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PRESENTED BY:
Dr. BRAJENDRA SINGH TOMAR
PG 1ST YEAR
DEPT. OF PROSTHODONTICS
GUIDED BY:
Dr. G. S. CHANDU
• THE ANATOMY OF EDENTULOUS RIDGES IN THE MAXILLA
AND MANDIBLE IS VERY IMPORTANT FOR THE DESIGN OF
THE COMPLETE DENTURE
• THE TOTAL AREA OF SUPPORT FROM THE MANDIBLE IS
SIGNIFICANTLY LESS THAN FROM THE MAXILLA.
• THE AVERAGE AVAILABLE DENTURE BEARING AREA FOR AN
EDENTULOUS MANDIBLE IS 14cm2 , WHEREAS FOR
EDENTULOS MAXILLA IT IS 24cm2. THEREFORE THE
MANDIBLE IS LESS CAPABLE OF RESISTING OCCLUSAL
FORCES THAN THE MAXILLA.
INTRODUCTION
• THE CONSISTENCY OF THE MUCOSA AND THE UNDERLYING
BONE IS DIFFERENT IN VARIOUS PARTS OF THE EDENTULOUS
RIDGE
• SOME PARTS OF THE RIDGE ARE CAPABLE OF
WITHSTANDING MORE FORCE THAN OTHER AREARS
 SERVES AS A CUSHION
BETWEEN THE DENTURE
BASE AND THE
SUPPORTING BONE.
 MUCOUS MEMBRANE IS
COMPOSED OF MUCOSA
AND SUB MUCOSA.
 SUBMUCOSA IS FORMED
BY CONNECTIVE TISSUE
THAT VARIES FROM DENSE
TO LOOSE AREOLAR
TISSUE
 MUCOSA COVERING THE
HARD PALATE AND THE
CREST OF THE RIDGE IS
CLASSIFIED AS
MASTICATORY MUCOSA
 CHARECTERIZED BY ITS
WELL –DEFINED
KERATINIZED EPITHELIUM
AND LACK OF TISSUE
 LIMITING STRUCTURES
 SUPPORTING STRUCTURES
 RELIEF AREAS
 LABIAL FRENUM
 LABIAL VESTIBULE
 BUCCAL FRENUM
 BUCCAL VESTIBULE
 HAMULAR NOTCH
 POSTERIOR PALATAL SEAL AREA
 FOLD OF MUCOUS
MEMBRANE
 NO MUSCLE
 NO ACTION OF ITS OWN
 A “V” SHAPED NOTCH
SHOULD BE RECORDED
DURING IMPRESSION
MAKING
 LABIAL NOTCH OF THE
LABIAL FLANGE OF THE
DENTURE MUST BE JUST
WIDE ENOUGH AND JUST
DEEP ENOUGH TO
ACCOMMODATE THE
LABIAL FRENUM
 IT IS DIVIDED LEFT AND
RIGHT BY THE LABIAL
FRENUM
 ORBICULARIS ORIS IS THE
MAIN MUSCLE WHICH
FORMS THE OUTER
SURFACE OF THE LABIAL
VESTIBULE
 ORBICULARIS ORIS
MUSCLE HAS ONLY AN
INDIRECT EFFECT ON THE
LABIAL VESTIBULE
BECAUSE ITS FIBERS RUN
IN HORIZONTAL
DIRECTION
 DIVIDING LINE BETWEEN
THE LABIAL AND BUCCAL
VESTIBULE.
 FRENUM MAY BE SINGLE
OR DOUBLE.
 LEVETOR ANGULI ORIS
MUSCLE ATTACHES
BENEATH THE FRENUM.
 ORBICULARIS MUSCLE
PULLS THE FRENUM
FORWARD.
 BUCCINATOR MUSCLE
PULLS IT BACKWARD.
 REQUIRE MORE
CLEARENCE FOR ITS
ACTION
 EXTEND FROM BUCCAL
FRENUM TO HAMULAR
NOTCH
 BOUNDED LATERALLY BY
THE CHEEKS AND
MEDIALLY BY THE RIDGE.
