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MORPHOLOGY

OF
PERMANENT MOLARS
Dental Anatomy
Dent 201
Summer semester
2005/20006
Permanent Molars
❧Class traits
● 3 or more cusps
● At least 2 buccal cusps
● One or more lingual
cusps
● In general 2 or 3 roots
Maxillary permanent molars
❧ Arch traits
● 3 roots: 2 B & 1 L
● Crown: BL > MD dimension
● Cusps
• 3 major cusps
– ML, MB & DB
– Arranged in a tricuspate-triangular
pattern
• Lesser-sized DL cusp & sometimes
missing
● Oblique ridge: ML to DB cusp
● B cusps are of unequal size
● ML cusp is larger than DL
Maxillary permanent molars
❧ Type trait (in general)
● DL cusp reduces in size
when going posteriorly &
may be missing in 3rd molar
● 1st molar is the largest & shows
the least morphological variation
● Cusp of Carabelli
● Roots become more D inclined
& much closer when going
posteriorly
Maxillary permanent 1st molar

❧Buccal aspect
● MB & DB cusps are of equal
height
● MB is wider
● Separated by B groove
• Terminates halfway
● Slopes of DB are steeper
● Tip of the ML cusp between B
cusps
Maxillary permanent 1st molar
❧ Buccal aspect
● M profile is highly convex in occlusal
2/3s
● M HOC is ¾ the distance from CL to MR
● Cervical 1/3 is flat or concave
● D profile is entirely convex
● D HOC is 3/5 the distance from CL to
MR
● CL is 2 slightly curved segments
separated by apical peak
Maxillary permanent 1st molar
❧ Buccal aspect
● Buccal surface
• D surface is visible
• Cervical 1/3 is convex
• Occlusal 2/3s are flat
● Roots
• The 3 roots are visible
• B bifurcation is at junction between Cervical &
middle 1/3s
• Shallow vertical groove in the midline of the B root
trunk
• MB & DB roots are narrow & incline to each other
in the apical 1/3 (type trait)
• MB root apex is in line with MB cusp tip (type
trait)
• The longest L root is visible between the B roots
Maxillary permanent 1st molar
❧ Lingual aspect
● 2 cusps of unequal size
● ML cusp
• Makes 3/5s of MD width of the crown
• Prominent & blunt
● DL cusp
• Rounded, shorter & narrower
• Larger than those of 2nd & 3rd max.
molars
(type trait)
● L groove
• Separates L cusps
• Terminates midway of L surface
Maxillary permanent 1st molar
❧ Lingual aspect
● M profile is convex except in the flat C 1/3
● D profile is entirely convex
● L surface
• Evenly convex OC
• L groove divides L surface into M & D segment
• Cusp of Carabelli on M segment (racially variant)
● Roots
• The 3 roots are visible
• Proximal outline of B roots
• L root
– Tapered with blunt apex
– Shallow vertical depression from CL to 2/3s
– L root apex is in line with crown midline (type
trait)
Maxillary permanent 1st molar

❧ Mesial aspect
● Maximum MD dimension at the
cervix of the crown
● ML is higher than MB cusp
● B cervical 1/3 is strongly convex
● B outline continues lingually in a
straight line
● L outline is uniformly convex
● L HOC is at the midpoint
● CL is slightly convex occlusally
Maxillary permanent 1st molar
❧ Mesial aspect
● Mesial surface
• M MR is marked by several tubercles &
supplementary grooves (type trait)
• Contact point is between middle & occlusal 1/3s
• Cervical 1/3 is flat or concave
• Occlusal 2/3s are convex
● Roots
• MB & L roots
• MB root is broad BL
• L root is narrow & Banana-shaped,
curves L then B at the apex
• Both MB & L roots project beyond crown profile
Maxillary permanent 1st molar
❧ Distal aspect
● DB cusp is more prominent than DL
● Only small portions of M cusps are
visible (type trait)
● D MR is shorter & less
prominent than M
● D MR rarely has tubercles
● B & L profiles are similar to
those of M aspect
● CL is nearly straight
Maxillary permanent 1st molar

❧Distal aspect
● Distal surface
• Uniformly convex
● Roots
• 3 roots visible
• DB root is shorter &
narrower than MB root
Maxillary permanent 1st molar

