Biologic considerations in edentulous mandibular arches/ dental crown & bridge courses

BIOLOGICBIOLOGIC
CONSIDERATIONS INCONSIDERATIONS IN
EDENTULOUSEDENTULOUS
MANDIBULAR ARCHESMANDIBULAR ARCHES
INDIAN DENTAL ACADEMY
Leader in Continuing Dental Education
www.indiandentalacademy.comwww.indiandentalacademy.com

INFORMATION
EXAMINATION
HISTORY
VISUAL
DIGITAL

CONTENTS
•ANATOMY OF MANDIBLE
•PHYSIOLOGY OF BONE
•MUCOUS MEMBRANE
•MYOLOGY
•DENTURE LIMITING STRUCTURES
•PROSTHETIC CONSIDERATIONS
•SUMMARY

 ANATOMY OF MANDIBLE
 MOVABLE MEMBER OF STOMATOGNATHIC
SYSTEM
 LARGEST AND STRONGEST BONE OF THE
FACE
 “DIPLOIC BONE”-- CONSISTS OF THE INNER
AND OUTER TABLE OF COMPACT BONE WITH
AN INTERVENING POROUS LAYER WHICH IS
OCCUPIED BY SPONGY SUBSTANCE
CONSISTING OF BONE MARROW
 ON GROSS STRUCTURE IT CAN BE DIVIDED
INTO FIVE PROCESSES

EXTERNAL OBLIQUE RIDGE
 FROM THE MENTAL FORAMEN IT EXTENDS SUPERIORLY AND
DISTALLY BECOMING CONTINUOUS WITH THE ANTERIOR
BORDER OF RAMUS
 ANATOMIC GUIDE FOR LATERAL TERMINATION OF BUCCAL
FLANGE OF DENTURE

 BUCCAL SHELF AREA
 DESIGNATED AS PRIMARY STRESS BEARING AREA
ITS DENSITY,MUCOSAL COVERING,AND ITS RELATION TO
VERTICAL CLOSURE OF JAW IS FAVOURABLE
BOUNDED ANTERIORLY BY THE BUCCAL FRENUM AND
POSTERIORLY BY THE RETROMOLAR PAD,LATERALLY BY
EXTERNAL OBLIQUE RIDGE AND MEDIALLY BY THE SLOPE
OF THE RESIDUAL ALVEOLAR RIDGE

 MYLOHYOID LINE
 IS AN IRREGULAR, ROUGH BONY CREST
EXTENDING FROM THE 3RD
MOLAR REGION TO THE LOWER
BORDER OF THE MANDIBLE IN THE REGION OF THE CHIN
DENTURE FLANGE SHOULD EXTEND INFERIOR TO THE LINE
IF PROMINENT – SURGICAL INTERVENTION

 LINGUAL TUBEROSITY
 IRREGULAR AREA OF BONY PROMINENCE AT DISTAL TERMINATION OF
THE MYLOHYOID LINE
 IF EXCESSIVELY PROMINENT OR ROUGH IT MAY PRESENT A
UNDESIREABLE UNDERCUT
 GENIAL TUBERCLES
 SHARP BONY PROJECTIONS IN THE MIDLINE
 IF RESORPTION IS EXTENSIVE THEN THEY ARE PLACED SUPERIORLY---
SURGICAL INTERVENTION

 PHYSIOLOGY OF BONE
 BONE IS A DYNAMIC TISSUE WHICH IS IN CONTINUOUS
FLUX THROUGHOUT LIFE
DESTRUCTION OF OLD BONE IS BY OSTEOCLAST AND
FORMATION OF NEW BONE IS BY OSTEOBLAST
DIFFERENTIAL RATE OF RECONSTRUCTION..
 BONE CONSTANTLY ADAPTS TO ACCOMMODATE THE
FUNCTIONAL DEMANDS OF A PERSON
 ACCORDING TO WOLFF’S LAW , CHANGE IN FORM FOLLOWS A
CHANGE IN FUNCTION OWING TO ALTERATION OF INTERNAL
ARCHITECTURE AND EXTERNAL CONFORMATION OF BONE IN
ACCORDANCE WITH MATHEMATICAL LAWS
 BUT CONTINUOUS PRESENCE OF THE DENTURE--- PRESSURE
OF SUFFICIENT INTENSITY---RESORPTION
 PARTICULARLY TRUE IN CASE OF MANDIBULAR DENTURE
WHERE GRAVITY EXERTS STEADY PULLwww.indiandentalacademy.comwww.indiandentalacademy.com

