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ANATOMICAL LANDMARKS
OF MAXILLA
Dr. Shweta Thomas
MUCOUS MEMBRANE
• Composed of mucosa and submucosa
• The denture base rests on the mucous membrane which serves as a cushion
between the base and the supporting bone
• Mucosa is classified as :
• Masticatory
• Specialised
• Lining
Masticatory mucosa-
• mucosa covering the hard palate and crest of the residual ridge
• It is formed by keratinised stratified squamous epithelium and a
thin layer connective tissue lamina propria
Specialised mucosa- It covers the dorsal surface of the tongue
and is keratinized
Lining mucosa- It is nonkeratinised and it covers
lips,cheeks,sulcus,soft palate,ventral surface of tongue, and
slopes of residual ridge
Submucosa
• Formed by connective tissue
• It makes up the bulk of mucous membrane
• The support and stability depends on the thickness of
submucosa and its attachment to the underlying bone
• A dense firmly attached submucosa will successfully
withstand the pressure of the denture
• A thin layer can be easily traumatised
• A loosely attached layer is easily displaceable
LIMITING STRUCTURES
Labial frenum
Labial vestibule
Buccal frenum
Buccal vestibule
Hamular notch
Posterior palatal seal area
SUPPORTING STRUCTURES
PRIMARY STRESS BEARING AREA
Hard palate
Posterolateral slopes of residual alveolar ridge
SECONDARY STRESS BEARING AREA
Rugae
Maxillary tuberosity
Alveolar tubercle
RELIEF AREA
• Incisive papilla
• Cuspid eminence
• Mid-palatine raphe
• Fovea palatina
LIMITING STRUCTURES
They determine and confine the extent of the denture
• LABIAL FRENUM
 It is a fibrous band covered by mucous membrane that
extends from the labial aspect of the residual ridge to the
lip
 It has no muscle fibers
 Hence it is a passive frenum
 A v-shaped notch should be recorded during impression
making to accommodate the labial frenum
LABIAL VESTIBULE
• It is defined as the portion of the oral cavity
which is bounded on one side by the teeth,
gingiva and alveolar ridge(in the edentulous
mouth the residual ridge)and on other side by
the lips and cheeks
• The vestibule is covered by lining mucosa
BUCCAL FRENUM
• The buccal frenum seperates the labial
and buccal vestibule
• It attaches:
 levator anguli oris-attaches
beneath the frenum
orbicularis oris –pulls the frenum in
forward direction
 buccinator-pulls the frenum in
backward direction
• These muscle influences the position of
the buccal frenum hence it needs greater
clearance on the buccal flange of the
denture
BUCCAL VESTIBULE
• Is the area from the distal portion of the buccal
frenum to the hamular notch posteriorly.
• This space may be actual or potential and if a space
(postmalar pocket) exists it should be filled.
• The size of buccal vestibule varies with:
Contraction of buccinators
Amount of bone loss in the maxilla
HAMULAR NOTCH
• It is depression situated between the maxillary
tuberosity and the Hamulus of medial pterygoid plate.
• It is soft area of loose areolar tissue.
• The distolateral border of denture base rests in the
hamular notch.
• The denture border should extend till the hamular
notch.
POSTERIOR PALATAL SEALAREA(POSTDAM)
• It is defined as the soft tissue at or along the junction of
the hard and soft palate on which pressure within the
physiological limits of the tissues can be applied by a
denture to aid in the retention of the denture.
• This is the area of the soft palate that contacts the
posterior surface of the denture.
• It prevents air entry between the denture base and the
soft palate.
• It is the area between the anterior and posterior vibrating
line
Functions:
Aids in retention
Reduces the tendency for gag reflex
Prevents food accumulation
Compensates for polymerisation shrinkage
It can be divided into two regions based upon anatomical
landmarks
Pterygomaxillary seal
Postpalatal seal
PTERYGOMAXILLARY SEAL
This is the part of posterior palatal seal that extends across the
hamular notch(pterygomaxillary notch) and it extends 3-4 mm
anterolaterally to end in the mucogingival junction on the posterior
part of maxillary ridge.
The posterior extent of the denture in this region should end in the
hamular notch and not extend over the hamular process as this can
lead to severe pain during denture wear.
