Definition (teeth): There are two definitions

Primary (deciduous)
Secondary (permanent)
 Dental Anatomy
Dentition (teeth): There are two dentitions

Primary (deciduous)
Consist of 20 teeth
Begin to form during the
first trimester of pregnancy
Typically begin erupting
around 6 months
Most children have a
complete primary dentition
by 3 years
of age

1. Oral Health for Children: Patient Education Insert. Compend Cont Educ Dent.
 Dentition (teeth): There are two dentitions

Maxilla Incisors
Secondary (permanent)
Canine (Cuspid)
Consist of 32 teeth in most cases
Begin to erupt around 6 years Premolars
of age
Molars
Most permanent teeth have erupted
by age 12
Third molars (wisdom teeth) are the
exception; often do not appear until
late teens or
early 20s

Mandible
 Dental Anatomy
Identifying Teeth

Classification of Teeth:
Incisors (central and lateral)
Canines (cuspids)
Premolars (bicuspids)
Molars

Incisor Canine Premolar Molar

 Apical
Teeth: Identification Apical

Tooth Surfaces

Apical
Labial Mesial Distal

Lingual
Labial
Distal
Lingual
Mesial
Incisal
Incisal Incisal
 Apical Apical
Apical: Pertaining to the apex or
root of the tooth
Labial: Pertaining to the lip;
describes the front surface of
anterior teeth Mesial Distal
Lingual: Pertaining to the tongue;
describes the back (interior) Labial
surface of all teeth
Distal: The surface of the tooth
that is away from the median line Lingual

Mesial: The surface of the tooth

that is toward the median line
 Dental Anatomy

Enamel
The Dental Tissues: Dentin

Enamel (hard tissue)

Dentin (hard tissue) Odontoblast Layer Gingiva
Odontoblast Layer
Pulp Chamber (soft tissue)
Periodontal Ligament
Gingiva (soft tissue)
Periodontal Ligament (soft tissue) Pulp
Cementum (hard tissue) Chamber
Alveolar Bone (hard tissue) Cementum
Pulp Canals
Alveolar Bone
Apical Foramen
Apical Foramen

Pulp Canals
 Dental Anatomy

Anatomic Crown
The 3 parts of a tooth:
Anatomic Crown
Anatomic Root
Pulp Chamber
Pulp
Chamber

Anatomic Root
 Dental Anatomy

Anatomic Crown
The anatomic crown is the
portion of the tooth covered by
enamel.
The anatomic root is the lower
two thirds of a tooth.
The pulp chamber houses the
Pulp
dental pulp, an organ of Chamber
myelinated and unmyelinated
nerves, arteries, veins, lymph
channels, connective tissue cells,
and various other cells.
Anatomic Root
 Enamel

The 4 main dental tissues: Dental Pulp

Dentin
Enamel
Dentin
Cementum
Dental Pulp

Cementum
 Dental Anatomy

Dental TissuesEnamel

Structure
Highly calcified and hardest
tissue in the body
Crystalline in nature
Enamel rods
Insensitiveno nerves
Acid-solublewill demineralize at a
pH of 5.5 and lower
Cannot be renewed
Darkens with age as enamel is lost
Fluoride and saliva can help with
remineralization
 Dental Anatomy

Dental TissuesDentin

Softer than enamel

Susceptible to tooth wear
(physical or chemical)
Does not have a nerve supply
but can be sensitive
Is produced throughout life
Three classifications
Primary
Secondary
Tertiary
Will demineralize at a pH of
6.5 and lower
 Dental Anatomy

Dental TissuesDentin

Three classifications:
Primary dentin forms the initial shape of the tooth.
Secondary dentin is deposited after the formation of the primary dentin on all
internal aspects of the pulp cavity.
Tertiary dentin, or reparative dentin is formed by replacement odontoblasts in
response to moderate-level irritants such as attrition, abrasion, erosion, trauma,
moderate-rate dental caries, and some operative procedures.
 Dentin

