maxilla landmarks

8/3/2019 Maxilla Landmarks

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Anatomical landmarks andtheir clinical significance in

Edentulous Maxillary arch


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Importance

To decide upon the distribution of forces invarious locations of the foundation area.

The dentures and their supporting tissuescoexist for a reasonable length of time.


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The ultimate support for maxillary denturecomes from the hard palate and the softtissues that increases the surface area ofthe basal seat.


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Compact bone

Adipose tissue

Sub mucosa

Mucosa


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ANATOMIC STRUCTURES

LIMITING STRUCTURE

SUPPORTING STRUCTURE

RELIEF AREAS


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LIMITING STRUCTURE

Labial frenum

Labial vestibule

Buccal frenum Buccal vestibule

Hamular notch

Posterior palatal seal area


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Supporting structures

Support is the resistance to the displacement towards

the basal tissue or underlying structures.

Primary stress bearing area /Supporting area

The horizontal portion ofthe hard palate lateral to the

midline

posterolateral slopesSlopes of residual alveolar ridge

Secondary stress bearing area /Supporting area

Rugae area set at an angleto residual ridge

Maxillary Tuberosity


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RELIEF AREAS

Incisive papilla

Mid-palatine raphe

Crest of the residual alveolar ridge Cuspid eminence

Fovea palatine


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Labial frenum:

Fold of mucous membrane atthe median line.

Moves with muscles of lip.

No muscle of its own

Action: vertical narrownotch

A- correct

contour

B

incorrect

contour.

C- area should

have been

covered.

Labial notch

LIMITING STRUCTURES


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BUCCAL FRENUM

Single or double folds of mucousmembrane.

Broad and fan shaped.

Moves with muscles during

speech and mastication.( levatoranguli oris, orbicularis oris,buccinator)

Adequate relief for muscle

activity-more clearence.

Maxillary buccal frenum area.

Denture border contour in buccal

frenum area.

Buccal notch


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Labial to buccalfrenum.

Muco-gingival line-limits upper border.

Record adequatedepth/width.

Overextension causesinstability/soreness.

Proper contouringgives optimal esthetics.

Labial flange

LABIAL VESTIBULE


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BUCCAL VESTIBULE

Buccal frenum to hamular notch.

Record adequate depth/width.

Improper extension causesinstability/soreness.

Size varies contraction ofbuccinator, position of mandible &the amount of bone lose frommaxilla.

Buccal flange


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Distal end of the buccalvestibule

Influenced by coronoid

process of mandible. This space is usually higher

than any other part of theborder.

Should be examined with themouth as nearly closed aspossible

Disto-buccal area / Corono-maxillary space


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Is a soft area of areolar tissue between

distal surface of tuberosity and the

hamular process of the medial

pterygoid plate.

Significance : it houses the disto-lateral termination of the denture

Aids in achieving posterior palatal

seal.

Overextension causes soreness.

Underextension poor retention

HAMULAR NOTCH.

Area of hamular notch


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POSTERIOR PALATAL SEAL

AREA

The soft tissue area at or beyond the junction of the hardand soft palates on which pressure within physiologicallimits, can be applied by a complete denture to aid in itsretention.

Parts Postpalatal seal Pterygomaxillary seal

Extensions Anteriorly Anterior vibrating line

Posteriorly Posterior vibrating line Laterally 3-4mm anterolateralto hamular notch.


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VIBRATING LINE

An imaginary line across the posterior partof the palate marking the division betweenthe movable and immovable tissues of thesoft palate. This can be identified when the

movable tissues are functioning.

Anterior vibrating line valsalva maneuver

ah with short vigorous bursts

Posterior vibrating line ah in short bursts in a normal, unexaggerated

fashion.


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Hard palate

Support for themaxillary denture.

Primary stressbearing area-horizontal portion ofhard palate lateral to

midline.


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Residual alveolar ridge

The portion of theresidual bone , softtissue covering that

remains after theremoval of teeth .

Important supportarea subjected to

resorption.Alveolar groove


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Rugae

Raised areas ofdense connectivetissue radiating fromthe median suture inthe anterior 1/3rd ofpalate .

Secondary stressbearing area.

Should not bedistorted in theimpression.


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MAXILLARY TUBEROSITIES.

Are distal aspects ofthe posterior ridgeterminating in thehamular notch

Grossenlargement(fibrousor bonysurgical

correction.

Area of tuberosity


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Incisive papilla pad offibrous connectivetissue over the incisiveforamen.

Location :behind andbetween the centralincisors

Relief necessary -burning sensation andpain.

Indication of resorption.

INCISIVE PAPILLA

Incisive fossa


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Extends from incisivepapilla to distal end ofhard palate.

Thin mucosal coveringand non-resilient..

Relieve adequately toavoid trauma from

denture base.

Mid palatine raphae.

Mid palatine groove


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Fovea Palatinae

Bilateral indentationsnear the midline of palate.

Formed by coalescence ofseveral mucous glandducts.

Posterior to junction ofhard and soft palate.

Always on soft palate


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Labial frenum.

Shorter and widerthan the maxillary

frenum. Adequate relief for

muscle activity(mentalis).

Proper fit around itmaintains sealwithout soreness.

Mandibular arch.

Labial notch.


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Buccal frenum.

Adequate relief formuscle activity.

Proper denture seal.

Buccal notch


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Labial vestibule. Labial-buccal frenum.

Overextension causesinstability/soreness.

Muscles attachmentclose to the crest of theridge- limits the dentureflange extension.

Mucolabial fold limitsthe depth of the flange.

Record adequate depth

and width. Proper contouring gives

optimal esthetics.Labial flange

B l ib l


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Buccal vestibule.

Buccal frenum-retromolar pad.

Record adequate

depth and width. Impression is widest

in this area.

Buccal flange


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Buccal shelf

Extends from buccal frenumto retromolar pad.

Between external obliqueridge and crest of alveolar

ridge. Primary stress bearing

area(cortical bone)- lies atright angles to vertical

occlusal forces.


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External oblique ridge.

A bony ridge runsantero-posteriorlyoutside the buccal

shelf. Denture border 1-2

mm beyond this ridge.

Shows as Groove inimpression.


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Alveolar ridge

Residual bone withmucous membrane.

Crest to be relieved.

Buccal and lingualslopes are secondarystress bearing areas.


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Retromolar pad.

Triangular soft pad oftissue.

Posterior end of loweredentulous ridge.

Limiting landmark ofdistal extension ofcomplete denture uptoant 2/3 rd of retro molarpad.

Determines height andwidth of the occlusaltable.Retromolar fossa


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Alveolo-Lingual sulcus.

Between lingual frenum toretromylohyoid curtain.

Anterior region- lingualfrenum to mylohyoid ridge.

Premylohyoid fossa-premylohyoid eminence inimpression.

Border of Impression tomake contact with the

mucosa of the floor of themouth when tonguetouches the upper incisor.

Overextension causessoreness and instability.

Lingual flange

Premylohyoid

eminence


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Middle region.

From pre-mylohyoidfossa to the distalend of the mylohyoidridge.

Lingual flangeextends below thelevel of the

mylohyoid ridge-tongue rests on thetop of flange andaids in stabilizing the

lower denture.


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Posterior region.

The flangepasses into theretromylohyoidfossa.

Proper recordinggives typical Sform of the

lingual flange.


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Retromylohyoid space.

Distal end of lingualsulcus.

Area posterior to the

mylohyoid muscle. Good seal aids in

retention and stability.Retromylohyoid eminence


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Mylohyoid ridge.

Attachment for themylohyoid muscle.

Sharp or irregular

covered by themucous membrane.

Trauma from denturebasereliefnecessary.


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Mylohyoid muscle.

Floor of the mouth isformed by mylohyoidmuscle.

Lies deep to thesublingual gland in theanterior region- does notaffect the border ofdenture.

Posterior regionaffectsthe lingual border inswallowing and tonguemovements.


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Lingual frenum.

Fold of mucousmembrane.

Base of tongue to

supragenial tubercle. Registered in

function.

Lingual notch

maxilla landmarks

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