TechBOOI<

Simplifying Posterior
Dental Anatomy
Simpli in Posterior
Dental natomy .

John C. Ness CDT

PTC
www.ajlobby.com
 Dedica ted to
L Ron Hubb ard
for your admini stratio n and study techno logy,
and so much more

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Editor
1v1ark Larson
Illustration
Christoph er Cross BA, MA
Jeff Felson, BA
Photogr aphy
Christoph er Cross BA, MA
Special Acknow ledgmen t to
James Mahan CDT
This publication was adapted
from methods developed by
John C. Ness CDT

© 2009 John C. Ness and Productivity Training Corporation

All worldwide rights reserved. No part of this publication may be reproduced

or transmitted in any form or by any means, electronic or mechanical,
including photocopying, recording, scanning or by any information storage
and retrieval system, without prior written permission of Productivity
Training Corporation .

ISBN 10: 0-9797402-1 -5

ISBN 13: 978-0-9797402- 1-3

Printed in the USA.

Published by

Productivity Training Corporation

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Morgan Hill, CA 95037

Phone: 408-776-0433 • 800-448-8855 •Fax: 408-776-0145

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Revision 3.26.9

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Contents
07 I Introductory Reference I Full Arch Tooth Reference

12 I Part One I Primar y Anatom y

13 The Five Tooth Surfaces

14 The Five Basic Features

16 Simplifying Anatomy

17 Cusps

19 Two Unique Teeth

20 Ridges

22 Fossae

25 Dissectional Grooves

27 j Part T1vo I Second ary Anatom y

28 Seconda ry Grooves

31 Tooth Similarities

37 I Part 1hree I Tooth Numbe ring Systems

38 The Universal System

39 The Internati onal System

40 The Palmer System

45 IAppend ix I Individ ual Tooth Referen ce

56 j PTC Training l\1aterial.. -.! v. --tenz..

,,

64 I G/o . ·sa ry

68 j lnde. ~

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 . · due rJ efe "e ce

Full Arch
Tooth Reference

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Maxillary Primary Anatomy

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Mandibular Secondary Anatomy
 Pa 19

rimary Anatomy
 The Five Tooth Surfaces
The first five terms we need to study refer to the
surfaces of the tooth. They are:

Mesia I
The mesial surface is the surface of the tooth that
faces toward the midline, or toward the front of
the mouth.

Distal
The distal is the surface that faces away from the
midline, or toward the back of the mouth.

Buccal
The buccal is the surface that faces the cheek,
or the outside of the mouth. Your cheek rests
against the buccal surfaces of the teeth.

Lingual
The lingual is the surface toward the tongue,
or the inside of the mouth. Your tongue rests
against the lingual surfaces of your teeth. Fi:. 1 I the five swfaces

Occlusal
The occlusal surface is the surface with which
we chew food. When you close your inouth, the
occlu al surfaces of the upper and lower teeth
come together.

These five term mean exactly the aine thing on

both the upper and lower teeth.
 The Fiv Basic F atures
Th n 't five ter111s refer to the "hills" and
"valley " of the occlusal surface. These features
are also called the primary anatomy of the teeth.
They are:

1. Cusps
Cone shaped elevations on the occlusal surface
of posterior teeth. (Fig. 1)

2. Ridges
Ridges are elongated raised areas on the occlusal
surface. There are three kinds of ridges that we
are concerned with.

Marginal Ridges
The marginal ridge is the height of the occlusal
or biting surface of the tooth at the border with
another tooth. Every tooth has two marginal
ridges: one on the mesial and one on the distal.
(Fig. 2)

Oblique Ridges
Oblique ridges are found on some bicuspids and
all molars. They are at approximately 45° angles
to the central dissectional groove, which we'll
define on the next page. (Fig. 2)

Transverse Ridges
Transverse ridges are found only on bicuspids.
They are directly opposite one another and are
perpendicular (90°) to the central dissectional
groove. (Fig. 3)
 Pnri One I Primary Anatomy I 15

3. Fossae
Fo ae are concavities, or depressions in the
occlu al surface bordered by the occlusal table
(defined below) a'ii.d the ridges. The fossae
receive the cusps of the opposing posterior teeth.
(Fig. 1) The lowest point of the fossa is called
the "pit".

4. Dissectional Grooves
Dissectional grooves are curving grooves that
literally dissect the tooth. All dissectional
Fig. 1 lfossae
grooves break through the occlusal "table", to
define the perimeters of the cusps. There are two
kinds of dissectional grooves. (Fig. 2)

Central Dissectional Groove

Every posterior tooth has a central dissectional
groove, which runs from the mesial to the distal
of the tooth.