 SIZE OF THE VESTIBULE
VARIES WITH THE
CNTRACTION OF
BUCCINATOR MUSCLE,
POSITION OF THE
MANDIBLE, AND AMOUNT
OF BONE LOST FROM
MAXILLA.
 ADEQUATE DEPTH/WIDTH
SHOULD BE RECORDED
 DISTAL LIMIT OF THE
BUCCAL VESTINULE.
 SITUATED BETWEEN THE
TUBROSITY AND
HAMULUS OF THE MEDIAL
PTERYGOID BONE.
 TENSOR VELI PALATINI
MUSCLE RUNS
HORIZONTALLY
THROUGH THIS NOTCH.
 AIDS IN ACHIEVING
POSTERIOR PALATAL
SEAL.
 “THE SOFT TISSUE AT OR ALONG THE JUNCTION OF THE HARD
AND SOFT PALATE ON WHICH PRESSURE WITHIN THE
PHYSIOLOGICAL LIMITS OF THE TISSUE S CAN BE APPLIED BY A
DENTURE TO AID IN THE RETENSION OF THE DENTURE” -GPT.
PARTS:
•POSTPALATAL SEAL
•PTERYGOMAXILLARY SEAL
EXTENSIONS:
•ANTERIORLY- ANTERIOR VIBRATING LINE
•POSTERIORLY- POSTERIOR VIBRATING LINE
•LATERALLY- 3-4 MM ANTERIOLATERAL TO
HAMULAR NOTCH
 “THE IMAGINARY LINE ACROSS THE POSTERIOR PART OF
THE PALATE MAKING THE DIVISION BETWEEN THE
MOVABLE AND IMMOVABLE TISSUES OF THE SOFT PALATE
WHICH CAN BE IDENTIFIED WHEN THE MOVABLE TISSUES
ARE MOVING”-GPT
Anterior &Posterior
Vibrating line
PRIMARY STRESS
BEARING AREA
SECONDRY STRESS
BEARING AREA
 HARD PALATE
 MAXILLARY
TUBEROSITY
 RESIDUAL
ALVEOLAR RIDGE
 COVERED BY KERATINIZED SQUAMOUS
EPITHELIUM.
 ANTERIOLATERALLY, THE SUBMUCOSA
CONTAINS ADIPOSE TISSUE.
 POSTEROLATERALLY IT CONTAINS
GLANDULAR TISSUE.
 THE HORIZONTAL PORTION OF THE
HARD PALATE PROVIDES THE PRIMARY
STRESS-BEARING AREA
 IT IS THE POSTERIOR
CONVEXITY OF THE
MAXILLARY BODY.
 THE MEDIAL AND
LATERAL WALLS RESIST
THE HORIZONTAL AND
TORQUING FORCES
WHICH WOULD MOVE
THE DENTURE BASE IN
LATERAL OR PALATAL
DIRECTION.
 THEREFORE MAXILLARY
DENTURE BASE SHOULD
COVER THE TUBEROSITY
AND FILL THE HAMULAR
NOTCHES.
 COVERED BY KERATINIZED SRATIFIED
SQUAMOUS EPITHELIUM.
 THE SUB MUCOSA IS CHARECTERIZED BY DENSE
COLLAGENOUS FIBERS THAT ARE CONTIGUOUS
WITH LAMINA PROPRIA
 CONSIDERED AS A SECONDRY STRESS BEARING
AREA BECAUSE IT IS SUBJECTED TO RESORPTION
TO HORIZONTAL PORTION OF HARD PALATE
 INCISIVE PAPILLA
 MEDIAN PALATAL RAPHE
 FOVEA PALATINE
 SITUATED ON A LINE
IMMEDIATELY BEHIND
AND BETWEEN THE
CENTRAL INCISORS
 THE INCISIVE FORAMEN IS
LOCATED BENEATH THE
INCISIVE PAPILLA.
