ANATOMICAL

LANDMARKS

International Journal of Applied Dental Sciences

2017; 3(2): 26-29
 INTRODUCTION
• The anatomy of the edentulous ridge in the
maxilla and mandible is very important for
the design of a CD.
• The consistency of the mucosa and the
architecture of the underlying bone is
different in various parts of the edentulous
ridge.
• Hence, some parts of the ridge are capable of
withstanding more force than other areas.
• A thorough knowledge of these landmarks
is essential even prior to impression
making.

• The landmarks can be classified into

following categories:
A)- Supporting structures
B)- Limiting structures
C)- Relief areas
MAXILLARY LANDMARKS
 LIMITING
STRUCTURES
• Labial frenum
• Labial vestibule
• Buccal frenum
• Buccal vestibule
• Hamular notch
• Posterior palatal seal area.
MAXILLARY LABIAL FRENUM
• Fibrous band covered by
mucous membrane.

• Extends from labial aspect of

residual ridge to lip.

• Fan shaped superiorly and

converges at the terminal
attachment.
• It may be single / multiple.
• It may be narrow / broad.
• Passive frenum- no significant muscle
attachment
Labial notch :
• Should be narrow.
• It should be just wide enough and just deep
enough to allow the frenum to pass through
it.
• Overzealous border molding of this area
leads to wide notch, thus causing loss of seal.
 FRENUM ATTACHMENTS
Priyanka, et. Al., Journal of Indian Society of Periodontology. 2017:1;12-7
• Clinical Consideration: Sufficient relief
should be given during final impression
procedure and in completed prosthesis
because overriding of function of frenum will
cause pain and dislodgement of denture.

• During impression procedure the lip should

be stretched horizontal outwards for the
proper recording of frenum. If frenum is
attached close to the crest frenectomy is
done, failure of which will lead to the denture
border being placed on the bone tissue which
will cause decreased border seal.
 LABIAL VESTIBULE
(SULCUS) :

• It is divided into right and

left vestibule by labial
frenum.

• Orbicularis oris fiber passes

horizontally through the lip
and anastomose with
buccinator muscle.
• Indirect effect on the extent on denture base.
• MUCOSA: thin and non-keratinized.
• SUBMUCOSA: Loose submucosa with
elastic lamina propria.

• Clinical Consideration: For effective border

contact between denture and tissue, vestibule
should be completely filled with impression
material.
 BUCCAL FRENUM:

• It may be single or double,

• Broad fan-shaped.
• Divides the labial and
buccal vestibule
• Fibrous connective tissue
ATTACHMENTS:
MUSCLES ACTION
ATTACHMENT
Levator angularis oris Attaches beneath the frenum and
pulls it downward.

Orbicularis oris Pulls the frenum in a forward

direction
Buccinator Pulls the frenum in the backward
direction

These muscles influence the position of frenum

hence needs greater (wider and relatively shallower)
clearance on buccal flange of denture
• Clinical Consideration:
During final impression procedure and in final
prosthesis

sufficient relief for the movement of frenum

pain and dislodgement of denture.

• During impression procedure the cheek should be
reflected laterally and posteriorly.

• If frenum is attached close to the crest of alveolar

ridge, frenectomy is called for.
 BUCCAL VESTIBULE:
• Extends from buccal frenum to
hamular notch.

• Size of buccal vestibule varies

with:-
Contraction of buccinator
Position of the mandible
Amount of bone lost from the
maxilla
• Distal to the buccal frenum and superior to
the vestibule is the roof of zygoma, which is
located opposite to the first molar.

• Limits the extent of denture border.

Clinical Consideration:

The vestibule should be completely filled with

impression material.

For proper border contact between denture and

tissues.
The vestibular space distal and lateral to the alveolar
tubercles.

Properly filled with denture flange

The stability and retention of the maxillary denture is

increases.
 The buccal flange borders.

Depend upon the borders movement of ramus of

mandible at the distal end of buccal vestibule.

Hence the patient should move the mandible

laterally and protrusively.

To make sure the mandible does not interfere

with these functions.
 To effectively record the maxillary buccal sulcus.

The mouth should be half way closed.

Because wide opening of the mouth narrows the

space and does not allow proper contouring of sulcus.

