This document discusses the anatomical landmarks of the maxilla that are important to consider when fabricating a removable denture. It outlines the limiting structures like the labial and buccal frenums and vestibules. The supporting structures that provide areas of support are described as the hard palate, posterior slopes of the residual ridge, and maxillary tuberosity. Relief areas like the incisive papilla are also indicated that should be relieved in the denture to avoid pressure on delicate tissues. Understanding these anatomical structures is key to designing a retentive and comfortable maxillary denture.
A Complete presentation explaining the complete morphology of Maxillary first molar, for the benefit of people like me who tried and failed to find everything in one package
A number of theories have been put forward for impressions. each having its own advantage and disadvantage.
Different spacers guide and aid in in making the desired impression with adequate pressure in the desired region of the arch in maxilla and mandible. different materials are used for spacers depending on the need.
A Complete presentation explaining the complete morphology of Maxillary first molar, for the benefit of people like me who tried and failed to find everything in one package
A number of theories have been put forward for impressions. each having its own advantage and disadvantage.
Different spacers guide and aid in in making the desired impression with adequate pressure in the desired region of the arch in maxilla and mandible. different materials are used for spacers depending on the need.
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DEVELOPMENT OF ENAMEL
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PHYSICAL PROPERTIES
CHEMICAL PROPERTIES
STRUCTURE OF ENAMEL
DEVELOPMENT OF ENAMEL
EPITHELIAL ENAMEL ORGAN
AMELOGENESIS
LIFE CYCLE OF AMELOBLASTS
AGE CHANGES IN ENAMEL
DEFECTS OF AMELOGENESIS
CLINICAL IMPLICATIONS
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3. LIMITING STRUCTURES IN MAXILLA
Labial frenum
Labial vestibule
Buccal frenum
Buccal vestibule
Hamular notch
Posterior palatal seal area
4. LABIAL FRENUM
Fibrous band covered by mucous membrane
Extends from labial aspect of residual ridge to lip
Has no muscle fibres
Passive frenum
V-shaped notch recording during impression making to accommodate the labial
frenum
Labial notch of denture should be narrow but deep to avoid interference
5.
6. LABIAL VESTIBULE
Defined as, “that portion of the oral cavity which is bounded on one side by the teeth,
gingiva, and alveolar ridge (in the edentulous mouth, the alveolar ridge) and on the
other side by the lips and cheeks”.
Runs on buccal frenum on one side to the other side of the ridge
Divided in to two compartments by the labial frenum
Vestibule is covered by lining mucosa
Orbicularis oris is the main muscle of the lip. Its tone depends on support received
from labial flange of denture and position of artificial teeth. Fibres run horizontally
and has indirect displacing effect on denture
7.
8. BUCCAL FRENUM
Separates labial and buccal vestibule
Has attachments of following muscles:
Levator anguli oris – attaches beneath the frenum
Orbicularis oris – pulls frenum in forward direction
Buccinator – pulls frenum in backward direction
Muscles influence position of buccal frenum hence it needs
greater (wider and relatively shallower) clearance on buccal
flange of denture
9.
10. BUCCAL VESTIBULE
Extends from buccal frenum anteriorly to hamular notch
posteriorly
Size of buccal vestibule varies with the:
Contraction of buccinator
Position of mandible
Amount of bone loss in maxilla
Ramus and coronoid process of mandible and masseter modify
the size of this vestibule during mouth opening
11.
12. HAMULAR NOTCH
Depression situated between the maxillary tuberosity and hamulus of medial
pterygoid plate
Soft area of loose areolar tissue
Tissues in this region can be displaced to achieve posterior palatal seal
Distolateral border of denture rests in hamular notch
Denture border should extend till hamular notch
If border located anteriorly near maxillary tuberosity, denture will not have
retentive properties because the border seal is absent over non-resilient tissues
13.
14. POSTERIOR PALATAL SEAL
Defined as, “that portion of the intaglio surface of a maxillary removable
complete denture, located at its posterior border, which places pressure, within
physiologic limits, on the posterior palatal seal area of the soft palate; this seal
ensures intimate contact of the denture base to the soft palate and improves
retention of the denture”
Posterior palatal seal area: “the soft tissue area limited posteriorly by the
distal demarcation of the movable and non-movable tissues of the soft palate
and anteriorly by the junction of hard and soft palates on which pressure, which
physiologic limits, can be placed; this seal can be applied by a removable
complete denture to aid in retention.”
15. POSTERIOR PALATAL SEAL
Area of soft palate that contacts posterior surfaces of denture
base
Prevents air entry b/w denture base and soft palate
Area b/w anterior and posterior vibrating lines
Can be divided into two regions:
Pterygomaxillary seal
Postpalatal seal
16. FUNCTIONS OF POSTERIOR PALATAL SEAL
Aids in retention by maintaining constant contact with soft palate during
functional movements like speech, mastication, and deglutition
Reduces tendency for gag reflex as it prevents formation of gap between
denture base and soft palate during functional movements
Prevents accumulation of food b/w posterior border of denture and soft
palate
Compensates for polymerization shrinkage
17.
18. SUPPORTING STRUCTURES OF MAXILLA
Primary stress bearing areas:
Hard palate
Postero-lateral slopes of the residual alveolar ridge
Secondary stress bearing areas:
Rugae
Maxillary tuberosity / alveolar ridge
19. HARD PALATE
Divided into anterior and posterior parts
Posterior part consists of glandular tissue
which aids in retention but does not provide
significant support for denture because of
higher resiliency at this site
Mucous glands in this region are relatively
thick
21. RUGAE
Mucosal folds located in anterior region of
palatal mucosa
Acts as secondary support area
Folds of mucosa play an important part in
speech
Metal denture bases reproduce this
contour making it very comfortable for the
patient
22. MAXILLARY TUBEROSITY
Bulbous extension of residual ridge in the
second and third premolar region
Posterior part of ridge and tuberosity areas
are considered as one of the most important
areas of support because they are least likely
to resorb
Rough prominence formed behind position of
last tooth called the alveolar tubercle
23. RELIEF AREAS OF MAXILLA
These areas resorb under constant load. Contain fragile structures within. Denture
should be designed such that the masticatory load is not concentrated over these
areas.
Incisive papilla
Mid-palatine raphe
Fovea palatinae
Cuspid eminence
24. INCISIVE PAPILLA
Mid-line structure situated behind the central incisors
Exit point of nasopalatine nerves and sphenopalatine vessels
It should be relieved. If not, denture will compress nerves and vessels, leading to
necrosis of distributing areas and paresthesia of anterior palate
25. MID-PALATINE RAPHE
Median suture area covered by thin
sub-mucosa
Should be relieved during denture
fabrication
This area is most sensitive part of
palate to pressure
26. FOVEA PALATINAE
Formed by coalescence of ducts of several mucous glands
Acts as an arbitrary guide to locate posterior border of denture
Denture can extend 1-2mm beyond the fovea palatinae
Secretion of fovea spreads as a thin film on the denture thereby aiding in retention
In patients with thick ropy saliva, fovea should be left uncovered or else thick saliva
flowing b/w tissue and denture can increase hydrostatic pressure and displace the
denture
27.
28. CUSPID EMINENCE
Bony elevation on residual alveolar ridge formed after extraction of canine
Located between canine and first premolar region