ANATOMICAL LANDMARKS OF

MAXILLARY AND MANDIBULAR CAST

Gopika P Madhavan
1

MDS 2020 batch

 CONTENTS
 Introduction

 Anatomical landmarks of maxillary cast

• Limiting structures
• Supporting structures
• Relief areas
 Anatomical landmarks of mandibular cast
• Limiting structures
• Supporting structures
• Relief areas
 Conclusion
 References

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 INTRODUCTION

 Anatomical landmark is a recognizable anatomic structure used as a point of reference.

 As they are the foundation of the denture-bearing area, we must fully understand the anatomy of
the supporting and limiting structures involved.

 The denture base must extend as far as possible without interfering in the health or function of
the tissues.

 It is convenient to regard the impression surface of a denture as comprising two areas:

 stress-bearing or supporting area
 peripheral or limiting area

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ANATOMICAL LANDMARKS OF MAXILLARY CAST

Labial frenum
Limiting structures Labial
Labial sulcus
sulcus
• Labial frenum Buccal
Buccal frenum
frenum
• Labial vestibule
Buccal
Buccal sulcus
sulcus
• Buccal frenum
• Buccal vestibule
• Hamular notch Hamular
Hamular notch
notch
• Fovea palatine
Posterior
Posterior palatal
palatal seal
seal area
area
Fovea palatine
• Posterior palatal seal area

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Supporting structures
• Primary stress bearing areas
• Slopes of hard palate
• Maxillary tuberosity
• Secondary stress bearing areas
• Residual alveolar ridge
• Rugae

 Relief areas
• Incisive papilla
• Mid palatine raphe
• Torus palatinus
• Sharp bony prominences
• Fovea palatinae 5
LIMITING STRUCTURES OF MAXILLA

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 LABIAL FRENUM
• The labial frenum may be single or multiple.

• It appears as a fold of mucous membrane extending from the mucous

lining of the mucous membrane of the lips to or toward the crest of the
residual ridge on the labial surface.

• The frenum may be narrow or broad. It contains no muscle fibers of

signifigance

• Surgically excised if it attaches too near the crest of the alveolar ridge.

• It inserts in a vertical direction. It starts superiorly in a fan shape and

converges as it descends to its terminal attachment on the labial side of
the ridge.

Clinical significance

The labial notch in the labial flange of the denture must be wide and deep enough to allow the frenum to pass through it
without manipulation of the lip
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 LABIAL VESTIBULE

• Extends from labial frenum to the buccal frenum.

• The labial frenum divides it into left and right labial vestibule.
• The mucosa of the vestibular spaces are classified as lining mucosa
• It is relatively thin mucosa.
• The submucosal layer is thick and contains large amounts of loose areolar tissue and
elastic fibers.
• It is normally devoid of a keratinized layer and is freely movable with the tissues to
which it is attached.

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• Bounded by the labial aspect of the residual alveolar ridge, the mucolabial alveolar fold, and the orbicularis
oris muscle
• The fibers of the orbicularis oris pass horizontally through the lips and anastomose with the fibers of the
buccinator muscle.

Clinical significance
• Fibers of orbicularis oris runs in a horizontal direction, thus has only an indirect effect on the extent of an
impression and hence on the denture base.
• The length of this flange should not extend beyond the normal drape of the mucolabial fold.
• The thickness of the flange depends upon the degree of alveolar resorption.

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 BUCCAL FRENUM

• Forms the dividing line between the labial and buccal vestibules.
• It is sometimes a single fold of mucous membrane, sometimes double and in
some mouths, broad and fan shaped.
• Muscles involved
• The levator anguli oris muscle attaches beneath the frenum
• The orbicularis oris pulls the frenum forward
• buccinator pulls it backward.

Clinical significance
As there is muscle attachments in the buccal frenum, sufficient relief should be
provided so that the denture will not dislodge during functions, like chewing, and
smiling
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 BUCCAL VESTIBULE

• Lies opposite the tuberosity and extends from the buccal frenum to the
hamular notch.
• Bounded externally by cheek and internally by residual alveolar ridge.
• The size of the buccal vestibule varies with the contraction of the buccinator
muscle, the position of the mandible, and the amount of bone lost from the
maxilla
• At the distal end of the residual ridge is the alveolar tubercle.
• When the vestibular space that is distal and lateral to the alveolar tubercles is
properly filled with the denture flange, the stability and retention of the
maxillary denture is greatly enhanced.

