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BIOLOGICAL

CONSIDERATIONS IN
MANDIBULAR
IMPRESSION.
CHRISTEENA JOSEPH
FIRST YR PG
Dept.of prosthodontics
CONTENTS

Introduction
Definition
Supporting structures
1. Bone
2.Mucous membrane
Anatomy of limiting structures in
mandibular region
Anatomy of supporting structures
in mandibular region
Anatomy of relief structures in
mandibular region
Muscle attachments
summary
Conclusion
INTRODUCTION
The fundamental principles involved in
the support of mandibular and maxillary
dentures are the same .
The denture bases must be extented to
cover the maximum area possible
without interfering with the health or
function of the tissues ,whose support
is from bone.
The prosthodontist must have a
complete understanding of macroscopic
and microscopic anatomy of edentulous
mouth of patient.
ANATOMICAL
LANDMARK
“ a recognizable anatomic structure
used as a point of reference.”
GPT-8
In both maxilla and mandible anatomic
landmarks has been divided in-
-supporting structures
-peripheral or limiting structure

Principle and technique of complete denture -


Iwao hayakawa
SUPPORTING
STRUCTURES
“Those areas of maxillary and
mandibular edentulous ridges that are
considered best suited to carry the
forces of mastication when dentures
are in function.” (GPT-8)
Maxillary and mandibular dentures transfer
occlusal loads to these so called supporting
structures .
The ultimate support for a denture is
provided by the underlying bone which is
covered by mucous membrane.
principle and technique of complete denture-iwao
hayakawa
HARD TISSUE
The success of complete
denture prosthesis is
particularly dependent on the
degree of stability that the
underlying bone can
maintain.
The structure of alveolar
ridge has a direct relation on
stability and retention of
Bone of maxilla and mandible is formed by
outer cortical bone and central meduallary cavity
filled with red or yellow bone marrow.
The marrow cavity is intercepted
throughout its length by reticular network of
trabecular (alternatively cancellous or spongy
bone).
These internal trabeculae act as reinforcement
rods to support outer thicker cortical crust of
compact bone.
bouchers prosthodontic treatment for edentulous
Surrounding every compact bone is osteogenic (bone
forming) CT membrane Periosteum consists of 2
layers.
Inner layer - next to bone surface consists of bone
cells their precursors and a rich micro vascular
supply.
Outer layer - is fibrous layer giving rise to sharpey
fibres.
hand book of osteology -s.poddar, ajay bhagat.
The requirements of a successful complete denture
include;
Compatibility with the surrounding oral environment.
Restoration of masticatory efficiency within limits.
Ability to function in harmony during mastication,
speech, respiration and deglutition.
Esthetic acceptability.
Preservation of that which remains.
principlesand technique of complete denture- Iwao hayakawa .
ALVEOLAR BONE
Healing of bony sockets after tooth extraction is similar to that of bone
fractures which is:
Primary clot formation in the socket.
Organisation of clot by proliferating young CT’s.
Gradual replacement of young CT’s by coarse fibrillar bone.
Reconstruction by resorptive activity on one side and replacement of
immature bone by mature bone on the other and ,
Epithelialisation and healing of the surface occurring simultaneous with
other reparative processes.
syllabus of complete denture -charles m .heartwell
During the period of general body growth, the rate of bone

formation exceeds the rate of bone resorption. In the adult, the two
processes are more nearly balanced.
In the aged or in any person with local or systemic disease, the rate of
bone resorption exceeds that of formation.
This is only one of the many reasons some dentures appear to be
physiologically tolerated over a period of time and then seem to fail.
syllabus of complete dentures-charles m. heartwell
DIRECTION OF RIDGE
RESORPTION
The maxilla resorb upward and and inward to
become progressively smaller because of the
inclination of the teeth and the alveolar process.
The opposite is true for the mandible ,which inclines
outward and progressively wider.
mastering the art of complete denture-halperin ,graser,rogoff
BLOOD SUPPLY
The blood supply to bone of maxillae and mandible is derived
principally from medullary and periosteal vessels that form plexuses .
When teeth are present, intra-osseous vessels supply pulpal, periodontal
and alveolar branches.
These various vessels anastomose with periosteal, gingival and other
vessels supplying the surrounding soft tissues. However, in edentulous
patient, the pulpal, periodontal and depending on extent of alveolar bone
resorption the alveolar branches are lost.
syllabus of complete denture-charles m.heartwell .jr
The blood to the mandible comes from branches facial, buccal

and lingual arteries instead of inferior alveolar artery.


The relationship between these and other changes in the blood supply to
RR may influence the biologic responses of denture supporting tissues to
preprosthetic surgery and to the success of subsequently fabricated
dentures.
syllabus of complete denture -charles m. heartwell
The following represent some ways the dentist and patient can help

make a denture better tolerated by bony support.;


Record tissues in impression at their rest position.
Decrease the number of teeth.
Decrease size of food table.
Develop an occlusion that eliminates, as much as possible horizontal and
torque force.
principles and techniques of complete denture-Iwao hayakawa.
Extend denture base for maximum coverage within
tissue limits.
Eat by placing small masses of food over the
posterior teeth where supporting bone is best suited
to resist forces.
Remove dentures for 8 hour of every 24hour.
principles and technique of complete denture- Iwao
hayakawa
Oral submucous
membrane
The bone of upper and lower edentulous jaws,
and the oral cavity is lined with a soft tissue that is
known as ‘mucous membrane’.
Denture bases rest on the mucous membrane,
which serve as a cushion between denture base and
supporting bone.
The mucous membrane composed of :-
(i) Mucosa
(ii) Sub mucosa
syllabus of complete denture – charles m. heartwell
MUCOSA
.

Mucosa is formed by stratified squamous


epithelial cells.
There is subadjacent narrow layer of
connecting tissue to the mucosa, known as
lamina propria.

Syllabus of complete denture- charles m.


heartwell
SUBMUCOSA

Sub mucosa is formed by connective tissue.


Connective tissue varies in character from dense to
loose alveolar tissue and also varies considerably in
thickness.
It may contain glandular, fat or muscle cells.
Submucosa transmit the blood and nerve supply to
the mucosa.
Sub mucosa attaches mucosa to the periosteal
covering of the bone.
Syllabus of complete denture-charles m.heartwell
The oral mucosa can be divided into three categories depending

on its location in the mouth and its function.


They are
Masticatory mucosa - which covers the crest of residual ridge,
including residual attached gingiva, firmly adherent to supporting bone.
Secondly the hard palate.
orbans textbook of oral histology and embryology- g.s.kumar
The masticatory mucosa is characterised by well-
keratinised layer on its outermost surface that is subject
to changes in thickness depending on whether dentures
are worn and on the clinical acceptability of dentures.

Lining mucosa - is generally found to cover the mucous


membrane in the oral cavity that is the firmly attached to
periosteum of the bone.
Orban's textbook of histology and embryology-g.s
kumar
It forms the covering of lips and cheeks, the
vestibular spaces, the alveololingual sulcus, the soft
plate, the ventral surface of tongue, and the
unattached gingiva found on slopes of residual ridges.
It is devoid of keratinised layer and is freely movable
with the tissues to which it is attached because of its
elastic nature of lamina propria.

orban's textbook of oral histologyand embryology-


g.s.kumar
The specialized mucosa - covers the dorsal
surface of tongue. The mucosal covering is
keratinised and includes specialized papillae
on upper surface of tongue.

Orban's textbook of oral histology and


embryology-g.s kumar
ANATOMICAL
LANDMARKS
LIMITING STRUCTURES
Labial frenum
Labial vestibule
Buccal frenum
Buccal vestibule
Lingual frenum
Alveolingual sulcus
Retromolar pads
Pterygomandibular raphe
SUPPORTING STRUCTURES
Buccal shelf area
Residual alveolar ridge
RELIEF AREA