 PRESSURE TO BONE COVERED BY PERIOSTEUM DISRUPTS
BLOOD CIRCULATION---- RESORPTION
 HENCE DENTURES SHOULD BE REMOVED ATLEAST 8 HRS
OUT OF EVERY 24 HRS
 ALVEOLAR PROCESS IS THE BONY SUPPORT MOST
AFFECTED BY RESORPTION
 AFTER EXTRACTION THERE IS LOSS OF BONE …… FORMATION
OF COMPACT LAMELLAE AT SURFACE OF THE SCAR
ACCORDING TO CRADDOCK- RESORPTION TAKES PLACE IN 2 STAGES
1) EARLY RESORPTION ---PART OF HEALING PROCESS
2) DELAYED RESORPTION--- INEVITABLE SEQUELAE
 RATE OF CONTOUR CHANGES REACHES PEAK WITHIN 3-4TH
WEEK AFTER EXTRACTION AND IS CONTINUOUS UPTO 4-5TH
MONTH
 HENCE A WAITING PERIOD OF ---- SIX WEEKS TO TWO MONTHS

Alveolar measurementsAlveolar measurements
Incisal edge to vestibuleIncisal edge to vestibule 19mm19mm
Alveolar crest toAlveolar crest to
vestibulevestibule
10mm10mm
 BONE HEIGHT -- MANDIBULAR

Alveolar MeasurementsAlveolar Measurements
Occlusal plane toOcclusal plane to
inferior borderinferior border
40mm40mm
Mental nerve toMental nerve to
15mm15mm
Alveolar crest toAlveolar crest to
32mm32mm

CLASSIFICATION OF ALVEOLAR ATROPY
 TYPE I: Residual bone height of 21mm or
greater measured at the least vertical height of
the mandible.
TYPE II: Residual bone height of 16-20 mm
measured at the least vertical height of the
mandible
TYPE III: Residual alveolar bone height of 11-15
mm measured at the least vertical height of the
mandible
 TYPE IV: Residual vertical bone height of 10
mm or less measured at the least vertical height
of the mandible

 ORAL MUCOUS MEMBRANE
 ONE OF THE PRIME FACTORS FOR THE SUPPORT OF THE
DENTURE
 MUCOUS MEMBRANE IS COMPOSED OF MUCOSA AND
SUBMUCOSA
MUCOSA IS FORMED BY STRATIFIED SQUAMOUS MEMBRANE –
KERATINISED OR NON KERATINISED
SUBMUCOSA IS FORMED BY THE CONNECTIVE TISSUE THAT
VARIES IN CHARACTER…
SUBMUCOSA IS FIRMLY ATTACHED TO THE UNDERLYING
PERIOSTEUM
WHEN LOOSELY ATTACHED TO THE PERIOSTEUM, THE TISSUE
IS EASILY DISPLACEABLE– STABILITY AND SUPPORT
ADVERSELY AFFECTED
THICKNESS AND CONSISTENCY RESPONSIBLE FOR SUPPORT…


 DENTURE IS SURROUNDED BY CHEEK AND LIPS WHICH IS
COVERED BY LINING MUCOSA
IT IS IN INTIMATE CONTACT WITH DENTURES DURING
FUNCTIONING OF RELATED MUSCLES---- “FACIAL DRAPE”
LINGUAL SURFACES ARE ALSO LINING MUCOSA --- INTIMATE
CONTACT WITH THE TONGUE AND ITS SPECIALISED MUCOSA
MUCOSA OF ALVEOLAR RIDGE– MASTICATORY MUCOSA – IS
FIRM,RESILIENT AND STIPPLED
IS KERATINISATION A FACTOR FOR SUPPORT ?
ACCORDING TO CHARLES .I. NEDELMAN AND SOL .BERNICK “THE
EPITELIUM UNDER THE DENTURE EXHIBITED DECREASE IN THE
DEGREE OF KERATINISATION AND AN INCREASE IN DEGREE OF
KERATINISATION WAS NOTED IN RIDGES WHERE NO DENTURES
HAD BEEN WORN”

