Landmarks

ANATOMICAL LANDMARKS OF
MAXILLARY AND MANDIBULAR

ARCH
Dr. Ayesha Aslam

BDS, M.Sc., CHPE
Senior Lecturer
Dept. of Prosthodontics
Army Medical College / Armed Forces Institute of Dentistry
National University of Medical Sciences (NUMS), Islamabad.
Anatomical Landmarks
Limiting/Peripheral Primary stress-

Structures bearing areas
Anatomical
Landmarks
Supporting Secondary stress-
Structures bearing areas
Relief areas
• Limiting/Peripheral Structures:
• Structures that limit the extent of denture base
• For example frenum, muscular attachments
• Primary Stress-bearing Areas:

• Those areas of the arch which provide major support to the prosthesis
• These areas can be compressed during impression recording
• E.g. Hard palate, buccal shelf

• Secondary Stress-bearing Areas:
• Those areas of the arch that can provide only limited support
• E.g. Residual ridge
• Relief Areas:
• Areas in the arch that can be easily traumatized and must be relieved of any
pressure/compression
• E.g. Mid-palatal raphe
MAXILLARY ARCH
Anatomical Landmarks of Maxillary Arch
Primary Stress Bearing
Limiting Structures Secondary Stress Bearing Areas Relief Areas
Areas
Labial Frenum Rugae Incisive Papilla

