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238 S. Sissereet al.Braz Dent J (2004) 15(3) : 238-242

Educational Material of Dental Anatomy Applied toStudy the Morphology of Permanent Teeth

Selma SISSERE1,2

Mathias VITTI1

Luiz Gustavo de SOUSA1

Marisa SEMPRINI1

Simone Ceclio Hallak REGALO1

1Department of Morphology, Stomatology and Physiology, Faculty of Dentistry of Ribeiro Preto,

University of So Paulo, Ribeiro Preto, SP, Brazil2Department of Morphological Sciences, Faculty of Dentistry of Uberaba, University of Uberaba, Uberaba, MG, Brazil

The purpose of this report is to present educational material that would allow the dental student to learn to easily identify themorphologic characteristics of permanent teeth, and how they fit together (occlusion). In order to do this, macro models of permanentteeth with no attrition were carved in wax and later molded with alginate. These molds were filled with plaster, dental stone and/or cold-cured acrylic resin. The large individual dental stone tooth models were mounted on a wax base, thus obtaining maxillary andmandibular arches which were occluded. These dental arches were molded with plaster or dental stone. The authors suggest that thesetypes of macro models allow an excellent visualization of the morphologic characteristics of permanent teeth and occlusion. Dentalstudents are able to carve the permanent dentition in wax with great facility when they can observe macro models.

Key Words: macro models, dental morphology, permanent teeth.

Correspondence: Dr. Mathias Vitti, Faculdade de Odontologia de Ribeiro Preto, USP, Avenida do Caf s/n, Monte Alegre, 14040-904 RibeiroPreto, SP, Brasil. e-mail: mvitti@forp.usp.br

ISSN 0103-6440

INTRODUCTION

Dental anatomy, as a branch of biology, com-prises the study and organization of the tooth as anisolated entity and as an integrant of both the dental andthe masticatory systems. Although anatomy, in general,seems to be a descriptive and static science, dentalanatomy escapes from this rule, because it needs toexplain the reason for the existence of dynamic func-tions of the teeth (1). Teeth, dental arches, and peri-odontal tissues constitute the major part of most dentalpractices (1).

Teeth are mainly mineralized structures, situ-ated in the initial section of the digestive system. Their

origin is the oral mucosa epithelium. Human teeth aredistributed in the maxilla and mandible. Among theirmany functions are skull-facial growth, chewing, de-glutition, phonation, aesthetics, and protection to softtissues. Human teeth have a rich variety of anatomic

characteristics and thus deserve detailed study (2).The professional (surgeon/dentist) who is com-

mitted to the preservation of human teeth should have aclear understanding of the characteristics and funda-mentals of dental morphology and must develop enoughmanual dexterity to reproduce any part of the dentalsystem, maintaining perfect correlation with the whole.Of great importance is a knowledge of function andanatomic dental elements, a knowledge that is inti-mately related to most dental areas. The use of com-puter-graphics to aid in teaching three-dimensionaldental anatomy (3) and the development of a computer-assisted learning program designed to teach the anatomyof adult dentition (4) are current realities in teaching.

Nonetheless, drawing and dental carving are consid-ered to be very practical and objective methods forteaching and motivating dental students to obtain thisknowledge (5).

The purpose of this study was to present the

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educational material that was used for teaching andlearning dental morphology in the discipline of DentalAnatomy of the Faculty of Dentistry of Ribeiro Preto(FORP-USP).

