Manish Pandey

Introduction
The mandibular molars are larger than any other

mandibular teeth. The mandibular first molar is the largest tooth in mandibular arch. It has 5 well developed cusps-2 buccal,2 lingual and 1 distal It has 2 well developed roots ,1 mesial and 1 distal.

Importance of permanent mandibular first molar

It maintains arch perimeter
It bears maximum masticatory load It is a key factor in occlusion Has maximum root surface area It provides best anchorage Is a growth center It is most commonly decayed

Chronology
1st evidence of calcification-- at birth
Enamel completed --

2 and a half to 6 yrs Eruption -- 6 to 7 yrs Root completed -- 9 to 10 yrs

Dimensions (in mm)

Cervico occlusal length of crown

-- 7.5 Length of root -- 14 Mesiodistal diameter of crown -- 11 Mesiodistal diameter of crown at cervix -- 9 Buccolingual diameter of crown --10.5 Buccolingual diameter of crown at cervix -- 9 Curvature of cervical line mesially --1 Curvature of cervical line distally --0

Dental formula
Palmers notation -- 6 6
FDI notation Set Class Arch Type

-- 36,46 -- permanent -- molar -- mandibular -- first

BUCCAL ASPECT
Crown is roughly trapezoidal

5cusps are presentmesiobuccal,distobuccal,dista l,mesiolingual and distolingual

Mesiobuccal distobuccal cusps andbuccal portion of

lingual cusp with the tips of lingual cusp can be seen from this aspect.

BUCCAL ASPECT
Mesial outline-is concave at

cervical third upto the convex outline of broad contact area Distal outline- is straight above cervical line to its junction with convex outline of distal contact area

BUCCAL ASPECT
Cervicval line-is

regular,dipping apically towardsroot bifurcation

BUCCAL ASPECT
2developmental grooves

appear on crown Mesiobuccal developmental groove-separates mesiobuccal and distobuccal lobe.it is shorter and terminates centrally crvico-occlusally.

BUCCAL ASPECT
Distobuccal developmental

groove-separates distobuccal and distal lobes.it terminates near the distobuccal ine angle at cervical third.

BUCCAL ASPECT
Mesiobuccal,distobuccal

cusps are flat while distal cusp is pointed Mesiobuccal cusp is widest mesiodistally.

BUCCAL ASPECT
distobuccal cusp is almost as

wide with cusp ridge of somewhat greater curvature. the distal cusp ridge is very round occlusally and is sharper than other 2 buccal cusps

BUCCAL ASPECT
Surface is smoothly convex at

the cusp portions with developmental grooves between the cusps. in the middle third a developmental depression is noticeable which runs in mesiodistal direction above cervical ridge.

BUCCAL ASPECT
Cervical rigde may show

smooth depression progressing cervically. Mesial Distal outline of mesial root is concave from bifurcation to apex root is curved mesially from cervical line to middle third portion.

BUCCAL ASPECT
From here it curves distally to

tapered apex. Distal root is less curved than mesial ,its axis is in distal direction from cervix to apex.

BUCCAL ASPECT
Point of bifurcation of of roots

is located 3mm below cervical line. Deep developmental depression is present bucally on root trunk.

LINGUAL ASPECT
From this aspect Mesiolingual

,distolingualcusps and lingual portion of distal cusp is The lingual cusps are pointed.mesiolingual cusp is widest mesiodistally and is more pointed.

LINGUAL ASPECT
The lingual develomental

groove is present between 2cusps and extends for a short distance

LINGUAL ASPECT
Mesial outline-is convex from

cervical line To marginal ridge. Distal outline is straight from cervical line to distal contact area,this area is represented by convex curvature that outlines distal surface of distal cusp.

LINGUAL ASPECT
Cervical line is irregular and

tends to point sharply towards root bifurcation.

