Dental Anatomy, Embryology, and Histology Units 12-15 Exam 2, Exams of Dental Anatomy

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Dental Anatomy, Embryology, and

Histology Units 12-15 Exam 2

Protrusive - Anterior/forward postion Retrusive - -Posterior/backward position -NOT A FUNCTIONAL MOVEMENT Occlusion - Contact of teeth and mandibular arch with those in the maxillary arch Centric occlusion - -Relationship of opposing occlusal surfaces which provide maximum contact -Posterior teeth are touching and anterior teeth have very light or no contact Centric relation - -Most unstrained retruded position of the heads of the condyle in the glenoid fossae -Most retrusive position of the mandible in relation to the maxilla Functional or dynamic occlusion - Tooth contacts while the mandible is in action during mastication (chewing) and swallowing Vertical rest - -Relaxed position of the jaws with teeth separated 2-6mm -Lips closed and the tongue behind the maxillary centrals Restricted opening - Use three fingers vertically Curve of Spee - -Viewed from buccal aspect -Cusp tips curve anterior to posterior -Curve of occlusal surfaces of the arches

Curve of Wilson - -Best viewed from the anterior aspect with the mouth slightly open -Cusp tips of the posterior teeth follow a gradual curve from the left side and the right side of the mouth -Curve in mandibular arch is concave; curve in maxillary arch is convex Overjet (horizontal overlap) - -Abbreviated OJ or HO -Incisal edges of the maxillary anterior teeth are labial to the mandibular incisors -Excessive overjet is over 3mm Overbite (vertical overlap) - -Abbreviated OB or VO -Incisal edges of the maxillary anterior teeth extend below the mandibular anteriors -Don't measure in mm Intercuspation - -Cusps of the maxillary teeth rest between cusps of the mandibular teeth (posterior teeth) Right lateral excursion - Contracting left external pterygoid Left lateral excursion - Contracting right external pterygoid What happens in lateral excursion? - In lateral excursion the side to which the jaw moves is the working side, the other side is the balancing side Angle's key to occlusion - Permanent maxillary and mandibular first molars Normal occlusion is the ____ relationship - Ideal

Explain normal/ideal occlusion - -The mesiobuccal cusp of the maxillary first molar is in the mesiobuccal groove of the mandibular first molar with all teeth in alignment -The maxillary canine is in the embrassure of the mandibular canine and the first premolar Malocclusion - The incorrect positioning of one or more teeth Class I malocclusion - -AKA neurtoclusion -The same positioning of the molars and canines as in normal occlusion with some malposition teeth Class II malocclusion - -Distoclusion -The mesiobuccal cusp of the maxillary first molar is mesial to the mesiobuccal groove of the mandibular first molar -The canine is between the canine and the lateral incisior -Two divisions: Divison 1- the maxillary incisors are protruded (Bugs Bunny) Division 2- the maxillary incisors are retruded (Cher) Class III malocclusion - -Mesioclusion -The mesiobuccal cusp of the maxillary first molar is distal to the mesiobuccal groove of the mandibular first molar -The canine is in the middle of the first premolar Should you check both sides of the mouth when checking occlusion? - Yes If Angle's key to occlusion is missing can you classify occlusion? - No

Crossbites - -Anterior crossbite: maxillary anterior incisors are lingual to the mandibular incisors; can be bilateral or unilateral -Posterior crossbite: Posterior teeth are either buccal or lingual to their normal position; bilaterally or unilaterally Edge-to-edge - Incisal edges to incisal edges; anterior teeth (Picture is an example of edge-to-edge with openbite) End-to-end - Cusp to cusp; posterior teeth (Picture is an example of end-to-end Openbite - -Lack of occlusal or incisal contact between certain maxillary and mandibular teeth -Need to measure in mm -Observed when in centric occlusion Example: posterior teeth in contact; anterior teeth no contact Normal/mild overbite - Incisal edges of maxillary teeth are within the incisal third of the mandibular teeth Moderate overbite - Incisal edges of maxillary teeth appear within the middle third of the mandibular teeth Deep (severe) overbite - Incisal edges of the maxillary teeth are within the cervical third of the mandibular teeth Buccoversion - -Buccal to its normal position -AKA facioversion

