ANATOMICAL LANDMARKS OF DENTURE

BEARING AREA OF
MAXILLA AND MANDIBLE
 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 SECONDRY STRESS BEARING AREA

• HARD PALATE
• MAXILLARY TUBEROSITY • 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 STRESS-BEARING 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 buccal
frenum

• Muscle 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. 13 th Edition.

Chapter 8.
• Winkler’s –Essentials of Complete Denture Prosthodontics.
Chapter-7.
• Heartwell’s 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