As the coronoid process of mandible comes closer to

the sulcus
CORONOMAXILLARY AREA
Many terms have been used to identify this area:
• Buccal space or vestibule
• Buccal pocket
• Tuberosity sulcus
• Distobuccal angle of the buccal vestibule
• Buccal sulcus
• Buccal pouch
• Buccal mucous membrane reflection region
• Post-malar area
• Coronomaxillary space
• It is defined as the anatomic region
that lies medial to the coronoid
process and lateral to the maxillary
tuberosity.

• Boundaries:
o Anteriorly - base of zygomatic
process
o Posteriorly - hamular notch
o Inferiorly - crest of residual
alveolar ridge
• Size of this space is primarily
influenced by the action of
coronoid process.

• The distal end of buccal

flange of the denture should
be adjusted in such a way that
there is no interference to the
coronoid process during
mouth opening.
• There are two extension types of the coronomaxillary
region.

General Dentistry 2012;60(4):263-7

 PTERYGOMAXILLARY
(HAMULAR) NOTCH:
• Forms distal limit of the
buccal flange.
• Depression between the
maxillary tuberosity and
the Hamulus of medial
pterygoid plate.
• Palpated by mouth mirror
or T-burnisher.
SUBMUCOSA: Thick with loose areolar tissue.

SIGNIFICANCE :
• Overextension will cause trauma to the mucosa
• If border is placed anteriorly -loss of seal
• Constitutes the lateral boundary of posterior
palatine seal area in maxillary foundation.
• Clinical Consideration: Denture should not
extend beyond the hamular notch, failure of
which will result in: Restricted
pterygomandibular raphe movement. When
mouth is wide open the denture dislodges.
POSTERIOR PALATAL SEAL
AREA (POST DAM):
“The soft tissues at or along the junction of
the hard and soft palates on which pressure
within the physiological limits of the tissues
can be applied by a denture to aid in the
retention of the denture.” GPT 8
Function:
• Aids in retention
• Reduces the tendency for gag.
• Prevents food accumulation between the
posterior border of the denture and the soft
palate.
• Compensates for polymerization shrinkage
 The posterior palatal seal area can be divided into
two regions based upon anatomical landmarks,
namely:
1. PTERYGOMAXILARY SEAL
• It extends across the hamular
notch, 3-4 mm anterolaterally to
end in the mucogingival junction
on the posterior part of the
maxillary ridge.
• It contains loose connective
tissue and few fibres of Tensor
Veli Palatini muscle covered by a
thin layer of mucous membrane
2. POSTPALATAL SEAL
• This is a part of the posterior palatal seal that
extends between the two maxillary tuberosities
 VIBRATING LINES

“The imaginary line across the posterior part

of the palate marking the division between
the movable and immovable tissue of the soft
palate which can be identified when the
movable tissues are moving”.- GPT
• ANTERIOR VIBRATING LINE
Immovable tissues over hard palate and slightly
movable tissues of the soft palate
Cupid bow shape
It can be located:
1. “Valsalva” maneuver.
2. Say “ah” in short vigorous bursts.
• POSTERIOR VIBRATING LINE
located at the junction of the soft palate that
shows limited movement and the soft palate that
shows marked movement.
Also represents junction of aponeurosis of the
tensor veli palatine muscle and the muscular
portion of soft palate.
It can be located:
1. Say “ah’ in short but normal
non-vigorous fashion
• Significance: It improves retention by more than 10
times.
• Instills confidence in a patient to wear and retain
maxillary denture.
• Helps in awarding of gagging reflex.
• Reduces learning period of wearing denture.
 SUPPORTING
STRUCTURES
• Primary stress bearing area
1. Posterio-lateral slopes of hard palate

• Secondary stress bearing area

1. Hard palate
2. Rugae area
3. Maxillary tuberosity
 POSTEROLATERAL SLOPE OF
HARD PALATE
• Mucosa - Stratified squamous
epithelium (highly keratinized)
• Submucosa - devoid of adipose
cells
• The submucosa over the ridge has
adequate resiliency to support the
denture.
• PRIMARY STRESS BEARING
 HARD PALATE
• Anterior part - palatine shelves of the
maxillary bone,
• Posterior part - horizontal plate of palatine
bone .
• Keratinized epithelium

