Anatomy

By: Wildan Humairah 090600020

Anatomy in Relation to Complete Denture

Border Structures Limit Dentures periphery

Intra-oral Landmarks

Extra-oral Landmarks

Maxillary Anatomical Landmarks

Mandibular Anatomical Landmarks

Maxillary

Mandibular

Extra-oral Landmarks
1. 2. 3. 4. 5.

6.

Nasolabial Sulcus Mento Labial sulcus Philtrum Vermillion border Angle of the mouth Modiolus

Extra-oral Landmarks
Nasolabial Angle
Angle between columella of nose & philtrum of lip Normally, approximately 90 as viewed in profile

Extra-oral Landmarks
Mento labial Sulcus

Extra-oral Landmarks
Mento labial Sulcus

Angle Class II

Class I

Class III

Extra-oral Landmarks Philtrum

Depression below nose

Extra-oral Landmarks Vermillion Border

Denture provides lip support Affects vermilion border width

Extra-oral Landmarks Angle of the mouth (commicure)

Extra-oral Landmarks
Modiolus

Intra-oral Landmarks
Maxillary Anatomical Landmarks
a. b.

Labial frenum Buccal frenum

c.
d. e.

Labial vestibule
Anterior buccal vestibule Posterior buccal vestibule Retrozygomatic space Coronoid bulge Hamular notch Pterygomaxillary notch Fovea palatini Vibrating line

f.

g. h.

i.
j. k. l.

Residual alveolar ridge

Palatal rugae Incisive papilla Median palatine raphe

m.

Maxillary tuberosity

Anatomy in Relation to Complete Dentures

Edentulous Maxilla
a.

Labial frenum Fold of mucous membrane Does not contain muscle Labial notch in denture is narrow Buccal frenum Overlies levator anguli oris May be moved in an A-P direction by the actions of the orbicularis oris and buccinator

b.

Anatomy in Relation to Complete Dentures

Edentulous Maxilla
c.

Labial vestibule Reflection contains no muscle

d.

Anterior buccal vestibule Overlies buccinator muscle whose fibers are downward and forward and limit the height and thickness of the buccal flange Posterior buccal vestibule Thickness determined by the masseter muscle Coronoid process of the mandible encroaches on the space during lateral excursions Labial and buccal flanges of the denture must contact movable tissues in order to make a seal

e.

Anatomy in Relation to Complete Dentures

Edentulous Maxilla
f.

Hamular notch Pterygomaxillary notch Does not contain any muscles or ligaments to interfere with the addition of pressure with a postdam Fovea palatini 2 small pits representing mucous gland openings Usually located just posterior to the vibratingline

g.

Anatomy in Relation to Complete Dentures

Edentulous Maxilla
h.

Vibrating line Imaginary line across palate Connects the pterygomaxillary notches

Posterior Palatal Seal

Area not a line Functions: border seal, prevent food impaction beneath, improve retention, compensate for shrinkage of denture resin Pressure on displaceable mucosa that covers palatal glands Anterior border junction between hard and soft palate; blow line Posterior border (vibrating line) junction between movable and immovable soft palate; AH line

Anatomy in Relation to Complete Dentures

Edentulous Maxilla
Denture bearing areas
i.

Residual alveolar ridge

Crest is primary stress bearing area Fibrous CT least displaceable and best able to carry the stress of mastication

j.

Palatal rugae
Secondary stress bearing area

Anatomy in Relation to Complete Dentures

Edentulous Maxilla
k.

Incisive papilla

l. m.

Guards the incisive canal Pressure will interfere with the blood and nerve supply causing a burning sensation Provide relief Median palatine raphe Maxillary tuberosity Distal to the maxillary third molar, the alveolar process ends in a prominence that is called the maxillary tuberosity

Anatomy in Relation to Complete Dentures

Edentulous Mandible
a. b.

Labial frenum Buccal frenum

c.
d. e. f.

Lingual frenum
Labial vestibule Buccal vestibule Residual alveolar ridge

g.
h. i. j. k. l.

