PERMANENT

MANDIBULAR MOLARS

 Largest and strongest teeth First , second and third molars Functionally similar but vary in form 2 roots mesial and distal sometimes fused

Mand third molar Mand second molar Mand first molar

Shorter height cervico occlusally MD measurements of all molars > MD measurements of all Mand anteriors MD > BL measurement B

 Perform the major work during mastication because of Bulk due to greater dimensions Anchorage due to multiple roots and bifurcated root trunk

Root bifurcation

B Mand molar MD > BL

D B

L M Max molar BL > MD P D

MANDIBULAR
FIRST MOLAR ( 36 & 46)

MANDIBULAR FIRST MOLAR

BASIC MORPHOLOGY
Largest tooth in the mandibular arch Cusps 5 cusps
Buccal cusps 2 Lingual cusps 2 Distal -- 1 D
M B

 Roots
2 roots mesial root distal root

Broad buccolingually , widely separated at the apices

CHRONOLOGY
First evidence of calcification Enamel completion Eruption Root completion 3 - 4 months 4 - 5 yrs 6 - 7 yrs 9 yrs

MEASUREMENT
Cervico incisal length of the crown Length of the root Mesio distal diasmeter of the crown Mesio distal diameter at the cervix Labiolingual diameter of the crown Labiolingual diameter at the cervix Curvature of the cervical line mesial distal - 9.5 mm - 12.5 mm - 5.0 mm - 3.5 mm - 6.0 mm - 5.3 mm - 3 mm - 2 mm

NOMENCLATURE
SYSTEM Zsigmondy and Palmer Universal FDI system Victor and Haderup
6

TOOTH NUMBER
6

19 , 30 46 36
66-

5 ASPECTS

BUCCAL ASPECT

BUCCAL ASPECT OF MANDIBULAR FIRST MOLAR

OUTLINE OF THE CROWN CUSPS DEVELOPMENTAL GROOVES BUCCAL SURFACE ROOTS

Crown outline
TRAPEZOIDAL IN SHAPE WITH LONGER OCCLUSAL SIDE

 MESIAL OUTLINE  DISTAL OUTLINE  CERVICAL LINE

MESIAL OUTLINE : Concave at the cervical third of the crown Convex mesial contact area DISTAL OUTLINE: Straight above the cervical line Convex distal contact area CERVICAL LINE: Regular in outline dipping apically towards the root bifurcation Mesiodistally 1.5 2 mm less than at the contact areas D M

Cusps
Mandibular first molar has 5 cusps 2 buccal cusps, distal cusp and 2 lingual cusps

From the buccal aspect2 buccal cusps Buccal portion of distal cusp Tips of 2 lingual cusps

Cusps
Size of the cusps: Mesiobuccal cusp - widest mesiodistally, less curvature of the cusp ridges, Distobuccal cusp Distal cusp - as wide as MB cusp, greater curvature of the cusp ridges - smallest of all the cusps and more pointed

Buccal cusps are worn considerably to become flat showing the buccal cusp ridges at the same level

WHY?

Developmental grooves
2 grooves buccally
Mesiobuccal DG Distobuccal DG

Developmental grooves

Mesiobuccal developmental groove

Line of demarcation between mesiobuccal and Distobuccal lobe Shorter of the two grooves Little mesial to the root bifurcation Terminus centrally located cervico occlusally

Developmental grooves
Distobuccal developmental groove
Line of demarcation between Distal lobe and Distobuccal lobe Longer of the two grooves Travels with the axis of the distal root Terminus at the cervical third of the crown near the distobuccal line angle
DBLA

Buccal surface of first molar

Convex and smooth 2 developmental grooves between the cusps Developmental depression at the middle third of the buccal surface (mesiodistally) Cervical ridge at the cervical third of the crown

Roots
Mesial root Distal root Root trunk

Roots
D M

Mesial root
From cervical to middle third mesial curvature From middle third to apical third distal curvature Tapered apex directly below the Mesio buccal cusp Crest of curvature - mesial to the crown cervix

Roots
Distal root
Axis in a distal direction from cervix to the apex Less curved than the mesial root Pointed apex, curved mesially or distally, below or distal to the DCA of the crown

Roots
Root bifurcation
Located 3mm below the cervical line Deep developmental depression progressing cervically No developmental grooves 3mm

