Beruflich Dokumente
Kultur Dokumente
Dr.S.N.Thakur
1st year PG Resident
Department of
Prosthodontics &
Maxillofacial
Prosthetics
1
contents
Introduction
Development of mandible
Ossification of mandible
skeletal landmarks of mandible
Soft tissue attachment of mandible
Sequele of loss of teeth
Anatomy of mandibular denture bearing area
Anatomy of limiting structure and its significance
Anatomy of supporting structures and its significance
Anatomy of relieving structure and its significance
conclusion
Reference
2
Introduction
Largest and strongest bone of the face
with horse shoe shaped body which
lodges the teeth and a pair of rami
which projects upwards from the
posterior end of the body and provide
attachment to the muscle.
Development of
mandible
Ossification of
mandible
as a wedgeshaped nucleus
takes place in the membrane covering the outer surface of
ventral
end of
inthe
the
condyloid
Meckels cartilage
process and
extending
each half of the bone is formed from a single center which
appears, near
the
downward
through
mental foramen, about the sixth week of fetal life
the ramus;
By the tenth week, the portion of Meckels cartilage which
lies below
andalong
a small
strip
behind the incisor teeth is surrounded and invaded by the membrane bone
the anterior
border of the
later,accessory nuclei of cartilage make their appearance,
coronoid
process;
in
the front part of
both alveolar
The inner alveolar border is formed by an ingrowth from the main mass of the
walls and along
bone
the front of the
lower border of the
7
bone
skeletal landmarks of
mandible
External surface
Incisive
fossa
Mandibular foramen
Mylohyoid ridge
Genial tubercles
10
Muscle attachment of
mandible
11
Masseter muscle
Buccinator
Temporalis
Mentalis
Depressor anguli oris
Depressor labi inferioris
Platysma
12
Medial pterygoid
Lateral pterygoid
Temporalis
Superior constrictor
Mylohyoid muscle
Genioglossus
Geniohyoid
Anterior belly of digastric
13
14
As resorption continues,
The width of inferior border of mandible
from side to side is greater than width of
totalmandible
width in
ofalveolar
bony process
foundation
from side to
mandibular basal side
seat becomes
The
and
greater in molar region
15
16
17
Labial frenum
Labial vestibule.
Buccal frenum.
Buccal vestibule.
Retromolar pads.
Pterygomandibular
raphe
Lingual frenum.
Alveololingual
sulcus.
Buccal shelf
area
(Primary stress
bearing area)
Residual
alveolar
ridge(secondar
y stress
bearing area)
Crest of the
residual alveolar
ridge.
Mental foramen.
Genial tubercles
Torus
mandibularis.
18
19
Limiting structures
Mandibular dentures should be extended as far as
possible within limits of health and function of the
tissues and structures that support and surround them.
Labial frenum
Labial vestibule.
Buccal frenum.
Buccal vestibule.
Retromolar pads.
Alveololingual
sulcus.
Lingual frenum.
20
Labial Frenum
Contains band of fibrous connective tissue
that helps to attach the orbicularis oris
muscle.
Labial frenum
21
Histology
Thin non keratinized epithelium
Submucosa consist of loosly
arranged connective tissue fibres
mixed with elastic fibres
22
significance
The frenum is quite sensitive and active and
must be carefully fitted to maintain a seal
without causing soreness
Method of recording
impression
During the
impression procedure,the
lip has to be reflected
outward,upward and inward.
Labial notch
24
Labial vestibule:
Runs from labial frenum to buccal
frenum on both right and left side
25
Histology
The epithelium -thin and non
keratinized
submucosa -loosly arranged
connective tissue fibres mixed with
elastic fibres and muscle fibres
26
Significance
Mandibular labial vestibule region
has limited extension because the
fibres of orbicularis oris and
mentalis runs close to the crest of
the ridge
27
Significance contd.
28
Significance contd.
The mentalis
muscle originates from
mental tubercle with its muscle fibres
placed vertically and inserts into lower
lip(orbicularis oris).
When
the
lip
is
pulled
too
much
during
border
molding, the vestibule
becomes shallow as
the mentalis muscle
attachment is higher
then the base of labial
29
Method of recording
impression
LABIAL FLANGE
30
BUCCAL FRENUM
Usually in the area of 1st pre molar.
may be single band or two or more bands
Buccinator-backward direction
depressor anguli oris-attached
beneath the frenum
Orbicularis oris-forward
direction
31
Significance
Oral activities in this area are
horizontal as well as vertical so wider
clerance is needed .
The contour of the denture is little
narower due to the activity of
depressor anguli oris.
