Mohamed Ali El Maroush

Ph.D of prosthodontics & Maxillofacial

)Ain Shams University(
 Extra-oral landmarks
1- Inter-pupillary line
 Anatomy: Imaginary line running
. between the two pupils of the eye

Importance: for establishing the

anterior occlusal plane of the artificial
.teeth of the denture
Ala-tragus line (Camper’s line) -2

Camper’s Line
 Anatomy: Imaginary line running
from the inferior border of the ala of
the nose to the superior border of the
. tragus of the ear
Importance: establishing the
posterior occlusal plane of the artificial
.teeth of the denture
Ala-tragus line (Camper’s line) -2
Ala-tragus line (Camper’s line) -2
3 -Canthus-tragus line
Anatomy: Imaginary line running
from the outer canthus of the eye
to the superior border of the tragus
.of the ear
Importance: Arbitrary locating
.the position of the condyles
 D

………………………………………………………… D
……………………………………………………………
4- Naso-labial sulcus
5- Vermillion border
6- Philtrum
.Naso-labial sulcus -4
Anatomy: A depression that
extends from the ala of the nose in a
downward and lateral direction to the
.corner of the mouth
Importance: the sulcus become
deeper and more prominent with
.aging and loss of teeth
Nasolabial Sulcus
:Vermillion border -5
Anatomy: Transitional epithelium
between the mucous membrane of
.the lip and the skin
.Philtrum -6
Anatomy: A diamond shaped area
between the center of the upper lip
.and base of the nose
Importance: proper denture will
restore a good contour to the
philtrum within a short time after
.insertion
A

B
‫لكم التعليق‬
Angle of the mouth -7

Angular
cheilitis
Mento-labial sulcus -8
Anatomy: A depression runs from
side to side horizontally between the
.lower lip and chin
Importance: Its curvature
frequently indicates the character of
.maxillo-mandibular relationship
Mento-labial sulcus -8

A B C

.………A- class
………B- class
………C- class
 Modiolus-9
.B: buccinator m
DAO: depressor anguli oris
m. (triangularis)
.II: Incisivus inferior m
.IS: incisivus superior m
LAO: levator anguli oris m.
(caninus)
.OO: orbicularis oris m
.ZM: zygomaticus major m

It is a node or depression, below and distal to the

corner of the mouth, contributed to The union of
.the lip and cheek muscles
Extra oral Landmarks
Intraoral landmarks of prosthetic
.importance
.A- In the maxilla
 A-Maxillary anatomical landmarks
Incisive Labial frenum Labial vestibule
papilla
Rugae

Hard palate Buccal

frenum
Palatine
raphe
Buccal
vestibule Residual ridge
..

Maxillary Tuberosity Hamular notch

Fovae Palatina
Soft Palate
Vibrating line
 Maxillary supporting structures

1-Residual ridge.
The residual ridge is considered the
primary stress bearing area in the
upper jaw.
 Anatomy: The portion of the
alveolar process and its soft tissue
covering that remains after removal
.of the teeth
Importance: for supporting the
.denture
Types of alveolar ridges and
palatal form
 2- Maxillary tuberosity.
Anatomy : A rounded prominent
bulge behind the distal end of the
maxillary ridge
Important:
retention and support of the maxillary
denture .
.Maxillary tuberosity -2
NB extremely large tuberosity may need
surgical correction before complete denture
.construction
 Maxillary supporting structures

3- Median palatine raphe:

The midpalatal suture is covered with
a thin mucoperiostium with little or no
submcosa called the median palatine
raphe.
Importance: The median palatine
raphe should be relieved to prevent
the upper denture from rocking and
splitting.
Median palatine raphe -3
 ‫تمشي بالرجلين‬
‫وتبكي بال عينين فما‬
‫هي ؟؟؟؟؟؟؟؟؟؟؟‬
 Maxillary supporting structures
4- Incisive papilla:
Anatomy: It is a pear-shaped
elevation of soft tissues at the midline
just behind the central incisors. It
covers the opening of the incisive
foramen.
:Incisive papilla -4
 :Incisive papilla -4