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• When the masseter muscle contracts under heavy closing pressures, it reduces the size of the space
available for the distal end of the buccal flange.
• The extent of the buccal vestibule is reduced by the coronoid process when the mouth is opened
wide
• Distal to the buccal frenum lies the root of the zygoma, which is located opposite the first molar
region. With increasing resorption of the ridge, it becomes more noticeable, and a denture may
require relief over this area to prevent soreness of the underlying tissue.

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 HAMULAR NOTCH
• The hamular notch is distal to the alveolar tubercle. This narrow cleft extends from the tubercle to the
hamulus of medial pterigoid plate.
• It is approximately 2 mm in extent anteroposteriorly.
• The mucous membrane of the hamular notch consists of a thick submucosa made up of loose areolar
tissue.
• It can be displaced by the posterior palatal border of the denture to help achieve a posterior palatal seal.

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Clinical significance
• The denture border should extend till the hamular notch.
• If the denture border is short of the hamular notch, the denture will not have a posterior seal resulting in
loss of retention of the denture.
• If the denture border is extended beyond the hamular notch, the pterygomandibular raphe is pulled
forward when the patient opens the mouth wide open causing dislodgement of the denture.

 The pterygomandibular raphe is attached to the tip of the pterygoid hamulus at one end and to the
mandible behind 3rd molar tooth at the other end.

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 FOVEA PALATINE

• The fovea palatine are two depressions that lie bilateral to the midline of
the palate, at the approximate junction between the soft and hard palate
• Generally occur within 2 mm of the vibrating line.
A) The midpalatine raphe
• Denote the sites of opening of ducts of small mucous glands of the palate. B) The fovea palatini

Clinical significance
• The secretion of the fovea spreads as a thin film on the denture aiding in
retention.
• In patients with thick ropy saliva, the fovea palatine should be left
uncovered or else the thick saliva flowing between the tissue and the
denture can displace the denture.
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 POSTERIOR PALATAL SEAL

The distal palatal termination of the denture base is termed the posterior
palatal seal area.

Vibrating line: An imaginary line across the posterior part of the soft
palate marking the division between the movable and immovable tissues;
this can be identified when the movable tissues are functioning (GPT-9)

It marks the beginning of motion in the soft palate when an individual

says “ah.” It extends from one hamular notch to the other. Movement
may be active or passive. This junction is more definitely demonstrated if
the patient’s nostrils are closed, and he is asked to exhale through his
nose. The soft palate will flex at the junction
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• Anterior vibrating line is an imaginary line at the junction of the attached tissue overlying
the hard palate and the immediate movable tissue of the soft palate.
• It takes the shape of a cupid’s bow due to the projection of the posterior nasal spine

• Posterior vibrating line is an imaginary line at the junction of the aponeurosis of the tensor
veli palatini muscle and the musculature of the soft palate. It is the demarcation between the
part of the soft palate that has limited movement during function and the remainder of the soft
palate that is markedly displaced during function.
• It is a slightly curved line.

• Posterior palatal seal area is the soft tissue area limited posteriorly by the distal demarcation
of the movable and non movable tissues of the soft palate and anteriorly by junction of hard
and soft palates on which pressure, within physiological limit an be placed
• The width and depth of the posterior palatal seal depend on the type and displaceability of soft
palate
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Functions
This can be divided into its importance when incorporated in the impression tray and complete denture.
 Impression tray
• Establishes positive contact posteriorly and prevents impression wash material from sliding down the
pharynx.
• Guides the positioning of impression tray.
• Creates slight displacement of soft tissues
• Helps verify retention and seal of potential denture border

 Complete denture
• Primary function is retention of maxillary denture
• Reduces gag reflex by reducing patient awareness of this area
• Prevents food accumulation beneath the posterior aspects of the denture.
• Reduces patient’s discomfort when contact occurs between dorsum of tongue and posterior part of denture.
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SUPPORTING STRUCTURES OF MAXILLA

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 HARD PALATE

• The palatine processes of the maxillae and the palatine bone form the foundation
for the hard palate and provide considerable support for the denture
• A cross section of the hard palate shows that the palate is covered by soft tissue of
varying thickness, even though the epithelium is keratinized throughout.
• Anterolaterally the submucosa contains adipose tissue and posterolaterally it
contains glandular tissue.
• The horizontal portion of the hard palate lateral to the midline provides the
primary support area for the denture
• The trabecular pattern in the bone is perpendicular to the direction of force making
it capable of withstanding any amount of force.

