‫بسم اهلل الرحمن الرحيم‬

Dr. IBRAHIM RAMADAN ELTORKY

Professor of Prosthodontics
Faculty of Dentistry, Al Manara for medical sciences
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• The knowledge of the structure
and function of tissues in the
vicinity of the denture can be used
to determine the proper design.

• The muscles of facial expression

need support from the teeth for
proper function.

• If the muscles of facial expression

are not properly supported, some
of the facial expressions appear
abnormal.
1.1. Nasolabial
Nasolabial sulcus
sulcus
2.2. Mentolabial
Mentolabial sulcus
sulcus
3.3. Philtrum
Philtrum
4.4. Vermillion
Vermillion border
border
5.5. Angle
Angle of
of the
the mouth
mouth
6.6. Modiolus
Modiolus
- It runs from side to side horizontally
between the lower lip and chin.

a. In normal ridge relationship Angle

class I , the mentolabial sulcus shows
an obtuse angle.

b. In Angle class II, the mentolabial

sulcus presents an acute angle.

c. - In Angle class III, the mentolabial

sulcus presents an angle of 180 degree.
It is a diamond shaped area
at the center of the upper lip
and base of the nose.
Improper tooth alignment
may obliterate the philtrum.
 vermilion border.

 It is the transitional epithelium

between the mucous membrane of
the lip and skin.
 The amount of vermilion border
shown depends on:
a. The bulk of orbicularis oris
muscle.
b. The amount of labial alveolar
bone.
c. The alignment of teeth.
 vermilion border.

 With loss of teeth and resorption of the labial alveolar bone, the orbicularis oris
loses its support and drops inwards (Palatally) and diminution of the amount of the
vermilion border.
 This gives the characteristic appearance of the edentulous face.
 Angle of the mouth
(commisure)
Denture should support the mouth
angle.
Lack of proper support of the upper lip
may lead to angular chielitis which is
fissuring and inflammation of the
angle of the mouth as a result of
continuous wetting from saliva and
a reduced vertical dimension
Modiolus:

 located at the meeting place between the buccinator and other

facial muscles near the angle of the mouth .
 With loss of teeth, it is displaced giving the characteristic
appearance of edentulous patient (sunken appearance).
The oral cavity is divided into two compartments:
• The vestibule.
• oral cavity proper.

The vestibule is further divided into:

• A labial.
• A buccal vestibule.

The vestibule is bordered laterally by the mucous

membrane of the lips and cheeks and medially
by the outer surface of the natural teeth and
adjacent alveolar mucosa.

After extraction of teeth, the alveolar bone that supports the teeth begins to
resorb and decrease in size. The bone of the alveolar process that remains is
called the residual ridge.
Maxillary anatomical land marks:

1. Alveolar ridge:
It Is the portion of the alveolar process and its
soft tissue covering that remains after the
extraction of teeth.
The highest continuous surface of the ridge is
called the crest of the ridge.
It is covered with a layer of dense fibrous
connective tissue.
The residual ridge is considered the primary
stress bearing area in upper jaw.
Maxillary anatomical land marks:

2. Maxillary tuberosity:
Distal to the maxillary third molar, the alveolar process ends in a prominence
that is called the maxillary tuberosity.
It is a rounded bulge behind and slightly above the distal end of the residual
maxillary ridge.
It should be included in the denture supporting area as it permits coverage of a
wide area and good bearing surfaces.
Extremely large tuberosities may need surgical corrections before complete
denture construction.
Maxillary anatomical land marks:

3. Hamular or pterygo maxillary notch:

It is a depression distal to the maxillary tuberosity used as a landmark for the

correct extension of the upper denture.
The posterior palatal seal should extend through the hamular notches.
Maxillary anatomical land marks:

4. Palatine vault:
•It is formed anteriorly by the hard palate and posteriorly by the soft palate.
•The palatal surface of the alveolar arch forms the lateral and anterior boundaries
of the vault.
•The palatal arch may be high and V-shaped, or shallow and flat.
•The U-shaped vault is more desirable for denture stability.
Maxillary anatomical land marks:

5. Median palatine raphe:

•The hard palate is formed by the premaxilla and two palatine processes of the
maxillary bone.
•The suture that joints the two palatine processes at the midline is called the
midpalatal suture.
•This suture is covered by a thin, dense mucoperiosteum with little or no
•submucosa.
•Its position in the palate is marked with a raised area of mucous membrane
called the median palatine raphe, which may be hard or sensitive.
•It is generally relieved to prevent the upper denture from rocking.
•Improper relief of the median palatine raphe may cause instability of the upper
denture that may cause fracture of the upper denture at the midline.
Maxillary anatomical land marks:

6. Incisive papilla:
•This is a pear shaped elevation of fibrous connective tissue situated at the
midline just posterior to the crest of the edentulous ridge.
•When teeth are present it is situated just behind the central incisors.
•It covers the opening of the incisive foramen (nasopalatine canal).
•The nasopalatine nerves and vessels that supply the anterior two thirds of the
palate pass through the incisive foramen.
•Pressure from the denture in this area may cause burning sensation,
consequently the incisive papilla should be relieved.
•The two central incisors should be place anterior to the incisive papilla.
Maxillary anatomical land marks:

7. Rugae:
•These are irregularly shaped ridges of connective tissues covered by the mucous
membrane in anterior third of the hard palate.
•The rugae play a part in speech, especially the letter "s“.
•It should not be disturbed by the impression.
Maxillary anatomical land marks:

8. Torus palatinus:
•There is usually a raised, bony ridge running down the center of the hard palate
from the anterior palatine foramen to the posterior border, or any part of this
distance which is known as torus palatinus.
•If the size of the torus is too big or extended posteriorly to where the posterior
palatal seal is placed, it should be surgically removed.
•If the torus is small, the denture base over this area must be relieved.
Maxillary anatomical land marks:

9. Fovea palatinae:
These are two small pits or depressions in the posterior aspect of the palate, one on
each side of the midline, posterior to the junction of the hard and the soft palate.
They are openings of the ducts of minor salivary glands.
They are always found in soft tissues and so are often used as a landmarks in
locating the position of the posterior palatal border of the maxillary denture which
should be few millimeters posterior to it.
Mandibular anatomical landmarks:

1. Alveolar ridge:
•Like in the maxilla, it is the part of the alveolar process and its soft tissue
covering that remains after extraction of teeth.
•It is the highest continuous surface of the ridge is the crest of the ridge.
Mandibular anatomical landmarks:

2- Retromolar pad:
•It is pear-shaped area of mucous membrane at the posterior end of the mandibular
alveolar ridge and anterior to the Pterygomandibular raphe.
•It is a pad of loose, areolar tissue that contains retromolar mucous glands.
•It is bounded medially and laterally by the fibers of the temporalis muscle.
•It acts as a cushion and also provides a posterior seal for the mandibular denture.
•It is a guide for locating the occlusal plane of the mandibular denture.
•It must be covered by the denture.
 Mandibular anatomical landmarks:

3- External oblique ridge:

•It is a ridge of dense bone extending from just above the mental foramen
superiorly and continuous with the anterior border of the ramus of the mandible.
•The lower denture should cover but not extend beyond the external oblique ridge
to avoid denture displacement by the powerful musculature in this area.
 Mandibular anatomical landmarks:

4- Buccal shelf area:

•It is bounded externally by the external oblique ridge and internally by the slope of
the residual ridge.
•The bone in this area is very dense.
•Forces of occlusion can be directed more nearly at right angles to the buccal shelf
than at any other area of support.
•It is considered as. a primary stress bearing area, therefore it should be covered
by the lower denture to provide support.
 Mandibular anatomical landmarks:

5- Mental foramen:
•It is located on the buccal surface of the mandible in the premolar region between
the roots of the first and second premolar.
•The mental nerves and vessels pass through it.
•In cases of severe ridge resorption, the mental foramen is located on the crest of
the ridge where relief of the denture in this area is necessary to avoid pain and
numbness of the tower lip as a result of pressure on the mental nerve.
 Mandibular anatomical landmarks:

6- Torus mandibularis:
•It is a bony projection sometimes found on the inner surface of the mandible in
the premolar region.
•It may be unilateral or bilateral.
•It is covered by a thin mucous membrane, where relief of the lower denture in this
area will be necessary.
•When the torus mandibularis is large, and interfere with the seating of denture, it
should be removed surgically.
 Mandibular anatomical landmarks:

7. Internal oblique ridge: (mylohyoid ridge):

•It extends near the inferior border of the mandible in the incisal region, terminated
just distal to a the lingual tuberosity.
•The mylohyoid ridge gives attachment to the mylohyoid muscle that forms the
floor of the mouth.
•In cases of excessive bone resorption, the mylohyoid ridge comes to be close to the
crest of the residual ridge.
•The mylohyoid ridge should be included in the denture bearing area.
•If it is sharp and prominent, it should be reduced surgically or otherwise relieved.
Mandibular anatomical landmarks:

8- Genial tubercles: (mental spines):

These are two small prominences located on the inner surface of the mandible, one
on each side of the symphysis.
The genioglossi muscles are attached to their upper surface and the geniohyoid
to their lower surface.
Normally they cannot be palpated, however in extreme alveolar bone resorption
they may be located on the crest of the ridge.
In such cases relief of the lower denture must be made.
The foundation area on which a dental prosthesis rests.

Denture foundation area

As the bone is covered by mucosa and submucosa of varying thickness, the ability
of these tissues to bear the load to which they are subjected by the denture will
differ.

Stress bearing areas:

A.Primary stress bearing areas.
B.Secondary stress bearing areas.
A. Primary Stress bearing areas:
Those areas which are able to resist the vertical forces of occlusion.

In the maxillary arch and palate:

1.The crest of the ridge.
2.The flat areas of the palate.
In the mandibular arch :
1.The buccal shelf of bone.
2.The crest of well formed ridge.
A. secondary Stress bearing areas:
Those areas which are able to resist the lateral forces of occlusion.

In the maxillary arch and palate:

1.Lateral slopes of the palate.
2.Rugae areas.
3.Labial and buccal surface of the ridge.
In the mandibular arch :
1.All ridge slopes.
Structures marking the denture
periphery
 Border structures that limits the periphery of the denture

It extends on both sides.