 EFFECTS OF FUNCTION AND PARA FUNCTION
FUNCTION AND PARAFUNCTION– DISPLACES THE SOFT
TISSUES
THERE IS INITIAL ELASTIC DISPLACEMENT OR COMPRESSION –
FOLLOWED BY DELAYED ELASTIC COMPRESSION
AFTER REMOVAL OF LOAD THERE IS INSTANTANEOUS ELASTIC
RECOVERY----- CONTINUED BY DELAYED ELASTIC RECOVERY
HUMAN SOFT TISSUE TAKES 4 HRS TO RECOVER AFTER
MODERATE LOADING FOR 10 MINUTES

 AGE CHANGES IN MUCOSA
 ACCORDING TO CHARLES .I. NEDELMAN AND SOL .BERNICK
-ALVEOLAR AND GINGIVAL ARTERIES EXHIBITED ARTERIOSCELROSIS
-COLLAGEN UNDERGOES PHYSICAL AND CHEMICAL CHANGES “ DECREASE
-EXTENSIBILITY OF COLLAGEN DIMINISHES REBOUND
-DECREASE IN RATIO OF GROUND SUBSTANCE TO COLLAGEN CAPACITY”
-DECREASE IN WATER CONTENT
 “ LYTLE AND KYDD AND DALY HAD ADVOCATED THAT SOFT
TISSUE CONDITIONING AND REMOVAL OF DENTURES FOR SPECIFIC
TIME PERIODS BEFORE MAKING NEW IMPRESSION ALLOWED THE
TISSUE TO ASSUME NORMAL STATE”
BUT IF CHANGES ARE IRREVERSIBLE, NEED TO INCREASE
MANDIBULAR BASE FORM OF DENTURES AND EFFICIENCY OF THE
TOOTH FORMS TO COMPENSATE THE FORCES EXERTED UPON
RIDGES BECOMES EVIDENT

 MYOLOGY
 MUSCLES OF FACIAL EXPRESSION
 DO NOT INSERT INTO BONE AND NEED SUPPORT OF THE
TEETH FOR PROPER FUNCTION
IF NOT SUPPORTED NONE OF THE FACIAL EXPRESSION
APPEAR NORMAL
 NASOLABIAL SULCUS , PHILTRUM,COMMISSURE,
MENTOLABIAL SULCUS WILL NOT HAVE NORMAL
APPEARANCE
LOSS OF SUPPORT ALLOWS SAGGING
 STRETCHING RETARDS NORMAL CONTRACTURE OF
MUSCLES-- INCORRECTLY POSITIONED TEETH OR
INCORRECTLY CONTOURED DENTURE BASE ---- AFFECTS
NORMAL TONICITY

 MENTALIS MUSCLE
 ELEVATES THE SKIN OF CHIN AND TURNS THE LOWER LIP
OUTWARD
 ORIGIN EXTENDS TO A LEVEL HIGHER THAN THAT OF FORNIX
OF VESTIBULE --- WHILE CONTRACTING IT RENDERS THE
VESTIBULE SHALLOW

 BUCCINATOR
 IT IS A WIDE RATHER THAN THIN MUSCLE PLATE
 ARISES FROM THIN HORSE SHOE TYPE LINE FROM SURFACE
OF MAXILLA AND MANDIBLE OPPOSITE THE SOCKETS OF 1ST
MOLAR
EXTENDS FROM MODIOLUS TO THE PTERYGOMANDIBULAR
RAPHE
MUSCLE BECOMES A PART OF THE DENTURE BEARING AREA
ACTION IS PARALLEL TO PLANE OF OCCLUSION

SUPRAHYOID MUSCLES
 THE FUNCTION OF THESE GROUP OF MUSCLES IS TO EITHER
ELEVATE HYOID BONE AND LARYNX OR DEPRESS THE
MANDIBLE
 MYLOHYOID MUSCLE
 IS A THIN SHEET THAT ARISES FROM WHOLE LENGTH OF
MYLOHYOID LINE – FORMS THE FLOOR OF THE MOUTH
 FIBRES ARE DIRECTED – DOWNWARD, MEDIALLY & FORWARD
IT ELEVATES THE HYOID BONE, TONGUE AND FLOOR OF THE
MOUTH DURING SWALLOWING…
 IF THE DENTURE FLANGE IS EXTENDED BELOW AND UNDER
THE MYLOHYOID LINE IT WILL IMPINGE AND UNSEAT THE
DENTURE…
 IN EXTENSIVE BONE LOSS IT CAN BE DETACHED AND
REATTACHED MORE INFERIORLY WITHOUT IMPAIREMENT OF
FUNCTION

