/prisms, with rod sheaths interconnected by interprismatic substances acting as glue.

Why is enamel considered selectively permeable?

96% inorganic material

4% organic material and water.

What is the composition of enamel in permanent teeth?

92-94% inorganic material

6-8% organic material and water.

What is the composition of enamel in deciduous teeth?

Dentin

Substantia Eburnuea

Dentin

What forms the major portion of the tooth and provides basic shapes to the tooth and the enamel?

Pulp cavity

Dentin covers the _____ (lies beneath the crown and the cementum of the root). 

Pulp Cavity

What lies beneath the crown and the cementum of the root?

Pulp cavity

What part of the tooth reacts to the physiological and pathological changes and attacks of the tooth?

Main functions of dentin

• Covers the pulp.

• Make the shape of the tooth.

Location of dentin

Beneath enamel

Hardness of dentin

• Less harder than enamel. 

• Harder than bone & cementum. 

Color of dentin for permanent dentition

Yellow

Color of dentin for deciduous dentition

Light - yellow

Transparency for dentin

Semi-transparent

Permeability for dentin

Permeable because of dentinal tubules.

Elasticity for dentin

Very high but it is less radio opaque than the enamel because of less mineralization.

Consistency for dentin

More organic substance than the enamel because it contains:

65% Inorganic

35% Organic

Dentinal tubules

What allows higher permeability to dentin?

Odontoblastic cells

What does dentinal tubules contain?

cells; odontoblastic cells

Enamel has no ___, but dentin has ______

stimulus; direct transmission

When you drink cold water, it will transmit ____ to the nerve because odontoblastic cells have a ________ from the enamel up to the pulp.

Peritubular dentin

The dentin that immediately surrounds the dentinal tubules. 

1. Cementum

2. Periodontal ligament

3. Alveolar bone

4. Gingival tissue.

What does periodontium makes up of?

Cementum

Substanstia Ossea

Cementum

is the covering of the root of the tooth, therefore it extends from the CEJ to the apical foramen. 

CEJ - Apical foramen

Cementum is the covering of the root of the tooth, therefore it extends from the ___ to the _____ 

CEJ

What gives attachment to the periodontal ligament through which the tooth is attached to the alveolar wall/bone.

At the apical foramen and near the furcation of the root

Where is the thickest part of cementum?

Permeability of cementum

Permeable to any various materials

Pulp

Living soft tissue which occupies the pulp cavity of a vital tooth & contains the tooth's blood vessels & nerve supply.

Pulp

It is present in the pulp cavity which occupies the central portion of the tooth. 

Pulp

It contains nerves, lymphatics, and the vessels

Proper order of tooth’s anatomy

Enamel – DEJ – Dentin – Pulp

Pulp

It makes the tooth vital because of the presence of the nerve.

Two: Coronal pulp & Radicular pulp

The pulp organ present in the pulp cavity can be divided into how many parts and what are they?

Coronal pulp

Nerve in the crown portion

Radicular pulp

Extend down from the cervical region of the crown to the root apex

Pulp cavity

Entire internal cavity of a tooth which contains the pulp (Where the pulp is seen).

• Pulp/Root canal

• Pulp chamber

• Pulp horns/cornu

What is the pulp cavity composed of?

Pulp canal/Root canal

Portion of pulp cavity which is located in the root of the tooth.

Pulp chamber

Enlarged portion of pulp cavity which is found mostly in anatomical crown.

Pulp horns/cornu

Usually pointed incisal or occlusal elongations of pulp chamber which often correspond to cusps, or lobes of teeth. Sungay.

Pulp horns

Usually pointed and open to correspond to the elongation of the cusps. Itsura ng cusps = itsura ng horns. Pumapalo sa cusps ng ngipin. 

Accessory nerves/canals

Mga nerves na napupunta sa ibang canals. Ang roots kasi ay may excess canals and if hindi na seal yung canals na yun, ang root canal will be a failure.

Form the dentin — The odontoblast forms the dentin.

What is the main function of the dental pulp?

Function of the dental pulp as a formative

Cells of the pulp produce dentin which surrounds and protects the tissue.

Function of the dental pulp as a sensory/protective

Pertains to the temperature, pressure, or the trauma to the dentin. (Nasiko ng basketball so naapektuhan ang pulp at namaga because of trauma to the dentin.

Na trauma because of pain. Or may extreme temperature na kapag uminom ng malamig na tubig ay sumasakit because there’s already a trauma that occurs in the tooth).

Function of the dental pulp as a defensive/reparative

That's why, when a cavity forms, a temporary filling is sometimes placed to allow the production of secondary or tertiary dentin.

This dentin generates odontoblastic cells around the nerve, which fight infections and form a protective layer to defend the nerve. This process helps repair the affected area of the cavity.

Junctions of the tooth tissues

• Cementoenamel Junction (CEJ)

• Dentinoenamel Junction (DEJ)

• Cementodentinal Junction

Cementum covers the enamel

Cementum overlapping the enamel

End-to-end proximation of the junction

The enamel meets the cementum end-to-end. Dulo-dulo.