DIFFERENCES BETWEEN
PRIMARY AND PERMANENT
TEETH
Presented by-
Dr. Mathew Thomas Maliael
BDS
CONTENTS
Introduction
General differences
Eruption sequences
Crown
Pulp
Root
Enamel
Dentin
Periodontium
Histological differences
Individual differences in morphology of tooth
GENERAL ANATOMY OF THE TOOTH
INTRODUCTION
Primary teeth are also called as temporary , milk ,
deciduous or baby teeth.
They are present from infancy stage till early
teenage.
Though they are erroneously considered as a
annoyance , they play a major role in mastication
and maintaining space for eruption of permanent
teeth.
Significant differences in different aspects
distinguish them from their permanent counterparts.
GENERAL DIFFERENCES
No. of teeth present:- primary-20
permanent – 28-32
Teeth formula:- ICPM/ICPM
primary- 2102/2102
permanent- 2123/2123
Bicuspids and third molars are absent in the primary set of
tooth.
Primary teeth are smaller in size when compare to permanent
teeth.
1st tooth to erupt into the oral cavity is mandibular incisor
whereas in permanent teeth it is the mandibular first molar.
Primate space is absent in primary teeth.
Primary teeth are present within the age of 6 months-10 to 12
years ( @ the age of 13 years only about 5% of primary teeth
remains).
ERUPTION SEQUENCES
Eruption sequence follows a pattern –
incisors-first molars- canines-second molars.
This pattern is generally followed by both arches,
with the mandibular arch preceding the maxillary
arch.
The loss of deciduous teeth tends to mirror the
eruption sequence.
Caries susceptibility is reverse of this order.
CROWN
PRIMARY TEETH PERMANENT TEETH
Bluish white in color. Refractive Grayish white to yellowish
index similar to that of milk( white in color.
RI=1). Larger in dimensions.
smaller in all dimensions . Larger in cervico-occlusal
Exposed area is about one-half dimension than the mesio-
that of the permanent teeth. distal dimension. this gives a
Wider mesio-distally in relation longer appearance to
to cervico-occlusal dimension. permanent anterior teeth.
this gives a cup shaped
appearance to the anterior
teeth and squat shaped
appearance to the molars.
PRIMARY TEETH PERMANENT TEETH
Cuspids are slender and to be Cuspids are less conical.
more conical. The cervical ridges are flatter.
Cervical ridges are more There is less convergence of
pronounced especially on buccal and lingual surface of
buccal aspect of first primary molars towards occlusal
molar. surface.
Buccal and lingual surface of
molars , especially 1st molar,
converge towards occlusal
surface so they have a narrow
occlusal table in the bucco-
lingual plane.
PRIMARY TEETH PERMANENT TEETH
Occlusal plane is relatively flat. Occlusal plane has relatively
Molars are bulbous and are curved contour.
sharply constricted cervically. They have less constriction at
The contact areas between the neck.
molars are broader , flatter and The contact point between
situated gingivally. permanent molars is situated
occlusally.
PRIMARY TEETH PERMANENT TEETH
Supplemental grooves are Supplemental grooves are
more. less.
Mammelons are absent. Mammelons are present on
1st molar is smaller in incisal edges of newly erupted
dimension than the 2nd molar incisors.
1st molar is larger in dimension
than the 2nd molar.
PULP
(PULP CHAMBER ANATOMY IN BOTH PRIMARY AND PERMANENT TEETH CLOSELY APPROXIMATES THE
SURFACE SHAPE OF THE CROWN)
PRIMARY TEETH PERMANENT TEETH
Pulp chamber is larger in Pulp chamber is smaller in
relation to crown size. relation to crown size.
Pulpal outline follows DEJ Pulpal outline follows DEJ less
more closely. closely.
Pulp horns are closer to the The pulp horns are
outer surface. Mesial pulp horn comparatively away from the
extends to a closer outer surface.
approximation of surface than Comparatively less degree of
the distal pulp horn. cellularity and vascularity in
High degree of cellularity and tissue.
vascularity in tissue. Comparatively less potential for
High potential for repair. repair.
PRIMARY TEETH PERMANENT TEETH
Comparatively less tooth More tooth structure protecting
structure. the pulp.
