A human tooth consists of a root and a crown. Each of them differs in structure and shape. All teeth have a certain number of roots. It depends on the location in the dentition. The retaining system is stronger in those teeth that bear more loads.

But you should not assume that the number of canals in a tooth corresponds to the number of roots. Very often the roots have different holes. The canal may bifurcate near the pulp. In such cases, it is quite easy to find and seal additional passages. It also happens that they are located in the same root and run parallel.

In addition, bifurcation of the canals in the apex area is possible. Thus, the root has two apexes. It is very difficult to seal such passages, but with the help of modern equipment the chances are significantly increased.

Number of canals in tooth

To determine their number, the dentist takes an x-ray; only with its help is it possible to accurately find out such information.

The upper teeth are often different from the lower teeth. In the upper canines and incisors, as a rule, there should be one canal. In turn, the lower central incisor often already has two of them. In percentage terms, as practice shows, in 2/3 of cases there is only one canal, and in the rest there are 2. Well, in about half of the cases the second lower incisor has 2 canal cavities. The fang in only 6% of cases has one canal, in the rest it is two-canal.

Next after the canines come the premolars. On the upper jaw, premolars are usually two-canal, but there are cases when there are 3 of them (in about 6% of cases). And it even happens that the premolar turns out to be single-channel (in about 9% of cases). On the lower jaw there are no first premolars with 3 canals; in 2/3 of cases they are single-canal, in 1/3 - two-canal.

The second premolars have approximately the same ratio. In the upper jaw, three-channel teeth are extremely rare - 1%, two-channel in 24%, and all others are single-channel. In the lower jaw, in most cases, the fifth teeth have one canal, and only in 11% of cases have 2.

The six on the upper jaw can have three or four canal passages, in a 1:1 ratio. But on the lower jaw, three-channel teeth are more common, sometimes two-channel, and in very rare cases even 4 branches are possible.

Sevens on the lower jaw are two-channel in 2/3 of cases, and three-channel in 1/3. On the upper jaw, the canals have the same ratio, the only difference is that three canals are more common, and four are less common.

The most amazing one is the eighth or, as it is also called, the wisdom tooth. On the upper jaw it can have up to 5 canal passages. On the lower jaw - up to 3, but during tooth treatment additional cavities are revealed.

The canals very often have an irregular shape; they are usually curved and have a narrow passage, which makes it difficult to fill them.

Considering all of the above, it becomes clear that such dental spaces have many features, which is why the doctor must be very careful during treatment so as not to miss an additional such cavity.

Treatment

Root canal treatment is considered one of the most difficult dental procedures. There is even a special branch that deals with this problem - endodontics.

The main purpose of this procedure is to treat the inside of the tooth - the root canals, which are filled with pulp. The pulp is a soft tissue that includes nerve fibers, lymphatic and blood vessels, and connective tissue.

The procedure for treating canal cavities allows you to save a tooth even in cases in which it had to be removed relatively recently. The probability of preservation is at least 80-90%, and in other cases they resort to the surgical method - using resection of the root apex or removal.

The complexity of the procedure lies in the fact that the canals are difficult to access by the dentist’s instruments, and it is also problematic to visually monitor the progress of the procedure.

Among the main indications for this type of dental treatment are inflammatory processes that lead to damage to soft tissue in the canal cavities.

Diagnosis to determine the need for treatment is carried out using x-rays or visually.

The cause of such inflammatory processes can be various dental diseases, most often pulpitis or caries. Also, with periodontitis, root canal treatment may be necessary.

Symptoms of the need for root canal treatment are usually the following: toothache or swelling of the gums near a tooth. Although in the chronic form of the disease, pain may not be observed, treatment of the canals will still be required.

Treatment of dental canals consists of the following stages:

1. injecting anesthesia (usually through an injection into the gum near the affected tooth);
2. separation of the tooth from the rest of the oral cavity using a cofferdam (a special rubber film that is attached to the tooth using small hooks);
3. Opening the tooth using a drill to gain access to the inflamed pulp (on incisors, the hole is made from the side of the tongue or palate, on molars and premolars - on the chewing surface);
4. The affected pulp or its remains are removed very carefully using a special tool, and the canals are simultaneously treated with medications;
5. Drying the canals using special paper points;
6. Filling canals with various materials, usually gutta-percha (rubber resin) is used.

The duration of the entire treatment procedure directly depends on the complexity of the underlying clinical situation, as well as on which teeth are being treated, since they all have a different number of canals. On average, the procedure takes from half an hour to an hour.

The success of this procedure will depend on how well the dental canals were cleaned, as well as how tightly they were sealed.

After canal treatment is completed, the crown part of the tooth is restored using various materials, most often with filling.

In cases where the dental crown is sufficiently damaged, filling is carried out using dental pins. To do this, the dentist removes part of the gutta-percha from the canal in order to obtain an area for installing a pin. After which the pin is attached to the tooth canal using special dental cement. After this, filling material is placed around the pin and the anatomical shape of the tooth is restored.

The filling of the tooth crown is carried out immediately after the canals are filled or at the next appointment.

After the procedure

After the root canal treatment process, the patient may experience toothache for some time, especially when pressing on a filled tooth, as well as general malaise and an unpleasant feeling of discomfort in the oral cavity.

In some cases, after the procedure, for several days, increased sensitivity of the teeth to temperature changes and chemical irritants is possible. Therefore, it is not recommended to subject the treated tooth to heavy loads. After a few days, all discomfort should disappear.

If the pain is intense enough, you can take painkillers.

If the pain does not disappear for a long time, then you need to contact your dentist again, since there is a possibility that the treatment was not carried out correctly, and this may also cause any complications.

For example, this may be a sign of an allergic reaction to the components of the material used for filling. In addition to pain, in such cases other signs of an allergic reaction appear: the appearance of a rash, itching. If such symptoms appear, it is necessary to determine which component caused the reaction, and then replace the filling with a new one that does not contain the allergen.

Also, if the filling was placed recently, then there is a possibility that it may fall out due to poor preparation of the cavity. The reason for this may be that the walls of the tooth were under-dried or, on the contrary, over-dried. In addition, the filling is likely to be damaged when chewing if the patient neglected the doctor’s recommendations and ate earlier than two hours after the procedure. Therefore, it is very important to follow all instructions from your dentist.

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Number of roots in each tooth

Often the root is located in the area under the gums, below the surface of the cervix and its size is about 70% of the total volume of the organ. The number of chewing organs and the roots present in them is not the same. In dentistry, there is a special system with the help of which the number of roots, for example, in the sixth unit at the top or a wisdom tooth, is determined.

So how many roots do adults have? This indicator is different for each person, it depends on various reasons - on heredity, on size, on location, on the age and race of the person. For example, representatives of the Mongoloid and Negroid races have one more root than representatives of the Caucasian race, and they also grow together quite often.

Attention! For ease of identification in dentistry, each tooth has a specific number. This system involves numbering according to the following principle - the jaw of each person is visually dissected vertically in the center, with incisors going to the left and right, from which the counting is carried out. From the area of ​​the central incisors, numbering is made to the ears. ×

According to the numbering system, each tooth has its own number and certain features of the root system:

This system applies to adults. But as for children's milk teeth, their root system has some differences. Many people believe that dairy plants have no bases and they grow without them, but this is not true. Typically, the first teeth appear from the root system; each unit usually has one base, which is completely dissolved at the time it falls out. That's why many people believe that they don't exist at all.

How many channels

Important! It is worth considering that the number of channels does not correspond to the number of root bases. In place of the incisors there may be two or three, but there may be one, which is divided into several. However, each person has a different number of grooves. For this reason, to make an accurate determination, the doctor usually performs an X-ray examination. ×

There are no requirements for the number of recesses in dentistry; they are usually determined according to a percentage.

Features of the number of channels:

How many canals does a wisdom tooth have?

How many wisdom teeth can there be? This is a difficult question, because this organ has a very unusual structure. If it is located at the top, then it can have four and sometimes even five channels.

If this tooth is in the lower row, then it usually has no more than 3 indentations.
In most cases, when teething and already at the moment of full growth, the figure eight causes unpleasant sensations and severe discomfort. To clean it, it is recommended to use a special brush, which is designed for hard-to-reach places. Typically, wisdom teeth have narrow sockets that have irregular shapes. This property causes great difficulties when performing medical procedures. Often, if improper eruption or other pathological processes occur, the figure eight is completely removed.

What is a nerve needed for?