Buccal and Lingual Dissectional Grooves

Some teeth have buccal and lingual dissectional
grooves, which run from the central groove to
either the buccal or lingual side of the tooth. Fig. 2 I dissectional grooves

5. Ocdusal Table
The occlusal table is the outline of the occlusal
surface of the tooth. This outline is created where
the outside surfaces and the occlusal surface of
the tooth come together. (Fig. 3)

hg. 3 ' occlusal table

 Simplifying Anatomy
All of th detail we have covered o far make up
the primary anatomy. The primary anatomy is
the overall anatomy of the tooth.

Anatomic Features of the Teeth

You have learned that all posterior teeth ha\ e
the same basic features. What makes one tooth
different from another is the way that those
features are arranged. Since there are remark-
able similarities among most teeth, you will not
have to study 20 individual teeth to understand
posterior anatomy. Once you have learned the
anatomy of one tooth, you will have learned the
anatomy of several teeth.

As depicted in Figure l, a tooth on one side of

the n1outh is the "mirror image" of the corre-
sponding tooth on the other side of the mouth.
For example, the lower first molar on the right
side of the mouth is the mirror ilnage of the
lower first molar on the left side of the mouth.
(Figs. 1 and 2)

In this manual we will describe the teeth on the

right side of the mouth. The features we describe
are exactly the opposite on the left teeth.

Fig. ,.,., 1 mirror image

 R i0 lt Primary Anatomy 17

Cusps
On the upper teeth, each upper bicuspid has
two cusps, and each upper molar has four cusps.
(Fig. 1)

On the lower teeth, the first bicuspid has two

cusps. The second bicuspid has three cusps. The
first molar has five cusps. The second and third
molars have four cusps each. (Fig. 2)

Notice that the cusp tips on the lower first

bicuspid are directly opposite one another. One
cusp faces directly toward the lingual, while the Fig. 2 j lower cusps/cusp tips
other faces directly toward the buccal.

Notice also that the lingual cusp is only half as

high as the buccal cusp. (Fig. 3)

The first and second upper bicuspids also have

cusps opposite one another. However the lingual
cusp on these teeth is only slightly shorter than
the buccal cusp. (Fig. 4) Fig 3 I lower 1st bicuspid

The lingual borders of all upper bicuspids and

lower first bicuspids are considerably narrower
than the buccal borders. (Fig. 5)

I 1 • 1 upper cusps/c usp tips

1 ' Primar Anatom I n-t 11

Next, we can cover all upper molars and the

second and third lower molars at one time. On
all of these teeth the following features are the
same:

1. The four cusps face toward the "corner s".

(Fig. 1)

2. The mesio- buccal cusps are more bold or

promin ent.

3. The disto-b uccal cusps are less promin ent or

Fi~. 1 I cusps are oblique slightly depressed.

4. On the upper molars, the lingual cusps are

offset toward the distal, giving the teeth the
appear ance of a paralle logram when viewed
from the occlusal. (Fig. 2)

5. The mesio- lingual cusp on upper molars

is twice the size of the distal-lingual cusp.
(Fig. 3)

6. On lower first molars, the cusps are arranged

in a neat, symme trical pattern . (Fig. 4)

Fig. 2 1 lingual cusps offset

Fz~ J I symmetrical arrangement

F( 1 ., ! larger mesio-lingual cusp

 Part One , Primary Anatomy I 19

Two Unique Teeth

The lower second bicuspid and the lower first
molar are unique. The lower second bicuspid
is like a cross between a bicuspid and a molar.
These are the unique features of the lower second
bicuspid: (Fig. 1)

1. On the buccal side of the central dissectional

groove, it looks like a bicuspid.

2. On the lingual side, it looks like a small

molar.
Fig. 1 I lower 2nd bicuspid
3. It has three cusps:

a. The cusp on the buccal side faces directly

toward the buccal surface (transversely),
just as it does on the first bicuspid.

b. The two cusps on the lingual side

face toward the "corners" of the tooth
(obliquely), just as they do on the
molars.

The only unique feature on the lower first molar

is an additional small cusp located on the buccal Fig. 2 I extra cusp
surface near the distal contact area. This is a non -
functional cusp that is part of the contact area
with the second molar. Other than that s1nall
cusp and the features that go with it, it is just like
the other molars. (Fig. 2)
 Ridges
As we inent ioned earlier, all teeth have mesial
and distal marginal ridges. (Fig. 1)

On the upper teeth, the first and second bicus-

pids have transverse cusp ridges. Transverse
means that these ridges are directly across from
one anoth er at 90° to the central dissectional
Fi~"· ' , margin al ridges
groove. (Fig. 2)

On the lower teeth, the first bicuspid has trans-

verse ridges. The second bicuspid has a trans-
verse ridge on the buccal side and two oblique
ridges on the lingual side. (Fig. 3)

Oblique ridges run approximately 45° to the

central dissectional groove.

