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-Today we will talk about the anatomy of the Edentulous Ridges.

"The reading assignment for the anatomy lectures from the text book are (pg211 to pg251)", this includes the impression procedure and the anatomy for the maxillary and mandibular arches. The anatomy for the maxillary arch is about 6-7 pages in the beginning of the chapter. Last week we talked about primary impressions and pouring up the primary impression. This week were working on making the custom trays to make the secondary impressions . Now whats important here is that we have alginate impression or the impression compound for taking the primary impression, ,and finally ending with a primary cast which we used to make a custom tray.
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- When we talk about the anatomy of the maxillary arch, it will be a good idea to talk a little bit about the extra oral anatomy; not the extra oral anatomy that we used to, such as the extra muscle for facial expression and so on. Actually, some landmarks that we will talk about when we talk about history & examination of the patient -now There are specific landmarks that you are very familiar with Extra oral anatomy Vermilion boarder the vermilion border of the lips; is essentially the meeting of the oral mucosa with the skin ) ( vermilion = . . Vermilion borders are important because whether the lips have support from the dentures or not, determines whether the vermilion borders will be clear or more hidden or straight.(meaning that the denture that I fabricate will affect how much of the vermilion boarder shows which affects esthetics so its important for me ) When the lips are supported by teeth(resting or bushed out by teeth) the vermilion border is more clear, however; with age or teeth extraction the lip gets smaller.( , ) ** You can see the upper and lower vermilion borders in the picture. nasio- labial groove and labio- mental groove nasio liabial groove is the line present in the area where the upper lip meets with the cheek extending from the lateral edge of the nose to the angle of the mouth.(the upper arrow) Labiomental groove : is the line present at the area where the lower lip meets the chin.(the lower arrow) All of these specific facial features(lines) become more clear with age. If we dont have teeth support they become even more & more exaggerated. They are signs of age. Why??
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- Because we are losing essential facial support as we have no teeth. Not only we lose the support anterio-posteriorly and laterally, but also we lose the support as the jaws become closer and more approximate to each other (we lose the support vertically). We lose anterior facial height " " So we have loss of facial tone. **Some patients can do quite exaggerated facial expressions; you will be surprised how closely jaws could be brought together when we have lost the teeth support!! some patients could bring their lower lips above their nose. The atrophy or resorbtion is continuous after extraction and it continues for life. The earlier the patient extracts his teeth,the more bone resorbtion will occur so the less bone they will have. The resorbtion will continue through the alveolar bone to the Basel bone (from top to bottom). Until The bone is so week that it fractures by itself.* () *notice that we are talking about bone of residual alveolar ridge. **Bone resorbtion means there is no support for the facial tissue because when teeth are extracted we can get some support from residual alveolar ridge for but when the ridge starts to resorb the whole support is lost. Philtrum The Philtrum is essentially a small area in the midline in the upper lip ( .) But opposing the philtrum we have something that is called columella. columella -The columella opposes the philtrum . So we have a depression in the upper lip. The columella is essentially below the bridge of the nose, it's the area between the nares " openings of the nose". It's like a column, and if you follow the columella down there is the philtrum .

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Nasiolabial angle : - The angle between the columella is another important feature affected by my denture and this angle ,if there is adequate or sufficient labial support ,should be approximately 90 like the picture . What we attempt to see is that there is an angle between them. But If the patient loses his lip support. What will happen? -The angle will become obtuse ( ) more than 90, the lip will lose it support. This is important fact when we set teeth in the lab and when we do jaw relationship record in the clinic. We talked about specific guidelines we must follow when we set the teeth and do jaw relationship record, one of the main guidelines that we look for is: this anglensio-labial angel. Whats the main muscle in the cheek? It is the Buccinator (origin:pterygomandibular ligament) and we have the masseter muscle(origin:zygomatic arch ,insertion:angle of the mandible). We are just mentioning this because later on you will see that it functions in the denture in an indirect way. Those of you who have taken the lab have already heard some of the things that Im going to talk about today. Hopefully the repetition will help you. intra oral anatomy: When we talked about the intra-oral anatomy of the Edentulous Arches (the maxillary and the mandibular), we essentially divided the anatomy into two parts: 1- A part which supports the denture (the denture bearing area, the support area). 2- Peripheral structures (the limiting structures around the denture).