❧ Occlusal aspect
● Square or rhomboidal
● MB & DL angles are acute
● ML & DB angles are obtuse
● 1/3 of B surface & ½ of L
are visible
● B outline: D part is more L
than M part
Maxillary permanent 1st molar
❧Occlusal table
● 2 distinct components
• Trigon
– Bears MB, ML & DB cusps
– Tricuspate triangle
• Talon
– Bears DL cusp & D MR
– Located DL to the tricuspate
triangle
– Well-developed in 1st molar &
undergoes reduction in size in
2nd & 3rd molars
Maxillary permanent 1st molar
❧ Occlusal table
● Cusps in order of decreasing size:
ML, MB, DB & DL
● M MR is longer & more prominent
than D MR
● Oblique ridge
● Major Fossae
• Central fossa
– Central pit
– B & D grooves
– Central groove
• Distal fossa
– D pit
– DL groove which continues as the L groove
Maxillary permanent 1st molar
❧Occlusal table
● Minor fossae
• M triangular fossa
– M pit
– MB & ML supplementary
grooves
• D triangular fossa
– Distal pit
– DB & DL supplementary
grooves
Maxillary permanent 1st molar
❧ Pulp
● MD section
• 2 horns, MB is higher
• Pulp chamber, roof &
floor
• Canals, narrow
• Canal orifice
● BL section
• Pulp chamber is wider
• 2 horns of equal height
● X-section
• 3 canals
Maxillary permanent 2nd molar
❧Buccal aspect (type traits)
● Smaller crown size
● Less prominent DB cusp & narrower
MD
● Distally inclined B roots
❧Lingual aspect
● DL cusp is smaller in width & height
● L root is narrower MD & slightly D
inclined
● No cusp of Carabelli?
Maxillary permanent 2nd molar

❧Mesial aspect
● Less numerous MR tubercles
● MB & L roots are less divergent
❧Distal aspect
● Smaller D cusps
● A greater portion of the occlusal
aspect is visible
Maxillary permanent 2nd molar
❧Occlusal aspect
• MB & DL angles are more acute
• ML & DB angles are more obtuse
• Talon is more reduced in size
• More variable pit/groove pattern
• More numerous supplementary
groove
• Crown is more constricted MD
❧Pulp
● Similar to that of 1st molar
Maxillary 3rd molar
❧Buccal aspect (type traits)
● Crown is smallest in all dimensions
● Roots are much short & commonly
fused
● Shows a pronounced distal
inclination
❧Lingual aspect (type traits)
● DL cusp is usually missing
● L root is commonly fused with the
B roots
Maxillary 3 molar rd

❧Mesial aspect
● Crown profile is irregular
● Fused roots
❧Distal aspect
● DL cusp is absent
● More of the occlusal surface is
visible compared with 1st & 2nd
Maxillary 3rd molar
❧Occlusal aspect (type traits)
● Triangular or heart-shaped
outline
● DB cusp is of minimal size
● Oblique ridge is barely visible
● Pit/groove pattern is variable
● Numerous supplementary
grooves
Maxillary 3rd molar

❧Pulp
● MD section
• Large MB horn &
small DB horn
● BL section
• MB & L horns are
of equal prominence
● X- section
• Ovoid
• Narrow MD
Maxillary 3rd molar

Anatomic variation
Mandibular permanent molars
❧ Upper & lower molars show
progressive reduction posteriorly
(human trait)
❧ The 1st to appear of permanent
dentition (6 yrs)
❧ Arch traits
● 2 roots; M & D
● 4 major cusps & 1 lesser-sized 5th cusp
(in 1st molars)
● Crowns broader MD than BL
● The 2 L cusps are of equal size
● MB & DB cusps are of equal size
Mandibular permanent 1st molar

❧ Buccal aspect
● Widest MD (type trait)
● MB, DB & D cusps
● MB cusp is the widest then DB & D
● MB & DB are of equal height
● D cusp is conical located in the DB
corner
● MB & DB grooves
Mandibular permanent 1st molar

❧ Buccal aspect
● M profile
• C 1/3 is straight or concave
• Occlusal 2/3s are convex
● D profile is entirely convex
● M & D profiles are convergent cervically
● CL is similar to that of upper 1st molar
❧ Buccal surface
● Buccal cervical ridge in C 1/3
● MB groove ends halfway
● DB groove extends most of B surface
length
Mandibular permanent 1st molar
❧Buccal surface
● Roots
• 2 roots; M & D
• Widely separated (type trait)
• Share a common trunk that has
a shallow vertical depression
• Apical half of M root is distally
inclined
• D root projects distally without
curvature
Mandibular permanent 1st molar

❧Lingual aspect
● ML & DL cusps
• Of equal size
• Higher & more conical than B cusps
● Lingual groove
● Narrower MD than B profile
● M & D profiles
• Generally convex except in the
straight or concave C 1/3
• Convergent cervically
Mandibular permanent 1st molar