Attention! In addition to roots and canals, each tooth has a nerve. Typically, nerve fibers cover the area of ​​the canals, with the nerves grouped into branches. Each base of the unit has a nerve branch, and often there are several branches at the same time, with the branch splitting in the upper part. ×

So how many nerves can there be? The number of nerves is related to the number of bases and channels present.
Nerve fibers can influence the process of development and growth of dental units, due to which sensitivity properties are provided. Due to the presence of roots, the tooth is not just a piece of part of the jaw, but is a living organ that has sensitivity and reactions.
Dental anatomy is a fairly complex science that covers all areas. Despite the fact that this organ is not large, it contains all the vital parts that ensure its normal and complete functioning. Thanks to all these qualities, we are able to chew and eat food every day, as well as perform other important processes.

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The tooth root is located in the inner part of the gum. This invisible part makes up about 70% of the entire organ. There is no clear answer to the question: how many roots does this or that organ have, since their number is individual for each individual patient.

Factors influencing the number of roots include:

1. organ location;
2. degree of load on it, functional features (masticatory, frontal);
3. heredity;
4. patient's age;
5. race.

Additional information! The root system of representatives of the Negroid and Mongoloid races is somewhat different from the European one; it is more branched, which, in fact, is why a larger number of roots and canals is justified.

Dentists have developed a special system for numbering teeth, thanks to which it is almost impossible even for a non-specialist to get confused in the units of the upper and lower dentition.

To understand the principle of numbering, you need to mentally divide the cranium in half vertically. First come the incisors - the frontal units of the upper and lower rows on the right and left. There are two of them on each side: central (No. 1) and side (No. 2). Next come the fangs or so-called triplets. The four (No. 4) and five (No. 5) are the first and second premolars. These teeth are also called small molars. All of the above units are united by the fact that they have only one cone-shaped “spine” in both the top and bottom rows.

The situation is somewhat different with the first, second and third molars, we are talking about tooth No. 6, 7 and 8. The upper six and seven (large molars) are endowed with three roots, however, in the wisdom tooth located on top, as a rule, there are also 3 grounds. The sixth tooth and the 7th tooth of the bottom row usually have one less root than their upper counterparts. The exception is the lower eight; this tooth may even have not three, but four roots. This feature should be taken into account during the treatment of a four-canal tooth.

Additional information! Many people mistakenly believe that their children's primary teeth do not have roots. This is absolutely not true. There are bases, and their number can reach up to three; with their help, the chewing organs of babies are attached to the jaw. By the time the milk units are replaced with permanent ones, the “roots” disappear, as a result of which parents have the opinion that they did not exist at all.

How many canals are there in teeth?

It should be immediately noted that the number of channels does not necessarily correspond to the number of roots. These concepts are not identical. You can accurately determine how many canals there are in a tooth using an x-ray.

So, the upper incisors, as a rule, are endowed with two or three canals; in some cases there may be one, but branched in two. It all depends on the characteristics of the root system and genetic predisposition. The lower central incisors are predominantly single-channel, in 70% of cases, the remaining 30% have two recesses.

Lower lateral incisors in most cases, they are endowed with 2 canals, however, like the lower canines. Only in rare cases canine teeth located on the lower jaw are two-canal (5-6%).

The distribution of recesses in the remaining units of the dentition is carried out according to the following scheme, from which you can find out how many channels each tooth has:

• upper first premolar – 1 (9% of cases), 2 (85%), 3 (6%);
• bottom four – 1, less often 2;
• upper second premolar (No. 5) – 1 (75% of cases), 2 (24%), 3 (1%);
• the lower 5 are predominantly single-channel;
• upper first molar – 3 or 4;
• lower first molar – 3 (60% of cases), less often – 2, extremely rarely – 4;
• top and bottom seven - 3 (70%), 4 - in other cases.

How many canals does a wisdom tooth have?

The number eight or the so-called third molar is somewhat different from other units of the dentition. To begin with, it should be noted that not all people have it, which is due to genetic factors.

This organ, in addition to its inconvenient location, which causes discomfort during oral hygiene, has other differences. Thus, the upper third molar is the only unit whose number of canals can reach 5. It is worth noting that this happens extremely rarely, mostly wisdom teeth have three or four canals. The bottom eight has no more than 3 indentations.

Number eight is often the cause of the development of dental pathologies. For example, incorrect placement of the third molar can contribute to impaired growth of adjacent units. In such cases, its removal is required. If the figure eight does not bother or hurt, there is no need to pull it out. The only indication for removal is the presence of pain and the negative impact of the third molar on other units of the row.

So that there are no problems with the eight, dentists advise adhering to the following rules of oral care:

• due to the inconvenient location of the figure eight, it is necessary to use a special brush;
• Owners of a third molar should visit the dentist for a routine examination at least 2 times a year.

Why does a tooth need a nerve?

A special feature of the cavity in the tooth is the presence of branched nerve endings in it, grouped into branches. The number of nerve endings directly depends on the number of roots and canals.

Purpose of dental nerves:

1. influence the development and growth of dental units;
2. thanks to the nerves, the organ is sensitive to external influences;
3. The dental nerve makes the masticatory organ not just a bone, but a living unit of the oral cavity.

The development of dental pathologies can be prevented only by following the advice of qualified doctors and observing the rules of oral hygiene.

• do not abuse the rules of hygiene, brush your teeth only in the evening and in the morning. More frequent exposure to tooth enamel contributes to its wear;
• hygiene procedures should be carried out half an hour after eating;
• use rinses to destroy germs remaining in the mouth after brushing;
• Cleaning should be carried out for at least 3 minutes, performing circular movements.

The main rule– if you detect the first signs of the disease, you should immediately contact your dentist. This will help prevent further development of pathology and preserve teeth.

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Why is there no accurate data on the number of canals in each specific tooth?

This situation is explained by the individual characteristics of the structure of each person’s teeth. Therefore, the dentist relies on statistical data and, if necessary, receives accurate information after appropriate research.

How do doctors figure out how many canals are in each specific tooth? A certain pattern does exist in this matter: the deeper a tooth is located in the mouth, the more complex its canal system is. This feature is due to the load that the tooth has to withstand.

In addition, statistics show that there are more canals in the upper teeth than in the lower ones, but not always. Therefore, it is possible to say about the exact number of canals only after opening the tooth or based on radiography. To preliminary determine the number of canals in teeth, statistical data are used, and to obtain accurate information, radiography results are used.

Why do you need to know about the number of channels? This question is very important during treatment and filling. If the doctor has not treated one of the canals, then an infection will remain in it, which will negate the result of the treatment.

Accurate determination of the number of channels using an x-ray image

An x-ray allows you to determine exactly how many canals there are in a tooth. This method allows the doctor to see a complete picture of the condition of the teeth: the location of the roots, the presence of a cyst. The image helps to evaluate the quality of the filling performed, as well as to calculate how many canals there are in a particular tooth.

Some patients associate the word “X-ray” with something dangerous. However, modern devices do absolutely no harm to humans. The procedure does not require preliminary preparation; it is often carried out directly in the dentist’s office. The whole process takes no more than 5 minutes.

As a result of radiography, the doctor has a complete, and most importantly, clear picture of what is happening to the teeth. Where crowns or fillings are installed, white areas appear in the image, cavities appear black, and tissues and fluids acquire gray shades. The information obtained allows the doctor to determine the number of channels as accurately as possible and perform treatment while minimizing negative consequences.

Dental X-rays can be done even for nursing and pregnant women. Of course, there must be serious reasons for this, but in general the procedure is absolutely safe. The only unpleasant moment may be the appearance of a gag reflex. It occurs when the film is fixed to the gum. Deep breathing through the nose helps reduce the urge to vomit.

The images that can be obtained using x-rays are divided into two types:

• Orthopantogram - displays a complete picture of the condition of the teeth of the upper and lower rows. Such photographs are needed at the initial stage of treatment in order to draw up a general plan of the necessary procedures, identify pathologies, structural features, and the relative position of the teeth.
• Targeted – allow you to obtain complete information about a specific tooth. The image gives a clear idea of ​​the internal structure, number and location of the channels, and helps make a final decision on the treatment method.
• Sight shots are sometimes called control shots. Their implementation after treatment allows us to evaluate their effectiveness and quality of implementation.

Approximate number of canals in the teeth of the upper jaw

The number of dental canals is one of the few points on which dentistry cannot give a clear answer. Such a concept as “norm” does not apply here. This is due to the individual characteristics inherent in the teeth of each person. They are determined by the location of the tooth in the row and on the jaw.

In general, you can rely on the following data:

• canines and incisors – usually 1 root;
• premolars 1-2 roots;
• molars have 3-4 roots;
• Wisdom teeth have up to 5 roots.