Mylohyoid ridge
Mental formen
Genial tubercles
Torus mandibularis

Textbook of prosthodontics – v.rangarajan


MANDIBULAR
SUPPORTING AREAS
RESIDUAL ALVEOLAR
RIDGE

- covered by keratinized
layer and firmly attached to
the periosteum
- cancellous in nature, does
not have a good cortical plate
covering it
Significance
-hence it is a secondary
relief area, usually relieved
during impression.
boucher's prosthodontic
SLOPES OF RESIDUAL
ALVEOLAR RIDGE
- has thin plate of cortical bone
Significance
- because walls are steep and at an angle to
occlusal forces, it is not suited for primary
stress bearing, hence it is secondary stress
bearing.
syllabus of complete denture-charles m.
heartwell
BUCCAL SHELF
AREA
Buccal shelf area
- bounded by
anteriorly – buccal frenum
posteriorly – retromolar pad
medially – crest of alveolar ridge
laterally – external oblique ridge
Inferior part of buccinator is attached in
the buccal shelf area, but does not
interfere with the denture because the
fibers runs anteroposteriorly.
Significance
buccal shelf area may be very
wide and is at right angles to the
vertical occlusal forces. For this
reason it offers excellent
resistance to such forces.
hence considered as primary
stress bearing area.
syllabus of complete denture
charles m. heartwell.
RELIEF AREAS OF
MANDIBLE
MYLOHYOID
RIDGE
bony ridge found on lingual side of the
mandible
- mylohyoid muscle is attached to this ridge
- soft tissue usually hides the sharpness of
the ridge, which can be found by palpation
- anteriorly the muscle attaches close to the
inferior border of the mandible and posteriorly
it may flush with superior surface of residual
ridge.
boucher's prosthodontic treatment for
edentulous patients
significance
- level, inclination and prominence vary widely
between patients
- thin, sharp mylohyoid ridge can result in soft
tissue irritation when denture is placed over it.
Surgical correction may be required
- height of the lingual flange is determined by
the mylohyoid ridge.
boucher's prosthodontic treatment of
edentulous patients
MENTAL FORAMEN
AREA
This is of concern when the
ridge is extremely resorbed
Foramen is found near or on
the ridge crest in premolar
region
significance
In such cases it should be
relieved
Pressure on mental nerve can
cause numbness of the lip.
Syllabus of complete denture -
charles m. heartwell.
TORUS
MANDIBULARIS
rounded prominences found in some
individuals
located in the region of premolars,
midway between soft tissues of the floor
of the mouth and crest of the ridge
significance
-covered by a thin layer of mucous
membrane which may be irritated by the
denture, it should be relieved when
present.
Boucher's Prosthetic treatment of
-large tori should be
surgically removed if they
interfere with denture seal
GENIAL TUBERCLE
These are pair of bony
tubercles found anteriorly on
the lingual side of the mandible.
Due to resorbtion ,it may
become increasingly prominent
making denture usage difficult
Superiorly ,it is attached with
genioglossus muscle and there
inferior tubercle gives
attachment to the geniohyoid
muscle.
Boucher's prosthetic treatment
for edentulous patients.
MANDIBULAR LIMITING
STRUCTURES
LABIAL FRENUM
contains a band of
fibrous connective
tissue that helps to
attach the orbicularis
muscle
the frenum is quite
sensitive and active
the denture must be
fitted carefully to
maintain seal without
causing soreness
LABIAL VESTIBULE
extends from labial frenum to the
buccal frenum
length and thickness of the labial
flange vary with amount of tissue that
has been lost
There is muscle extending from the
residual ridge to the lip, the two
depressor anguli oris, so the labial
flange can be extended in length and
thickness to provide support to the lip.
The mucous membrane lining the labial
vestibule is relatively thin and is classified as
lining mucosa
When the patient’s mouth opens wide, the
orbicularis oris muscle becomes stretched,
narrowing the sulcus.
This would displace the mandibular denture
if the flange is unnecessarily thick. hence,
impressions will always be narrowest in the
anterior labial region
The extent of
denture flange in this
region often is limited
because of the
muscles that are
inserted close to the
crest of ridge.
The
mentalis muscle is
particularly active in
this region.
Boucher's prosthetic treatment for edentulous patients.
Significance
It accomdates the labial flange of the
dentures
It forms a part of peripheral seal areaa