F(cr. _: transverse ridges

Fia. ~ I lower bicuspids

 Pt11 One I Priinary Anatomy I 21

All upper molar and the lower second and third

m lar have four oblique cusp ridges, and no
tran ver e ridge . (Figs. 1 and 2) The lower first
molar has five oblique cusp ridges, matching its
five cu p . (Fig. 3)

Be ides their four oblique cusp ridges, all upper

molars have an additional oblique ridge that is
not really a cusp ridge. This ridge is actually the
distal slope of the mesio-lingual cusp, which runs
Fig. 2 I lower molar oblique cusp ridges
at an oblique angle across the occlusal table to
the base of the disto-buccal cusp ridge. (Fig. 4)
This 5-'tra ridge is usually referred to simply as
"the extra oblique ridge".

Sometimes, upper first molars contain an extra

little "cusp" on the lingual side of the mesio-
lingual cusp. Even though it's technically not a
cusp, we call it the "Cusp of Carabelli". (Fig. 4)

When fabricating, use the opposite upper first

molar as a guide. If it contains a Carabelli cusp,
then the tooth you are working on should also Fig. 3 Ifive oblique ridges
have one. If the opposite molar does not have
one, don't put one on the new crown, either.

Fig -1 I unique features

upper molar oblique cusp ridges

 Fossae
Fos ae are depressions into which the cusps 011
the opposing teeth fit. All molars have three
fossae. All bicuspids have two fossae, except the
lower second bicuspid, which has three.

Notice the fossae on the lower second molar.

There's a 1nesial fossa, which is bordered by the
inesial marginal ridge, the center lines of the
n1esial oblique ridges, and the occlusal table.
(Fig. 1)

The central fossa is bordered by the center lines

of all four oblique ridges and the occlusal table.
(Fig. 2)

The distal fossa is bordered by the center lines

of the distal oblique ridges, the distal marginal
ridge, and the occlusal table. (Fig. 1)

There are two fossae on all bicuspids except the

Fi rT. ~ central joss a lower second bicuspid. On bicuspids, the mesial
fossa is bordered by the center line of the trans-
verse ridges, the mesial marginal ridge, and the
occlusal table. The distal fossa is similar, except
that it's on the other side of the tooth. (Fig. 3)
 Port lt' I Primary Anatomy I 23

n the lower econd bicuspid, the two major

f; ae are like the fos ae on the other bicuspids,
rcept that on the lingual side of the tooth, they
are bordered by the center lines of the oblique
ridge . The third fossa on the tooth is a small
one between the two lingual oblique ridges.
(Fig. 1)

The fossae on the upper molars and the lower

Fig. 1 I lower 2nd bicuspid
first molar are shaped slightly different because
of their unique dissectional grooves. The easy
way to remember the border of these fossae is
that they don't include the area of these unique
grooves. (Figs. 2 and 3)

Fig. 2 I upper molars

 -1 I n to1u ' I

Pits
Every fossa is deepest at its center point, which
is called the "pit" of the fossa. These fossa pits,
or occlusal pits, are the deepest points on the
occlusal surface. (Fig. 1)

Dissectional grooves and secondary grooves

come out of the pits. The pits are the deepest
points of the grooves. (Fig. 2)
F ...,_ J
1
occlusal pits
Since everything else depends on the proper
placement of the pits, it's iinportant that you
understand exactly where each pit belongs on
every tooth. When you can visualize the pit
placement before you start your work, you'll end
up with a tooth that is functional and in harmony
with the rest of the teeth.

Even though the pit is simply just the lowest

Fig. 1 I deepest in the pits
point of the fossa, you can think of the pit as
the starting point for your work on the ocdusal
anatomy. If you establish the location and depth
of the pits first, all the other features will fall
readily into place.

Fig. 3 I central dissectional groove

 Pt?rt One I Primary Anatomy I 25

Dissectional Grooves
Every posterior tooth has a central dissectional
groove that runs from the mesial to the distal
and dissects the tooth into buccal and lingual
parts. (Fig. 3 previous page) This groove goes
deep into the pit of each fossa and runs high up
over each ridge.

Molars also have buccal and lingual dissectional

Fig. 2 I buccal dissectional groove
grooves, which dissect the teeth into mesial and
distal parts. All upper molars and the second
and third lower molars each have one buccal
dissectional groove and one lingual dissectional
groove. These grooves run from the central
dissectional groove between the cusps of the
buccal or lingual surface. (Figs. 1 and 2)

Like the other molars, the lower first molar has

a lingual dissectional groove. However, because
this tooth has an extra buccal cusp, it also has an
extra buccal dissectional groove. (Fig. 3)

Fig. 1 I extra dissectional groove

 1'

On lower 1nolars, the lingual dissectional groove

runs from the pit of the central fossa, between
the lingual cusps, and down the lingual surface.
(Fig. 1)

On upper molars, the lingual groove starts distal

to the central fossa and curves toward the mesial
as it separates the lingual cusps, finally curving
F:· l. J , lower molars
through the lingual surface. (Figs. 2 and 3)

Lower bicuspids also have lingual dissectional

grooves. On the first bicuspid, the groove is in
the mesio-lingual area. On the second bicuspid,
the groove is in the center of the lingual surface.
(Fig. 4)

Dissectional grooves are the only grooves that

break through the occlusal table.

Fig. 2 I upper molars

Fig. 4 I lingual dissection.al grooves

Fig. 3 I upper molar occlusal view

 ~t

Secondary Anatomy
 atom) I Ii ·t Ti 0
1

Secondary Grooves
The secondary anatomy of the posterior teeth
comprises the subtle, flowing curved grooves
that look like an elongated letter "S" or reverse
"S". These grooves are wide and deep at the pits
and get shallow and narrow as they come up
toward the cusp tip. They vary in length and are
never straight. They blend the curved surfaces
of the tooth, but they do not break through the
Fi~. 1 I marginal ridge grooves occlusal table.

These grooves define the perimeters of the ridges

on the occlusal surfaces. That is, at each side of a
ridge, or convexity, is a groove. Some secondary
grooves we call "auxiliary grooves", and we'll
get into those more a little later. The important
thing to understand for now is the direction
in which the secondary grooves run from the
central groove.

Every posterior tooth has four curving secondary

grooves that define the marginal ridges. Two of
Fig. 2 I transverse ridge grooves these grooves run toward the buccal side, and
two run toward the lingual side. (Fig. 1)

For every transverse or oblique cusp ridge there

will be two secondary grooves that form the sides
of each ridge. (Figs. 2 and 3)

Sometimes the grooves that define the marginal

ridges and the grooves that define the oblique
ridges will be the same grooves. Notice in Figure
3 that some of the grooves that define the oblique
ridges also define the marginal ridge .
 Pc t Ti I Secondary Anatomy I 29

n th u r i u pid and the lower first

i u i ther ar £ ur econdary grooves that
£ rm th tran '"er e ridge . Two run toward the
u id , and two run toward the lingual side.
(Fi . 1)

n the loV\ er econd bicu pids, there are two

ec ndary grom e runnin g toward the buccal
ide to form the buccal transverse ridge. There
are £ ur econda ry grooves runnin g toward
the lingual side to form the two lingual oblique
ridge . The e secondary grooves are at an angle F(t;z. 1 I lower 1st and upper bicuspids
of about 45° to the central dissectional groove.
(Fig. 2)

All upper molars are alike. Four second ary

grom e run toward the buccal to define the
buccal oblique ridges, and four others run
toward the lingual to define the lingual oblique
ridges. It's important to note that because the
disto-lingual cusp is smaller than the others,
the secondary anatomy grooves in this area are
shorter than the others. On the mesio-lingual
cusp, the grooves are longer, and they may have
small auxiliary grooves. (Fig. 3) Fig 1 I lower 2nd bicuspid

r ._'· ' all upper molars


Fi.._. 1 I lower 2nd and 3rd molars
Fig. 2 I lower 1st molars
All lower second and third molars are also alike.
Four secondary grooves run toward the buccal
and four run toward the lingual at about 45° from
the central dissectional groove. (Fig. 1)
The lower first molar is unique because of its
extra cusp. This tooth has four secondary
grooves running toward the lingual, just like the
other 1nolars. However, there are six secondary
grooves running toward the buccal to define the
three buccal oblique ridges. (Fig. 2)
Auxiliary Grooves
Sometimes small secondary grooves tend to
branch off other secondaries. We call these
grooves "auxiliary grooves".
Auxiliary grooves are really just secondary
grooves that we distinguish as a way to commu-
nicate them to other technicians. Keep in mind
that auxiliary grooves may branch from other
grooves, and that you may not even see them
on some teeth. Follow the patient's natural teeth
when deciding whether to include auxiliary
grooves.
Figure 1 shows examples of some places you may
find auxiliary grooves. Remember, auxiliary
grooves are just secondary grooves that we've
given a special name, because they tend to branch
off other secondaries and they may or not be
present on all teeth.
 Part TH o Secondary Anatomy I 31

Tooth Similarities
Posterior anatomy is actually easy to learn if you
concentrate first on the similarities among the
teeth, and then learn the few unique features.

