ANATOMICAL LANDMARKS

OF DENTURE BEARING
AREA OF
MAXILLA AND MANDIBLE

PRESENTED BY:
Dr. BRAJENDRA SINGH TOMAR
PG 1ST YEAR
DEPT. OF PROSTHODONTICS

GUIDED BY:
Dr. G. S. CHANDU

INTRODUCTION

THE ANATOMY OF EDENTULOUS RIDGES IN THE MAXILLA

AND MANDIBLE IS VERY IMPORTANT FOR THE DESIGN OF
THE COMPLETE DENTURE

THE TOTAL AREA OF SUPPORT FROM THE MANDIBLE IS

SIGNIFICANTLY LESS THAN FROM THE MAXILLA.

THE AVERAGE AVAILABLE DENTURE BEARING AREA FOR AN

EDENTULOUS MANDIBLE IS 14cm2 , WHEREAS FOR
EDENTULOS MAXILLA IT IS 24cm2. THEREFORE THE
MANDIBLE IS LESS CAPABLE OF RESISTING OCCLUSAL
FORCES THAN THE MAXILLA.

THE CONSISTENCY OF THE MUCOSA AND THE UNDERLYING

BONE IS DIFFERENT IN VARIOUS PARTS OF THE EDENTULOUS
RIDGE

SOME PARTS OF THE RIDGE ARE CAPABLE OF WITHSTANDING

MORE FORCE THAN OTHER AREARS

THE MUCOUS MEMBRANE

SERVES AS A CUSHION
BETWEEN THE DENTURE
BASE AND THE SUPPORTING
BONE.
MUCOUS MEMBRANE IS
COMPOSED OF MUCOSA AND
SUB MUCOSA.
SUBMUCOSA IS FORMED BY
CONNECTIVE TISSUE THAT
VARIES FROM DENSE TO
LOOSE AREOLAR TISSUE
MUCOSA COVERING THE
HARD PALATE AND THE CREST
OF THE RIDGE IS CLASSIFIED
AS MASTICATORY MUCOSA
CHARECTERIZED BY ITS WELL
DEFINED KERATINIZED
EPITHELIUM AND LACK OF TISSUE
MOVEMENTS.

ANATOMICAL LANDMARKS OF THE

MAXILLA

LIMITING STRUCTURES
SUPPORTING STRUCTURES
RELIEF AREAS

LIMITING STRUCTURES

LABIAL FRENUM
LABIAL VESTIBULE
BUCCAL FRENUM
BUCCAL VESTIBULE
HAMULAR NOTCH
POSTERIOR PALATAL SEAL AREA

LABIAL FRENUM

FOLD OF MUCOUS
MEMBRANE
NO MUSCLE
NO ACTION OF ITS OWN
A V SHAPED NOTCH
SHOULD BE RECORDED
DURING IMPRESSION
MAKING
LABIAL NOTCH OF THE
LABIAL FLANGE OF THE
DENTURE MUST BE JUST
WIDE ENOUGH AND JUST
DEEP ENOUGH TO
ACCOMMODATE THE
LABIAL FRENUM

LABIAL VESTIBULE

IT IS DIVIDED LEFT AND

RIGHT BY THE LABIAL
FRENUM
ORBICULARIS ORIS IS
THE MAIN MUSCLE
WHICH FORMS THE OUTER
SURFACE OF THE LABIAL
VESTIBULE
ORBICULARIS ORIS
MUSCLE HAS ONLY AN
INDIRECT EFFECT ON THE
LABIAL VESTIBULE
BECAUSE ITS FIBERS
RUN IN HORIZONTAL
DIRECTION

BUCCAL FRENUM

DIVIDING LINE BETWEEN

THE LABIAL AND BUCCAL
VESTIBULE.
FRENUM MAY BE SINGLE
OR DOUBLE.
LEVETOR ANGULI ORIS
MUSCLE ATTACHES
BENEATH THE FRENUM.
ORBICULARIS MUSCLE
PULLS THE FRENUM
FORWARD.
BUCCINATOR MUSCLE
PULLS IT BACKWARD.
REQUIRE MORE
CLEARENCE FOR ITS
ACTION