32
33
Buccal vestibule:
It extends from the buccal frenum posteriorly
to the outside back corner of the retromolar
pad and from the crest of the residual alveolar
ridge to the cheek
34
37
Significance
Buccal shelf area is covered with dense
cortical bone and is also a wide area lying
perpendicular to the direction of occlusal
force.
The denture should completely cover the
buccal shelf area despite of the fact that it
will rest directly on fibres of buccinator muscle
38
40
Buccal
flange
41
42
43
44
45
Retromolar pad
It is a triangular soft pad of tissue at the
distal end of lower denture bearing area.
46
It is consist of
Mucosa
thin non keratinized epithelium
Submucosa
BUCCINATOR
PTERYGOMANDIBULAR
RAPHE SUPERIOR
CONSTRICTOR
TENDON
OF
TEMPORALIS
47
Significance
The retromolar pad consist of fibrous
connective tissue in its anterior half and
soft tissue containing molar glands in its
posterior half
49
4-6 mm
below the
mylohyoid
ridge
1 mm
beyond
external
oblique
ridgs
50
LINGUAL
Lingual
frenum
BORDER
Alveololingual sulcus
Sublingual gland area
51
Lingual frenum:
It is the anterior attachment of tongue.
And is extermenly active and often wide
52
Significance
The denture should be completely
functionally trimmed so that
movement of lingual frenum will not
displace the denture or create
soreness here.
Tongue tie
53
Alveololingual sulcus
Space between the residual ridge and tongue extends posteriorly from the retromylohyoid curtain to
the lingual frenum .
55
Anterior lingual sulcus also known as sub lingual crescent area or sublingual fold
Middle lingual sulcus also called the mylohyoid area
Distolingual sulcus also called as lateral throat form or retromylohyoid fossa
56
57
Significance
It is mainly influenced by
Genioglossus muscle
Lingual frenum
Anterior portion of sublingual gland
58
Genioglossus muscle
Originated from genial tubercles
genioglossus
geniohyoid
61
62
64
Mylohyoid muscle
It is the largest muscle in the floor of mouth
and principle function occurs during
swallowing
Origin:
Insertion:
65
Mylohyoi
d muscle
67
A. Tongue
B. Space into which
lingual flange of
denture is placed
under tongue away
from bony contour of
mandible
C. Epithelium
D. Mylohyoid muscle
E. Buccinator muscle
69
F. Mandibular canal
Method of recording
impression
71
Distolingual sulcus
74
76
76
Method of recording
impression
The extension of denture border can be
detremined by examining the tightness of
the fossa with a mouth mirror when the
patient is instructed to make moderate
tongue movements like touching the
maxillary anterior ridge with the tip of the
tongue
78
Records effects of
contraction of medial
pterygoid muscle on
retromylohyoid curtain
80
81
82
83
Applied anatomy of
tongue
84
86
Supporting structures
Residual alveolar
ridge
Buccal shelf area
88
89
submucosa
Spongy bone
90
It is bounded
91
92
93
Relief areas
The relief areas have following
features
have fragile structures within
covered by thin mucosa
bcan be easily traumatized.
95
MYLOHYOID RIDGE
Mylohyoid ridge running along
the lingual surface of the
mandible anteriorly lies close to
the inferior border of the
mandible while posteriorly it lies
close to the ridge.
96
Mental foramen
The anterior exit of mandibular
canal and inferior alveolar nerve.
97
98
Torus Mandibularis:
It is the bony prominence usually found in the
region of premolars.
Covered by extremely
thin layer of mucous
membrane and so may
be irritated by slight
movement of denture
base.
It should be removed
surgically if relief cannot
be provided.
99
Genial tubercles:
Conclusion
Mandible is in the process of
constant change throughout our
lifetime. Sound knowledge of its
structure, pathologies and
abnormalities associated aids not
only in proper diagnosis and
treatment planning of any disease
or abnormality associated with it,
but also to execute the required
treatment in a better manner.
101
Refrences
BOUCHERS prosthodontic treatment for edentulous
patients: 9th edition.
Clinical dental prosthetics.
HRB FENN, KP LIDDELOW, AP GIMSON
Essentials of complete denture prosthodontics
SHELDON WINKLER
2ND EDITION
Principles & practices of complete dentures by iawa
hayakwa
Impression for complete dentures Bernard Levin
Comparative evaluation of the lateral throat form and the
border
extension of mandibular complete denture in the
distolingual
region among the south coastal karnataka population: an in
vivo study by parajuli PK1, shetty TB2, shenoy VK3,
rodrigues SJ4
Impression for complete dentures: Bernard Levin
102
THANK YOU
103