 LOCATION OF THE INCISIVE
PAPILLA GIVES AN
INDICATION AS TO THE
AMOUNT OF RESORPTION
THAT HAS TAKEN PLACE.
 THE NASOPALATINE
NERVES AND VESSELS PASS
THROUGH THE INCISIVE
FORAMEN.
 THE SUBMUCOSA IS
EXTREMELY THIN IN THE
REGION OF MEDIAL
PALATAL SUTURE, SO THE
MUCOSAL LAYER IS IN
CLOSE CONTACT WITH THE
UNDERLYING BONE.
 FOR THIS REGION, THE SOFT
TISSUE COVERING THE
MEDIAN PALATAL TISSUE IS
NONRESILIENT IN NATURE
& MAY NEED TO BE
RELIEVED.
 BILATERAL INDENTATION
NEAR THE MIDLINE OF
PALATE
 FORMED BY COALESCENCE
OF SEVERAL MUCOSAL
GLAND DUCT
 POSTERIOR TO JUNCTION OF
HARD AND SOFT PALATE
 ALWAYS ON SOFT PALATE
 LIMITING STRUCTURES
 SUPPORTING STRUCTURES
 RELIEF AREAS
 Labial frenum
 Labial vestibule
 Buccal frenum
 Buccal vestibule
 Lingual frenum
 Alveolingual sulcus
 Retromolar pad
 Pterygomandibular raphe
 It is a fold of mucous
membrane at the median
line.
 It divids the labial
vestibule into left and
right labial vestibule
 Recorded as a notch in
the impression made
 Frenum contains
fiber of Orbicularis
oris and Mentalis
muscle
 Therefore the
frenum is quite
sensitive and active,
and the denture
must be fitted
carefully around it
to maintain a seal
without causing
soreness
 The labial vestibule
extend from the
labial frenum to the
buccal frenum
 Muscle attachment
close to the crest of
the ridge –limits the
denture flange
extension
 The buccal frenum
forms the dividing
line between the
labial and buccal
vestibule.
 It overlies the
depressor anguli oris
muscle.
 Fibers of buccinator
muscle attached to
the frenum.
 Frenum may be
single or double,
broad U shaped or
sharp V shaped.
 It should be relieved
to prevent
displacement of the
denture during
function.
 Extend from buccal
frenum to retromolar
pad
 The extent of buccal
vestibule is influenced
by the buccinator
muscle,
which extends from the
modiolus anteriorly to
the pterygomandibular
raphe posteriorly
 The impression is widest
in this region.
 Fold of mucous
membrane.
 •Base of tongue to
supragenial tubercle.
 The anterior region of
the lingual flange is
called sub-lingual
crescent area
 A high frenum is
called as Tongue tie.it
should be corrected if
it affects the stability
of the denture.
Space between the
residual ridge & tongue .
Extends from lingual
frenum to retromylohyoid
curtain .
3 regions (anterior,
middle & posterior)
The anterior region
extends from the lingual f.
back to where mylohyoid
muscle curves above the
level of the sulcus
(premylohyoid fossa) .
The middle region extends from
premylohyoid fossa to the distal
end of the mylohyoid ridge,
curving medially from the body
of the mandible. This curvature is
caused by the prominance of
mylohyoid ridge & the action of
mylohyoid muscle.
The posterior region: here the
flange passes into the
retromylohyoid fossa &
completes the typical S form of
the correctly shaped lingual
flange.
The retromylohyoid
space lies at the distal
end of the
alveololingual sulcus.
Bounded by
Anterior tonsillar
pillar,posteriorly by the
retromylohyoid
curtain.
 Formed
 posteriorly by the
superior constrictor
muscle,
 Laterally by the
mandible &
pterygomandibular
raphe,
 Anteriorly by lingual
tuberosity, and
 Inferiorly by the
mylohyoid muscle.