BUCCAL VESTIBULE

EXTEND FROM BUCCAL

FRENUM TO HAMULAR
NOTCH
BOUNDED LATERALLY BY
THE CHEEKS AND MEDIALLY
BY THE RIDGE.
SIZE OF THE VESTIBULE
VARIES WITH THE
CNTRACTION OF
BUCCINATOR MUSCLE,
POSITION OF THE
MANDIBLE, AND AMOUNT
OF BONE LOST FROM
MAXILLA.
ADEQUATE DEPTH/WIDTH
SHOULD BE RECORDED

HAMULAR NOTCH

DISTAL LIMIT OF THE

BUCCAL VESTINULE.
SITUATED BETWEEN THE
TUBROSITY AND HAMULUS
OF THE MEDIAL
PTERYGOID BONE.
TENSOR VELI PALATINI
MUSCLE RUNS
HORIZONTALLY THROUGH
THIS NOTCH.
AIDS IN ACHIEVING
POSTERIOR PALATAL SEAL.

POSTERIOR PALATAL SEAL

THE SOFT TISSUE AT OR ALONG THE JUNCTION OF THE HARD

AND SOFT PALATE ON WHICH PRESSURE WITHIN THE
PHYSIOLOGICAL LIMITS OF THE TISSUE S CAN BE APPLIED BY A
DENTURE TO AID IN THE RETENSION OF THE DENTURE -GPT.

PARTS:

POSTPALATAL SEAL
PTERYGOMAXILLARY SEAL

EXTENSIONS:

ANTERIORLY- ANTERIOR VIBRATING LINE

POSTERIORLY- POSTERIOR VIBRATING LINE
LATERALLY- 3-4 MM ANTERIOLATERAL TO
HAMULAR NOTCH

VIBRATING LINE

THE IMAGINARY LINE ACROSS THE POSTERIOR PART OF

THE PALATE MAKING THE DIVISION BETWEEN THE
MOVABLE AND IMMOVABLE TISSUES OF THE SOFT PALATE
WHICH CAN BE IDENTIFIED WHEN THE MOVABLE TISSUES
ARE MOVING-GPT

Anterior &Posterior
Vibrating line

SUPPORTING STRUCTURES
PRIMARY STRESS BEARING
AREA

HARD PALATE
MAXILLARY
TUBEROSITY

SECONDRY STRESS
BEARING AREA

RESIDUAL ALVEOLAR
RIDGE

HARD PALATE

COVERED BY KERATINIZED SQUAMOUS

EPITHELIUM.

ANTERIOLATERALLY, THE SUBMUCOSA

CONTAINS ADIPOSE TISSUE.

POSTEROLATERALLY IT CONTAINS GLANDULAR

TISSUE.

THE HORIZONTAL PORTION OF THE HARD

PALATE PROVIDES THE PRIMARY STRESSBEARING AREA

MAXILLARY TUBEROSITY

IT IS THE POSTERIOR
CONVEXITY OF THE
MAXILLARY BODY.

THE MEDIAL AND LATERAL

WALLS RESIST THE
HORIZONTAL AND TORQUING
FORCES WHICH WOULD MOVE
THE DENTURE BASE IN
LATERAL OR PALATAL
DIRECTION.

THEREFORE MAXILLARY
DENTURE BASE SHOULD
COVER THE TUBEROSITY AND
FILL THE HAMULAR NOTCHES.

RESIDUAL ALVEOLAR RIDGE

COVERED BY KERATINIZED SRATIFIED SQUAMOUS

EPITHELIUM.