It will be easier for you to understand posterior

anatomy if you look at the teeth in groups. Take
one upper molar, for instance. You have learned
the following about the upper molar: (Fig. 1)

1. It has four cusps.

Fig. 1 1 all upper molars
2. One of the lingual cusps is bigger than usual
and the other is smaller.

3. The lingual cusps are offset toward the distal

to form a parallelogram.

4. It has two marginal ridges and four oblique

cusp ridges pointing approximately 45° from
the central dissectional groove.

5. It has three fossae.

6. It has a central dissectional groove, a disto-

lingual dissectional groove and a buccal
dissectional groove.

7. It has secondary anatomy grooves that define

the ridges.

The other five upper molars are exactly like the

one you just studied. This means that when you
understand one tooth, you understand six teeth,
or 30% of all you need to lrnow about posterior
occlu al anatomy. (Fig. 2)
 ndary . . nat llll) , ·t Tt <

Now look at the upper bicuspid. Notice the

features of the tooth. (Fig. 1)

1. It has two cusps across from one another,

with transverse ridges that are at 90° to the
central dissectional groove.

2. It has two marginal ridges.

3. It has two fossae.

4. It has secondary grooves that define the

ridges, but no buccal or lingual dissectional
grooves.

The other three upper bicuspids are just like this

one.

The only difference between the upper bicuspids

and the lower first bicuspids is that the lower
first bicuspids have mesio-lingual dissectional
grooves, and the lingual cusp is shorter. Once
again, when you understand one tooth, you
understand six teeth, or another 30% of the
teeth. (Fig. 2)

FiR. .: 60% of posterior anatomy

 Secondary Anatomy 33

Now look at the lower second molar. It has all

the cusps, ridges, fossae, dissectional grooves
and secondary grooves that we found on the
upper molars. It's different from them because
the cusps are arranged in a neat, symmetrical
pattern. (Fig. 1)

The other lower second molar and both lower

third molars are exactly the same. One tooth is
worth another four teeth, or 20%.
Fig. lower 2nd and 3rd molars
Now you have reviewed just three teeth, and you
already have learned about 16 teeth, or 80% of
posterior anatomy. (Fig. 2)
 ondar ' ·t TI

1he fourth tooth is the unique lower second

bicuspid. This tooth is easy to understand if you
remember that the buccal side is like a bicuspid,
and the lingual side is like a small molar.
(Fig. 1)

The other lower second bicuspid is just the same.

One tooth gets you 10% more. (Fig. 2)

F·g _ 90% of posterior anatomy

 n + T1 { I Secon dary Anato my 3 5

The last tooth is the lower first molar. It's just

like the other lower molars, except that it has that
e:A.1:ra little cusp and an extra dissect ional groove
on the disto-buccal. (Fig. 1)

One more tooth gives us 100% of poster ior

occlusal anatomy. (Fig. 2)

Fig. ~ lower 1st molar

Tooth Numbering
Systems
 Tooth Numb ering ystem 37

Be ides knoV\ring the names of the teeth, you

need to under tand the numb ering system s
that are u ed to identif) teeth in the mouth .
A numbering S) stem is an abbreviated way to
specif) a tooth or a group of teeth.

There are three main systems used worldwide

to numb er teeth. We'll study all three of those
systems in this course. While your labora tory
probably has a prefer red system, the dentis ts
sending you their work will have been traine d
at a \ ariety of dental schools aroun d the world,
so it's impor tant for you to under stand all three
systems.

F·r universal number ing system

Midline
2 3 4 5 6 7 8 9 10 11
Right
12 13 14 15 16
32 31 30 29 Left
28 27 26 25 24 23 22 21 20 19 18 17
UNIVERSAL NUMBERING CHAR T
 I 11

The Universal System

1. m t mn ly u d ) t i in th Unjt d
1

t i th Univ r al y m. Remember that

th d nti t it n the · atient' right o you tart
ountina wi h the t th do e t to the dentist, the
upper right third molar. Starting with 1, count
all the way around to the upper left third molar,
which is number 16.

Drop straight down to the lower left third molar,

number 17, and count all the way back around
to number 32, the lower right third molar.
(Fig. 1)

The dentist uses the Universal nwnbering system

to chart the condition of patient's teeth, using a
chart similar to the one shown in Figure 2. The
chart is drawn as if you are in front of the patient,
looking at the teeth. Study this chart until you
can draw it from memory.

Note: Remember all teeth are numbered from

the patient's point of view.

Mid line

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Left
Right
32 31 30 29 28 27 26 25 24 23 22 21 20 19 18 17
~

- universal numbering chart

 t I Too th Nu mb eri ng Sys tem s 39

The International
System
Much of the wo rld use s the Int ern atio nal
numbering system, where the mo uth
is divided
into four quadrants, and the tee th num
ber ed
within each quadrant.