❧Lingual surface
● Occlusal 2/3s are convex in both
H & V planes
● Cervical 1/3 is flat or concave
❧Roots
● Vertical shallow depression on
the midline of the root trunk
● Proximal surfaces of roots are
visible
Mandibular permanent 1st molar
❧ Mesial aspect
● ML cusp is slightly higher than MB
● MR is higher & has mesial marginal groove
● From buccal cervical ridge, B outline curves
sharply lingually (arch trait)
● L profile is convex
● L HOC between middle & occlusal 1/3s
● M surface is flat or concave in the C 1/3
& convex in the occlusal 2/3s
● Roots
• Broad BL (type trait)
• Blunt apex
• Proximal root concavity
Mandibular permanent 1st molar
❧ Distal aspect
● 3 cusps
• DL, DB & D (order of decreasing size)
• D cusp is L to DB cusp
• DB groove
• D MR is shorter than M & has a distal
marginal groove
• 1/2 of B surface is visible
• CL is straight
• Narrower BL than M surface
• Root
– Broad BL, but narrower than M root
– Blunt apex
– may have shallow depression
Mandibular permanent 1st molar
❧ Occlusal aspect
● Crown is pentagonal (type trait)
● B profile is longer than L
● M profile is longer than D
● B profile
• 3 regions
• DB is the most prominent
• Maximum BL diameter is just D
to MB groove (type trait)
Mandibular permanent 1st molar
❧Occlusal aspect
● MB angle is sharp
● DB angle is rounded
● M & D profiles are convergent
L (type trait)
● L profile 2 regions
● 2/3s of buccal surface are
visible (arch trait)
● L profile: only occlusal 1/3 is
visible
Mandibular permanent 1st molar

❧ Occlusal table
● 5 cusps (type trait)
● 2L cusps, MB, DB & distal (order of
decreasing size)
● L cusps are more pointed & conical
● M & D MRs converge L (type trait)
● M MR is higher and longer
● Marginal grooves
Mandibular permanent 1st molar
❧ Occlusal table
● Fossae
• Central fossa
• 2 M & D triangular fossae
● Grooves
• Central
• MB & L terminate in the
central pit
• DB (y-shape with MB & L
[type trait])
● Pits
• M, D & central
Mandibular permanent 1st molar
❧ Pulp
● MD section
• 2 horns
– MB > DB
• Narrow canals
● BL section
• 2 horns
– ML > MB
• 2 canals in M root
● Transverse section
• Rectangular
Mandibular permanent 2nd molar
❧ Buccal aspect
● Smaller than 1st but larger than
3rd in all dimensions (type traits)
● Only 2 B cusps & 1 B groove
(type trait)
● L cusps are more prominent
from B aspect (type trait)
● Roots (type traits)
• Much closer together
• D inclined
Mandibular permanent 2nd molar

❧ Lingual aspect
● Crown is shorter OC
● Little of proximal surfaces is visible
● M & D profiles are less convergent
cervically
❧ Mesial aspect
● Root is narrower BL with sharp apex
Mandibular permanent 2nd molar

❧Distal aspect
● D cusp is missing (type trait)
● Less of B surface is visible (type
trait)
● D root is much narrower BL with
a pointed apex (type trait)
Mandibular permanent 2nd molar

❧ Occlusal aspect (type traits)


● Crown is rectangular
● B profile = L in length
● M profile = D in length
● Most prominent of B profile
is in the region of the MB cusp
● Maximum BL dimension is
just M to B groove
● M cusps are wider MD than D cusps
Mandibular permanent 2nd molar

❧Occlusal aspect
● MRs
• Straight BL
• Not crossed by marginal grooves
● “+” groove pattern
● More numerous Supplementary
grooves
Mandibular permanent 2nd molar

❧Pulp
● Similar to that of 1st
● BL section
• Usually 2 canals in M root
• Sometimes 1 canal in M
root
● T-section
• M dimension > D
Mandibular 3rd molar

❧Buccal aspect
● Highly variable
● Roots are short, fused & D inclined
❧Lingual aspect
● Short crown of highly bulbous
outline
● Rounded cusps
Mandibular 3rd molar
❧ Mesial
● B & L profiles are highly convex
● Distance between apices of M cusps is
shorter
❧ Distal
● Almost entire B surface is visible
● D root is the narrowest BL & shortest
of all mandibular molars
❧ Pulp is similar to mandibular 2nd molar
Mandibular 3rd molar
❧ Occlusal aspect
● Ovoid in outline
● M half is wider BL than D half
● B & L Profiles converge D
● Highly restricted occlusal table in
MD & BL dimensions (type trait)
● 4 narrow conical cusps
● Highly convex MRs
● Irregular pit/groove pattern
● Shorter grooves
Permanent Molar - size & eruption

Tooth Crown MD crown BL crown Tooth Age at


height diameter diameter length eruption
16 or 26 7.5 mm 10.0 mm 11.0 mm 19.5 mm 6 yrs
17 or 27 7.0 mm 9.0 mm 11.0 mm 18.0 mm 12 yrs
18 or 28 6.5 mm 8.5 mm 10.0 mm 17.5 mm 18+yrs
36 or46 7.5 mm 11.0 mm 10.5 mm 21.5 mm 6 yrs
37 or47 7.0 mm 10.5 mm 10.5 mm 20.0 mm 12 yrs
38 or 48 7.0 mm 10.0 mm 9.5 mm 18.0 mm 18+yrs