Greater thickness of dentin Comparatively lesser thickness
over occlusal fossa of molars. of dentin over the pulpal wall at
Root canals are more ribbon the occlusal fossa of molars.
like. the radicular pulp follows Root canals are well defined
a thin , tortuous and branching with less branching.
path. Floor of pulp chamber does not
Floor of pulp chamber is have any accessory canal.
porous. Accessory canals in
primary pulp chamber floor
leads directly into inter-
radicular furcation.
ROOT
PRIMARY TEETH PERMANENT TEETH
Roots are larger and more slender Roots are shorter and bulbous
in comparison to crown size.
in comparison to crown.
Furcation is more towards cervical
area so that root trunk is smaller . Placement of furcation is apical
Roots are narrower mesio-distally. , thus the root trunk is larger.
At the cervical region, the roots of
the primary molars flare outward
Roots are broader mesio-
and continue to flare as they
approach the apices to distally.
accommodate permanent tooth Marked flaring of roots is
buds.
absent.
Undergo physiologic resorption
during shedding of primary teeth. Physiologic resorption is
absent.
ENAMEL
PRIMARY TEETH PERMANENT TEETH
Bands of retzius are less Bands of retzius are more
common. This maybe partly common.
responsible for the bluish white Neonatal lines are only present
color. in 1st molars
Neonatal lines are present in The enamel is thicker and has
all teeth. a thickness of about 2-3mm.
Enamel is thinner and has a Enamel rods are oriented
more consistent depth of about gingivally.
1mm thickness throughout the
entire crown
Enamel rods at the cervical
slopes occlusally from the DEJ.
DENTIN
PRIMARY TEETH PERMANENT TEETH
Dentinal tubules are less Dentinal tubules are more
regular. regular.
Dentin thickness is half that of Den.
permanent teeth. Thickness is Dentin is thicker.
limited in some places.
Dentin is denser and difficult to
Less dense and easy to cut. cut.
Interglobular dentin is absent. Interglobular dentin is present.
PERIODONTIUM
PRIMARY TEETH PERMANENT TEETH
Cementum is very thin and o Secondary cementum is
the primary type. Secondary present.
cementum is characteristically Alveolar atrophy occurs.
absent.
Gingivitis is common in adults.
Alveolar atrophy is rare.
Gingivitis is generally absent in
a healthy child. Similarly
recession is in frequent.
HISTOLOGICAL DIFFERENCES
PRIMARY TEETH PERMANENT TEETH
Roots have enlarged apical Foramens are restricted. Thus
foramens. Thus , the abundant reduced blood supply favors a
blood supply demonstrates a calcific response and healing
more typical inflammatory by calcific scarring.
response. Reparative dentin formation is
Incidence of reparative dentin less.
formation beneath carious Pulp nerve fibres terminate
lesion is more extensive and mainly among the odontoblasts
irregular. and even beyond the
Pulp nerve fibers pass to the predentin.
odontoblastic area, where they
terminate as free nerve
endings.
PRIMARY TEETH PERMANENT TEETH
Density of innervations is less Density of innervations is more.
because of which primary teeth Infection and inflammation in
are less susceptible to pulp is localized .
operative procedures. Neural
tissue is the first to degenerate
when root resorption takes
place.
Localization of infection and
inflammation is poorer in pulp
INDIVIDUAL DIFFERENCES IN TOOTH
MORPHOLOGY
MAXILLARY CENTRAL INCISOR
Mesio-distal measurement is
greater than cervico-incisal
measurement.
Labial surface is slightly
convex with little evidence
of developmental grooves.
The incisal edge joins the
mesial surface at an acute angle
and the distal surface at a more
obtuse angle.
MAXILLARY LATERAL INCISOR
Smaller in most
dimensions.
Disto-incisal angle is
more rounded.
Lingual anatomy is less
prominent.
Root is longer in
proportion to the
crown.
MAXILLARY CANINE
Larger than incisors in all
dimensions.
All crown surfaces the
are convex creating a
more pronounced
constriction at the cervix
prominent cusp.
Lingual surface presents
a lingual ridge , fossa and
marginal ridges.
The root is long and
tapered toward the apex,
and shows increase in
diameter just apical to the
cervical line.
