Você está na página 1de 20

Anatomy

Wednesday, March 5, 2008


Anatomy

If dentures and their supporting


tissues are to coexist for a
reasonable length of time, the
dentist must fully understand
the anatomy of the supporting
and limiting structures
involved, for these are the
foundation of the denturebearing area.

Anatomy

Anatomy


The amount of biting force an edentulous ridge will tolerate

The denture base must


extend as far as possible
without interfering in the
health or function of the
tissues.

is directly proportional
to the amount of surface area covered

Anatomy

Anatomy

Force directed to a large bearing area is more equally


distributed and much less per sq. mm. than the same force
directed against a smaller area.
F

Consequently, if we hope to assist a patient to achieve


maximum biting force and preserve the supporting
structure over a longer period of time,

The maximum amount of denture bearing


area must be covered.

Anatomy

Anatomy
Are all the supporting tissues the same ?

Are all the supporting tissues the


same ?

Macroscopically (Residual Ridges, Palate)


Microscopically
(Mucous Membrane)

NO !

"

Mucosa + Submucosa

"

Too thin =

Too loose, inflamed, or edematous =


7

Anatomy

Anatomy

What defines the maximum amount of bearing area ?

The

LIMITING
- OR PERIPHERAL TISSUES
9

Anatomy

10

Anatomy
LF

LV

IP

CE

BF

MS

AR

BV

PPB

AT
MT
FP

11

ZA

VL
JHSP
PR

HN

12

Anatomy

Anatomy

Li
F

A-L S

BV
BF
13

LaV
14

Anatomy

Anatomy

Buccal Shelf

15

LaF

Retromylohyoid
Space - Lateral
Throat Form

16

Anatomy

Anatomy

17

Anatomy

18

Anatomy

19

20

Anatomy

Anatomy

21

Anatomy

TEMPORALIS
MUSCLE

22

Anatomy

MASSETER
MUSCLE
23

24

Anatomy

Anatomy

Are these tissues all equal


in their capability to
support a denture under
pressure?

(1) Primary stress bearing area,


(2) Relief area
(3) Peripheral seal area

NO !
25

Anatomy

26

Anatomy

Relief area

Primary stress bearing area


Best to resist vertical forces of occlusion

Pressure causes discomfort to the patient

Base of cortical bone

Pressure causes instability of the denture base

Protected by firmly attached epithelial type tissue


Sufficient thickness to form a cushion against the forces
of occlusion.

27

28

Anatomy

Anatomy

Stress
Bearing

Peripheral seal area


Soft tissue border areas, which the periphery of the
denture must contact in order for the factors of retention
to be effective.

Ridge Crest
Lateral Hard Palate

The peripheral seal area is divided into two parts:

(1) Resistant peripheral area

Ridge Crest

(2) Nonresistant peripheral area

Buccal Shelf
Retromolar Pads
29

Anatomy

30

Anatomy

Relief
Areas

Resistant Peripheral Areas

Papilla
Zygomatica
Suture

Mylohyoid Ridge
Mental Foramen
31

32

Anatomy

Resistant Peripheral Areas

Anatomy

33

Anatomy

Resistant Peripheral Areas

35

Resistant Peripheral Areas

34

Anatomy

Resistant Peripheral Areas

36

Anatomy

Resistant Peripheral Areas

Anatomy

Maxillary Resistant Peripheral Areas

Hamular Process of the


Medial Pterygoid Plate

Lip

Hamular Process of the


Medial Pterygoid Plate

Lip
Mucosa

Alveolar
Bone

Tuberosity
Hamular Notch

Mucosa

Alveolar
Bone

Tuberosity
Hamular Notch
Pterygomandibular
Raphe

Pterygomandibular
Raphe
Retromolar Pad

37

Anatomy

Resistant Peripheral Areas

Anatomy

38

Non-Resistant Peripheral Areas

It is imperative that all maxillary denture


bases terminate in this notch.