SECONDARY STRESS BEARING AREA

 RUGAE AREA:
• Mucosal folds located in the
anterior region of the palatal
mucosa.
• They are at an angle to the
residual alveolar ridge

SECONDARY STRESS BEARING

THINLY COVERED BY SOFT TISSUE
• Significance: concerned with phonetics.
• Increase the surface area of the foundation
and thus supplement the values of retention.
 MAXILLARY
TUBEROSITIES:

 It is a bulbous extension of
the residual ridge.
 Dense fibrous connective
tissue with minimal
compressibility.
 Least likely to resorb.
 Soft tuberosity – does not aid in retention
 Bony tuberosity – aid in retention

SECONDARY STRESS BEARING AREA

Significance: The last posterior tooth should

not be placed on the tuberosity.
• Clinical Significance: Often there is lateral and
vertical growth of tuberosity and the area
assumes importance when maxillary antrum
extends laterally with undercuts at the
tuberosity region.

• It is important to prevent oro-antral fistula so it

is important to have radiograph before
resection of the tuberosity.
• It can be used for the retention of the denture.

• Tuberosity should be resected on one side

only i.e. if patient is right side chewer we
should retain that sided tuberosity.
 RELIEF AREAS
1. Area resorbs under constant load or contains
fragile structure within it.
2. Masticatory load should not concentrated
over these areas.
• Incisive papilla
• Cuspid eminence
• Mid-palatine raphe
• Fovea palatina.
• Torus palatina
 INCISIVE PAPILLA
• Pad of fibrous connective tissue
• Incisive foramen is located beneath the incisive
papilla through which the nasopalatine nerve
and vessels pass.
• Pressure in this area will create paresthesia,
pain, and burning sensation.
• Significance:

• Stable landmark and gives its relation to

incisive foramen through which the
neurovascular bundle emerge and lie on the
surface of bone.
It is a biometric guide giving information on
positional relation to central incisors which are
about 8-10 mm anterior to incisive papilla.
• Biometric guide which gives us information about
location of maxillary canines.
• Clinical Consideration: During final
impression procedure, care should be taken not
to compress the papilla. Hence the incisive
papilla should be relieved with a spacer.

• Compression of blood vessels leads to the

obliteration of the lumen that deprives nutrition
to tissues and leading to breakdown of tissues.

• Pressure on nerve causes paraesthesia in the

region of upper lip.
 CUSPID EMINENCE
• It is a bony elevation on the residual alveolar
ridge formed after extraction of the canines.
• Located between the canine and first
premolar region.
Significance:
• Relief should be given at this region.
• pain and ulceration.
 MEDIAN PALATINE RAPHE:
• Junction of the palatine
processes of the maxilla.

• Slightly raised

• Extremely thin
submucosa and mucosa
lie directly on the
underlying bone.
• Soft tissue in this area is non- resilient.

• Should be relieved to prevent trauma from

the denture.

• SIGNIFICANCE : Function of sutural joint

is growth and sometimes there will be
overgrowth of the bone at the sutural joint
resulting in torus palatinus.
 FOVEAE PALATINAE:
(coalescences of ducts)
• Two opening of minor salivary
gland on the distal end of hard
palate.
• Acts as an arbitrary guide to
locate the posterior border of
denture
• Denture can extend 1-2 mm
beyond it.
Significance:
• Should be relived so as to prevent irritation
to the soft tissues in this region.
 TORUS PALATINUS

• A hard bony
enlargement that
occurs in the midline
of the roof of the oral
cavity in few patients.
• It is covered by thin layer of mucous
membrane that can easily get traumatized by
the denture base, unless the area is relieved
• Large tori- surgical excision.
Mandibular landmarks
MANDIBULAR
LANDMARKS

Presented By:
Dr. Aishwarya Mahajan
Department Of Prosthodontics
SUPPORTING
STRUCTURES
 RESIDUAL ALVEOLAR
RIDGE
• Covered by fibrous
connective tissue.
• Fibrous connective
tissue closely
attached to bone-
more favorable for
resisting external
forces.
• Cancellous bone- on crest (relief area)
• Cortical bone- rest of the ridge (support area)
 BUCCAL SHELF AREA
• Area between mandibular
buccal frenum and anterior
edge of masseter muscle.