 The retromolar pad is a
pear shaped area
containing glandular
tissue, loose areolar
connective tissue,the
lower margin of the
pterygomandibular
raphe,fibers of
buccinator and superior
constrictor, along with
the fibers of temporal
tendon.
 The retromolar papilla is a pear shaped area just
anterior to the retromolar pad, it is dense, fibrous
connective tissue.
 Buccal shelf area
 Residual alveolar ridge
 Extend from the buccal
frenum to the anterior
edge of the masseter
muscle.
 Boundries :
Medially- crest of the ridge
Laterally- external oblique
ridge.
Distally –retromolar pad
The mucous membrane
covering the buccal
shelf area is loosely
attached, less
keratinized & contains
thick submucosal layer.
Considered as a
primary stress-bearing
area because it is
covered by a layer of
cortical bone, & it lies at
right angles to vertical
occlusal forces
 The crest of the
residual alveolar
ridge is covered by
fibrous connective
tissue,
 But in many mouths
the underlying bone
is cancellous and
without a good
cortical bony plate
covering it.
 The mucous membrane covering the crest of the
residual ridge is covered by keratinized layer
and is attached by its submucosa to the
periosteum of the mandible.
 The extent of this attachment varies
considerably. In some people, the submucosa is
loosely attached to the bone over the entire
crest of the residual ridge, and the soft tissue is
quite movable.
 In others, the submucosa is firmly attached to
the bone on both the crest and the slopes of the
lower residual ridge.
 However, because underlying bone is often
cancellous (bony spicules and nutrient canals),
the crest of the residual ridge may not be
favorable as the primary stress-bearing area for
a lower denture.
 Mental foramen
 Genial tubercle
 Mylohyoid ridge
 Mandibular tori.
 As resorption takes place,
the mental foramen will
come to lie closer to the
crest of ridge.
 In these circumstances, the
mental nerve and blood
vessels may be compressed
by denture base unless relief
is provided.
 Pressure on mental nerve
can cause numbness of
lower lip.
 The genial tubercle are a
pair of dense
prominences at the
inferior border of the
mandible at the lingual
midline.
 They represents the
muscle attachment of
the genioglossus and
geniohyoid muscle.
 They only become
relevant in the denture
when there is excessive
resorption of the
residual ridge.
 The mylohyoid ridge is a boney
prominence along the lingual
aspect of the mandible
 Soft tissue usually hides the
sharpness of mylohyoid ridge.
 Anteriorly, this ridge with
mylohyoid muscle is close to
inferior surface of mandible.
 Posteriorly, after resorption, it
often flushes with the residual
ridge.
 The mucous membrane
overlying the sharp or irregular
mylohyoid ridge needs to be
relieved.
 Mandibular tori are
lingual bilateral
prominences of
cortical bone in the
premolar area.but they
may extend
posteriorly to the
molar area.
 small tori may only
require relief in the
denture.
 Large tori reguire
removal before a
denture can be
fabricated
 Boucher's Prosthodontics Treatment for
Edentulous Patients. 13th Edition.
Chapter 8.
 Winkler’s –Essentials of Complete Denture
Prosthodontics.
Chapter-7.
 Heartwell’s syllabus of complete
denture.4th edition.
Chapter 6.
 THESE ARE THE
MUCOSAL FOLDS IN THE
ANTERIOR REGION OF
THE HARD PALATE.
 IN THE AREA OF THE
RUGAE , THE PALATE IS
SET AT AN ANGLE TO
THE RESIDUAL RIDGE &
COVERED BY THIN SOFT
TISSUE.
 PALY AN IMPORTANT
ROLE IN SPEECH

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Anatomical landmarks of denture bearing area of.pptx final

  • 1. PRESENTED BY: Dr. BRAJENDRA SINGH TOMAR PG 1ST YEAR DEPT. OF PROSTHODONTICS GUIDED BY: Dr. G. S. CHANDU
  • 2. • THE ANATOMY OF EDENTULOUS RIDGES IN THE MAXILLA AND MANDIBLE IS VERY IMPORTANT FOR THE DESIGN OF THE COMPLETE DENTURE • THE TOTAL AREA OF SUPPORT FROM THE MANDIBLE IS SIGNIFICANTLY LESS THAN FROM THE MAXILLA. • THE AVERAGE AVAILABLE DENTURE BEARING AREA FOR AN EDENTULOUS MANDIBLE IS 14cm2 , WHEREAS FOR EDENTULOS MAXILLA IT IS 24cm2. THEREFORE THE MANDIBLE IS LESS CAPABLE OF RESISTING OCCLUSAL FORCES THAN THE MAXILLA. INTRODUCTION • THE CONSISTENCY OF THE MUCOSA AND THE UNDERLYING BONE IS DIFFERENT IN VARIOUS PARTS OF THE EDENTULOUS RIDGE • SOME PARTS OF THE RIDGE ARE CAPABLE OF WITHSTANDING MORE FORCE THAN OTHER AREARS
  • 3.  SERVES AS A CUSHION BETWEEN THE DENTURE BASE AND THE SUPPORTING BONE.  MUCOUS MEMBRANE IS COMPOSED OF MUCOSA AND SUB MUCOSA.  SUBMUCOSA IS FORMED BY CONNECTIVE TISSUE THAT VARIES FROM DENSE TO LOOSE AREOLAR TISSUE  MUCOSA COVERING THE HARD PALATE AND THE CREST OF THE RIDGE IS CLASSIFIED AS MASTICATORY MUCOSA  CHARECTERIZED BY ITS WELL –DEFINED KERATINIZED EPITHELIUM AND LACK OF TISSUE
  • 4.  LIMITING STRUCTURES  SUPPORTING STRUCTURES  RELIEF AREAS
  • 5.  LABIAL FRENUM  LABIAL VESTIBULE  BUCCAL FRENUM  BUCCAL VESTIBULE  HAMULAR NOTCH  POSTERIOR PALATAL SEAL AREA
  • 6.  FOLD OF MUCOUS MEMBRANE  NO MUSCLE  NO ACTION OF ITS OWN  A “V” SHAPED NOTCH SHOULD BE RECORDED DURING IMPRESSION MAKING  LABIAL NOTCH OF THE LABIAL FLANGE OF THE DENTURE MUST BE JUST WIDE ENOUGH AND JUST DEEP ENOUGH TO ACCOMMODATE THE LABIAL FRENUM
  • 7.  IT IS DIVIDED LEFT AND RIGHT BY THE LABIAL FRENUM  ORBICULARIS ORIS IS THE MAIN MUSCLE WHICH FORMS THE OUTER SURFACE OF THE LABIAL VESTIBULE  ORBICULARIS ORIS MUSCLE HAS ONLY AN INDIRECT EFFECT ON THE LABIAL VESTIBULE BECAUSE ITS FIBERS RUN IN HORIZONTAL DIRECTION
  • 8.  DIVIDING LINE BETWEEN THE LABIAL AND BUCCAL VESTIBULE.  FRENUM MAY BE SINGLE OR DOUBLE.  LEVETOR ANGULI ORIS MUSCLE ATTACHES BENEATH THE FRENUM.  ORBICULARIS MUSCLE PULLS THE FRENUM FORWARD.  BUCCINATOR MUSCLE PULLS IT BACKWARD.  REQUIRE MORE CLEARENCE FOR ITS ACTION
  • 9.  EXTEND FROM BUCCAL FRENUM TO HAMULAR NOTCH  BOUNDED LATERALLY BY THE CHEEKS AND MEDIALLY BY THE RIDGE.  SIZE OF THE VESTIBULE VARIES WITH THE CNTRACTION OF BUCCINATOR MUSCLE, POSITION OF THE MANDIBLE, AND AMOUNT OF BONE LOST FROM MAXILLA.  ADEQUATE DEPTH/WIDTH SHOULD BE RECORDED
  • 10.  DISTAL LIMIT OF THE BUCCAL VESTINULE.  SITUATED BETWEEN THE TUBROSITY AND HAMULUS OF THE MEDIAL PTERYGOID BONE.  TENSOR VELI PALATINI MUSCLE RUNS HORIZONTALLY THROUGH THIS NOTCH.  AIDS IN ACHIEVING POSTERIOR PALATAL SEAL.