 MUSCLES OF MASTICATION
THEY ARE VERY POWERFUL MUSCLES
 INVOLVED IN MASTICATORY AND NON-MASTICATORY
MOVEMENTS
 MASSETER
ORIGIN FROM ZYGOMATIC BONE AND INSERTS INTO
OUTER SURFACE OF MANDIBLE
ELEVATES THE MANDIBLE
 CONTRACTION PUSHES THE BUCCINATOR IN MEDIAL
DIRECTION --- MASSETRIC GROOVE
IT HAS TO BE RECORDED IN THE IMPRESSION AND
CONTOURED TO ACCOMMODATE THE ACTION

 TEMPORALIS
 IS A FAN SHAPED MUSCLE HAS ITS ORIGIN FROM TEMPORAL
FOSSA
INSERTION INTO THE CORONOID PROCESS AND REACHES
DOWN TO THE RAMUS OF THE MANDIBLE
DIVIDED INTO 3 FIBRES… AND TWO TENDONS..
ANTERIOR FIBRES– ELEVATORS & POSTERIOR AND MIDDLE
FIBRES-- RETRACTORS

 MEDIAL PTERYGOID MUSCLE
 ORIGINATES FROM MEDIAL SURFACE OF LATERAL PTERYGIOD
PLATE AND MAXILLARY TUBEROSITY
INSERTION TO THE MEDIAL SURFACE OF RAMUS
 ANTERIOR BORDER CAN BE PALPATED WHEN THE MOUTH IS
OPENED WIDELY
DOES NOT INFLUENCE THE DENTURE STABILITY..

 CLINICAL SIGNIFICANCE
DEPRESSORS OF THE MANDIBLE ARE
RELATIVELY WEAKER THAN THE ELEVATORS
MUSCLES THAT PROTRUDE AND MOVE THE
MANDIBLE TO SIDE TO SIDE ARE MORE
STRONGER THAN THE RETRACTORS
BRUXISM (SIDE TO SIDE MOVEMENT) AND
CLENCHING OF TEETH ( ELEVATING AND
CLOSING THE TEETH ) ARE MORE DAMAGING TO
THE SUPPORTING STRUCTURES
IN RECORDING JAW RELATION , CENTRIC
RELATION IS RECORDED BY WEAK FIBRES OF
TEMPORALIS

 TONGUE
 IS A MUSCULAR ORGAN , ATTACHED WITH
ITS BASE AND CENTRAL PART OF ITS BODY
TO FLOOR OF THE MOUTH
IT IS IN INTIMATE CONTACT WITH THE
LINGUAL FLANGE OF THE MANDIBULAR
DENTURE
DENTURE FLANGES MUST BE CONTOURED
TO ALLOW THE NORMAL RANGE OF
FUNCTIONAL MOVEMENTS
CONTROLLED BY TWO GROUPS OF
MUSCLES…

 GENIOGLOSSUS
 ARISES FROM GENIAL TUBERCLES
ANTERIOR FIBRES INSERT INTO TIP OF THE TONGUE
POSTERIOR FIBRES REACH BASE OF THE TONGUE
ACTS AS PROTRACTOR AND DEPRESSOR OF TONGUE

 PALATOGLOSSUS
 FORMS A THIN SHEET IN LOWER PART OF SOFT PALATE
FIBRES CONVERGE TO FORM SLENDER SLIP---
PALATOGLOSSAL ARCH---- LATERAL BORDER OF TONGUE
TOGETHER WHEN THEY CONTRACT –CLOSE THE ISTHUMUS OF
FAUCES---BRING LATERAL PRESSURE TO DENTURE FLANGE

 MUSCLE ATTACHMENTS
The location and influence
of the muscle attachments
affecting a complete denture
are most commonly
associated with the
mandibular denture.

Type AType A
Adequate attached mucosal base withoutAdequate attached mucosal base without
undue muscular impingement during normalundue muscular impingement during normal
function infunction in
all regionsall regions..