Dental TissuesDentin (Tubules) Pulp

Dentinal tubules connect the dentin and

the pulp (innermost part of the tooth,
circumscribed by the dentin and lined with
a layer of odontoblast cells)
The tubules run parallel to each other in an
S-shape course
Tubule
Tubules contain fluid and nerve fibers
External stimuli cause movement of the
dentinal fluid, a hydrodynamic movement, Fluid Nerve Fibers
which can result in short, sharp pain
Odontoblast
episodes Cell
 Enamel

Dental TissuesDentin (Tubules)

Presence of tubules renders dentin
permeable to fluoride Tubules

Number of tubules per unit area

varies depending on the location
because of the decreasing area of Exposed
the dentin surfaces in the pulpal Dentin

direction Receding
Gingiva

Odontoblast
Dental TissueCementum
Thin layer of mineralized
tissue covering the dentin
Softer than enamel and dentin
Anchors the tooth to the
alveolar bone along with the
periodontal ligament
Not sensitive
 Dental Anatomy

Dental TissueDental Pulp

Innermost part of the tooth
A soft tissue rich with blood
vessels and nerves
Responsible for nourishing the
tooth
The pulp in the crown of the tooth
is known as the coronal pulp
Pulp canals traverse the root of the
tooth
Typically sensitive to extreme
thermal stimulation (hot or cold)
 Dental Anatomy

Periodontal Tissues
Gingiva
Alveolar Bone Gingiva
Periodontal Ligament
Cementum Periodontal Ligament

Alveolar bone

Cementum
 Dental Anatomy
Dental TissueDental Tissue

Gingiva: The part of the oral

mucosa overlying the crowns of
unerupted teeth and encircling
the necks of erupted teeth,
serving as support structure for Gingiva

subadjacent tissues.
 Dental Anatomy
Dental TissueDental Tissue

Alveolar Bone: Also called the

alveolar process; the thickened
ridge of bone containing the tooth
sockets in the mandible and maxilla.

Alveolar bone
 Dental Anatomy
Dental TissueDental Tissue6

Periodontal Ligament: Connects the

cementum of the tooth root to the
alveolar bone of the socket.

Periodontal Ligament
 Dental Anatomy
Dental TissueDental Tissue6

Cementum: Bonelike, rigid

connective tissue covering the root of
a tooth from the cementoenamel
junction to the apex and lining the
apex of the root canal. It also serves as
an attachment structure for the
periodontal ligament, thus assisting in
tooth support.

Cementum
 The tongue is a mass of striated muscle covered with mucous
membrane
The tongue is divided by a median fibrous septum
Mucous membrane
Upper surface:
- V-shaped groove called sulcus terminalis divides upper surface
into ant. 2/3 and post. 1/3
- Upper surface of ant. 2/3 of tongue contains tongue papillae
- Tongue papillae are filiform, fungiform, foliate and vallate
Lower surface: has no papillae and therefore smooth
 Tongue papillae are filiform, fungiform and vallate
filiform: cone-shaped and no taste buds, threadlike and
scaly, whitish appearance
fungiform: mushroom-shaped with few taste buds, red in
appearance
Foliate: small lateral folds of mucosa with few taste buds
vallate: largest,8-12 in number, many taste buds on lateral
walls
Taste buds contain: taste cells (sensory bipolar neurons),
supporting cells and basal cells
1. Body of the Mandible
1) alveolar arch
2) mental protuberance
3) mental foramen
4) mental spine
2. Ramus of the Mandible
1) coronoid process
2) condylar process
a. head of mandible
b. neck of mandible
 A muscular structure in oral cavity and covered
by mucous membrane.
Divided into 2 parts:-
Oral movable part
Pharyngeal non - movable part
It separated into halves by median fibrous
septum.
Each half consist of identical complement of
extrinsic & intrinsic muscles.
 The tongue mobility is greatly aided by its
attachment to mandible, styloid process and
hyoid bone.