  • 11.  “THE SOFT TISSUE AT OR ALONG THE JUNCTION OF THE HARD AND SOFT PALATE ON WHICH PRESSURE WITHIN THE PHYSIOLOGICAL LIMITS OF THE TISSUE S CAN BE APPLIED BY A DENTURE TO AID IN THE RETENSION OF THE DENTURE” -GPT. PARTS: •POSTPALATAL SEAL •PTERYGOMAXILLARY SEAL EXTENSIONS: •ANTERIORLY- ANTERIOR VIBRATING LINE •POSTERIORLY- POSTERIOR VIBRATING LINE •LATERALLY- 3-4 MM ANTERIOLATERAL TO HAMULAR NOTCH
  • 12.  “THE IMAGINARY LINE ACROSS THE POSTERIOR PART OF THE PALATE MAKING THE DIVISION BETWEEN THE MOVABLE AND IMMOVABLE TISSUES OF THE SOFT PALATE WHICH CAN BE IDENTIFIED WHEN THE MOVABLE TISSUES ARE MOVING”-GPT Anterior &Posterior Vibrating line
  • 13. PRIMARY STRESS BEARING AREA SECONDRY STRESS BEARING AREA  HARD PALATE  MAXILLARY TUBEROSITY  RESIDUAL ALVEOLAR RIDGE
  • 14.  COVERED BY KERATINIZED SQUAMOUS EPITHELIUM.  ANTERIOLATERALLY, THE SUBMUCOSA CONTAINS ADIPOSE TISSUE.  POSTEROLATERALLY IT CONTAINS GLANDULAR TISSUE.  THE HORIZONTAL PORTION OF THE HARD PALATE PROVIDES THE PRIMARY STRESS-BEARING AREA
  • 15.  IT IS THE POSTERIOR CONVEXITY OF THE MAXILLARY BODY.  THE MEDIAL AND LATERAL WALLS RESIST THE HORIZONTAL AND TORQUING FORCES WHICH WOULD MOVE THE DENTURE BASE IN LATERAL OR PALATAL DIRECTION.  THEREFORE MAXILLARY DENTURE BASE SHOULD COVER THE TUBEROSITY AND FILL THE HAMULAR NOTCHES.
  • 16.  COVERED BY KERATINIZED SRATIFIED SQUAMOUS EPITHELIUM.  THE SUB MUCOSA IS CHARECTERIZED BY DENSE COLLAGENOUS FIBERS THAT ARE CONTIGUOUS WITH LAMINA PROPRIA  CONSIDERED AS A SECONDRY STRESS BEARING AREA BECAUSE IT IS SUBJECTED TO RESORPTION TO HORIZONTAL PORTION OF HARD PALATE
  • 17.  INCISIVE PAPILLA  MEDIAN PALATAL RAPHE  FOVEA PALATINE
  • 18.  SITUATED ON A LINE IMMEDIATELY BEHIND AND BETWEEN THE CENTRAL INCISORS  THE INCISIVE FORAMEN IS LOCATED BENEATH THE INCISIVE PAPILLA.  LOCATION OF THE INCISIVE PAPILLA GIVES AN INDICATION AS TO THE AMOUNT OF RESORPTION THAT HAS TAKEN PLACE.  THE NASOPALATINE NERVES AND VESSELS PASS THROUGH THE INCISIVE FORAMEN.