Importance:
I- It should be relieved to avoid
burning sensation.
II- It is often used as a midline
landmark.
III- A guide to the anteroposterior
position of the teeth the labial surface
of central incisors are 8-10 mm in front
of the incisive papilla.
 Maxillary supporting structures
5- The palatine rugae:
Anatomy:
Irregularly shaped ridges of dense
connective tissues in the anterior one
third of the hard palate.
Importance:
a- Plays a part in speech (s sound).
b- it is a secondary bearing area as it
resists forward movement of the
denture.
Raugae Area
:The palatine rugae -5
 Maxillary supporting structures
6- Torus palatinus:
Anatomy: A Bony projection of varying size
and forms in the midline of the palate or on
each side lateral to the median palatine suture.
Importance :
a- If the size of the torus is too big or extended
posteriorly placed it should be surgically
removed.
b- If the torus is small, the denture base over
this area must be relieved.
 Maxillary supporting structures
7-Fovea palatinae:
Anatomy:
openings of the ducts of minor salivary
glands usually two in each side of the midline
just posterior to the junction of hard and soft
palate.
Importance:
Land mark for the posterior border of the
maxillary denture (2mm posterior) to the
fovea palatinae.
Vibrating line,fovea palatinae
Maxillary anatomical
landmarks on cast
Maxillary anatomical landmarks on
cast
B-Mandibular anatomical landmarks

Retromolar pad
Mylohyoid bone
Buccal shelf
Lingual frenum Residual ridge
Buccal sulcus
Lingual sulcus
Buccal frenum

Floor of the mouth Labial vestibule

Labial frenum
 Mandibular supporting structures

1- Residual ridge:
Anatomy:
The remaining portion of the alveolar
process after teeth extraction .

Importance:
The porous and cancellous nature of
this bone, makes it unsuitable as a
primary stress bearing area.
Mandible –Note the varying degrees of ridge width and height

.Support and retention are affected by the shape of the residual ridge
 2-External oblique ridge:
Anatomy: A dense bony ridge which
descends obliquely from the ramus
until it fades near mental foramen.

External Oblique
Line
Mandibular supporting structures
Mandibular supporting structures
Importance : of External oblique
ridge, the lower denture should
cover the external oblique ridge but
not extend beyond the external
.oblique ridge
 Mandibular supporting structures

3-Buccal Shelf Area:

Anatomy: Lies between the crest of
the residual ridge and the external
oblique ridge formed from dense
compact bone and nearly lies
perpendicular to the vertical masticatory
forces.
Importance: It is considered a
primary stress bearing area..
:Buccal Shelf Area-3
 Mandibular supporting structures
4-Mental foramen:
Anatomy:
Located on the buccal surface of the
mandible in premolar region between the
roots of the first and second premolars.
Importance:
In cases of sever ridge resorption, the
mental foramen is usually located on the
crest of the ridge it should be relieved.
 ‫سورة في القران‬
‫الكريم ال يوجد فيها‬
‫بسملة ما هي؟؟؟‬
 Mandibular supporting structures
5- Retromolar pad:
Anatomy:
Small pear shaped area at the distal
end of the residual mandibular ridge.
 Mandibular supporting structures

5- Retromolar pad:
Importance:
a. It should be covered by the lower
denture. It acts as a cushion or
shock absorbable.
b. It forms soft tissues seal for
retaining the denture.
 Mandibular supporting structures
6-Torus mandibularis:
Anatomy:
Unilateral or bilateral bony projections
sometimes found on the inner surface of
the mandible in the premolar region.
 Torus mandibularis-6
:Importance
Sufficient relief should be made in
this. If the torus is large it should be
.surgically removed
 Mandibular supporting structures
7-Internal oblique ridge:
Anatomy: Bony ridge on the medial
surface of the mandible represent the
attachment of the mylohyoid muscle. It
becomes prominent with resorption.
Importance: Should be included in the
denture bearing area.
 Thin sharp mylohyoid ridge should be

