introduction to complete denture and anatomical landmarks.

1. Introduction to complete denture &
Anatomical landmarks
Prepared by :-
 Barkha Bhatia

2. COMPLETE DENTURE
 Denture:- An artificial substitute for missing natural teeth and adjacent tissues.
(GPT 9)
 Complete Denture:- A fixed or removable dental prosthesis that replaces the entire
dentition and associated structure of maxillae or mandible. (GPT 9)
 Complete Denture Prosthodontics:- refers to that body of knowledge and skills
pertaining to the restoration of edentulous arch with a complete denture. (GPT 9)

3. Objectives
The completed denture should satisfy the following functional objectives:
1. Compatibility with surrounding oral environment.
2. Restoration of mastication.
3. Harmony with functions of speech, respiration and deglutition.
4. Aesthetics .
5. Preservation of remaining oral tissues.

4. Surfaces of complete denture
Surface of
Complete denture
Impression/
intagilo surface
Occlusal surface
Polished/external/
cameo surface

5.  Impression surface :- The portion of the denture surface that has its
contour determined by the impression.(GPT 9)
 Occlusal surface:- A surface of posterior tooth or occlusion rim that
is intended to make contact with an opposing occlusal surface.(GPT
9)
 Polished/external surface:- the portion of the surface of a denture
that extends in an occlusal direction from the border of the denture
and include the palatal surface. It is a part of the denture base that is
usually polished and it includes the buccal and lingual surface of
teeth.(GPT 9)

6. Component part of complete denture
Component
parts
Denture base Denture flange
Denture
borders
Denture teeth

7.  Denture base:- The part of a denture that rest on the foundation
tissues and to which teeth are attached.(GPT 9)
 Denture flange:- The part of denture base that extends from the
cervical ends of the teeth to denture border.(GPT 9)
Classified according to the vestibule:-
1. Labial flange
2. Buccal flange
3. Lingual flange

8. o Denture border:- the margin of the denture base at the junction of the cameo
surface and the intaglio/impression surface.(GPT 9)
o Denture tooth:- A term commonly referring to an artificial tooth used in the
fabrication of a resin base prosthesis.(GPT 9)

9. Steps in fabrication of complete denture
 Clinical procedures
1. Diagnosis and treatment planning
3. Mouth preparation
4. Primary impression
7. Secondary impression
10. Recording jaw relation
13. Try-in
15. Denture insertion
16. Postinsertion review and maintenance.
 Laboratory procedures
2. Making diagnostic casts
5. Primary cast
6. Fabrication of custom trays
8. Master cast
9. Fabrication of occlusal rims
11. Articulation
12. Arrangement of artificial teeth
14. Processing of denture

10. Anatomical
landmarks of
mandible

11. LIMITING
STRUCTURES
1. Labial frenum
2. Labial vestibule
3. Buccal frenum
4. Buccal vestibule
5. Lingual
frenum
6. Alvelolingual
sulcus
7. Retro molar pad
8. Pterygomandibular
raphe.
SUPPORTING
STRUCTURES
Crest of alveolar
ridge
PRIMARY
STRESS
BEARING
SECONDARY
STRESS
BEARING
Buccal shelf area
1. Genial tubercle
2. Torus Mandibularis
3. Mental foramen
RELIEF
AREAS

13. SUPPORTING
STRUCTURES

14. Buccal ShelfArea
 The area between the buccal frenum and the anterior border of masseter
 Boundaries
 Laterally - external oblique line
 (Medially) internally-slopes of residual ridge
 Anteriorly - buccal frenum
 Posteriorly - retro molar pad.

15. Significance
 Primary stress bearing area:- it lies at right angle to the occlusal
forces
 Width of buccal shelf area increases with alveolar resorption.
 It contains cortical bone which can withstand maximum forces
 Fibers of buccinator are attached horizontally to buccal shelf area
creating tension and helps to prevent ridge resorption.