  • 19.  THE SUBMUCOSA IS EXTREMELY THIN IN THE REGION OF MEDIAL PALATAL SUTURE, SO THE MUCOSAL LAYER IS IN CLOSE CONTACT WITH THE UNDERLYING BONE.  FOR THIS REGION, THE SOFT TISSUE COVERING THE MEDIAN PALATAL TISSUE IS NONRESILIENT IN NATURE & MAY NEED TO BE RELIEVED.
  • 20.  BILATERAL INDENTATION NEAR THE MIDLINE OF PALATE  FORMED BY COALESCENCE OF SEVERAL MUCOSAL GLAND DUCT  POSTERIOR TO JUNCTION OF HARD AND SOFT PALATE  ALWAYS ON SOFT PALATE
  • 21.  LIMITING STRUCTURES  SUPPORTING STRUCTURES  RELIEF AREAS
  • 22.  Labial frenum  Labial vestibule  Buccal frenum  Buccal vestibule  Lingual frenum  Alveolingual sulcus  Retromolar pad  Pterygomandibular raphe
  • 23.  It is a fold of mucous membrane at the median line.  It divids the labial vestibule into left and right labial vestibule  Recorded as a notch in the impression made
  • 24.  Frenum contains fiber of Orbicularis oris and Mentalis muscle  Therefore the frenum is quite sensitive and active, and the denture must be fitted carefully around it to maintain a seal without causing soreness
  • 25.  The labial vestibule extend from the labial frenum to the buccal frenum  Muscle attachment close to the crest of the ridge –limits the denture flange extension
  • 26.  The buccal frenum forms the dividing line between the labial and buccal vestibule.  It overlies the depressor anguli oris muscle.  Fibers of buccinator muscle attached to the frenum.
  • 27.  Frenum may be single or double, broad U shaped or sharp V shaped.  It should be relieved to prevent displacement of the denture during function.
  • 28.  Extend from buccal frenum to retromolar pad  The extent of buccal vestibule is influenced by the buccinator muscle, which extends from the modiolus anteriorly to the pterygomandibular raphe posteriorly  The impression is widest in this region.
  • 29.  Fold of mucous membrane.  •Base of tongue to supragenial tubercle.  The anterior region of the lingual flange is called sub-lingual crescent area  A high frenum is called as Tongue tie.it should be corrected if it affects the stability of the denture.
  • 30. Space between the residual ridge & tongue . Extends from lingual frenum to retromylohyoid curtain . 3 regions (anterior, middle & posterior) The anterior region extends from the lingual f. back to where mylohyoid muscle curves above the level of the sulcus (premylohyoid fossa) .
  • 31. The middle region extends from premylohyoid fossa to the distal end of the mylohyoid ridge, curving medially from the body of the mandible. This curvature is caused by the prominance of mylohyoid ridge & the action of mylohyoid muscle. The posterior region: here the flange passes into the retromylohyoid fossa & completes the typical S form of the correctly shaped lingual flange.
  • 32. The retromylohyoid space lies at the distal end of the alveololingual sulcus. Bounded by Anterior tonsillar pillar,posteriorly by the retromylohyoid curtain.
  • 33.  Formed  posteriorly by the superior constrictor muscle,  Laterally by the mandible & pterygomandibular raphe,  Anteriorly by lingual tuberosity, and  Inferiorly by the mylohyoid muscle.
  • 34.  The retromolar pad is a pear shaped area containing glandular tissue, loose areolar connective tissue,the lower margin of the pterygomandibular raphe,fibers of buccinator and superior constrictor, along with the fibers of temporal tendon.  The retromolar papilla is a pear shaped area just anterior to the retromolar pad, it is dense, fibrous connective tissue.
  • 35.  Buccal shelf area  Residual alveolar ridge
  • 36.  Extend from the buccal frenum to the anterior edge of the masseter muscle.  Boundries : Medially- crest of the ridge Laterally- external oblique ridge. Distally –retromolar pad
  • 37. The mucous membrane covering the buccal shelf area is loosely attached, less keratinized & contains thick submucosal layer. Considered as a primary stress-bearing area because it is covered by a layer of cortical bone, & it lies at right angles to vertical occlusal forces
  • 38.  The crest of the residual alveolar ridge is covered by fibrous connective tissue,  But in many mouths the underlying bone is cancellous and without a good cortical bony plate covering it.
