118 Section 5 + Permanent Dentition

Flowchart 9.1 : Maxillary central incisor—major anatomic landmarks.

Maxillary central incisor

Crown Root

• Single con;ca! root

Lobes — Mesial Labial Distal Lingual - •3 pulp horns and
single puip canal

Cingulum
Elevations b(on newly erupted tooth)
Mesial

Ridges Incisal ridge Marginal ridge

Distal
Fossa
Grooves

• 2 buccal grooves on labial surface • 2—3developmental grooves

separating 3 lobes may be seen seen in lingual fossa

p its Rare

Flowchart 9.2: Maxillary central incisor—summary.

Maxillary central incisor

Crown

Root
Labial aspect Lingual aspect Mesial aspect Distal aspect Incisal aspect
Geometric form Number
Trapezoidal Trapezoidal Wedge/triangular Wedge/triangular • Triangular • Single
shaped
• Mesioincisal Crown converges Curvature of • Appears bulky Size
angle—sharp lingually Labial outline— cervical line
convex from incisal view • 2—3 mm longer
1 mm shorter than crown
• Distoincisal Lingual surface— Lingual outline— (2—5 mm) • Wider
angle—rounded irregular concavoconvex mesiodistally Form
• Distal contact than • Conical root,
• Incisal ridge— • Cingulum in Height of labial area junction of labiolingually evenly tapers to
very straight cervical third contour—at incisal and
cervical third apex
middle third • Labially broad
• Labial surface— • Shallow lingual
and convex Cross-section at
smooth,convex fossa in middle Height of lingual
both cervico- and incisal third contour—at cervix
cervical third • Lingually-— • Triangular with
incisally and
mesiodistally Usually 2 cingulum seen base labially and
Cervical line— apex linguaily
developmental curves incisally
• Height of labial grooves in lingual (maximum
Incisal edge—
contour—at fossa curvature amon clearly seen Apical root
cervical third all teeth 3.5 mm sloping lingually curvature
Height of lingual perpendicular to • Usually straight,
contour—at
• Incisal ridge is in labiolingual sometimes labial
cervical third line with vertical bisecting line curvature
root axis
Mesial contact—- Apex
area at incisal . Blunt
third near incisal
ridge
Box9.I: Maxillary centralincisor=identification features
Identification features of maxillary central incisor:
Tooth with longest crown and single, conical root
Crown more symmetrical and wider mesiodistally
Greatest cervical line curvature among all teeth
Lingual fossa and cingulum on lingual aspect
Straight incisal ridge
Sideidentification:
Sharp mesioincisal angle and rounded distoincisalangle
 Flowchart 9.3: Maxillary lateral incisor—major anatomic landmarks.
Maxillary lateral incisor

Crown Root

• Single conical root

Lobes Mesial Labial Distal Lingual •2 pulp horns and a pulp
canal

3 mamelons Cingulum
Elevations on newly erupted tooth

Fossa

Grooves Developmental grooves seen in lingual fossa • Palatolingualgroove

Pits Commonly found in lingual fossa

124 Section 5 + Permanent Dentition
Flowchart 9.4: Maxillary lateral incisor—summary.
Maxillary lateral incisor

Crown (smaller and shorter than that of central incisor)

Labial aspect Lingual aspect Mesial aspect Distal aspect Incisal aspect Root
Geometric form Number
• Trapezoidal Trapezoidal Wedge/triangular Wedge/triangular • Oval • Single
Labial outline
• Cervical line— Crown converges convex Curvature of • Wider Size
curves apically lingually cervical line labiolingualjy than • Slender and
Height of labial 1 mm lesser mesiodistally proportionally
• Mesial outline—- Marginal ridges contour cervical longer
straight more pronounced third Palatogingival Crown more
groove may be convex labially Form
• Distal outline— • Cingulum more Lingual outline— seen crossing and lingually than • Conical root
shorter prominent concavoconvex cingulum central incisor
Developmental
• Mesioincisal • Lingual fossa Height of lingual groove
angle—rounded deeper and well contour at • On mesiajand
circumscribed cervical third distal surfaces
• Distoincisal
angle—more Deep Cervical line Apical root
rounded developmental curves incisally curvature
grooves often • Usually distai
• jncisal ridge— present Incisal ridge is in curvature also
more rounded line with root axis labial curvature
not straight • Palatogingival line
groove may be Cross-sectionat
• Labial surface is present • Mesial contact cervix
more convex area—at junction • Oval
than that of Lingual pit and of incisal and
central incisor tubercle common middle third

Box 9.2: Maxillary lateral incisor—identification features.

