Tooth form

and occlusion
Structure of teeth
 Structure of teeth

The teeth are composed of:

 Enamel.
 Dentin.
 Pulp.
 Cementum.
 Structure of teeth

Enamel

 It covers the anatomical crown of the teeth.

 It is the hardest tissue in the body.
 It is permeable to certain ions.
 It is soluble in acidic medium.
 Enamel surfaces can be etched with acidic
solution to form a pitted and irregular surface.
Enamel

 Chemically, it is composed of 95%

inorganic material and 4% water which
important in ions exchange.
 Structurally, it is composed of enamel rods.
 The structural component of enamel rod is
the appetite crystal.
 Structure of teeth

Enamel

 Enamel rod follow a wavy course.

 They are aligned at right angle to both the DEJ
and the external tooth surface.
 Enamel rods are converge in the concave areas
like pits& fissures, they are diverge in the
convex surfaces like cusps & ridges.
 Enamel rod direction is influence the direction of
enamel walls during cavity preparation
 Structure of teeth

Enamel

 uncut enamel (aprismatic or prismless) in

which the crystalline run parallel to each
other and perpendicular to the underlying
prismatic enamel.
 Enamel pellicle is an organic layer cover
enamel surface formed of protein-fat-
carbohydrayte complex
 Structure of teeth

Enamel

 Important considerations :
During cavity preparation.
During shade selection.
During composite resin restoration.
 Structure of teeth

Dentin

 Dentin is composed of inorganic apatite

crystal embedded in across linked organic
matrix of collagen fibers.
 It is traversed by dentinal tubules which
contain dentinal fluid and odontoblastic
process

 Dentin

 Dentin is formed of 75% inorganic

material, 20% organic material, and 5%
water.
 It is more elastic than enamel.
 It is provides support for enamel.
 Structure of teeth

Types of Dentin

 Primary dentin is formed before and shortly after

eruption.
 Secondary dentin is formed at slower rate after
eruption as a continuation of primary dentin.
 Reparative or tertiary dentin is formed in
response to irritations.
 sclerotic dentin
 Peritubular and intertubular dentin
 Dentin

Dentin sensitivity. 
Dentin permeability 
Smear layer & smear plug 
 Important considerations :

During cavity preparation.

During the restoration.
 Structure of teeth

Dentin

During cavity preparation, dentin can be

distinguished from enamel by:
 Color: dentin is normally yellowish white
and darker than enamel.
 Appearance: a flat dull dentin surface
reflection versus shiny enamel surface.
 Structure of teeth

Dentin

During cavity preparation, dentin can be

distinguished from enamel by:
 Sound: dull sound of dentin when an
explorer is moved across the surface
compared to that of enamel.
 Tactile sensation: a feeling of greater yield
to pressure than enamel.
 Structure of teeth

Pulp
 It is specialized c.t. that occupies the pulp cavity
of the tooth.
 It is circumscribed by dentin, and lined
peripherally by odontoblast.
 It is composed of nerves, arteries, veins, lymph
channels, c.t. cells, odontoblast, intercellular
substance, collagen, and fine fibers.
 Structure of teeth
Pulp

The pulp serves four functions:

 Formative: production of primary and secondary
dentin.
 Nutritive: it supplies nutriments to the dentin
through the blood supply to the odontoblast.
 Sensory: through the presence of nerves.

 Defensive: it responds to different stimuli in

different ways.
 Structure of teeth

Pulp

Defensive action of the pulp:

 Reparative dentin is formed followed mild
irritation.
 Sclerotic dentin and dead tract are other
forms of pulp response.
 In severe irritation the pulp responds by
inflammatory reaction.
Physiology of tooth form
 occlusion
The contact of the opposing surfaces of the two jaws

 Centric relation
 It is a bone to bone relation between maxilla
and mandible when the condyles are in the
near most position in the gleniod fossae
 Centric occlusion
 It is a relation between the upper and lower
teeth wheen the mandible in the centric
relation
 occlusion
The contact of the opposing surfaces of the two jaws

 Maximum intercuspation
 it is the most closed complete inter-digitation
of mandibular and maxillary teeth irrespective
of condylar centricity.
 Physiology of tooth form

 The normal tooth form is the proper

alignment and relations of the tooth with
the adjacent, opposing, and other
related structures in the oral cavity in
order to serve four functions:
1. Mastication.
2. Esthetics.
3. Speech.
4. Protection of the supporting tissues.
 Physiology of tooth form

The form of the teeth refers to:

 Their contour.
 Their contact.
 Their occlusal anatomy.
 Physiology of tooth form

Aims of maintenance of normal tooth form

 Maintenance of healthy and comfortable

masticatory apparatus.
 Ensure efficiency in function.
 Assist in the articulation of certain sounds.
 Important in esthetic.
 Sustaining the teeth in the dental arch by
protection of the supporting tissues.
 Physiology of tooth form

Abnormal tooth form

Abnormal tooth form may lead to:

 Abnormal jaw movements.

 T.M.J. disturbance.

 Affection of the supporting structures.