recontoured to permit better flange

placement.
 Mandibular supporting structures
8- Genial tubercles or mental
spine:
Anatomy: Two bony projections
covered by thin tissues that are
located on the medial surface of the
mandible.
Importance: In cases of sever ridge
resorption these tubercles lies very
close to the crest of the ridge thus
may require relief.
Genial tubercles
Genial tubercles or mental spine
Mandibular anatomical landmarks on
cast
Maxillary limiting structures
 Maxillary limiting structures
1- Labial frenum.
Anatomy: single or multiple folds of
mucous membrane , extending from the
mucous membrane of the lip towards
the residual ridge on the labial surface.
Importance: A labial notch must be
done opposite to its position to allow
motion without causing ulceration and
dislodgment.
.
2-Labial mucous membrane
reflection area or the labial
vestibule.
Anatomy: it is the reflection of the
mucous membrane from the lip to
the labial alveolar bone,
extending from labial frenum to
buccal frenum.
Importance: lies denture in place .
 Labial
frenum
Labial
vestibule
3-Buccal frenum.
4-The buccal mucous
membrane reflection area or
the buccal vestibule.
 Maxillary limiting structures
5- Hamular notch:
Anatomy:
a band of loose CT Lies between the
pterygoid hamulus of the sphenoid
bone and the distal portion of the
maxillary tubeosity.
Importance:
used as a landmark for the correct
extension of the upper denture.
:Hamular notch
 Maxillary limiting structures
6-Vibrating line of the palate:
Anatomy:
An imaginary line It marks the beginning of
motion in the soft palate at the midline it
passes 2mm behind the fovea palatinae.
Importance:
It determines the posterior extension of the
maxillary dentures.
 Maxillary limiting structures
Vibrating line used as a landmark for
the correct extension of the upper
denture.
‫ما شاء هللا‬
 Mandibular limiting structures
.Mandibular labial frenum -1
Labial mucous membrane reflection -2
.area
.Buccal frenum-3
Buccal mucous membrane reflection-4
.area (buccal vestibule
 Mandibular limiting structures
5-Masseter muscle influence area:
The distobuccal corner of the
mandibular denture is in relation to the
masseter muscle.
the buccal flange of the denture must
converge in a medial direction to avoid
displacement by the contracting
pressure of the masseter muscle.
Masseter muscle influencing area

Distobuccal area
 Mandibular limiting structures
6-Distal extension of the
mandibular denture:
- The lower denture should cover the
retromolar pad.
 Mandibular limiting structures
7- Lingual frenum:
Anatomy: A fold of mucous
membrane that extends from the
floor of the mouth along the midline
to the under surface of the tongue.
Importance: The denture flange must
be well rounded in this`area
 Mandibular limiting structures
8- Alveolingual sulcus:
Anatomy: it is The space between the
residual ridge and the tongue.
Importance: The lingual flange of the
denture extends in the lingual sulcus as
determined by of the functional
.movements of the mylohyoid ridge
 Mandibular limiting structures
9-Sub-lingual salivary gland area:
Anatomy:
in The premolar region, the lingual flange
of the lower denture is in relation to the
sublingual salivary gland.

Importance:
With excessive resorption the gland may
bulge superiorly affecting the depth of the
lingual flange in this area.
 Sublingual salivary
gland area

Sublingual salivary
gland area

Sublingual salivary
gland area
Mandibular limiting structures
 Mandibular limiting structures
4-Retromylohyoid space or fosa:
Anatomy:
It extends from the end of the mylohyoid
ridge to the retromylohyoid curtain.
Importance:
Overextension of the distolingual flange
in this area will cause sore throat due
to pressure on the superior constrictor
muscle
Mandibular limiting structures
 The anatomy of the Retromylohyoid space
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