anatomicl lan marks of maxilla

1. Surface Anatomy of the oral cavity
Oral cavity divided into vestibule & oral cavity proper
Vestibule further div into Labial & buccal
Vestibule bounded labially by labial & buccal mucosa,
Lingual – by the labial & buccal surface of teeth &
adjacent alv mucosa, Ant opening into vestibule is
through oral fissure
Superior & inferior boundaries of the vestibule are called
the fornix, they are the reflection of the oral mucosa from
lip & cheek into the alv ridge.

2. Anatomic landmarks
Maxillary arch

3. Labial Frenum:
Single or multiple – fold of MM Extending from the
mucous lining of mucous membrane of lip towards the
Crest of RR on labial surface. Maybe narrow or broad, has
no muscle fibers ,
can be excised if encroaches the ridge. It inserts in
vertical direction. accommodated by groove in the labial
flange of denture.

4. Labial Vestibule:
Extends on both sides from labial frenum to buccal
Frenum. The reflection of MM superiorly determines the
Height. No muscles.
Buccal frenum: fold / folds of MM vary in size &
position & Extends from the buccal mucous membrane
reflection area to the slop / crest of RR . No muscles
Direction of reflection is anteroposterior direction.

5. Buccal vestibule:
Space distal to buccal frenum to the hamular notch
bounded externally by cheek & internally by RR.
When vestibular space is properly filled with denture
Flange stability & retention of maxillary denture is greatly
Enhanced.
It is filled within the limitation imposed by malar process,
Buccinator, masseter muscle & coronoid of the mandible.

6. Maxillary tuberosity: (alveolar tubercle)
Bulbous extension of RR in the second or 3rd molar region
Terminating in hamular notch
Hamular notch:
Distal to MT, Narrow cleft extends from tubercle to the
ptrygoid hamulus. Ptrygomandibular ligament attaches
to the hamulus. Narrow cleft of loose CT approximately
2mm in extent A – P. houses the disto lateral termination
of denture base

7. Bony frame work consist of Posterior surface of MT-
anteriorly, tip of the lateral ptrygoid plate, pyramidal
process of palatal bone & medial ptrygoid plate with
hamular process posteriorly

8. Posterior palatal seal area:
“The soft tissue along the junction of hard &soft palate on
Which pressure within physiological limits of tissue can be
applied by a denture to aid in retention of denture”
Not a straight line, extends from one hamular notch to
Other.
Lies between the anterior and posterior vibrating lines.

9. AVL – Imaginary located at the junction of attached
tissue overlying the HP & movable tissue of immediately
Adjacent soft palate. Located by Valsalva maneuver /
“ah” with short vigorous bursts
PVL :Imaginary line at the junction of aponeurosis of
tensor veli pallatini & the muscular portion of the soft
Palate. Demarcates the part of soft palate that has
limited or shallow movements during function &
remaining soft palate that is markedly displaced during
Function. Visualized by “ah” in short un exaggerated
fashion. Marks the distal extension of denture base.

10. Fovea palatina
Glandular opening within the tissue of posterior portion of
hard palate. Two in number, one on each side of the mid
line.
Ductal opening into which the ducts of minor salivary
glands open.
Median palatal raphe:
Overlies the mid palatal suture. Contains little or no sub
mucosa, Cannot tolerate the stresses placed on it.
Needs relief within the denture base, relief compensates
for the movement of maxillary denture & potential
soreness.

11. Rugae:
Raised areas of dense CT radiating from median suture
In anterior one third of palate,
Considered as secondary stress bearing area, as it resist
anterior displacement of denture.
Incisive papilla:
Pad of fibrous CT overlying the orifice of nasopalatine
Canal, In dentulous mouth located between two central
incisors in palatal aspect . Relief area

12. Stress bearing area (Maxilla)
Primary: Crust of the residual alveolar ridge.
Secondary: rugae area
Relief areas: Median suture, incisive papilla

13. Mandibular Arch:

14. Mandibular Arch:
Labial frenum: Not as pronounced as maxilla.
Influenced By incisivus & orbicularis oris muscle.
Labial flange: Extends from LF – BF , limited inferiorly
by MM reflection, internally by RR & labially by lip.
Length not to exceed mucolabial fold.
Position – support to lower lip

15. Buccal frenum:
Overlies the depressor anguli oris ,extends from buccal
MM reflection to the slop or crest of RR. Reflection is in
A-P direction
Buccal vestibule:
Houses buccal flange, overlies horizontal shelf of bone
called buccal shelf,
The fibers of buccinator have attachment on the mucosa
& body of mandible, lateral to the molar teeth & out to
the external oblique line.