Functions of tongue :-
Mastication
Taste
Talking
Deglutition(swallowing)
Pappilae :-
A projection of lamina propria covered by stratified
squamous epithelium.
Most contain taste buds receptor for gustation.
Some lack taste bud but contain receptors for touch .
It also increase friction between tongue ang food
making easier for tongue to move food in oral cavity,
 The muscles of the tongue belong to two groups:
intrinsic
extrinsic.
Intrinsic muscles lie entirely within the tongue; that is their origin
and insertions are inside the tongue. There are four groups of
them:
Superior
Inferior longitudinal
Transverse or horizontal
Vertical
 The extrinsic tongue muscles are those that continue
beyond the tongue, anchoring it to other structures.
There are four pairs of them:
Genioglossus attaches the tongue to the
mandible, the jaw bone
Hyoglossus attaches the tongue to the hyoid
bone in the neck
Styloglossus attaches the tongue to the styloid
process, a protrusion from the temporal bone, one
of the skull bones
Palatoglossus attaches the tongue to the palate
For extrinsic muscles :-
Genioglossus helps to protrude the tongue, depress the
central part of tongue making it concave, and move the
tongue to the opposite side
Hyoglossus helps to depress the tongue
Styloglossus helps to pull the tongue upwards and
backwards to aid swallowing
Palatoglossus pulls the soft palate onto the tongue
while swallowing
For intrinsic muscles, their function is alter the shape and size of
the tongue for speech and swallowing.
Superior longitudinal shortens and curls the tongues apex
upward.
Inferior longitudinal shortens and curls the tongues apex
downward.
Transverse narrow lengthens.
Vertical broadens flattens.

All the tongue muscles are controlled by the hypoglossal nerve

which is the 12th cranial nerve except for the pair of
palatoglossus muscles which are supplied by a part of the
accessory nerve, the 11th cranial nerve.
 Mastication or chewing is the process by which food is
crushed and ground by teeth.
It is the first step of digestion and it increases the surface area
of foods to allow more efficient break down by enzymes.
During the mastication process, the food is positioned between
the teeth for grinding by the cheek and tongue.
As chewing continues, the food is made softer and warmer,
and the enzymes in saliva begin to break down carbohydrates
in the food.
After chewing, the food (now called a bolus) is swallowed. It
enters the esophagus and continues on to the stomach, where
the next step of digestion occurs.
Bone involved in mastication :-
Base of skull and mandible
They articulate at TMJ

Muscles involved in mastication :-

Masseter (strongest)
Temporalis
Medial pterygoid
Lateral pterygoid

All muscles of mastication are innervated by the

mandibular division of trigeminal nerve (1 st pharyngeal
arch)
Pattern of moving planes by muscles of
mastication :-
Elevation / depression
Protrusion / retrusion
Side to side exursion

Although the buccinator is not a muscle of

mastication, it aids in keeping the bolus
against the teeth to help in mastication.
 Masseter elevates mandible as in closing mouth
Temporalis elevates and retracts mandible
Medial pterygoid elevates and protrudes mandible
and moves mandible from side to side
Lateral pterygoid protrudes mandible, depresses
mandible as in opening mouth and move mandible side
to side.
 The temporomandibular joint, or TMJ, is the
articulation between the condyle of the mandible
and the squamous portion of the temporal bone
 The condyle is elliptically shaped with its long
axis oriented mediolaterally.
 The articular surface of the temporal bone is
composed of the concave articular fossa and
the convex articular eminence.
 The MENISCUS is a fibrous, saddle shaped structure that
separates the condyle and the temporal bone.
The meniscus varies in thickness: the thinner, central
intermediate zone separates thicker portions called the
anterior band and the posterior band.
Posteriorly, the meniscus is contiguous with the posterior
attachment tissues called the bilaminar zone.
The bilaminar zone is a vascular, innervated tissue that
plays an important role in allowing the condyle to move
forward.
The meniscus and its attachments divide the joint into
superior and inferior spaces.
The superior joint space is bounded above by the articular
fossa and the articular eminence. The inferior joint space is
bounded below by the condyle.
Both joint spaces have small capacities, generally 1cc or less.
 When the mouth opens, two distinct motions occur at
the joint.
The first motion is rotation around a horizontal axis
through the condylar heads.
The second motion is translation. The condyle and
meniscus move together anteriorly beneath the
articular eminence.
In the closed mouth position, the thick posterior band
of the meniscus lies immediately above the condyle.
 As the condyle translates forward, the thinner
intermediate zone of the meniscus becomes the
articulating surface between the condyle and the
articular eminence.
When the mouth is fully open, the condyle may
lie beneath the anterior band of the meniscus.
The TMJ is used throughout the day to move the
jaw, especially in biting and chewing, talking, and
yawning. It is one of the most frequently used
joints of the body.
 The mandible (from Latin mandibula, "jawbone") or
inferior maxillary bone forms the lower jaw and
holds the lower teeth in place
In normal function, the movements of the jaw vary
directly in magnitude with the hardness of the
ingested food while the extent of tongue movement
varies inversely.
Consequently, as hard food is converted into a soft
bolus in the mouth, the amplitude of jaw movements
reduces while the amplitude of tongue/hyoid
movement increases.
 Human
Jawbone
Masseter
oSuperficial head
oDeep head
Temporalis

