Permanent Incisors

Revised 2006
The Permanent Incisors
First and second teeth from the midline
Incisors of the same arch resemble each other
Maxillary incisors larger than mandibular incisors
Maxillary central larger than maxillary lateral
*Mandibular lateral larger than mandibular central
Functions of the Incisors
Mastication - biting, cutting and shearing
Esthetics - size, shape, color and manner of placement contribute to a persons appearance. The incisors
also provide facial support.
Phonetics - they are necessary for the production of certain sounds.(to test if denture work right or not)
Esthetics - beauty is in the eyes of the beholder.
Four Unique Features of the Incisors
Incisal edge
Mamelons
Position and angulation of the marginal ridges (on lingual surface)
Lingual fossa and cingulum
Anterior Tooth Form - Mesial and Distal Surfaces
In a proximal view, the crowns of the anterior teeth exhibit a triangular or wedge shape.
The base of the triangle is at the cervical.
The apex of the triangle is at the incisal.
In a labial view, the mesial surface of the crown is straighter; distal surface of the crown is more rounded or
curved.
In a labial view, the mesio-incisal line angle is squarer; disto-incisal line angle is more rounded.

Dont have to differentiate between 24 and 25 if not possible

Maxillary Central Incisors
Share mesial contacts
Crown size - largest of the incisors
Widest mesiodistally of any anterior tooth
Maxillary Central Incisors - Development
Initiation of calcification: 3 to 4 months
Completion of enamel: 4 to 5 years
Eruption: 7 to 8 years
Completion of root: 10 years

2-3 years from eruption to complete

Maxillary Central Incisor
Labial or lingual view - the crown is trapezoidal with the base or longest parallel side at the incisal.
Maxillary Central Incisors - Labial
Incisal margin - generally straight and nearly perpendicular to long axis
Incisocervical and mesiodistal crown dimensions more nearly equal than for other incisors
Mesial outline - slightly convex (nearly straight). Height of contour - incisal third
Distal outline - more rounded than mesial. Height of contour - incisal third
Mamelons - sometimes found on the incisal edge of newly erupted incisors and have been referred to as
evidence of three labial lobes, the most common number of mamelons is three.
Note - due to the rounding of the disto-incisal angle, the most common number of mamelons on a maxillary
lateral incisor is two.
Developmental depressions - straight, shallow depressions, which extend from the incisal edge toward the
gingival, and fade out in the middle third.
Imbrication lines - faint, curved lines which roughly parallel the CEJ in the cervical third of the crown.
They are usually, but not always, present.
Maxillary Central Incisors - Lingual
Lingual more narrow than labial - due to faciolingual taper.
Lingual fossa - found in incisal half to two-thirds of the crown. The fossa covers the largest area of the
crowns lingual surface.
Marginal ridges mark the mesial and distal borders of the crowns lingual surface.
Cingulum - bulky convexity located in the cervical portion of the crowns lingual surface. The cingulum is
generally smooth.
A linguogingival groove and a lingual pit may also be found. These structures are not usual findings on the
crown of any permanent incisor.