16. Crest of Alveolar Ridge
 Secondary SupportArea:
 The soft tissue covering the crest when firmly attached to underline bone is capable
providing good soft tissue support
 Lack of muscle attachment
 Presence of cancellous bone
 Porosity and roughness
 Rapid resorption

17. Limitingstructures

18. Importance
 Extension : labial aspect of residual ridge
to the lip
 Muscle attachment : Orbicularis Oris
1. During final impression this frenum is
recorded as LABIALNOTCH
2. It has to be relived in denture to allow
unrestricted frenal movements
3. Failure to relive frenum can lead
to irritation and soreness.
Labial Frenum
It is a band of fibrous connective tissue
that overlies the orbicularis oris muscle

19. Importance:-
1. It provides border seal.
2. Provides support to the lower
lip musculature.
3. Extension and thickness of the
denture flange affects the
appearance of the patient.
4. Thick denture flange may
cause dislodgement of
dentures when patient
opens the mouth wide.
5. Length of the labial flange of
the denture is limited by
muscles-orbicularis oris and
incisive labii inferioris.
Labial vestibule
It is the sulcus area bounded by the
labial slope of residual alveolar
ridge and lower lip.
Extension: runs from the labial
frenum to the buccal frenum
between the residual alveolar ridge
and lip .
. Muscle attachment : ORBICULARIS
MUSCLE and THE INCISIVE LABI
INFERIORIS (which are fairly close to
the crest ridge)

20.  Importance:-
1. The fibers of buccinator are
attached to the frenum.
2. It should be relieved to
prevent displacement of the
denture during function.
3. Requires more clearance than the
labial frenum.
4. Buccal border of the denture
should be functionally moulded to
fit exactly the depth and width of
this frenum when it is in function.
Buccal frenum
It is fold or folds of mucous
membrane which forms the dividing
between the labial and buccal
vestibule and overlies to depressor
anguli oris.

21.  Importance:-
1. This space is infunced by the
action of masseter.
2. When masseter contracts it
producer a bulge in the mouth
which can be recorded only when
the masseter contracts. It is
reproduce as a notch in the
denture flange called
the masseteric notch.
3. Provides border seal
4. Provide support to the lower lip
musculature.
5. Over extension in this region
causes sorness and movement of
denture.
EXTENSION:
Anteriorly : Buccal Frenum
Posteriorly : Retromolar pad.
MUSCLE ATTACHMENT:
Anteriorly : Buccinator
Posteriorly : Pterygomandibular
Raphe
Buccal vestibule

22.  Importance :-
1. Overlies the genioglossus muscle
which take origin from superior
genial tubercle .
2. The relief for the lingual frenum
should be registered during function.
3. It is active and extremely resistant.
4. It should be accommodated as a
notch in the mandibular denture.
5. A high lingual frenum is called a
tongue tie. It should be corrected if it
affects the stability of the denture.
6. Anterior portion of the lingual flange
called as sub lingual crescent.
Lingual frenum
It is the fold of mucous membrane
existing when the tip of tongue is
elevated .

23. Alvelolingual sulcus
 It is considered in three regions:
1. Anterior region (premylohyoid)
2. Middle region (mylohyoid)
3. Posterior region (postmylohyoid)  Space between residual alveolar ridge and
the tongue
 Extension: Lingual Frenum to
Retromylohyoid curtain.

24. Significance
1. Lingual flange :- short anteriorly than posteriorly in middle region
slopes medially towards the tongue and maintains the peripheral
seal .
2. Lingual flange in posterior region passes into the Retromylohyoid
fossa and turns laterally towards the ramus and forms typical S-
shaped form of lower denture.
3. Provides border seal.

25. Importance:-
1. provides distal limit to
denture extension.
2. Provides border seal
3. Retromolar papilla area
formed by the residual scar of
third molar extraction gives
secondary support
4. The tendons of temporalis
buccinator,
Pterygomandibular raphe and
superior constrictor limit the
denture extent and prevent the
placement of extra pressure
during impression making.
Retromolar pad
It is a triangular soft pad of tissue at the
distal end of lower ridge which limits distal
border of the lower denture.

26. Importance
1. Retromylohyoid curtain is
bounded by:
Posterolaterally : superior
constrictor
Posteromedially : palatoglossus
and lateral border of tongue.
Inferiorly : submandibular
gland.
Retromylohyoid
fossa
It is the area posterior to the mylohyoid
muscle and bounded by Retromylohyoid
curtain.