Hard Palate
Posterior lateral Midpalatine

Labial Vestibule
slopes of Residual Raphe
Tuberosity
Ridge
Buccal Frenum
Buccal Vestibule
Hamular Notch
Posterior Palatal Seal
Fovea Palatinae
• LABIAL FRENUM:
• fibrous band covered by mucous membrane
• Extends from labial aspect of residual ridge to lip
• May be single or double, narrow or broad
• Contains NO muscle fibers
• SIGNIFICANCE:
• Relief for labial frenum must be given during final impression by making a
“labial notch”
• If relief is not given, denture will impinge on the frenum and cause pain
• Movement of frenum will cause dislodgment of denture
• LABIAL FRENUM:
• LABIAL VESTIBULE:
• Space extending from labial frenum to the buccal frenum
• Bounded by labial aspect of residual ridge, muco-labial fold and orbicularis oris
muscle
• Mucosa: thin with non-keratinized epithelium
• Submucosa: thick, contains large amount of loose areolar tissue and elastic fibers
• SIGNIFICANCE:
• This space is occupied by labial flange of denture which provides support to lip
• Labial flange is in intimate contact with labial vestibule to create peripheral seal
• BUCCAL FRENUM:
• Band of tissue that overlies the Levator anguli oris muscle
• Orbicularis oris – pulls the frenum forward
• Buccinator – pulls the frenum backward
• SIGNIFICANCE:
• Muscles attached to frenum will move during function (smiling, chewing)
• Relief must be provided in buccal flange of denture to allow easy movement
of muscles
• Otherwise, denture will be dislodged during function
• BUCCAL FRENUM:
• BUCCAL VESTIBULE:
• Extends from buccal frenum to hamular notch
• Bounded externally by cheek, internally by residual ridge
• Space is obliterated by CORONOID PROCESS when the mouth is opened wide
• SIGNIFICANCE:
• Width and height of buccal flange of denture must not hinder the movement of coronoid
process during mouth opening
• During impression recording, patient must be asked to open his mouth wide and move it
from left to right so that the effect of coronoid process is recorded.
• Otherwise, denture will fall whenever the mouth is opened wide (e.g. during yawning)
• HAMULAR NOTCH:
• Forms the distal limit of buccal vestibule
• Situated between pterygoid hamulus and tuberosity
• Pterygomandibular ligament is attached to this notch
• SIGNIFICANCE:
• Denture border should extend till the hamular notch
• If border is short, denture will not have a seal and will not be retained
• If denture is over-extended into the notch, it will impinge on the tissues causing
soreness
• Also, on mouth opening, pterygomandibular raphe is pulled forward and denture
will be dislodged.
• HAMULAR NOTCH:
• POSTERIOR PALATAL SEAL:
• Soft tissue along the junction of hard and soft palates, extending from one hamular notch to the
other, on which pressure within the physiological limits of tissues can be applied by denture to
aid in denture retention
• Not a straight line; follows the contour of distal border of palate
• At midline, it passes 2 mm in front of fovea palatinae
• Bound anteriorly by anterior vibrating line, posteriorly by posterior vibrating line and laterally by
hamular notches
• Anterior Vibrating Line: area at the junction b/w immovable tissues over hard palate and slightly
movable tissues of soft palate
• Posterior Vibrating Line: area at the junction of aponeurosis of tensor veli palatine and muscular
portion of soft palate
• FUNCTION:
• Aids in denture retention by intimate contact with mucosa
• Reduces gag
• Prevents food accumulation beneath the denture
• SIGNIFICANCE:
• Distal end of maxillary denture should extend up to the vibrating line or 1-2
mm beyond it
• Must provide seal to ensure denture retention
• HARD PALATE:
• Consists of bones of two maxillae and the palatine bone
• Covered by keratinized epithelium
• Palatine bones joined in the middle by midpalatine suture
• Soft tissue covering the midpalatine suture is non-resilient
• In the anterior region, rugae are present. Here, palate is set at an angle to the
ridge and covered by dense soft tissue
• SIGNIFICANCE:
• Primary support for maxillary denture is provided by horizontal portion of the
hard palate lateral to the midline
• HARD PALATE:
• MAXILLARY TUBEROSITY:
• Bulbous extension of residual ridge in 2nd and 3rd molar region
• Terminates in the hamular notch
• Covered by dense firm mucosa
• SIGNIFICANCE:
• Serves as primary stress-bearing area for maxillary denture
• Artificial teeth must NOT be set on the tuberosity
• MAXILLARY TUBEROSITY:
• RESIDUAL ALVEOLAR RIDGE:
• Composed mainly of cancellous bone, which is covered by a layer of cortical
bone in the anterior region
• Mucous membrane is firmly attached to the periosteum via submucosa
• Submucosa is thin
• Thick stratified squamous epithelium
• SIGNIFICANCE:
• Crest of the ridge serves as secondary stress bearing area for maxillary
denture
• RESIDUAL ALVEOLAR RIDGE:
• RUGAE:
• Mucosal folds located in anterior region of palatal mucosa
• Covered by firm mucosa
• SIGNIFICANCE:
• Help in speech
• Serve as secondary-stress bearing area for maxillary denture
• Excessive pressure must not be applied on rugae as it will cause tissue
distortion
• RUGAE:
• INCISIVE PAPILLA:
• A small rounded protuberance between/immediately behind central incisors
• Covers the incisive foramen
• Nsaopalatine nerves and vessels pass through the foramen
• With resorption, papilla lies very close to the crest of residual ridge
• SIGNIFICANCE:
• Must be adequately relieved under a denture base
• Pressure on papillae will compress vessels and nerves, causing necrosis and
paresthesia of anterior palate.
• INCISIVE PAPILLA:
• MIDPALATINE RAPHE:
• Midpalatal suture covered by thin submucosa
• SIGNIFICANCE:
• Cannot withstand excessive pressure
• Must be relieved under a denture base
• If recorded under pressure, denture base will cause soreness over midpalatal
raphe.
• MIDPALATINE RAPHE:
MANDIBULAR ARCH
Anatomical Landmarks of Mandibular Arch
Limiting Structures Primary Stress Bearing Secondary Stress Bearing Areas
Areas Relief Areas
Labial Frenum Residual Mental