 Physiology of tooth form

Factors affecting tooth form

 Patient age.
 Type of occlusion-strength of the bite.
 Arrangement of the teeth in the arch.
 Oral health condition.
 General health condition.
 Physiology of tooth form
Tooth contour

 Definition: the convexity of the axial surfaces

of the tooth.
 Function:
1. Protection of the supporting tissues.
2. Stimulation by directing the food parallel to the
gum. In this way it:
 Massages rather than irritate the gum.
 Stimulate circulation.
 Clean the tooth surface
 Physiology of tooth form

Tooth contour
Location:
 Cervical 1/3 of the crown on lingual and facial
surfaces of anterior teeth.
 Cervical 1/3 of buccal surface and middle 1/3
of lingual surface of posterior teeth.
 Proximal height of contour serves:
1. Contact.

2. embrasure.
 Physiology of tooth form

Abnormal tooth contour

 Abnormal flat surface:
Too low height of contour trauma to the
attachment apparatus.
 Abnormal too convex surface:
Too high height of contour the tissue
receive less stimulation tendency to
periodontal disease and caries.
 Physiology of tooth form

Abnormal tooth contour

Sequla of abnormal tooth contour:

 Deprive the tooth from the natural cleaning
mechanism.
 Deprive the gum from the natural massage.

 The food will impinged directly into the

gingiva periodontal affection.
 Physiology of tooth form

Tooth proximal contact

Definition:
 It is the area of height of contour of the
proximal surface of the tooth that touch
its adjacent tooth in the same arch.

Initial contact point contact area

 Physiology of tooth form

Tooth proximal contact

Functions of tooth proximal contact:

 Maintain healthy interdental papillae.

 Increase accessibility of artificial cleansing.

 Maintain the interdigitation of the teeth.

 Maintain the growth of the jaws.

 Maintain proper esthetic appearance.

 Physiology of tooth form

Tooth proximal contact

Location of the proximal contact:

 Incisal third of upper and lower incisors,
slightly to the labial surface.
 Near the junction between the occlusal
and middle third of molars and premolars.
 Physiology of tooth form
Tooth proximal contact
Restoration of the proximal contact:
It is can be done by:
 Proper diagnosis.

 Determine the degree of teeth drifting and

separation.
 Restore contact in proper form, dimension and
location.
 Physiology of tooth form

Tooth proximal contact

Abnormal proximal contact will lead to:

Drifting abnormal stresses

looseness.
 Physiology of tooth form

Tooth proximal contact

Derangement of contact may be due to:

 Caries.

 Local irritant.

 Faulty restoration.
 Physiology of tooth form

Tooth proximal contact

 Faulty restoration at a higher level lead to:

No spillway is created concentration

of stresses fracture of the
restoration especially at the marginal ridge.
 Physiology of tooth form
Tooth proximal contact

 Faulty restoration at a lower level lead to:

No gingival embrasure food

stagnation gingivitis and
periodontitis.
 Physiology of tooth form

Embrasure

 It is a perfect V shaped interproximal space

between each two adjacent teeth and named
for the direction toward which they radiate:
1. Facial.
2. Lingual.
3. Incisal-occlusal.
4. Gingival.
 Physiology of tooth form

Embrasure

 Narrow embrasure wide contact

the food deflected away from the
gingiva atrophy.
 Large embrasure the food will be
forced interproximally gingival
recession.
 Physiology of tooth form

Embrasure

 Improper marginal ridge weak contact

food impaction caries recurrence and
periodontal disease.
 In posterior teeth the lingual embrasure is larger
than the buccal one to allow more food
to be displaced lingually the tongue can
return the food to the occlusal surface
 Physiology of tooth form

Occlusal anatomy

 The teeth are provided with various anatomic

marking on their occlusal surface to serve
many functions:
1. Mastication of food.
2. Stabilization of the jaw in different positions.
3. Maintenance of interarch relationship.
 Physiology of tooth form

Occlusal anatomy

1.Cusps. Definite form.

2.Ridges. Definite size. To
3.Fossa Definite location. perform
4.Groves. Definite relation. function.
 Physiology of tooth form

Occlusal anatomy

 Forces of stable vertical centric closure

directed along the axes of the teeth.
 Improper restoration affection of
the functional performance
physiologic adaptation
development of light wear facets.
 Physiology of tooth form

Occlusal anatomy
 If abnormalities are beyond the adaptive
power of tissue pathologic
changes occur as:
1. Periodontal disease.
2. Teeth wear
3. Looseness of teeth.
4. Development of abnormal chewing habits.
5. TMJ disturbances
 Physiology of tooth form

Occlusal anatomy

 During restoration of teeth the following points

should be noted(clinical consideration):
1. The incisors should be provided with incisal
edges designed to cut food.
2. The cusped have pointed cusps to tear food.
 Physiology of tooth form

Occlusal anatomy

3. Premolars and molars provided with cusps and

ridges acting as mortar and pestles.
a) cusps and groves are mortar and pestle for
crushing food.
b) mesial and distal triangular fossae define
marginal ridges and sharpen occlusal anatomy.
c) supplemental groves widen the pathway for
opposing cusps movements.
 Physiology of tooth form

Occlusal anatomy

4. The mandibular and maxillary teeth are

arranged in opposing arches to facilitate
jaw movements.
5. The cusps and ridges undergo wear by
age flatter.
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