THE SUB MUCOSA IS CHARECTERIZED BY DENSE

COLLAGENOUS FIBERS THAT ARE CONTIGUOUS
WITH LAMINA PROPRIA

CONSIDERED AS A SECONDRY STRESS BEARING

AREA BECAUSE IT IS SUBJECTED TO RESORPTION
TO HORIZONTAL PORTION OF HARD PALATE

RELIEF AREAS
INCISIVE PAPILLA
MEDIAN PALATAL RAPHE
FOVEA PALATINE

INCISIVE PAPILLA

SITUATED ON A LINE
IMMEDIATELY BEHIND AND
BETWEEN THE CENTRAL
INCISORS
THE INCISIVE FORAMEN IS
LOCATED BENEATH THE
INCISIVE PAPILLA.
LOCATION OF THE INCISIVE
PAPILLA GIVES AN
INDICATION AS TO THE
AMOUNT OF RESORPTION
THAT HAS TAKEN PLACE.
THE NASOPALATINE NERVES
AND VESSELS PASS
THROUGH THE INCISIVE
FORAMEN.

MEDIAN PALATAL RAPHE

THE SUBMUCOSA IS
EXTREMELY THIN IN THE
REGION OF MEDIAL
PALATAL SUTURE, SO THE
MUCOSAL LAYER IS IN
CLOSE CONTACT WITH THE
UNDERLYING BONE.
FOR THIS REGION, THE
SOFT TISSUE COVERING
THE MEDIAN PALATAL
TISSUE IS NONRESILIENT IN
NATURE & MAY NEED TO BE
RELIEVED.

FOVEA PALATINA

BILATERAL INDENTATION
NEAR THE MIDLINE OF
PALATE

FORMED BY COALESCENCE
OF SEVERAL MUCOSAL
GLAND DUCT

POSTERIOR TO JUNCTION OF
HARD AND SOFT PALATE

ALWAYS ON SOFT PALATE

ANATOMICAL LANDMARKS OF MADIBUALR DENTURE BEARING

AREA

LIMITING STRUCTURES
SUPPORTING STRUCTURES
RELIEF AREAS

Limiting structures

Labial frenum
Labial vestibule
Buccal frenum
Buccal vestibule
Lingual frenum
Alveolingual sulcus
Retromolar pad
Pterygomandibular raphe

Labial frenum

It is a fold of mucous
membrane at the
median line.

It divids the labial

vestibule into left and
right labial vestibule

Recorded as a notch
in the impression
made

Frenum contains
fiber of Orbicularis
oris and Mentalis
muscle

Therefore the
frenum is quite
sensitive and active,
and the denture
must be fitted
carefully around it
to maintain a seal
without causing
soreness

Labial vestibule

The labial vestibule

extend from the
labial frenum to the
Musclefrenum
buccal
attachment close
to the crest of the
ridge limits the
denture flange
extension

Buccal frenum

The buccal frenum

forms the dividing
line between the
labial and buccal
vestibule.
It overlies the
depressor anguli
oris muscle.
Fibers of buccinator
muscle attached to
the frenum.

Frenum may be
single or double,
broad U shaped or
sharp V shaped.

It should be
relieved to
prevent
displacement of
the denture
during function.

Buccal vestibule

Extend from buccal

frenum to retromolar pad

The extent of buccal

vestibule is influenced by
the buccinator muscle,
which extends from the
modiolus anteriorly to
the pterygomandibular
raphe posteriorly

The impression is widest

in this region.

Lingual frenum

Fold of mucous
membrane.
Base of tongue to
supragenial tubercle.
The anterior region of
the lingual flange is
called sub-lingual
crescent area
A high frenum is called
as Tongue tie.it should
be corrected if it affects
the stability of the
denture.

Alveololingual sulcus

Space between the residual

ridge & tongue .
Extends from lingual
frenum to retromylohyoid
curtain .
3 regions (anterior, middle
& posterior)
The anterior region extends
from the lingual f. back to
where mylohyoid muscle
curves above the level of
the sulcus (premylohyoid
fossa) .

The middle region extends from

premylohyoid fossa to the distal
end of the mylohyoid ridge,
curving medially from the body
of the mandible. This curvature
is caused by the prominance of
mylohyoid ridge & the action of
mylohyoid muscle.
The posterior region: here the
flange passes into the
retromylohyoid fossa &
completes the typical S form of
the correctly shaped lingual
flange.

Retromylohyoid space

The retromylohyoid
space lies at the
distal end of the
alveololingual
sulcus.

Bounded by
Anterior tonsillar
pillar,posteriorly by
the retromylohyoid
curtain.

