TOOTH NUMBERING SYSTEM •
Learning nomenclature is the first step in understanding dental anatomy. Tooth numbering or “shorthand” system of tooth notation is necessary in
clinical practice for recording data and communication.
Q
The various tooth notation systems are as follows: 1. Zsigmondy Palmer notation system 2. Universal notation system 3. FDI(federation dentaire internationale) system 4. Hader up system
Zsigmondy/Palmar System •
In 1947 a committee at the America
Dental
Association(ADA) recommended the symbolic (Zsigmondy/Palmar) system as the numbering method of choice. •
The symbolic system for the permanent dentition was introduced by Adolph Zsigmondy of vienna in 1861 and then modified for primary dentition in 1874.
•
Palmar published also the symbolic system in 1870.
•
The symbolic system is most often referred to as the Palmar notation system in the United States and less
commonly as the Zsigmondy/Palmar notation system. •
In this system the arches are divided into quadrants with the entire primary dentition being notated as follows:
E D C B A A B C D E E D C B A A B C D E Example:
A = maxillary right central incisor.
A = mandibular left central incisor. •
•
The zsigmondy/palmar notation for the permanent dentition is a fourquadrant symbolic system, in which beginning with the central incisors, the teeth are numbered 1 through 8 in each arch.
•
For example, the right maxillary first molar is designated as 6 and the left mandibular central incisor as 1.
•
The palmar notation for the entire permanent dentition is as follows:
8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8
ADVANTAGES •
System is simple to use.
•
Easier for beginner due to less confusion as permanent teeth and deciduous teeth are indicated differently .
DISADVANTAGES •
universal in application
•
there is no differentiation between right upper, right lower, left upper and left lower.
•
segments has only one number and used to designate particular tooth.
•
No provision to identify supernumerary tooth
FDI SYSTEM •
FDI- stands for ‘Federation dentaire Internationale’
•
A two digit system for both primary and permanent dentitions has been adopted by the WHO (world health organization) and accepted by other organizations such as IADR(international association for dental research).
•
The FDI system of tooth notation for primary teeth is as follows: upper right
upper left
55 54 53 52 51
61 62 63 64 65
85 84 83 82 81
71 72 73 74 75
lower right
lower left
Numeral 5 = maxillary right, 6 = maxillary left, 7 = mandibular left, 8 = mandibular right. •
The second number of the two – digit number is the tooth number for each side.
•
Example: 51 refers to the maxillary right primary central incisor.
•
The FDI system of tooth notation for permanent teeth is as follows: upper right
upper left
18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28 48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38 lower right •
lower left
As in the two-digit FDI system for the primary dentition, the first digit indicates the quadrant (1 to 4) and second digit indicates the tooth within a quadrant(1 to 8).
•
Example :11=the permanent upper right central incisor(pronounced oneone , not eleven)
•
ADVANTAGES •
simple to teach and easy to understand
•
can be communicated readily for printing over phone
•
easier to speak
•
can be coded by computer
•
gives a visual sense, cognitive sense
•
Easy to pronounce in conversation and dictation.
DISADVANTAGES •
Can be confused with ADA numbering system. UNIVERSAL SYSTEM
•
In 1968 the ADA officially recommended the universal system.
•
The universal system of notation for the primary dentition uppercase letters for each of primary teeth.
•
Example :maxillary teeth, beginning with the right second molar, use the letters A through J; for the mandibular teeth, letters K through T are used, beginning with the left mandibular second molar. right A B C D E F G H I J
left
T S R Q P O N M L K
•
In the universal notation system for the permanent dentition, the maxillary teeth are numbered from 1 through 16,beginning with the right third molar.
•
Beginning with the mandibular left third molar, the teeth are numbered 17 through 32.
•
Thus the maxillary left central incisor as 9 the right mandibular first molar as 30.
1 2 3 4 5 6 7 8
9 10 11 12 13 15 16
32 31 30 29 28 27 26 25 24 23 22 21 20 19 18 17
ADVANTAGES •
separate number/ alphabet is given for individual tooth
•
Easy to visualize DISADVANTAGES
•
confusing when comparing with palmer notation system
•
cannot be coded by computer…
•
confusing and difficult to remember.
•
it doesn’t consider the jaw quadrant clearly, thus similar teeth are given
various numerous in different quadrants.
OTHER SYSTEMS WHICH ARE NOT IN USE:: 1)HADER UP SYSTEM: •
•
invented by Viktor Haderup of denmark in 1891. According to this teeth are numbered in each segment starting with number 1 for central incisor.
