RMPRO811: Anatomy Part I and II

Retention

resistance to vertical displacement away from the bearing surface

Resistance to vertical displacement away from the bearing surface

Retention

Stability

resistance to lateral displacement

Resistance to lateral displacement

Stability

Support

Factors of the bearing surfaces that absorb or resists forces of occlusion

Factors of the bearing surfaces that absorb or resist forces of occlusion

Support

Factors that impact Retention, Stability, and Support

Nature of the Bearing Mucosa

Bone Contours and Retromolar Pad

Muscle Attachments

Saliva

Disease Factors

The Nature of the Bearing Mucosa

-____ vs ___

- degree of ___

attached vs unattached

keratinization

Bone Contours and Retromolar Pad

-___&___ of the alveolar ridge

-presence of ___

-___ patterns

height and contour

tori

resorption

Muscle Attachment

frenum

floor of the mouth, mylohyoid, retromylohyoid space

tongue posture

Saliva

flow rates

palatal glands

posterior palatal seal

effect on retention and comfort of denture

Disease Factors

candida, angular chelitis, epulis fissuratum

Frenum

folds of mucous membrane and do not contain significant muscle fibers.

Frenum attachments close to the crest of the ridge will _____ denture retention and may require surgical excision.

compromise

What will compromise denture retention and may require a frenectomy?

frenum attachments close to the crest of ridge

Labial Frenum

---

Buccal Vestibule

when the vestibule is properly filled with the denture flange

What greatly enhances stability and retention?

buccal vestibule

Canine Eminence

bony evidence that provides support and presents the denture from rotating and improves denture stability

Incisive Papilla

pad of fibrous connective tissue overlying the orifice of the nasopalatine canal.

Pressure in ___ will cause a disruption of blood flow and impingement on the nerve, causing the patient to complain of pain or a burning sensation.

incisive papilla

Maxillary and Mandibular Tuberosity

important denture support area.

Provides resistance to horizontal movements of the denture

tuberosity

Posterior Palatal Seal Area

distal to the junction of the hard and soft palate at the vibrating line

Rugae

raised area of dense connective tissue in the anterior 1/3 of the palate.

This area resistance anterior displacement of the denture and is a secondary support area for maxillary

Rugae

Hamular Notch

narrow cleft that extends from the tuberosity to the pterygoid hamulus muscles. The pterygomandibular ligament attaches to the pterygoid hamulus which is a thin curved process at the terminal end of the medial pterygoid plate of the sphenoid bone.

Capturing ___in an impression is critical to the retention of the maxillary denture.

hamular notch

Coronoid Process

the patient is instructed to open wide, protrude and go into lateral movements.

The width of the distobuccal flange will then be contoured by the anterior border of the coronoid process.

Fovea Palatina

two small pits or depressions in the posterior aspect of the palate, one on each side of the midline, at or near the attachment of the soft palate to the hard palate and slightly anterior to the termination of the denture.

Minor Salivary Glands

located at the posterior 1/3 of the hard palate the tissue is very glandular and displaceable.

Zygomatico-Alveolar Crest

the crest has been likened to the buccal shelf in the mandible as a stress bearing area.

What is very thin and not good for stress bearing (poorly keratinized mucosa)

Zygomatico-alveolar crest

Hard Palate

consists of the two horizontal palatine processes and appears to resist resorption.

What is the primary support area for the maxillary denture?

Hard Palate

Midline Palatal Suture

extends from the incisive papilla to the distal end of the hard palate.

Major Palatine Foramen

the orifice of the anterior palatine nerve and blood vessels

Ideal maxillary Ridge

abundant keratinized attached tissue

square arch

palate U-shape in cross-section

moderate palatal vault

absence of undercuts

frenum attachments not approximating the crest of the ridge

well-defined hamular notches

Mentalis

elevates the skin of the chin and turns the lower lip outward.

What dictates the length and thickness of the labial flange extension of the lower denture?

mylohyoid m

Buccal Sheft

bordered externally by the external oblique line and internally by the slope of the residual ridge

What is the primary stress bearing area in the mandibular arch?