Identification features ofmaxil/ary lateral incisor.
Tooth with small asymmetrical crown
Slender and proportionately long root
Round mesioincisal and more rounded distoincisalangle
Rounded incisal ridge
Deep lingual fossa with grooves and pits
Side identification:
More rounded distoincisal angle
Incisal ridge slants distally
Root shows distal curvature at apical third

Table 9.3: Differences between maxillary permanent central and lateral incisors (type traits).
Box 10.1: Mand!bular central incisor—identification features.

Identification features of mandibular central incisor

Smallest tooth in permanent dentition
The crown and root narrow mesiodistally and wider
labiolingually
The crown is bilaterally symmetrical
Mesial and distal incisal angles are sharp
Mesial and distal contact areas are at same level near
mesial and distal incisal angles
Viewed incisally, the incisal ridge is perpendicular to the
line bisecting the crown labiolingually
Side identification
Difficult to differentiate left and right mandibular central
incisors since the tooth is bilaterally symmetrical
Developmental depression on root is deeper on distal
surface
The root may show a distal curvature at the apex
 Section 5 Permanent Dentition

Flowchart 10.1 : Mandibular central incisor—major anatomic landmarks.

Mandibular central incisor

Crown Root
• Single conical root
Lobes Mesial Labial Distal Lingual • Single pulp canai

3 mameions Cingulum
Prominences (in newly erupted tooth) (less prominent)

Incisal ridge Marginal ridge

Ridges (straight, perpendicular to
labiolingual bisecting line)
(on lingual aspect)

Mesial Distal

Lingual fossa (shallow,smooth)

Developmental —x No groove
grooves

Pits No pits

Flowchart 10.2: Mandibular central incisor (summary).

Mandibularcentral incisor

Crown

Labial aspect Lingual aspect Mesial aspect Distal aspect Root

Incisal aspect
Geometricshape
. Trapezoidal • Trapezoidal • Triangular/wedge • Triangular/wedge
Number
• Oval labiolingually • Single root
Mesialand distal outlines Lingual Labial and lingual Similar to mesial
Taper evenly convergene Relative Pulp canal
Mesial outlines aspect except that dimensions
from incisal • Crown narrower • Labial—straight, • Single canal
angles to • Cervical line • Crown wider
• Distal on lingual convex at cervical curvature less in Size
narrow cervix labiolingually than
Incisal angles Cingulum 3rd extent by 1 mm mesiodistally . Long root
Small, not • Lingual— Form
• Sharp and right angled Symmetry
prominent concavoconvex . Conical
Jncisal ridge • Crown bilaterally
Lingualfosse Incisal ridge location symmetrical . Convex
• Straight, perpendicular to long • Shallow • Placed lingual to
axis of crown Equal mesial and mesiodistally
concavity the root axis line
• Mamelons in newly erupted (crown inclined
distal halves and flattened
• Smooth, devoid labiolingually
tooth lingually) • More labial surface
of any
Crownsymmetry Lingual inclination seen Apical
developmental
grooves Incisalridge curvature
• Bilaterally symmetrical of crown
• The incisal ridge/ . Usually
Labial surface Marginalridge Crown inclined straight
, Ill defined lingually on root edge in at right
• Smooth, convex, flattened angles to the • Sometimes
incisally Incisal edge base
labiolingual distal
Contactareas • Slopes labially True for all curvature
mandibular teeth, bisecting line
• Both mesial and distal contact facilitates normal Apex
areas at same level—incisal overjet pointed
3rd near incisal angles
 Chapter 10 + The Permanent 137
Mandibular Incisors
Flowchart 10.3: Mandibular
lateral incisor—major anatomic landmarks.
Mandibular lateral incisor

Crown
Root
• Single, conical root
Lobes Mesial Labial • Sometimes bifurcated
Distal Lingual
into buccal and lingual
roots
• Single root canal
sometimes buccal and
lingual canals
Prominences 3 mamelons Cingulum
(on newly erupted tooth) (less prominent)

Incisal ridge
Ridges (curved distally, at an angle to Marginal ridges
the labiolingual bisecting line) (on lingual aspect)

Mesial Distal

Fossae Lingual fossa (shallow,smooth)

Grooves No developmental grooves

Pits No pits

Flowchart 10.4: Mandibular lateral incisor (summary).