MATERIAL AND METHODS

In agreement with the morphology of naturalteeth without attrition, macro models were carved outusing Horus dental carving wax (Petrpolis, RJ, Brazil)associated with Horus utility wax. A digital caliper rule(Mitutoyo Absolut Digimatic, Japan) was used to ob-tain the measurements of the natural permanent teeth ofboth the maxillary and mandibular arches of the sameindividual. The following measures were made: lengthof crown, width of crown in mesiodistal (MD) andbuccolingual (BL) directions, width of tooth necks inMD and BL directions, and cervical curves mesial (M)and distal (D). The length, width and thickness of the

roots were also measured. Areas of greater widthbetween the points used as a reference to obtain toothmeasurements were also considered for both the crownand the root. The obtained measurements were thenmagnified 6X to establish the proportion between the

macro models and the natural teeth (6:1) and the waxcarving was then made. In this phase, only the crownwas carved (Figure 1). After carving, the wax wassmoothed using a wax carver and silk stockings. Thesewax macro models were then molded with alginate(Jeltrate, Dentsply, Petrpolis, RJ, Brazil), thus obtain-ing the mold (Figure 2). Next, the mold was filled withWilson plaster stone type III (So Paulo, SP, Brazil),which was leaked with the aid of a plaster vibrator, toavoid the inclusion of air bubbles. Hence, macro mod-els of permanent teeth crowns were obtained (Figure 3).

After all macro models of the crowns of allpermanent teeth were finished, they were mounted oneby one in a base of wax #7, thus obtaining the maxillaryand mandibular arches (Figure 4). These macro modelswere mounted in occlusion.

These wax mounted arches were molded againusing Jeltrate Dentsply alginate and the mold was thenimmediately filled with plaster stone type III (Wilson),obtaining the maxillary and mandibular arches totallyin plaster (Figure 5).

Complete macro models (crowns and roots) were

Figure 1. Crown macro model in wax carving of a first mandibularleft molar. Lingual view.

Figure 2. Crown alginate mold.

Figure 3. Crown macro model in plaster stone of a first maxillaryright premolar. Distolingual view in which anatomical accidentsof the occlusal face can be observed.

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also made from auto-polymerized acrylic. In order toobtain the macro models in auto-polymerized acrylic,macro models were initially carved using dental carv-ing wax. The crown and the root were carved in agree-ment with the morphology and initially obtained mea-

surements of the natural permanent teeth, which werelater magnified 6X (Figure 6). In the same way, the waxwas smoothed and then the mold was obtained with theJeltrate alginate (Figure 7). Colorless auto polymerizedacrylic resin (Jet, So Paulo, SP, Brazil) was used toimmediately fill the mold, with the aid of a plaster

Figure 7. The alginate mold of the macro model in wax.

Figure 6. Macro model (crown and root) in wax carving of a first

maxillary right molar. Distopalatine view.

Figure 5. Plaster arches in occlusion. a) Macro models. b) Modelswith normal size.

Figure 4. Macro models mounted in wax base. Top: maxillaryarch.Bottom: mandibular arch.

vibrator.Following the polymerization of the acrylic, we

proceeded to polishing using sandpaper ribbon and amandrel coupled to a low-speed instrument. Pumice

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stone and water were also used together with a feltwheel, coupled to a buffing wheel, providing bettersmoothening and burnishing of the macro model (Fig-ure 8).

studies, dental carving techniques and methods areextremely important. Research and activities in dentalanatomy carving can also be directly related to thepractice of Restorative Dentistry. The importance ofthe recognition of morphologic and anatomy-functional

characteristics of teeth, seeking adaptation to indi-vidual conditions, has been acknowledged (6).

The development of alternative methods, suchas computer-graphics, to aid in teaching three-dimen-sional dental anatomy (3) and Tooth Morphology, whichis a computer-assisted learning program designed toteach the anatomy of the adult dentition (4) are impor-tant for motivating and teaching students. The ToothMorphology program, in combination with interactiveclass meetings, has replaced traditional dental anatomylectures (4); however, it does not replace the practice ofdental sculpting.

The purpose of carving is the reintegration, bymeans of total or partial reconstruction, of one or moredental elements in its form and function inside the arch,re-establishing the lost balance in the physiology ofmastication. Secondarily, it is a precious auxiliarymethod in the assimilation or re-memorization of theanatomical knowledge and a process of manual ability,which is useful and necessary in professional activities(5).