Type BType B
 Adequate attached mucosal base in allAdequate attached mucosal base in all
regions except anterior buccal vestibule—regions except anterior buccal vestibule—
cuspid to cuspidcuspid to cuspid
 High mentalisHigh mentalis
muscle attachmentmuscle attachment

Type CType C
 Adequate attached mucosal base in allAdequate attached mucosal base in all
regions except anterior buccal and lingualregions except anterior buccal and lingual
vestibules—cuspid to cuspidvestibules—cuspid to cuspid
 High genioglossusHigh genioglossus
and mentalis muscleand mentalis muscle
attachmentsattachments

Type DType D
 Adequate attached mucosal base only inAdequate attached mucosal base only in
the posterior lingualthe posterior lingual
regionregion
 All other regions areAll other regions are
detacheddetached

Type EType E
 No attached mucosa in any regionNo attached mucosa in any region
 Cheek and lipCheek and lip
movement = tonguemovement = tongue
movementmovement

 DENTURE LIMITING STRUCTURES
1. LABIAL FRENUM
 CONTAINS A BAND OF FIBROUS CONNECTIVE
TISSUE THAT HELPS TO ATTACH THE ORBICULARIS
MUSCLE
 THE FRENUM IS QUITE SENSITIVE AND ACTIVE
 THE DENTURE MUST BE FITTED CAREFULLY TO
MAINTAIN SEAL WITHOUT CAUSING SORENESS

2. LABIAL VESTIBULE
 EXTENDS FROM LABIAL FRENUM TO THE BUCCAL FRENUM
 LENGTH AND THICKNESS OF THE LABIAL FLANGE VARY WITH
AMOUNT OF TISSUE THAT HAS BEEN LOST
 DENTURE FLANGE IS LIMITED BECAUSE THE MUSCLE IS
INSERTED CLOSE TO THE CREST OF THE RIDGE
 DEPTH OF THE FLANGE IS DETERMINED BY THE TURN OF THE
MUCOLABIAL FOLD

3. BUCCAL FRENUM
IS A BAND OF FIBROUS CONNECTIVE TISSUE TWO OR MORE
IN NUMBER
DEPRESSOR ANGULI ORIS IS THE MUSCLE WHICH
INFLUENCES THE FRENUM
HENCE IT IS ACTIVE AND SENSITIVE , HAS TO BE RELIEVED
IN DENTURE

4. BUCCAL VESTIBULE
 IT EXTENDS FORM THE BUCCAL FRENUM TO THE CONER OF
THE RETROMOLAR PAD
EXTENT OF BUCCAL VESTIBULE IS INFLUENCED BY THE
BUCCINATOR MUSCLE
IT IS POSSIBLE TO STRETCH AND DISPLACE THE TISSUE… TO
INCREASE THE AREA FOR STABILITY AND SUPPORT

5. RETROMOLAR PAD
 IS A TRIANGULAR SOFT PAD OF TISSUE AT DISTAL END OF
LOWER RIDGE
ITS MUCOSA IS COMPOSED OF THIN NON-KERATINISED
EPITHELIUM
SUBMUCOSA CONTAINS GLANDULAR TISSUE,FIBRES OF…
ACTION OF THESE MUSCLES LIMIT THE EXTENT OF THE
DENTURE AND PREVENTS PLACEMENT OF EXTRA PRESSURE
ON DISTAL PART OF THE RETROMOLAR PAD
HENCE THE DENTURE BASE SHOULD EXTEND ½ TO 2/3RD
OF
PAD

6. ANTERIROR LINGUAL VESTIBULE
MAINLY INFLUENCED BY GENIOGLOSSUS,LINGUAL FRENUM
AND ANTERIOR PORTION OF SUBLINGUAL GLAND
LINGUAL FRENUM IS SUPERIMPOSED OVER GENIOGLOSSUS
WHICH IS ATTACHED TO GENIAL TUBERCLES
IF RIDGE IS HIGHLY RESORBED, THE GENIAL TUBERCLES ARE
AT HIGHER LEVEL– LITTLE OR NO VESTIBULAR SPACE
THEN IT HAS TO BE RELIEVED OR SULCUS DEEPENING
PROCEDURE BY “STARSHAK” IS RECOMMENDED

7. MIDDLE LINGUAL VESTIBULE OR MYLOHYOID AREA
 IS THE LARGEST AREA AND IS MAINLY INFLUENCED BY THE
MYLOHYOID AND BY SUBLINGUAL GLANDS
 ITS PRINCIPAL FUNCTION OCCURS DURING SWALLOWING
DUE TO MEMBRANOUS ATTACHMENT THE MUSCLE APPEARS
TO BE HORIZONTAL WHEN CONTRACTING
“NAGEL AND SEARS” HAVE SHOWN THAT AT MAXIMUM
CONTRACTION FIBRES ARE STILL IN DOWNWARD AND
FORWARD DIRECTION
AVERAGE MYLOHYOID BORDER IS 4-6MM