Labioversion - -Labial to its normal position -AKA facioversion Linguoversion - Tooth lingual to its normal position Supraversion - Tooth extended coronal to the line of occlusion Infraversion - A tooth extended apical to the line of occlusion Torsoversion - Tooth that is rotated or turned from normal position Diastemas - -Spacing in a permanent dentition -Needs to be measured in mm Midline shift or deviation - -Distance between the maxillary midline and the mandibular midline -Needs to be measured in mm -If diastema is present or teeth are missing you this can't be measured Mesognathic facial profile - Protruded jaws, straight profile Prognathic facial profile - Prominent mandible and normal maxilla Retrognathic facial profile - Prominent maxilla with a retruded mandible

Primate spaces - -Normal diastemas or gaps in a tooth row in primary dentition -Lack of primate spaces may suggest future othodontic problems Functional contacts - Normal contacts of maxillary and mandibular teeth during swallowing, mastication, and speaking Parafunctional contacts - Outside the norm, usually nervous habits which can be dangerous to supporting structures Tooth-to-tooth - Bruxism (grinding), clinching, and tapping Tooth-to-hard objects - Nail biting, pins, pencils, and ice Tooth-to-oral tissue - Cheek biting, lip biting, and cuticle biting Types of trauma from occlusion - -Primary: Excessive occlusal force exerted on a tooth with normal bone support (a high restoration) -Secondary: Occlusal force on a tooth with bone loss already present Effects of trauma from occlusion - -Circulatory disturbances -Tissue destruction -Bone resorption Clinical findings - -Mobility: different classes -Fremitus: vibration or movement upon palpation -Sensitivity to pressure -Occlusal wear, wear facets

-TMJ problems -Open contacts -Muscular disturbances Need to teach the patient - -Role of malocclusion in periodontal disease and dental caries -Malocclusion and dental care (brushing, flossing) -Space maintaining for primary and permanent dentitions -Necessity for early dental care for children Glabella - Elevated area between the eyebrows (flat in kids) Frontal eminence - Prominence of the forehead (pronounced in kids) Label the ear - A- External acoustic meatus B- Intertragic notch C- Lobule D- Antitragus E- Tragus Is the external acoustic meatus and tragus important for extraoral radiographs? - Yes Lacrimal gland - -Behind each upper eyelid and within the orbit -Produces lacrimal fluid fluid or tears -Can cause nose to run as well

Lateral canthus - Outer corner where the upper and lower eyelids meet Medial canthus - Inner angle of the eye Naris - Nostrils- inferior to the apex Plural is nares Ala of the nose - Winglike cartilaginous structures Plural is alae Mental protuberance - Prominence of the chin Are lips the gateway to the oral region? - Yes Vermilion zone - -Transition area between the skin of the face and the oral mucosa -Where lipstick goes Vermilion border - -Lips are outlined from the surrounding skin by a transitional zone -Where lipliner goes Philtrum - -Midline of the upper lip, extending downward from the nasal septum -Vertical groove Labial commisure - Upper and lower lips meet at each corner of the mouth

Nasolabial sulcus - Groove running upward between the labial commisure and the ala of the nose Labiomental groove - Separates the lower lip from the chin in the mental region Vestibules - Upper and lower spaces between the lips, cheeks, and gums Oral cavity proper - Extends from the lingual surfaces of teeth to the oropharynx (throat) Fordyce granules/spots - -Small, yellowish elevations on the mucosa -Misplaced sebaceous glands -Often seen on labial and buccal mucosa -Usually happen after puberty Parotid papilla (Stenson's Duct) - -Inner portion of buccal mucosa; opposite the maxillary second molar -Small elevation of tissue -Contains the duct opening from the parotid salivary gland Mucobuccal fold - -Deepest and highest part of vestibule -Fold in vestibule where the labial or buccal mucosa meets the alveolar process Maxillary tuberosity - -A small, rounded extension of bone, covered with soft tissue -Posterior to the last maxillary tooth Retromolar area/pad - -A triangular area of bone, covered with dense, soft tissue -Posterior to the last mandibular tooth

Median palatine raphe - Midline ridge of tissue on hard palate Incisive papilla - -Small bulge of tissue -Lingual to anterior teeth Palatine rugae - -Directly posterior to incisive papilla -Firm, irregular ridges Fovea palatinus - -Two small indentations; one on either side of the median palatine raphe -Located at the junction of the hard and soft palate -Remnants of minor salivary glands Uvula - Downward projection of the soft palate Pterygomandibular fold - -Fold of tissue that extends from the junction of the hard and soft palate down to the mandible Base of the tongue - -Posterior 1/ -Base attaches to the floor of the mouth -Base lies within the oral part of the throat Body of the tongue - -Anterior 2/ -Lies within the oral cavity Doral and ventral surface of the tongue - -Dorsal is top surface; known as dorsum