Before talking about intra oral anatomy there are some very important terms that you have to know to be able to understand what we are talking about :
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**denture foundation area: the surfaces of oral structures available to support a denture.* **denture base :the part of the denture which rests on the foundation tissue and to which teeth are attached.* **support : the foundation area on which a dental prosthesis rests .with respect to dental prostheses the resistance to displacement away from the basal tissue or underlying structure .* **Denture stability :1.the resistance of the denture to move on its tissue foundation especially to lateral (horizontal forces) 2.a quality of a denture that permits it to maintain a state of equilibrium in relation to its tissue foundation.* **denture retention :1.the resistance in the movement of a denture away from its tissue foundation especially in vertical direction.2. a quality of a denture that holds it to the tissue foundation.* *glossary of prosthodontic terms . ^^^Good retention needs support and stability also helps in retention. we said that the object of taking the primary or secondary impression is to register the entire surface area and the Edentulous Ridge, so that we have better support for the denture. Its in our interest and the patients interest to cover the largest area. If I cover a small area, and the patient chews the denture will hurt the patient in that area. The more support I have, the greater surface area, the better and the more comfortable the patient is. -Now we are going to talk about some rules that we should consider when making complete denture: 1) * one of the most important rules in making complete denture is to cover the largest surface area possible but not to over extend or cover areas that causes discomfort to the patient. 2) dont over extend denture boarders into muscle or movable areas.

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So Ill cover as much as of the Edentulous Arch as I can. As I said, if I enlarge this support area and I keep reaching the borders beyond the Edentulous Ridge Im going to run into the tissues that move because Ive muscles. We said that we have the Buccinator in the cheek and orbicularis oris around the opening of the mouth and posteriorly I have the soft palate and levator and tensor veli palatini, there are a number of muscles that attach the maxilla to the mandible into the tongue. And in the mandibular arch I have the tongue with extrinsic and intrinsic muscles. These tissues move and I cant extend the denture into this movement. Extending the denture to the movable areas leads to one of two things : 1- Dislodgement and movement of the denture which is uncomfortable to the patient. (when the over extension is large enough to cause dislodgement) 2- The denture is relatively stable so it will cause trauma ( ( ( if the over extension is not large enough to cause dislodgment) So I have a dilemma! I want to cover as much as possible but I dont want to go beyond the normal movement. These things are important when I talk about the impression, because as you will see the impression is taken in two stages: secondary impression two stages: 1- Registering the boarders or the limiting structures that surrounds our denture. (Border molding on the edges of the tray as you saw in the lab). 2- Then we take an impression of the whole area. So we have the external structure around the denture and then the denture bearing areas. Quick review to the things that we'll be talking about today: we can take a look at the palate, the residual ridge, the vestibule externally and the soft palate posteriorly. Plz refer to your book (prosthodontic treatment for edentulous patients zarb-bolender) page 215 and see figure 13-5 it contains all the anatomical land marks that are important for you and that we are going to talk about in this lecture. Residual alveolar ridge:

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The elevation or part of bone as you know that remains after the teeth are extracted; we call it the alveolar bone or the residual bone. It s shape changes after extraction with time. And the way it resorbs or atrophies is very different from patient to patient. The resorbtion occurs in specific directions, sometimes more resorbtion happens on the labial than the lingual side, while other parts resorbs from the lingual more than the labial, depending on the density of the bone and the anatomy of the bone in that area. So The ridge can have different shapes, it can be prominent, atrophied, regular, irregular, symmetrical or nonsymmetrical. Maxillary tuberousities: At each end of the residual ridge in the maxillary arch we have large prominence called the maxillary tuberousity (designated with the squares), sometimes they are small depending on whether they were removed during extraction. So essentially the residual ridge extends from one maxillary tuberousity to the other.

Maxillary tuberousity and supra eruption: -The tuberousity as you can see it can be very large. If the last teeth to be extracted are the molars sometimes with time the teeth supra-erupt. if I remove one tooth, 1. the teeth next to it in the same arch and