Retromylohyoid curtain

Formed
posteriorly by the
superior constrictor
muscle,
Laterally by the
mandible &
pterygomandibular
raphe,
Anteriorly by lingual
tuberosity, and
Inferiorly by the
mylohyoid muscle.

Retromolar pad

The retromolar pad is a

pear shaped area
containing glandular
tissue, loose areolar
connective tissue,the
lower margin of the
pterygomandibular
raphe,fibers of buccinator
and superior constrictor,
along with the fibers of
temporal tendon.

The retromolar papilla is a pear shaped area just

anterior to the retromolar pad, it is dense, fibrous
connective tissue.

SUPPORTING STRUCTURES

Buccal shelf area

Residual alveolar ridge

Buccal shelf area

Extend from the
buccal frenum to the
anterior edge of the
masseter muscle.
Boundries :
Medially- crest of the
ridge
Laterally- external
oblique ridge.
Distally retromolar pad

The mucous
membrane covering
the buccal shelf area is
loosely attached, less
keratinized & contains
thick submucosal
layer.
Considered as a
primary stress-bearing
area because it is
covered by a layer of
cortical bone, & it lies
at right angles to
vertical occlusal forces

Residual alveolar ridge

The crest of the

residual alveolar
ridge is covered by
fibrous connective
tissue,
But in many mouths
the underlying bone
is cancellous and
without a good
cortical bony plate
covering it.

Residual alveolar ridge

The mucous membrane covering the crest

of the residual ridge is covered by
keratinized layer and is attached by its
submucosa to the periosteum of the
mandible.

The extent of this attachment varies

considerably. In some people, the
submucosa is loosely attached to the
bone over the entire crest of the residual
ridge, and the soft tissue is quite
movable.

RESIDUAL ALVEOLAR RIDGE

In others, the submucosa is firmly

attached to the bone on both the crest
and the slopes of the lower residual
ridge.

However, because underlying bone is

often cancellous (bony spicules and
nutrient canals), the crest of the residual
ridge may not be favorable as the
primary stress-bearing area for a lower
denture.

Relief area

Mental foramen
Genial tubercle
Mylohyoid ridge
Mandibular tori.

Mental foramen

As resorption takes place, the

mental foramen will come to

lie closer to the crest of ridge.

In these circumstances, the

mental nerve and blood
vessels may be compressed
by denture base unless relief
is provided.

Pressure on mental nerve can

cause numbness of lower lip.

Genial tubercle

The genial tubercle are a

pair of dense prominences
at the inferior border of
the mandible at the lingual
midline.
They represents the
muscle attachment of the
genioglossus and
geniohyoid muscle.
They only become
relevant in the denture
when there is excessive
resorption of the residual
ridge.

Mylohyoid ridge

The mylohyoid ridge is a boney

prominence along the lingual
aspect of the mandible

Soft tissue usually hides the

sharpness of mylohyoid ridge.

Anteriorly, this ridge with

mylohyoid muscle is close to
inferior surface of mandible.

Posteriorly, after resorption, it

often flushes with the residual
ridge.

The mucous membrane overlying

the sharp or irregular mylohyoid
ridge needs to be relieved.

Mandibular tori

Mandibular tori are

lingual bilateral
prominences of cortical
bone in the premolar
area.but they may
extend posteriorly to
the molar area.
small tori may only
require relief in the
denture.
Large tori reguire
removal before a
denture can be
fabricated

References

Boucher's Prosthodontics Treatment

for Edentulous Patients. 13th
Edition. Chapter 8.
Winklers Essentials of Complete
Denture Prosthodontics.
Chapter-7.
Heartwells syllabus of complete
denture.4th edition.
Chapter 6.

THANK YOUYOU

MAXILLARY RUGAE

THESE ARE THE MUCOSAL

FOLDS IN THE ANTERIOR
REGION OF THE HARD
PALATE.

IN THE AREA OF THE

RUGAE , THE PALATE IS SET
AT AN ANGLE TO THE
RESIDUAL RIDGE & COVERED
BY THIN SOFT TISSUE.

PALY AN IMPORTANT ROLE IN

SPEECH