INTRO TO PROSTHODONTICS 1.

Philosophic
- Accepts dentist's judgement and instructions, best
prognosis.
PROSTHODONTICS
2. Exacting/Critical
- Branch of dental art and science pertaining to the
restoration and maintenance of oral function by - Methodical and demanding, asks a lot of
the replacement of missing teeth and associated questions, good prognosis.
structures by artificial devices 3. Hysterical/Skeptical
- Emotionally unfit, never happy, worst prognosis.
PROSTHESIS – appliance (bridge, crown, denture) 4. Indifferent
- Doesn't care about dental treatment and gives up
easily.

PROSTHODONTICS

ANATOMY OF EDENTULOUS
Removable
Prosthodontics
Fixed Partial
Prosthodontics
Maxillofacial
Prosthodontics
Implant
Prosthodontics
MAXILLA & MANDIBLE

Removable Partial Complete Denture

CLASSIFICATION OF MUCOSA
Denture Prosthodontics 1. MASTICATORY MUCOSA – well-defined
Prosthodontics
stratified squamous keratinized layer on its
outermost surface subject to changes in thickness
- Found on stress-bearing areas
- Covers the following:
BRANCHES OF PROSTHODONTICS 1. Crest of residual ridge (inc. maxillary tuberosity)
2. Attached gingiva on slopes of the residual ridge
3. Hard palate and palatine rugae
2. LINING MUCOSA – stratified squamous non-
keratinized
- Covers the following:
1. Mucous membrane of the lips, cheeks
2. Vestibular spaces – between the lips, cheeks and
the residual alveolar ridge
3. Alveolo-lingual sulcus – between the tongue and
COMPLETE DENTURE PROSTHESIS residual alveolar ridge
1. CONVENTIONAL – for completely edentulous 4. Soft palate (posterior to vibrating line)
patients 5. Ventral Surface of the tongue
2. IMMEDIATE – patients about to lose their teeth 6. Free gingiva on the slopes of the residual ridge
o Badly carious; beyond restoration 3. SPECIALIZED MUCOSA – keratinized mucosa
3. OVERDENTURE – not completely edentulous seen on the dorsal surface of the tongue
o Implant patients
o No bone resorption. Roots are preserved. CONSISTENCIES OF MUCOSA
1. RESILIENT
OBJECTIVES AND AIMS ✔ Most ideal type for complete denture.
1. Restore function
✔ Returns to its original form when
2. Restore phonetics
3. Provide esthetics distorted after pressure is applied
4. Provide comfort 2. NON-RESILIENT (Unyielding)
✔ very thin mucosa and submucosa
YMATO FACTOR – Relationship of dentist, patient, ✔ Tightly attaches to the ridges.
and technician. 3. FLABBY
- Dentist interacts with both technician and patient. ✔ More then 3-5mm ridge and wiggly.
- Technician only applies mechanical principles ✔ Thin mucosa, thick submucosa
but cannot analyze biological considerations ✔ Not a good candidate for CD
✔ Cannot take an impression of the
PSYCHOLOGICAL CLASSIFICATION anatomical ridge form
OF PATIENTS (Dr. House)
OPEN WINDOW IMPRESSION TECHNIQUE – tray
used is perforated. Therefore less pressure to capture the 5. Frenae – fold of tissue that restricts movement
anatomical ridge form - Relief area (cannot bear stress/pressure)
a. Labial Frenum – moves vertically
B. HARD & SOFT TISSUE LANDMARKS b. Buccal Frenum – movement is
OF THE MAXILLA AND MANDIBLE horizontal
- Orbicularis Oris (buccal frenum forward)
MAXILLARY ARCH
- Buccinator (buccal frenum back)
1. Residual Alveolar Ridge
o - Levator anguli oris (buccal frenum up)
Resorption of
the maxillae

2. Incisive Papilla
- Originally found lingually in between the
* Retract check, forward, back and down to capture
2 maxillary central incisors.
correct relief area of buccal frenum.
- Most stable landmark for the midline * Tray should be extended up to the vestibule.
(incisive foramen and nasopalatine nerve Overextended = roundness of vestibule not captured
blocking) Too short = no vestibule
- Guide for bone resorption
(Moves anteriorly as bone resorbs) 6. Vestibule
- pocket formed by the soft tissue of the
lips/cheeks and the gingiva

3. Maxillary Tuberosity
- Most posterior, bulbous part of the
residual alveolar ridge at the 3rd molar 7. Palatine Fovea
area. - 2 small openings located 2mm posterior
- Secondary stress-bearing area. to the vibrating line
- Functions to lubricate mouth via
coalescence of ducts of salivary glands
- Should not be part of the denture or else:
o Can cause gag reflex
o Dislodgement. Lack of saliva
lessens retention of the denture.
- Can be used as a guide for the midline
4. Hamular Notch or Pterygomaxillary
- Found between the maxillary tuberosity
and the hamulus of the pterygoid plate.
- Posterior limit of the denture base:
hamular notch and vibrating line