Medial Pterygoid
oSuperficial head

oDeep head

Lateral Pterygoid
oSuperior head

oInferior head

Additional muscles
 All supplied by the mandibular third division
of the Trigeminal nerve
 Superficial layer
O : lower border of anterior 2/3
Zygomatic arch & zygomatic
process of maxilla

R : Downward and Backward

I : Angle of mandible and

inferior half of the lateral side
of mandible

60
 Deep layer
O : Internal surface of
zygomatic arch
R : Downward (vertical)
I : Ramus of mandible and
base of coronoid process
50 degree between 2 layers

61
 3 bundles
Anterior bundle (vertical fibre)

Action: Mandible elevator

(Close jaws), crushing and
chewing at C.O.

Inaction: Mandible
depression (except Max.
Opening and Opening against
resistance)

62
 Posterior bundle (Horizontal
bundle)
Action: Mand. retraction and
positioner
Inaction: Mand. depression
and protrusion
Intermediate bundle
Action: Protrisive movement

Nerve supply
Ant. and Post. deep
temporal nerve

63
 Rectangular shape at medial surface of ramus,
synergistic with masseter muscle
O : Pterygoid fossa and medial
surf. of the lateral pterygoid
plate
I : Inf. + Post. border of ramus
and angle of mand.
R : Downward and Backward
N : Medial Pterygoid nerve

64
 Superior head
O: Wing of sphenoid and
infratemporal crest
R: Downward and Backward

Inferior head
O: Lateral surf. of lateral
pterygoid plate
R: Upward and backward

65
Insertion of superior and inferior
heads
Ant. portion of the condylar neck
(pterygoid fovea)
Ant. surface of the articular
capsule
Ant. Border of the disk
Function
Open the jaws, protrude and
lateral movement with moving
disk forward

66
A complex giniglymoarthrodial (hinge and glide)
articulation with limited capability of
diarthrosis (free movement)
70
 Composed of
Condyle
Mandibular fossa
Articular capsule
Synovial tissue
Articular disc
Ligaments

71
 Modified barrel shape approx. 20 x
10 mm (ML x AP)
Perpendicular to the ascending
ramus of mandible
Dense cortical bone covered with
dense fibrous connective tissue
with irregular cartilage like cell

72
 Dense cortical bony surface of
temporal bone
Posterior to articular eminence
Posterior nonarticular fossa is
formed by tempanic plate
Thin at the roof of the fossa and
tympanic plate

73
74
 Ligamentous capsule surrounds
the joint
Attached to the neck of the
condyle and around the border of
the articular surface of the
temporal bone
anterolateral aspect of the capsule
may thicken form the
Temporomandibular ligament
function as stabilising structure

75
 Consist of
internal synovial layer
outer fibrous layer
containing veins, nerves, and
collagen fibres.
Innervation of capsule disk
arises from CN V;
auriculotemporal and
masseteric nerves
Venous plexus at posterior
aspect

76
 Synovial cell and connective tissue covering
the lower and upper-joint spaces

Synovial fluid, a proteoglycan-hyaluronic acid

complex acts as a lubricant and may
participated in nutritional and metabolic
interchange for central part.

