PRECLINICAL REMOVABLE COMPLETE PROSTHODONTICS COURSE

ANATOMICAL LANDMARKS
Removable Complete Prosthodontics

ANATOMICAL LANDMARKS

Extra-oral landmarks
Landmark

Significance

1- Ala of
the nose

At the side of the nose, indicates the position of upper

right and left canine in complete denture.
Supported by buccinator muscle, can be maintained
by proper posterior teeth setting.
Meeting of buccinator muscle with other facial muscle
near angle of the mouth, lost with tooth extraction
(old age appearance).
Diamond shaped area from base of the nose to the
center of upper lip, becomes flattened with anterior
teeth extraction
It`s the transitional epithelium between mucous
membrane of the lip and skin, it disappears in the
upper lip following extraction.
Meeting point between upper and lower lip, becomes
inflamed due to lack of upper lip support and decrease
vertical dimension of the face leading to dribbling of
saliva.
Depression extends downward and laterally to corner
of the mouth, prominent with aging due to upper
canine extraction.

2- Cheek
3- Modiolus

4- Philtrum
5Vermilion
border
6- Corner of
the mouth
7- Nasolabial
sulcus
8- Mentolabial
sulcus

9- Inter-

Running horizontally between lower lip and chin,

indicating the relation between maxilla and mandible.

Imaginary line extending between two pupils of

Graph

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pupillary
line
10- Ala
tragus line
11Canthus
tragus line

ANATOMICAL LANDMARKS

the eye, indicating the level of anterior occlusal

plan.
Imaginary line from inferior border of ala of the
nose to superior border of tragus of the ear,
indicating the level of posterior occlusal plan.
Imaginary line extending from the outer canthus
of the eye to superior border of tragus of the ear,
indicating arbitrary position of the condyles.

Intra-oral landmarks (Maxilla)

Limiting

Landmark
1- Labial
frenum

2- Labial
vestibule
3- Buccal
frenum

Significance
Fold of mucous membrane extending
from the mucous membrane of lip to
labial surface of the ridge, v-notch is
made to avoid ulceration or denture
movement.
Reflection of mucous membrane from the
lip to labial alveolar bone, related to
orbicularis oris and incisive labii
superiosis Ms. limiting the thickness of
labial flange.
Fold of mucous membrane extending
from the buccal mucous membrane to
the crest of residual ridge, properly
denture trimming with v shaped notch to
avoid denture movement.

Graph

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4- Buccal
vestiblule

5Hamular
notch

Supporting

6Vibating
line

7- Median
palatine
raphe
8Palatine
rugae

ANATOMICAL LANDMARKS

Reflection of mucous membrane from the

cheek to crest of the ridge distal to
buccal frenum. Bounded externally by the
cheek and internally by residual ridge.
Flange should extend to buccinator Ms.
attachment and proper thickness of
flange to accommodate coronoid procees
movement.
Loose connective tissue lying posteriorly
to the maxillary tuberosity, it is important
for posterior extension of upper complete
denture.
Imaginary line extending from hamular
notch of one side to hamular notch of the
other side. (AH line) determining
posterior extension of upper complete
denture.
Thin muco periosteum covering the
median palatine suture that joins the 2
palatine processes, it should be relieved if
prominent to prevent rocking of the
denture.
Irregular ridges of dense connective
tissue extending from the median
palatine suture in the anterior 1/3 of hard
palate, plays a role in speech (s) and

ANATOMICAL LANDMARKS

secondary stress bearing area.

9- Incisive
papilla

10Residual
ridge
11Maxillary
tuberosity
12- Fovea
palatinus

13- Torus
palatinus

Pear shaped elevated soft tissue in the

midline posterior to crest of the ridge
covering the opening of naso palatine
nerve and vessels of incisive foramen,
should be relieved to avoid burning
sensation and used to mark the midline
and antero posterior position of the teeth.
Part of the alveolar process with soft
tissue covering after teeth extraction with
the highest point called crest of the ridge,
considered primary stress bearing
area.
Rounded prominent bulge behind and
above the maxillary residual ridge, giving
retention and support to the denture.
Openings of minor salivary glands ducts 2
in number found on each side of the
midline, the posterior border of the
denture should extend 2 mm behind it.
Bony projection at the junction of 2
palatine processes in the midline, if too
large extending posteriorly affecting
posterior seal, if small it requires relieve.