Mandibular lateral incisor

Crown

Distal aspect Incisal aspect Root

Labial aspect Lingual aspect Mesial aspect

Geometricshape Number
•Trapezoidal • Trapezoidal • Trapezoidal/ • Triangular/wedge . Oval • Single
wedge Cervical line labiolingually Pulp canal
Crownoutlines Lingual
Crown outlines • Less curved Relative • Single canal
•Mesial convergence dimensions
. Present • Labial-straight Distalsurface • Crown wider Size
—Straight concavoconvex
lingually • Shorter than labiolingually . Long root
—Longer than distal outline Incisal ridge mesial surface
Lingual fossa than Form
• Distal location Distal contact area mesiodistally
• Shallow • Lingual to vertical Conical
—Slightly convex • At incisal 3rd but Symmetry
• Devoid of root axis • Narrow
Crownsymmetry developmental cervical to mesial • Crown bilaterally mesiodistally,
Lingual inclination contact area not symmetrical
• Bilaterally asymmetrical grooves of crown wide and
• Distal half larger Marginalridges • Crown inclined Incisal ridge flattened
lingually over • Not labiolingually
Incisalangles . Relatively well
• Mesioincisal—right angled formed root base perpendicular Sometimes
Mesial surface • Is at an angle to divided into
•Distoincisal— rounded buccal and
• Longer than labiolingual
Incisalridge bisecting line lingual roots
distal surface
• Straight Curves distally
Mesial contact
• Stopes cervically in a distal direction area
•Marnelonsin newly erupted tooth • At incisal 3rd
Labialsurface near mesioincisal
angle
• Smooth convex
• Flat incisally
Table 10.3: Differences between mandibular permanent central and lateral incisors (type traitsr
Characteristics Mandibuiar permanent central incisor Mandibular permanent lateral
Tooth nomenclature
Universal system Right 25; Left 24 Right 26; Left 23
Zsigmondy/Palmersystem
FDI system Right 41; Left 31 Right 42; Left 32
Chronology
Eruption 6-7 years, first tooth to erupt along with 1st molar 7-8 years
Root completion 9 years 10 years
Dimensions Smallest tooth in permanent dentition Slightly larger than the mandibular central incisor in all
dimensions
Crown
Labialaspect
Crown width Smallest tooth Wider than the central incisor
Symmetry Crown bilaterally symmetrical Bilaterally asymmetrical
Mesiai and distal outlines Both mesial and distal outlines are straight Straight mesial outline and slightly curved distal outline
Incisalangles
• Mesioincisal angle Both incisal angles are sharp and right angled • Mesial:Sharp and right angled
• Distoincisal angle • Distal:Slightly rounded
Proximal contacts Both contact areas are at same level, very near to Not exactly same level though still in incisal third.Contact
incisal ridge in incisal third areas are cervically located than those of central incisor
incisal ridge Straight Slopes downwards distally
Lingualaspect
No major differences seen except that the lateral incisor is wider
Marginal ridge Ill-defined Well-defined
incisal ridge/edge Located lingual to the vertical root axis Lingual to vertical root axis
incisal ridge/edge Is at right angles to the labiolingual bisecting line Is at an angle to the labiolingual bisecting line. It is
twisted distolingually on the root base to conformto the
mandibular arch curvature
Cingulum Cingulum is centered mesiodistally Positioned distally (Cingulum is off center to distal)
Root
Number Single Single
Size Shorter and smaller Longer and larger
Developmentalgrooves On both mesial and distal surfaces deeper on distal
On both mesial and distal surfaces
surface
Pulp canals Usually I canal
1 canal
*Mandibular central and lateral incisors appear very similar in
form and could only be differentiated by examining them
from incisal aspect
Box 10.2: Mandibuiar lateral incisor—identification features, BIBLIOGRAPHY
Identification features of mandibular lateral incisor l. Benjamin KA, Dowson J.
Incidence of two canals in human
The mandibular lateral incisor is slightly larger than the mandibular incisor teeth. Oral Surg Oral
Med Oral patholOral
mandibular central incisor Radiol Endod.
The crown is bilaterally asymmetrical 2. Brand RW, Isselhard
DE. Anatomy of Orofacial Structures,5th
Mesioincisal angle is sharp, distoincisal angle is slightly edition. St Louis: CV Mosby;
1994.
rounded 3. Kabak YS, Abbott PV.
Endodontic treatment of mandibLIW
— Viewed incisally, the incisal ridge is placed at an angle to incisors with two root canals:
report of two cases. AustEndod
the line bisecting the tooth labiolingually
Side identification 4. Miyashita M, Kasahara Of
E, Yasuda E, et al. Root canal system
Mesioincisal angle is sharp the mandibular incisor. J
Distoincisal angle 5. Rankine-Willson RW, Endod. 1997;23(8):479-84. ill
Henry P. The bifurcated root canals
lower anterior teet