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2. the teeth opposite to it in the opposing arch they will lose the balance and drift mesially or distally into space (the same arch) or they will go up or down supra erupt to the opposing space(in opposing arches) eg. If I remove the lower tooth without removing the upper tooth sometimes the upper tooth will drift and go down with the bone surrounding it. Sometimes, if I leave posterior teeth too long, the tooth will supraerupt and will bring the bone with it. Sometimes, I end up with maxillary tuberousities that are so large that they come down and touch the lower arch. In such cases we do surgery to reduce the amount of bone, we have too much bone in this case. *** (the tuberousity is too large they went for surgery the above picture) Incisive papilla : At the junction of the anterior part of the palate and the residual ridge you have the incisive papilla (the circle). The incisive papilla is essentially small prominence which over lays the exit of the naso-palatine nerve and blood vessels. Its a sensitive part, we dont like to load it, its what we call a relief area!! We dont want pressure in this area. If you feel the upper part of your mouth, just behind your central incisors you will find a small prominence, is the incisive papilla. rugae area: Behind the incisive papilla in the anterior part of your mouth, we have an irregular area called rugae; we will talk about it in more detail. the mid palatine suture : In the midline, at the junction between the palatine process of the maxilla and the palatine bones we have the mid palatine suture (mid palatine raphe). soft palate:

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If we go further behind( posteriorly) we will run into the soft palate, which has a part of it that is movable , this information is important for us we will know why in a minute Sulcus or vestibule : if we go further facially, we'll end up into a pocket like structure called a vestibule (sulcus). This is divided anteriorly and posteriorly into the labial sulcus anteriorly and the buccal sulcus posteriorly on either side. The labial sulcus is separated from the buccal sulcus by the buccal frenum on either side. In the middle of the labial sulcus we have labial frenum. Hamular notch: In the back, we have the (Hamular Notch) which is a depression between the maxillary tuberousity and the hamular process of medial pterygoid plate. ** The stuctures in labial vestibule in the maxillary arch that provide support is not significant as in the mandibular arch. Zygoma : Like I said we have buccal vestibule and the labial vestibule, The buccal vestibule is divided by the Buccal Frenum- sometimes there is one frenum or there are two frena/frenum. Posterior to the buccal frenum beneath the vestibule you can spot a solid buccal bone (support) from the zygoma, this doesnt usually affect the fabrication of the denture unless there is a large amount of resorbtion in the ridge in that area Coronoid process : there is another landmark that we must take into consideration when making a denture which is the coronoid process (found lateral to the maxillary tuberousity, the coronoid process comes forward when the jaw is opened completely (this movement must be taken into account when making the denture). Modulus:
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Recall from your Head and Neck Anatomy Lectures the major muscles of facial expression: The Buccinator , the orbicularis oris and mentalis. All the major muscles of facial expression anastomose (join together) at the corner of the mouth; this anastomosis is called the modulus. The modulus is significant because it moves the buccal frenum with it, so when the Buccinator pulls the cheek back, the buccal frenum will go back and when the orbicularis oris contracts the entire modulus comes forward .when the patient smiles the modulus will go up. This means when we make an impression we need to be careful in the area of the buccal frenum, we must create a notch in the denture that allows the buccal frenum to move freely without restriction. ( ) **Soft tissue classification: *Special type of tissue scar tissue on the alveolar ridge Microscopically the tissue found in the mouth on the residual ridge is a scar tissue; If you cut yourself the tissue will heal and it will leave a scar, When we extract teeth the tissue that remains after extraction is a scar tissue (healing tissue). It wasnt designed to withstand the force of a denture, Its important to understand this. The Edentulous mouth wasnt designed to support the denture. We take advantage of it to support the denture, but the tissue and the mucosa above it arent specifically designed for denture, It is a sensitive mucosa. *keratinized and non-keratinized mucosa You know that the tissue in the mouth before extraction is divided into keratinized and non- keratinized (masticatory mucosa and lining mucosa) or specialized mucosa (like the surface of the tongue where we have the taste bud). If you take a look on the maxillary Edentulous Ridge, you will notice that the entire palatal surface and the residual ridge are keratinized mucosa (masticatory mucosa), it will withstand a certain amount of friction even thought it wasnt specifically designed to have a denture sitting on top of it. The further out we go (sliding from palate towards the cheek), were going towards a junction between two types of mucosa, Masticatory mucosa is an attached mucosa; its
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attached to the bone in the palate or in the residual ridge. However, when we go further out to the vestibule, there will be a junction at which the tissue is no longer attached. So, we have attached and un-attached tissue. We want to extend just onto the unattached tissue but not beyond it. The un-attached tissue will be lining mucosa (nonkeratinized). Friction and movement of the denture in this part of the mouth might cause ulceration and trauma. Its not only that we want to extend to the extent of the muscle we also want to have support from tissue that can withstand friction and force.