Hard palate
Green—Secondary support area
Blue—Primary support area
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 MAXILLARY TUBEROSITY

• The maxillary tuberosity is usually a bulbous extension of the residual alveolar

ridge in the second and third molar region terminating in the hamular notch.
• Artificial teeth are not set on the tuberosity region because it leads to lever
imbalance and cheek biting in posterior region
• The tuberosity region can hang down abnormally low when the maxillary posterior
teeth are retained in the absence of mandibular molars.
• These enlargements often are fibrous but can be bony.
• This excess tissue can prevent proper location of the occlusal plane and may
interfere with the lower denture, if it is not surgically removed.

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 RESIDUAL ALVEOLR RIDGE

• It is defined as the portion of residual bone and its soft tissue covering that remains after the removal of
teeth
• This is covered by a cornified stratified squamous epithelium over a dense collagenous submucosa and
attached firmly to the underlying bone. It is the area most tolerant to resisting denture movement and
resulting irritation.
• It is considered as secondary supporting area as the underlying bone is subject to resorption, which limits
its potential for support.
• The shape and size of the alveolar ridges change when the natural teeth are removed. The resorption
following extraction of the teeth is rapid at first, but it continues at a reduced rate throughout life.
• The residual ridge may become small, and the crest of the ridge may lack a smooth, cortical bony surface
under the mucosa. There may be large, nutrient canals and sharp bony spicules

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 RUGAE
• Rugae are irregular raised areas of dense connective tissue radiating from the median suture in the anterior
one third of the palate.
• This is considered as secondary stress bearing area, as it resists anterior displacement of the denture.

• Increase the surface area, thus aids in retention of the denture.

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RELIEF AREAS OF MAXILLA

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 INCISIVE PAPILAE AND INCISIVE FORAMEN

• The incisive papilla is a pad of fibrous connective tissue overlying the

orifice of the nasopalatine canal.
• In the dentulous mouth it is located between the two central incisors on
the palatal side.
• In the edentulous mouth it may lie on or labial to the crest of the residual
ridge.
• The location of the incisive papilla gives an indication about the amount
of resorption that has taken place as it lies nearer to the crest of the ridge
as resorption progresses.

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 Incisive Foramen is located beneath the incisive papilla
 Clinical significance
• The nasopalatine nerves and blood vessels pass through
the foramen, and care should be taken that the denture
base does not impinge on them as it might lead to
necrosis of distributing areas and paraesthesia of anterior
palate.

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 MIDPALATINE RAPHAE
• The median palatal raphae is the area extending from the incisive papilla to the distal end of the hard palate.

• The mucosa over this area is usually tightly attached and thin.

• The underlying bony union is very dense and often raised. It is here that the palatal torus, if present, is located

• Soft tissue covering the medial palatal suture is non-resilient and may need to be relieved to avoid trauma from the
denture base

Mid
palatine
suture

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28
 TORUS PALATINUS
• The torus palatinus is a hard bony enlargement that occurs in the
midline of the roof of the mouth and is found in about 20% of the
population.
• It is covered by a thin layer of mucous membrane that is easily
traumatized by the denture base unless a relief is provided.
• This relief should conform accurately to the shape of the torus
because an extensive arbitrary relief robs the denture of part of its
support area.

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 SHARP BONY PROMINENCES

• Sharp, spiny processes on the maxillary and palatine bones usually cause no problems because they are
covered deeply by soft tissue.
• When there is considerable resorption of the residual ridge, they can irritate the soft tissue left between
them and the denture base.
• The posterior palatine foramina often have a sharp, spiny overhanging edge that may irritate the covering
soft tissues as a result of pressure from the denture.

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 MANDIBULAR ANATOMICAL LANDMARKS

 Limiting structures
• Labial frenum
• Labial vestibule
• Buccal frenum
• Buccal vestibule
• Lingual frenum
• Alveololingual sulcus
• Retromolar pads

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Supporting structures
• Primary stress bearing areas
• Buccal shelf area
• Retromolar pad
• Secondary stress bearing areas
• Alveolar ridge

 Relief areas
• Crest of residual alveolar ridge
• Mental foramen
• Genial tubercles
• Torus mandibularis
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LIMITING STRUCTURES OF MANDIBLE

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 LABIAL FRENUM
• The mandibular labial frenum contains a band of fibrous connective tissue
which is influenced by the incisivus and orbicularis oris. Therefore, the
frenum is sensitive and active.

• It is not usually as pronounced as the frenum in the maxillary arch but is

histologically and functionally similar.

• It overlies the genioglossus muscle which takes origin from the superior
genial spine on the mandible

• It is accommodated by a groove in the mandibular denture

• Sufficient relief must be given for the labial frenum without compromising
the peripheral seal

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 LABIAL VESTIBUBLE

• It runs from the labial frenum to buccal frenum.

• The epithelium is thin and non-keratinized, and the submucosa is
formed of loosely arranged connective tissue fibers mixed with
elastic fibers and muscle fibers

• It is limited inferiorly by the mucous membrane reflection, internally

by the residual ridge, and labially by the lip.
• Fibres of orbicularis muscle, incisivus, and mentalis are inserted near
the crest of the ridge.
• Mentalis muscle is particularly the active muscle.

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Clinical significance

• Extent of the denture flange in this region is often limited because of muscles that are inserted
close to the crest of the ridge.

• Lower lip pull actively across the denture border. Thick denture flanges may cause dislodgement
of dentures when patient opens the mouth wide open.

• Depth of the flange is determined by the mucolabial fold.

• Denture is always narrowest in the anterior labial region

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 BUCCAL FRENUM

• The buccal frenum is a fold or folds of mucous membrane extending

from the buccal mucous membrane reflection to or toward the slope or
crest of the residual ridge in the region just distal to the cuspid eminence.
• This membrane may be single or double, broad U-shaped, or sharp V-
shaped.
• The reflection is in an anteroposterior direction.
• The buccal frenum overlies the depressor anguli oris.

Clinical significance
• Clearance must be achieved in the denture base to avoid dislodgment
of the mandibular denture.

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 BUCCAL VESTIBULE

• The buccal vestibule houses the buccal flange of the mandibular denture. The buccal flange overlies a
horizontal shelf of bone called the buccal shelf. This is the external oblique ridge.
• The buccinator muscle attaches to the external oblique ridge, and the denture base itself rests on part of the
buccinator attachment, which does not exhibit a dislodging effect upon the denture base.

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 LINGUAL FRENUM

It is a fold of mucous membrane existing when the tip of the tongue is

elevated.

The lingual frenum can exhibit differing configurations, both in width and
height, but must be accommodated within the sublingual crescent area.

It overlies the genioglossus muscle which takes origin from the superior
genial tubercle.

Clinical significance

• The relief for the lingual frenum should be registered during function.

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 ALVEOLOLINGUAL SULCUS
It is the space between the residual ridge and the tongue, extends from the lingual frenum to the retromylohyoid curtain

Divided into 3 region

1. Anterior region : Extends from lingual frenum to premylohyoid fossa

where the mylohyoid ridge curves down below the level of the
sulcus.

2. Middle region : Extends from premylohyoid fossa to the distal end

of the mylohyoid ridge curving medially from body of mandible.
This curvature is caused by the prominence of the mylohyoid ridge
and the action of the mylohyoid muscle

3. Posterior region : The flange passes into the retromylohyoid fossa.

No longer influenced by mylohyoid muscle.

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Sublingual crescent area
• It is the anterior portion of the lingual flange.
• The length and width of the border in this area depends on the movements of the tongue and displaceability
of the floor of the mouth
• This maintains the seal in this area, but the denture border should not interfere with the lingual frenum or
the sublingual caruncles of Wharton’s duct.

• The lingual flange of the mandibular denture terminates in the space at the distal end of the alveololingual
sulcus. This extension maintains peripheral contact and avoids a disturbing action of the lateral borders of
the tongue upon the inferior termination of the lingual flange of the denture.
• The distolingual portion of the flange is influenced by the glossopalatine and superior constrictor muscles
which constitute the retromylohyoid curtain. The denture border should extend posteriorly to contact the
retromylohyoid curtain when the tip of the tongue is placed against the front part of the upper residual
ridge. 41
Extend of lingual flange:

• The lingual flange will be shorter anteriorly than posteriorly.