Buccal Shelf Ridge
Area Foramen
Labial Vestibule Genial Tubercles

Retromolar Pads
Buccal Frenum Mylohyoid Ridge
Buccal Vestibule
Lingual Frenum
Alveolo-lingual sulcus
Pterygomandibular
Raphe
• LABIAL FRENUM:
• A band of fibrous connective tissue
• Helps attach orbicularis oris muscle
• Active and sensitive
• SIGNIFICANCE:
• Sufficient relief must be given for the frenum in denture base to move during
function without compromising peripheral seal
• LABIAL FRENUM:
• Extends from labial frenum to buccal frenum
• Bound externally by muco-labial fold and internally by alveolar ridge
• Fibers of orbicularis oris, incisivus and mentalis are inserted near the crest of
the ridge
• SIGNIFICANCE:
• Thickness of the denture base in this area must accommodate the movement
of these muscles
• A thick denture flange may lead to denture dislodgment on wide mouth
opening
• BUCCAL FRENUM:
• A fold of mucous membrane
• Lies just distal to the cuspid eminence
• May be single/double, broad U/V shaped
• Overlies the depressor anguli oris
• SIGNIFICANCE:
• Space must be created in denture flange to accommodate frenal movement
and avoid denture displacement
• BUCCAL FRENUM:
• Extends from buccal frenum to outside back corner of retromolar pad
• Lies at almost right angles to the biting forces
• Extent of the vestibule is influenced by Buccinator
• Buccinator:
• extends anteriorly from the MODIOLUS to PTERYGOMANDIBULAR RAPHE
posteriorly
• has its own fibers attached to buccal shelf and external oblique ridge
• Upon clenching, masseter muscle contracts and pushes inwards against
buccinator muscle. Tis movement is recorded as “masseteric notch” in the
distobuccal border of mandibular denture
• SIGNIFICANCE:
• The distobuccal border of the lower denture should accommodate the
contracting masseter muscle so that denture does not dislodge during heavy
closing forces.
• LINGUAL FRENUM:
• Fold of mucous membrane
• Extends from the tip of the tongue to the floor of the mouth
• Overlies “Genioglossus” muscles that originates from superior genial tubercle
• SIGNIFICANCE:
• Lingual frenum must be recorded in function by asking the patient to elevate his tongue
• Adequate space must be created in lingual flange of lower denture to allow its
movement
• Otherwise, frenum will be trapped below the denture and tongue movement will be
hindered.
• LINGUAL FRENUM:
• RETROMOLAR PAD:
• Pear-shaped pad of tissue at distal end of lower ridge
• Bone: cortical, resistant to resorption
• Mucosa: thin, nonkeratinized epithelium and loose areolar tissue
• Submucosa: glandular tissue, fibers of buccinator and superior constrictor
muscle, pterygomandibular raphe and terminal part of the tendon of
temporalis
• SIGNIFICANCE:
• Serves as primary stress bearing area for lower denture
• Helps create posterior palatal seal
• Distal end of denture should cover at least two-thirds of retromolar pad
• RETROMOLAR PAD:
• ALVEOLOLINGUAL SULCUS:
• Space between residual ridge and tongue
• Extends from lingual frenum to retromylohyoid curtain posteriorly
• SIGNIFICANCE:
• Denture flange must slope downwards from the crest of ridge towards the
tongue
• Posteriorly, flange should turn laterally towards ramus
• Contact with tissues should provide peripheral seal
• Otherwise, food may accumulate below the denture
• ALVEOLOLINGUAL SULCUS:
• RETROMYLOHYOID FOSSA:
• Area posterior to mylohyoid muscle
• Bounded by retromylohyoid curtain
• Retromylohyoid curtain:
• Postero-laterally: superior constrictor muscle
• Postero-medially: Palatoglossus, lateral surface of tongue, inferior wall of
submandibular gland
• Protrusion of tongue cause the retromylohyoid curtain to move forward
• SIGNIFICANCE:
• If denture is over-extended in this area, it will cause soreness or displacement during