Start with the qua dra nt closest to the

dentist,
who sits on the patient's right. Qu adr ant
1 is the
right half of the patient's upper, or max
illary, jaw.
Start counting at the midline, the cen
tral bei ng
tooth l, and continue back to the thir
d molar,
which is 8. (Fig. 1)

With the International num ber ing sys

tem, you
place the quadrant num ber first and
the too th
number second. For instance, too th
1-1 is the
patient's upper right central. Tooth
1-8 is the
upper right thir d molar. Tooth 4-1 is
the lower
right central, and 4-5 is the lower righ
t sec ond
bicuspid.

Some dentists do not use the hyp hen Fig. 1 inte rnat iona l num beri ng syst em
bet we en
the quadrant and too th numbers. In
tha t case,
the lower rig ht cen tral , for ins tan ce,
sim ply
becomes "41".

The dentist uses the Inte rna tion al num

ber ing
system to chart the con diti on of patien
t's teeth,
using a chart similar to the one shown
in Figure 2.
The chart is dra wn as if you are in fro
nt of the
patient, looking at the teeth. Study
this cha rt
until you can dra w it from memory.

Qua dran t 1
Mid line
Qua dra nt 2
1-8 1-7 1-6 1-5 1-4
Righ t ~~ ~~~~~~~~~~~~~-i-~~~~ 1-3 1-2 1-1 2-1 2-2
· 2-3 2-4
~~ ~~ -= -- =- -- =-
2-5
-= --
2-6
-- =-
2-7 2..S
4-8 4-7 4-6 4-5 4-4 4-3 4-2 4-1
~- -=-= -Lett
3-1 3-2 3-3 3-4 3-5 3-6 3-7 3..g
Qua dran t 4
int mal iona l num b rin char Qua dra nt 3
t
 I' I f 771 "t' c

in th n1ilitar , It i the least u ed

in th Unit d tate but it is till
untri ar und the world.

In · ilitar numbering y te1n the mouth is

d int quadrant the teeth being numbered
' •thin ach quadrant. Start at the mid.line, with all
central being number l , and count back to the third
molar which are nun1ber 8. (Fig. 1)

The tooth nmnber is created by nan1ing the quad-

rant and the tooth. For example, the upper left
lateral is called "upper left 2", while the lower right
first molar is called "lower right 6".

To write a tooth number, draw a right angle repre-

senting the quadrant, and place the tooth number
in it. The angle is drawn from the perspective of
the viewer, as in the chart below. Imagine cross I
Fig. 1 military numbering system
hairs drawn between the upper and lower teeth and
through the mid.line. For example, JJ is the upper
right cuspid, and f4 is the lower left first bicuspid.
Some dentists prefer to abbreviate the quadrant
names, sueh as "UR 3" or "LL 4" .

The dentist uses the Military numbering system to

chart the condition of patient's teeth, using a chart
similar to the one shown in Figu-re 2. The chart is
drawn as if y ou are in front of the patient, looking
at the teeth. Study this chart until you can draw it
from memory.
Midline

6 5 4 3 2 1 1 2 3 4 5 6 7 8
8 7

5 4 3 2 1 1 2 3 4 5 6 7 8
8 7 &
military numbering chart
Individual Tooth
Reference
tl

Upper Right Bicuspid

 I dividual Toot h e.iere
_..,c ce 43

Upper Left Bicuspid

~ 'm 11li[\·111 ~1 I oft 1u 1 I

,·nt ii \ nat Ill\
Upper Right First Molar
 · I Indiv idual Toot h Re1ere
'- nce I 45

