Anatomical Landmarks for Complete Dentures

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Anatomical Landmarks for Complete Dentures

  1. 1. Extraoral LandMarks •Nasolabial sulcus •Mentolabial sulcus •Filtrum •Vermillion border •Angle of the mouth •Modiolus
  2. 2. NasoLabial Sulcus  Crease that extend laterally and downward from the ala of the nose to corner of the mouth.  Cant easy to remove but may be reduced by denture.
  3. 3. Mento labial sulcus  Run horizontally between the lower     lip and chin . Indicate maxillo mandibular relasionship. In normal class 1 it show a gentle curvature which represent an obtuse angle . In class 2 it represent acute angle in which the lower lip is folded toward chin. In class 3 it may form angle of 180 degree.
  4. 4. Philtrum
  5. 5. Vermillion border  Transitional epithilium between the mucous membrane of the lips and the skin.  In edentulous face there is dimintion of amount of vermellion border on the upper lip and relative fullness of the lower lip.  Its theckness
  6. 6. Angle of the mouth(commisure)  Denture should support the mouth angle to avoid angular chielitis which is fissuring and inflammation of mouth angle as result of continous wetting by saliva.
  7. 7. Modiolus  The meeting place of the buccinators and other facial muscles near the mouth angle.  With teeth loss the modiouls displaced and give appearance of sunken cheecks.  The buccal surface of the lower denture at premolar region must be thin to avoid the modiolus lifting the denture.
  8. 8. Ala of the nose
  9. 9. The tragus of the ear
  10. 10. Ala tragus line
  11. 11. Intraoral LandMarks  The oral cavity divided into the vestibule and oral cavity proper.  The vestibule divided into labial and buccal vestibule.  After extraction of the teeth alveolar bone absorbed and the remaining part is called residual ridge.
  12. 12. Maxillary anatomical landmarks
  13. 13. Alveolar ridge  The portion of alveoler process and its covering soft tissue that remain after extraction of teeth.  The highest portion is called crest of the ridge.  Considered the primary stress bearing area in the upper jaw.
  14. 14. Maxillary tuberosity  Rounded prominence behind and slightly above the distal end of maxillary residual ridge.  Its size is affected by extent of maxillary sinus.  Should included in the impression , it permits coverage of more area and good bearing surface.  Extremely large tuberosities need surgical correction.
  15. 15. Hamular or pterygo maxillary notch  Depression distal to maxillary tuberosity.  Used as land mark for correct extension of the upper denture.
  16. 16. Palatine vault  Formed anteriory by the hard palate and posteriory by the soft palate.  May be high and V-shaped, or flat and shallow, the more common is high and U-shaped and its more desirable.
  17. 17. Median palatine raphe  The suture that join the two palatine processes at the midline.  Covered with thin,dense mucoperiostium with little or no mucosa.  Improper relief of it may cause instability of the upper denture.
  18. 18. Incisive papilla  Pad of fibrous connective tissue overlying the nasopalatine canal.  Used as landmark for correct placement of artificial central incisors.  Relief the upper denture to avoid pressure on the incisive nerve which cause burning sensation.
  19. 19. Torus palatinus  Is raised, bony ridge running down the center of the hard palate from the anterior palatine foramen to the posterior border.  If its too big, it should be surgical removed.  If its small, the denture is reliefed.
  20. 20. Rugae  Irregular shaped ridges of the connective tissue covered by mucous membrane in the anterior third of the hard palate.  Play part in speech.  Shoudnt be disturbed by impression for maximum comfort.
  21. 21. Fovea palatinae  Openings of ducts of minor salivary gland.  Found at the midline just posterior to the junction of the hard palate and soft palate.  Landmark for posterior border extension of the upper denture.
  22. 22. Mandibular Anatomical Landmarks Alveolar ridge Like maxilla
  23. 23. Retromolar pad  Pear shaped area found on each side of the distal end of the residual mandibular ridge.  Its important to avoid displacement of the retromolar pad while making the impression.  Used as guide to located the occlusal plane of the mandibular denture.which must not be higher than half its vertical height.
  24. 24.  Must be covered by denture to avoid its move backward
  25. 25. External oblique ridge  Ridge of dense bone extending above the mental foramen superiory and distally.  The lower denture must cover but not extend beyond it to avoid displacement by powerful musculature in this area.
  26. 26. Buccal shelf area  Bound externally by the external oblique ridge and internally by the slop of the residual ridge.  Bone is dense and can withstand the force.  Should be covered by lower denture to provide support.  Is primary stress bearing area.