*sub-mucosa Whats underneath the mucosa? We have the sub-mucosa and mucosa have squamous epithelium, lamina propria and the sub-mucosa which has blood vessels , glandular tissue and adipose tissue and so on (It provides support). The thickness of the sub-mucosa varies in different parts of the mouth, and in our case it varies in the maxillary arch, Some parts of the arch have a thick sub-mucosa, some of them have loose sub-mucosa and some of them have very thin area. Depending on the thickness of sub-mucosa, we'll find that some areas are designed well to stand stress from the denture while other areas are not! We need to relieve or avoid them from the denture so they wont cause pain, ulceration or friction in the patients mouth. We already said that in the incisive papilla area we have a group of blood vessels and nerves (a relief area). In the posterior part of the palate, we have the greater and lesser palatine nerves (we dont want a heavy load in this area either). Thankfully, we have thick sub-mucosa so it wont be a problem. In the midline palatine raphe, the mucosa is very thin, so it's a (relief area). Depending on the tissue and the sub-mucosa, whether it's thick or thin and depending on other factors you will see that some areas are considered primary stress bearing areas, or secondary stress bearing areas and some are considered relief areas (we dont want to place force on them). If you look closely in some mouths you will actually see a groove (depression on the residual ridge), it indicates where the facial and lingual gingiva met after healing (like we said its a scar tissue). The position of this groove is sometimes helpful to us when we set
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teeth just as the incisive papilla is! It does not usually change its place with resorbtion so it's a good guideline of setting of the teeth. What can we see behind the maxillary tuberousity (the small depression referring to the slides? Its the hamular notch, it's a soft area with relatively thick sub-mucosa, the only thing that you can find here are tendinous attachments for two muscles of the soft palate which are the : levator veli palatini and tensor veli palatini. You cant extend the denture behind this area for a specific reason, because behind it we have a rigid tissue, it's called pterygo-mandibular raphe. It attaches to end of the pterygoid process of the medial pterygoid plate. ***In our body when we have a prominence( )of bone, If you find the bone raised when looking at the skeleton its raised because there is tension on this area ,and it is usually attachment of muscle or a tendon. 9) Pterygo-mandibular raphe : Its a raphe (attachment between muscles fibers) that extends from the pterygoid process down to the posterior part of the mandible in an area called retro molar pad "we will talk about it next week inshallah". Its not there for no reason, its a junction between muscles, its an anastomosis of two muscles, which are the Buccinator and the superior constrictor muscles,This tension (from muscles attached there) makes the bony process (pterygoid process). If you want to look for this process in a young child, you properly wont find it, it wont be very clear. Just like the mastoid process, it wont be very large. Young children dont have large sternocleidomastoid muscles. These bones tend to be larger and more prominent as time goes on because There is tension on these areas. So, back here we have bony process and in the end of the bony process we have pterygo mandibular raphe. So, I cant extend beyond here because I essentially have pterygo mandibular raphe and i cant press so much on it because its movable and on its level lateral to it I have the thin attachment of the soft palate muscles. However, the (Hamular Notch) is important because it delineate the posterior part of the denture. posterior part of the denture is very important.
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Where do we end our denture posteriorly ? -The junction between the hard and soft palate is not the end of the denture, I extend my denture beyond the anatomic junction between the hard and soft palate, just onto the soft palate. How far in the soft palate? Thats determined by which part of the soft palate moves. We know that the soft palate goes up and down, it closes up the nose from the oropharynx and closes up the mouth from the nasopharynx when we breathe or eat. This movement will end on the soft palate not the hard palate, that means that I can take an advantage of the soft palate to determine the end of my denture. *** usually the junction between the movable and the unmovable parts of the soft palate is called the vibrating line . Because the soft palate moves when the patient speaks or says aaaah , we take a look inside the patient s mouth and then we can see parts of the soft palate in this area vibrating moving up and down ,here where we want our denture to end. *so posteriorly we end our denture on the vibrating line that is the junction between movable and non-movable parts of soft palate. If we go posteriorly, we reach the (Hamular Notch) . Its difficult to see and not every patient has a prominent tuberousity, usually well take an instrument like a mouth mirror or a blunt instrument and run it along the residual ridge until the instrument drops. When it drops we know weve reached depression we want. The vibrating line is not always visible as some of these clinical pictures. So, here we have the imaginary vibrating line which we said is usually not on the hard palate, its just into the soft palate , to find it we I do one of 2 things: defining the vibrating line: I ask the patient to say aaaah and I look inside the mouth and I see where the motion starts I take an advantage and use a special marking pencil and I
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mark it inside the mouth to see which part of the soft palate moves and which part of the soft palate remains stable. And also can take an advantage of certain anatomic landmarks. We know there two small dots depressions in the posterior part of the palate which are called Fovea Palatine. The Fovea Palatine are usually located 12mm behind the vibrating line they can be anterior to it but usually its behind. When we see Fovea Palatine we mark them and we know where the vibrating line is , just in front of the Fovea Palatine by 12mm. we use a a marking pencil (called copia pencil)to mark so when I put a custom tray in the patients mouth, the line will imprint from the patients mouth onto the custom tray . So,I can even imprint it on the primary impression if I marked it in the mouth before I take the impression then after marking I take the impression to imprint the line on the impression material. Copia pencil :( , )custom tray And usually we take it at different stages during the fabrication of the denture. Like I said we take advantage of these Fovea Palatine. What are Fovea Palatine histologically?? They are essentially grooves representing mucous minor salivary gland. They dont have that much significance in the mouth except that they provide good landmark to find the vibrating line. (In the posterior end of the denture). You will notice that the posterior part of the denture depends on the shape of the soft palate. We said that the significance of knowing the limiting structures is that we dont want the movement of the muscles to cause a displacement in the denture. We said that the way the denture remains inside the patient mouth is very significant, Do you know how exactly the denture is retained inside the patient mouth?. Where do we get denture retention from ?? 1- Physical forces that keep the denture in the mouth like (adhesion and cohesion)
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Adhesion and cohesion( you dont have to memorize the definitions its just to have an idea about their meaning ) Adhesion: the property of remaining in close proximity .* Cohesion: the act or state of sticking together tightly .* *from glossary of prosthodontic terms