Buccal Shelf

Why is the buccal shelf is a primary stress bearing area?

parallel to the occlusal plane and the bone is very dense

Mental Foramen

the anterior exit of the mandibular canal and the inferior alveolar nerve.

Retromolar Pad

glandular tissue, loose areolar connective tissue, the lower margin of the pterygomandibular raphe, fiber of the buccinator and superior constrictor and fibers of the temporal tendon.

What is another primary support of the mandibular denture?

retromolar pad

External Oblique Line

ridge of dense bone from the mental foramen coursing superiorly and distally to become continuous with the anterior region of the ramus.

The External Oblique Line is an anatomic guide for the ___ termination of the buccal flange of the mandibular denture

lateral

Masseter Groove

where distobuccal flange of t3he denture should be contoured to allow freedom for the superior and medial buccinator movements.

Function in the elevation of the hyoid bone and depression of the mandible

Suprahyoid Muscles

Suprahyoid Muscles

digasatric

stylohyoid

mylohyoid

geniohyoid

What forms the muscular floor of the mouth?

mylohyoid muscle

What determines the lingual flange extension of a denture?

mylohyoid muscle

Geniotubercle (Mental Spines)

attachment sites of the genioglossus and geniohyoid muscles

Lingual frenum

overlies the genioglossus muscle, which makes origin from the superior genial spine

Sublingual Folds

formed by the superior surface of the sublingual glands and the ducts of the submandibular glands

What is important for the denture stability and retention?

Retromylohyoid Space

Ideal Mandibular Ridge

well defined retromolar pad

blunt mylohyoid ridge

deep retromylohyoid space

low frenum attachments

absence of undercuts

abundant keratinized mucosa

adequate alveolar height

Intrinsic Muscles

originate and inset within the tongue and produce changes in the shape of the tongue

What type of muscles originate and inset within the tongue?

Intrinsic muscles

What type of muscles originate outside of the tongue ?

Extrinsic muscles

Extrinsic Muscles

originate in structures outside the tongue and move the tongue and alter its shape

What are the Extrinsic Muscles ?

Genioglossus

Styloglossus

Hyoglossus

Palatoglossus

Facial Muscles for Expression

modiolus

mentalis

buccinator

orbicularis oris

incisivus labii superiorus & inferiorus

Modiolus

forceful area that influences the labial flange thickness of the maxillary denture

Buccinator

support and mobility of soft tissues of the cheek

As a person ages, this area tension is lost which predisposes to cheek biting

Buccinator

Mentalis

elevates the skin of the chin and turns the lower lip outward

Dictates the length and thickness of the labial flange in mandibular

Orbicularis Oris

sphincter muscle

T/F: Muscles of Facial Expression insert in bone and do not need support from the teeth and denture flanges

FALSE

Ridge Form is in how many classes?

7

Class I

dentate

Class II

immediate post extraction

Class III

well rounded ridge form, adequate in height and width

Class IV

knife edge, adequate height with INadequate width

Class V

flat ridge, inadequate in height and width

Class VI

depressed ridge form with basalar bone loss

Anatomy and the Ridge form have a ___ influence on patient satisfaction

positive

There are __ classes for muscles of mastication and expression

3

Class I Muscles

tissues are normal in tone and function

Class II Muscles

tissues are slightly impaired in tone, and approximately normal in function

Class III Muscles

Tissues are greatly impaired in tone and function

___ is critical for retention of and comfort in wearing removable prosthesis

Saliva

Adhesion

bond between the oral mucosa and the denture base

Cohesion

the bonding between salivary components that lead to greater retention of the prosthesis

Surface Tension

saliva allows for the formation of a vacuum pressure on seating of the denture

__gland is a very important gland

palatal

___ salivary flow is correlated with ___ patient satisfaction

decreased

decreased

___ muscle tone is correlated with ___ maxillary denture retention

decreased

decreased

Parameters we can change for denture satisfaction

quality of denture

JRR

Occlusion

Clinical techniques/lab techniques

JRR

jaw relationship records

Correct assessment of ___ and ___ is positively correlated to patient satisfaction

VDO

Occlusion