LINGUAL ASPECT
The angle formed by

distolingual cusp ridge of mesiolingual cusp and vice versa is more obtuse than angle formed cusp ridges at tips of lingual cusps.i.e 100 degrees. Distal cusp is at a lower level than mesiolingual cusp. Crest of contour meially is higher than distally.

LINGUAL ASPECT
Surface is smooth and

spheroidaland becomes flat while approaching cervical line. Roots measure 1mmlonger lingually than buccally Root bifurcation lingually starts at a point approx.4mm below cervical line.

LINGUAL ASPECT
Bifurcation groove is in line

with developmental groove of crown.dev.depression is smooth throughout and fades below cervical line.

MESIAL ASPECT
Mesiobuccal,mesiolingual ,

cusps and mesial root is seen Buccolingual measurement is greater mesially then distally.buccolingual measurement of mesial root is greater than distal root. Crown is roughly rhoimboidal and entire crown has less lingual tilt in relation to root axis.

MESIAL ASPECT
Buccal outline is convex

immediately above cervical line outlining buccal cervical ridge.above cervical ridge it is slightly concave or flat occlusally. Lingual outline is straight from cervical line to middle third .the crest of contour is located at center of middle third

MESIAL ASPECT
Lingual outline is straightfrom

cervical line to junctionof middle and apical thirdthen it is sharply buccal to bluntly tapered apex. Cervical line is irregular and curves occlusally about 1mm towards center of mesial surface.

MESIAL ASPECT
The mesial marginal ridge is

placed about 1mm below level of cusp tips.it is confluent with marginal ridges of mesiobuccal and mesiolingual cusps. Surface is smooth and convex. a slightly concave area exists at cervical line and joins the concavity of central portion of root

MESIAL ASPECT
Buccal outline of mesial root

drops straight down to the junction of cervical and middle third of root.a gentle curve starts lingually from this point to apex. Lingual outline of root is slanted in buccal direction.

 Surface is convex at the buccal

and lingual borders with broad concavity between convexities for full length of root.

DISTAL ASPECT
The outline of crown and root

is similar to mesial aspect. The distal cusp is placed a little buccal to center buccolingually with distal contact area appearing on its distal contour. Distal contact area is placed just below the distal cusp ridge of distal cusp at slightly higher level than cervical line.

DISTAL ASPECT
Distal marginal ridge is short

and dipps sharply in cervical direction meeting at obtuse angle. Often developmental groove or ridge is found crossing marginal ridge. Cervical line distally isstraght,dipping rootwise just below distal contact area.

DISTAL ASPECT
The end of distobuccal

developmental groove is located on distal surface and forms concavity at cervical portion ofdistobuccal line angle More of tooth is seen from distal aspect because the crown is shorter distally than mesially and bucal and lingual surfaces converge distally.

DISTAL ASPECT
Smooth flat surface below

contact area remains fairlyconstant to apical third sometimes showing developmental depression. The apical third of root is more rounded as it tapers to a shorter apex

OCCLUSAL ASPECT
It is hexagonal in shape .

The crown measures 1mm more mesiodistally than buccolingually. Buccolingual measurement is greater on mesial than on distal. Crown converges lingually from contact ares.

OCCLUSAL ASPECT
The occlusal surface shows-

1 major central fossa which is circular and centrally placed

2minor fossae-

1)mesial triangular fossa

2)distal triangular fossa

OCCLUSAL ASPECT
The developmental grooves

are Central Mesiobucal Distobuccal And lingual They all converge in the center of central fossa at the central pit.

Occlusal aspect
DBCRdistobuccal cusp ridge DBDG-distal cusp ridge DTF-distal triangular fossa DLCRdistolingual cusp ridge

OCCLUSAL ASPECT

MLCR-mesiolingual cusp ridge MTF-mesial triangular fossa MBCR-mesiobuccal cusp ridge MBDG-mesiobuccal developmental groove

OCCLUSAL ASPECT
LDG-lingual developmental groove SGsupplemental groove

OCCLUSAL ASPECT
It shows 4 major cusps Mesiobuccal Distobuccal Mesiolingual Distolingual And a minor cusp Distal cusp Mesiobuccal cusp is the largest and distal cusp is smallest.