8. Vibrating Line
**Flat Palate = Broad
Round Palate = Medium
Deep Palate= Narrow
POST-DAM constitutes hamular notch to the vibrating
line
- For retention
** Posterior Palatal Seal Area (PPSA)
- Hamular notch + vibrating line
- Denture base should be extended up to this area
- Provides peripheral seal
9. Rugae
- Irregular folds of tissue on the hard palate
BORDERS OF DENTURE
- Not perpendicular to masticatory forces
MAXILLA MANDIBLE
therefore a secondary stress bearing area
ANT. Labial vestibule (mucolabial fold)
Buccal vestibule
LAT. Buccal shelf
(mucobuccal fold)
Retromolar pad
Hamular notch
POST. Pterygomandibular
Vibrating line
10. Median Palatine Suture raphe
- Made up of compact bone Alveolo-lingual sulcus
Median palatine
MED. Retromylohyoid
- Covered with a very thin layer mucosa raphe
curtain
like a non-resilient mucosa
- Considered as a relief area
MANDIBULAR ARCH
1. Retromolarpad
- Most distal part of the residual ridge
- Oblong, triangular or pear-shaped
- Primary stress bearing area
o Mucosa is thin, non-keratinized
o Submucosa – made up of
glandular tissue, fibers of
11. Coronoid Bulge buccinator, superior constrictor,
- Found at the coronomaxillary/tuberosity PMR (pterygomandibular raphe)
sulcus area (deepest part of the maxillary and temporal part of the tendon
buccal vestibule) of the temporalis muscle
- Caused by the coronoid process which - Denture base can be extended 2/3 of the
moves forward when mouth is opened. retromolar pad if the patient cannot
- Therefore, tolerate it being extended in the whole
coronomaxillary sulcus
part of the retromolar pad
becomes more shallow
- 2/3 of the retromolar pad height =
- In denture making, phlanges should not
occlusal surface of mandibular molars
completely invade tuberosity sulcus.

2. Buccal Shelf
12. Torus Palatinus
- Anteriorly: buccal frenum
- Affects retention and support of denture
Posteriorly: masseteric notch
- Usually removed via surgery
Laterally: external oblique ridge
- Wax cannot be used in relieving the area. Medially: crest of the residual ridge
Just use tin foil or stones - Primary stress bearing area
 - A relief area at the lateral part of the
retromolar pad.
- When the masseter muscle activates it
can lift the denture thus dislodging it
7. Vestibule
3. Residual Ridge - space between lips/cheeks and the
- The slope is a primary stress-bearing area residual alveolar ridge
- The crest is composed of spongy bone 8. Retromylohyoid curtain
and cannot accommodate the occlusal - Curtain-like tissue found behind the
forces retromylohyoid space
- Sometimes denture base can be extended
up to this area as long as the patient can
tolerate
9. Pterygomandibular raphe
- Part of the oral cavity that connects the
maxilla and the mandible
** If denture base is extended up to this area once
the patient opens the mouth PMR will move
4. Frenae forward thus dislodging the denture
a. Labial
b. Buccal
c. Lingual

5. Alveololingual Sulcus
- space located between the tongue and the 10. Lingual/Genial Tubercle
residual ridge - 4 mental spines
- May become too prominent due to
alveolar ridge resorption.
- Can be used as a support if there is no
residual ridge
- Outline can be extended up to this area if
the patient can tolerate
11. Submandibular caruncle
- Opening of the submandibular duct
a. Retromylohyoid area (Wharton’s duct)
o Deepest part of the vestibule
o Posterior segment and the
deepest part; found below and
posterior to the mylohyoid ridge
o Provides retention and stability
** Insert mouth mirror between the tongue and
the residual ridge, and ask patient to protrude
tongue.
- If mouth mirror moves, shallow sulcus. 12. Torus Mandibularis
b. Mylohyoid space - Common in men
o Middle compartment where the - Not used for support
mylohyoid ridge is found - Surgical removal should be done
c. Premylohyoid / Sublingual Crescent
o Crescent shape area on the
anterior part of the alveolo-
lingual sulcus formed by the
lingual wall of the mandible and
the adjacent sublingual fold.
o It runs from canine-to-canine
6. Masseteric notch
 MAXILLA MANDIBLE
Incisive Papilla
- Needs to be relived because it Crest of the Residual Alveolar Ridge
houses the nasopalatine nerve
Median Palatine Raphe
RELIEF AREAS - Covered by a thin layer of mucous Labial, Buccal, Lingual Frenae
- Must not be membrane
covered by any part Labial and Buccal Frenae Masseteric Notch
of the denture base. Cuspid eminence
- Will result in - After canine extraction, prominent
Mental Foramen
insufficient bony socket may be left
retention, or support underneath
or easy Extensive undercut
dislodgement Bony Spicules
- Cannot recontour the bone
Sharp bones
- When surgical procedures cannot Torus Mandibularis
be done
Torus Palatinus
PRIMARY
STRESS- Hard Palate Buccal Shelf
BEARING AREAS
- Receives
perpendicular forces
of mastication
- Must be covered Crest of Residual Alveolar Ridge Slope of Residual Alveolar Ridge
by denture for even
distribution of load

SECONDARY
STRESS Rugae Retromolar Pad
BEARING AREAS
- Do not receive
perpendicular forces
Slope of Residual Alveolar Ridge
of mastication