Boucher's prosthetic treatment for edentulous patients


BUCCAL FRENUM
Is a band of fibrous
connective tissue
two or more in
number
Depressor anguli
oris is the muscle
which influences the
frenum
Hence it is active
and sensitive, has
to be relieved in
Boucher's prosthetic treatment for edentulous patients
It is an active frenum as the fibres of the
triangularis, zygomaticus and caninus muscles
converge here to form a strong but movable base
from which the orbicularis oris and buccinator
may operate as antogonists.
These fibrous and muscular tissues pull actively
across the denture borders, therefore the
impression must be functionally trimmed to have the
maximum seal and yet not displace the denture
when lip is moved.

Boucher's prosthetic treatment for edentulous patients


BUCCAL VESTIBULE
it extends form the buccal
frenum posteriorly to the
the retromolar region
buccinator attaches in the
lower side in the molar
region in the buccal shelf of
the mandible
The extent of buccal
vestibule is influenced by the
buccinator muscle, which
extends from the modiolus
anteriorly to the
Boucher's prosthetic treatment for edentulous patients
pterygomandibular raphe
Extension of distobuccal
border at the end of buccal
vestibule is influenced by
masseter muscle activity.
When the masseter
contracts, it’s anterior
fibres alters the shape and
size of the distobuccal end
of lower buccal vestibule
by pushing inward against
the buccinator muscle .

Boucher's prosthetic treatment for edentulous patients


.
LINGUAL FRENUM
It is a mucosal fold that orginates at
the midline,under the tongue and
often terminates at the sublingual
salivary caruncles.
Fibrous band of tissue that overlies
the centre of genioglossus muscle. It
is usually a narrow single band of
tissue but may be broad and exist as
two or more frenums.

Boucher's prosthetic treatment for edentulous patients


It originates at midline under surface of tongue and often terminates at
the sublingual (salivary) caruncles.
it crosses and bisects the sublingual crescent space and attaches to
lingual aspect of mandibular ridge. Often it fans out to find a broad
insertion in alveolar mucosa.
This structure should be palpated for tension during tray adjustment
procedure. Careful clearance is needed in the denture because the lingual
frenum is attached to tongue and inadequate clearance may result in pain
or displacement of denture.

Boucher's prosthetic treatment for edentulous patients


Just beneath the lingual frenum
genioglossus muscle is found
which originates from superior
genial tubercles.
It is a powerful and active but
fortunately narrow muscle.
Anterior fibers of this muscle
when tensed raises up from floor
of mouth and impinge on lower
denture base

Boucher's prosthetic treatment for edentulous patients


Frenums are basically fibrous connective tissue.
They do not contract or expand like muscles but
rather are ligaments. They are accessory limiting
structures for tongue, lips, and muscles of cheek.

Boucher's prosthetic treatment for edentulous patients


ALVEOLINGUAL
SULCUS
It is the space between the residual ridge and
tongue. It extends posteriorly from lingual frenum to
retromylohyoid curtain. Part of it is available for the
lingual flange of denture.
The alveololingual sulcus can be considered in 3
regions

Boucher's prosthetic treatment for edentulous patients


1. The anterior region (Premylohyoid fossa)
This extends from lingual frenum to where the
mylohyoid ridge curves down below the level of sulcus.
This fossa results from the concavity of mandible joining
the convexity of mylohyoid ridge.
Lingual border of impression in anterior region make
definite contact with mucous membrane of mouth when tip

of tongue touches upper incisors.


Boucher's prosthetic treatment for edentulous patients
2. middle region

The part of alveololingual sulcus


extends from premylohyoid fossa to
distal end of mylohyoid ridge
curving medially from the body of
mandible.
When mylohyoid muscle and
tongue are relaxed, the muscle
If the lingual flange slopes towards the tongues, the
tongue can rest on top of flange and aid in stability of
lower denture on RR it also prevents displacing the
denture during tongue movements and swallowing thus
maintaining the seal.
The length and width of mylohyoid flange is
determined by membranes attachment of tongue to
mylohyoid ridge and width of hyoglossus muscle and can
only be determined by skilful border molding and
impression.
Boucher's prosthetic treatment for edentulous patients
The lingual borders in mylohyoid areas are formed
by contact with mylohyoid muscles in a functional but
not extreme contracted or elevated position.