•
Teeth are then numbered 1-8
•
To differentiate between upper and lower quadrants , (+) for upper and () for lower jaw
•
These signs are placed to right of numeral
•
Temporary teeth are shown by addition of ‘0’ in conjunction with ‘+’ or ‘ -’
signs. PERMANENT DENTITION
8+ 7+ 6+ 5+ 4+ 3+ 2+ 1+ 8- 7- 6- 5- 4- 3- 2- 1-
+1 +2 +3 +4 +5 +6 +7 +8 -1 -2 -3 -4 -5 -6 -7 -8
PRIMARY DENTITION
05+ 04+ 03+ 02+ 01+ 05- 04- 03- 02- 01-
+01 +02 +03 +04 +05 -01 -02 -03 -04 -05
MICAP – a novel system for identification and communication of dental problems.
•
MICAP is a new tooth notification system to record and communicate
dental as well as periodontal problems. •
It is the abbreviation of first letter of Latin derived name of tooth classes and the dentist describing the system where M-molar, I-incisor, C- canine, A- Akram (Family name of the dentist) and P-premolar.
ANAASEA letters and TOT digits for permanent teeth •
The permanent tooth classes are Incisor, Canine, Premolar and Molar.
•
They are identified and designated by first letter of their names as I, C, P and M which are termed as ANAASEA letters for permanent teeth.
•
As in each quadrant of the maxillary and mandibular arch, four tooth classes and their types are arranged from the midline are arranged from the miThe digits are allotted to permanent teeth as Incisor 1,2, Canine 1, Premolar 1,2, and Molar 1,2,3.
•
The digits(1,2,3) are called TOT digits.
•
Imaginary horizontal and vertical lines passing through the mid and tip respectively divide each ANAASEA letter into four quadrants as maxillary right, maxillary left, mandibular right and mandibular left.
•
midline as two incisors, one canine, two premolar and three molars. Rule of printing of TOT digits at ANAASEA letters
•
The TOT digits, allotted to appropriate types of classes of permanent teeth, are printed at upper right and left corner as well as lower right and left corner of ANAASEA letters.
•
The allotted TOT digits printed at the upper corner of both the right and left side of a given ANAASEA letter indicate that particular class and its types of maxillary teeth of both the right and left side.
•
Similarly, the assigned TOT digits printed at the lower corner of right and left side of a particular ANAASEA letter indicate the appropriate mandibular tooth class and its type on the right and left side. MICAP tooth notation system for permanent teeth
•
The ANAASEA letters for permanent teeth are always written in block letters with the hash sign (#) to differentiate the types of appropriate tooth classes while writing in the clinical application and ⁄ or text method.
•
Whereas the appropriate types of right and left maxillary as well as mandibular tooth classes are identified by writing allotted TOT digits (1, 2, 3) on upper right and left corner and lower right and left corner of each ANAASEA letter respectively.
•
The appropriate tooth types (TOT digits) , written as superscript ⁄ subscript and smaller than ANAASEA letters, are always pronounced separately as 123 (one,two, three) instead of one twenty three (123) or three twenty one (321). The sign (#) indicates the appropriate types of a tooth class and differentiates the types (TOT digits) of tooth classes (ANAASEA letters) from each other. MICAP tooth notation system for deciduous teeth
•
The letters (dI, dC, dM) are the ANAASEA letters for deciduous teeth. As in deciduous dentition there are no premolars or third molars, the ANAASEA letter P and the TOT digit (3) are absent.
•
The letter ‘d’ is always written on the left side, after the sign (#), of each ANAASEA letter (I, C, M) to indicate the deciduous tooth ⁄ teeth. Whereby
the TOT digits (1,2),written on upper right and left corner as well as lower right and left corner of a particular ANAASEA letter indicate the types of appropriate tooth classes of maxillary and mandibular deciduous teeth respectively as explained previously for permanent teeth MIXED DENTITION •
If a particular permenant tooth class/type is present then its appropriate deciduous tooth class/type will be absent and vice versa.
•
The deciduous and permanent tooth classes and their types are described in figure.
•
In the case of the mixed dentition, only erupted deciduous and permanent tooth classes/types are recorded and notified by the MICAP system.
NOTATION OF NUMERICAL ABNORMALITES BY AN ADDITION TO THE FDI SYSTEM
•
Among the different systems proposed for the notation of teeth, the twodigit system by Viohl {also proposed by Drum) gradually acquired supporters in the international odontologic panorama, especially as information from clinical documentation in the dental office has increased.
•
This method, adopted by the Federation Dentaire Internationale (FDl)- in 1970 and officially accepted and recommended by the World Health Organization- in 1977, considers neither the numbering of supernumerary teeth (presenting difficulties in epidemiologic surveys in regions where supernumerary teeth are a common variation) nor anatomic abnormalities that have repercussions on the total number of teeth (eg, gemination, concrescence, and fusion).