• At the premylohyoid fossa, the flange becomes larger as it extends below the level of the mylohyoid
ridge.

• When the middle of the lingual flange is made to slope toward the tongue, it can extend below the
level of the mylohyoid ridge. In this way, the tongue rests on top of the flange and aids in stabilizing
the lower denture on the residual ridge.

• In the posterior region the flange can turn laterally toward the ramus to fill the fossa and complete the
typical S form of the correctly shaped lingual flange

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 RETROMOLAR PADS

• The retromolar pad is a triangular soft pad of tissue at the distal end of the lower ridge.
• Its mucosa is composed of a thin and non-keratinized epithelium. Submucosa contains glandular tissue.
• The retromolar papilla is a small pear-shaped area just anterior to the retromolar pad. It is dense, fibrous
connective tissue.

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• Structure related are:
• fibers of the buccinators
• superior constrictor muscle
• pterygomandibular raphe
• terminal part of the tendon of the temporalis muscle.

• The action of these muscles limits the extent of the denture and prevents placement of extra
pressure on the distal part of the retromolar pad during impression procedures. Because of this,
the denture base should extend approximately one half to two thirds over the retromolar pad
and aids in the stability of the denture by adding another plane to resist movement of the base.

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 Masseteric notch
• Situated at the distobuccal area of the denture base
• Accommodates the mesial border of the masseter
muscle.
• The masseter influences the denture base at this point
during both opening and closing movements of the
mandible.
• Overextension will result both in tissue soreness and in
movement of the denture base.

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SUPPORTING STRUCTURES OF MANDIBLE

46
 BUCCAL SHELF AREA
• The area between the mandibular buccal frenum and the anterior edge of the masseter muscle
• Bounded
 laterally by the external oblique ridge
 medially by the crest of the mandibular ridge
 distally by the anterior aspect of the retromolar pad
 anteriorly by the buccal frenum

47
It is the primary stress-bearing area:
• The soft tissue and muscle attachments do not restrict coverage and extension of the mandibular base
• The bone in this area is very dense (cortical bone) and the trabeculation is arranged almost at right angles to
the path of jaw closure.
• Forces of occlusion can be directed more nearly at right angles to the buccal shelf than at any other area of
support.

• The mucous membrane covering the buccal shelf is more loosely attached and less keratinized than the
mucous membrane covering the crest of the lower residual ridge and contains a thicker submucosal layer.
• The total width of the bony foundation in this region becomes greater as alveolar resorption continues. This
is the reason that the width of the inferior border of the mandible is greater than the width at the alveolar
process.

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 RESIDUAL ALVEOLAR RIDGE
• The configuration of the bone that forms the support for a mandibular denture varies considerably among
individuals.
• Many edentulous mandibles are extremely flat, the bearing surface can become concave, allowing the attaching
structures, especially on the lingual side of the ridge, to fall over onto the ridge surface. Such conditions require
displacement of these tissues by the impression and make the lingual flange of the denture more difficult to adapt.

49
• The maxilla resorb upward and inward to become progressively smaller because of the direction and
inclination of the roots of the teeth and the alveolar process. The longer the maxilla have been edentulous,
the smaller their bearing area is likely to be.

• Mandible inclines outward and becomes progressively wider according to its edentulous age. This
progressive change of the edentulous mandible and maxillae makes many patients appear prognathic.

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RELIEF AREAS OF MANDIBLE

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 CREST OF ALVEOLAR RIDGE

• The crest of the residual alveolar ridge is covered by fibrous connective

tissue
• It may be sharp, thin, cancellous, or contain large nutrient canal

• It is covered by a keratinized layer and is attached by its submucosa to the

periosteum of the mandible.

• The mucous membrane of the crest of the lower residual ridge, when
securely attached to the underlying bone, is capable of providing good soft
tissue support for the denture.
• However, as the underlying bone is often cancellous, the crest of the
residual ridge is not favorable as the primary stress-bearing area

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 MYLOHYOID RIDGE

• The shape and inclination of the ridge vary greatly among edentulous
patients.
• Soft tissue usually hides the sharpness of the mylohyoid ridge.
• Anteriorly it lies close to the inferior border of the mandible.