The average mylohyoid border is 4-6mm below


mylohyoid ridge fair-good ridge-width 2-3mm.

Boucher's prosthetic treatment for edentulous patients


3. The posterior region
(Retromylohyoid fossa/space)

It extends from end of mylohyoid


ridge to retromylohyoid curtain being
bounded on lingual by anterior tonsillar
pillar, at the distal end by
retromylohyoid curtain , superior
constrictor and on buccal by mylohyoid
muscle, mandibular ramus and retro
The superior support for retromylohyoid curtain is
provided by superior pharyngeal constrictor. The action of
the muscle and the tongue determine the posterior extent

of lingual flange.
Pouch shaped retromylohyoid space is lined completely
with loosely attached mucosa.
There are no supporting structures here since the medial
surface of mandibular body slope obliquely outward from
mylohyoid ridge to mandibular border forming
Distal to mylohyoid
muscle the space dips
toward and outward to
permit formation of
retromylohyoid
eminence of mandibular
denture.

Boucher's prosthetic treatment for edentulous patients


EXTERNAL OBLIQUE
RIDGE
the EOR does not govern the extension
of the buccal flange because the
resistance or lack of resistance
encountered in this region varies widely
buccal flange may extended to the
EOR, or up on to it, or even over it,
depending on the location of the
mucobuccal fold.
palpation of EOR is a valuable aid or
landmark in helping to ascertain the
relative amount of resistance or lack of
RETROMOLAR PAD
Definition – “a mass of tissue
comprised of non-keratinized
mucosa located posterior to
retromolar papilla and
overlying loose glandular
connective tissue”.

GPT-8
Is a triangular soft pad of
tissue at distal end of lower
ridge
Must be covered by the
denture to perfect the border
seal in this prosthetic
Boucher's region treatment for edentulous patients
Its mucosa is composed of a thin, nonkeratinized
epithelium, and in addition to loose alveolar tissue.
its submucosa contains;
glandular tissue,
fibers of the buccinator and superior constrictor
muscles,
the pterygomandibular raphe, and
terminal part of the tendon of the temporalis muscle.

Boucher's prosthetic treatment for edentulous patients


action of these muscles limit the extent of
the denture and prevents placement of extra
pressure on distal part of the retromolar pad

Boucher's prosthetic treatment for edentulous patients


PTERYGO
MANDIBULAR RAPHE
The pterygo mandibular raphe or ligament originates from the

pterygoid hamulus of medial pterygoid plate and attaches to distal end of


pterygoid ridge.
It is partly the origin of buccinator muscle laterally and the superior
constrictor muscle medially.
It is quite prominent in some patients and may even require , notch like
clearance in maxilla denture. A simple wide-open digital and visual
inspection will usually determine whether clearance is required or not.
syllabus of complete denture- charles .m. heartwell
Tendinuos pterygomandibular
raphe extends inferiorly from
pterygoid hamulus inserting in
the trigonum retromolar and
retromolar pad
The raphe is covered by a fold of
mucous membrane, plica
pterygomandibularis
When mouth is opened widely,
the raphe is stretched, causing
plica to stand out like string
between the pterygoid hamulus
and retromolar pad
Significance:

Streched raphe lifts the posterior


part of retromolar pad, denture that
has been extended on to this
structure may be dislodged during
energitic opening movement of the
mandible.
syllabus of complete denture-
charles m. heartwell
Mental foremen
It is located on the lateral surface of body of mandible
between the first and second bicuspids about halfway
between the lower border of mandible and the alveolar crest.
If the loss of RR is extensive, the foramen occupies a more
superior position and denture base must be relieved over the
foramen to keep the denture base from irritating the mental
neurovascular bundle failing which the pressure exerted will
cause numbness
syllabus of lower denture-
of complete lip. charles m. heartwell
Lingual tuberosity
It is an irregular bony prominence on distal
end of mylohyoid line. When this area is
excessively prominent or rough it may present an
undesirable undercut requiring surgical
intervention.