The main purpose of molars is to grind food. Therefore, they have a wide flat surface, and their root part is firmly fixed in the gum. The chewing teeth of the upper jaw usually have 3 roots, but with 4 canals. For comparison, the same teeth in the lower row often have 2 roots, but 3 canals.

Statistics tell you best about the number of channels:

The teeth located on the upper jaw are very different in the number of canals from the lower ones. The situation is simplest with incisors. The 1st, 2nd and 3rd incisors usually have only 1 canal. The fourth tooth is a little more complicated: in 85% of cases it has 2 canals, in 9% 1, and in only 6% 3 canals. In the fifth tooth, statistics give the following result: most often (75% of cases) there is 1 channel, less often (24%) - 2 and only 1% of cases - 3 channels.

In the sixth tooth, dentists find 3 and 4 canals, respectively, in 57 and 43% of cases. Among the “seven”, 3 channels are more common (57%), less often – 4 (43% in total). The doctor obtains the exact result in each specific case through direct examination or with the help of an image.

Approximate number of canals in lower jaw teeth

The situation with the teeth of the lower jaw is somewhat different from the upper one. Statistics show that in the first tooth, 1 canal is most often found (70%), 2 canals - respectively, in 30% of cases. In the second tooth, we can say it’s 50/50: a little more than half (56%) for there to be 1 canal, and 44% for two. In the “troika,” 1 channel is predominantly found (94%), the remaining 6% are 2. Slightly more often, 2 channels are found in the “four” (26%). The probability of meeting them in the “five” is even greater: 89%, the remaining 11% for 1 channel.

The “six” and “seven” have a more branched structure. In the sixth tooth, 3 (65%) or 4 (29%) canals are most common, 1 canal is least common - 6%. In the “seven” the dentist usually finds 3 canals (77%) and 2 canals (13%). It is very rare, but even in it you can find only 1 channel. This result shows only 1% of cases.

Wisdom teeth are considered extraordinary in all respects. Even when they start to cut themselves, they cause a person a lot of unpleasant moments. Then they most often occupy the wrong position, and cleaning them is another almost impossible task. There are even special brushes available that help you reach hard-to-reach places.

The number of G8 channels is also difficult to quantify. They are unique for each person. The number of channels in the upper eight can be 1-5, and in the lower eight most often it is 3. Although often opening a tooth reveals the presence of additional branches. Sometimes the dentist says that the patient has a single-channel “eight”. This usually means that there are actually more roots, but they have grown together.

A special feature of wisdom teeth canals is their non-standard shape. They are usually strongly curved, with narrow passages. This greatly complicates the dentist’s work during treatment and filling.

In addition, the proximity of lymph nodes and blood vessels contributes to the rapid spread of infection to the head and neck area. Given the existing difficulties in treating wisdom teeth, dentists often advise removing them. Otherwise, they quickly become sources of problems for neighboring teeth and mucous membranes.

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Canals in human teeth

It is known that the number of canals in teeth is not equal to the number of their roots. In one incisor there are two or three of them, and sometimes there is one, but which is divided into several. The specific number of channels can be determined by a highly qualified, competent dentist in the clinic using an x-ray.

There are no general and clear rules on the canals in human teeth and their number in the field of dentistry. As a rule, information about their number is generated by doctors. An approximate general scheme for the number of channels is as follows:

This is what dentists rely on when treating a diseased tooth, but this is only a general classification; in fact, there may be some deviations from the norm, which the doctor can only determine from an x-ray.

How many roots does each tooth have?

No less interesting is the answer to the question of how many roots a person’s teeth have. The tooth is designed in such a way that its root is located under the gum, below the neck and equals at least 70% of the organ itself. Their number and the number of their roots are also not always the same. Dentists have developed a whole system in order to roughly find out how many roots there can be in the upper 6th tooth, in the lower 6th tooth, in the 4th upper tooth, etc. The number of roots very often depends on many factors, for example, on genetics, belonging to a particular race, and a person’s age. To roughly understand how many roots each human tooth can have, dentists numbered each of them. This can be seen from the diagram below.

It will be quite difficult for a person not knowledgeable in the field of dentistry to decipher it. It presents a general classification of the root system of adult teeth. Teeth numbered one and two are called incisors, number three teeth are called canines, and numbers four and five are called molars. They grow on both jaws. They have one cone-shaped root. Others, numbered six, seven and eight, are called large molars and wisdom teeth, and they grow from above. They are the owners of three roots. Numbers six and seven, located below, most often have two roots, and number eight three or four. Central incisors, located in both the lower and upper jaws, rarely have more than one root. The first premolars are equipped with two bases at the top and one at the bottom. The second premolars have one root both above and below. The first molars have three roots above and at least two below, and the second molars have two or three bases above and two below.

Number of roots and channels for eights

The anatomy of the root canals of wisdom teeth is of interest to many due to the fact that they are somewhat different in structure from the rest of the masticatory organs. The number of roots they have can vary from two to five. Their roots are very curved, which causes a lot of inconvenience when treating them in dentistry. The number of their channels can reach up to eight.

When it grows from above, its channels can correspond to the number five, and from below, as a rule, three. These teeth are quite problematic, as they cause discomfort as they grow, they are very difficult to clean due to their inaccessibility, and difficult to treat for the same reasons.

Number of nerves in a molar tooth

Many of us have never thought about how many nerves there are in a molar, but this entirely depends on how many roots and canals it has.

Total number of human masticatory organs

By the age of twelve, each of us should become the owner of at least twenty-eight teeth. The remaining chewing organs can afford to grow only by the age of 25-30, but it may also happen that they will not exist at all. The total number of teeth in a person can reach thirty-two; among our distant ancestors, scientists counted forty-four chewing organs, due to the fact that the jaws at that time performed very hard work, chewing hard food.

Prevention of the development of diseases of the root system of teeth

In order to avoid any dental diseases, it is necessary to take good care of oral hygiene, as this will help preserve your teeth for as long as possible. Factors affecting the masticatory organs:

• Some dentists do not recommend brushing your teeth more than twice a day, as this can cause the enamel to become thinner.
• You should not clean immediately after eating; it is better to wait 20 or 30 minutes.
• To avoid the proliferation of pathogenic microorganisms in the mouth, it is worth rinsing your mouth either with special rinses or decoctions of chamomile, oak bark or sage.
• Do not forget that cleaning the chewing organs should be for at least two minutes and in a circular motion.

For any, even the smallest dental problems, seek medical help so as not to aggravate the situation and contribute to the development of more serious diseases associated with the oral cavity and masticatory organs.

First of all, we note that the price for treating pulpitis of a three-canal tooth really depends on the number of these very root canals in it, and here the general rule is this: the more there are, the more expensive the treatment procedure usually costs. And not only more expensive, but, in addition, with a large number of roots, a number of nuances of endodontic procedures often arise, which we will talk about in more detail later.

Note

is a disease in which inflammation of the so-called dental “nerve” (pulp) occurs. Large molars (molars) most often have three canals, each of which contains a neurovascular bundle. When an inflammatory process occurs in the pulp, it swells and is compressed, as a result of which a person can feel severe pain.

Pulpitis requires mandatory treatment: you should not expect that everything will somehow resolve and the pain will go away on its own, as sometimes happens in the case of pain with. The pain may indeed disappear when the “nerve” completely dies, but then it will begin to decompose right inside the tooth, and without appropriate treatment this will not lead to anything good.

Treatment of pulpitis of a three-canal tooth, in contrast to a single-canal one, is often technically more difficult, so in order to carry out high-quality work, the doctor has to spend more effort and time, and also actively apply the achievements of modern dentistry.

Today, in most clinics, three-channel pulpitis is almost always treated by extirpation - from all canals and filling them at the final stage of intracanal treatment.

This is interesting

In the upper wisdom teeth there are the most unpredictable variations in the number and location of roots and canals. As a rule, doctors are faced with one-, two- and three-canal eighth teeth, but there have also been cases of 4 and even 5-root teeth with up to 8 full canals!

The main stages of treatment of three-channel pulpitis

Three-channel pulpitis in most dental clinics is treated in two visits. For these purposes, the so-called vital extirpation technique is well suited, when, under local anesthesia, the pulp is removed from all three canals and they are filled, followed by the placement of temporary filling material on the tooth. And on the second visit, the permanent filling is successfully installed.

Let's now see how this happens in practice.