Bases short of the hamular notch will


end on the thin - nonflexible - tissue
of the tuberosity and will
consequently lack retention.
39

40

10

Anatomy

Non-Resistant Peripheral Areas

Anatomy

Non-Resistant Peripheral Areas

41

Anatomy

Non-Resistant Peripheral Areas

42

Anatomy

Alveolar
Process

Hard Palate
Posterior Limit
of Hard Palate
Soft Palate

Lip
Labial
Vestibule

43

Mucosa

Vibrating Line

44

11

Anatomy

Non-Resistant Peripheral Areas

Anatomy

Non-Resistant Peripheral Areas

Classifications of Throat Form


CLASS I
6 - 8 mm of soft palate extends beyond the hard
palate before dropping downward or registering
movement when the patient speaks
CLASS II
3 - 4 mm
CLASS III
0 mm
45

Anatomy

Non-Resistant Peripheral Areas

CLASS III

46

Anatomy

AHH

Non-Resistant Peripheral Areas

CLASS III
AIR

Lip

Vibrating Line

For the Class III throat form where the movement of the soft
palate starts immediately at the posterior border of the hard
palate, problems may be encountered in establishing a good
seal.
47

Lip

For the Class III throat form where the movement of the soft
palate starts immediately at the posterior border of the hard
palate, problems may be encountered in establishing a good
seal.
48

12

Anatomy

AHH

Anatomy

Non-Resistant Peripheral Areas

Resistant Peripheral Areas

CLASS III

AIR

Lip

Mandibular Peripheral Areas

1.Labial frenum
2.Buccal frenum
3.Distobuccal arch
4.Pterygomandibular raphe
5.Retromylohyoid curtain
6.Alveolo-lingual fold
7.Lingual frenum
Nonresistant border areas
8.Labial vestibule
9.Buccal vestibule

For the Class III throat form where the movement of the soft
palate starts immediately at the posterior border of the hard
palate, problems may be encountered in establishing a good
seal.
49

Anatomy

50

Anatomy

Mandibular Peripheral Areas


3.Distobuccal arch
4.Pterygomandibular raphe
5.Retromylohyoid curtain

Mandibular Peripheral Areas


3.Distobuccal arch
4.Pterygomandibular raphe
5.Retromylohyoid curtain

Posterior Limit of the Lower Denture

The distobuccal arch is under the control of the masseter muscle


which has its origin at the zygomatic arch. It is attached to the
lateral border of the mandibular ramus. Dentures, which are
overextended in this area, interfere with the contraction of the
masseter muscle, which pushes forward against the buccinator
muscle creating discomfort when the patient closes. The
distobuccal arch flange, if properly shaped, will usually run at a
45-degree angle from the mesiobuccal arch to the apex of the
51
retromolar pad.

The pterygomandibular raphe forms the attachment


of the superior constrictor to the buccinator muscle.
It runs from the posterior border of the hamular
notch downward to the apex of the retromolar pad.
The raphe stretches when the mouth is opened,
pulling the distal edge of the pad upward. Dentures
should not extend beyond this line of movement.
A

52

13

Anatomy

Anatomy

Mandibular Peripheral Areas


3.Distobuccal arch
4.Pterygomandibular raphe
5.Retromylohyoid curtain

3.Distobuccal arch
4.Pterygomandibular raphe
5.Retromylohyoid curtain

Distolingual Extension of the Lower Denture


The retromylohyoid curtain lies lingual and inferior to the retromolar
pad. It is formed by the mucous membrane of the lingual lateral border
of the mandible and is attached to the posterior sides of the tongue. Its
size, shape, and position vary with tongue movements. The curtain
moves upward and backward as the tongue moves upward and
backward in swallowing. It moves upward and forward during
protrusive and lateral movements of the tongue. The amount of
upward and forward movement of the curtain during these protrusive
and lateral movements is referred to as the lateral throat form of the
mandibular denture. If this movement is slight and the angle formed by
the posterior part of the curtain to the retromolar pad is approximately
90 degrees, it is a Class I throat form. Extreme forward movement of
the curtain resulting in an angle of 45 degrees or less in Class III throat
53
form and in between the two is Class II throat from