POSTPALATAL SEAL
This is a part of posterior palatal seal that extends between
the two maxillary tuberosity
The points should be remember while recording the
posterior palatal seal
The posterior border of the denture should not be
placed over the mid palatine raphe or the posterior
nasal spine
If there is a palatine torus which extends
posteriorly the tori should be removed
The position of fovea palatina also influences the
position of posterior border of denture.it can
extend 1-2mm across the fovea palatina
If a mid palatine fissure is present then the pps
should extent into it to obtain a good
peripheral seal
In patients with thick ropy saliva the fovea
palatina should be left uncovered or else the
thick saliva flowing between the tissue and
denture can increase the hydrostatic pressure
and displace the denture
DIFFERENT FORMS OF POSTERIOR PALATAL SEAL
(WINLAND AND YOUNG)
According to shape:
• Single bead scribed on the posterior vibrating line
• Double line scribed in the anterior and posterior
vibrating line
• Butterfly shaped pps
• Butterfly shaped pps with notching of posterior
vibrating line
• Butterfly shaped pps with notching of hamular notch
Variations used with different shaped soft palate based on
the classification
• Class I-a butterfly shape pps with 3-4mm width
• Class II-pps is narrow with 2-3mm of width
• Class III-a single beading made on the posterior
vibrating line
VIBRATING LINE
• The imaginary line across the posterior part of the palate
marking the division between the movable and immovable
tissues of the soft palate which can be identified when the
movable tissues are moving
• It marks when the individual says “ah”
• It extends from one hamular notch to other
• It passess about 2 mm infront of the fovea
palatina
• This line should lie on the soft palate
• The distal end of the denture must cover the
tuberosities and extend into hamular notch.it
should end 1-2mm posterior to the vibrating
line.
There is a presence of two vibrating lines:
1. Anterior vibrating line
2.Posterior vibrating line
ANTERIOR VIBRATING LINE
• An imaginary line lying at the junction between the
immovable tissues over the hard palate and the slightly
movable tissues of the soft palate.
• The anterior vibrating line is cupid bow shaped
• Due to the projection of posterior nasal spine ,the
anterior vibrating line is not a straight line between
both hamular process
• It can be located by asking the patient to perform
”Valsalva maneuvar” or by asking the patient to say
“ah” in short vigorous bursts.
• Valsalva maneuvar : the patient is asked to close his
nostrils firmly and gently blow through his nose.
POSTERIOR VIBRATING LINE
• An imaginary line is located at the junction of the soft
palate that shows limited movement and the soft palate
that shows marked movement
• The posterior vibrating line is an imaginary line at the
junction of aponeurosis of the tensor veli palatine
muscles and the muscular portion of the soft palate
• It is recorded by asking the patient to say “ah”in short
but normal vigorous fashion
• This line is usually straight
PRIMARY STRESS BEARING AREA
• HARD PALATE
1. The horizontal portion of hard palate lateral to the
midline act as primary supporting area
2. The trabecular pattern of bone is perpendicular to
the direction of force making it capable of withstanding
any amount of force
SUPPORTING
STRUCTURES
RESIDUAL RIDGE
• Defined as the portion of alveolar ridge and its soft tissue
covering which remains following the removal of teeth
• It resorbs rapidly following extraction and continue
throughout life in a reduced rate
• The submucosa over the ridge has adequate resiliency to
support the denture
SECONDARY STRESS BEARING AREA
RUGAE
• These are mucosal folds located in the anterior region
of palatal mucosa
• The folds of mucosa play an important role in speech
• Metal denture base reproduces this contour making it
very comfortable for patient
MAXILLARY TUBEROSITY
• It is bulbous extention of the residual ridge in the2nd
and 3rd molar region
• The posterior part ridge and the tuberosity are most
important parts of support because they are least likely
to resorb.