( ) however in the mouth, this not enough, it is there, it helps us but its not enough to keep the denture in the patients mouth while the patient chews, speaks, shouts and whatever . It is there, it helps but it is not significant. ** Some students said that we use some kind of glue to help the denture stay in its position (but we dont use adhesives to prevent the denture falling by the gravity but it has its own indications for special cases so in most cases we dont use denture adhesive(glue) so we dont consider it a method of retention. 2- Sometimes, we have mechanical retention. In some mouths we have prominent bone; we can keep the denture over the prominence but it is not possible in every mouth and we cant take an advantage in every mouth even if its there. We said the primary method of the denture will remain in the patients mouth according to the Physical forces. 3- atmospheric pressure (peripheral seal): (the main force that keeps denture in place) there is something called peripheral seal ( ) a suction force, the patient places the denture in mouth , the pressure underneath the denture is less than in the surrounding environment so the pressure from outside keeps denture in place. If the patient tries to remove it, the pressure will resist the movement force. So, we have negative atmospheric pressure underneath the denture. How can I keep the area sealed to keep the pressure ? ( ) .. ... we are very fortunate the limiting structures in
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the labial vestibule and a buccal vestibule are already there, I have the cheek buccally and the lip labially. Posteriorly, I have a problem because I dont have a muscle that comes down I dont have anatomical seal , I have a soft palate which moves but I dont have an actual muscle that comes down and helps the denture. So, what we said in the lab is the vibrating line is important because I dont want to extend the denture posteriorly to the movable parts of the soft palate but I want to go back as far as possible in order to extend the denture onto tissues that I can press on. The back part; the posterior part of the denture is made so that it compresses slightly into the tissue soft palate ( .. so the back end of the denture will actually press into the tissue not a lot it wont hurt the patient it only goes (half) mm in depth. So, the cheeks and the lips they will come down and they will create a seal. posteriorly, because the soft palate doesnt come down like that so what I do is that I design the denture in away to make it press or go up into the soft tissue. the significance of the vibrating line is 1- it helps me go as far back as possible to make maximum coverage without going into mobile soft palate. 2- it helps me define the area where I can press the tissue to get posterior seal. If I end the denture on the hard palate the tissue is very thin so I cant compress it without traumatizing the tissues so locating the vibrating line is very important thing to create the seal it is called border or peripheral seal. It will give me retention for the denture. 4- Physiological forces/retention (muscular control): some patients even if the denture doesnt stay in the mouth by itself, they are able to keep the denture in their mouth just by trapping it between the muscles ( ) Buccinator and orbicularis oris ( ) this varies from one patient to the another. Some patients can control the denture and brace it and other patients are unable to do that) .so we try to make the denture as retentive as possible by itself using the other forces available without an effort from
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the patient. The Physiological forces/retention from muscle is more important for the mandibular arch than the maxillary. Palatal form and its effect: (soft palate) The palatal form is different from person to person, some people are tall some people are shorter. The soft palate is sometimes more horizontal in some patients or more vertical in others . These positions make it easier or more difficult for us to create the posterior seal ( ) Soft palate classification: House classification the horizontal is class l , the vertical is class lll and class ll is the one in between , the most favorable is class l ~ -In general, class I represents the gentle movement, class III represents the excessive movement, while class II lies in the middle.

