Prosthesis - 2nd Dental year

1. Introduction to Dentures
Lecturer
Hatem Dousouky Ahmad

2. TerminologyTerminology
•Prosthetics
•Prosthesis
•Prosthodontics
•Dentulous
•Edentulous
•Partially edentulous
•Complete Denture
•Partial Denture
•Immediate denture

3. Complete Denture
“A prosthesis that replaces the lost natural dentition and associated
structures of the mandible and / or the maxilla “ .
Definitions :
Component Parts :
Denture Base
Denture Flange
Denture Border (Edge)
Denture Surfaces :
Fitting Surface
Polished Surface
Occlusal Surface

4. Complete denture consists ofComplete denture consists of

5. Objectives in complete denture constructionObjectives in complete denture construction::
1. Restoration of mastication.
2. Restoration of facial dimensions and
contours.
3. Restoration of speech.
4. Restoration of the remaining natural
tissues.
5. Satisfaction and comfort of the patient.

6. Anatomical Landmarks In
Relation to Complete Denture:
• Extraoral
landmarks
• Intraoral
landmarks

7. Changes The Happened After Teeth Loss :
Face :

8. Inter pupillary line
Ala Tragus Line
Philtrum
Naso – Labial sulcus
Labiomental sulcus
Extra Oral Landmarks
Angle of the mouth
Vermillion borderModiolus

10. Landmarks of Importance in
Occlusal Plane Orientation
Interpupillary line Ala tragus line

11. Landmarks restored by proper
lip support
• Naso – Labial sulcus
Becomes deeper with age
and with loss of teeth
• Philtrum
becomes flat with loss of teeth
• Modiolus
moves inwards and downwards
• Vermillion border
becomes reduced in size

12. Landmarks restored by Proper
Vertical Dimension
• Vermillion border
• Angle of the mouth
becomes inflammed  angular cheilitis

14. The Labiomental Sulcus
Angle Class I Angle Class II Angle Class III
A Landmark helpful in determining the Jaw Relation

15. Intraoral Landmarks
• Maxilla
Supporting structures
&
Limiting structures
• Mandible
Supporting structures
&
Limiting structures

17. Maxillary Supporting Structures
Incisive Papilla
• 1 . The incisive papilla is a thick part of the
mucous membrane covering
• the incisive foramen.
• 2 . It is located at the anterior end of the median
palatine raphae .
• 3 . The nasopalatine nerves and vessels pass
through the incisive foramen
• to supply the anterior 2 / 3 of the palate.
• 4 . In some cases due to the excessive bone
resorption, the papilla may lie
• on the crest of the ridge.
• 5 . The incisive papilla should be relieved to
avoid pressure on the incisive
• nerves and vessels.

18. Cont. max. supporting structures
Rugae Area
Palatine Rugae
1 . It is an irregular shaped elevation of the soft tissue extending
laterally from the midline in the anterior part of the hard palate.
2 . If serves as one of stress bearing area in the palate .

19. Cont. max. supporting structures
Median Palatine Raphae
Median Palatine Raphae
1 . The midline of the hard palate is covered by a thin layer of
mucoperiostium , that covers the median palatine suture .
2 . That suture joins the right and the left halves of the hard palate.
3 . It is usually relieved to increase denture stability by preventing its rocking .

20. Cont. max. supporting structures
• Torus Palatinus
When small  relieved
When large  surgical excision

21. Cont. max. supporting structures
Fovia Palatina
Fovea Palatina
1 . It is helps in the determination of the posterior border
of the upper denture.
2 . The posterior border of the upper denture should be 2 mm
posterior to the fovea Palatina .

22. Residual Alveolar Ridge
Cont. max. supporting structures
Residual Alveolar Ridge
1 . It should be firm .
2 . since it is usually well developed, it might
be considered as a primary stress bearing area.

23. Cont. max. supporting structures
Tuberosity
Tuberosity
1 . It is important for retention and support of the upper denture
against lateral movement.
2 . The denture should cover it .

24. Cont. max. supporting structures
Buttress Part Of Bone
Buttress Part Of Bone
1 . It is formed of the lower portion of the zygomatic process of the maxilla
(the area above the first molar teeth) .
2 . It provides excellent resistance to the vertical forces(Support).