•
To diminish these difficulties some suggestions, consisting of the addition of a third digit, as recently proposed by krysinsky, have been outlined.
•
This studies the possibility of amplifying the range of the FDI system by the circumstantial addition of a third digit, which by its form and position, will allow nomenclature of any supernumerary tooth and provide additional information concerning its anatomic form, topography, and possible anatomic abnormalities. FUSED NORMAL TEETH
•
The first digit specifies the quadrant in accordance with the present FDI system.
•
The second digit indicates the mesial tooth that participates in the fusion, and
•
•
the third digit indicates the distal tooth of the fusion. Figure 1 is an example of the fusion of each primary mandibular lateral incisor wilh its adjacent canine. These fused teeth are designated, in accordance with the proposed system, as tooth 723 (left) and tooth 823(right). Figure 2 is an example of the identical abnormality in the
permanent teeth of another patient. These are represented by tooth 323(left) and tooth 423(right).normal GEMINATED TEETH •
Gemination results from the fusion of a normal tooth and a supernumerary one. Geminated supernumerary teeth are represented by 9. The first digit indicates the quadrant. The second and the third digits, respectively, are the number of the normal tooth participating in the gemination and 9, which represents the fused supernumerary. Figure 3 is an example of maxillary right lateral incisor fused with a supernumerary incisor, numbered tooth 129. SUPERNUMERARY TEETH
•
Supernumerary teeth are noted by a letter of the alphabet.
•
A capital letter is used if the supernumerary tooth resembles a normal one.
•
A lower ease letter is used in the case of a tooth abnormal in shape or size. This letter indicates the position of the supernumerary tooth and helps distinguish between several adjacent teeth. A : Supernumerary teeth placed outside the dental arch( buccally or lingually )
•
The letter is interposed between the two digits of the normal adjoining teeth.
•
A V (or a v in the case of an abnormal tooth) is used if the supernumerary tooth is positioned buccally(vestibular); if there are more than one, the are, successively, from mesial to distal sides; V, E, S,and T ( the first four letters of the Latin term vestibularis).
•
An L (or an I) is used if the extra tooth is positioned Iingually; if there are several, the letters L,I,N and G ( from the term lingualis) will be used successively in the mesiodistal direction. Figure shows two maxillary left
supernumerary molars, positioned buccally to the dental arch, which become tooth 2v8 {mesial) and tooth 2e8 {distal). B. Supernumerary teeth placed within the dental arch •
•
(proximal to a normal tooth or a tooth of reference). The letters P, .R, O, and X {from the Latin proximalis) are used. The letter is placed as a third "digit," when the supernumerary tooth is distal to the tooth of reference.
•
.The letters P. R. O. and X are used respectively to designate successive teeth in the mesiodistal direction. The appropriate letter is placed as a first "digit,“ when the supernumerary tooth is mesial to the tooth of reference
(eg, in the case of the mesiodens). In this case, the notations used are P. R, O, and X, respectively , in the distomesial direction •
ooth 2v8 {mesial) and tooth 2e8 {distal).
•
Figure presents a maxillary right hypoplastie supernumerary molar, which is called tooth 18p. The notations for two maxillary left supernumerary molars, the first of normal morphology and the second of hyp oplastic, become teeth 28P and 28r.
•
Figure shows a third mandibular left incisor, which is noted as tooth 32P and an anatomically normal third mandibular left premolar, which is called tooth 45P.
•
A maxillary mesiodens is named tooth P11 (or P21, because it is proximally to both teeth 11 and 21) when it resembles the morphology of a normal incisor,and tooth p11(or p21) if it is cone shaped.
•
Figure demonstrates the notations of three nontypical mesiodentes interposed in a line between the central maxillary incisor: tooth p11 (right); tooth p21 (left), and tooth r11 (center).
•
In the case of three mesiodentes, if the left and the right are placed lingually to the central mesiodens, the notations used are tooth 111 and tooth 211, respectively; the central mesiodens is tooth p11 REFERENCES
•
Villa vigil M.A., Alvarez Arenal A. , Rodriguez Gonzalez M.A., Quitessence Int 1989;20,:299-302
•
International Dental Journal 2011;61: 31-36
•
Edward F. Harris,Tooth-coding systems in the clinical dental setting;2005;18: 43-49
•
Jens C. Turp, Kurt W. Alt, Quitessence Int 1995;26:501-504
•
Wheeler’s, dental anatomy, physiology, and occlusion, 8
th
edition.