First visit:

• tooth pain relief;
• preparation of carious softened tissues with a turbine tip, removal of necrotic and pigmented dentin;
  
• washing with antiseptics;
• opening good access to the mouths of three canals;
• expansion of mouths;
• rubber dam application;
  
• extirpation (extraction) of pulp from all three canals using pulp extractors;
• passing the canals with files, measuring their length, expanding with K-files, H-files, machine instruments with constant irrigation (washing) of the canal system with sodium hypochlorite solution;
• the use of EDTA preparations for poorly traversed canals;
• drying of the canals, control measurement of their lengths;
• filling the canals using the method of cold lateral condensation of gutta-percha pins with paste or using the Termafil system for obturation;
• placement of a temporary filling or temporary restoration of a tooth;
• control image (x-ray).

Second visit:

• reprocessing of the tooth;
• placement of a permanent filling made from a light-curing composite or other imported material (an example is shown in the photo below).

Sometimes pulpitis of a three-rooted tooth is treated in three visits or even more. This depends on the chosen technique, the doctor’s tactics, the level of his professional skills and sometimes on the difficulties that arise during intracanal treatment.

If it is impossible to immediately remove the pulp from the canals, the dentist places a devitalizing drug on the opened pulp chamber in order to “kill the nerve” for the next appointment. Accordingly, this increases the treatment of three-channel pulpitis by one visit.

In Soviet times, even single-channel pulpitis was treated with “arsenic” for a period of 24 hours. This practice is no longer acceptable at the current level of development of dentistry. Treatment of pulpitis of a single-canal tooth, as well as a double-canal one, is almost always carried out in one visit (with rare exceptions).

Large molars (mainly lower ones), due to the structural features of the jaw and the location of the nerves that determine the sensitivity of the tooth, sometimes may not be “frozen” to such an extent that the nerve can be removed immediately, that is, pain sensitivity remains. Therefore, the way out of this situation is the preliminary use of pulp-killing pastes (popularly they are still called “arsenic,” although modern preparations have not contained arsenic for a long time).

Note

In a number of clinics, it is always carried out in one visit, regardless of the number of canals: they are filled, and a permanent filling is immediately installed on the tooth. Studies have shown that this practice often leads to long-term negative consequences, since the material introduced into the canals must first harden. In construction, work is not started until the foundation hardens, as the consequences can be disastrous - and the situation is the same here. That is why it is recommended to treat pulpitis in at least two visits.

The use of a microscope in the treatment of pulpitis

The microscope in endodontics is used, in particular, to diagnose the number of root canals and the quality of their passage. Treatment of pulpitis of a three-rooted tooth under a microscope allows you to quickly find and treat even the most difficult canals, and there are many such cases in dentist practice.

An endodontic microscope allows us to say with almost 100% confidence at the end of the treatment that all canals have been passed and properly sealed. It is he who allows you to control each stage of treatment of pulpitis, preventing. Traditional treatment without the use of a microscope is often associated with long-term negative consequences, for example, due to the fact that the doctor simply did not notice the additional canal in the tooth and missed it during treatment, leaving infected pulp in it.

Sometimes, when treating pulpitis, the doctor finds 3 canals, but in fact there is a “well hidden” 4th (or even fifth) in the tooth. There are cases of missing not just one canal, but several, as there are complex variations in their location in the tooth.

This is interesting

For the treatment of canals, microscopes were first used quite recently - in the USA (1992). A modern endodontic microscope allows you to treat teeth under almost 30 times magnification. During the procedure, the doctor looks through the microscope eyepiece and performs complex manipulations in the canals. A video camera can be connected to the microscope, allowing you to transfer the image to the monitor. At the same time, the doctor is not too close to the patient, since the microscope helps to treat the tooth somewhat remotely, which satisfies those patients who do not like it when their personal space is invaded. This treatment is considered one of the most progressive in the world.

The high price for the treatment of pulpitis of a three-canal tooth can scare away patients even with normal income, since it can be two or even three times more than the traditional treatment option (and imagine how things would be with the treatment of pulpitis of a four-canal tooth). However, such an increased price is often quite justified taking into account the specifics of complex and lengthy endodontic treatment, so you should not immediately think that they are trying to deceive you and swindle you out of money.

What is the price for the treatment of three-channel pulpitis?

First of all, we note a characteristic point regarding the pricing policy of most clinics for the treatment of pulpitis - the cost depends on each canal found in the tooth. The fact is that each channel means additional labor-intensive work for the doctor and additional costs for materials.

For example, a person’s tooth may have three, four or more canals instead of one. Therefore, it is not difficult to guess that the price for the treatment of three-channel or four-channel pulpitis consists primarily of the amount of work performed by the doctor: passage of the canals, their irrigation (washing), expansion, filling...

The cost of pulpitis treatment also includes:

• Local anesthesia;
• Additional instrumental methods of canal control and therapy: apex location (length determination), x-ray examination, ultrasound or laser treatment, irrigation, use of a microscope, placement of temporary medications under a bandage into the canals, etc.
• Permanent filling material. After filling the canal, at the next visit the doctor installs the permanent filling that the patient chooses, focusing on a price that is acceptable to him.

Taking into account the above, it becomes quite obvious that regardless of the dental institution to which the patient turns for help, treatment of pulpitis of a single-canal tooth will cost much less than a three-canal one.

This is interesting

One canal is present in 100% of cases in the upper incisors and canines. Moreover, in fangs, the canal is most often very wide and long. In the lower incisors there is predominantly one canal, but two are often found. The lower canine is only two-canal in 6% of cases, and single-canal in the rest. The second premolar (5 upper and lower teeth) in more than 70-80% of cases have one canal.

Different clinics mean different prices for services: what exactly are you paying money for?

Depending on the price-quality indicator for the services provided, all dentistry can be divided into three categories:

1. Budgetary organizations (clinics, hospitals);
2. Private economy class clinics;
3. Private business class clinics.

Advantages of a budget organization:

• Free treatment or low price for services (as a rule, only the cost of paid materials is taken into account);
• There is no need to sit in a chair for a long time, the reception is as quick as possible.

As a result of poor-quality treatment of three-channel pulpitis in a budget organization, the following problems may arise in a short time:

• pain in the tooth due to poorly washed, unfilled canals or due to removal of the filling material beyond the root (it will be painful to bite);
• swelling of the gums and cheeks due to missed canals (with infection), or a fragment of a dental instrument left in the canal, which is also not uncommon (see photo below);

The mistakes of a budget doctor can be listed endlessly, but it is worth remembering that there are many doctors, even in hospitals and clinics, who are provided with materials and have a high level of professional qualities that allow them to treat even three- or four-channel pulpitis at a fairly high level, although today This is rather an exception to the rule.

Advantages of an economy class private clinic:

• Availability of services for people with average incomes;
• No long queues;
• As a rule, the doctor’s professional level is quite high;
• Availability of necessary equipment and materials for the implementation of economy class services;
• Guarantee for root canal treatment and filling.

• Lack of maximum quality control of treatment at all stages (the risk of complications after canal filling can be described as average);
• The materials are not good enough for artistic restoration and often do not make the filling completely invisible to the eyes of others.

A business-class private clinic, unlike previous options, allows us to provide very high-quality services thanks to the availability of modern equipment and highly trained qualified dentists.

The use of a microscope, as an intermediary between the doctor and the patient’s tooth, significantly increases the already considerable price for the treatment of pulpitis of a three-canal tooth. However, thanks to such equipment, the patient can forget for the rest of his life that treatment was once carried out in the canals of his tooth, and he will only occasionally have to come to the dentist to examine the condition of the filling.

There are often situations when a patient, having contacted a local clinic, loses a tooth within a year or two due to tooth decay, and ends up undergoing expensive prosthetics for the missing tooth at a price even higher than the treatment of three-channel pulpitis, but in a business-class clinic.

There are also cases when, for example, 5-7 years after treatment of pulpitis in an economy class clinic (for about 6-7 thousand rubles), it is discovered that against the background of a fragment of an instrument left in the canal, a huge granuloma has developed on the root, due to where it is not possible to save the tooth. In such a situation, it is already difficult to say for the patient what is better for him: to lose a tooth in 5-7 years and deal with expensive prosthetics, or, or immediately go to a business-class clinic, where treatment of pulpitis of a three-channel tooth will cost around 12-14 thousand rubles, but such a tooth will last almost the rest of its life.

Interesting video: treatment of pulpitis of the upper tooth, which turned out to be not three-channel, but 4-channel

And here you can see all the stages of pulpitis treatment, including filling

Correctly determining the number of canals in a tooth is only possible using an x-ray. Of course, their number depends on where the tooth is located - with a greater chewing load on the teeth in the back of the jaws, the retaining system is stronger; accordingly, they are larger, have more roots and canals. However, this is not a constant indicator, and it does not mean that the upper or lower incisors will have only one canal; it all depends on the individual characteristics of the jaw structure of each person. Therefore, how many canals in a diseased tooth require filling can be determined by the dentist during an autopsy or with the help of an x-ray.