-Ventral is the underside of the tongue Median lingual sulcus - Midline depression on the dorsum surface Sulcus terminalis - V-shaped groove that separates the base from the body of the tongue Papillae of the tongue - Filiform- slender; thread-like NO TASTE FUNCTION; provide tactile sensation Fungiform- red, mushroom-like, more numerous at the apex and contain tastebuds Circumvallate- 10-14 in number; line up along the sulcus terminalis; have taste buds Foliate- posterior lateral surface of the tongue; noted for its vertical ridges; some contain taste buds Foramen cecum - -Where the sulcus terminalis points backward toward the throat -Pit like depression Plica fimbriata - -Located on ventral surface of the tongue; lateral to each lingual vein; a fold with fringe- like projections -Plicae fimbriatae is plural Lingual frenum - -Midline fold of tissue between the ventral surface of the tongue and the floor of the mouth Sublingual fold - -Ridge of tissue on each side of the floor of the mouth -Contains duct openings from the sublingual salivary gland Sublingual caruncle - -Round elevation at the anterior end of each sublingual fold on either side of the lingual frenum -Contains opening for Wharton's duct

Fauces - -Isthmus (narrowing); opening from the oral cavity into the pharynx (arches) Anterior tonsillar pillar or glossopalatine arch - -Thin fold of tissue extending lateral and inferior from both sides of the soft palate to the base of the tongue -Marks entry to the pharynx Posterior tonsillar pillar or pharyngopalatine arch - -Thin fold of tissue more posterior and narrower than the anterior arch Palatine tonsils - -Lymphoid tissue found in between the anterior tonsillar pillar and posterior tonsillar pillar What are the functions of bones? - -Provides a rigid support system -Protects delicate structures -Supplies calcium to blood; formation of blood cells -Attachment of muscles Types of bones with examples - -Long bones: extremities femur and upper arm -Short bones: wrist, ankle bones, hands, feet -Flat bones: ribs, cranial bones -Irregular bones: vertebrae, facial bones -Sesamoid bones: rounded mass of bone embedded in certain tendons (patella) -Alveolar bone: specialized bone found in the maxilla and mandible Divisions of the skeleton - -Axial skeleton: 74 total -Appendicular skeleton: 126 total

Neurocranium - Bones surrounding the brain (cranial bones)

• -Occipital:
• -Frontal:
• -Sphenoid:
• -Ethmoid:
• -Parietal:
• -Temporal:
• -Mandible: Viscerocranium - Bones surrounding the face (facial bones)
• -Vomer:
• -Maxillae:
• -Zygomatic:
• -Lacrimal:
• -Nasal:
• -Inferior nasal conchae:
• -Palatine:
• Major sutures on the skull - -Coronal #
• -Squamosal #
• -Sagittal #
• -Lambdoidal #42,
• -Intermaxillary #
• -Median palatine #

-Transverse palatine # Fontanels: soft spots (ossification happens after birth) -Bregma: anterior fontanel where sagittal and coronal sutures meet -Lambda: posterior fontanel where sagittal and lambdoidal sutures meet What bones make up the orbit of the eye? - -Frontal -Ethmoid -Lacrimal -Zygomatic -Sphenoid (greater wing and lesser wing) -Maxilla -Palatine bones What structures make up the nasal cavity? - -Piriform aperture # -Nasion -Bridge of nose -Nasal conchae #16a -Nasal septum #17 vomer and #15 ethmoid Occipital bone - -Foramen magnum: largest foramen -Occipital condyles: # -Hypoglossal canals: # -Jugular notch: marked in pen -Jugular foramen: # -Foramen lacerum: #36 (usually filled with cartilage throughout life

Frontal bone - -Frontal eminence -Glabella -Supraorbital ridge -Supraorbital notch/foramen Temporal bones (3 parts) - Squamous (fan-shaped) -Articular/glenoid/mandibular fossa #30 (where mandible fits) -Articular eminence # -Postglenoid process Tympanic -External acoustic meatus # -Petrotympanic fissure (marked by a line) Petrous -Mastoid process #5 and mastoid notch #32 red -Styloid process # -Stylomastoid foramen # -Jugular notch of temporal bone (marked in orange) -Jugular foramen # -Internal acoustic meatus # -Carotid canal (carries internal carotid artery) # -Foramen lacerum # Sphenoid bone - Body of sphenoid bone (middle portion) -Contains sphenoid sinuses #62 and 63