Maxillary Central Incisors - Proximal

Labial height of contour - cervical third
Lingual height of contour - cervical third
Incisal outline - on a newly, erupted incisor the projection of enamel at the incisal termination is the incisal
ridge. The ridge is normally pointed or slightly rounded. As the incisal ridge wears, it flattens and becomes
known as the incisal surface or incisal edge.
Incisal Wear
On an older maxillary incisor, the incisal edge slants down from labial to lingual. The linguo-incisal line
angle is lower than the labio-incisal line angle.
On an older mandibular incisor, the incisal edge slants down from lingual to labial. The labio-incisal line
angle is lower than the linguo-incisal line angle.
Maxillary Central Incisor - Mesial Aspect
When viewing a maxillary central incisor from the proximal, the incisal ridge of the crown is normally in
line with the center of the root.
Maxillary Central Incisors - Incisal Aspect
Crowns outline is roughly triangular in the incisal view.
Incisal edge is relatively straight mesiodistally and is roughly centered over the root.
Greatest contour of the cingulum is offset to the distal.
Maxillary Central Incisors - Root Structure
The root is single, conical, relatively straight and tapers to a rounded apex.
A cervical cross section of the root shows a rounded triangular outline.
In younger patients, the pulp chamber is triangular shaped, becoming more rounded with age.
Maxillary Central Incisors - Root Structure
A mid-root cross section shows a somewhat ovoid outline.
The root is approximately one and a half times the crown length.
Maxillary Central Incisors - Variations and Anomalies
Talon cusp - large accessory cusp on the lingual surface of the crown
Supernumerary teeth - extra teeth that may be found between the roots of the centrals
Hutchinsons incisors - screwdriver shaped crown caused by congenital syphilis
Maxillary Lateral Incisors
Resembles the maxillary central incisor, but on a smaller scale.
The lateral is generally a more rounded tooth.
It is relatively longer incisocervically and narrower mesiodistally.
Displays greatest variation in form of any permanent tooth, except for the third molars.
Maxillary Lateral Incisors - Development
Initiation of calcification: 1 year
Completion of enamel: 4 to 5 years
It erupts at 8 to 9 years of age.
Completion of root: 11 years
Maxillary lateral incisor - last permanent incisor to erupt.
Maxillary Lateral Incisors - Labial
Mesial outline - resembles maxillary central incisor, but mesio-incisal angle is more rounded. Height of
contour - incisal third
Distal outline - more rounded than the maxillary central incisor. The disto-incisal angle is noticeably more
rounded. Height of contour - junction of the incisal and middle thirds
Maxillary Lateral Incisors - Labial
Incisal margin - not as straight as the maxillary central incisor, due to the greater rounding of the two
incisal angles. If mamelons present, the most common number is two.
The labial surface is more convex.
Labial developmental depressions and imbrication lines are normally present.
The largest incisal embrasure exists between the maxillary lateral incisor and canine.
Maxillary Lateral Incisor - Lingual
The marginal ridges are the most distinct of any of the incisors.
The lingual fossa is the most distinct of any of the incisors.
The crowns lingual surface has been described as markedly concave.
It is the anterior tooth most likely to have a lingual pit. The lingual pit is potential caries site.
Linguogingival grooves and lingual pits more common than on the other incisors.
Maxillary Lateral Incisors - Proximal
The labial and lingual heights of contour are in the cervical third.
Crown outline - triangular in shape
The distal surface is smaller and more convex than the mesial surface.

Maxillary Lateral Incisors - Incisal

The crown resembles the maxillary central, but the cingulum is often more prominent.
The crown exhibits relatively more convexity labially and lingually.
The crown outline may appear somewhat rhomboidal.
Maxillary Lateral Incisors -Root Structure
The root is wider labiolingually than mesiodistally.
The actual root length is the same length or slightly shorter than that of the central.
The cervical and mid-root cross sections are ovoid.
Variations and Anomalies
The maxillary lateral incisor has more variation in form than any other tooth except for the third molars.
These include: congenitally missing (agenesis)
peg lateral
palatogingival groove
lingual pit
dens in dente.
Congenitally missing - agenesis (tooth bud does not form)
Peg lateral - due to lack of development of the mesial and distal portions of the crown.
Linguogingival fissure - a groove which extends from the lingual pit down onto the cingulum and
sometimes the root. Syn.- palatogingival groove.
Caries is often associated with the lingual pit and dens in dente.
Dens in dente - an invagination of enamel and dentin into the tooths pulp cavity. The entrance site of the
invagination is the lingual pit. Dens in dente literally means tooth within a tooth.
The tooth frequently has an abnormal relationship and contact with adjacent teeth in the same arch.
Distorted crowns and unusual root curvatures
Tubercle - elevated structure found on the incisal portion of the cingulum.
Mandibular Incisors
Simplest and least variable teeth in the mouth
Smallest of the permanent teeth
Mandibular incisors resemble each other more than the maxillary incisors.
The crowns are relatively longer incisocervically and markedly narrower mesiodistally.
Mandibular Central Incisors
Narrowest mesiodistally of any permanent tooth
The crown is very symmetrical, with the mesial and distal halves being nearly identical.
Difficult to distinguish between the mesial and distal portions
Mandibular Central Incisors - Development
Initiation of calcification: 3 to 4 months
Completion of enamel: 4 to 5 years
The first permanent anterior teeth to erupt: 6 to 7 years
Completion of root: 9 years
The first succedaneous teeth to erupt
Note - the first permanent teeth to erupt are the mandibular first molars.
Mandibular Central Incisors - Labial
Mesial and distal outlines - both outlines taper evenly towards the gingival in nearly straight lines.
The labial surface has less convexity mesiodistally and incisocervically than the maxillary incisors.
Developmental depressions and imbrication lines are not normally present.
The mesial and distal heights of contour are in the incisal third.
Incisal outline - straight and at a right angle to the long axis of the tooth.
Mamelons - if present, the most common number is three.
Mandibular Central Incisors - Lingual
Lingual surface is relatively smooth.
Marginal ridges and lingual fossa are indistinct.
There are normally no grooves, fissures or pits on the lingual surface.
Cingulum is not as prominent as on the maxillary incisors.
Mandibular Central Incisors - Proximal
Labial and lingual heights of contour are in the cervical third.
Crown outline - triangular in shape
The profile of the incisal edge develops an inclination down towards the labial. This is opposite to the slope
of the incisal edges of the maxillary incisors.

