📢Dear Members, today's article is written by D.D.S., Ph.D.

Professor Ikiru Atsuta 熱田生 , Associate

Professor of Kyushu University. If you have any questions, please comment below.

**✅RE-POST:Re-consideration of retro molar pad (Introduction)**

In patients using partial dentures, I often hear the chief complaint that "the mandibular denture hurts
deeper when chewed." It is particularly common in patients with free end defects in the mandibular jaw,
most commonly due to improper placement of the rest or the size of the denture base, and dentures
digging into the subfloor mucosa.

Therefore, in this time, because Dr. Ogino and Dr. Wada know the detail about the design of the
denture, I am only focusing into "Retromolar Pad" which is a landmark of the posterior edge of the
denture base in the mandibular jaw.

**1. What is a retromolar pad?**

Retromolar pad is the gingival swelling behind the molars. Speaking properly, it is the mucous
membrane that covers the posterior triangle (posterior ridge) behind the last molar. In the edentulous
part, most of the ulcer remains at the posterior end of the mandibular alveolar ridge as "mucosal
bulge"(Fig. 1).

This retromolar pad is divided into two parts, front and rear, depending on its composition. In the
anterior region, the submucosa consists of dense fibrous connective tissue, which is less mobile, and
apparently follows the alveolar ridge. The posterior part on the other hand is a completely different
part, with a mucous gland, a molar gland, and a highly mobile part. Furthermore, it is necessary to
understand that the morphology changes greatly depending on the opening and closing opening
because the wing protrudes from the upper jaw and continues to the wing protruding mandibular jaw
(the pad is stretched backward because the opening is under tension, and when closed, folded to the
lingual side to loosen)(Fig. 2).

**2. Muscle around the retromolar pad**

It is not only the influence of the wings and mandibular jaw folds that the retromolar pad changes the
form at the opening and closing. In the retromolar pad, the buccal muscle from the buccal side, the
nasopharyngeal contractile muscle from the lingual side, and the pterygomandibular raphe included in
the wing projection mandibular fold are inserted from the upper posterior medial angle. Also, behind
the retromolar pad, there is an inner diagonal line of the mandibular branch, and the inner leg of the
bifurcated temporal muscle tendon is long and reaches the retromolar pad. In addition, small muscle
bundles separated from the medial pterygoid muscle may also enter. It does not mean that it is easy to
cover it because it receives such muscle movement.
**3. Clinical significance of retromolar pad**

However, retromolar pads are not as susceptible to age-related changes as Hamler's notch and are
known to serve as a guide for setting the occlusal plane. It is also said that it serves as a cushion against
occlusal pressure and helps prevent ridge resorption. The soft part at the rear also acts as a margin
block. However, as mentioned earlier, the torso is a complex part that moves due to functional
movement, and there is no line that cooperates with the marginal closure. That is why it is necessary to
extend the floor to the soft part of the retromolar pad and to seal the margin with the denture base
even with a little pressure. Also, since this part is the end of the alveolar ridge, it is the part that is
strongly sandwiched between the buccal mucosa and the base of the tongue. A denture having an
appropriate shape at this portion will acquire not only the suction at the retromolar pad portion but also
the stability of being sandwiched from the left and right (Fig. 3).

**4. The position of the retromolar pad**

As I wrote above, I think you can easily find the place, but sometimes. By the way, it is obvious that
retromolar pads are not bones. As everyone knows, if a young dentists searches for a retromolar pad
while touching it with his finger, he may follow the inner diagonal line of the mandibular ramus and
pursue the bone morphology. Actually, I understand the inner soft tissue and the head, but I think that is
because the image of the "support zone" is strong (Fig. 4). As a result, the posterior edge of the denture
is brought too far to the buccal side and jumps up when opening, which directly leads to the lifting of
the denture.

So how can you impress the retro molar pad correctly? Next time, I will talk about the impression of
retromolar pad and the actual shape of the posterior edge of the denture.

Best regards

D.D.S., Ph.D. Professor 熱田生,

Associate Professor of Kyushu University