MANDIBULAR CENTRAL INCISOR
Smaller in all dimensions
than MCI.
Labially appears
symmetric, less convex
and smooth without
evidence of
developmental grooves.
Lingual surface is usually
smooth with poorly
defined fossa and
marginal ridges.
Root is long and evenly
tapered toward the apex.
MANDIBULAR LATERAL INCISORS
Similar in morphology to that
of CI, except that the incisal
edge slopes downward
distallly forming a more
obtuse disto-incisal angle.
Slightly larger cervico-
incisally and mesiodistally
than CI.
Root is conical, longer than
that of CI and shows definite
inclination at the apex.
Distal surface of the root will
show a longitudinal
depression or groove
separating labial and lingual
surfaces.
MANDIBULAR CANINE
Appears more slender
than MC because of
smaller mesio-distal
diameter in relation to
crown height
The disto-incisal edge is
longer.
Marginal ridges and
cingulum are less
prominent.
Labio-lingual diameter is
smaller than MC.
Root is smoothly tapered
from the cervical line to
the apex.
MAXILLARY FIRST MOLAR
Appears triangular when viewed
occlusally.
Proximal surfaces converge lingually
creating a crown that is wider mesio-
distally at the bucal surface.
Mesio-lingual cusp is the largest
followed by mesio-buccal and disto-
buccal.
Mesially , prominent bucco-cervical
ridge can be seen
3 long and slender roots are present.
Lingual root is the longest
All three roots extend from a short root
base in a divergent manner.
MAXILLARY SECOND MOLAR
Similar to maxillary 1st permanent
premolar (crown form, pit , groove and
cusp arrangement.
Four cusps.
Largest is mesiolingual . Distobuccal is
the smallest and other 2 are almost of the
same size.
Occlusal surface 3 pits which meet at the
intersection of the developmental groove
3 roots. Lingual root is the largest and
distobuccal is the smallest.
Root morphology is similar to that of to
that of 1st permanent molar except that
roots are flared and diverge more from
the root base.
MANDIBULAR 1ST MOLAR
When viewed from occlusal aspect the
outline is rhomboidal in shape.
2 buccal cusps and 1 lingual cusp.
3 pits are found on occlusal surface of
which the surface-central is most
prominent.
A distinguishing feature is heavy
transverse ridge connecting the mesio-
buccal and mesio-lingual cusps.
2 roots ; mesial and distal. They show
typical flaring and end in a sharp edge
which may be slightly bifid
The most unique feature of this tooth is
that is does not resemble any tooth in
the permanent set.
MANDIBULAR 2ND MOLAR
Smaller replica of the mandibular 1st
permanent molar.
3 buccal cusps;
distobuccal(largest),followed by the
mesio-buccal and the distal.
2 lingual cups which are similar in size.
3 pits ; central(prominent) ,mesial, distal.
Crown morphology shows typical
cervical constriction and bucco-cervical
ridge as seen of other primary molars.
2 roots ;mesial and distal. Narrow
mesiodistally and broad buccolingually.
Roots are more diverged than 1st molar
MORPHOLOGIC CONSIDERATIONS
Crowns are smaller and more bulbous than their permanent counterparts, and
the molars are bell shaped , with a definite constriction in the cervical region
The characteristic sharp lingual inclination occlusally of the facial surfaces results
in the formation of distinct faciogingival that ends abruptly at the CEJ.
The sharp constriction at the neck of the primary molar necessitates special care
in the formation of the gingival floor during class2 tooth preparation .
The buccal and lingual surfaces of the molars converging sharply occlusally
results in a narrow occlusal surface or food table.
The pulpal outline follows the DEJ more closely than that of the permanent teeth
.
The pulpal horns are longer and more pointed than the cusps would indicate.
The dentin also has less bulk or thickness, and so the pulp is proportionately
larger than that of the permanent teeth .
The enamel of primary teeth is thin but of uniform thickness . The enamel surface
tends to be parallel to the DEJ.
REFERENCES
Textbook of Pedodontics- Shoba Tandon
Textbook of Pediatric Dentistry-Nikhil Marwah
Dentistry for child and adolescent-McDonald &
Avery