25. Labial Frenum
Maxillary Limiting Structures
Labial Frenum
It must be relieved in the denture by making a V-shape notch
in the labial flange opposite to its position .
Labial Frenum

26. Labial Vestibule
Cont. Maxillary Limiting Structures
Labial Vestibule
1 . It Is the reflection of the mucosa of the lip to the mucosa of the
alveolar process in the labial vestibule.
2 . The denture in this area is in relation to the orbicularis oris and the
superior incisive muscles .
3 . These muscles limit the thickness and the length of the labial flange
of the denture.

27. Buccal Frenum
Cont. Maxillary Limiting Structures
Buccal Frenum
1 . It is a fold of mucous membrane (tendon of the buccinator muscle)
varies in size in number and in position .
2 . A notch is made in the denture flange opposite to its position to
facilitate its functional movements.

28. Buccal Vestibule
Cont. Maxillary Limiting Structures
Buccal Vestibule
1 . The denture in this area is related to buccinator muscle.
2 . Buccal flanges must extend in the buccal vestibule .
3 . Due to the horizontal direction of the fibers of this muscle contraction
of this muscle will not displace the denture.

29. Cont. Maxillary Limiting Structures
Hamular Notch
Hamular Notch
1 . It is one of the important landmarks for determination of the posterior
limit of the upper denture .
2 . A straight line from hamular notch on one side to the other on the other
side determine the posterior limit of the upper denture

30. Vibrating Line
( Ah Line)
Cont. Maxillary Limiting Structures
Vibrating Line
( Ah Line)
1 . It separate the movable part from the immovable part of the soft palate.
2 . This line is 2mm posterior to the fovea palatine .
3 . This line determines the posterior end of the upper denture.
Postdam area

31. Cont. Maxillary Limiting Structures
• Curvature of the soft palate
III
II
I
Class I  gentle curvature
Class II  medium curvature
Class III  abrupt curvature

34. Labial Frenum
Mandibular Limiting Structures
Labial Frenum
Denture should be notched
opposite to it.

35. Cont. Mandibular Limiting Structures
• Labial Vestibule
Labial Vestibule
Limits the denture flange
thickness and length.

36. Buccal Frenum
Cont. Mandibular Limiting Structures
1 . It is a fold of mucous membrane in the premolar area, movement of
the lip and the cheek move the frenum .
2 . A notch is made in the lower denture to accommodate the frenum.
Buccal Frenum

37. Buccal Vestibule
Cont. Mandibular Limiting Structures
Buccal Vestibule
1 . The denture in this area is related to the buccinator muscle .
2 . Its contraction does not displace the lower denture so flanges of
the lower denture must extend in the buccal vestibule.

38. Cont. Mandibular Limiting Structures
• Masseter muscle influencing area
• Masseteric notch
Distobuccal area

39. Cont. Mandibular Limiting Structures
• Posterior end of retromolar pad
Posterior end
of retromolar pad
• It constitutes the posterior limit of the lower denture
at which postdamming can be performed.

40. Cont. Mandibular Limiting Structures
• Palatoglossal arch
Distolingual area
Denture overextension in this
area will cause sore throat.

41. Lingual Pouch
Cont. Mandibular Limiting Structures
More posteriorly the lingual flanges are related to the lingual pouch with
its boundaries which are :
Posteriorly : The palatoglosssus muscle .
Anteriorly : The Mylohyoid muscle.
Medially : The tongue .
Laterally : The medial aspect of the mandible.
Lingual Pouch
Lingual pouch

42. Cont. Mandibular Limiting Structures
• Mylohyoid muscle influencing area
(internal oblique ridge)
Mylohyoid muscle
influencing area
Mylohyoid muscle
influencing area

43. Sublingual salivary
gland area
Cont. Mandibular Limiting Structures
Sublingual salivary
gland area
The lingual flanges of the lower denture should not extend in this area
because with excessive resorption of the mandible the gland may
bulge superiorly above the body of the mandible.
Sublingual salivary
gland area

44. Lingual Frenum
Cont. Mandibular Limiting Structures
Lingual Frenum
1 . More anteriorly a fold mucous membrane attach the mucosa of the
tongue tip to mucosa of the floor of the mouth
2 . It moves with the movement of the tongue so a notch is made to
accommodate the frenum.