RELIEF AREAS
1. INCISIVE PAPILLA
• It is a midline structure situated behind the central incisors
• It is the exit point of nasopalatine nerves and vessels
• It should be relieved if not the denture will compress the
vessels or nerves and lead to necrosis of distributing areas
and paraesthesia of anterior palate
MIDPALATINE RAPHE
• It is the median suture area covered by a thin
submucosa
• This area is the most sensitive part of the
palate to pressure
FOVEA PALATINA
• The fovea is formed by the coalescence of the ducts of
several mucous glands
• This act as an arbitrary guide to locate the posterior
border of the denture
• The secretion of the fovea spreads as a thin film on the
denture through by aiding in retention
• In patients with thick ropy saliva the fovea palatina
should be left uncovered or else the thick saliva flowing
between the tissue and the denture can increase the
hydrostatic pressure & displace the denture
CUSPID EMINENCE
• It is a bony elevation on the residual alveolar
ridge formed after extraction of the canine
• It is located between the canine and 1st
premolar region
TORUS PALATINUS:
If the torus extends to the bony limits of
the palate leaving little or no room to place
the posterior border seal then its removal is
indicated
PALATAL THROAT FORM
HOUSE’S CLASSIFICATION
Class I-the soft palate is almost horizontal curving gently downwards
ClassII-the soft palate turns downwards at about45 degree angle from
the hard palate
ClassIII-the palate turns downwards sharply at about 70degree angle to
the hard palate
MUSCLES OF PALATE
Palate consists of 5 paired muscles
1. Tensor veli palatini muscle
2. Levator veli palatine muscle
3. Palatopharyngeus muscle
4. Palatoglossus muscle
5. Muscle of the uvula
TENSOR VELI PALATINI MUSCLE
• ORIGIN:
a) lateral side of auditory tube
b) adjoining part of the base of the skull
• INSERTION:
Pterygoid Hamulus ,passes through the origin of buccinator and
flattens out to form palatine aponeurosis
• ACTIONS:
Tightens the anterior part of soft palate ,opens the auditory tube to
equalize the air pressure between the middle ear and the
nasopharynx
LEVATOR VELI PALATINI
• ORIGIN:
a) medial aspect of auditory tube
b) adjoining part of inferior part of petrous temporal bone
• INSERTION:
It is inserted into the upper surface of palatine aponeurosis
• ACTION:
a) elevates soft palate and closes the pharyngeal isthumus
b) opens the auditory tube
MUSCULOUS UVULAE
• ORIGIN:
 Posterior nasal spine
 Palatal aponeurosis
• INSERTION:
 Mucous membrane of uvula
• ACTION:
 Pulls up the uvula
PALATOGLOSSUS
• ORIGIN:
Oral surface of palatine aponeurosis
• INSERTION:
a) descends in the palatoglossal arch
b) side of the tongue at the junction of its oral and pharyngeal parts
• ACTION:
a) Pulls up the root of the tongue
b) Approximate the palatoglossal arch
c) Closes the oropharyngeal isthumus
PALATOPHARYNGEUS
• ORIGIN:
Anterior fasciculus-posterior border of hard palate
• INSERTION:
a) Posterior border of the lamina of thyroid cartilage
b) wall of the pharynx and its median raphe
• ACTION:
Pulls up the wall of the pharynx and shortens it during swallowing
REFERENCE:
1.BOUCHER
2.WINKLER
THANK YOU

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Anatomical landmarks of maxila

  • 2. MUCOUS MEMBRANE • Composed of mucosa and submucosa • The denture base rests on the mucous membrane which serves as a cushion between the base and the supporting bone • Mucosa is classified as : • Masticatory • Specialised • Lining
  • 3. Masticatory mucosa- • mucosa covering the hard palate and crest of the residual ridge • It is formed by keratinised stratified squamous epithelium and a thin layer connective tissue lamina propria Specialised mucosa- It covers the dorsal surface of the tongue and is keratinized Lining mucosa- It is nonkeratinised and it covers lips,cheeks,sulcus,soft palate,ventral surface of tongue, and slopes of residual ridge
  • 4. Submucosa • Formed by connective tissue • It makes up the bulk of mucous membrane • The support and stability depends on the thickness of submucosa and its attachment to the underlying bone • A dense firmly attached submucosa will successfully withstand the pressure of the denture • A thin layer can be easily traumatised • A loosely attached layer is easily displaceable
  • 5. LIMITING STRUCTURES Labial frenum Labial vestibule Buccal frenum Buccal vestibule Hamular notch Posterior palatal seal area
  • 6. SUPPORTING STRUCTURES PRIMARY STRESS BEARING AREA Hard palate Posterolateral slopes of residual alveolar ridge SECONDARY STRESS BEARING AREA Rugae Maxillary tuberosity Alveolar tubercle
  • 7. RELIEF AREA • Incisive papilla • Cuspid eminence • Mid-palatine raphe • Fovea palatina
  • 8. LIMITING STRUCTURES They determine and confine the extent of the denture • LABIAL FRENUM  It is a fibrous band covered by mucous membrane that extends from the labial aspect of the residual ridge to the lip  It has no muscle fibers  Hence it is a passive frenum  A v-shaped notch should be recorded during impression making to accommodate the labial frenum
  • 9. LABIAL VESTIBULE • It is defined as the portion of the oral cavity which is bounded on one side by the teeth, gingiva and alveolar ridge(in the edentulous mouth the residual ridge)and on other side by the lips and cheeks • The vestibule is covered by lining mucosa
  • 10. BUCCAL FRENUM • The buccal frenum seperates the labial and buccal vestibule • It attaches:  levator anguli oris-attaches beneath the frenum orbicularis oris –pulls the frenum in forward direction  buccinator-pulls the frenum in backward direction • These muscle influences the position of the buccal frenum hence it needs greater clearance on the buccal flange of the denture
  • 11. BUCCAL VESTIBULE • Is the area from the distal portion of the buccal frenum to the hamular notch posteriorly. • This space may be actual or potential and if a space (postmalar pocket) exists it should be filled. • The size of buccal vestibule varies with: Contraction of buccinators Amount of bone loss in the maxilla
  • 12. HAMULAR NOTCH • It is depression situated between the maxillary tuberosity and the Hamulus of medial pterygoid plate. • It is soft area of loose areolar tissue. • The distolateral border of denture base rests in the hamular notch. • The denture border should extend till the hamular notch.
