1. Permanent Maxillary Molars

2. Maxillary First Molar

3. General Characteristics
Arch position: 6th tooth from midline
Universal #3 and #14
Mesially, contacts primary 2nd molar and later 2nd premolar
Largest tooth in maxillary arch
Largest crown in mouth
Least variable in anatomic form among max molars

4. General form: Three roots: L, MB, DB Slightly wider F-L than M-D
Trapezoidal geometric form F/L and proximal views
Occlusal view: rhomboidal geometric form (described as 5-sided)
mesial
facial

5. Development Timeline:
Initial calcification: at birth*
Enamel completed: years
Eruption: years
Root completed: years

6. Facial view, mesial outline:
Mesial HOC at junction of occlusal and middle thirds
Outline relatively flat cervical to mesial HOC
M-D > O-C dimension

7. Facial view, distal outline:
Distal HOC at middle third
Entire distal outline convex
Disto-occlusal angle more rounded than mesio-occlusal angle
Distal surface visible from facial view (rhomboidal effect)

8. Facial view, cervical line:
Oftentimes a V-shape dip CE line pointing towards buccal bifurcation

9. Facial view, occlusal portion:
MB and DB cusps separated by buccal groove
MB cusp wider, DB cusp tip sharper* (sharpest of 4 cusps)
ML cusp visible between MB and DB cusps

10. More facial… Buccal groove usually ends midway O-C in a buccal pit
Bucco-gingival ridge runs horizontally, more prominent towards mesial
Facial HOC at cervical third

11. Lingual View DLG separates larger ML cusp from smaller DL cusp
DLG oftentimes terminates in lingual pit
Lingual groove midway M-D
M-D width as wide or wider lingually than facially*

12. Lingual view… Cusp of Carabelli* Lingual HOC at middle third
Georg Carabelli
court dentist to
Austrian emperor
(1842 A.D.)
Cusp of Carabelli*
Lingual surface of ML cusp
Varies in size: non-existent to prominent
Lingual HOC at middle third
Lingual root depression*

13. Mesial view, facial outline:
Buccal HOC at cervical third (bucco-gingival ridge)
Facial surface fairly flat from HOC to cusp tip

14. Mesial view, lingual outline:
Lingual HOC at middle third
Overall convex curvature
Palatal root apex is lingual to the crown

15. Mesial view, occlusal outline:
Only MB and ML cusps visible
Mesial marginal groove usually present, midway of marginal ridge
Mesial contact area situated buccal to mesial groove, at junction of occlusal and middle thirds

16. Distal View More of occlusal surfaces visible
All four cusp tips visible
Distal marginal groove usually present, midway of marginal ridge
Pronounced distal cervical crown/root concavity*

17. Distal view…
More of facial surface visible, but less of lingual surface (rhomboidal form)
Distal contact area located midway F-L, more cervical than mesial contact (middle third)
Mesial
view

18. Occlusal View Rhomboidal geometric form 5-sided (pentagonal)
Acute MB and DL corners
Obtuse DB and ML corners
5-sided (pentagonal)
Largest F-L dimension of any tooth*

19. Occlusal view… F-L and M-D dimensions more nearly similar*
M-D width as wide or wider lingually than facially*
Four major cusps: ML, MB, DB, DL (largest to smallest)
Cusp triangle: MB, DB, ML (trigon)

20. Occlusal view… Transverse ridge Oblique ridge
Triangular ridges of MB and ML cusps
Oblique ridge
Triangular ridges of DB and ML cusps (distal cusp ridge?)
About same height as the marginal ridges*
Mesial 2/3 looks like max premolar

21. Occlusal view… Three pits: mesial, central, distal
Three primary developmental grooves: central, buccal, distolingual
Four fossae: mesial, central, distal, distolingual

22. Root Form Root trunk with trifurcation: Lingual root: Largest, longest
Wider M-D than F-L*
MB root
2nd largest
Apex in line with MB cusp tip*
DB root
Smallest of three

23. Root form... DB root area may have pronounced cervical concavity*
MB and DB root forms look like “plier handles”
MB root could have two pulp canals (70% possibility)
Root depression, lingual surface of lingual root

24. How To Tell Right From Left:
Distolingual groove
Cusp of Carabelli on ML cusp
Broader MB root than DB root
MB prominence of facial surface

25. Maxillary Second Molar

26. General Characteristics
Arch position: 7th from midline
Universal #2 and #15
Wider F-L than M-D
Similar to 1st, except smaller
Smaller DL cusp

27. Development Timeline:
Initial calcification: 2½ - 3 years
Enamel completed: years
Eruption: years
Root completed: years

28. Facial View Narrower M-D than 1st MB cusp larger than DB
M-D > O-C dimension
MB cusp larger than DB
Buccal groove more distally located than 1st
MB root tip in line with buccal groove*

29. Lingual View Smaller DL cusp than 1st
Lingual groove more distally located
No Cusp of Carabelli

30. Mesial and Distal Views
Similar to 1st except shorter O-C
Facial HOC at cervical third
Lingual HOC at middle third
Mesial HOC at junction of occlusal-middle
Distal HOC slightly more cervical

31. Occlusal View Narrower M-D than F-L Tapers lingually
Two major crown forms:
- Rhomboidal
- Heart-shaped (diminished DL cusp)

32. Root Form MB and DB roots closer than 1st
MB apex in line with buccal groove*
No lingual root depression

33. How To Tell First From Second:
Occlusal view of first less rhomboidal than second
Cusp of Carabelli only on first
M-D and F-L dimensions more similar with first, narrower M-D with second*

34. First from second...
MB root apex in line with MB cusp tip with first, in line with buccal groove with second*

35. Maxillary Third Molar

36. General Characteristics
Arch position: 8th from midline
Universal #1 and #16
No distal contact area
Only maxillary tooth that has single opposing tooth*
Smallest of all molars shortest O-C dimension of any tooth*

37. Development Timeline:
Initial calcification: years
Enamel completed: years
Eruption: years
Root completed: years

38. Crown Form Most variable of maxillary posteriors
Heart-shape most common
Diminished or absent DL cusp
3-cusp form (L, MB, DB cusps)
Still wider F-L than M-D
Occlusal table more constricted
No distal contact wear facet

39. Root Form Three roots, partially or fully fused
Roots much shorter than 1st and 2nd, crown:root ratio closer to 1:1
Roots shorter than any other tooth (other than mandibular 3rds)

40. How To Distinguish a Third:
Shorter root: Crown to root ratio nearly 1:1*
Roots usually fused
More supplemental occlusal grooves*
Heart-shape occlusal outline, narrower occlusal table

41. How To Tell Right From Left:
MB root larger than DB root
MB prominence of facial surface
DLG, if present
Contact area wear facet only on mesial

42. TOOTH ID

49. That’s All, Folks!