Intra-oral landmarks (Mandible)

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Landmark
1- Labial frenum

Outside Limiting

2- Labial
vestibule

3- Buccal frenum

4- Buccal
vestibule

5- Masseter Ms.
influencing area

ANATOMICAL LANDMARKS
Significance
Fold of mucous membrane extending from
the mucous membrane of lip to labial
surface of the ridge, v-notch is made to
avoid ulceration or denture movement.
Reflection of mucous membrane from the
lip to labial alveolar bone, related to
orbicularis oris and incisive labii inferiosis
Ms. limiting the thickness of labial flange.
Fold of mucous membrane extending from
the buccal mucous membrane to the crest
of residual ridge in the premolar region,
properly denture trimming to avoid
denture movement.
Reflection of mucous membrane from the
cheek to crest of the ridge distal to buccal
frenum. Bounded externally by the cheek
and internally by residual ridge. Flange
should fit to buccinators Ms. attachment
and proper thickness of flange.
Disto buccal corner in relation to masseter
Ms., the buccal flange of the denture
should converge medially to avoid
displacement by masseter muscle
contraction.

Graph

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Inside Limiting

6- Distal
extension of
mand. denture

ANATOMICAL LANDMARKS
Related to retro molar pad and anterior
border of the ramus
Fold of mucous membrane extending from

7- Lingual
frenum

the floor of mouth in the midline to the

under surface of the tongue, flange should
be rounded in this area.
In the premolar region in relation to

8- Sublingual
salivary gland
area

sublingual salivary gland, depth of lingual

flange is affected due to ridge resorption
and bulging salivary glands above the
ridge.
Space between residual ridge and tongue,

9- Lingual
vestibule
(alveolingual
sulcus)

depth of the lingual flange is affected by

10Retromylohoid
space

Distal end of lingual vestibule extending

functional movement of floor of mouth

and should extend to the lingual sulcus.

from the end of mylohyoid ridge to

retromylohyoid curtain. Bounded medially
by tongue, laterally by medial surface of
mandible, posteriorly by palatoglossus

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ANATOMICAL LANDMARKS
Ms., anteriorly by posterior portion of
mylohyoid Ms.
Over extension of distolingual flange will
cause sore throat due to pressure on

Supporting

superior constrictor Ms.

11- Residual
ridge

12- External
oblique ridge

13- Internal
oblique ridge

14- Buccal shelf

of bone
15- Retro molar
pad

Part of the alveolar process with soft

tissue covering after teeth extraction with
the highest point called crest of the ridge.
Dense bony ridge extending downwards
and forwards from the ramus to the
mental foramen. The flange should not
extend beyond it and avoid masseter Ms.
influencing area.
Irregular bony ridge on medial surface of
mandible to which mylohyoid Ms. is
attached from third molar region to lower
border of the mandible near midline.
Lying between crest of residual ridge and
external oblique ridge, dense compact
bone. It`s considered as primary stress
bearing area.
Small pear shaped area distal to residual
ridge containing mucous glands and
muscles, should be covered (shock

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16- Mental
foramen

17- Genial
tubercles

18- Torus
mandibularis

ANATOMICAL LANDMARKS

absorber) and retain mandibular denture

in place.
Located on the buccal surface on the
mandible between the roots of first and
second premolar through which mental
nerve is passing, relieve is required in this
area due to frequent bone resorption and
mental foramen situated on the crest on
the ridge.
2 bony projections covered by thin tissue
located on the medial surface of the
mandible on each side of the symphysis
for genioglossus and geniohyoid Ms.
attachment, requires relief in case of ridge
resorption.
Uni or bilateral bony projections on the
inner surface of the mandible in premolar
region, relief is required if small size or
surgery if large size.