• Boundaries:
1. Medially- crest of residual
alveolar ridge
2. Anteriorly- buccal frenum
3. Laterally- external oblique
line
4. Distally- retromolar pad
• Wide and at right angle to
the direction of vertical
occlusal forces.
• Some buccinator fibers -
under the buccal flange-
attachment of the muscle
is close to crest of residual
ridge in molar region.
• Antero-posterior fibers-
parallel to bone- on
contraction- no significant
effect on denture.
• Principle stress bearing area (takes load off
the irregular crest of alveolar bone)
1. Smooth cortical bone
2. Perpendicular to occlusal plane
If the residual alveolar ridge is irregular, sharp,
spiney and full of nutrient canal.

Forces are transferred to buccal shelf area.

Other wise can be wore by residual alveolar

ridge.
FLAT ALVEOLAR RIDGES
• On the labial surface of anterior region of the
mandible- several muscles shows proximity to
crest of the resorbed ridge.

• Short flanges

• Muscle should not be impinged on.(action right

angle to flange)
 • Extremely flat ridges.
1. Resorption of cortical bone(Concave surface).
Structures on lingual side falls onto the ridge.

• Requires placement of these tissues by impression

• Gradually re-establishes the bearing area.

2. The crest is on the level of mental foramen

Impinged on mental nerves and vessels

Area should be palpated and relieved.

BONE OF BASAL SEAT
• Changes includes :
1. Stage change in mandible
2. Sharp mylohyoid ridge
3. Mental foramen area resorption
4. Insufficient space between mandible and
tuberosity
5. Low mandibular ridges
6. Opposite direction of resorption of ridges
7. Torus mandibularis
1. Stage change in mandible
2. Sharp mylohyoid ridge
3. Mental foramen area resorption

• On or near the crest

• Pressure on mental nerve and vessels
• Paresthesia or numbness of lower lip.
4. Insufficient space between mandible and
tuberosity:
• Maxillary sinus enlarges through out the life
(if not restricted by teeth and denture)
• Moving the tuberosities downwards.

• Angle of mandible become obtuse due to

early loss posterior teeth
• Disrupting the muscular counterbalance
against the muscle pull at angle of mandible.
(Straightening of mandible)
5. Low mandibular ridges

• Depressed supporting area.

• Difference in resorption rate of cortical and
cancellous bone.
• Lingually, bone shrunk till the level of
attachment of structures.
• Lingual flange more difficult to adapt
6. Direction of resorption of ridges
• 7. Torus mandibularis
• Bony prominence present between premolars.
• Superior border flushes with crest of ridge on
lingual side in extremely resorbed ridges.
• Covered with extremely thin layer od mucous
membrane- irritated by slight movement of
denture.
• Surgically removed, if relief cannot be provided.
.
LIMITING
STRUCTURES
BUCCAL AND LABIAL
BORDER ANATOMY
• Mandibular denture should wide back of buccal
frenum and narrow in the anterior labial region.
• Labial frenum/notch -
• Active- Orbicularis oris muscle
• Labial vestibule/flange:
• Between labial and buccal frenum/notch.
• Limited in extension- fibres of orbicularis
oris and incivius labii inferioris runs close to
the crest.
• Length and thickness of flange vary with
amount of tissue lost.
• Tone of skin of lip and orbicularis oris
muscle depends on the thickness of flange
and position of teeth.
• Buccal frenum/ notch:
• It overlies depresser anguli oris
muscle.
• Fibres of buccinator muscles are
attached to the frenum.
• May have a single or double folds.
• Found in the area of pre molar region
• Should be relieved to prevent
displacement of denture during
function.
• Buccal vestibule/ flange:
• From buccal frenum to back corner of retromolar
pad.

• Distobuccal border of buccal vestibule is

bordered by the vertical fibres of masseter
muscle.

• Occlusal forces activate the masseter muscle,

which causes bulge in the buccinator muscle,
creating massetric notch in posterior lateral
denture border.
• Buccal flange may extend to or up on to or
over the external oblique ridge depending on
the position of muco-buccal fold.

• Buccal shelf area- buccinator fibers parallel

to border, unlike masseter- exert minimum
dislodging force on denture.
MASSETER MUSCLE REGION

• Masseter muscle
fibers passes outside
the buccinator- rapid
convergence of
distobuccal corner of
mandibular denture.
• If the ramus of mandible has a perpendicular
surface and the origin of the muscle on the
zygomatic arch is medialward, the muscle
pulls more directly across the disto-buccal
denture border, forcing the buccinator and
tissues inward, reducing the space in the
region.

