DENTAL MORPHOLOGY

Introductory notes on the course; human dentition; monophyodont, diphyodont and polyphyodont dentition; tooth - subject of research; palaeontology - taxonomy, physical anthropology, evolution, phylogenetic reconstruction, human genetics; embryology - growth and development - teratology; significance of tooth morphology, clinical dentistry

- Dental notation – Zsigmondy notation system (Zsigmondy cross), Haderup system (+/-), two-digit system, notation using the first letter of Latin-derived names; odontometrics – meaning of the term; anatomical planes – sagittal, frontal and transverse, in which dental specialties they are used and why; permanent incisors – number, size, morphology, first and second upper permanent incisors, first and second lower permanent incisors, crown, root, surface of the tooth; general characteristics of incisors – dimensions

- Permanent canines – upper canines – time of eruption; dimensions; morphology; surface of the tooth; pulp cavity; importance for dental prosthetics; variations in the size of canines; hypodontia of canines

- Human premolars; variations in incisors and canines – upper and lower premolars; differences in the shape of occlusal surfaces and morphology of the crown; number of roots and root canals; variations in the morphology of incisors and canines; accessory cusps; pronounced cusps; supernumerary roots;

- Human permanent molars – general characteristics; number; dimensions; differences in the shapes of the occlusal surface of the upper and lower molars; differences in the number of roots and root canals; pulp cavity images

- Variations in premolars and molars – dimensions; accessory cusps; abnormalities and variations in the shape of the crown, root, pulp chamber, root canals; enamel pearls, cusp of Carabelli

- Gonadal dysgenesis – influence of extra or missing sex chromosomes on the growth and development of dental and osseous structures of the craniofacial region and oral cavity organs.

- Human deciduous teeth – general characteristics; differences and similarities with permanent teeth; number; colour; dimensions, diastemata; morphological characteristics of the crowns and roots of deciduous teeth; chronology of eruption; shape of dental arches of deciduous teeth

- Early stage of human tooth development – tooth development stages; bud stage, cap stage, bell stage; formation of the dental papilla; dentinogenesis; amelogenesis; crown and root development; Hertwig sheath; tooth eruption stages; inner enamel epithelium; outer enamel epithelium; stellate reticulum; odontoblasts; ameloblasts

- Root development, periodontal ligament; Hertwig sheath; epithelial diaphragm; single-rooted tooth development; multi-rooted tooth development; periodontium formation; periodontal ligament formation; alveolar process formation; tooth eruption; tooth eruption stages; chronology of eruption

- Development of occlusion – what is occlusion; types of occlusion; axial position of teeth and roots; relations in the intercuspal position; occlusal surface of teeth; occlusion of the upper and lower dental arch; radiographic images

- Human masticatory system – functional anatomy of the orofacial system; mastication; structures involved in mastication; articulation of the temporomandibular joint; muscles involved in mastication; occlusion of molars

- Dental arch; lip-cheek-tongue system – position of teeth in the upper dental arch; position of teeth in the lower dental arch; curvature of the upper and lower dental arch; various palatal heights; role of tongue in mastication

- Dental articulation, mechanism and characteristics – what is dental articulation; intercuspal position; protrusive movement; retrusive movement; occlusion; ideal occlusion; mandibular movements – symmetrical and asymmetrical; movements of the condyle; external and internal aspect of premolar and molar cusps; guiding cusps; supporting cusps

- Self-protective features of human dentition; interdental spaces; occlusion; dental arch curvature; tooth morphology and its influence; variations in lingual inclination; cementodentinal junction in the upper and lower dental arch; continuity of the upper and lower dental arch; effect of saliva and ferments; effects of vertical, axial and horizontal forces; cheeks and mucosa – protection from mechanical trauma; protection of the periodontium; variations in the shape of teeth affecting the development of periodontal disease

- Microscopic structure of dental hard tissue – including enamel, cementum and dentine; enamel – the hardest tissue in the human body, covers the surface of the crown, consists of enamel prisms, ameloblasts; dentine – the thickest layer of the tooth, covers the enamel, consists of dentinal tubules, high percentage of inorganic compounds; cementum – covers the tooth root, dentinoenamel junction, cementoenamel junction

- Enamel – chemical composition of the enamel; histological structure of the enamel; striae of Retzius, incremental lines; aprismatic enamel; enamel prisms – appearance, shape, size; unmineralised portions of the enamel – lamellae, tufts, spindles, Hunter-Schreger bands; thickness of the enamel on cusps, in the dental neck area; hydroxyapatite crystals, dimensions

- Dentine – chemical composition; histological structure of dentine; dentinal tubules; hydroxyapatite crystals; Tomes' processes; primary dentine; mantle dentine; secondary dentine; reparative secondary dentine; dead tracts, sclerotic dentin; tubular; intertubular; peritubular; atubular; predentine; Tomes' granular layer; permeability; cementodentinal junction

- Dental pulp – pulp anatomy, coronal pulp; radicular pulp; apical foramen; accessory canals; histological structure of the pulp; odontoblasts; fibroblasts; other cells in the pulp; ground substance of the pulp; vascularisation and innervation of the pulp; nutrition of the pulp-dentine complex; function of the pulp; regressive changes; fibrotic changes; denticles; diffuse calcification

- Cementum – the role of cementum on the surface of the root; part of the periodontium; physical and chemical properties; cellular and acellular cementum; age-related differences; cementicles; cementum repair; cementum cells; fibres; cementum resorption

- Anatomy of the periodontium – periodontal ligament, collagen fibres of the periodontal ligament – Sharpey's fibres, periodontal ligament cells

- Physiology of the periodontium – periodontal ligament cells, fibroblasts, cementoblasts, osteoblasts, osteoclasts and cementoclasts, epithelial cells, blood vessels and nerves, lymphatic system.