77
 Biconcave oval structure
interposed between the condyle
and the temporal bone
1 mm in the middle and 2-3 mm
at periphery
Dense collagenous connective
tissue
Centre area is a vascular, hyaine
and devoid of nerve

78
 Fuse to a strong ligament at
lateral side connect to the
neck of the condyle

The other borders are

attached to capsule ligaments
or synovial membranes
separate between two joint
spaces.

79
80
 Temporomandibular
ligament
extend from base of
zygomatic process of the
temporal bone downward
and oblique to the neck of
the condyle

81
 Stylomandibular
ligament
From styloid process and
runs downward and
forward to attach broadly
on the inner aspect of the
angle of mandible

82
 Sphenomandibular
ligament
arising from the angular spine
of sphenoid bone and
petrotympanic fissure, ending at
lingula of mandible

83
 Accessory ligaments may limit border
movements of the mandible
Fibrous capsule and TM ligament may
limit of extreme lateral movements in
wide opening of mandible

84
The teeth have the most important role &
the hardest structure in human's jaws. Helps
us in speaking, chewing properly and
deglutition of food.
To perform these functions the jaws have
powerful muscles capable of providing an
occlusive force between upper & lower
teeth.
Besides that, provided with projections &
facets that interdigitate, so that the upper
set of teeth fits with the lower. This fitting is
called occlusion.
Enamel Enamel

Dentin
Cementum Dental Pulp

Dental Pulp Dentin

Cementum
 Enamel Enamel

Dentin
Cementum Dentin
Dental Pulp

Dental Pulp

Cementum

The outermost layer of the tooth, the hardest, most mineralized

tissue in the body, to protect the inner tooth as a protective coat.
Besides that, it also works as the outer biting surface for chewing
the food.
 Enamel

Enamel Dentin
Dental Pulp

Dentin
Cementum
Dental Pulp

Cementum

Functions to protect the pulp.

Dentin is also the most abundant dental tissue (odontoblast
cell) in determines the size & shape of teeth.
Unique structure & composition of dentin allows it to function as
the substructure for rigid enamel tissue thereby providing teeth
with the ability to flex and absorb tremendous functional loads
without fracturing.
Dentin also gives the tooth its color.
 Enamel
Enamel
Dental Pulp
Dentin Dentin

Cementum
Dental Pulp
Cementum

P. Function: is to form dentin (by the odontoblasts).

Nutritive: the pulp keeps the organic components of the
surrounding mineralized tissue supplied with moisture and
nutrients like oxygen and remove waste products.
Sensory: extremes in temperature, pressure, or trauma to the
dentin or pulp are perceived as pain.
Protective: the formation of reparative or secondary dentin (by
the odontoblasts).
Incisors:
All the incisors are broad, flat teeth with a narrow edge good
for cutting or snipping off pieces of food.

Canines:
They are thick and come to a single sharp point, ideal for
ripping and tearing at foods that might be tough, such as
meat, and for piercing and holding.
Premolars:
They have sharp points for piercing and ripping, but they also
have a broader surface for chewing and grinding.

Molars:
Molars are large teeth with broad surfaces designed for
crushing, grinding and chewing food.
Gingiva
Alveolar Bone
Periodontal Ligament Gingiva

Cementum
Periodontal Ligament

Alveolar bone

Cementum
 Gingiva
Alveolar Bone Gingiva
Periodontal Ligament
Cementum Periodontal Ligament
Alveolar bone

Cementum

Serving as support structure for subadjacent tissues & protective

type of skin that is closely adapted to the necks of the teeth & it
also covers the bone holding the roots of the teeth as a protective
layer to jaw bone and roots of the teeth.

It also permits the movement and stretching associated with

mastication, speech and facial expression.
 Gingiva
Alveolar Bone
Periodontal Ligament Gingiva

Cementum
Periodontal Ligament

Alveolar bone

Cementum

Is a part of the jaws which forms & protects the sockets for the
teeth.
 Gingiva
Alveolar Bone Gingiva
Periodontal Ligament
Cementum Periodontal Ligament

Alveolar bone

Cementum

Helps to connect the cementum of the tooth to the alveolar bone

of the socket.