OCCLUSAL ASPECT
Mesial triangular fossa-is

small and concave. The mesial portion of central groove terminates in this path. A buccal and a lingual supplemental groove join it at the mesial pit.

OCCLUSAL ASPECT
Distal triangular fossa-is less

distinct. The central groove terminats here An extension of central groove often crosses the disal marginal ridge.

OCCLUSAL ASPECT

CP-central pit MP-mesial pit DP-distal pit

OCLUSAL ASPECT

MMR-mesial marginal ridge

DMR-distal marginal ridge CDG-central developmental groove

OCCLUSAL ASPECT
The central fossa is a concave

area bounded by distal slope of mesiobuccal cusp, mesial and distal slopes of distobuccal cusps, distal slope of mesiolingual cusp, and mesial slope of distolingual cusp.

OCCLUSAL ASPECT
Central developmental

groove-starts at central pit and travels an irregular course mesially.

OCCLUSAL ASPECT
A short distance mesially from

central pit, it joins mesiobuccal developmental groove which courses in a mesiobuccal direction at the botom of sulcate groove separating mesio and distobuccal cusps.

OCCLUSAL ASPECT
The lingual developmental

groove of occlusal surface is an iregular groove coursing in a lingual direction at the botom of lingual sulcate groove to the junction of lingual cusp ridges. Here it is confluent with lingual extension of same groove

OCCLUSAL ASPECT
Starting at central pit the

central developmental groove may be followed in a distobuccal direction to a point where it is joined by disto buccal developmental groove of occlusal surface. From this point it courses in distolingual direction terminating at distal triangular fossa

OCCLUSAL ASPECT
The distobuccal

developmental developmental groove -passes from its junction with central groove in a distobuccal direction , It joins its buccal extention on buccal surface at the junction of cusp ridges of distobuccal and distal cusps.

OCCLUSAL ASPECT
The central developmental

groove is centally located in relation to buccolingual crown dimension This arrangement makes the triangular ridges of lingual cusps longer tha buccal cusps.

OCCLUSAL ASPECT
The mandibular first molar

mostly has a functioning distal cusp Occasionally, 4 cusp molars are found Sometimes distal and distobuccal cusps may show fusion.

Class traits (molar)

Molars have largest occlusal surface than any other

teeth in the arch. They have 3-5 major cusps. They are the only teeth having 2 or more buccal cusps. They have 2-3 large roots. They are shorter cervico-occlusally but overall dimensions are greater.

Arch traits (mandibular)

Mandibular molars have generally 2 roots-mesial and

distal. They genrally heve 4 major cusps and 5th of lesser size. Crowns are always broader mesiodistally than buccolingually.

Arch traits (mandibular)

They are the only units in dentition in which 2 major

lingual cusps are of equal size. 2 lingual cusps are at higher level and more or less pointed. Mesiobuccal and distobuccal cusps are appriximately equal in size.

Type traits (first)

Presence of 3 buccal cusps and 2 lingual cusps.
Crown shows maximum mesiodistal diameter It is widest of all molars. Mesial and distal profile converge lingually. Crown is narrower at cervix. Almost half of distal surface is made up of distal cusp.

Type traits (first)

Occlusal table is hexagonal.
Mesial and distal roots are highly separated and are

relatively vertical Buccal crown profile and portion of lingual profile is visible from lingual aspect Distobuccal line angle is very much prominent while mesiobuccal line angle is sharp and acute.

Side determination
3 buccal and 2 lingual cusps are present.
Distal cusp is at distal most aspect and is smallest. Mesiobuccal groove is shorter than distobuccal groove. Mesial root is wider buccolingually than distal.

WHEELERS-textbook of dental anatomy and occlusion DAMLE-textbook of pediatric dentistry