swallowing and when tongue is raised/protruded.
• Must ask patient to move his tongue during impression recording
• RETROMYLOHYOID FOSSA:
• PTERYGOMANDIBULAR RAPHE:
• Originates from hamular process and attaches to mylohyoid ridge
• It is pulled forward on wide mouth opening
• SIGNIFICANCE:
• Denture base must NOT impinge on the raphe
• Relief in the shape of a “notch” may be required in the denture base
• PTERYGOMANDIBULAR RAPHE:
• RESIDUAL RIDGE:
• Covered by fibrous connective tissue
• Crest of ridge is CANCELLOUS
• Slopes of ridge have a thin plate of CORTICAL bone and lie at right angles to
occlusal forces
• SIGNIFICANCE:
• Slopes of the ridge serve as secondary stress-bearing areas
• Tissues lying over the crest of the ridge must not be compressed by denture
base
• RESIDUAL RIDGE:
• BUCCAL SHELF AREA:
• Area b/w buccal frenum and anterior edge of the masseter
• Bounded by:
• Medially: Crest of the ridge
• Laterally: External oblique ridge
• Distally: Retromolar pad
• Anteriorly: Buccal frenum
Primary Stress Bearing
• Bone: dense, smooth CORTICAL bone
Area For Mandibular
• Lies at right angles to occlusal forces
Denture
• Fibers of Buccinator muscle are attached to it
• SIGNIFICANCE:
• Resistant to resorption
• Pressure can be applied on it (recorded under compression)
• Serves as primary stress bearing area
• BUCCAL SHELF AREA:
• MENTAL FORAMEN:
• A foramen in the premolar region, usually between 1st and 2nd premolar
• Mental nerves and vessels pass through it
• SIGNIFICANCE:
• As alveolar bone is resorbed, mental foramina come to lie closer to the crest
of ridge.
• If not relieved, denture will compress the nerves and vessels passing through
the foramen.
• Patient will complain of “numbness of lower lip”.
• MENTAL FORAMEN:
• GENIAL TUBERCLES:
• Small projection, sometimes two, in the middle line of the posterior surface
of the body of the mandible
• Gives attachment to the geniohyoid and the genioglossus muscle
• SIGNIFICANCE:
• With resorption, tubercles will become more prominent
• Relief may be required to avoid soreness and denture displacement
• GENIAL TUBERCLES:
• TORUS MANDIBULARIS:
• Bony prominences found bilaterally lingually near the 1 st and 2nd premolar midway
between the floor of the mouth and crest of ridge
• Covered by very thin mucosa
• Easily traumatized
• SIGNIFICANCE:
• Makes impression making difficult
• Ideally, should be surgically removed
• If small in size, can be accommodated in denture base
• If too large, they will compromise peripheral seal and will be ulcerated during
denture insertion and removal
• TORUS MANDIBULARIS:
• Mylohyoid Ridge:
• Bony prominence on the lingual aspect of mandible
• Extends from the 3rd molar region to lower border of mandible in the region
of chin
• With resorption, the ridge may lie flush with crest of the residual ridge
• Soft tissue usually hides the sharpness of the ridge
• Mylohyoid muscle is attached to it, and forms the floor of the mouth
• SIGNIFICANCE:
• Influences the lingual flange of the denture
• Relief may be required to prevent the denture form traumatizing the soft
tissue over a spiny ridge

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ANATOMICAL LANDMARKS OF

MAXILLARY AND MANDIBULAR

Dr. Ayesha Aslam

Limiting/Peripheral Primary stress-

• For example frenum, muscular attachments

• Primary Stress-bearing Areas:

• These areas can be compressed during impression recording

• E.g. Hard palate, buccal shelf

• E.g. Residual ridge

Labial Frenum Rugae Incisive Papilla

Posterior lateral Midpalatine

Posterior Palatal Seal

Labial Frenum Residual Mental

Labial Vestibule Genial Tubercles

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