27. Relief areas

28. MYLOHYOID RIDGE
Runs along lingual surface of
mandible
.
Importance:-
1. The thin mucosa over the
mylohyoid ridge may get
traumatized and should be
relieved.
2. The area under this ridge is an
undercut .
3. Mylohyoid muscle attaches to
this ridge.
Sharpness is hidden by overlying THIN SOFT TISSUE
THEREFORE relived

29. MENTALFORAMEN  CLINICAL
SIGNIFICANCE:
1. Due to ridge resorption,
it may lie close to crest
of the ridge ridge.
2. Pressure on this area can
causes paraesthesia of
lower lip
• Lies b/w 1st & 2nd premolar region
labially.
• Opening for mental nerves &
vessels.

30. Clinical significance
1. Due to resorption, it may
become increasingly
prominent making denture
usage difficult
2. Geniohyoid and
genioglossus gets
attachment to it.
3. Mucosa covering it is very
thin.
4. Failure to relive it can
cause pain and soreness.
Genial Tubercle
Pair of bony tubercles found anteriorly
on lingual side of body of mandible

31. Clinical significance
 Covered by extremely thin
mucosa which is easily
traumatized.
 surgical removal
Torus
Mandibularis
Abnormal bony prominence
usually found bilaterally &
lingually near the 1st & 2nd
premolar midway b/w soft
tissues of the floor of mouth &
crest of alveolar ridge

32. Anatomical
landmarks
of Maxilla

34. MAXILLA
Supporting
structures
Primary
stress
bearing area
Secondary
stress
bearing area
Relief area
Limiting
structure

35. Limiting structures

36. Labial frenum
Fibrous band covered by
mucous membrane that
extends from the labial
aspect of residual ridge to
the lip.
 Clinical significance
1. It has no muscle fibre
2. It has Serves as a guide to
locate the midline to upper
occlusal rim
3. Has to be relived in denture to
allow unrestricted frenal
movements.
4. Failure in doing so can lead to
irritation and soreness.

37.  Importance
1. Orbicularis oris ; main
muscle of the lip; it’s
activity depends on the
support received from the
labial flange of the denture
and position of artificial
teeth
2. Provide border seal
3. No activity in this area ;
sufficient wide impression
and deep thick flanges.
Labial vestibule
That portion of the oral cavity which
is bounded on one side by the teeth,
gingiva and alveolar ridge and on the
other side by the lips and cheeks.
(GPT9)

38. Buccal frenum
Buccal frenum
separates the labial
and buccal
vestibule.
Muscle
attachment
1)Levator anguli
oris
Attaches
beneath the
frenum
2)Orbicularis
oris
Pulls the frenum
in foreword
direction
3)Buccinator
Pulls the frenum
in backward
direction

39. Significance
 Requires more clearance than the labial frenum
 Buccal border of the denture should be functionally moulded to
fit exactly the depth and width of this frenum when in function

40. Buccal vestibule
It extends from the
buccal frenum
anteriorly to the
hammular notch
posteriorly
Modify
the size of
this
vestibule
Coronoid
process of
mandible
Ramus of
mandible
masseter

41. Significance
 Distal end of the buccal flange of the denture should be adjusted in
such a way that there is no interference to the coronoid process
during mouth opening.
 Provide border seal
 Provide support to the buccal musculature

42.  Importance
1. Soft area of loose areolar
tissue
2. Distolateral border of
denture rests in hammular
notch
3. No muscle/ligament present
; can be safely displaced by
posterior border of denture
to achieve peripheral seal
4. Can be located easily with a
‘T –burnisher’
Hammular
notch
The hammular notch is a depression
situated between the maxillary
tuberosity and the hauls of medial
pterygoid plate

43.  Importance
1. Area of soft palate that
contacts the posterior
surface of the denture base
2. Aids in retention
3. Reduces the tendency for
gag reflex
4. Prevents food accumulation
5. Compensates for
polymerisation shrinkage.
Posterior
palatal seal area
The soft tissue at or along the
junction of hard and soft palate on
which pressure within the
physiological limits of the tissue
can be applied by a denture to aid
in the retention of the
denture(GPT 9)

44. Vibrating lines
 An imaginary line across the posterior part of the palate
marking the division between the movable and immovable
tissues of the soft palate. This can be identified when the
movable tissues are functioning.(GPT 9)
Anterior vibrating line
An imaginary line at the
junction of the attached
tissue overlying the hard
palate and the immediate
movable tissue of the soft
palate.
Always on the soft palate
Posterior vibrating
line
An imaginary line at the
junction of aponuerosis
of the tensor veli palati
muscle and the
musculature of the soft
palate.