-Sella turcica (holds pituitary gland which supplies hormones) Processes of the sphenoid bone -Lesser wing #60; most anterior process and makes up base of orbital apex -Greater wing #61; posterior lateral process -Pterygoid process (inferior to greater wing of sphenoid); Lateral pterygoid and medial pterygoid and pterygoid fossa between them -Spine of sphenoid bone -Hamulus: off the medial pterygoid plate -Infratemporal crest Foramina of the sphenoid bone -Foramen lacerum #36. Foramen ovale #34. Foramen rotundum #68. Foramen spinosum #35. Inferior orbital fissure #12. Optic canal and foramen #66. Pterygoid canal (green dot). Superior orbital fissure # Ethmoid bone - -Perpendicular/vertical plate: forms superior part of the nasal septum; contains crista galli # -Horizontal cribriform plate: olfactory nerves pass through # -Lateral portions of ethmoid bone forms superior and middle nasal conchae and paired orbital bones -Between orbital plate and nasal conchae are where the ethmoid sinuses are located Palatine bones - -Vertical plate: forms parts of lateral wall of the nasal cavity and a small portion of orbital apex # -Horizontal plate: forms posterior 1/3rd of hard palate # Two foramen -Greater palatine foramen # -Lesser palatine foramen

What two bones have no muscle attachment? - Vomer bone(forms lower part of nasal septum)#17 and inferior nasal conchae #16a Maxilla - -Frontal process # -Inferior orbital fissure -Infraorbital foramen # -Canine eminence # -Canine fossa -Zygomatic process # -Median and transverse palatine suture #52 and # -Incisive foramen #31 (underneath the incisive papilla Mandible - -Mental protuberance (area around #18) -Symphysis (around #18) -Mental foramen # -Body of mandible -Alveolar process -Ramus/rami (plural) (20 through 21) -Coronoid process # -Coronoid notch (down the slide of coronoid process) -Condyle # -Neck of condyle -Mandibular/sigmoid notch (between coronoid process and condyle) -Angle of the mandible # -External oblique line -Genial tubercules/mental spines (where the screw is located on the skull)

-Retromolar triangle -Mylohyoid ridge/internal oblique line #34 red -Sublingual fossa (above mylohyoid ridge) -Submandibular fossa (below mylohyoid ridge) -Mandibular foramen # -Lingula (projection off of mandibular foramen) -Mylohyoid groove (groove above #27 blue) -Pterygoid fovea #26 blue Bones of the neck - Cervical vertebrae -Atlas: first cervical vertebrae -Axis: second cervical vertebrae Hyoid bone -U-shaped bone -Suspended by ligaments from the styloid process -Doesn't articulate with any other bones -Many muscles attach to the hyoid bone Paranasal sinuses - -Paired, air-filled cavities in bone -Lined with mucous membranes -Sinuses communicate with the nasal cavity through small ostia or openings in the lateral nasal walls to the various meatuses Functions of paranasal sinuses - -Lighten the skull so it's not heavy -Provide mucous for the nasal cavity (if mucous becomes inflamed it can cause congestion which can lead to sinusitis)

-Acts as a sound resonator (helps to amplify sound which makes it sound like a stereo; rich and loud Frontal sinuses - Location -Superior to nasal cavity -Paired; drains into middle meatus Sphenoid sinuses - Location -Body of the sphenoid bone -Paired; drains superior to each superior nasal conchae Ethmoid sinuses - Location -In the ethmoid bone; variable number of small cavities in the lateral mass of ethmoid bone -Drains into the middle and superior meatuses Maxillary sinuses - Location -Body of maxilla -Largest of the paranasal sinuses; often seen on x-rays; roots of max. teeth may innervate sinuses -Drained by the middle meatus of the nasal cavity Clinical importance of sinuses in dentistry - -When patient has a cold or sinus infection their posterior teeth may ache -If a patient has an infection at the apex of a tooth, the infection may perforate the sinus floor and infect the sinius mucosa -During an extraction, it's possible for a root to fracture and enter the maxillary sinus General functions of muscles - -Movement; locomotion