A. In the maxillary denture:
B. The labial frenum:
• Fold of mucous membrane extending from the mucous lining of the lips
toward the crest of the residual ridge on the labial surface .
• A labial notch must be provided in the midline of the denture border opposite
to its position. This will facilitates the functional movements of the frenum.
 Border structures that limits the periphery of the denture

2. Labial vestibule: (Labial m.m reflection area):

•it extends on both sides from the labial frenum to the buccal frenum.
•The reflection of the mucous membrane superiorly determines the height of
the denture flange.
 Border structures that limits the periphery of the denture

3. The buccal frenum:

• It is a fold or folds of m.m that extends from the buccal mucous membrane
reflection area to the crest of the residual ridge.
• It contains no muscle fibers.
• The border of the denture should be trimmed to fit exactly the depth and width
of the frenum.
• Inadequate clearance of the buccal frenum can cause dislodgment of the
denture.
 Border structures that limits the periphery of the denture

4.The buccal vestibule: (buccal m.m reflection area)

• It is the space distal to the buccal frenum.
• It is bound externally by the cheek and internally by the residual ridge.
• In this area the denture flange is in relation to the buccinator muscle which will
not displace the denture due to the horizontal direction of the muscle fibers.
• The thickness of the distal end of the buccal flange in these areas must be
adjusted to accommodate the coronoid process of the mandible, otherwise it will
push the denture out of place.
 Border structures that limits the periphery of the denture

5. Hamular notch:
• It is a notch located between the maxillary tuberosity anteriorly and the
pterygoid hamulous posteriorly.
• The posterior palatal border of the upper denture should extend from
hamular notch on one side, to the hamular notch on the other side, passing
through the vibrating line of the soft palate.
 Border structures that limits the periphery of the denture

6. Vibrating line of the soft palate:

• The extension of the posterior palatal border of the upper denture depends on
the functional activity of the soft palate.
• The soft palate has two parts, the anterior part that is adjacent to the hard palate
is immovable while the posterior part is movable.
• The posterior limit of the maxillary denture (the area of the posterior palatal
seal) should be located at the Junction of these two parts.
• The junction is the beginning of movement of the soft palate and is called the
vibrating line.
 Border structures that limits the periphery of the denture

B. In the mandibular denture :

1. The labial frenum:
• It is a fold of m.m that connects the mucosa of the lower lip to that of the
alveolar process at the midline.
• It moves with the movement of the lip.
• A labial notch must be provided in the lower denture flange to allow free
movement of the frenum.
 Border structures that limits the periphery of the denture

2. Labial vestibule: (Labial m.m reflection area):

•The part of the denture that extends in this area is called the mandibular labial
flange.
•In this area the denture flange is in relation to the orbicularis oris and incisivus
labii inferioris muscles which determine the length and thickness of the labial
flange in this area.
 Border structures that limits the periphery of the denture

3. The buccal frenum:

• This is a fold of mm in the premolar area attaching the lip and cheek to the
alveolar ridge.
• Functional movements of the lip and cheek change the form and tension of
the frenum.
• A buccal notch must be provided through the lower denture flange to
accommodate the frenum and prevent displacement of the denture during lip
movement.
 Border structures that limits the periphery of the denture

4. buccal vestibule: (buccal m.m reflection area):

• It extends posteriorly from the buccal frenum to the anterior border of the
ramus of the mandible.
• The buccal flange of the lower denture should extend to the buccal vestibule
resting on the attachment of the buccinator muscle.
• Contraction of this muscle does not displace the denture.
 Border structures that limits the periphery of the denture

5. Masseter muscle influencing area:

• The distobuccal corner of the mandibular denture is in relation to the
masseter muscle.
• In this area the buccal flange of the denture must converge rapidly in a
medial direction to avoid displacement due to contraction of the masseter
muscle
 Border structures that limits the periphery of the denture

6. Retromolar pad:
The lower denture should cover the retromolar pad and extends posteriorly till the
anterior border of the ramus of the mandible.
 Lingual border anatomy

1. Palatoglossal Arch:
It is formed by the palatoglossus muscle over extension of the distolingual
border of the lower denture will cause sore throat as a result of pressure on
the muscle.
 Lingual border anatomy

2. Lingual pouch:
The lingual pouch is pounded:
Posteriorly by palatoglossus muscle,
Anterior1y by the mylohyoid muscle, and
Medially by the lateral aspect of the tongue, and
laterally by the medial aspect of the mandible.
From the retromolar pad, the denture flange must be carried downwards to the
depth of the lingual pouch.
 Lingual border anatomy

3. Sublingual salivary gland area:

• It should not be covered by the denture base.
• The salivary glands change their size during function and the m.m of the floor
of the mouth is the least keratinized and the most sensitive to irritation.
 Lingual border anatomy

4. Lingual frenum:
• It is a fold of m.m that extends from the floor of the mouth to the under
surface of the tongue in the midline.
• It overlies the genioglossus muscle and moves with the movement of the
tongue.
• A notch must be made in the lingual flange for the lingual frenum.