Mental spines
They are situated on lingual aspect of
mandibular body in midline slightly above the body.
syllabus of complete denture- charles m. heartwell
These bony elevations are often divided
into a superior and an inferior section
and sometimes into right and left
prominences. When loss of RR is
extensive these spines are more superior
position than crest of existing ridge,
requiring surgically intervention

syllabus of complete denture- charles m. heartwell


ANTERIOR LINGUAL
VESTIBULE
.
mainly influenced by genioglossus,lingual
frenum and anterior portion of sublingual
gland
lingual frenum is superimposed over
genioglossus which is attached to genial
tubercles
if ridge is highly resorbed, the genial
tubercles are at higher level– little or no
vestibular space
The lingual border of the impression in this
region should extend down to make definite
contact with the mucous membrane floor of
mouth, when the tip of the tongue touches
the upper incisors.
MIDDLE LINGUAL VESTIBULE
OR MYLOHYOID AREA
Is the largest area and is mainly
influenced by the mylohyoid and by
sublingual glands
Sublingual gland lies above the
mylohyoid muscle. The gland is
raised when the mylohyoid
contracts during swallowing
If the denture border is made short
to relieve the raised sublingual
gland, a space will occur between
the denture border and the mucosa
when the mylohyoid is at rest and
thus the peripheral seal will be lost.
priciples and techniques of complete denture -Iwao
hayakawa.
DISTOLINGUAL
VESTIBULE .
Space distal to the mylohyoid
muscle is referred to as the
retromylohyoid fossa
anteriorly ----mylohyoid muscle
posterlaterally ---superior
constrictor
posteromedially – palatoglossus
medially --- tongue
laterally ---pear shaped pad
priciples and techniques of complete denture -Iwao
hayakawa.
There is no structure and so it is possible to
lengthen the denture border into this space
the ‘s’ shaped curve of mandibular denture
results from strong instrinsic a nd extrinsic
muscles of tongue which usually place
retromylohyoid borders more laterally and
toward retromylohyoid fossa as they oppose
the weaker superior constrictor muscle
TONGUE POSITION

In normal position, the tongue appears


relaxed and completely fills the lower arch
with its apex lightly contacting the lingual of
lower teeth.this is important to obtain lingual
border seal.
If the tongue retrudes while opening the
mouth then it is virtually impossible to get the
lingual seal.
MUSCLE
ATTACHMENTS........
The musculature of denture space is divided
into 2 groups
Those muscles which primarily dislocate the
denture during activity
Vestibular dislocating muscles
Lingual dislocating muscles
Those muscles that fix the denture by
muscular pressure on its secondary
supporting surfaces
Vestibular fixing muscles
Lingual fixing muscle
article on dynamic nature of lower dentures JPD-1965,15 (3)-n
.brill,dr.odont,g tryde LDS, R.cantor.DDS
VESTIBULAR
DISLOCATING MUSCLES
Masseter muscle region
Masseter muscle contracts,
it alters the shape and size
of distobuccal end of the
lower buccal vestibule
It pushes inwards against
the buccinator, hence the
distobuccal borders of the
mandibular denture must
converge rapidly
article on dynamic to avoid
nature of lower dentures JPD-1965,15 (3)-n
.brill,dr.odont,g tryde LDS, R.cantor.DDS
displacement
MENTALIS MUSCLE

Origin:
Frontal surface of the mandible
between alveolar jugum of lateral
incisor and canine eminence.
Extends inferiorly,anteriorly, and
medially to fuse in midline with
corresponding muscle fibers from
the opposite side.