Upper Left First Molar

zmplifl 11 I t11n n t/1"\ u t , 1

4 Indi idual Tooth Re1erence
c I p1nt:11dix
.r

Upper Right Second oa

 4.ppt 11 ii.x I Indivi dual To 0 th R eieren
c ce I 4 7

Upper Left Second Molar

1U t 71 \
4 Individual Tooth Reference Appendix

Lo er Lef F. s
 pp ndix I Individua l Tooth Reference 49

Lower Right First Bicuspid

I 11f 11 fI

Lower Left Second Bicuspid

 4ppozdix I Individ ual Tooth Reference i 51

Lo er Right Second Bicuspid

111 phf 111 Po ·te1 ior Dt 11 t d \ 1 , t 111

Upper Right Molar
 ppt ndi. . I Indivi dual Tooth Re1eren
.c ce I 53

Upper Left Molar

z11plrf m p t t.:11 , D ntal n t 111 ,

Lower Left Second Molar
 Appt 11di I Individua l Tooth Reference I 55

Lo er Right Second Molar

m pltf1 m Po te1 i01 Du1tal natonn

ossar
 anatomical Lifelike , real. Having a certain
form. In dentistry, having all the landmarks of
natural teeth.
anatomist A skilled artist who analyzes and
understands the relationships, structures and
functions of natural teeth.
anatomy The form or structure of an object.
The features that define the shape of a tooth.
Dental anatomy can be though t of as a series of
convexities and concavities that form the light
reflective surfaces that create the apparent shape
of the tooth.
auxiliary Serving a suppor ting role or purpos e.
auxiliary groove A secondary groove on a
posterior tooth which branches off anothe r
groove, usually anothe r secondary groove.
bicuspid The frontmost of the posteri or teeth
in each arch. The fourth and fifth tooth from the
midline.
buccal Referring to the cheek.
buccal surface The surface of a posteri or tooth
facing the cheek.
canine A cuspid, the third tooth from the
midline of the mouth.
carabelli cusp A raised protrus ion on the
mesio-lingual cusp of an upper molar, usually
only found on the upper first molar.
cemento-enamel junctio n The line on the
surface of a tooth which marks the meetin g of the
cement um and the enamel.
cementum The hard, bony layer covering the
dentin on the root of the tooth.
central Referring to the middle of an object. A
central incisor.
central dissectional groove A groove in the
occlusal surface of a posteri or tooth that runs
from the mesial to the distal and dissects the
tooth into buccal and lingual parts.
central fossa A shallow depression found
approximately in the middle of the occlusal
surface of a molar, border ed by the cusp ridges
and the occlusal table. Someti mes used to
describe the lingua- middle fossa of a lower
second bicuspid.
central incisor One of the two anterio r teeth in
the middle of each arch. The tooth next to the
midline.
concave Curved inward.
concavity A hollowed or rounde d inward
depression. Concavities cause shadow s on tooth
surfaces.
convex Curved outward.
convexity Curved or rounde d outwar d like the
surface of a sphere. The area that reflects light
from a tooth.
cusp A cone-s haped elevation on the occlusal
surface of a posteri or tooth.
cusp ridge A raised part of the occlusal surface
of a posteri or tooth that runs from a cusp tip to
the central dissectional groove.
cusp tip The highes t point of a cusp.
cuspid A tooth having a single cusp. The third
tooth from the mid.line.
dental Referring to the teeth.
dentin The hard tissue V\hich forms the main
body of a tooth. It surrou nds the pulp and i
covered by the ename l and the cemen tum .
dentit ion The teeth.
depression A concav ity on a urfac .
dissect To divide into part .
dissectional groov e A gr , th t di ·d
a po terior tooth into two di tin t p rt .
di ectional gr ove br ,. thr u h th u ·
table.
distal F in
th ur
 11 V\ d pr i n found in the
lu al urface fa posterio r
t median line An imaginary line which extends
the cu .p ridges the margina l
ri clusal table.
dis al surface The urface of the tooth facing
a fr n1 the n1idline folloV\ ing the curve of the
dental arch.
enamel A hard glossy coating. The smooth,
transluc ent hard substance which covers the
croV\Tll of a tooth over the dentin.
fossa A rounded or angular depression in the
occlusal surface of a posterior tooth bordere d by
the cusp ridges and the occlusal table.
fossae The plural of fo ssa.
imbrica tion lines Small semi-circular lines or
depressions in the gingival third area that diffuse
light reflected from the surface.
incisor A tooth with a narrow biting edge,
located at the front of the dental arch.
lateral incisor The tooth next to (lateral to)
the central incisor. The second tooth from the
mid.line of the arch.
lingua The tongue.
lingual Referrin g to the tongue.
lingual surface The surface of a tooth facing the
tongue.
mandib le The lower jaw.
mandib ular Referring to the mandible. Lower.
margin A border or perimeter.
margin al Referring to a margin or border of an
object.
margin al ridge The highest part of the occlusal
surface of a posterio r tooth that borders another
tooth and the elevation of enamel which forms