  • 13. POSTERIOR PALATAL SEALAREA(POSTDAM) • It is defined as the soft tissue at or along the junction of the hard and soft palate on which pressure within the physiological limits of the tissues can be applied by a denture to aid in the retention of the denture. • This is the area of the soft palate that contacts the posterior surface of the denture. • It prevents air entry between the denture base and the soft palate. • It is the area between the anterior and posterior vibrating line
  • 14. Functions: Aids in retention Reduces the tendency for gag reflex Prevents food accumulation Compensates for polymerisation shrinkage It can be divided into two regions based upon anatomical landmarks Pterygomaxillary seal Postpalatal seal
  • 15. PTERYGOMAXILLARY SEAL This is the part of posterior palatal seal that extends across the hamular notch(pterygomaxillary notch) and it extends 3-4 mm anterolaterally to end in the mucogingival junction on the posterior part of maxillary ridge. The posterior extent of the denture in this region should end in the hamular notch and not extend over the hamular process as this can lead to severe pain during denture wear.
  • 16. POSTPALATAL SEAL This is a part of posterior palatal seal that extends between the two maxillary tuberosity
  • 17. The points should be remember while recording the posterior palatal seal The posterior border of the denture should not be placed over the mid palatine raphe or the posterior nasal spine If there is a palatine torus which extends posteriorly the tori should be removed The position of fovea palatina also influences the position of posterior border of denture.it can extend 1-2mm across the fovea palatina
  • 18. If a mid palatine fissure is present then the pps should extent into it to obtain a good peripheral seal In patients with thick ropy saliva the fovea palatina should be left uncovered or else the thick saliva flowing between the tissue and denture can increase the hydrostatic pressure and displace the denture
  • 19. DIFFERENT FORMS OF POSTERIOR PALATAL SEAL (WINLAND AND YOUNG) According to shape: • Single bead scribed on the posterior vibrating line • Double line scribed in the anterior and posterior vibrating line • Butterfly shaped pps • Butterfly shaped pps with notching of posterior vibrating line • Butterfly shaped pps with notching of hamular notch
  • 20. Variations used with different shaped soft palate based on the classification • Class I-a butterfly shape pps with 3-4mm width • Class II-pps is narrow with 2-3mm of width • Class III-a single beading made on the posterior vibrating line
  • 21. VIBRATING LINE • The imaginary line across the posterior part of the palate marking the division between the movable and immovable tissues of the soft palate which can be identified when the movable tissues are moving • It marks when the individual says “ah” • It extends from one hamular notch to other
  • 22. • It passess about 2 mm infront of the fovea palatina • This line should lie on the soft palate • The distal end of the denture must cover the tuberosities and extend into hamular notch.it should end 1-2mm posterior to the vibrating line.
  • 23. There is a presence of two vibrating lines: 1. Anterior vibrating line 2.Posterior vibrating line
  • 24. ANTERIOR VIBRATING LINE • An imaginary line lying at the junction between the immovable tissues over the hard palate and the slightly movable tissues of the soft palate. • The anterior vibrating line is cupid bow shaped • Due to the projection of posterior nasal spine ,the anterior vibrating line is not a straight line between both hamular process • It can be located by asking the patient to perform ”Valsalva maneuvar” or by asking the patient to say “ah” in short vigorous bursts. • Valsalva maneuvar : the patient is asked to close his nostrils firmly and gently blow through his nose.