Interest calculation

Due to the fact that each person is individual and there are no clear norms and rules for determining how many canals are in the teeth, in dentistry data on this issue are given as a percentage. Initially, they are repelled by the fact that the same teeth of the upper and lower jaws are very different from each other. If the first three upper incisors in almost one hundred percent of cases have only one canal, then with the same teeth of the lower jaw everything is much more complicated, and they have approximately the following percentage:

• In the first incisor, most often there is only one canal - this is in 70% of cases from the general statistics, and only in 30% there can be two of them;
• The second tooth can have either one or two canals in almost equal proportions, or more precisely, a ratio of 56% to 44%;
• The third incisor of the lower jaw almost always has only one canal, and only in 6% of cases can there be two.

Premolars have a larger structure, more pressure and load are already placed on them, so it is logical to assume that there are more canals in the tooth, however, not everything is so simple here. For example, in the fourth tooth of the upper jaw there are really only 9% of teeth have one canal, in 6% of cases there may even be three, but the rest most often occur with two. But at the same time, the next premolar (fifth tooth), which seems to bear an even stronger load, most often has one canal and only in some cases more (of which only 1% is accounted for by three branches).

At the same time, in the lower jaw the situation is completely different - the first and second premolars are not three-canal at all, but most often have only one canal (74% - four and 89% - five) and in only 26% of cases for four and 11% for five - two.

The molars are already larger and the number of canals is increasing. The sixes of the upper jaw can have either three or four branches with equal probability. On the lower jaw, a two-canal tooth can sometimes be found (usually no more than 6% of cases), but most often there are three canals (65%) and sometimes four.

Posterior molars usually have the following relationship:

• Top seven: 70 to 30% three and four channels;
• Bottom seven: 13 to 77% two and three channels.

The figure eight or wisdom tooth is quite unique and does not meet the standards and statistics. The upper one can have a completely different structure with channels from one to five. The lower eight is most often found to be three-channel, however, often upon opening during treatment additional branches may be discovered.

Among other things, a wisdom tooth differs from others in that its canals are rarely of the correct shape, often very curved and with a narrow passage, which greatly complicates their treatment and filling.

Misconception

Since a tooth consists of roots and a pre-crown part, there is sometimes a misconception that There are as many canals in teeth as there are roots.. This is far from true, because the canals quite often branch and bifurcate near the pulp. Moreover, several channels can run parallel to each other in one root. There are also cases of their bifurcation at the apex, which means that one root has two apices and this, of course, complicates the work of doctors when filling such teeth.

Taking into account all the features of the individual structure of teeth, dentists need to be very careful when treating and filling, so as not to miss any branch. After all, sometimes without an x-ray it is very difficult, even during an autopsy, to identify how many canals there are in the teeth.

Treatment

The development of modern medicine and dentistry in particular, today makes it possible to increasingly preserve those diseased teeth that just yesterday had to be removed due to the impossibility of treatment. Root canal treatment procedure in teeth itself is quite complex, because they are filled with soft tissue - pulp, which contains a large number of nerve endings, blood vessels and other connective tissues. Today, this is dealt with by a separate branch of dentistry – endodontics, the development of which makes it possible to improve the condition of a person’s teeth and cure even complex problems in more than 80% of cases, preserving the tooth itself.

The goals of this treatment are:

• Removing developing infection inside the root system;
• Preventing pulp decay or removing it;
• Removal of infected dentin;
• Preparing the canal for filling (giving it the desired shape);
• Increasing the effect of medications.

The difficulty of such treatment of the root system is that the dentist is quite difficult to reach diseased canals and monitor the progress of the procedure. After all, if you do not remove even a microscopic part of the infection, it can develop again over time.

One of the main indicators for such treatment is the inflammatory process, which leads to damage to the soft tissue of the pulp inside the canals. Most often, various diseases such as caries and pulpitis lead to this, but root canal treatment may also be necessary for periodontitis.

The first symptoms of the need for such treatment are tooth pain or swollen gums. However, it is worth considering that if the disease passes into the chronic stage, pain may not be observed, but the disease develops and will ultimately lead to tooth loss. This is why it is so important to have regular dental checkups.

Process and stages of root canal treatment

The root canal treatment process has clear sequence of stages:

If the doctor has any doubts (usually this happens when the tooth is inconveniently positioned and instruments have difficult access to it), he puts a temporary filling, after which he sends the patient for an x-ray, using the photo of which he checks whether he has removed all the infection and whether he has cleaned all the channels. The permanent filling is then placed approximately two weeks later.

This whole procedure, of course, is not very pleasant, but it allows you to save the tooth. Its duration depends on the location of the tooth, the number of canals in it, the complexity of the developed infection and usually takes from thirty minutes to one hour. And success depends on the professionalism of the doctor and the high-quality work he has done, since it is necessary to remove all the affected pulp from the canals without leaving a single drop of infection, otherwise it can develop again and tightly seal the tooth so that nothing else can get into the cleaned cavity.

After the root system treatment procedure, some time stress should be avoided on a treated tooth, moreover, you should not eat food earlier than two hours after therapy, otherwise the not completely hardened filling may simply fall out. However, the same thing can happen if the doctor uses low-quality drugs or carries out incorrect treatment (for example, the canals are over-dried or not dried before filling).

Also after filling the tooth for some time (up to several days) may be painful when pressed or simply ache, cause discomfort, have increased sensitivity. This is usually a normal condition, but if the pain is severe, you can take painkillers. If the pain does not go away after a certain time, this may also be an indicator of poor treatment (insufficient cleaning of the infection or infected pulp, leaky filling, use of low-quality drugs or materials).

Sometimes there are cases occurrence of allergic reactions, which is also accompanied by incessant pain, sometimes itching and rashes appear on the body. It may be caused by a reaction to the drug or the material that was used for the filling. In this case, it must be replaced with another one that will not cause allergies.

In all these situations, it is imperative to consult a doctor as soon as possible for a re-examination and dental prophylaxis in order to identify the cause of deviations from the norm.

In total, a person has thirty-two teeth - sixteen on each jaw. They differ in shape and function: there are incisors, canines, small molars and large molars. Before we tell you how many roots a molar has, let’s learn more about teeth.

Structure of teeth

Each tooth in the mouth has a crown protruding above the gum, a neck covered by the gum, and a root that is located deep in the tooth socket. Almost all teeth have only one root, and only a few have two or three. The tooth is formed by dentin. In the area of ​​the tooth crown, dentin is covered with enamel, and where the neck and root are located, it is covered with cement. Inside the tooth there is a cavity made up of the cavity of the crown, which passes into a narrow canal of the tooth root, which opens with a hole at the top. It is through it that nerves and blood vessels pass into the tooth cavity containing the pulp. Around the root there is a connective tissue periodontium, which plays the role of a tooth retainer in the dental alveolus.

Teeth growth

During his life, a person experiences two periods of teething. When a newborn is born, he has no teeth. They begin to erupt between six months and two years of age, resulting in twenty milk teeth, that is, ten on each jaw. Then the second period begins, lasting from six to twenty, and for some up to thirty years, when thirty-two permanent teeth grow. The last teeth to appear, the so-called wisdom teeth, may not appear at all or may not fully erupt. This is usually directly related to the individual characteristics of the individual.

Functions of teeth

The functions of teeth directly depend on their structure. So, the incisors have a crown that resembles a chisel and these teeth are located in front, four at a time, on the upper and lower jaws. The fangs differ in length and they sit quite deep. These two types of teeth have simple single roots, and themselves are used for biting food. Behind the fangs there are two small and three large molars and they are located on each side of both jaws.

Molars

Finally, we got to clarifying the specific question of how many roots a molar has, and it turns out that this can be a different number. Thus, small molars have a single root, but large molars in the upper jaw have three roots, and their counterparts in the lower jaw have two. These teeth have a lumpy chewing surface and are designed to crush and grind food.

As already mentioned, the upper molars have three roots - two cheek and one lingual, while the lower ones have two roots, one anterior and the other posterior. Wisdom teeth have three roots that can merge into one, which has a conical shape.

Take care of your teeth

If the teeth are not in order, then a person’s digestion is impaired due to poorly crushed food entering the stomach, as well as its insufficient preparation for further chemical processing. In addition, microorganisms that can provoke inflammatory processes in the intestines or other important organs get inside. All this is to say that your teeth require careful daily care. Clean them twice a day - morning and evening, after meals, and generally after each meal, you must thoroughly rinse your mouth.