• If the opposite is true greater extension is

allowed on the distobuccal portion of the
mandibular impression.
• To record-
• A soften compound is place in this region
and downward pressure is applied by the
clinician.
• Also ask the patient to close against this
force.
• This will contract the muscle, trimming the
compound in the area.
RETROMOLAR REGION
• Distal end of mandi
denture- anterior
border of ramus.
• Retromolar pad defines
the posterior extension
of the denture.
• Triangular soft pad of
tissue present at distal
end of the alveolar ridge
• Contents:
1. Glandular tissue
2. Fibers of temporal tendon
3. Buccal side- buccinator fibers
4. Lingual side- superior pharyngeal
constrictor fibers
5. Top back side- Pterygomandibular raphe
• The action of these structures limit the extent
of the denture and prevent placement of extra
pressure on the retromolar pad during
impression procedure.
LINGUAL BORDER
ANATOMY
• Most abused and misunderstood border region.
• Due to less direct resistance of lingual tissues
(easily distort during impression making).
• It will not tolerate overextensions.
• The boney landmark for extension- into the
undercut below mylohyoid ridge.
• Such mechanical lock seems desirable but
cannot be tolerated by soft tissue under
physiologic movements.
MYLOHYOID MUSCLE &
RIDGE
• The denture border should be extended
beyond the palpable portion of mylohyoid
ridge but not into undercut.

• Lack of direct pressure on the ridge decreases

chances of soreness.
 1. If pressure is applied on the ridge

Displacement of denture and soreness from

vertical and lateral forces.

2. If border place above the ridge

Vertical forces will cause soreness and loss of

peripheral seal easily.
SUBLINGUAL GLAND
REGION
LINGUAL FRENUM
• Should be recorder on the function, at resent the
position is deceptive.
• In function come close to crest where as at rest is
much lower in position.
DIRECTION OF LINGUAL
FLANGE
ALVEOLOLINGUAL SULCUS

• Space between residual ridge and tongue.

• Extents from lingual frenum to the

retromylohyoid curtains.

• Part of this sulcus is available for lingual

flange of the denture.
• Considered in three parts:
• ANTERIOR REGION:
• Lingual frenum to are where
mylohyoid ridge curves down
below the level of sulcus.
• Here a depression
(premylohyoid fossa- formed
by concavity of mandible
joining the convexity of
mylohyoid ridge) can be
palpated corresponding to an
elevation (premylohyoid
eminence) in the impression.
Lingual border of impression in anterior region

Definite contact with mucous membrane of

floor of mouth

Tip off tongue touches the upper incisors.

• MIDDLE REGION:
• Pre-mylohoid fossa to the distal end of the
mylohyoid ridge.
• So the sulcus curves medially from the body of the
ramus due to prominence of mylohyoid ridge.
 When the tongue is relaxed

Mylohyoid muscle drapes back under the

mylohyoid ridge.

If impression made in this state, muscle will be

trapped back, buccal to the functioning
position when the tongue is place on upper
incisors.
 Sublingual gland and submaxillary duct- displaced
down and laterally by force of impression material.

Avoided by placing the flange sloped towards the

tongue and impression by soft material.

Advantage:
1. Sloping make it possible to place margin below
the mylohyoid ridge
2. The tongue can rest on the flange and aids in
stabilizing the denture on ridge
3. Provides space for elevation of floor of mouth
• POSTERIOR REGION:
• The retromylohoid fossa is present here.
• Boundaries:
1. Lingual side- anterior tonsillar pillar
2. Distal end- retromylohyoid curtain and superior
constrictor
3. Buccal side- mylohyoid muscle, ramus and
retromolar pad

• The action of superior constrictor and muscle of

tongue determines the posterior extension of
denture (contact the retromylohyoid curtain)
 Mylohyoid muscle – 1 cm behind mylohyoid
ridge

Prevent locking of denture to bone in posterior

region.(provide characterstic S-hape)

• Advantage:
1. Border seal is made continusos with retromolar
pad.
2. Flange guide the tongue to rest over it.
LATERAL THROAT FORM
• Lateral throat form (LTF) is the critical area
which has to be recorded properly for obtaining
proper retention and stability in complete
denture especially in geriatric patients with
resorbed ridges.