  • 25. POSTERIOR VIBRATING LINE • An imaginary line is located at the junction of the soft palate that shows limited movement and the soft palate that shows marked movement • The posterior vibrating line is an imaginary line at the junction of aponeurosis of the tensor veli palatine muscles and the muscular portion of the soft palate • It is recorded by asking the patient to say “ah”in short but normal vigorous fashion • This line is usually straight
  • 26. PRIMARY STRESS BEARING AREA • HARD PALATE 1. The horizontal portion of hard palate lateral to the midline act as primary supporting area 2. The trabecular pattern of bone is perpendicular to the direction of force making it capable of withstanding any amount of force SUPPORTING STRUCTURES
  • 27. RESIDUAL RIDGE • Defined as the portion of alveolar ridge and its soft tissue covering which remains following the removal of teeth • It resorbs rapidly following extraction and continue throughout life in a reduced rate • The submucosa over the ridge has adequate resiliency to support the denture
  • 28. SECONDARY STRESS BEARING AREA RUGAE • These are mucosal folds located in the anterior region of palatal mucosa • The folds of mucosa play an important role in speech • Metal denture base reproduces this contour making it very comfortable for patient
  • 29. MAXILLARY TUBEROSITY • It is bulbous extention of the residual ridge in the2nd and 3rd molar region • The posterior part ridge and the tuberosity are most important parts of support because they are least likely to resorb.
  • 30. RELIEF AREAS 1. INCISIVE PAPILLA • It is a midline structure situated behind the central incisors • It is the exit point of nasopalatine nerves and vessels • It should be relieved if not the denture will compress the vessels or nerves and lead to necrosis of distributing areas and paraesthesia of anterior palate
  • 31. MIDPALATINE RAPHE • It is the median suture area covered by a thin submucosa • This area is the most sensitive part of the palate to pressure
  • 32. FOVEA PALATINA • The fovea is formed by the coalescence of the ducts of several mucous glands • This act as an arbitrary guide to locate the posterior border of the denture • The secretion of the fovea spreads as a thin film on the denture through by aiding in retention • In patients with thick ropy saliva the fovea palatina should be left uncovered or else the thick saliva flowing between the tissue and the denture can increase the hydrostatic pressure & displace the denture
  • 33. CUSPID EMINENCE • It is a bony elevation on the residual alveolar ridge formed after extraction of the canine • It is located between the canine and 1st premolar region
  • 34. TORUS PALATINUS: If the torus extends to the bony limits of the palate leaving little or no room to place the posterior border seal then its removal is indicated
  • 35. PALATAL THROAT FORM HOUSE’S CLASSIFICATION Class I-the soft palate is almost horizontal curving gently downwards ClassII-the soft palate turns downwards at about45 degree angle from the hard palate ClassIII-the palate turns downwards sharply at about 70degree angle to the hard palate
  • 36. MUSCLES OF PALATE Palate consists of 5 paired muscles 1. Tensor veli palatini muscle 2. Levator veli palatine muscle 3. Palatopharyngeus muscle 4. Palatoglossus muscle 5. Muscle of the uvula
  • 37. TENSOR VELI PALATINI MUSCLE • ORIGIN: a) lateral side of auditory tube b) adjoining part of the base of the skull • INSERTION: Pterygoid Hamulus ,passes through the origin of buccinator and flattens out to form palatine aponeurosis • ACTIONS: Tightens the anterior part of soft palate ,opens the auditory tube to equalize the air pressure between the middle ear and the nasopharynx
  • 38. LEVATOR VELI PALATINI • ORIGIN: a) medial aspect of auditory tube b) adjoining part of inferior part of petrous temporal bone • INSERTION: It is inserted into the upper surface of palatine aponeurosis • ACTION: a) elevates soft palate and closes the pharyngeal isthumus b) opens the auditory tube
  • 39. MUSCULOUS UVULAE • ORIGIN:  Posterior nasal spine  Palatal aponeurosis • INSERTION:  Mucous membrane of uvula • ACTION:  Pulls up the uvula
  • 40. PALATOGLOSSUS • ORIGIN: Oral surface of palatine aponeurosis • INSERTION: a) descends in the palatoglossal arch b) side of the tongue at the junction of its oral and pharyngeal parts • ACTION: a) Pulls up the root of the tongue b) Approximate the palatoglossal arch c) Closes the oropharyngeal isthumus
  • 41. PALATOPHARYNGEUS • ORIGIN: Anterior fasciculus-posterior border of hard palate • INSERTION: a) Posterior border of the lamina of thyroid cartilage b) wall of the pharynx and its median raphe • ACTION: Pulls up the wall of the pharynx and shortens it during swallowing