45.  Importance
1. Forms by joining together
of several mucous salivary
gland
2. Vibrating line is 2mm
anterior to the fovea;
serves as an ideal guide to
locate posterior border of
denture
3. Secretion of fovea ;spread
as a thin film on the
denture therefore aiding in
retention.
Fovea palatini
The fovea palatine are two small
depressions in the posterior part of
the palate near the midline

46. Supporting structures Areas -
primary secondary
• Hard palate
• Slopes of
residual alveolar
ridge
• Maxillary
tuberosity
• Rugae

47.  Importance
1. Provides primary support
for maxillary denture
2. Increases the surface area
for maxillary denture thus
aids in retention.
Hard palate
• Horizontal portion of the
hard palate , lateral to
midline provide support.
• Consists of two parts:
1. Antero lateral
2. Postero lateral
Masticatory forces
perpendicular to
the compact bone
making it capable
of withstanding
any amount of
force

48.  clinical
significance
1. It resorbs rapidly following
extraction
2. Sub mucosa over the ridge
has adequate resiliency to
support the denture
3. Bone of the residual alveolar
ridge trabecular –spongy,
and covered by a thick layer of
cortical bone.
Slopes of residual
alveolar ridge
The portion of the alveolar ridge and its
soft tissue covering ,which remains
following the removal of teeth (GPT)

49. Secondary stress bearing area
Palatal rugae
 These are mucosal folds located
in the anterior region of the
palatal mucosa.
 clinical significance
1. Resist the forward movement of
denture ; aid in denture stability
2. Should be reproduced on polished
surface for better phonetics.
Should be
recorded without
pressure
Because if
tissue distorts
Rugae can
rebound
Unseat the
denture

50.  Importance
1. Posterior limit for artificial
teeth arrangement.
2. Teeth are not set on the
tuberosity region
Maxillary
tuberosity
It is the bulbous extension of the
residual ridge in the second and
third molar region .
Posterior part of
the tuberosity
rarely resorbs
most important
area providing
support to the
maxillary denture.

51. Relief areas

52. That portion of the denture whichis relieved to eliminate
excessive pressure on specific parts of the denture
supporting tissues.
Relief
area
Incisive papilla
Mid palatine raphe
Torus palatinus
Cuspid eminence

53.  Importance
1. It is the exit point of nasopalatine
nerves and vessels.
2. Guide to locate midline in upper
dental arch.
3. Continuous resorption it
comes to lie near the crest.
Incisive papilla
It is a pad of fibrous
connective tissue overlying
the orifice of the
nasopalatinecanal.
Undue
denture
pressure
Compression
of blood
vessels
obliteration
of the
lumen
deprive
nutrition
to tissues
breakdown
of tissues.

54.  Importance:-
1. Area extending from the
incisive papilla to the distal
end of hard palate.
2. Undue denture pressure
causes soreness and severe
pain.
Mid palatine raphe
It is a slightly raised bony ridge
along the midline of the hard
palate which denotes the junction
of the palatine process of the
maxilla.
Prominent
median
palatal suture
Inadequate
relief
Creation of
fulcrum point
Rocking of
denture
Excessive
relief
Midline
fracture

55.  Importance
1. Location: Centre of the
palate, covers the
midline
but always posterior to the
rugae.
2. Inadequate relief
tissue soreness
3. Excessive relief
loss of support to the
denture.
Torus palatinus
It is a hard bone enlargement that occurs
in the midline in the roof of the mouth.

56.  Location : Between canine
and first premolar region.
 Must be relived in the
denture to avoid under
pressure condition.
Cuspid eminence
It is the bony elevation on the residual
alveolar ridge formed after extraction of
the canine.

57. Thank you