Prosthodontics Flashcards
Which muscle makes the labial frenum in the mandible?
Orbicularis oris
What is the posterior border of the maxillary buccal vestibule?
Hamular notch
What is the hamular notch?
It is a notch/fissure formed at the junction of the maxilla and the hamular process of the sphenoid bone
What are the lateral extents of the vibrating line?
It runs from hamular notch to hamular notch
How do you discover the vibrating line?
By asking the patient to say “ah”
What is the vibrating line 2mm away from?
Fovea palatini
What is the “butterfly line”?
The clear demarcation of the soft and hard palate, and the vibrating line is just behind it
How do you locate the butterfly line?
Valsalva maneuver
How do you perform the valsalva maneuver?
Hold your nose and gently try to push air through the nose. This balloons the soft palate down.
What do the butterfly line and vibrating line together form?
The posterior palatal seal area
Where is the posterior palatal seal area of the denture located?
Between the butterfly line and the vibrating line
What is the function of the posterior palatal seal area of the denture?
To approximate with the soft palate to create a tight vacuum-like seal to prevent displacement of the denture
What do you do to the master cast in the posterior palatal seal area?
You carve it a bit more around the vibrating line, to create a larger area for the denture to compress the soft palate
Why is the coronoid notch relevant in Complete Denture creation in the maxilla?
It marks the distobuccal area of the custom tray impression during maxilla denture making.
How do you record the border moulding at the coronoid notch area of a maxillary denture?
You ask the patient to do lateral excursives (move mandible left and right) so that the anterior portion of the coronoid process contours the distobuccal flange of the custom tray
What is the pterygomandibular raphe?
It’s a band of fibrous tissue that connects the buccinator anteriorly to the superior pharyngeal constrictor posteriorly
How is the pterygomandibular raphe relevant to maxillary dentures?
When you ask the patient to open their mouth wide, the pterygomandibular raphe moves forward and marks the impression material in the very back of the denture.
Which one is more broad - maxillary or mandibular edentulous arch?
Maxilla
Which muscle attaches in the maxillary labial frenum?
None
Which muscles attach in the mandibular buccal frenums?
Orbicularis oris and buccinator
Which muscles attach in the maxillary buccal frenums?
Orbicularis oris and buccinator
Which muscle attaches into the lingual frenum?
Genioglossus
Which muscle forms the inferior border of the mandibular labial vestibule?
Mentalis
Which muscle forms the inferior border of the mandibular buccal vestibule?
Buccinator
Why do I need to know about the muscles that form the vestibules?
Because their attachment will determine the extent of the flanges of the mandibular denture
Which muscle attachments are contained within the retromolar pad?
- temporalis
- buccinator
- superior pharyngeal constrictor
- pterygomandibular raphe
Do you cover the retromolar pad with the denture?
Yes - because the integrity of the bone is maintained in the area
What is the masseteric notch?
It’s the distobuccal area on the mandibular impression or denture
How do you record the masseteric notch?
Make the masseter contract by closing the mouth against resistance
What is the area between the mandibular alveolar ridge and tongue called?
Alveololingual sulcus
How many regions does the alveololingual sulcus have and what are they called?
3: Anterior, middle and posterior regions
What is the extent of the anterior region of the alveololingual sulcus?
Lingual frenum to premylohyoid fossa
Which gland sits in the anterior region of the alveololingual sulcus?
Sublingual gland
Is the lingual flange of the lower denture short or long in the anterior region?
Short. Because it has to sit above the mylohyoid muscle and not impinge on the sublingual gland
What are the extents of the middle region of the alveololingual sulcus?
From premylohyoid fossa to distal end of mylohyoid ridge (from the beginning to end of mylohyoid line)
What does “mylo” in mylohyoid stand for?
Molars
What function is the mylohyoid muscle responsible for?
Elevating the hyoid bone and tongue during swallowing and speaking
How is the flange of the mandibular denture affected in the middle region of the alveololingual sulcus?
The flange is deflected medially - due to the presence of the mylohyoid ridge laterally and the contraction of the mylohyoid medially.
What is the extent of the posterior region of the alveololingual sulcus?
It extends from the end of the mylohyoid line into the retromylohyoid fossa
Are mylohyoid attachments on the mandible higher posteriorly or anteriorly?
Posteriorly
How are attachments of the mylohyoid fibers different when comparing anterior to posterior attachments?
Anterior attachments are more horizontal, posterior attachments are more vertical
How is it possible for the lingual flange to be longer in the posterior area of the alveololingual sulcus when the mylohyoid insertions are higher on the ridge?
Because the mylohyoid fibres are more vertically oriented in the posterior region
What limits the extension of the lower denture in the distolingual area?
Palatoglossus and superior constrictor muscles
What causes a sore throat in denture patients?
Overextension of the lower denture in the distolingual area - impinging on the palatoglossus and superior constrictor muscles
Where is the buccal shelf located?
Just lateral to the posterior mandibular alveolar ridge
What is the function of the buccal shelf wrt dentures?
It’s a flat landing area and provides support for the mandibular denture
Why is the buccal shelf used to support mandibular dentures?
It lies flat and perpendicular to occlusal forces and hence helps resist occlusal forces
Does the buccal shelf have any muscle attachments?
Yes - the buccinator
Does the buccal shelf coincide with a vestibule?
Yes - the buccal vestibule