- Alveolar bone – classification, compact bone and spongy bone; morphology; chemical properties of the alveolar bone; organic matrix; non‐collagenous proteins; bone histology – osteoid; structural characteristics of the bone; Haversian canals; bone cells; (bone resorption); Sharpey's fibres; changes in bone structure

- Oral mucosa – the role of oral mucosa; epithelial layers – basal layer, spinous layer, granular layer, stratum corneum; cytokeratins; non-keratinocyte cells; melanocytes; Langerhans cells; Merkel cells; lamina propria; vermilion border; labial mucosa; alveolar mucosa; free and attached gingiva; dentogingival fibres

- Physiology of the oral cavity

- Vertebrate dentition – dentition of fish, amphibians and reptiles; characteristics of teeth during phylogenesis – changes in the number of teeth, specialisation and number of tooth replacements throughout life; horny teeth; forms of tooth implantation – acrodont, thecodont and pleurodont dentition; aprismatic and prismatic enamel; differences in the structure of dentine; examples of polyphyodont dentitions; chameleon – an example of monophyodont dentition; teeth of non-venomous snakes, snake teeth for injecting poison – a dentine canal or groove at the back side of the fang; turtles.

- Dentition of mammals – differences in the teeth of carnivores and herbivores - Toothless mammals – an example of baleen whales and anteaters; Baleen whales – number of teeth, homodont and polyphyodont dentition; Characteristics of the teeth of mammals – heterodont dentition, reduced number of teeth, highly specialised teeth, diastema; Characteristics of molars – secodont, selenodont, lophodont molars; Characteristics of the teeth of marsupials – carnivores and herbivores; Characteristics of the teeth of insectivores, cusps for piercing chitin shells of bugs

- Characteristics of ever-growing teeth - Definition and characteristics of ever-growing teeth, ever-growing incisors, canines and molars; Characteristics of the histological structure – enamel, dentine and predentine, deposition of secondary and tertiary dentine, dental pulp; Effect of tooth wear on tooth function; Characteristics of tooth eruption in the upper and lower jaw – consequences of fractures, characteristics of eruption in case of absence of the antagonist tooth; Congenital disorders related to ever-growing teeth.

- Evolution and formation of new species

- Dentition of monkeys; dentition of hominids

Topics of preclinical exercises:

1. Introductory notes on the subject matter of the course, terminology related to tooth morphology and dental anthropology, basic information about human dentition, anatomical reference points; topographic and anatomic signs on teeth – signs for identifying teeth; lingual inclination of lateral teeth; types of dental notation; based on a plaster model, students model the crown in a 1:3 ratio – first upper permanent incisor and upper permanent canine – using modelling clay

2. Modelling the crown and root of the first upper premolar using modelling clay, based on a plaster model and carving the second upper premolar in plaster; introductory notes about teeth; practicing various types of dental notation

3. General characteristics of molars (trigon and talon); lateral teeth are the most distal teeth; large occlusal surface area; teeth with supernumerary cups and laminae divided by fissures and grooves; they have an important role in crushing solid food; a total of 12 molars; lower molars – two roots; upper molars – three roots; modelling the first upper permanent molar using modelling clay; common variations in upper premolars; carving the upper lateral incisor in plaster

4. Carving the second upper molar in plaster based on a plaster model, in a 1:2 ratio – crown and roots; common variations in upper permanent molars; cusp of Carabelli – 0-7-grade classification, accessory cusps; reduced number of cusps; supernumerary roots and root canals; modelling the lower permanent central incisor in a 1:3 ratio using modelling clay, based on a plaster model

5. Modelling the second lower molar in a 1:3 ratio based on a plaster model; variability of lower permanent molars; enamel pearls; accessory cusps; root fusion and carving the lower permanent canine in plaster; variability of lower permanent front teeth

6. Modelling the first lower premolar in a 1:3 ratio based on a plaster model and carving the second lower premolar in plaster; lingual inclination of lower lateral teeth; variability of lower premolars

7. Modelling the lower permanent lateral incisor in a 1:3 ratio based on a plaster model and carving the first lower permanent molar; basic forms of lower molar occlusal surface drawings (Y and X)

8. Introductory notes about deciduous dentition in relation to permanent dentition – differences in colour, dimensions, physiological diastemata; eruption chronology; morphological differences; carving the upper deciduous central incisor in plaster and modelling the first upper deciduous molar in a 1:2 ratio using modelling clay, based on a plaster model

9. Modelling the upper deciduous lateral incisor in a 1:2 ratio using modelling clay, based on a plaster model and carving the second upper deciduous molar in plaster

10. Modelling the upper deciduous canine in a 1:2 ratio using modelling clay, based on a plaster model and carving the lower deciduous canine in plaster

11. Modelling the lower deciduous central incisor in a 1:2 ratio using modelling clay, based on a plaster model and carving the first lower deciduous molar in plaster

12. Modelling the lower deciduous lateral incisor in a 1:2 ratio using modelling clay, based on a plaster model and carving the second lower deciduous molar in plaster

13. Drawing morphological characteristics of coronal and root parts of the permanent lower teeth in various sectional views in a 1:2 ratio, using graph paper, based on an existing drawing; labial surface; palatal surface; drawing histological details of coronal and root parts of the permanent lower teeth – enamel, dentine, pulp chamber, cementum.

15. Test of modelling/carving two permanent teeth without a template