Mandibular Central Incisors - Incisal

Most notable features are
(1) the symmetry of the mesial and distal portions
(2) the straight incisal edge.
Crown outline is roughly four sided or diamond-shaped.
The tooth is normally wider labiolingually than mesiodistally.
Cingulum is centered.
Mandibular Central Incisors - Root Structure
The root is normally single and straight.
The root is wider labiolingually than mesiodistally.
In cross section the root is roughly rectangular with rounded corners.
Root concavities or longitudinal grooves may be present on the mesial and distal surfaces of the roots.
Clinical Significance - Root Concavities
Increase the surface area of the root
Provide a mechanical lock for the alveolar bone. This not only increases retention, but it also helps the
tooth resist forces which are not on the long axis of the tooth.
With recession of the supporting structures, the root concavities are exposed and are difficult to clean.
Mandibular Central Incisors - Variations and Anomalies
Variations and anomalies are rare.
Most common variation is a bifurcated root. Branches are on the labial and lingual.
Fusion between the mandibular centrals or the centrals and laterals can occur.
Mandibular Lateral Incisors
The mandibular lateral incisors closely resemble the mandibular central incisors.
The mandibular lateral incisor is slightly larger.
It complements the central in function.
Mandibular Lateral Incisors - Labial
Incisal outline - the incisal surface may slope slightly gingivally toward the distal. The disto-incisal angle is
more rounded than that of the central incisor.
The mesial and distal heights of contour are both in the incisal third.
Mandibular Lateral Incisors - Lingual
The cingulum is offset to the distal.
The curvature of the cervical line is also offset distally.
Mandibular Lateral Incisors - Incisal
Incisal edge is not straight mesiodistally; it angles towards the lingual as it progresses distally.
It is easy to visualize the bulking of the cingulum to distal.
These factors give the crown the appearance of being slightly twisted on its root.
This positions the distal marginal ridge more lingual than the mesial marginal ridge.
Mandibular Lateral Incisors - Mesial
In a mesial view, you can see the distal marginal ridge peeking out on the lingual surface. (Favorite national
board question.)*
This is due to incisal surface angling lingually as it goes distally.
The distal surface is slightly shorter than the mesial surface.
Mandibular Lateral Incisors - Root Structure
The root is slightly longer, thicker and wider than that of the central.
If root concavities are present, the concavity on the distal is usually more pronounced.
Mandibular Movements and Positions - Centric
Centric Occlusion/ Maximum Intercuspation a tooth to tooth relationship of the jaws determined by the
relation of the occlusal surfaces of the teeth where the maxillary and mandibular teeth interdigitate
maximally.
Mandibular Movements and Positions - Protrusive
Protrusive Movement - the straight forward movement of the mandible
Incisal Edge Position - the relationship that the maxillary and mandibular teeth assume as they move
forward to the edge-to edge position.
Mandibular Movements and Positions Lateral Excursions
Right and Left Lateral Movements - the side the mandible moves toward is the working side. The side it
moves away from is the non- working side.
Canine Protected Occlusion
Canine Protected Occlusion (syn. Cuspid Rise) - the canine protects the posterior teeth as the jaw moves to
the working side. The canines are the only teeth that contact in this movement. In the picture cuspid rise is
illustrated on the left side.
Group Function

Group function - all the teeth on the working side function together as the jaw moves to that side.
Overbite
Overbite - the vertical overlapping of the anterior teeth. The normal amount of overbite is 1.5-2.0 mm.
Overjet
Overjet - the horizontal overlapping of the anterior teeth
Anterior Guidance
Anterior guidance - the functional relationships of the anterior teeth during mandibular movements.
Anterior guidance is largely determined by the overbite and overjet.
Dentinogenic Theory of Tooth Form
The dentinogenic theory relates the incisal point angles and incisal embrasures of anterior teeth to female
and male characteristics.
Female form - open incisal embrasures and rounded point angles.
Male form - closed incisal embrasures and square point angles.
This theory is no longer considered valid.
Square, Tapering, Ovoid Theory
The square, tapering, ovoid theory relates anterior tooth form to the inverse of the patients face form.
Three measurements are taken across the patients face (temple, malar process and angle of the jaw) and
one the length of the face (hair line to the border of the chin).
Tooth form is taken as 1/16 to 1/17 of these measurements.
Smile Line
Smile line - a relationship formed by the line through the maxillary incisal edges and the line formed by the
lower lip when smiling.
A more curved smile line is characteristic of a feminine form.
A straighter smile line is characteristic of a masculine form.
Oral Habits
Bruxism - clenching, grinding
Mouth habit - opening bobby pins, holding objects in mouth
Thumb sucking - causes anterior open bite
Tongue thrusting - causes anterior open bite