  27. 27. Mental foramen  Located in the buccal surface of mandible in premolar region.  Mental nerve and vessels pass through it.  Relief denture in this area to avoid pain and numbness of the lower lip.
  28. 28. Torus mandibularis  Bony projection on the inner surface of the mandible in premolar region.  May be unilateral or bilateral.  The lower denture relief in this area  If its large, must be surgically removed.
  29. 29. Internal oblique ridge  Ridge that extends near the inferior border of the mandible in the incisal region and progrssive higher posteriory  Give attachment to mylohyoid muscle.  Should be included in the denture bearing area.  If sharp or prominent it reduced surgically.
  30. 30. Genial tubercles  Two small prominences on the inner surface of the mandible on each side of the symphesis.  In extreme bone deposition it may located at crest of ridge. So the denture relief in their position
  31. 31. Denture foundation area  Foundation area on which the dental prosthesis rest.  The surface of oral vestibule to support the denture  The amount of force applied inversely proportional to the amount of surface area.
  32. 32. Stress bearing areas Primary stress bearing areas :Able to resist the vertical forces of occlusion, formed of cortical bone. In maxillary arch: The crest of the ridge.  The flat areas of the palate. In the mandibular arch: The buccal shelf area.  The crest of the ridge if well formed.
  33. 33. secondary stress bearing areas:areas that their histological nature and their inclined plane can resist the lateral force of occlusion and aid in resistance to the vertical forces. In maxillary arch: Rugae area.  Lateral slopes of the palate.  Labial and buccal surface of the ridge. In mandibular arch: all ridge slopes.
  34. 34. Relief areas  Portion of the denture that reduced to eliminate excessive pressure on specific part on the supporting tussue. In the maxillary arch and palate: Incisive papilla.  Median raphe.  Torus palatinus.  Sharp bony prominance.
  35. 35. In mandibular arch: Genial tubercle  Sharp mylohyoid ridge  Crest of a knife edge ridge  Mental foramen  Sharp bony prominance
  36. 36. Border structures that limits the periphery of the denture A- Maxillay denture: 1- The labial frenum  2- Labial vestibule  3- Buccal frenum  4- Buccal vestibule  5- Hamular notch  6- Vibrating line of the soft palate
  37. 37. B- Mandibular denture Facial border anatomy  1- Labial frenum  2- Labial vestibule  3- Buccal frenum  4- Buccal vestibule  5- Masseter muscle influencing area  6- Retromolar pad
  38. 38. B- Mandibular denture Lingual border anatomy  1- Palatoglassal arch  2- Lingual pouch  3- Sublingual salivary gland area  4- Lingual frenum
  39. 39. A. Maxillay denture 1. Labial frenum  It may be single or multiple, appearing as a fold of mucous membrane extending from the mucous lining of the lips toward the crest of the residual ridge on the labial surface
  40. 40. Labial vestibule  It extends on both sides from the labial frenum to the buccal frenum
  41. 41. Buccal frenum  It is a fold or folds of mucous membrane that extends from the mucous membrane reflection area to the crest of the residual ridge.
  42. 42. Buccal vestibule  It is the space distal to the buccal frenum. It is bounded externally by the cheek and internally by the residual ridge.
  43. 43. Hamular notch  It is a notch located between the maxillary tuberosity anteriorly and the pterygoid hamulous posteriorly.  The upper denture must extend between hamular notch of each side.
  44. 44. Vibrating line of the soft palate  The extension of the posterior palatal border of the upper denture depends on the functional activity of the soft palate.
  45. 45. B- Mandibular denture Labial frenum  It is a fold of mucous membrane that connects the mucosa of the lower lip to that of the alveolar process at the midline
  46. 46. Labial vestibule  That part of the denture that extends in this area is called the mandibular labial flange.
  47. 47. Buccal frenum  This is a fold of mucous membrane in the premolar area attaching the lip to the alveolar ridge.
  48. 48. Buccal vestibule  It extends posteriorly from the buccal frenum to the anterior border of the ramus of the mandible.
  49. 49. Masseter muscle influencing area  The distobuccal corner of the mandibular denture is in relation to the masseter muscle
  50. 50. Palatoglossal arch  It is formed by the palatoglossus muscle, over extension of the distolingual border of the lower denture will cause sore throat as a result of pressure on the muscle.
  51. 51. Lingual pouch  It is bounded posteriorly by palatoglossus muscle, anteriorly by the mylohyoid muscle, and medially by the lateral aspect of the tongue and laterally by the medial aspect of the mandible.
  52. 52. Sublingual salivary gland area  It should not be covered by the denture base.
  53. 53. Lingual frenum  It is a fold of mucous membrane that extends from the floor of the mouth to the under surface of the tongue in the midline.

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