Transcript Document

Introduction to Dentures
Lecturer
Hatem Dousouky Ahmad
Terminology
•Prosthetics
•Prosthesis
•Prosthodontics
•Dentulous
•Edentulous
•Partially edentulous
•Complete Denture
•Partial Denture
•Immediate denture
Complete Denture
Definitions :
“A prosthesis that replaces the lost natural dentition and associated
structures of the mandible and / or the maxilla “ .
Component Parts :
Denture Base
Denture Flange
Denture Border (Edge)
Denture Surfaces :
Fitting
Surface
Polished Surface
Occlusal Surface
Complete denture consists of
Objectives in complete denture construction:
1. Restoration of mastication.
2. Restoration of facial dimensions and
contours.
3. Restoration of speech.
4. Restoration of the remaining natural
tissues.
5. Satisfaction and comfort of the patient.
Anatomical Landmarks In
Relation to Complete Denture:
• Extraoral
landmarks
• Intraoral
landmarks
Changes The Happened After Teeth Loss :
Face :
Extra Oral Landmarks
Inter pupillary line
Ala Tragus Line
Naso – Labial sulcus
Philtrum
Labiomental sulcus
Angle of the mouth
Modiolus
Vermillion border
Landmarks of Importance in
Occlusal Plane Orientation
Interpupillary line
Ala tragus line
Landmarks restored by proper
lip support
• Naso – Labial sulcus
Becomes deeper with age
and with loss of teeth
• Philtrum
becomes flat with loss of teeth
• Modiolus
moves inwards and downwards
• Vermillion border
becomes reduced in size
Landmarks restored by Proper
Vertical Dimension
• Vermillion border
• Angle of the mouth
becomes inflammed  angular cheilitis
The Labiomental Sulcus
A Landmark helpful in determining the Jaw Relation
Angle Class I
Angle Class II
Angle Class III
Intraoral Landmarks
• Maxilla
Supporting structures
&
Limiting structures
• Mandible
Supporting structures
&
Limiting structures
Maxillary Supporting Structures
Incisive Papilla
•
•
1 . The incisive papilla is a thick part of the
mucous membrane covering
the incisive foramen.
•
2 . It is located at the anterior end of the median
palatine raphae .
•
3 . The nasopalatine nerves and vessels pass
through the incisive foramen
to supply the anterior 2 / 3 of the palate.
•
•
•
•
•
4 . In some cases due to the excessive bone
resorption, the papilla may lie
on the crest of the ridge.
5 . The incisive papilla should be relieved to
avoid pressure on the incisive
nerves and vessels.
Cont. max. supporting structures
Palatine Rugae
Rugae Area
1 . It is an irregular shaped elevation of the soft tissue extending
laterally from the midline in the anterior part of the hard palate.
2 . If serves as one of stress bearing area in the palate .
Cont. max. supporting structures
Median Palatine Raphae
Median Palatine Raphae
1 . The midline of the hard palate is covered by a thin layer of
mucoperiostium , that covers the median palatine suture .
2 . That suture joins the right and the left halves of the hard palate.
3 . It is usually relieved to increase denture stability by preventing its rocking .
Cont. max. supporting structures
• Torus Palatinus
When small  relieved
When large  surgical excision
Cont. max. supporting structures
Fovea Palatina
Fovia Palatina
1 . It is helps in the determination of the posterior border
of the upper denture.
2 . The posterior border of the upper denture should be 2 mm
posterior to the fovea Palatina .
Cont. max. supporting structures
Residual Alveolar Ridge
Residual Alveolar Ridge
1 . It should be firm .
2 . since it is usually well developed, it might
be considered as a primary stress bearing area.
Cont. max. supporting structures
Tuberosity
Tuberosity
1 . It is important for retention and support of the upper denture
against lateral movement.
2 . The denture should cover it .
Cont. max. supporting structures
Buttress Part Of Bone
Buttress Part Of Bone
1 . It is formed of the lower portion of the zygomatic process of the maxilla
(the area above the first molar teeth) .
2 . It provides excellent resistance to the vertical forces(Support).
Maxillary Limiting Structures
Labial Frenum
Labial Frenum
Labial Frenum
It must be relieved in the denture by making a V-shape notch
in the labial flange opposite to its position .
Cont. Maxillary Limiting Structures
Labial Vestibule
Labial Vestibule
1 . It Is the reflection of the mucosa of the lip to the mucosa of the
alveolar process in the labial vestibule.
2 . The denture in this area is in relation to the orbicularis oris and the
superior incisive muscles .
3 . These muscles limit the thickness and the length of the labial flange
of the denture.
Cont. Maxillary Limiting Structures
Buccal Frenum
Buccal Frenum
1 . It is a fold of mucous membrane (tendon of the buccinator muscle)
varies in size in number and in position .
2 . A notch is made in the denture flange opposite to its position to
facilitate its functional movements.
Cont. Maxillary Limiting Structures
Buccal Vestibule
Buccal Vestibule
1 . The denture in this area is related to buccinator muscle.
2 . Buccal flanges must extend in the buccal vestibule .
3 . Due to the horizontal direction of the fibers of this muscle contraction
of this muscle will not displace the denture.
Cont. Maxillary Limiting Structures
Hamular Notch
Hamular Notch
1 . It is one of the important landmarks for determination of the posterior
limit of the upper denture .
2 . A straight line from hamular notch on one side to the other on the other
side determine the posterior limit of the upper denture
Cont. Maxillary Limiting Structures
Vibrating Line
( Ah Line)
Vibrating Line
( Ah Line)
Postdam area
1 . It separate the movable part from the immovable part of the soft palate.
