biological considerationsin mand and max.pptx

Nsnsnnsjsjsjsjmzmzmsmmzkzkkkknj jii kii bro I am not able to clear the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to Nsnsnnsjsjsjsjmzmzmsmmzkzkkkknj jii kii bro I am not able to clear the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to Nsnsnnsjsjsjsjmzmzmsmmzkzkkkknj jii kii bro I am not able to clear the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to Nsnsnnsjsjsjsjmzmzmsmmzkzkkkknj jii kii bro I am not able to clear the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to hjhhahajNsnsnnsjsjsjsjmzmzmsmmzkzkkkknj jii kii bro I am not able to clear the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to Nsnsnnsjsjsjsjmzmzmsmmzkzkkkknj jii kii bro I am not able to clear the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the workers and you can do it for you to the moon and back on the basis of the wo

1. GOOD MORNING

2. BIOLOGICAL CONSIDERATIONS OF MAXILLARY AND MANDIBULAR IMPRESSIONS

3. CONTENTS Introduction Oral mucosa Biological considerations of maxillary impressions macroscopic anatomy- supporting structures limiting structures microscopic anatomy- supporting structures limiting structures Biological considerations of mandibular impressions macroscopic anatomy microscopic anatomy Related anatomic structures Conclusion references

4. INTRODUCTION

5. Oral mucosa Divided into 3 categories depending on location in the mouth: 1) Masticatory mucosa : covers the crest of residual ridge including residual attached gingiva and hard palate. 2) Lining mucosa : covers the mucous membrane not firmly attached to periosteum. 3) Specialized mucosa : covers the dorsal surface of tongue.

6. BIOLOGIC CONSIDERATIONS OF MAXILLARY IMPRESSIONS

7. Supporting structures incisive papilla palatal rugae median palatine raphe maxillary tuberosity residual alveolar ridge fovea palatini Limiting structures Labial and buccal frena Labial and buccal vestibules pterygomaxillary notch Posterior palatal seal area Coronoid bulge

8. MACROSCOPIC ANATOMY Supporting structures: Residual ridge: primary stress bearing area. With continuous resorption. . .

9. Rugae – R aised areas of dense connective tissue in the anterior 1/3 of the palate. This area resists anterior displacement of the denture and is a secondary support area. No function While making impressions. . .

10. Incisive papilla - Is a pad of fibrous connective tissue overlying the orifice of the nasopalatine canal. Pressure in this area will cause a disruption of blood flow and impingement on the nerve, causing the patient to complain of pain or a burning sensation. The denture should be relieved over this area.

11. Tuberosity - is an important denture support area. It also provides resistance to horizontal movements of the denture. In the absence of mandibular molars. . .

12. Fovea palatinae – 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. Guide for posterior border of denture.

13. Bone of the basal seat Incisive foramen location with resorption. . . relief area. determining vertical dimension.

14. Zygomatic process: location- opposite 1 st molar region relief area

15. Torus palatinus : a hard bony enlargement that occurs in the midline of the roof of the mouth. Should be relieved.

16. Limiting structures: Frenum - folds of mucous membrane and do not contain significant muscle fibers. High frenum attachments will compromise denture retention and may require surgical excision (frenectomy).

17. Buccal frenum : amount of clearance. muscles affecting it (caninus, orbicularis oris, buccinator)

18. Labial vestibule – thickness of labial flange. . . Buccal vestibule- thickness of distal end of buccal flange. . .

19. Coronoid bulge - 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.

20. Hamular Notch - this narrow cleft extends from the tuberosity to the hamulus of medial pterygoid plate. The pterygomandibular ligament attaches to the pterygoid hamulus. Extension of the denture. . .

21. Posterior palatal seal area - distal to the junction of the hard and soft palate at the vibrating line. Enhances retention & maintain the peripheral seal of the maxillary denture

22. MICROSCOPIC ANATOMY Supporting structures: Crest of residual ridge: mucous membrane- bone-

23. Hard palate: anterolatreally… posterolaterally…

24. Median palatine suture : thin sub mucosa non resilient denture tends to rock if not relieved bone sub mucosa mucosa

25. Limiting structures: (microscopic anatomy) Vestibular spaces : Thick mucosa containing large amounts of areolar tissue. Easily overextended in impressions.

26. Hamular notches : Additional pressure can be placed on this tissue at the centre of the notch to complete the posterior palatal seal. No space provided in impression tray in this region.