16. These fibers extends A- P & thus the tissue surface of
buccal flange rest upon the muscle.
At the D-B corner of the buccal flange ant fibers of
masseter when contracted will mold the denture border
by pressure on buccinator & MM – Massetric notch
Buccal shelf:
Bordered externally by external oblique line ,internally by
slop of RR. Bone in this area is very dense &
trabaculation is arranged at RT angles to the to the path
of jaw closure.
Force of occlusion can be directed rt angles to BSLF than
any other area of support

17. External oblique ridge:
Ridge of dense bone extending from just above the
mental foramen superiorly& distally, becoming cont with
the ant border of ramus of mandible.
Retromolar pad: Pear shaped pad. Aids in stability
of lower denture by adding another plane to resist
movement of the base.
Contains – Fibers of ptrygomandibular raphe, fibers of
superior phryngeal constrictor & buccinator muscle, fibers
of temporal tendon & glandular tissue

18. Position of RMP is fairly constant as alveolar resorption is
Not pronounced here.
Distal end of denture should cover as much of the pad as
possible.
Height of the pad may be used as a guide to determine
the occlusal plane of the denture.
The distal extension on RMP is limited by the anterior
border of ramus , temporal tendon, Buccinator muscle,
Ptrygomandibular raphe.

19. Retromolar papilla:
Small pear shaped area just anterior to retromolar pad it
is dense fibrous CT.
Lingual frenum: over lies genio glossus muscle.
Sublingual fold: Fold of MM from tongue to RR.

20. Alveolingual sulcus: Space between tongue &
alveolar ridge, its floor is mucosa covering the mylohyoid
muscle in the molar region, &mucosa covering the
sublingual gland anteriorly.
MyHy mucs has origin from the MyHy line of the mandible
Anterior portion of MyHy musc inserts into the median
raphe, posterior fibers also inserts into the median raphe
& anterior superior surface of body of hyoid. This
arrangement forms a sling across the body of mandible
& is referred to as muscular floor of mouth

21. Retromylohyoid space:
Lies at the distal end of alveolingual sulcus, bounded
medially by the anterior tonsillar piller, post by
retromylohyoid curtain (post by sup constrictor muscle,
lat by mandible & ptrygomandibular raphe, ant by lingual
tuberosity &inferiorly by mylohyoid muscle )

22. Distal Extension of alveolingual area:
Formed by Palato glossal arch, superior phryngeal
Constrictor, Mandibuloglossal muscle, Styloglossus.
The position of tongue & state of contraction of these
muscle & Hyoid musculature determine the distal
extension & curvature of disto lingual flange

23. Lingual flange:
Terminates at the distal end of alveolingual sulcus.
Maintains peripheral contact and avoids disturbing action
of lateral borders of the tongue.
Distolingual portion is influanced by glossopalatine &
superior constrictor muscle
Mylohyoid muscle influence the mid and anterior portion
of inferior border, movement of tongue and
Displaceability of floor of mouth determine the length of
flange at that area.
Anterior portion of lingual flange – sublingual cresent
area

24. Stress bearing area (Mandible)
Crust of the residual alveolar ridge, Buccal shelf area

25. Surface Anatomy of Face

26. Rima oris: Opening between lips / oral fissure
Philtrum: Vertical furrow in the midline of
upper lip Bounded laterally by a slight ridge.
Red/ Vermilion zone: Transitional zone
between skin & the oral mucosa.

27. Labial Tubercle: Slight mid line protrusion in the
red zone of upper lip, It gives the “cupids” bow
appearance of the upper lip.
Labial Commissure: Thin connecting fold at the
upper & Lower lip at the angle or corner of the mouth.
Modiolus: (hub of wheel) Bundle of tissue about 1cm
Lateral to the corner of mouth. Meeting place of eight
muscles – forms a distinct conical prominence at corner
of mouth

28. Contraction of modiolus presses the corner of mouth
against the premolar region so occlusal table is closed in
front , food crushed by premolars & molars does not
escape at the corner of mouth.
Modiolus represents the origin insertion or decussation of
Many fibers of various muscles of facial expression.
Zygomaticus major, Levator angulioris, incisivus
superioris, buccinator, depressor angulioris,
incisivusinferioris, orbicularis oris & risorius.

29. Nasolabial groove:
Oblique line from ala of nose to the superior edge of
modiolus, caused by repeated creasings of skin, as firm
mass of the upper lip is drawn upward under the more
fatty anterior region of cheek.
Labiomental groove: Between lower lip & chin & is convex
Upward

30. Labiomarginal sulcus: appears with
increasing age,
extends from the corner of mouth to the
inferior border of the mandible& is convex
posteriorly.