hard and soft palate

anatomy embriyology and application in prosthodontics

1. HARD AND SOFT PALATE Presentation by: Madhushree patil 1 st year PG student Dept of prosthodontics

2. content Introduction Hard palate Development and embryology Anatomy Developmental anomalies Prosthodontics consideration Soft palate Anatomy Developmental anomalies Prosthodontic consideration

3. INTRODUCTION Palate : Roof of the oral cavity. It has two parts –an anterior hard palate –a posterior soft palate

4. Palate is a bony plate covered above and below by Mucosa. Above : covered by respiratory mucosa and forms floor of nasal cavity Below : covered by oral mucosa and forms much of the roof of oral cavity

5. Development and embryology

6. Development of palate

7. Constituent of development of palate

8. Embryological subdivision

9. Anatomy and osteology The anteriolateral - margins of the palate are continuous with the alveolar arches and gums. The posterior- margin gives attachment to the soft palate . The superior - surface forms the floor of the nose. The inferior- surface forms the roof of the oral cavity

10. Palatine processes of the maxillae form the anterior 3/4 of the hard palate Horizontal plates of the palatine bones form the posterior 1/4

11. SUTURE: INTERMAXILLARY SUTURE INTERPALATINE SUTURE PALATOMAXILLARY SUTURE INCISIVE CANAL: Greater palatine vessels Nasopalatine nerve(terminal part) GREATER PALATINE FORAMEN: Greater palatine vessels Anterior palatine nerve LESSER PALATINE FORAMEN: Middle and Posterior palatine nerves

12. Developmental defects of palate Diagnosis generally unilateral and bilateral clefts in the palate is classified in 3 groups : Clefts of anterior (primary)palate ( i.e clefts ant. To incisive fossa)results from failure of mesenchymal masses in lateral palatine processes to meet and fuse with mesenchyme in primary palate

13. DAVIS AND RITICHIE CLASSIFICATION (1992) This is classification based on the location of cleft relative to alveolar process . a)Group 1-pre alveolar clefts : - unilateral - bilateral - median b)Group 2 -post alveolar clefts: c)Group 3 -Alveolar clefts: -Unilateral -bilateral -median

14. VEAU’S CLASSIFICATION SYSTEM(1931) Class 1 Class 2 Class 3 Class 4

15. FOGH ANDERSONS CLASSIFICATON (1942) Group 1: They are clefts of lips -single-unilateral -double –bilateral clefts Group 2: They are the clefts of lip and palate -single –unilateral -double – bilateral clefts. Group 3: They are cleft of palate extending up to Incisive formane

16. SCHUCHARDT AND PFEIFERS SYMBOLIC CLASSIFICATION

17. KERNAHAN’S STRIPPED (Y)CLASSIFICATION

18. Obturators A prosthesis used to close a congenital or acquired tissues opening ,primarily of hard palate and contiguous alveolar structures. Prosthetic restoration of defects often includes use of surgical obturators ,interim obturators , and definitive obturators . Prosthodontic Treatment for cleft palate

19. TORUS PALATINUS Localized nodular enlargement ( exostosis ) of the cortical bone Usually – midline of the palate Pose a mechanical problem in the construction of denture

20. INFLAMMATORY PAPILLARY HYPERPLASIA Common lesion that develops on the central hard palate in response to chronic denture irritation

21. Soft palate Movable, muscular fold, suspended from the posterior border of the hard palate. It separates the nasopharynx from the oropharynx. Acts as a valve that can be: depressed to help close the oropharyngeal isthmus; elevated to separate the nasopharynx from the oropharynx .

22. MUSCLES OF SOFT PALATE Tensor veli palatini Levator veli palatini Musculus uvulae Palato pharyngeus Palatoglossus anatomy

23. ORIGIN: Lateral side of auditary tube Scaphoid fossa of sphenoid bone INSERTION: Palatine aponeurosis NERVE SUPPLY: Mandibular nerve to medial pterygoid muscle ACTION : Tightens the soft palate Opens the auditory tube TENSOR VELI PALATINI

24. ORIGIN : Petrous temporal bone Inferior aspect of auditory tube INSERTION : Upper surface of palatine aponeurosis NERVE SUPPLY: Vagus N via pharyngeal plexus ACTION : Elevates the soft palate LEVATORE VELI PALATINI

25. ORIGIN: Posterior nasal spine of hard palate INSERTION : Connective tissue of uvula NERVE SUPPLY: Vagus N via pharyngeal plexus ACTION : Elevates and retracts uvula thickens central region of soft palate MUSCULUS UVULAE

26. ORIGIN : Inferior surface of palatine aponeurosis INSERTION : Lateral margin of tongue NERVE SUPPLY: Vagus N via pharyngealn plexus ACTION : Depresses palate Moves palatoglossal arch toward midline elevates back of the tongue PALATOGLOSSUS

27. ORIGIN: Superior surface of palatine aponeurosis INSERTION: Pharyngeal wall NERVE SUPPLY: Vagus N via pharyngeal plexus ACTION : Depresses soft palate moves palatopharyngeal arch toward midline elevates pharynx PALATOPHARYNGEUS

28. Greater palatine branch of the maxillary artery Ascending palatine branch of the facial artery Palatine branch of the Ascending pharyngeal artery Blood supply

29. VEINS : Pterygoid plexuses tonsillar plexuses of veins . LYMPHATICS : Upper deep cervical retropharyngeal lymph nodes .

30. NERVE SUPPLY • Supplied by the greater and lesser palatine nerves and the nasopalatine nerve • General sensory fibers carried in all these nerves originate in the pterygopalatine fossa from the maxillary nerve • Special sensory and scretomotor nerves are contained in lesser palatine nerves.

31. Movement and function of soft palate

32. The anatomy of the soft palate determines the location of the distal border of maxillary denture base and posterior palatal seal The posterior extention of the maxillary denture base lies in soft palate i.e , in palatal aponeurosis and overlying mucosa Palatine muscles and contour of the soft palate determines the extent and contour of the soft palate The seal should follow the contour of the palatine bones and extends from hammular notch to hammular notch Prosthodontic consideretion

33. House classification of palatal throat forms Found on line drawn between to hammular notches Class I- more than 5 mm of tissue available for post damming Ideal for retention

34. Class II – 3-5 mm distal about 1-5 mm tissue available Class III – 3-5 mm anterior less than 1 mm tissue available for post damming

35. The slender tendon of tensor palatinae could influence the denture contour when tout in hammular notch area Vibrating line determined by the elevation of soft palate during contraction of levator palatinae When 2 palatoglossi contract they draw the tongue and soft palate together and close the isthumus of fauces and bring lateral pressure ligual to the extension of the mandibular denture base Prosthodontic considerations of muscles of palate

36. summary Before construction of complete denture prostheses is begun,the oral tissues and oral environment should be assessed to ascertain that the denture bearing tissues will accept the prosthesis and support it in comfort proper border seal will ensure a more retentive prosthesis for patient,whose satisfaction is the dentists main concern if anatomy and physiology of area is understood

37. Refrences B D Chaurasia’s human anatomy 5th edition Human emnryology – inderbir singh 11th edition Burket’s oral medicine 11th edition Orban ’ s oral histology and embryology Shafers textbook of oral pathology 7 th edition