When the tooth is used for biting or chewing, the periodontal

ligament acts like a cushion and prevents the biting or chewing
force to be directly transferred to the jaw bone.
Gingiva
Alveolar Bone Gingiva

Periodontal Ligament
Cementum Periodontal Ligament

Alveolar bone

Cementum

Bonelike, rigid connective tissue covering the root of a tooth

(protective layer).
Give attachment to collagen fibres of the periodontal ligament.
It therefore is a highly responsive tissue maintaining integrity of
the root helping to maintain the tooth in its functional position in
the mouth (tooth support) and being involved in tooth repair and
regeneration too.
For optimal absorption of food & to ensure good
digestion
Optimal complete mastication
Inhibits of plaque formation
Prevents gingival inflammation
Improve keratinisation of gingival
Good esthetics properties
As a healthy teeth
Maxillary canine region Maxillary anterior region
Maxillary premolar region Maxillary molar region
Mandibular anterior region Mandibular canine region
Maxillary premolar region Maxillary molar region
1. nasal septum
2. Inferior nasal concha
3. Orbit with right
infraorbital canal
4. Laterobasal border
of the nasal cavity
5. horizontal portion of
the pyramidal bone
with the posterior
border of the nasal
cavity
6. maxillary sinus
7. nasal entrance into
incisive canal
8. incisive foramen
9. anterior nasal spine
with the nasal crest of
the maxilla
10. side of the nose
1. Maxillary sinus
2. Zygomatic bone
3. Zygomaticotemporal
suture
4. Zygomatic arch
5. Coronoid process of
the mandible
6. Pterygoid process of
the sphenoid bone
7. Maxillary tuberosity
8. Pterygopalatine fossa
9. Articular process of
the mandible
10. Articular tubercle of
the temporal bone
11. Styloid process
12. Temporal aspect of
the zygomatic bone.
1. Compact bone of the
mandible
2. Mental protuberance
3. Digastric fovea
4. Mental fovea
5. Mental foramen
6. Mylohyoid line
7. Submaxillary fovea
8. Hyoid bone
9. Base of the tongue
10. External auditory opening and soft tissues
11. Small osteoma
12. Radiolucency created by the lips
1. Anterior nasal spine
2. Boundary of the nasal
cavity
3. Maxillary nasal crest
and nasal septum
4. Superimposed conchae
5. Nasal bone
6. Maxillary sinus
7. Canine fossa and
infraorbital margin
8. Nasolacrimal canal
9. Buccal and lingual
compact bone
10. Mental spine
11. Mental foramen
 A radiograph is a two-dimensional representation of a
three-dimensional structure.
There is always superimposition of anatomical
structures and sometimes the projection of anatomy
into areas where you wouldn't expect it to be normally.
You must reconstruct the anatomy in your mind to
understand what you are seeing and understand how
the angle of the x-ray beam can affect the location of
structures on the film.
Being able to identify "normal" anatomy on x-ray
images is critical-otherwise, how would you recognize
an abnormality?
 X-ray images rely on the physical attenuation of the x-
ray beam to form an image on film.
The denser the tissue, the more radiation it will absorb.
The more radiation absorbed by the tissues, the less
reaches the film.
The more radiation that passes through the tissue and
reaches the film, the darker the area will be on the
image.
 The most dense area of a normal tooth is the enamel
cap- more radiopaque (white) than the other tissues.
The dentin is less dense and appears as a uniform grey
area.
The junction between the enamel and dentin is very
distinct.
The layer of cementum on the root surface is nearly the
same density as the dentin, thus it is usually not
apparent radiographically.
The soft tissues of the pulp are much less dense than
the other tooth structures and typically appear
radiolucent.
In normal, fully-formed teeth the root canal may be
apparent extending to the apex of the root with a
recognizable apical foramen.
 Supporting structures of the tooth that are visible radiographically
include the lamina dura, the alveolar crest, the periodontal
ligament space, and the cancellous bone.
When the x-ray beam is projected directly through the long axis of
the lamina dura, it is seen clearly as a thin, white line. If the beam
passes through at an angle, the lamina dura may appear more
diffuse or not be visible at all.
The radiographic appearance of the alveolar crest varies from a
dense layer of cortical bone to a smooth surface without cortical
bone. The level of the bony crest is considered normal when it is
not more than 1.5 mm from the cementoenamel junction of the
adjacent teeth.
The periodontal ligament space appears as a radiolucent space
between the root and lamina dura, beginning at the alveolar crest,
extending around the portion of the root within the alveolus, and
returning to the alveolar crest on the opposite side.
The width of the PDL varies from tooth to tooth, although it is
typically thinner in the middle of the root and wider near the
alveolar crest and root apex.
 Cancellous bone lies between the cortical plates of
both jaws and shows many small radiolucent pockets
of marrow which create the trabecular pattern we
see on the film.
The trabecular pattern varies considerably from
patient to patient and even within the same patient.
The trabeculae in the maxilla are typically small and
form a dense granular pattern while the trabecular
pattern of the mandible is larger and coarser.
 The borders of the maxillary sinus are formed of thin cortical bone
which appear as thin radiopaque lines on periapical radiographs.
The size of the maxillary sinus varies considerably although the
right and left sinuses are typically symmetrical.
The floor of the sinus is seen on periapical radiographs near the
apices of the molars and premolars, and may extend down as far
as the crest of the alveolar ridge, particularly in edentulous areas
Radiopaque lines traversing the sinus either horizontally or
vertically are septae, bony projections from the floor and wall of the
antrum.
Septae give the sinus the appearance of being divided into
compartments, although this is not the case. The radiolucent
compartments formed by the septae sometimes mimic periapical
pathoses.
FIGURE 1 : MAXILLARY SINUS
SEPTAE
FIGURE 2 : FLOOR OF THE SINUS
FIGURE 3 : EDENTULOUS AREAS
 Occasionally small bone nodules on the floor of the maxillary sinus may
imitate root tips. One way to differentiate the two is to look for trabecular
pattern; a nodule will show trabecular pattern while a root tip will not.