45. Michael H. Hart
(born April 28, 1932 in New York City)
• Graduate of the Bronx High School of
Science, received his undergraduate degree
at Cornell University in mathematics and
later earned a Ph.D. in astrophysics at
Princeton University. He also holds
graduate degrees in physics, astronomy,
and computer science, as well as a law
degree. He was a research scientist at
NASA before leaving to be a professor of
physics at Trinity University in San
Antonio, Texas.

48. ...‫مسلم‬ ‫بأنك‬ ‫تفخر‬ ‫وأنت‬ ‫سنين‬ ‫منذ‬
‫بك؟؟‬ ‫السل م‬ ‫ليفخر‬ ‫فعلت‬ ‫فماذا‬
•‫ال‬ ‫صصلى‬ ‫الص‬ ‫رسصول‬ ‫أصن‬ ‫عنصه‬ ‫الص‬ ‫رضصي‬ ‫هريرة‬ ‫أصبي‬ ‫عصن‬
‫أخبركم‬ ‫أل‬ ) ‫فقال‬ ‫جلوس‬ ‫أناس‬ ‫علصى‬ ‫وقصف‬ ‫وسصلم‬ ‫عليصه‬
‫ثل ث‬ ‫ذلك‬ ‫فقال‬ ، ‫فسصكتوا‬ : ‫قال‬ ( ‫شركصم‬ ‫مصن‬ ‫بخيركصم‬
‫من‬ ‫بخيرنا‬ ‫أخبرنا‬ ‫ال‬ ‫رسول‬ ‫يا‬ ‫بلى‬ : ‫رجل‬ ‫فقال‬ ، ‫مرات‬
‫وشركم‬ ‫شره‬ ‫ويؤمن‬ ‫خيره‬ ‫يرجى‬ ‫من‬ ‫خيركم‬ ) ‫قال‬ ، ‫شرنا‬
.‫الترمذي‬ ‫رواه‬ ( ‫شره‬ ‫يؤمن‬ ‫ول‬ ‫خيره‬ ‫يرجى‬ ‫ل‬ ‫من‬
•‫تعالى‬ ‫ال‬ ‫إلى‬ ‫العباد‬ ‫أحب‬
‫لعياله‬ ‫أنفعهم‬

49. Residual Ridge
Mandibular Supporting Structures
Residual Ridge
(Fibrous band of
connective tissue)
1. It covers the crest of the lower ridge.
2. Its mobility may cause pressure symptoms under the lower denture.
3 . Also can affect denture stability .

50. Cont. Mandibular Supporting Structures
External oblique ridge
External obique ridge

51. Buccal Shelf
Of Bone
Cont. Mandibular Supporting Structures
Buccal Shelf Of Bone
1 . The area that lies between the crest of the residual ridge and
the external oblique ridge.
2 . It is the primary stress bearing area in the lower arch .
3 . It forms good support for the lower denture .

52. Retromolar pad
Cont. Mandibular Supporting Structures
Retromolar pad
1 . It is a pear shaped area of mucous membrane at the posterior end of the
mandibular ridge and anterior to the pterygo­mandibular raphae .
2 . It consists of mucous glands , temporal tendon , fibers of the
buccinators and superior constrictor muscle .
3 . Lower denture should cover this area for retention and to cover
the buccal shelf of bone (Primary stress bearing area) it act as valve seal
area for the lower denture.

53. Cont. Mandibular Supporting Structures
Torus mandibularis
When small  relieved
When large  surgical excision
Torus mandibularis

55. Cont. Mandibular Supporting Structures
• Internal oblique ridge
• Internal oblique ridge
• If sharp, it should be
surgically reduced.

56. Cont. Mandibular Supporting Structures
• Mental foramen
•When the ridge is resorbed,
it appears on its crest .
• Since it covers nerves,
it should be relieved.

57. Cont. Mandibular Supporting Structures
• Genial tubercles
•When the ridge resorbed,
it appears on its crest .
•It is relieved or better
surgically reduced

59. THANK YOUTHANK YOU