MORPHOLOGY OF PERMANENT MOLARS

Dental Anatomy & Occlusion Dent 202

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 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 & 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
Occlusal table

st 1

molar

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 DL cusp is smaller in width & height L root is narrower MD & slightly D inclined No cusp of Carabelli?

Lingual aspect

Maxillary permanent 2nd molar

Mesial aspect

Less numerous MR tubercles MB & L roots are less divergent Smaller D cusps A greater portion of the occlusal aspect is visible

Distal aspect

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 DL cusp is usually missing L root is commonly fused with the B roots

Lingual aspect (type traits)

Maxillary

rd 3

molar

Mesial aspect
Crown profile is irregular Fused roots DL cusp is absent More of the occlusal surface is visible compared with 1st & 2nd

Distal aspect

Maxillary

rd 3

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
Pulp

rd 3

molar

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
Vertical shallow depression on the midline of the root trunk Proximal surfaces of roots are visible

Roots

Mandibular permanent
Mesial aspect

st 1

molar

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 Root is narrower BL with sharp apex

Mesial aspect

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 Short crown of highly bulbous outline Rounded cusps

Lingual aspect

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

rd 3

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
16 or 26 17 or 27 18 or 28 36 or46 37 or47

Crown height

MD crown BL crown diameter diameter

Tooth length

Age at eruption

38 or 48

7.5 mm 7.0 mm 6.5 mm 7.5 mm 7.0 mm 7.0 mm

10.0 mm 9.0 mm 8.5 mm 11.0 mm 10.5 mm 10.0 mm

11.0 mm 11.0 mm 10.0 mm 10.5 mm 10.5 mm 9.5 mm

19.5 mm 18.0 mm 17.5 mm 21.5 mm 20.0 mm 18.0 mm

6 yrs 12 yrs 18+yrs 6 yrs 12 yrs 18+yrs