• Popular method used for determining LTF is

Neil’s method which depends on the forces
applied by the floor of mouth when the tongues
protrude out.
Kalavathy N, Kumar PR, Gupta S, Sridevi J, Shetty M,
Sanketh AK. Lateral throat form re-classified using a
customized gauge: A clinical study. J Indian Prosthodont Soc
2016;16:20-5.
• A customized gauge was made to measure the
depth of the Lateral throal form (LFT)
• Two different observers classified the LTFs
according to Neil’s classification and by using a
customized gauge was inserted into the alveolo-
lingual sulcus to measure the depth in a total group
of 50 patients.
• Results:
• There was more inter-observer variability
when Neil’s classification was used as
compared to the one with the proposed
classification using the gauge.
• The proposed new classification for LTF
gave consistent results and was easier to use
with less variability when compared to the
Neil’s classification.
 LIMITING
STRUCTURES
Labial frenum.
Labial vestibule.
Buccal frenum.
Buccal vestibule.
Lingual frenum.
Alveololingual sulcus.
Retromolar pads.
 MANDIBULAR LABIAL
FRENUM
• Band of fibrous connective
tissue
• Mandibular labial frenum
usually shorter and wider
than the maxillary labial
frenum.
• The frenum contains fibers
of the orbicularis oris
muscle.
• Active frenum.
 LABIAL VESTIBULE

• Extents from labial frenum

to buccal frenum.
• Mentalis muscle is active in
this region. Excessive
activity during border
molding can leads to short
flanges and loss of seal.
• On wide open – orbicularis oris muscle will
become narrow.

• Hence, the impression will be the narrowest

in the anterior labial region.
• Clinical Consideration:
• During final impression procedure the lip has
to be reflected anteriorly and horizontally.

• During final impression procedure and in

final prosthesis provision should be made in
the form of notch to prevent overriding of
function which may result in laceration.
 BUCCAL FRENUM:
• It overlies depresser anguli
oris muscle.

• Fibres of buccinator
muscles are attached to the
frenum.

• May have a single or

double folds.
• Found in the area of pre molar region
• Should be relieved to prevent displacement
of denture during function.
 BUCCAL VESTIBULE:
• Extends posteriorly from
the buccal frenum to the
posterior lateral aspect of
retromolar pad.

• Denture is wide in this

area.
• Distobuccal border of buccal vestibule is
bordered by the vertical fibres of masseter
muscle.

• Occlusal forces activate the masseter muscle,

which causes bulge in the buccinator muscle,
creating massetric notch in posterior lateral
denture border.
 LINGUAL FRENUM:
• Fibrous band of tissue that
overlies genioglossus muscle
• Fan shaped
• Usually narrow and single,
but may be broad and two or
three frenums.
• Inadequate clearance can lead
to pain and displacement of
denture.
• Significance: It overlies the genioglossus
muscle which takes origin from the superior
genial spine on the mandible.

• Clinical Consideration: Sufficient relief

should be given in the final impression and
the final denture to prevent overriding of
function of frenum.
• During impression procedure touch the tip of
the tongue to the incisive papilla region.
 ALVEOLOLINGUAL SULCUS
• Space between residual ridge
and tongue.
• Extents from lingual frenum to
the retromylohyoid curtains.
• Recording this area of the
denture provides the
characteristic S-shape
appearance of the lingual
flange of the mandibular
denture.
• ANTERIOR REGION:
• Lingual frenum to the premylohyoid fossa.

• MIDDLE REGION:
• Pre-mylohoid fossa to the distal end of the
mylohyoid ridge.
• This region is shallower than other parts of
the sulcus. This is due to the prominence of
the mylohyoid ridge and action of the
mylohyoid muscle
• POSTERIOR REGION:
• The retromylohoid fossa is present here.
• The denture flange in this region should turn
laterally towards the ramus of the mandible
to fill up the fossa and complete the typical
S-form of the lingual flange of the lower
denture.
• The lingual flange should slope medially
towards the tongue. This sloping helps in
three ways:
1. The tongue rests over the flange stabilizing
the denture.
2. Provides space for raising the floor of the
mouth without displacing the denture.
3. The peripheral seal is maintained during
function.
 RETROMOLAR PAD:

• It is a triangular pad of
tissues at the distal end of
residual ridge.

