Premolars

Cliff Lee
Premolars
• Intermediate between canines and molars
• First premolars  sharp, good for ripping
• Second premolars  bit flatter, better for grinding
• Erupt around 10-12 years
Maxillary first premolar
• Two roots – bifurcates middle or apical third
• 2 pulp horns, 2 roots, 2 root canals
• Lingual shorter, rounder, thinner – one lobe
• On buccal cusp, longer mesial cusp slope than distal cusp slope
• Only tooth with mesial crown concavity
Maxillary first premolar
• Buccal > Lingual
• Buccal MCS > DCS
Maxillary first premolar
• Mesial marginal groove
• Mesial developmental depression
• Cusp tips centered over root
• DMR more cervical than MMR
Maxillary first premolar
• Hexagon shaped

• Occlusal anatomy:
• MBCR / DBCR
• MMR / DMR
• MLCR / DLCR
• BTR / LTR
• MTF / DTF
• CG
• MBDG / DBDG
• MLDG / DLDG
• MDP / DDP
Maxillary first premolar
• Hexagon shaped

• Occlusal anatomy:
• MBCR / DBCR
• MMR / DMR
• MLCR / DLCR
• BTR / LTR
• MTF / DTF
• CG
• MBDG / DBDG
• MLDG / DLDG
• MDP / DDP
Maxillary second premolar
• Very similar to first premolar
• More anatomical variation than first premolar
• Crown less angular (flatter), and more rounded
• Usually one root, but maybe 50% have 2 canals
Maxillary second premolar
• LC ~ BC
• Rounder cusp tip than first premolar
Maxillary second premolar
• No mesial marginal groove
• No mesial developmental
depression

• Other than, pretty similar to first

premolar
Maxillary second premolar
• Looks “wrinkled”
• More oval than hexagonal
Mandibular first premolar
• Smallest premolar
• Narrowest and smallest roots of premolars
• One root, usually one canal (30%ish have two canals)
• Most prominent transverse ridge of premolars

• Only tooth with a mesio-lingual groove

• Only tooth with MMR at a grossly different angle than DMR
Mandibular first premolar
• Can see four surfaces (distal mesial,
occlusal, and lingual) on the lingual
view

• Mesio-lingual developmental groove

separates MMR from LC

• MMR more cervical than DMR

Mandibular first premolar
• Mesio-lingual developmental groove
separates MMR from LC

• TBC centered over long axis of root

• TLC with lingual aspect to root

Mandibular first premolar
• Lots of variation
• Prominent triangular ridge
• Can see most of the buccal surface
• MMR curves cervically (mesio-lingual groove)
Mandibular second premolar
• Transition b/w first premolar and molar
• Bigger than mandibular 1st premolar
• Premolar most likely to be congenitally missing (3rd overall)
• Premolar most likely to have a central pit
• Premolar most likely to have 1 root and 1 canal
• Only premolar that can have 3 cusps
Mandibular second premolar
• Shorter buccal cusp, taller lingual
cusp than 1st premolar
• Cusps rounder/ridges flatter
• Can have two lingual cusps
(mesio/disto lingual)
Mandibular second premolar
• Longer root, blunter apex compared
to 1st premolar
• No mesio-lingual developmental
groove like in 1st premolar
• Crowns point lingually (most
posterior teeth)
• DMR more cervical than MMR
Mandibular second premolar
• 2-cusp = “crescent”, 3-cusp = “Y”
• MLC > DLC
Mesial vs Distal
Tooth Mesial vs Distal
Max 1st PM DMR more cervical than MMR, mesial marginal groove, mesial developmental depression,
mesial CEJ curvature more occlusal
Max 2nd PM DMR slightly more cervical than MMR, mesial CEJ curvature more occlusal
Mand 1st PM MMR more cervical than DMR, mesial CEJ curvature more occlusal
Mand 2nd PM DMR more cervical than MMR