Human teeth are the main components of the digestive system. Their function includes participation in the act of chewing, biting, kneading and crushing food. Teeth also take part in the act of breathing, the formation of speech, contribute to the clear pronunciation of sounds and determine the aesthetics of a person’s appearance.

A person has one change of teeth throughout his life. Temporary or primary teeth (dentes temporali s. lactice) are formed at the 6-8th week of embryonic life and begin to erupt in the child at 5-6 months. By 2 - 2 1/2 years, all teeth in the primary bite have erupted: 8 incisors, 4 canines and 8 molars. Normally, there are only 20 teeth in a primary dentition. Anatomical formula primary teeth 2.1.2, i.e. on one side there are two incisors, one canine and two molars. Each tooth according to the anatomical formula is designated in the primary occlusion I 1 I 2 C M 1 M 2:

I 1 - first (central) incisor

I 2 - second (lateral) incisor C - canine

M 1 - first molar M 2 - second molar

In clinical practice temporary (baby) teeth mark in Roman numerals:

A horizontal line conventionally separates the teeth of the upper jaw from the lower, and a vertical line separates the right and left sides of the jaws. Teeth numbering starts from the central (vertical) line, from incisors to molars.

Temporary teeth are gradually replaced by permanent teeth. Permanent teeth begin to emerge at 5 to 6 years of age, starting with the first molar.

The timing of the eruption of permanent teeth is:

central incisors - 6 - 8 years,

lateral incisors - 8 - 9 years,

fangs - 10 - 11 years,

first premolars - 9 - 10 years,

second premolars - 11 - 12 years,

first molars - 5 - 6 years,

second molars - 12 - 13 years,

third molars - 20 - 25 years.

There are 28 - 32 permanent teeth in total: 8 incisors, 4 canines, 8 premolars and 8 - 12 molars (not all people erupt third molars). Their anatomical formula is as follows: 2.1.2.3, i.e. On one side of each jaw there is a central and lateral incisor, a canine tooth, first and second premolars, and first, second and third molars.

In the permanent dentition, teeth according to the anatomical formula are designated:

I 1 - first (central) incisor,

I 2 - second (lateral) incisor,

P 1 - first premolar, P 2 - second premolar, M 1 - first molar, M 2 - second molar, M 3 - third molar.

In the clinic, permanent dentition teeth are designated in Arabic numerals. The dental formula is written in four quadrants, delimited by horizontal and vertical lines. It is generally accepted that the formula reflects the position of the teeth of a person facing the researcher.

The complete formula of permanent teeth has the following expression:

Currently, the dental formula proposed in 1971 by the International Dental Federation (FDI) is used. Its essence consists in designating each tooth with a two-digit number, in which the first digit indicates the quadrant of the row, and the second - the position occupied by the tooth in it. The quadrants of the jaws are designated by numbers from 1 to 4 for permanent teeth and from 5 to 8 for milk teeth:

For example, the upper left fifth tooth is written as 2.5, and the lower right sixth tooth is written as 4.6 (read two-five and four-six, respectively).

Formula of temporary teeth:

There are other systems for naming teeth (dental formulas). Thus, according to the nomenclature adopted in 1975, the dentition is designated as follows:

According to this system, tooth numbering begins with the right eighth upper tooth of the right upper quadrant and then proceeds clockwise. For example, the sixth tooth of the upper jaw on the right will be designated by the number 6, and the sixth lower tooth on the right by the number 30. In our country, this classification is not widespread.

In each tooth there are crown (corona dentis), root (radix dentis) And neck of the tooth (collum dentis). There are crowns anatomical - this is the part of the tooth that is covered with enamel, and clinical - This is the part of the tooth that is visible in the mouth and protrudes above the gum. Throughout life, the size of the clinical crown changes due to recession of surrounding tissues (Fig. 4.1).

Rice. 4.1. Tooth crowns:

1 - anatomical tooth crown

2 - clinical tooth crown

Rice. 4.2. Tooth structure:

1 - tooth crown

2 - tooth root

4 - dentin

5 - cement

6 - coronal cavity of the tooth

7 - root canal

8 - apical foramen

9 - neck of the tooth

Root - This is the part of the tooth covered with cement. The root of the tooth is located in the bony alveolus of the jaw. Between the root and the compact lamina of the alveoli is the periodontium. Periodontium performs various functions, the main one of which is support and retention. Neck - this anatomical formation, which is the place of transition of the crown to the root of the tooth, corresponds to the enamel-cement border.

There is a cavity inside the tooth (cavum dentis), the shape of which follows the external contours of the tooth and is divided into a coronal part (cavum coronale) and root canals (canalis radicis dentis). In the region of the root apex, the canals end in the apical (apical) foramen (foramen apicis dentis) (Fig. 4.2).

The surfaces of tooth crowns have different names depending on their group affiliation.

The surface of all teeth facing the vestibule of the oral cavity is called the vestibular surface (facies vestibularis). In groups of incisors and canines, these surfaces are called labial ( facies labialis), and in premolars and molars - buccal (facies buccalis) surfaces.

The surface of all teeth facing the oral cavity

called oral (facies oralis). This surface in the teeth of the upper jaw is called the palatine (facies palatinalis), and in the teeth of the lower jaw - lingual (facies lingualis).

In the incisors of the upper and lower jaws, the vestibular and oral surfaces converge to form the cutting edge.

In premolars and molars, the surface facing the teeth of the opposite jaw is called chewing ( facies masticatoria) or clamping surface (facies occlusalis).

the contacting surfaces of two adjacent teeth are called contact (facies contactus). In the group of anterior teeth, the medial surface is distinguished (facies medialis) and lateral surface ( facies lateralis). In premolars and molars, the contact surfaces facing anteriorly are called anterior ( facies anterior), and those facing posteriorly are posterior ( facies posterior).

Each tooth has anatomical characteristics that make it possible to determine its group affiliation. Such signs are the shape of the crown, cutting edge or chewing surface, and the number of roots.

Rice. 4.3. Signs of determining the side of the tooth: a - crown curvature b - sign of the crown angle b, c - sign of the root (indicated by arrows)

Along with these, there are signs to determine whether a tooth belongs to the right or left side of the jaw. There are three such features, or signs: 1) a sign of crown curvature; 2) sign of crown angle; 3) root sign (Fig. 4.3).

Sign of crown curvature (Fig. 4.3a) is that the convexity of the labial and buccal surfaces is not symmetrical. In the teeth of the frontal group it is shifted to the midline. Thus, closer to the medial surface, the crowns of the teeth are more convex, and their lateral part is convex to a lesser extent.

In the chewing group of teeth, the anterior part of the vestibular surface is correspondingly more convex and the posterior part less convex.

Crown angle sign (Fig. 4.3b) is expressed in the fact that the medial surface and cutting edge of the frontal teeth and the anterior and occlusal surfaces of the chewing group of teeth form a more acute angle. Actually, the opposite angles of the crowns are more obtuse.

Root sign (Fig. 4.3b, c) is that the roots of the frontal group of teeth are deviated from the midline in the lateral direction, and in the chewing group of teeth - in the posterior direction from the longitudinal axis of the root.

Permanentteeth- Dentes permanentes (rice. 4.4)

Rice. 4.4. Permanent teeth of an adult: 1 and 2 - incisors; 3 - fangs; 4 and 5 - premolars; 6, 7 and 8 - molars

Incisors - Dentes incisivi

A person has 8 incisors: four on the upper jaw and four on the lower jaw. Each jaw has two central and two lateral incisors. The central incisors of the upper jaw are larger than the lateral incisors. On the lower jaw, the lateral incisors are larger than the central ones. The central incisors of the upper jaw are the largest of the group of incisors and, conversely, the central incisors of the lower jaw are the smallest. On the incisors there are different

Rice. 4.5. Maxillary central incisor:

1 - vestibular surface

2 - palatal surface

5 - occlusal surface

(cutting edge)

These surfaces are: vestibular (labial), oral (palatal or lingual), contact (median and lateral). The vestibular and oral surfaces converge to form the cutting edge.

Central incisor of the upper jaw (dens incisivus medialis superior) (Fig. 4.5) has a chisel-shaped crown and one well-developed cone-shaped root. Its vestibular surface is convex, resembles the appearance of an elongated quadrangle, and tapers towards the neck of the tooth. Two vertical grooves separate three vertical ridges, which form three tubercles on the cutting edge. With age, the tubercles wear off, and the cutting edge becomes smooth. The crown is wider at the cutting edge and narrower at the neck of the tooth. The sign of curvature and angle of the crown is well expressed: the medial angle is pointed and smaller in size than the rounded lateral one.