The zygoma appears as a U-shaped radiopaque line with the round portion
superimposing the area of the first and second molars. Depending on the
angle in which the x-ray beam passes through the zygoma, it will vary in
size, width, and definition.

The nasolabial fold may appear as an oblique line traversing the premolar
region. The line of contrast is well-defined and the area of increased
radiopacity is caused by the superimposition of the cheek tissue. This
feature increases with age and can be used to identify the side of the
maxilla if the area is edentulous.

The medial and lateral pterygoid plates lying immediately posterior to the
maxillary tuberosities have a variable appearance(another view of the
pterygoid plates), often not being visible at all. Typical appearance is a
single radiopaque shadow with no trabecular pattern. The hamulus may be
seen extending inferiorly from the medial pterygoid plate and does show
trabecular pattern.
FIGURE 1 : ZYGOMA

FIGURE 3 : HAMULUS

FIGURE 2 : NASOLABIAL FOLD

 On periapical radiographs of the central incisors the mental fossa
appears as a radiolucent depression extending laterally from the
midline and between the alveolar ridge and the mental ridge. Due
to the thinness of the bone in the area, the mental fossa appears
slightly radiolucent compared to adjacent bone and may be
mistaken for periapical disease.
 The mental foramen is seen on some periapical radiographs
and has a varying appearance; sometimes round or oblong,
sometimes slitlike. Typically it is positioned halfway between
the lower border of the mandible and the alveolar crest, in the
region of the apex of the second premolar. It may appear over
the apex of a tooth, mimicking periapical pathoses. A second
radiograph from another angle will likely cause the appearance
of the foramen to shift in relation to the apex and confirm its
identity.
 The mandibular canal appears inconsistently
and is seen as a dark linear shadow with thin
radiopaque borders. The canal extends
radiographically from the mandibular foramen
to the mental foramen.
 The coronoid process is often seen in the
molar region and appears as a triangular
opacity superimposed on the area of the third
molar. Trabecular pattern may or may not be
visible.
 The mylohyoid ridge appears as a radiopaque
line running from the area of the third molars
to the premolar region, occasionally
superimposing the molar roots. The margin of
the ridge is varies and is often not well
defined.