8.DISTOLINGUAL VESTIBULE OR LATERAL THROAT FORM
 ANTERIORLY ----MYLOHYOID MUSCLE
POSTERLATERALLY ---SUPERIOR CONSTRICTOR
POSTEROMEDIALLY – PALATOGLOSSUS
MEDIALLY --- TONGUE
LATERALLY ---PEAR SHAPED PAD
 THE ‘S’ SHAPED CURVE OF MANDIBULAR DENTURE RESULTS
FROM STRONG INSTRINSIC AND EXTRINSIC MUSCLES OF TONGUE
WHICH USUALLY PLACE RETROMYLOHYOID BORDERS MORE
LATERALLY AND TOWARD RETROMYLOHYOID FOSSA AS THEY
OPPOSE THE WEAKER SUPERIOR CONSTRICTOR MUSCLE
POSTERIOR LIMIT OF DENTURE IS DETERMINED BY STRONGER
PALATOGLOSSUS AND WEAKER SUPERIOR CONSTRICTOR
MUSCLES--- “RETROMYLOHYOID CURTAIN”

 LATERAL THROAT FORM
NEIL’S CLASSIFICATION
 CLASS I– DEEP
 CLASS II– MODERATE
 CLASS III-- SHALLOW

 PTERYGOMANDIBULAR RAPHE
 SICHER DESCRIBES IT AS “A TENDINOUS BAND WHICH
ELEVATES THE FOLD OF THE MUCOUS MEMBRANE AND IS
ESPECIALLY PROMINENT IF THE MOUTH IS WIDELY OPENED”
IS A SOFT ,STRETCHABLE STRUCTURE WHICH PASSES
DIAGONALLY DOWNWARD AND OUTWARD FROM THE HUMULUS
TO THE MANDIBLE WHERE IT FADES AWAY INTO RETROMOLAR
PAD
MAY BE SHARP EDGED AND PROMINENT WHEN MOUTH IS
OPENED
ON PALPATION, THE SHARP EDGE IS SOFT, EASILY
DEFORMABLE AND MOVEABLE SIDE TO SIDE
BUT IT OVERLIES A HARD ROUND MASS ,NOT EASILY
DISPLACEABLE OR DEFORMABLE--- ANTERIOR BORDER OF
MEDIAL PTERYGOID
 THE FORMATION CAN BE COMPARED TO THE WEB ATTACHING
THE THUMB AND INDEX FINGER

 PROSTHETIC CONSIDERATION
TORUS MANDIBULARIS
STAFNE’S CYST
SKIN DISEASES
METABOLIC DISEASES
DENTURE HYPERPLASIA
DENTURE STOMATITIS
FLABBY RIDGE SEQUELAE OF WEARING
ALTERED TASTE SENSATION
BURING MOUTH SYNDROME
RESIDUAL RIDGE RESORPTION
COMPLETE DENTURE

Class I
Class II
Class III
Class IV
Diagnostic Criteria
1. Bone height--mandibular
2. Mucous membrane
3. Residual ridge morphology
4. Muscle attachments
Ideal or minimally
compromised
Moderately
compromised
Substantially
compromised
Severely
compromised
 SUMMARY

 REFERENCES
Prosthodontic Treatment For Edentulous Patients – ZARB
Syllabus Of Complete Dentures – CHARLES .M. HEARTWELL
Clinical Dental Prosthetics – FENN
Handbook Of Osteology --- S. PODDAR
 Oral Histology and Embryology – S.N.BHASKER
 The Significance Of Age Changes In Human Alveolar Mucosa And Bone;
CHARLES.I.NEDELMAN and SOL. BERNICK; JPD-1978;39;(5);495-501
Variable Denture Limiting Structures Of The Edentulous Mouth; H.R. KOLB
JPD-1966;16(2);202-211
The Structure Of The Mouth In The Mandibular Molar Region; R.
WHEELER HAINES and SIDNEY G. BARRETT;JPD-1959; 9(6); 962-974
Soft Tissue Displacement Beneath Removable Partial And Complete
Dentures; LYTLE R.B JPD-1962;12;34
Variations In Response To Mechanical Stress Of Human Soft Tissue As
Related To Age; KYDD.W.L and DALY E.A; JPD-1974;32;493

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