The lingual surface is concave, triangular in shape, and narrower than the vestibular surface. Along its edges there are protruding ridges (marginal ridges), which turn into a tubercle at the neck of the tooth. The size of the tubercle varies. With a large tubercle, a hole is formed at the point where the ridges converge.

The contact surfaces - medial and lateral - are convex, have the shape of a triangle with the apex at the cutting edge and the base at the neck of the tooth. At the neck of the tooth, the enamel-cement border is concave towards the apex of the tooth root. The root is cone-shaped. There are longitudinal grooves on the middle and lateral surfaces. The root sign is not clearly expressed, but the entire root deviates late

Rice. 4.6. Lateral (lateral) incisor of the upper jaw:

1 - vestibular surface

2 - palatal surface

3 - medial (middle)

surface

4 - lateral (side) surface

5 - occlusal surface

(cutting edge)

6 - difference in the size of the crowns

central and lateral incisor of the maxilla

ral from the midline (tooth axis).

Lateral incisor of the upper jaw (dens incisivus lateralis superior) (Fig. 4.6) is similar in shape to the central incisor, but smaller in size. The vestibular surface is convex, the palatal surface is concave and has the shape of a triangle. Along the edges of the palatal surface there are well-defined lateral ridges, which form a tubercle at the point of convergence at the neck.

Above the tubercle there is a pronounced blind fossa ( fovea caecum). The lateral surfaces are slightly convex and triangular in shape. The tubercles on the cutting edge are weakly expressed and are found only in unworn teeth. The sign of the crown angle is well defined, the medial angle is pointed, the lateral angle is rounded.

The root is cone-shaped, compressed in the medial-lateral direction, and has a well-defined vertical groove on the medial surface. On the lateral surface of the root, the vertical groove is less pronounced. The sign of crown curvature is well expressed and, to a lesser extent, the sign of the root. Sometimes the root apex deviates in the palatal direction.

Central incisor of the lower jaw (dens incisivus medialis inferior) (Fig. 4.7) is the smallest in size among the incisors. The vestibular surface of the crown has the shape of an elongated quadrangle, slightly convex, often flat. At a young age, two vestibular structures are found on the vestibular surface

Rice. 4.7. Central (medial) incisor of the lower jaw:

1 - vestibular surface

2 - lingual surface

3 - medial (middle) surface

4 - lateral (side) surface

5 - occlusal surface

(cutting edge)

grooves separating three vertical ridges, turning into tubercles on the cutting edge. The lingual surface is concave, flat, triangular in shape. The lateral ridges and tubercle are weakly expressed. The contact surfaces are triangular in shape, located almost vertically, slightly approaching each other in the area of ​​the tooth neck.

The root is compressed from the sides, thin. There are grooves on its medial and lateral surfaces. The groove on the lateral side is more pronounced, and this feature determines whether a tooth belongs to the right or left side.

The sign of curvature, crown and root angles are not expressed. The corners of the crown are straight, almost no different from each other.

Lateral incisor of the lower jaw (dens incisivus lateralis inferior) (Fig. 4.8) larger than the central incisor. The vestibular surface is slightly convex. The lingual surface is concave and has the shape of an elongated triangle. The medial surface is almost vertical, the lateral surface (from the cutting edge to the neck) is directed with an inclination.

The sign of crown curvature and crown angle are more pronounced than that of the medial incisor. The root is longer than that of the medial mandibular incisor, with a well-defined groove on the lateral surface and with a clearly visible root sign.

Fangs(Dentes canini)

Fang top jaws(dens caninus superior) (Fig. 4.9).

There are two fangs on the upper jaw - right and left. Every

Rice. 4.8. Lateral (lateral) incisor of the lower jaw:

1 - vestibular surface

2 - lingual surface

3 - medial (middle) surface

4 - lateral (side) surface

5 - occlusal surface

(cutting edge)

Rice. 4.9. Maxillary canine:

1 - vestibular surface

2 - palatal surface

3 - medial (middle) surface

4 - lateral (side) surface

5 - occlusal surface

(cutting edge)

of these is located lateral to the second incisor, forming the angle of the dental arch - the transition from cutting teeth to chewing teeth.

The canine crown is massive, cone-shaped, tapers towards the cutting edge and ends with one pointed tubercle. In the dentition, the crown of the canine is slightly deflected vestibularly and, accordingly, protrudes from the arch of the dentition.

The tubercle has two slopes, the medial slope is smaller than the lateral one.

Vestibular surface convex and has a vaguely pronounced

Rice. 4.10. Mandibular canine:

1 - vestibular surface

2 - lingual surface

3 - medial (middle) surface

4 - lateral (side) surface

5 - occlusal surface

(cutting edge)

long longitudinal ridge, better visible at the cutting edge. The roller divides the vestibular surface into two unequal parts (facets): the smaller one is medial and the larger one is lateral.

The cutting edge of the crown ends with a tubercle and has two obtuse angles - medial and lateral. The medial angle is located closer to the tubercle than the lateral one. The lateral part of the cutting edge is longer than the medial part and is often concave. The medial angle is usually lower than the lateral.

The palatal surface is narrower, convex and also divided by a ridge into two facets, which have depressions, or pits.

In the upper third, the ridge passes into a well-developed dental tubercle.

The contact surfaces are triangular and convex.

The root is cone-shaped, slightly compressed laterally, with vaguely defined grooves. The lateral surface of the root is more convex.

Fang bottom jaws(dens caninus inferior) (Fig. 4.10).

The shape of the crown is similar to the crown of the maxillary canine. However, the mandibular canine is shorter and smaller in size.

The vestibular surface of the crown is convex to a lesser extent than that of the upper canine, and has a greater height (longer from the cusp to the neck of the tooth).

The lingual surface is flattened or slightly concave.

Rice. 4.11. Maxillary first premolar:

1 - vestibular surface

2 - palatal surface

4 - rear contact surface

surface a - palatal root

6 - buccal root

The root is cone-shaped, shorter than that of the upper incisor. There are deep longitudinal grooves on the lateral surfaces.

Signs of angle, curvature and root are well expressed.

Premolars (Dentes premolares) or small molars

First premolar of the upper jaw (dens premolaris primus superior) (Fig. 4.11). The upper jaw has four premolars, two on each side. Premolars are teeth present only in the permanent dentition. They erupt in place of primary molars and are involved in crushing and crushing food. Their morphological structure combines the features of canines and molars.

The first premolar of the upper jaw is approximately rectangular in shape, elongated in the bucco-palatal direction. On the chewing surface there are two cusps - buccal and palatal, of which the buccal one is slightly larger. Between the tubercles there is a longitudinal fissure, along the edges of which there is

There are transverse grooves and small enamel ridges.

The vestibular (buccal) surface of the crown is similar to the vestibular surface of the canine, but it is shorter and is also divided by a vertical ridge into two halves: the smaller (anterior) and the larger (posterior).

When the vestibular surface transitions to the contact surface, rounded corners are formed. The contact surfaces are straight

Rice. 4.12. Maxillary second premolar:

1 - vestibular surface

2 - palatal surface

3 - front contact surface

4 - rear contact surface

surface

coal-shaped, with the rear surface being more convex than the front. The contact surfaces, without forming angles, transform into a more convex lingual surface.

There are two roots in a tooth: buccal and palatal. The roots are compressed in the anteroposterior direction and have deep grooves on their lateral surfaces. The closer to the neck the roots are separated, the more the buccal cusp is tilted towards the oral cavity. Often the buccal root is divided into two roots: anterior buccal and posterior buccal.

Distinctive features for determining whether teeth belong to the right or left side of the jaw are well defined. However, often the sign of crown curvature can be the opposite, i.e. the more convex is the posterior half of the buccal surface of the crown, and the more sloping is the anterior half of the same surface.

Second premolar of the upper jaw (dens premolaris secundus superior) (Fig. 4.12). In shape this

the tooth differs little from the first premolar of the upper jaw, but is somewhat smaller in size. On the chewing surface, the buccal and palatal cusps are the same size. The root is single, has a cone-shaped, slightly flattened shape with shallow grooves on the lateral surfaces. It occurs, although very rarely, bifurcation of the root in the apical area.

First premolar of the mandible (dens premolaris primus inferior) (Fig. 4.13). There are four premolars in the lower jaw, they are located

Rice. 4.13. Mandibular first premolar:

1 - vestibular surface

2 - lingual surface

3 - front contact surface

4 - rear contact surface

5 - ok fusion (chewing)

surface

There are two behind the fangs on each side, they are called the first and second.

The crown of the first premolar has a rounded shape and is inclined lingually in relation to the root. The chewing surface has two cusps: buccal and lingual. The buccal cusp is significantly larger than the lingual one. The tubercles are connected by a ridge, on the sides of which there are pits or small grooves.

