Variations of maxillary molars

1. VARIATIONS OF MAXILLARY
PERMANENT MOLARS
Made by : Shahd Ahmed ,Basma Ashry Hala Hisham, Sara Khalid
Semester two
Under supervision of : A.Prof Samah Kamel

3. 1- PARAMOLAR TUBERCLE
an additional cusp
occurring on the buccal
surface of a permanent
maxillary molar.
Caries , occlusal interference,
and may pose problems to the
clinician in procedures such as
orthodontic banding and rubber
dam placement.
CAUSE
WHAT
Paramolar tubercle, first
described by Prof. Bolk.
WHO

4. (A) Clinical image showing paramolar tubercles on
the buccal surface of tooth# 2.
(B) facial viewof the maxillary studymodel showing
paramolar tubercles.

5. Its incidence ranges from :
• 0% to 0.1%, in first maxillary molars.
• 0.4% to 2.8%,in second maxillary molars.
• 0% to 4.7% in third maxillary molars.
For successful TREATMENT , advanced radiographic
diagnostic aids such as SCT or volume acquisition CT
should be used.
small paramolar
tubercles may not have
pulp tissue, a very large
tubercle may contain
separate pulp chamber
and associated root
canal.

6. 2-FUSION OF MAXILLARY PERMANENT
MOLARS
• It results from the union of two
adjacent tooth germs ,
• the cause of fusion is heredity ,
trauma and crowding
• Early contact of developing tooth
germs can result in a fusion of
dentine ,
• later contact can result in the union
of roots only.
Fusion can be complete or incomplete
ones.
The root canals may be either fused or
separated

7. • Concrescence is a type of
fusion that occurs after root
formation is complete.
• The teeth are joined along
their roots by cementum.
• Often occurs with a common
pulp chamber or root canals.
• The cause is close contact and
mutual pressure of two
neighboring tooth germs.

8. 3- CUSPAL VARIATION IN MAXILLARY
FIRST PERMANENT MOLARS.
A Prevalence study conducted in india revealed a distinct three cusps on
the occlusal surface of upper 6.
1-These 3- cusped molar is unilateral in all the 4 cases.
2- mesiobuccal and distobuccal cusps are present
but the palatal surface had only a large single
cusp.
3- Cusp ridges don’t join to form transverse ridge.
4- These 3-cusped molar had a heart-shaped outline
5- It can resemble the 3-cusped mandibular second
premolars but somewhat larger in size compared to them.
The finding showed that :

9. RESULTS:
It was recorded that 32.6% of the cases had
their maxillary first molar with 5 cusps while
67.08% had 4 cusps and 0.32%(four cases
only) have only 3 cusps .

11. 4- MAXILLARY MOLAR WITH 4 ROOT
Palatal
Type I: Maxillary molars with two
widely divergent palatal roots that
are often long and and tortuous.
Type II: Maxillary molars with four separate roots also but
the roots are often shorter, run parallel, have buccal and
palatal root morphology, and have blunt root apices.
Type III: Maxillary molar with four roots but it is
constricted in root morphology with the mesio-buccal,
mesio-palatal, and disto-palatal canals encaged in a web

12. The first type (type A)
• mesial aspect comprising
a completely fused
accessory buccal root.
Buccal
The second type (type B)
• buccal aspect comprising a
central accessory buccal root,
between the mesiobuccal and
disto-buccal roots.
• It can be either separate or fused
to one of the adjacent roots or it
may be both separate and fused at
different levels of the root.

13. Mesial root
This variant comprises the bifurcation
of the mesiobuccal root into two mesial
roots (mesio-buccal and mesio-palatal
roots). The mesio-palatal root is usually
located between the mesio-buccal and
the palatal root.
Distal root
(disto-buccal and disto-palatal roots)
which are located buccally to the palatal
root.
This anatomical variant is most common
in maxillarythirdmolars.

14. PARA MOLARS
Maxillary molar with 4 root
Cuspal variation in maxillary first permanent molars.
FUSION OF MAXILLARY PERMANENT MOLARS
SUMMARY

15. REFERENCES
H T T P S : / / W W W . N C B I . N L M . N I H . G O V / P M C / A R T I C L E S / P M C 3 6 3 3 0 5 9 /
H T T P S : / / W W W . R E S E A R C H G A T E . N E T / P U B L I C A T I O N / 2 3 0 8 6 0 9 3 3 _ F U S I O N _ O F _ T H
E _ 2 N D _ M A X I L L A R Y _ M O L A R _ W I T H _ T H E _ I M P A C T E D _ 3 R D _ M O L A R
H T T P S : / / W W W . R E S E A R C H G A T E . N E T / P U B L I C A T I O N / 3 2 7 5 5 8 4 9 5 _ P A R A M O L A R _ T U B E R C
L E - _ B O L K _ C U S P _ A _ C A S E _ R E P O R T
H T T P S : / / W W W . S C I E N C E D I R E C T . C O M / S C I E N C E / A R T I C L E / P I I / S 2 3 5 2 0 0 3 5 1 4 0 0 0 1 0 0
H T T P S : / / O N L I N E L I B R A R Y . W I L E Y . C O M / D O I / P D F / 1 0 . 1 1 1 1 / J . 1 8 3 4 - 7 8 1 9 . 2 0 1 2 . 0 1 6 7 8 . X
H T T P : / / W W W . J C D R . N E T /