I beam principle
From the buccal aspect,
2 roots mesial and distal wider mesiodistally Developmental depressions are present on mesial and distal sides reduces the mesiodistal diameter of the roots at these areas Roots are thicker at the lingual borders

I beam principle

Buccal

Cross section at the furcation level of the root

I beam principle
Developmental depression on distal side L L Developmental depression on mesial side

D B

M B

LINGUAL ASPECT

LINGUAL ASPECT OF MANDIBULAR FIRST MOLAR

CROWN OUTLINES CUSPS DEVELOPMENTAL GROOVES LINGUAL SURFACE ROOTS

Crown outline

Mesial outline Distal outline Cervical line

D M

Crown outline
Mesial outline
Convex from the cervical line to the MMR Crest of contour is at a higher level (MCA) DMR MMR

Distal outline
Straight above the cervical line Convex DCA( distal surface of the distal cusp) Junction of DL cusp with the DMR is sharp - sometimes groove present at this junction Disto lingual cusp D M

Crown outline
Cervical line
Irregular Points sharply towards the root bifurcation

Cusps
cusps seen Lingual cusps
Pointed high cusp ridges D ML higher than , Width ML = DL Cusp ridges form obtuse angles (100 degrees) at the cuspal tips M 2 lingual cusps & Lingual potion of distal cusp

Distal Cusp
Lower level than the
Distal

ML DL

mesiolingual cusp

Grooves
Lingual developmental groove
Line of demarcation between two lingual cusps Travels for a short distance only

Lingual surface
Smooth and spheroidal on the lingual lobes Concave at the groove area Flat at the cervical region

Part of mesial and distal surfaces are seen due to lingual convergence of the crown mesiodistally

Roots
Mesial and distal roots
Measure 1mm longer than the buccal aspect

Why?

Roots
Cusp ridges and the cervical line are placed at a higher level than on the buccal surface of the crown, increasing the distance from the root bifurcation to the cervical line

buccal

lingual

Roots
Root bifurcation
Starts approx. 4mm below the cervical line Deep developmental depression present in line with he lingual groove on the crown
4mm

MESIAL ASPECT

Mesial surface of mandibular first molar

FEATURES SEEN FROM THIS ASPECT CROWN OUTLINE MESIAL MARGINAL RIDGE SURFACE ROOT COMPARISON WITH SECOND PREMOLAR

Features viewed from the mesial aspect

Mesial surface of mandibular first molar

2 cusps and 1 root
mesiobuccal and mesiolingual cusp mesial root Buccolingual measurement of

crown and root > than on the distal aspect

Crown is rhomboidal in shape Entire crown has a lingual tilt in relation to

the root axis MESIAL ASPECT

Crown outline
Buccal outline Lingual outline Cervical outline

Crown outline
Buccal outline
Convex above the cervical line cervical ridge buccal cervical ridge Above the ridge, it can be less convex or concave or flat
M3 L3 B L

Mesio buccal cusp is placed over the buccal third of the mesial root

B3

Crown outline
Lingual outline
Straight from the cervical to the middle third Pronounced lingual curvature from the

middle third to the tip of the mesiolingual cusp

M3

L3 B3

Tip of the ML cusp is placed above the lingual third of the root

Crown outline
Cervical line
Irregular and curves occlusally towards the center of the mesial surface Placed at a higher level lingually than buccally when tooth is posed vertically. When it is lingually tilted as in the oral cavity, the cervical line is in the same level buccolingually.

Marginal ridge
Mesial marginal ridge is confluent with the mesial ridges of mesiolingual and mesiobuccal cusp Placed about 1mm below the level of the cuspal tips

Mesial surface of the crown

Convex and smooth over the mesiobuccal and mesiolingual lobes Concavity at the center of the mesial root Contact area centered buccolingually on the mesial surface, below the crest of the marginal ridge

Mesial root
Buccal outline Straight from the cervical line till the middle third Curves lingually from the middle third to the apex Apex placed below the mesiobuccal cusp

Lingual outline

Slanted in a buccal direction Bluntly tapered apex

Mesial surface is convex with broad concavity in the middle to the full length of the root

DISTAL ASPECT

Distal surface of mandibular first molar

Features seen from this aspect Distal marginal ridge Surface of the crown Cervical line Developmental groove Root

Features viewed from the distal aspect

Features viewed

Part of all the 5 cusps Part of occlusal surface Distal marginal ridge Distal root Part of mesial surface of the crown and root