Along the edges of the chewing surface there are lateral enamel ridges that limit the contact surfaces.

The buccal surface is similar in shape to the buccal surface of the canine. It is divided by a longitudinal ridge into facets: the smaller one is the anterior one and the larger one is the posterior one. The buccal part of the chewing surface has a tubercle with two slopes - anterior and posterior.

The lingual surface is shorter than the buccal surface, which is due to the less developed lingual cusp. The contact surfaces are convex. The root is oval in shape, has faint grooves on the front and back surfaces. The signs of the tooth are well defined.

Second premolar of the mandible (dens premolaris secundus inferior) (Fig. 4.14) is larger in size than the first premolar of the mandible.

The chewing surface is round in shape, with two tubercles: buccal and lingual. The tubercles are well defined and are at the same level in height. The tubercles are separated by a longitudinal groove. Often a transverse groove extends from the longitudinal groove, dividing the lingual cusp into two cusps, thereby turning the tooth into a tricuspid one. The edges of the tubercles are connected by enamel ridges.

Rice. 4.14. Mandibular second premolar:

1 - vestibular surface

2 - lingual surface

3 - front contact surface

4 - rear contact surface

5 - occlusal (chewing)

surface

The buccal surface is shaped like the buccal surface of the mandibular first premolar.

The lingual surface is significantly larger than that of the first premolar due to the well-developed cusp.

The contact surfaces of the crown are convex and pass into the lingual surface without sharp boundaries.

The root of the tooth is cone-shaped. The root sign is well expressed. Signs of the angle and curvature of the crown are not clearly expressed.

Molars (Dentes molares)

There are 6 molars on the upper jaw, three on each side. The molars are located behind the premolars and are called the first, second, and third. Of all the molars, the first ones are the largest.

First molar of the upper jaw (dens molaris primus superior) (Fig. 4.15). The chewing surface of the crown is diamond-shaped, with four cusps - two buccal and two palatal. The buccal cusps have a sharp shape,

palatal - rounded. There is an additional tubercle on the anteropalatine tubercle The anterior tubercles are larger in size than the rear ones. The anterior buccal tubercle is most pronounced.

There are two grooves on the chewing surface: anterior and posterior.

The anterior groove begins on the buccal surface, crosses the chewing surface in an oblique direction and ends at the edge of the

Rice. 4.15. Maxillary first molar:

1 - vestibular surface

2 - palatal surface

3 - front contact surface

4 - rear contact surface

5 - occlusal (chewing)

surface a - palatal root

surface days. This groove separates the anterior buccal tubercle from the rest. The posterior groove begins on the palatal surface, obliquely crosses the chewing surface and ends at the edge of the posterior surface, separating the posterior palatal tubercle. The anterior palatal and posterior buccal cusps are connected by a ridge. Often these tubercles are separated by a groove.

The buccal surface is convex, turning into moderately convex contact surfaces. The anterior surface is larger than the posterior one

The palatal surface is somewhat smaller in size than the buccal surface, but more convex.

The tooth has three roots - two buccal (anterior and posterior) and one palatal. The palatine root is cone-shaped and larger than the buccal roots. The anterior buccal root is larger than the posterior buccal root and is curved posteriorly. The posterior buccal root is smaller and more straight.

All three signs are clearly expressed in the tooth, determining whether the tooth belongs to the right or left side of the jaw.

Second molar top jaws(dens molaris secundus superior)

(Fig. 4.16) is smaller in size than the first molar of the maxilla. There are four variants of the anatomical structure of this tooth. 1. The crown of the tooth is similar in shape to the crown of the first tooth

molar, but it is smaller in size, there is no additional

boo-slide (tuberculum anomale Carabelli).

Rice. 4.16. Maxillary second molar:

1 - vestibular surface

2 - palatal surface

3 - front contact surface

4 - rear contact surface

5 - occlusal (chewing)

surface a - palatal root

6 - anterior buccal root c - posterior buccal root

2. The crown of the tooth has the shape of a rhombus, more elongated in the anteroposterior direction. There are four hillocks. The anterior palatal and posterior buccal tuberosities are close together, the groove between them is not always pronounced.

3. The crown of the tooth has the shape of a rhombus, elongated in the anteroposterior direction. There are three hillocks. The anterior palatal and posterior buccal tuberosities merge into one, which has an oval shape. The tubercles are located on the same line.

4. The crown is triangular in shape, has three cusps: two buccal (anterior and posterior) and one palatal.

The first and fourth crown forms are more common.

The tooth has three roots, slightly smaller than the first molar. Often the buccal roots grow together; more rarely, all the roots grow together.

All the signs that determine whether the tooth belongs to the right or left side are clearly expressed in the tooth.

Third molar of the upper jaw (dens molaris tertius superior) (Fig. 4.17) is variable in its structure, has numerous variations in shape and size, but more often its structure resembles the shape of the first or second tooth of the upper jaw. In some cases, you can find spiky-shaped molars.

The chewing surface may have one or more bumps.

The number of roots also varies. Sometimes there is one cone-

Rice. 4.17. Maxillary third molar:

1 - vestibular surface

2 - palatal surface

3 - front contact surface

4 - rear contact surface

5 - ok fusion (chewing)

surface

Rice. 4.18. Mandibular first molar:

1 - vestibular surface

2 - lingual surface

3 - front contact surface

4 - rear contact surface

5 - occlusal (chewing)

6 - posterior root

a shaped root with well-defined grooves indicating the place of fusion of the roots. Often the roots are crooked and short.

First molar of the lower jaw (dens molaris primus inferior) (Fig. 4.18) the largest of the teeth in the lower jaw. The chewing surface is rectangular in shape, elongated in the anteroposterior direction. Its anteroposterior size is larger than buccolingual. There are five cusps: three buccal and two lingual. The largest tubercle is the anterior buccal, the smaller is the posterior buccal. lingual

Rice. 4.19. Mandibular second molar:

1 - vestibular surface

2 - lingual surface

3 - front contact surface

4 - rear contact surface

5 - occlusal (chewing)

surface a - anterior root

6 - posterior root

The tubercles have sharp apexes, the buccal tubercles are smoothed and rounded. A longitudinal fissure separates the buccal cusps from the lingual ones, and transverse grooves extend from it, separating the cusps. The buccal surface is convex and smoothed. There is a fossa in its upper third. The lingual surface is less convex. The crown of the tooth is tilted towards the lingual side.

A tooth has two roots - anterior and posterior. They are flattened in the anteroposterior direction. There are longitudinal grooves on the surface of the roots. There is no groove on the posterior surface of the posterior root. The signs of the angle, crown and root are well defined.

Second molar of the lower jaw (dens molaris secundus inferior) (Fig. 4.19). The crown of the tooth has an almost square shape, its size is slightly smaller than the first molar of the lower jaw. The chewing surface has four cusps - two buccal and two lingual, separated by a cruciform groove.

A tooth has two roots - anterior and posterior. The signs of the angle, crown and root are well defined.

Third molar bottom jaws(dens molaris tertius inferior) (Fig. 4.20). The size and shape of this tooth are variable, but more often the chewing surface resembles the shape of the chewing surface of the first or second molar of the mandible. Number of tubercles, roots from one or more. The roots are curved and often grow together.

The given data on the anatomical structure of teeth are the most characteristic and generalized data, based

Rice. 4.20. Mandibular third molar:

1 - vestibular surface

2 - lingual surface

3 - front contact surface

4 - rear contact surface

5 - ok fusion (chewing)

surface a - anterior root

6 - posterior root

bathrooms to study a large number of teeth by many generations of scientists.

Knowledge of the anatomical structure of teeth is necessary for the dentist when treating dental caries and its complications.

Temporary (baby) teeth - Dentes temporali (Fig. 4.21)

The anatomical structure of temporary teeth is basically identical to the structure of permanent teeth. However, they have a number of differences:

The size of temporary teeth is smaller than permanent teeth;

The width of the crowns is more pronounced compared to the height;

The enamel of the tooth crown is white with a bluish tint;

There is a well-defined enamel ridge at the neck of the tooth;

The sign of crown curvature is more pronounced;

The roots are shorter, flattened and diverge more to the sides;

The tooth cavity is wider, the walls of the crowns and roots are thinner;

Milk teeth are located more vertically in the dental arch as a result of the fact that behind their roots there are the rudiments of permanent teeth;

Primary teeth lack groups of premolars and third molars.

Rice. 4.21. Temporary (baby) teeth of the upper and lower jaw: a - from the vestibular surface b - from the oral surface