Tooth morphology,

tooth identification
and enamel
COH Revision for
finals

Revision for finals COH Paediatric Dentistry

Charting teeth differences between deciduous and permanent teeth

Premolars upper=oval in shape, central fossa

lower=round in shape

Suspiciously stained fissure

Deciduous/primary molars
Upper Ds are sort of triangular,
upper premolars are oval
Lower Ds are rectangular,
lower premolars are round
Both upper and lower Ds have
pronounced mesio-buccal cusps

Lower C D and E

Upper premolars

upper D

upper E

Lower premolars

lower D

lower E

Canines
Permanent canines are larger, wider and yellower than deciduous

Consider
the age of the child (usually palpable ~9y)
the eruption of the incisors/premolars (early or late mixed dentition)
the cusp tip of canine (if tip is worn down, likely to be deciduous)
if recent radiograph is available, identify permanent canine

8 yr old boy
Upper canine un-erupted
with root half formed
Lower canine erupted

Abnormal enamel relating to enamel formation

Enamel defect is a broad term describing abnormal enamel

1. Affecting all teeth

numerous types/appearances
a. Fluorosis
b. Amelogenesis imperfecta

Fluorosis

2. Affecting one of more teeth

a. Systemic, affecting teeth developing at time of insult
Chronological/linear hypoplasia, Molar Incisor Hypoplasia (MIH)

b. Local, caused by trauma or unknown etiology

Enamel defects on incisors

Amelogenesis imperfecta

Molar Incisor Hypomineralisation [MIH]

MIH has a systemic origin of one to four permanent first molars frequently
associated with affected incisors. Etiology is presently unknown.
MIH molars are fragile and caries can develop very easily, can be very sensitive
and difficult to manage (preformed metal crowns a treatment option).

www.ukgm.de Marburg Dental Clinic

Enamel defects
1. Enamel hypoplasia (hypo=less, plasia=substance):
groove or pit in enamel surface
2. Enamel hypomineralisation (less mineral, abnormal
maturation): smooth surface but colour differs to
normal
Chronological hypoplasia (time related: all
secreting ameloblasts affected)

Pre treatment

restored

Enamel defect (hypomineralisation) possibly related to traumatic injury of

deciduous incisor affecting permanent incisor - age 18 months/2y

Clinical Significance: High Fever During Enamel

Formation

Childhood diseases causing high temperatures can disturb

amelogenesis for the period of illness and cause a band of
poorly formed enamel known as chronologic enamel hypoplasia.
The position of the line is a snapshot of how much enamel and
dentine had formed at the time..

Hypoplasia on upper central incisors, canines and

lower incisors - disturbance to ameloblasts at
around 9m-1y
First molar occlusal surface may also be affected.
Upper laterals unaffected as insult was prior to
incisal edge formation

Schour and Massler Atlas 1941 London Atlas of tooth development 2009

Hypoplasia on upper lateral incisors

and canines age 2 to 4y

London Atlas of tooth development

Linear/chronological hypoplasia

Insult at age 2 to 3y

Insult at age 4 to 5y