2 . This line is 2mm posterior to the fovea palatine .
3 . This line determines the posterior end of the upper denture.
Cont. Maxillary Limiting Structures
• Curvature of the soft palate
I
Class I  gentle curvature
Class II  medium curvature
Class III  abrupt curvature
II
III
Mandibular Limiting Structures
Labial Frenum
Denture should be notched
opposite to it.
Labial Frenum
Cont. Mandibular Limiting Structures
• Labial Vestibule
Limits the denture flange
thickness and length.
Labial Vestibule
Cont. Mandibular Limiting Structures
Buccal Frenum
Buccal Frenum
1 . It is a fold of mucous membrane in the premolar area, movement of
the lip and the cheek move the frenum .
2 . A notch is made in the lower denture to accommodate the frenum.
Cont. Mandibular Limiting Structures
Buccal Vestibule
Buccal Vestibule
1 . The denture in this area is related to the buccinator muscle .
2 . Its contraction does not displace the lower denture so flanges of
the lower denture must extend in the buccal vestibule.
Cont. Mandibular Limiting Structures
• Masseter muscle influencing area
• Masseteric notch
Distobuccal area
Cont. Mandibular Limiting Structures
• Posterior end of retromolar pad
Posterior end
of retromolar pad
• It constitutes the posterior limit of the lower denture
at which postdamming can be performed.
Cont. Mandibular Limiting Structures
• Palatoglossal arch
Distolingual area
Denture overextension in this
area will cause sore throat.
Cont. Mandibular Limiting Structures
Lingual Pouch
Lingual Pouch
Lingual pouch
More posteriorly the lingual flanges are related to the lingual pouch with
its boundaries which are :
Posteriorly : The palatoglosssus muscle .
Anteriorly : The Mylohyoid muscle.
Medially
: The tongue .
Laterally
: The medial aspect of the mandible.
Cont. Mandibular Limiting Structures
• Mylohyoid muscle influencing area
(internal oblique ridge)
Mylohyoid muscle
influencing area
Mylohyoid muscle
influencing area
Cont. Mandibular Limiting Structures
Sublingual salivary
gland area
Sublingual salivary
gland area
Sublingual salivary
gland area
The lingual flanges of the lower denture should not extend in this area
because with excessive resorption of the mandible the gland may
bulge superiorly above the body of the mandible.
Cont. Mandibular Limiting Structures
Lingual Frenum
Lingual Frenum
1 . More anteriorly a fold mucous membrane attach the mucosa of the
tongue tip to mucosa of the floor of the mouth
2 . It moves with the movement of the tongue so a notch is made to
accommodate the frenum.
Michael H. Hart
(born April 28, 1932 in New York City)
• Graduate of the Bronx High School of
Science, received his undergraduate degree
at Cornell University in mathematics and
later earned a Ph.D. in astrophysics at
Princeton University. He also holds
graduate degrees in physics, astronomy,
and computer science, as well as a law
degree. He was a research scientist at
NASA before leaving to be a professor of
physics at Trinity University in San
Antonio, Texas.
‫منذ سنين وأنت تفخر بأنك مسلم‪...‬‬
‫فماذا فعلت ليفخر اإلسالم بك؟؟‬
‫• عن أبي هريرة رضي هللا عنه أن رسول هللا صلى هللا‬
‫عليه وسلم وقف على أناس جلوس فقال ( أال أخبركم‬
‫بخيركم من شركم ) قال ‪ :‬فسكتوا ‪ ،‬فقال ذلك ثالث مرات‬
‫‪ ،‬فقال رجل ‪ :‬بلى يا رسول هللا أخبرنا بخيرنا من شرنا ‪،‬‬
‫قال ( خيركم من يرجى خيره ويؤمن شره وشركم من ال‬
‫يرجى خيره وال يؤمن شره ) رواه الترمذي‪.‬‬
‫• أحب العباد إلى هللا تعالى‬
‫أنفعهم لعياله‬
Mandibular Supporting Structures
Residual Ridge
(Fibrous band of
connective tissue)
Residual Ridge
1. It covers the crest of the lower ridge.
2. Its mobility may cause pressure symptoms under the lower denture.
3 . Also can affect denture stability .
Cont. Mandibular Supporting Structures
External oblique ridge
External obique ridge
Cont. Mandibular Supporting Structures
Buccal Shelf Of Bone
Buccal Shelf
Of Bone
1 . The area that lies between the crest of the residual ridge and
the external oblique ridge.
2 . It is the primary stress bearing area in the lower arch .
3 . It forms good support for the lower denture .
Cont. Mandibular Supporting Structures
Retromolar pad
Retromolar pad
1 . It is a pear shaped area of mucous membrane at the posterior end of the
mandibular ridge and anterior to the pterygomandibular raphae .
2 . It consists of mucous glands , temporal tendon , fibers of the
buccinators and superior constrictor muscle .
3 . Lower denture should cover this area for retention and to cover
the buccal shelf of bone (Primary stress bearing area) it act as valve seal
area for the lower denture.
Cont. Mandibular Supporting Structures
Torus mandibularis
Torus mandibularis
When small  relieved
When large  surgical excision
Cont. Mandibular Supporting Structures
•
Internal oblique ridge
• If sharp, it should be
surgically reduced.
• Internal oblique ridge
Cont. Mandibular Supporting Structures
• Mental foramen
•When the ridge is resorbed,
it appears on its crest .
• Since it covers nerves,
it should be relieved.
Cont. Mandibular Supporting Structures
• Genial tubercles
•When the ridge resorbed,
it appears on its crest .
•It is relieved or better
surgically reduced
THANK YOU