the mesial or distal border of the lingual surface
of an anterior tooth.
maxilla The upper jaw.
maxilla ry Referring to the maxilla. Upper.
vertically through the middle of the face. Also
the midline of a model between the centrals.
mesial Toward the median line, following the
curve of the dental arch.
mesial fossa A shallow depression found in the
mesial third of the occlusal surface of a posterior
tooth, bordere d by the cusp ridges, the mesial
marginal ridge and the occlusal table.
mesial surface The surface of a tooth facing the
median line, following the curve of the dental
arch.
middle third bulge The convex area in the
buccal middle third of a posterior tooth that
deflects food away from the gingiva.
midline An imaginary line which extends
vertically through the middle of the face. Also
the median line of a model between the centrals.
molar The six most posterior teeth in each arch.
oblique Running at an angle, slanting.
oblique ridge A ridge that runs at an angle to
the central dissectional groove.
occlude To come together or close. When the
opposing teeth come together.
occlusal Referring to occlusion.
occlusal anatomy The physical features of the
biting surfaces of posterior teeth.
occlusal groove A groove on the occlusal
surface of a posterior tooth. We generally refer
to three types of grooves: dissectional or primary
grooves, secondary grooves, and auxiliary
grooves.
occlusal surface The surface of a posterior
tooth that comes into contact with the opposing
teeth.
 .occlusal table The perimeter of the occlusal secondary anatom y The features of a tooth that
surface. The sharp edge where the buccal and come after the primary anatomy. On a posterior
lingual surfaces of the tooth meet the occlusal tooth, the secondary grooves.
surface.
secondary groove A curving groove that forms
occlusion The relationship between the teeth of one side of an occlusal ridge, in the shape of a
the opposing arches when in contact. lazy "S': A secondary groove does not break
perikym ata area Small lines or ripplies on the through the occlusal table.
labial of a tooth, caused by the formation of the simplifying Making simple.
enamel prisms, that diffuse light reflected from
system An assemblage of organized ideas and
the surface.
principles intended to explain the arrangem ent
pit The deepest part of an occlusal fossa. or working of a systematic whole. A harmon ious
posterior Referring to the back. The back of the agreement.
mouth. systematic Methodi cal in procedu re. A plan
posterior teeth The bicuspids/premolars and marked by thoroug hness and regularity.
molars of either arch. transverse ridge A cusp ridge running at a 90
posterior tooth A tooth having an occlusal degree angle to the central dissectional groove.
surface. A bicuspid/premolar or molar.
premola r A bicuspid.
primary The first or the fundamental.
primary anatom y The basic physical features of
a tooth. On a posterior tooth, all features except
the secondary and auxiliary grooves.
primary groove A groove that divides a
posterior tooth into two distinct parts. A
primary groove breaks through the occlusal table.
A dissectional groove.
primary plane On a posterior tooth, the flat
planes at angles of 15 to 30 degrees which make
up the basic occlusal, buccal and lingual surfaces.
reverse "S" groove A secondary groove that
forms one side of an occlusal ridge, in the shape
of a lazy reverse "S':
ridge A long, narrow elevation.
"S" groove A secondary groove that forms one
side of an occlusal ridge, in the shape of a lazy 'S'~
secondary Supplemental, following the first.
 A F
anatomic 16, 57 fossa 15, 22-2 4
anatomy 8-11 central 22, 26
occlusal 8-11 fossa pit 15
prim ary 8-9
secondary 10-11 I
Inter natio nal num berin g system 39
B
bicus pid 17,1 9-24 ,26-2 7,29 ,32,3 4, L
39-4 0,48 -49,5 2-53 lingu al surfa ce 13, 44-5 7, 46-5 9, 48-6 1,
buccal surface 13, 44-5 7, 46-5 9, 48-6 1, 50-6 2,52 -62, 54-6 2
50-6 2,52 -62,5 4-62
M
c
man dibu lar 9, 11
cheek 13
marg inalr idge 14,2 0,22 ,28
cont act area
maxi llary 8, 10
proximal 19
mesi al surfa ce 13, 44-5 7, 46-5 9, 48-6 1,
cusp 14-2 7,17 -23,2 5-27 ,29-3 0,31 -
50-6 2,52 -62, 54-6 2
35
Mili tary num berin g syste m 40
Cusp of Carabelli 21
cusp ridge 14, 20-2 2, 25, 28-2 9, 31
N
oblique 14, 19-2 0, 21, 28-2 9
transverse 28-2 9 non- func tiona l cusp 19
cusp tip 14, 17, 28
0
D occlusal pit 24
dissectional groove 15, 23-2 6, 31-3 3, occlusal surfa ce 13, 44-5 7, 46-5 9, 48-6 1,
35 50-6 2,52 -62, 54-6 2
central 14-2 7, 15, 19-2 0, 22, 25, 28-3 0, occlusal table 15
31-3 2
distal surface 13, 44-5 7, 46-5 9, 48-6 1,
p
50-6 2,52 -62,5 4-62 Palm er num berin g syste m 40
prim ary anat omy 8-9

S1111plit1 in , Pu~ ft nc r nt nta/ 411.Jt nm

R
ridg e 14

s
seco nda ry anat omy 10-1 1

T
tong ue 13
toot h surf aces 13
tran sver se ridg e 20

u
Uni vers al num beri ng system 38