• Posteriorly, after resorption, it often lies close to the superior surface

of the residual ridge.
• The mucous membrane over a sharp or irregular mylohyoid ridge
will be easily traumatized by the denture base, unless relief is
provided in the denture base.
• The area under the mylohyoid ridge is an undercut, thus the denture
should not be extended towards this area.
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 MENTAL FORAMEN

• Lies on the external surface of the mandible in between the 1st and the 2nd premolar region.
• As resorption takes place, the mental foramen will come to lie closer to the crest of the residual ridge.
• The mental nerves and blood vessels passing through the foramen may be compressed by the denture
base causing paresthesia unless relief is provided.

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 GENIAL TUBERCLES

• They are two small bony prominences on the inner surface of the
mandible on each side of the midline. They usually lie well away
from the crest of the ridge.
Figure : In patients suffering from atrophied
• The genioglossus and geniohyoid muscles are attached to the mandibles, the residual ridge resorbs to the level of the
genial tubercles, which can easily be palpated. (A)
superior and inferior genial tubercles. residual ridge, (B) genial tubercles

• The mucosa covering the genial tubercle is thin and tightly

adherent to the underlying bone.
• The genial tubercles become increasingly prominent with
resorption.

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 TORUS MANDIBULARIS

• It is a bony prominence usually found bilaterally and lingually near the first
and second premolars midway between the soft tissues of the floor of the
mouth and the crest of the alveolar process.
• It is covered by an extremely thin layer of mucous membrane.

• In edentulous mouths, where considerable resorption has taken place, the

superior border of the torus may be flush with the crest of the residual
ridge.
• It often needs to be removed surgically because it can be difficult to
provide relief within the denture for the torus without breaking the border
seal.

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 CONCLUSION

The knowledge of all the above factors of anatomical and physiological relevance
in treatment procedures, execution of the factors and communication skills of the
operator are of paramount importance. Thus, the diagnostic and clinical acumen of
the operator constitute important considerations in the application of above
knowledge.

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 Importance of anatomical landmarks : Anatomical landmark is a recognizable anatomic
structure used as a point of reference. We should have a proper knowledge on the normal
intraoral anatomical landmarks so as to identify the variations and abnormalities in patients
mouth.

 Relief area
• That portion of the dental prosthesis that is reduced to eliminate excessive pressure
• These areas resorb under constant load or contain fragile structures within.
• The denture should be designed such that the masticatory load is not concentrated over
these areas

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Blockout is defined as the elimination of undesirable under cut areas on the
cast to be used in the fabrication of the denture.

Relief is an agent applied onto a preliminary cast in fabrication of a custom

tray to aid in reduction or elimination of undesirable pressure or force from
a specific region while making a definitive impression

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Undercuts
• Undercuts are blocked out to allow removal of the record bases from the master cast.
• Result in lack of tissue contact of the record base with the periphery.
• Found on maxillary and mandibular residual alveolar ridges.
• Significant only if the denture base cannot be manipulated into place over them, which usually
requires opposing undercuts.
• A path of insertion and withdrawal of the prosthesis can be readily determined together with
careful adjustment of a denture flange, which enables the dentist to use the undercuts for extra
stability

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Undercuts in maxilla and mandible

 In maxilla
• Unfavourable : Bony undercuts as result of exostoses (surgical removal)
Palatal tori
Enlarged maxillary tuberosity (unilateral or bilateral)
Canine eminence
• Favourable : Alveolar tubercle (used for retention)

 In mandible
• Unfavourable : Sharp mylohyoid ridge (covered by very thin mucosa)
Mandibular tori
• Favourable : Retromylohyoid space 61
Position of fovea palatine

The position on fovea palatine in relation to the anterior and the posterior vibrating line varies in
different individuals.

 A study conducted by T. t. Lye in 1975 revealed that although the mean position of vibrating line
is 1.31 mm behind the foveae, the posterior limit of the denture can be extended an additional
2mm before soft-tissue movement is sufficient to break the seal. This position is also
approximately at the junction of the soft and hard palates.

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 Ming-Sheh Chen in 1980 carried out a study to measure the distance between the fovea palatini
and the vibrating line.

Percentage of people
16 25
4.9 1.4

27.1
18.8

fovea on vibrating line 1 to 2 mm posterior to vibrating line

within 2 to 3 mm posterior to the vibrating line, within 3 to 4 mm posterior to the vibrating line

within 4 to 5 mm posterior to the vibrating line within 5 to 6 mm posterior to the vibrating line

more than 6 mm posterior to the vibrating line

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Overextension at hamular notch

• Swallowing is painful and difficult.