article on dynamic nature of lower dentures JPD-1965,15 (3)-n


.brill,dr.odont,g tryde LDS, R.cantor.DDS
SICHER AND TANDLER drew attention to the
important fact that the origin of the mentalis is
located closer to the crest of the RR than the
mucosal reflection in alvelolabial sulcus
Consequently the bottom of the sulcus is lifted
when mentalis contracts and their by the depth and
space of the oral vestibule can be decreased
considerably

article on dynamic nature of lower dentures JPD-1965,15 (3)-n


.brill,dr.odont,g tryde LDS, R.cantor.DDS
INCISIVE LABII
INFERIORIS MUSCLES
ORIGIN:
From lower canine jugum runs laterally and
extends anteriorly towards the angle
The fibers of this muscle become fused with
fibers of the orbicularis oris muscle
Has same effect as that of mentalis muscle ie.
Contraction of this muscle reduces denture
space by raising the bottom of the sulcus

article on dynamic nature of lower dentures JPD-1965,15 (3)-n


.brill,dr.odont,g tryde LDS, R.cantor.DDS
LINGUAL DISLOCATING
MUSCLE
Medial pterygoid muscle
Originates from pterygoid fossa, inserted on
the medial surface of ramus of mandible
Determines the extension of the denture in
lower posterior lingual part of denture space

article on dynamic nature of lower dentures JPD-1965,15 (3)-n


.brill,dr.odont,g tryde LDS, R.cantor.DDS
Palatoglossus muscle
Posterior lingual part of the denture space is further
influenced by palatoglossus running in palatoglossal
arch
The muscle descends from the soft palate in the arch
to enter in to lateral margin of the tongue
During deglution, the palatoglossus contracts, by
this action the mucosa covering the lower part of
muscle is lifted superiorly, anteriorly, medially

article on dynamic nature of lower dentures JPD-1965,15 (3)-n


.brill,dr.odont,g tryde LDS, R.cantor.DDS
MYLOHYOID MUSCLES;
Forms the floor of the oral cavity
Originates from mylohyoid line, runs medially to
meet and insert in fibrous mylohyoid raphe.
Posterior fibers inserts directly on the frontal
portion of the body of hyoid bone
The two mylohyoid muscle thus form a berth
like structure in which the tongue rests
When both mylohyoid muscle contracts, the
floor of oral cavity is lifted and tongue is pressed
against the palate, changing the denture space

article on dynamic nature of lower dentures JPD-1965,15 (3)-n


.brill,dr.odont,g tryde LDS, R.cantor.DDS
The alvelolingual sulcus will
be displaced upwards and
posterior part of sulcus will
change from almost vertical
position to nearly horizontal
one
TENDONS OF
GENIOGLOSSUS MUSCLES
Short but powerful tendons that run into
genioglossus muscle arises from genial
spines, located lingually on mandibular
symphysis
Peritendinous tissue of the tendon is covered
by lingual frenum
When the apex of the tongue is lifted,
tendinous fibers as well as lingual frenum will
be passively streched and lifted, thus easily
being capable of pressing on the borders of
the lower
article denture
on dynamic with
nature a dislocating
of lower effect (3)-n
dentures JPD-1965,15
.brill,dr.odont,g tryde LDS, R.cantor.DDS
LABIAL AND BUCCAL
FRENUM
Alveololabial sulcus is interrupted in the
region of mandibular central incisors by a fold
in mucous membrane., labial frenum
Similarly the alveolobuccal sulcus is
interrupted by the buccal frenum in cuspid and
bicuspid region
These folds of mucous membrane cover
strands of CT fibers that extend from
periosteal tissue of the alveolar bone, crosses
the vestibular sulcus and blend into
submucosa of lower lip and cheeks
With slightly
article resorbed
on dynamic nature ofalveolar process,
lower dentures the (3)-n
JPD-1965,15
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VESTIBULAR FIXING
MUSCLES
Buccinator
Has a horseshoe shaped origin
The maxillary part originates from the molar region at the
base of the alveolar process and runs posteriorly and
inferiorly past the maxillary tuberosity to continue into
pterygomandibular raphe
Significance:
The cheeks are pressed against dental arches. When the
buccinator muscle is contracted

article on dynamic nature of lower dentures JPD-1965,15 (3)-n


.brill,dr.odont,g tryde LDS, R.cantor.DDS
During chewing and swallowing the muscle is
rhythmically coordinated with the muscles of
mastication
Buccinator assists in positioning food between the
teeth and returning food that has escaped into the
vestibular sulcus to the occlusal table
Therefore, buccinator is sometimes called as
accessory muscle of mastication