Hard palate and residual ridge classification: -the residual ridge is important but the part of the hard palate is also important. Which shape do you think is better or more suitable to support the denture??? (remember you need a residual ridge for stability and a hard palate for support) . the U-SHAPED palate is the best one because you have a residual ridge at the edges laterally to provide some stability from side to side. The flat IS EXCLLENT retention and support but there is nothing on the sides; slight movement

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may hurt the peripheral seal no stability. The rounded is acceptable. The V-shaped properly the poorest. The residual ridges how they can be? Sharp, rounded, prominent or undercut. A nice well rounded ridge is properly the best type. rounded ridges are properly a good support for the denture because they have the largest surface area so the load is well distributed it wont cause pain at the crest of the ridge and it wont let the denture sink into the sulcus . *** atrophy is much faster in bone than in the soft tissue. ( ) so, when the bone resorbs , what will happen to the soft tissue?? The tissue will become loose just like someone whos very healthy they lose weight so they become thinner suddenly then the clothes will be loose. In the mouth this is the situation. In the mouth, the bone resorbs then the soft tissue on the ridge becomes loose in some cases, in these cases its very important to remove excess tissue surgically before making the denture . or we take our impression in a very special way to try to record the perfect fit despite the excess tissue.

**Torus Palatinus:

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Earlier we mentioned that the mid palatine raphe is important because the overlying tissue Is very thin, in the median suture of the mid palatine raphe sometimes there is a protrusion present called: Torus Palatinus, it is basically a bony mass very compact dense bone found in one of every five patients (20%). The size of these Torus differ (can be small or very large) but the tissue overlaying the bone is very thin, meaning that any excessive pressure on this area will cause trauma and irritations to the patient therefore we cannot rely on this area as a Denture support area because of patient sensitivity as well as the fact that its not present in most patients. Attempting to remove the Tori surgically will lead to formation of heavy scar tissue and cause irritation. there is also Tori in the mandible usually lingual to the canine (not a tumor just a bony mass) We only remove it in some cases when its too big and causes interference with removal/placement of the denture. Finally we will discuss the directions of resorption : In different parts of the mouth the bone have different angulations. In the upper anterior part of the mouth the teeth & the alveolar bone are slightly proclined at around 15 Degrees. ( ,), in the upper posterior part of the mouth the molars are angled very slightly outward so you can see the direction is buccally (the alveolar bone of the posterior molars follows in the same angulation), In the lower anterior teeth & alveolar bone is angulated slightly outwards. The only exception to this rule is the lower posterior teeth which are angulated in an inward direction (toward the tongue not toward the cheek) because they are trying to balance out the upper teeth which are angulated outward. ** Lower posterior teeth are the only teeth that are angulated inwards.
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Recall from the curves of occlusion that the occlusal plane is curved. (Curve of monson , curve of spee and the sphere of willson). When we extract a tooth the alveolar bone beneath it will start to resorb or atrophy so it becomes shorter, Compare the crest of the ridge before extraction and after extraction. Did it move towards the palate or toward the cheek?? It moved towards the palate. ( ,) another example: This is the residual ridge before and after (referring to the slides) ( ridge . ( The middle of the ridge becomes shorter and inward (further palatal). This is the case for all the Edentulous Ridges (Ridge & Bone) except the posterior of the mandible mandibular posterior goes outwards and the maxillary posterior goes inwards (they are moving opposite to each other). You will find that the movement/resorbtion of the ridge has a significance in making a denture and it has a significance in where we put the teeth during setting in the lab. In the upper arch we will put the teeth outside the Edentulous Ridges to compensate for the resorbtion . In the mandible, we will try to put them further in to mimic the situation before they were extracted. **The lower posterior teeth are the only ones that resorb differently. **Maxillary Arch becomes smaller **Mandibular Arch anteriorly becomes smaller, Premolar area stays the same & posteriorly it will become larger.

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