• Small ulcerated areas in the region of the soft palate will be evident.
• Patient will experience sharp pain, especially during function.
• The pterygoid hamuli must never be covered by the denture base.

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Palatal throat form
• The relationship between the softpalate and the hard palate is called palatal throat form

Class I
• Large and normal in form, relatively with an immovable band of tissue 5 to 12
mm distal to a line drawn across the distal edge of the tuberosity.

Class II
• Medium sized and normal in form with a relatively immovable resilient band
of tissues 3 to 5 mm distal to a line drawn across the distal edge of the
tuberosity.

Class III
• Usually accompanies a small maxilla.
• The curtain of soft tissue turns down abruptly 3 to 5 mm anterior to a line
drawn across the palate at the distal edge of the tuberosity.
65
Neil's classification of lateral throat form
Depending on the displaceability of the instrument placed in the alveolo-lingual sulcus on
protrusion of the tongue

Class I
• Deep
• No movement to clinician’s finger or hand mirror when patient is protruding

Class II
• moderate
• Half as long as class I and twice as long as class II

Class III
• Shallow
• Entire mirror is displaced

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Recording posterior palatal seal area

• Impression should be made when the soft palate is placed at a desired denture
border position.

• The patient, seated in the upright position, flexes his head 30 degrees forward

• Place the tongue under tension against either the handle of the impression
tray or the dentist’s finger which is held in the region of the upper maxillary
incisors.

• The tongue should be retained in a state of tension within the arch form, and
should not protrude beyond the lips because the soft palate will for-shorten
the posterior border of the impression
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The retromylohyoid fossa : Bounded medially by the anterior tonsillar pillar,
posteriorly by the retromylohyoid curtain.

Retromylohyoid curtain
• The posterolateral portion : overlies the superior constrictor muscle
• Posteromedial portion : palatoglossal muscle plus the lateral surface of the tongue.
• Inferior wall : overlies the submandibular gland, which fills the gap between the
superior constrictor muscle and the most distal attachment of the mylohyoid muscle.

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Distal extension of the denture

• Limited by the ramus and the pterygomandibular raphe.

• The border will gently curve under the tongue at midbody (premylohyoid area)

• The denture border should extend posteriorly to contact the retromylohyoid curtain when the tip of the
tongue is placed against the front part of the upper residual ridge.

• Protrusion of the tongue causes the retromylohyoid curtain to move forward.

• The medial pterygoid muscle lies behind the superior constrictor muscle.

• Contraction of the medial pterygoid muscle can cause a bulge in the wall of the retromylohyoid curtain

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Movement of tongue during impression making

• The lingual border is defined by the mylohyoid muscle along the entire length of the mandible

• The raising of the tongue will allow the impression material to flow under the tongue slightly,
and when the tongue retracts again, it rests on the denture border .

• The tongue should be protruded to lick the upper and lower lip, and the lateral cheek.

• Pushing the tongue tip against the operator’s thumb also can aggressively activate the anterior
muscle attachments.

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 REFERENCES

 The Glossary Of Prosthodontic Terms, 9th edition

 Syllabus Of Complete Dentures, Charles M Heartwell, Arthur O. Rahn, 4th Edition, Varghese Publishing
House

 Prosthodontics Treatment Of Edentulous Patients, Complete Denture And Implant Supported Prosthesis,
Zarb.Bolender, 12th Edition

 Prosthodontics Treatment Of Edentulous Patients, Complete Denture And Implant Supported Prosthesis,
Zarb.Bolender, 13th Edition

 Essentials Of Complete Denture Prosthodontics, Sheldon Winkler, 2nd Edition, A.I.T.B.S Publishers

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 Silverman, SI. Dimensions and displacement patterns of posterior palatal seal. J Prosthet Dent. 1971;
25:470-488

 Denture Prosthetic, Complete Denture, 2nd Edition, Raymond J. Nagle, D.M.D. Victor H. Sears, D.D.S.,
The C. V. Mosby Company

 Chen, M.-S. (1980). Reliability of the fovea palatini for determining the posterior border of the maxillary
denture. The Journal of Prosthetic Dentistry, 43(2), 133–137

 Lye, T. L. (1975). The significance of the fovea palatini in complete denture prosthodontics. The Journal of
Prosthetic Dentistry, 33(5), 504–510

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