  • 39.  The mucous membrane covering the crest of the residual ridge is covered by keratinized layer and is attached by its submucosa to the periosteum of the mandible.  The extent of this attachment varies considerably. In some people, the submucosa is loosely attached to the bone over the entire crest of the residual ridge, and the soft tissue is quite movable.
  • 40.  In others, the submucosa is firmly attached to the bone on both the crest and the slopes of the lower residual ridge.  However, because underlying bone is often cancellous (bony spicules and nutrient canals), the crest of the residual ridge may not be favorable as the primary stress-bearing area for a lower denture.
  • 41.  Mental foramen  Genial tubercle  Mylohyoid ridge  Mandibular tori.
  • 42.  As resorption takes place, the mental foramen will come to lie closer to the crest of ridge.  In these circumstances, the mental nerve and blood vessels may be compressed by denture base unless relief is provided.  Pressure on mental nerve can cause numbness of lower lip.
  • 43.  The genial tubercle are a pair of dense prominences at the inferior border of the mandible at the lingual midline.  They represents the muscle attachment of the genioglossus and geniohyoid muscle.  They only become relevant in the denture when there is excessive resorption of the residual ridge.
  • 44.  The mylohyoid ridge is a boney prominence along the lingual aspect of the mandible  Soft tissue usually hides the sharpness of mylohyoid ridge.  Anteriorly, this ridge with mylohyoid muscle is close to inferior surface of mandible.  Posteriorly, after resorption, it often flushes with the residual ridge.  The mucous membrane overlying the sharp or irregular mylohyoid ridge needs to be relieved.
  • 45.  Mandibular tori are lingual bilateral prominences of cortical bone in the premolar area.but they may extend posteriorly to the molar area.  small tori may only require relief in the denture.  Large tori reguire removal before a denture can be fabricated
  • 46.  Boucher's Prosthodontics Treatment for Edentulous Patients. 13th Edition. Chapter 8.  Winkler’s –Essentials of Complete Denture Prosthodontics. Chapter-7.  Heartwell’s syllabus of complete denture.4th edition. Chapter 6.
  • 47.
  • 48.  THESE ARE THE MUCOSAL FOLDS IN THE ANTERIOR REGION OF THE HARD PALATE.  IN THE AREA OF THE RUGAE , THE PALATE IS SET AT AN ANGLE TO THE RESIDUAL RIDGE & COVERED BY THIN SOFT TISSUE.  PALY AN IMPORTANT ROLE IN SPEECH

Notes de l'éditeur

  1. PRESENTED BY: Dr. Brajendra Singh Tomar
  2. THE CONSISTENCY OF THE MUCOSA AND THE ARCHITECTURE OF THE UNDERLYING BONE IS DIFFERENT IN VARIOUS PART OF THE EDENTULOUS RIDGE
  3. Submucosa is formed by connective tissue that varies from dense to loose areolar tissue and varies
  4. Covered by keratinized stratified squamous epithelium .In the region of medial palatal suture , the submucosa is extremely thin ; so relief should be provided to avoid trauma or rocking of the denture
  5. It is the posterior convexity of the maxillary body.*The medial & lateral walls resist the horizontal and torquing forces which would move the denture base in lateral or palatal direction.Therefore, maxillary denture base should cover the tuberosities and fill the hamular notches.
  6. - Covered by keratinized stratified squamous epithelium.The submucosa is characterized by dense collagenous fibers that are contiguous with lamina propria.Considered as a secondary stress-bearing area because it is subject to resorption contrary to horizontal portion of hard palate.
  7. Therefore the frenum is quite sensitive and active, and the denture must be fitted carefully around it to maintain a seal without causing soreness.
  8. Muscles attachment close to the crest of the ridge-limits the denture flange extension.