-Hold the body erect -Movement of fluids (such as blood and urine) Types of muscles - -Skeletal: voluntary and attached to bones of the skeleton -Smooth: visceral: involuntary and controlled by the autonomic nervous system -Cardiac: involuntary and found in the heart Origin of muscles - -End of a muscle attached to the least moveable structure (red on the skull) Insertion of muscles - -End of a muscle attached to the more moveable structure (blue on the skull) When the muscle is contracted does the insertion move toward the origin? - Yes Action - -Function of muscles; muscle fibers contracts causing movement Cervical muscles - Sternocleidomastoid #31 blue -Origin: medial portion of clavicle and sternum's superior and lateral surfaces -Insertion: mastoid process of temporal Trapezius #149 red -Origin: occipital bone (occipital protuberance) -Insertion: clavicle and scapula Muscles of mastication - Masseter # -Origin: superficial head: anterior 2/3rds if lower border of zygomatic arch. Deep head: posterior 1/3rd of lower border of zygomatic arch and medial surface of zygomatic arch

-Insertion: superficial head: lateral surface of the angle of the mandible. Deep head: ramus of the mandible Temporalis #25 -Origin: temporal bone: specified by the temporal fossa -Insertion: coronoid process of mandible and anterior border of ramus of mandible Muscles of mastication continued... - Medial pterygoid or internal pterygoid #27 -Origin: maxillary tuberosity and medial surface of lateral pterygoid plate -Insertion: medial side of mandible between mandibular foramen and angle Lateral pterygoid or external pterygoid -Origin: superior head; inferior surface of the greater wing of the sphenoid bone. Inferior head; lateral surface of the lateral pterygoid plate of the sphenoid bone -Insertion: both heads; anterior surface of the neck of the mandibular condyle at the pterygoid fovea and capsule of the TMJ Muscles of facial expression - Corrugator supercilli #13 -Origin: frontal bone (supraorbital ridge) -Insertion: eyebrow -Action: frowning- vertical wrinkles in forehead Procerus #9 -Origin: bridge of nose -Insertion: medial end of the eyebrow -Action: pulls eyebrows downward Orbicularis oris #14 -Origin: encircles mouth -Insertion: angle of the mouth -Action: closes lips or purses lips

Nasalis -Origin: maxillae -Insertion: bridge and ala of nose -Action: open and closes nostrils Muscles of facial expression continued... - Buccinator #22 -Origin: 3 areas. Alveolar process of maxillae. Alveolar process of mandible. Pterygomandibular raphe -Insertion: angle of the mouth -Action: chewing Depressor labii inferioris #20 -Origin: lower border of the mandible -Insertion: lower lip -Action: depresses the lower lip; exposing the mandibular incisor teeth Mentalis #23 -Origin: mandible near the midline -Insertion: chin -Action: raises the chin, protrude lower lip Platysma #30 -Origin: skin tissue superficial to the clavicle and shoulder -Insertion: lower border of the mandible -Action: raises skin of the neck and Suprahyoid muscles - Digastric anterior belly #32 -Origin: intermediate tendon -Insertion: medial surface of mandible

Digastric posterior belly -Origin: mastoid notch of temporal bone -Insertion: posterior belly of intermediate tendon Mylohyoid #34 (makes up floor of mouth, inferior to geniohyoid) -Origin: mylohyoid line of mandible -Insertion: body of hyoid bone Geniohyoid #39 -Origin: genial tubercules -Insertion: body of hyoid bone Stylohyoid #33 -Origin: styloid process of temporal bone -Insertion: body of hyoid bone Extrinsic muscles of the tongue control what? - The position of the tongue Extrinsic muscles of the tongue - Genioglossus #35 -Action: protrudes tongue Hyoglossus #36 -Action: depresses the tongue Styloglossus #37 -Action: retracts and elevates the tongue Palatoglossus (forms anterior tonsillar pillar) -Action: draws the side of the tongue up and back; depresses soft palate toward tongue Intrinsic muscles of the tongue control what? - The shape of the tongue

-The muscles are named for the direction in which they run -All intrinsic muscles are innervated by the hypoglossal nerve Intrinsic muscles of the tongue - Superior longitudinal -Runs length of the tongue from anterior to posterior; located near dorsum surface. Function is to widen the tongue and turn apex up Inferior longitudinal -Runs length of the tongue from anterior to posterior; located near ventral surface. Function is to widen the tongue and turn apex down Transverse -Runs from median septum to pass outward toward the lateral surface of tongue. Function is to make the tongue narrow Vertical -Runs from dorsum surface to ventral surface. Function is to widen the tongue apex