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.brill,dr.odont,g tryde LDS, R.cantor.DDS
LINGUAL FIXING
MUSCLE
Main bulk of the tongue is made up of
straited muscles
Extrinsic and intrinsic group of muscles
Extrinsic M have their origin external to
the tongue, but their course terminates
within it. Their contraction maintains a
certain position of the tongue
Palatoglossus, styloglossus,
genioglossus, hyoglossus
Intrinsic M lie completely within the
tongue and their
article on dynamic activities
nature sustain
of lower dentures or alter
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PASSIVE MUSCLE
FIXATION
The denture can be fixed by the mass
and weight of these structures and
through the pressure exerted by the
muscle tonus
Inclination of polished surfaces:
-buccal flanges must slope inferiorly
and laterally and borders must
extended out beneath a fold of the
buccinator
-lingual flanges must extend
inferiorly and medially below the
anterior and lateral parts of the tongue,
as far as permitted by range of action of
tongue
LINGUAL SPACES FOR EXTENTIONS
FOR RETENTION
Sublingual crescent space
-is in anterior part of the floor of mouth
above the sublingual gland
- tissues bounding this space move
freely and thus the anterior lingual flange
can be extended horizontally whenever the
tongue and tissues permit

Sublingual fossa
-during swallowing the mylohyoid
raises with
article on the nature
dynamic tongue and
of lower brings
dentures the floor
JPD-1965,15 (3)-n
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- frequently this muscle is shows signs of
flabbiness and it is possible to extend the lingual
flange of denture for additional retention
Retromylohyoid fossa
-Is below and behind the retromolar pad
-This space provides an excellent place for
extending the denture for positive retention especially
when extensions into sublingual crescent and
sublingual fossa cannot be made.

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.brill,dr.odont,g tryde LDS, R.cantor.DDS
NEUTRAL ZONE
CD are primarily mechanical devices, but
since they function in the oral cavity, they
must be fashioned so that they are in
harmony with normal neuromuscular
function.
All oral functions.
Failure to recognise the cardinal
importance of tooth position and flange
form and contour often results in dentures
which are unstable and unsatisfactory.
When all of the natural teeth have been
lost, there exists within the oral cavity a
void which is the potential denture space .
Syllabus of complete dentures-charles
m.heartwell.
The neutral zone is that area in the potential denture
space where the forces of the tongue pressing outward are
neutralized by forces of the cheeks and lips pressing
inward
The central thesis of the neutral zone approach to
complete dentures is to locate that area in the edentulous
mouth where the teeth should be postioned so that the
forces exerted by muscles will tend to stabilize the denture
rather than unseat it.
Where the alveolar ridge has been lost, denture stability
and retention are more dependent on correct position of
the teeth and contour of the external surfaces of the
dentures.
Syllabus of complete dentures-charles m.heartwe ll
SUMMARY
CONCLUSION
REFERENCES
PROSTHODONIC TREATMENTS FOR IDENTOLOUS
PATIENTS -GEORGE .A.ZARB,JUDSON
.C.HICKEY,CHARLES .L.BOLENDER [9 TH,12 TH
EDITION]
PRINCIPLES AND TECHNIQUE OF COMPLETE
DENTURE.-IWAO HAYAKAWA
ESSENTIALS OF COMPLETE DENTURE
PROSTHODONTICS[2ND EDITION] -SHELDON
WINKLER
CLINICAL DENTAL PROSTHETICS[2ND EDITION]-
H.R.B FENN,K.P LIDDELOW, A.P.GIMSON
MASTERING THE ART OF COMPLETE DENTURE-
HALPERIN, GRASER,ROGOFF/PLEKAVICH.
THE DYNAMIC NATURE OF LOWER DENTURES JPD-
1965;15(3)
N.BRILL,DR.ODONT,G.TRYDE .

STABILIZING LOWER DENTURES ON UNFAVOURABLE


RIDGES JPD 1962;12.
SIGNIFICANCE OF AGE CHANGES IN HUMAN
ALVEOLAR MUCOFOSSA AND BONE
CHARLES.I.NEDELMAN,S.D. BERNICK JPG 1978;39(5)