Buccal shelf
Retromolar pad Pterygomandibular raphe Mylohyoid ridge Alveololingual sulcus Retromylohyoid space

Anatomy in Relation to Complete Dentures

Edentulous Mandible
a.

Labial frenum Fold of mucous membrane Does not contain muscle Buccal frenum Overlies depressor anguli oris (VII) Movable by the buccinator and orbicularis oris (VII) resulting in a wide notch in the denture Lingual frenum Overlies genioglossus (XII) muscle

b.

c.

Anatomy in Relation to Complete Dentures

Edentulous Mandible
Labial vestibule e. Buccal vestibule Entire periphery of denture must end in soft tissues Stability of denture must come from the maximum use of all bony foundations where tissues are firmly and closely attached to bone
d.

Anatomy in Relation to Complete Dentures

Edentulous Mandible
Denture bearing areas
f.

Residual alveolar ridge

g.

Buccal shelf Bounded laterally by the external oblique ridge and medially by the crest of the ridge Attachment of buccinator muscle (VII) Buccal flange rests upon buccinator and should extend as far as the tissues permit Masseter muscle (V3) may crowd buccinator forward against the denture causing an indentation at the DB angle

Anatomy in Relation to Complete Dentures

Edentulous Mandible
h.

Retromolar pad Contains: Retromolar gland Pterygomandibular raphe Buccinator muscle Temporal tendon Underlying basal bone is resistant to resorption Coverage will provide some border seal Pterygomandibular raphe Extends from the pterygoid hamulus superiorly to the alveolar ridge inferiorly under the retromolar gland

i.

Anatomy in Relation to Complete Dentures

Edentulous Mandible
j.

Mylohyoid ridge Attachment of mylohyoid muscle (V3) which forms the muscular floor of the mouth Fibers are almost horizontal in front of the hyoid where they join those of the opposite side to form a raphe At the level of the hyoid they pass almost vertically downward to insert into the hyoid Alveololingual sulcus Slopes toward the tongue to permit action of the mylohyoid Length of flange distally compared to anteriorly is greater owing to the changed length and direction of the mylohyoid fibers

k.

Anatomy in Relation to Complete Dentures

Edentulous Mandible
l.

Retromylohyoid space DL extension determined by styloglossus (XII) Posterolateral extension determined by superior pharyngeal constrictor (X) and palatoglossus (X) Overextension may cause pain on swallowing

Border Structure that Limits the Periphery of the Denture

Maxillary Denture
Labial frenum. Labial vestibule Buccal frenum Buccal vestibule Hamular notch

Mandibular denture Facial border anatomy

Labial frenum. Labial vestibule Buccal frenum Buccal vestibule

Vibrating line of the soft palate Masseter muscle influencing area Retromolar pad

Border Structure that Limits the Periphery of the Denture

Maxillary Denture Mandibular denture Lingual border anatomy Palatoglossal arch. Lingual pouch Sublingual salivary gland area Lingual frenum Lingual border anatomy Palatoglossal arch.

Denture Support
Foundation area on which the dental prosthesis rest
Primary stress bearing areas

Secondary stress bearing areas

Stress bearing areas

Primary stress bearing areas

Areas which able to resist the vertical forces of occlusion

Maxillary arch
The crest of the ridge

Mandibular arch
The buccal shelf of bone The crest of the ridge

The flat area of the palate

Secondary stress bearing areas Areas resist the lateral forces of occlusion and can aid the resistance to the vertical forces
Maxillary arch
Lateral slopes of the palate Rugae area Labial & Buccal surfaces of the ridge

Mandibular arch

Anterior ridge. All ridge slopes

Relief area The portion of the denture is reduced to eliminate excessive presser on specific parts on the denture supporting tissues
Maxillary arch
1. 2. 3. 4. Incisive papilla Median palatine raphe Torus palatinus Sharp bony prominences

Mandibular arch
1. 2. 3. 4. Genial tubercle Sharp mylohyoid ridge Torus mandibularis Crest of knife edge ridge Mental foramen Sharp bony prominence

5. 6.