The amount of posterior lingual extension of the base is controlled by the


movement of this curtain. Overextension of the denture flange results in
the patient complaining of a sore throat or unseating of the denture.
Underextension handicaps the tongue in controlling the lower denture
and allows ingress of food under the denture. This tissue offers very little
resistance to pressure so the operator must be careful not to create a
false undercut by displacing it when making the impression.
54

Anatomy

MEDIAL PTERYGOID

Mandibular Peripheral Areas

Mandibular Peripheral Areas

MASSETER

SUPERIOR
CONSTRICTOR
PTERYGOMANDIBULAR
RAPHE

B
U
C
C
I
N
A
T
O
R

Palatoglossus
Superior
Constrictor
Mylohyoid

Anatomy

55

56

14

Anatomy

Anatomy

Mandibular Peripheral Areas

Mandibular Peripheral Areas

57

Anatomy

58

Anatomy

Mandibular Peripheral Areas

59

Mandibular Peripheral Areas

60

15

Anatomy

3.Distobuccal arch
4.Pterygomandibular raphe
5.Retromylohyoid curtain
6.Alveolo-lingual fold

The mylohyoid muscle originates at the mylohyoid ridge.


Its fibers pass downward and inward and are inserted
posteriorly to the hyoid bone - and anteriorly, with its
neighbor, form the opposite side at the median raphe.

Lingual Extension of the Denture


The alveololingual fold is formed by the mucous
membrane's attachment to the lingual side of the mandible
laterally and its attachment to the lateral borders of the
tongue lingually. Because of this attachment, the fold is
elevated when the tongue is protruded or when the tongue
is moved laterally. Supporting the mucous membrane and
forming the floor of the mouth is the mylohyoid muscle
posteriorly and the sublingual gland anteriorly.

Anatomy

61

62

Anatomy

The mylohyoid muscle originates at the mylohyoid ridge.


Its fibers pass downward and inward and are inserted
posteriorly to the hyoid bone - and anteriorly, with its
neighbor, form the opposite side at the median raphe.

Denture Base

Mylohyoid

Buccinator
Mandible

3rd Molar Region

1st Molar Region


Anatomy

Premolar Region

Canine Region
63

64

16

Anatomy

Anatomy

The mylohyoid muscle, along with the mucous membrane can


easily be displaced by pressure. Overextended bases in this lingual
area will cause the denture to either lift out of position or result in a
denture injury.
For this reason it is necessary that an accurate nonpressure
impression be obtained of the functional range of the fold.

65

Anatomy

66

Anatomy

Below the sublingual gland are the mylohyoid muscles, and when
this muscle raise upon swallowing it forces the gland and the floor
of the mouth upward. Therefore, this is a resistant border area,
and extension of the base is limited to the functional position of
these tissues.

Below the sublingual gland are the mylohyoid muscles, and when
this muscle raise upon swallowing it forces the gland and the floor
of the mouth upward. Therefore, this is a resistant border area,
and extension of the base is limited to the functional position of
these tissues.
Vibrating Line
Hard Palate

Soft Palate

Bolus

ESOPHAGUS

67

68

17

69

70

71

72

18

73

74

75

Forms & A should be completed by the


end of todays lab session and placed in the
white envelope designated for each bench. 76

Whats our job?


Impressioning

19

Thanks

March 3 & 5, 2008

Take a little break and head to


lab.

5910 LAB

This weeks GOALS:


Maxillary and mandibular casts
mounted on your Hanau H-2
articulator
&
Minimum of one pair of
baseplates with occlusion rims.

The faculty will be out on the floor


after we have a short meeting.

77

For next week March 10 & 12

78

5910 LAB

GOALS:

Set maxillary and


mandibular denture
teeth with a
lingualized occlusal
scheme.

79

20