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Ana to my and Physio log y In R el ati on to

Com ple te Den tur e Cons tr uc tio n


→ The knowledge of oral anatomy and physiology will help the operator and provides
enough landmarks to act as positive guide during denture construction.

→ This subject can be discussed under:


[ I ] Extra-oral landmarks of prosthetic importance.
[ II ] Intra-oral landmarks of prosthetic importance:
a) In the maxilla.
b) In the mandible.
[ III ] Border structures that limit the periphery of the denture:
a) In the maxilla.
b) In the mandible.
[ IV ] Anatomy and physiology of the T.M. J. and mandibular movements.

[ I ] Ex tr a-or al Lan dm ar ks Of Pr os th etic I mp or tan ce:


La nd mar k Desc rip tion Si gni fica nce
1- Inter-pupillary - Imaginary line running between - Establishing the anterior Occlusal
line the two pupils of the eye when the plane of the artificial teeth of the
pt. is looking straight forward. denture.

2- Ala-tragus line - Imaginary line running from the - Establishing the posterior
(Camper's line) Inferior border of the ala of the Occlusal plane of the artificial teeth
nose to the superior border of the of the denture.
tragus of the ear.

3- Canthus-tragus - Imaginary line running from the - Locating the position of the
line outer canthus of the eye to the condyles.
superior border of the tragus of
the ear.

4- Naso-labial - Depression that extends from the - After extraction of teeth it


sulcus ala of the nose in a downward and becomes accentuated and should be
lateral direction to the corner of restored by complete denture.
the mouth.

5- Vermillion - The transitional epithelium - After extraction disappears in the


border between the mucous membrane of upper lip and becomes accentuated
the lip and the skin. in the lower& should be restored
by a complete denture.

6- Mento-labial - Depression runs horizontally - It determines the Angle of


sulcus between the lower lip and chin. Classification:
1- Angle class [I]: Normal ridge
relationship.
2- Angle class [II[: Retruded
mandibular position.
3- Angle class [III]: Protruded
maxillo-mandibular relation ship.
La nd mar k Desc rip tion Si gni fica nce
7- Philtrum - Diamond-shaped area between - After extraction of teeth it
the center of the upper lip and the becomes flattened and should be
base of the nose. restored by a complete denture.

8- Modiolus - The point of meeting of facial - After extraction of teeth it


muscle fibers. becomes downwards and should be
restored by a complete denture.

9- Angle of the - Point of meeting between the - (Angular Chilitis): Inflammation


mouth (commissure upper and lower lip. and ulceration as a result of:
of the lips) 1- Prolonged edentulism.
2- ↓ vertical dimension of complete
denture.
3- Vitamin B deficiency.

Fig.1: A, The Philtrum, naso-labial sulcus, commissure of the lips& mento-labial sulcus.
B, Modiolus and Orbicularis Oris muscle.

Fig.2: Profile view showing the relation of the upper and lower anterior teeth and the curvature of
mento-labial sulcus.
[ I I ] In tr a-or al l and mar k of pr ost heti c impor ta nc e:
A- In the Maxilla:
La nd mar k Desc rip tion Si gni fica nce
1- Residual ridge - The portion of the alveolar - It covers by a dense connective
process& it's soft tissue covering tissue fibers so, it can be act as a
that remains after extraction. 1ry stress bearing area.

2- Maxillary - Bony prominence located - Aid in support, retention and


tuberosity posterior to the upper 3rd molar. stability of the complete denture.
- When it is large:
1- Relieved.
2- Modify the path of insertion.
(unilateral enlargement).
3- Surgical removal.

3- Median palatine - The mucoperiostium that covers - When it is prominent it should


raphe the median palatine suture. be relieved.
- Lack of relief cause:
1- rocking of the denture due to
bone resorption.
2- Tissue ulceration.
3- Mid-line denture fracture.

4- Incisive papilla - Pear-shaped elevation present in - After extraction of teeth it


the midline behind the 2 centrals. migrates to the crest of the ridge.
- It should be relieved to avoid
the burning sensation of the
palate.

5- Palatine rugae - It is irregular elevations radiates - 2ry stress bearing area.


from the midline of the anterior - Prevent forward movement of
part of the palate. the denture.
- If it is sensitive or prominent it
should be relived.

6- Torus palatinus - Bony prominence present at both - It should be:


sides of the midline of the palate. 1- Relieved.
2- Surgical removal.

7- Fovea palatinae - Two openings of minor salivary - It determines the posterior


glands present in both sides of the extension of the upper complete
midline posterior to junction of denture to be 2mm posterior to
hard and soft palate. it.

Fig.3: A, Diagram of
the upper arch.
B, Diagram of the
lateral surface of the
maxilla.
B- In the Mandible:
La nd mar k Desc rip tion Si gni fica nce
1- residual ridge - The portion of the alveolar - Don't used as 1ry stress bearing
process& it's soft tissue covering area → Covered by movable
that remains after extraction. fibrous connective tissue.
- Don't Provide stability or
support.

2- External - Bony ridge running downward - It is a limiting structure to the


oblique ridge and forward from ramus to reach complete denture and not extend
mental foramen. to it.

3- Buccal shelf - Bony area extends between the - Used as 1ry stress bearing area:
area external oblique ridge and the 1- Perpendicular to the vertical
residual ridge. masticatory force.
2- Formed from compact bone.
3- provide support.

4- Mental foramen - It's located on the Buccal surface - Lack of relief → numbness of
of the mandible between the roots the lower lip.
of 1st and 2nd premolar.

5- Retromolar pad - Pear-shaped area located distal - Shock absorbent.


to the lower 3rd molar. - Gives retention not support.
- Determine the level of the
Occlusal plane.

6- Torus - Bony prominence located at the - It should be:


mandibularis inner surface of premolar area. 1- Relieved.
2- Surgical removal.

7- Internal oblique - Irregular bony ridge of median - It should be relieved during


ridge (Mylohyoid surface of the mandible which the complete denture construction.
ridge) Mylohyoid muscle attached.

8- Genial tubercle - Two bony projections present at - Represent the attachment of


(Mental spine) the median surface of mandible at geniohyiod and genioglossus
midline of each side of symphesis. muscles.
- If it's prominent, it should be
relieved.

Fig.4: Diagram showing


the mandible:
A, Buccal view.
B, Lingual view.
[ III ] Border Structures That Limits The Periphery Of The Denture: