Anatomy

Question 1

Retromylohyoid region

Answer 1

-Distal end of alveolingual sulcus
-Inferior is mylohyoid
-Posterior is superior pharyngeal constrictor
-Medial is palatoglossus (ant tonsillar pillar)
-Lateral is pterygomandibular raphe

This region can be visualized physiologically by instructing patient to bring tongue forward which contracts the muscles forming the distolingual flange of md CD

Question 2

Buccal Shelf

Answer 2

-Area of primary support in md CD
-Limited by external oblique ridge
-Buccinator horizontal fibers run parallel to denture base
-When masseter contracts it pushes buccinator inwards

Question 3

Mx Buccal Frenum

Answer 3

It consists of one or more bands, may be totally absent or may be in an
entirely different location. Most of the muscles of expression converge at the corner of the mouth to form a nodule called the
Modiolus.
• The major muscles in this area are the Buccinator, Levator anguli oris, and Orbicularis oris. Clinical Consideration: During final impression procedure and in final prosthesis sufficient relief should be given for the movement of frenum because overriding of function of frenum will cause pain and dislodgement of denture. During impression procedure the cheek should be reflected laterally and posteriorly. If frenum is attached close to the crest of alveolar ridge,
frenectomy

Question 4

Mx Buccal Vestibule

Answer 4

It extends from buccal frenum or
from the first premolar area to the hamular notch.

It is bounded anteriorly by the buccal frenum, laterally by the buccal mucosa and medially by residual
alveolar ridge.

It is influenced mainly by the modiolus and buccinator muscle, and distally by the coronoid process. Clinical

Consideration: During impression procedure the vestibule should be completely filled with impression material for proper border contact between denture and tissues. When the vestibular space that is distal and lateral to the alveolar tubercles is properly filled with denture flange the stability and retention of the maxillary denture is greatly enhanced. To effectively record the maxillary buccal sulcus the mouth should be half way closed because wide opening of the mouth narrows the space and does not allow proper contouring of sulcus
because the coronoid process of mandible comes closer to the sulcus.

Question 5

Mx Stress Bearing Areas:

Answer 5

Primary Stress Bearing Area- • The areas that are most capable of bearing the masticatory
load providing a proper support to the denture.
• The Primary Stress Bearing area are: 1. Hard Palate: The shape of the hard palate in cross
section is either flat, rounded U-shaped or V-shaped.
It is covered by Keratinized squamous epithelium. Anterolaterally the mucosa contains adipose tissue and
posterolaterally it contains glandular tissue. Clinical Significance: The horizontal portion of the hard
palate provides the primary denture stress bearing area.

Secondary Stress Bearing Area- • Residual Ridge: The alveolar ridge is considered as a secondary area of support as the anterior
ridge seems to be more susceptible to resorption • Rugae: They are raised areas of dense connective tissue radiating from the midline in the anterior one-third of the
palate.
1 Clinical Considerations: Both acts as Secondary stress bearing areas. Rugae are concerned with phonetics. It increases the surface area of the foundation and thus supplement the values of retention. It is the denture stabilizing area in the maxillary foundation. They are often compressed or distorted from an ill fitting denture and should
be allowed to return to their normal form prior to impression making.

Question 6

Alveolingual Sulcus/ The Lingual Vestibule:

Answer 6

• The space between the residual ridge and the tongue. • It extends from the lingual frenum to the
retromylohyoid curtain.
It is divided into: 1. Anterior vestibule / the sublingual crescent area / premylohyoid / anterior sublingual
fold.Anterior Lingual Vestibule: Also known as
sublingual crescent area or anterior sublingual fold. • It extends from the lingual foramen to the point where the mylohyoid ridge curves down below the level of the
sulcus. • Lingual frenum is superimposed over the genioglossus
which raises the tongue Clinical Considerations: If the mandibular ridge is highly resorbed the attachment of the genioglossus lies almost at the level of the crest of the alveolar ridge. Surgical sulcus deepening may be required in such scenarios. The width of the border of the denture in this region is usually about 2mm.But the width depends on the tonicity of the genioglossus. The genioglossus and the lingual frenum are recorded by asking the patient to moderately protrude the tongue as
these tissues do not tolerate impingement.
2. Middle vestibule/the alveolingual sulcus/ mylohyoid area.• Middle Vestibule: Also known as mylohyoid vestibule.
Forms the largest part of the alveololingual sulcus
• Influenced by:
Mylohyoid muscle
Sublingual glands Clinical Considerations: The length and with of the mylohyoid flange is determined by the membranous attachment of the tongue to the mylohyoid ridge and the width of the hypoglossus muscle and can only be determined by skillful border molding
and impression procedures.
3. Distolingual vestibule / lateral throat form / retromylohyoid fossa / lingual pouch.• Distolingual Vestibule : Also known as lateral throat form or
retromylohyoid fossa.
• Boundaries -
Anteriorly- Mylohyoid Muscle
Laterally- Pear Shaped Pad
Postero-laterally- Superior Constrictor Muscle
Postero-medially- Palatoglossus
Medially- Tongue