Professionals require the knowledge of dentalelement morphology on a daily basis as a direct conse-

quence of the need to constantly restructure the dentalorgan and reinstate its function. Dental form is ex-tremely varied and difficult to reproduce. The normalanatomical form of teeth assures the efficiency of mas-tication (5).

The external anatomy of teeth should be verywell known. Theoretical studies are not enough. Thestudent should study the detailed description of thetooth with copies of them in their hands. Besides thestudy of extracted natural teeth, macro models made ofplaster or resins and dental arch models help to under-stand the aspects that must be taught. The drawing and

carving of teeth in wax are also valuable means oflearning dental anatomy, besides developing psycho-motor ability (7).

Macro models facilitate the assimilation or re-memorization of anatomy because they show all ana-tomical details that need to be reproduced. In this way,the student who practices dental carving exercises isable to develop normal anatomical form of teeth, rees-

Figure 8. Macro model in autopolymerized acrylic resin of a firstmandibular left molar. Distolingual view.

RESULTS

This work resulted in the production of plastercrown models of the maxillary and mandibular arches,mounted with all dental crowns in occlusion, as well asmacro models in autopolymerized acrylic with the crownand dental root.

This educational material is reproduced yearlyin plaster models for each student of the Dental Anatomy

Discipline of FORP-USP and used during the practicalclasses of this discipline for teaching and learning to aidthe student during individual dental carving, as well asfor the interpretation of dental occlusion.

DISCUSSION

Together with anatomy and dental morphology

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tablishing the function of the dental element. Macromodels allow a better visualization of the morphologiccharacteristics of permanent teeth and students of den-tal anatomy of the Dentistry course of FORP-USP areable to easily carve permanent teeth into wax guided by

the macro models. Macro models of the dental archesallow a better visualization and an easier understandingof the occlusion of permanent teeth.

RESUMO

O objetivo deste trabalho de apresentar um material didticoque permita ao aluno de odontologia, identificar com maiorfacilidade, as caractersticas morfolgicas dos dentes permanentesassim como entender mais facilmente a ocluso dos dentes. Paraisto, foram confeccionados macromodelos de dentes permanentessem desgaste, que foram obtidos da seguinte maneira: foramesculpidos macromodelos em cera; posteriormente estes foram

moldados com alginato e os moldes foram preenchidos comgesso pedra e resina acrlica. Os macromodelos de gesso pedraforam montados em ocluso em uma base de cera #7 sendoobtidas desta maneira as arcadas superior e inferior. Estas arcadasmontadas em cera foram moldadas novamente e o molde foi

preenchido com gesso pedra, obtendo ento as duas arcadastotalmente em gesso. Os autores concluram que os macromodelos

permite m uma mel hor visuali za o das caracte rst ica smorfolgicas dos dentes permanentes bem como da ocluso; osalunos conseguem esculpir dentes permanentes em cera, commaior facilidade, quando observam macromodelos.

ACKNOWLEDGEMENTS

We thank Luisa Caliri Juzzo for translating this paper to theEnglish Language.

REFERENCES

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2. Cantisano W, Palhares WR, Santos HJ. Anatomia Dental eEscultura. 3rd ed. Rio de Janeiro: Editora Guanabara Koogan,1987.

3. Pao YC, Reinhardt RA, Krejci RF, Taylor DT. Computer-graph-ics aided instruction of three-dimensional dental anatomy. J DentEduc 1984;48:315-317.

4. Bogacki RE, Best A, Abbey LM. Equivalence study of dentalanatomy computer-assisted learning program. J Dent Educ2004;68:867-871.

5. Santos Jr J, Fichman DM. Escultura Dental na Clnica e no

Laboratrio. 4th ed. So Paulo: Artes Mdicas, 1982.6. Eugnio OS. Anatomia e Escultura Dental: Teoria e Prtica de

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Sarvier, 2000.

Accepted April 19, 2004