Distal marginal ridge

DMR short ridge formed by distal cusp ridge of the distal cusp and distolingual cusp ridge of the distolingual cusp, meeting at an obtuse angle

A developmental groove or depression crosses the DMR

Distal surface of the crown

Distal cusp is seen DC A below the distal cusp ridge above the cervical line centered over the distal root buccal to center point of DMR Convex surface Flattened area below the contact area by wear

Cervical line

Straight or irregular across buccolingually

Developmental groove

The end of distobuccal developmental groove is located on the distal surface Forms a concavity at the cervical portion of distobuccal line angle

Root
Flat surface till the apical third Tapers to a sharp apex Lingual border of the mesial root is seen Sometimes a developmental depression is seen

OCCLUSAL ASPECT

Occlusal aspect of mandibular first molar

Features viewed Outline of the crown Cuspal details Fossae Developmental grooves

Features viewed from occlusal aspect

Greater part of buccal surface Small portion of lingual surface, lingual to lingual cusp ridges Mesial and distal marginal ridges All the 5 cusps with developmental grooves and fossae Mesial or distal surfaces are not seen

Crown outline
Hexagonal in form MD measurement > BL measurement BL measurement mesially > distally MD measurement buccally > lingually
B D M M B

Cuspal details
Size of the cusps 1. 2. 3. 4. Mesiobuccal cusp Lingual cusp Distobuccal cusp Distal cusp (also functional)
2 2 4 3 1

Occasionally four cusp molars - quadrilateral

fusion of distobuccal and distal cusp with no distobuccal developmental groove between them

Developmental Fossae
Fossae on mandibular first molar

Major fossa

Minor fossa

Central fossa

2Minor Fossae

Developmental Fossae
Central fossa
Placed between the buccal and lingual cusp ridges Concave roughly Centrally circular in shape Central pit in the center of the central fossa
B

Developmental Fossae
Minor fossa
Mesial triangular fossa
Distal to mesial marginal ridge Smaller than central fossa Bounded by mesiobuccal cusp, mesiolingual cusp and MMR D M

MMR

Developmental Fossae
Minor fossa
Distal triangular fossa
mesial to distal marginal ridge Less distinct than mesial fossa Bounded by distolingual cusp, distal cusp and DMR D

DMR

Developmental grooves
1. 2. 3. 4. 5. Central developmental groove Mesiobuccal developmental groove Distobuccal developmental groove Lingual developmental groove Supplementary grooves
3 1 4 2 5

Developmental grooves

MESIOBUCCAL DG DISTOBUCCAL DG CENTRAL DG LINGUAL DG

Developmental grooves
CENTRAL DEVELOPMENTAL GROOVE FROM THE CENTRAL PIT ON THE CENRAL FOSSA

MESIAL TRIANGULAR FOSSA JOINING THE MESIOBUCCAL DG IN THE MIDDLE

MESIOBUCCAL DG COURSES IN THE MESIOBUCCAL DIRECTION SEPERATING THE MESIO AND DISTO BUCCAL CUSP RIDGES

MESIOBUCCAL DG OF THE OCCLUSSAL SURFACE JOINS THE MESIOBUCCAL DG ON THE BUCACL SURFACE

Developmental grooves
CENTRAL DEVELOPMENTAL GROOVE FROM THE CENTRAL PIT ON THE CENRAL FOSSA

DISTAL TRIANGULAR FOSSA JOINING THE DISTOBUCCAL DG IN THE MIDDLE

DISTOBUCCAL DG COURSES IN THE DISTOBUCCAL DIRECTION SEPERATING THE DISTAL CUSP AND DISTO BUCCAL CUSP RIDGES

DISTOBUCCAL DG OF THE OCCLUSSAL SURFACE JOINS THE DISTOOBUCCAL DG ON THE BUCACL SURFACE

Developmental grooves
LINGUAL DEVELOPMENTAL GROOVE

FROM THE CENTRAL PIT ON THE OCCLUSAL SURFACE , TOWARDS THE LINGUAL DIRECTION, SEPERATING THE 2 LINGUAL CUSP RIDGES

JOINS THE LINGUAL DG ON THE LINGUAL SURAFCE

CENTRAL DEVELOPMENTAL GROOVE

PULPAL ANATOMY

OCCLUSION