• Anterior portion of
triangular pad- pear shaped
pad
• Posterior portion of triangular pad-
Thin non keratinized epithelium
Loose connective tissue
Glandular tissue
Fibers of temporalis tendon
Fibers of buccinator
Fibers of superior constrictor muscle
• Underlying bone is dense cortical bone, it has
muscle attachment

• Resistant to resorption.

• After molar loss, the bony alveolar process and

surrounding soft periodontal tissues remodel,
mainly resorb, and blend with the retromolar
pad.
• The bony residual ridge, attached muscles, and
covering mucosa occupy the mandibular
edentulous retromolar region.

• The bony mandible is connected by muscle

fibers to adjacent structures (cranium, tongue,
cheeks, hyoid bone), which are important for
diverse functions, such as mastication,
swallowing, deglutition, and speaking.

• Therefore, the anatomic foundation of the

supporting tissues and the various muscular
activities of the cheeks, lips, and tongue are
• The mandibular removable denture should be
designed to cover the retromolar ridge tissues.

• The form of the ridge determines the upper

and intaglio surfaces of the denture base.

• The reflection and resiliency of the muscle

fibers attached to the mandible at the floor of
the mouth shapes the contour of the facial and
lingual borders of mandibular dentures.
• There is reliable but insufficient information
on the different bone, mucosa, and muscle
tissue forms and distribution at the
mandibular regions in edentulous patients.

• Significance: Represents distal limit of

mandibular denture.
• Because of muscular tendinous elements the
area should not be subjected to pressure.
• Clinical Consideration:
Helps in maintaining the
occlusal plane.

• Divide retromolar pad

into anterior 2/3rd and
posterior 1/3rd. Posterior
height of occlusal rim
should not cross anterior
2/3rd.
• Helps in arranging
mandibular posterior teeth.
• Draw a line from highest
point in canine region to
the apex of the retro molar
triangle extending it to the
land of the cast.
• The central fossa of all
posterior teeth should lie
on this crestal line. Teeth
should not be placed on
the retro molar pad.
 MASSETRIC NOTCH AREA:
• It is immediately lateral to
retro molar pad and
continuous anteriorly to
buccal vestibular sulcus.

• Significance: It is due to
the contraction of masseter
that a depression is formed
at the distobuccal corner of
retro molar pad.
• Clinical Consideration: When mouth is
opened widely the borders cut into the tissue
so it should be recorded.

• During impression procedure in the area of

massetric notch downward pressure is
applied and the patient is asked to close the
mouth against the pressure.

• Overextension of denture causes -

Dislodgement of denture and Laceration
 MENTAL FORAMEN:
• It is located on the buccal surface of
the mandible in the premolar area,
through which the mental nerves
and vessels pass,

• Lie closer to the crest of the ridge in

case of resorption

• Pressure from the denture may cause

pain and paraesthesia.
 TORUS MANDIBULARIS:

• It is bilateral bony projection

sometimes found on the
lingual surface at the
premolar area.

• If it is small need relief, if it

is large it will require
surgical removal.
 GENIAL TUBERCLES OR
MENTAL SPINE
• Dense cortical prominence at the
inferior border of the mandible at
the lingual midline
• Following advanced alveolar ridge
resorption, these tubercles lie very
close to the crest of the ridge.
• In these cases the denture may
require relief in this area.
 MYLOHYOID RIDGE
• It is the bony prominence
along the lingual aspect of
the mandible.
• It is usually prominent
near the retromolar pad.
• This often requires relief
and may require surgical
correction if it is combined
with torus.
 CONCLUSION

• The basic goal of a successful complete denture

therapy is reaching the patients expectations in
fulfillment of better masticatory ability, unaltered
speech and a better esthetics.

• The clinician should have the anatomical

knowledge to fabricate prosthesis which in turn
aids in proper maintenance of stomatognathic
system.
• The knowledge of oral anatomy, microscopic
as well as macroscopic better equips us as
prosthodontists to:
1. Decide how to make the impression.
2. What material to use.
3. How to plan the treatment.

• All this will result in a successful prosthetic

treatment.