27. Ideal maxillary ridge: Abundant keratinized attached tissue Square arch Palate U-shaped in cross-section Moderate palatal vault Absence of undercuts High frenum attachments Well-defined hamular notches

28. Biological considerations in mandibular impressions

29. Supporting structures residual alveolar ridge Buccal shelf area Limiting structures labial and buccal frena lingual frenum Alveololingual sulcus retromylohyiod curtain masseteric notch

30. MACROSCOPIC ANATOMY Supporting structures: Alveolar ridge - High rate of resorption when excessive pressure is applied to this area. underlying bone is cancellous. Generally relieved.

31. Buccal Shelf - bordered externally by the external oblique line and internally by the slope of the residual ridge. This region is a primary stress bearing area in mandibular arch. The buccal shelf is a prime support area because it is parallel to the occlusal plane and the bone is very dense.

32. Retromolar pad: One constant, relatively unchanging structure on the mandibular denture bearing surface is the retromolar pad . The pad contains glandular tissue, loose areolar connective tissue, the lower margin of the pterygomandibular raphe, fibers of the buccinator, and superior constrictor and fibers of the temporal tendon. The bone beneath does not resorb secondary to the pressure associated with denture use.

33. Bone of the basal seat External Oblique ridge – A ridge of dense bone from the mental foramen, coursing superiorly and distally to become continuous with the anterior region of the ramus. This line is the attachment site of the buccinator muscle and an anatomic guide for the lateral termination of the buccal flange of the mandibular denture.

34. Mental Foramen – The anterior exit of the mandibular canal and the inferior alveolar nerve. In cases of severe residual ridge resorption, the foramen occupies a more superior position and the denture base must be relieved to prevent nerve compression and pain.

35. Mylohyoid ridge : mylohyoid muscle arises from the mylohyoid ridge of the mandible. Determines the lingual extension of the denture. Flange shouldn't extend into the undercut below the mylohyiod ridge.

36. Limiting structures: Labial frenum - histologically and functionally the same as in the maxilla (mucous membrane without significant muscle fibers)

37. Labial vestibule - limited inferiorly by the mentallis muscle, internally by the residual ridge and labially by the lip. Mentalis - elevates the skin of the chin and turns the lower lip outward. Dictates the length and thickness of the labial flange extension of lower denture.

38. Buccal frenum – Buccal frenum connects as a continuous band through the modiolus at the corner of the mouth up to the buccal frenum attachment on maxilla. Histologically and functionally the same as in the maxilla.

39. Masseter Groove - the action of the masseter muscle reflects the buccinator muscle in a superior and medial direction. The distobuccal flange of the denture should be contoured to allow freedom for this action otherwise the denture will be displaced or the patient will experience soreness in this area.

40. Lingual frenum - overlies the genioglossus muscle, which takes origin from the superior genial spine. Sublingual folds - formed by the superior surface of the sublingual glands and the ducts of submandibular glands.

41. Alvelolingual sulcus : anterior region middle region posterior region Premylohyoid eminence Retromylohyoid eminence

42. ‘S’ shaped alvelolingual sulcus

43. Retromylohyoid space - lies at the distal end of the alveolingual sulcus. Bounded medially by the anterior tonsilar pillar, posteriorly by the retromylohyoid curtain , laterally by the mandible and pterygomandibular raphe, anteriorly by the lingual tuberosity of the mandible and inferiorly by the mylohyoid muscle. ***The retromylohyoid space is very important for denture stability and retention.

44. Ideal mandibular ridge: • Well defined retromolar pad • Blunt mylohyoid ridge • Deep retromylohyoid space • Low frenum attachments • Absence of undercuts • Abundant attached keratinized mucosa

45. Related anatomic structures Muscles of soft palate: a) levator veli palatini b) tensor veli palatini c)pharynopalatinus d)musculus uvulae e)glossopalatinus

46. Muscles of the pharynx: superior constrictor (D) medial constrictor (E) inferior constrictor (F) stylopharyngeus pharyngopalatinus

47. CONCLUSION

48. LIST OF REFERENCES BOUCHER’S Prosthodontic treatment for edentulous patients. Impressions for complete dentures. BERNARD LEVIN Clinical dental prosthetics. HRB FENN, KP LIDDELOW, AP GIMSON Prosthetic treatment of edentulous patients. R M BASKER, J C DAVENPORT. 4 TH edition Essentials of complete denture prosthodontics SHELDON WINKLER 2 ND EDITION