Maxillary Landmarks
Importance
Dentist must fully understand the anatomy of
supporting and limiting structures :
• Foundations of the denture bearing areas
• Dentures and their supporting structures are
to coexist for reasonable length of time
GROUPING OF LANDMARKS
LIMITING STRUCTURES
These are the sites that will guide us in having an optimum
extension of the denture so as to engage maximum surface
area without encroaching upon the muscle actions
Encroaching upon these structures will lead to dislodgement
of the denture and/or soreness of the area while failure to
cover the areas upto the limiting structure will imply
decreased retention stability and support.
The limiting structures of the maxilla are:
1. Labial frenum
2. Labial vestibule
3. Buccal frenum
4. Buccal vestibule
5. Hamular notch
6. Posteror palatal seal area
`. Labial frenum
• Fold of mucous membrane at
the midline.
• Contains no muscle.
• Performs no action.
ATTACHMENT :
Superiorly: fan shaped
Inferiorly : attaches on
labial side of ridge
Labelled as 1
CLINICALLY:
•A V shaped notch is recorded
during impression making to
accommodate labial frenum
•The labial notch in the labial
flange of the denture should be
wide & deep enough to allow
the frenum to pass through it
without manipulation of the lip.
2. Labial vestibule
“That portion of the oral cavity
bound on one side by the
teeth,gingiva & alveolar ridge
& on the other side by the lips
& cheek”
- GPT
Vestibule is covered by the
lining mucosa.
SUBMUCOSA is thick &
contains areolar tissue &
elastic fibres
CLINICALLY:
Main muscle of the lip –
ORBICULARIS ORIS
forms the outer surface of the
labial vestibule.
Its tone depends on the support
received from the labial flange &
position of the teeth.
The fibres run horizontally & have
indirect displacing effect on the
denture.
Buccal frenum
It forms the dividing line
between the labial & buccal
vestibules.
It may be a single or double fold
of mucous membrane.
It has the following attachments:
•LEVATOR ANGULI ORIS
attaches beneath & effects the
position of the frenum.
•ORBICULARIS ORIS
Pulls the frenum forward
•BUCCINATOR
Pulls it backward
Hence it requires more clearance
for its action.
Buccal vestibule
• It extends from the buccal frenum
anteriorly to the hamular notch
posteriorly.
•Its size varies with the:
-contraction of the
buccinator -position of
the mandible
-amount of bone loss in the
maxilla.
CLINICALLY
The distal end of the buccal flange
of the denture should be adjusted not
to have any interference to the
coronoid process during mouth
opening .
Hence the buccal vestibule should
be measured with the mouth nearly
as close as possible.
Hamular notch
A depression between the
maxillary tuberosity & hamulus
of the medial pterygoid plate
It is soft area of loose areolar
tissue.
The distolateral border of the
denture rests in the hamular notch.
The tissues in the region can be
displaced to achieve the posterior
palatal seal.
So if the denture border is placed
anteriorly it will loose its retentive
properties.
Posterior palatal seal area
The soft tissues at or along the
junction of hard & soft palate on
which pressure within
physiological limits of the tissues
can be applied by a denture to aid
in the retention of the denture,
-GPT
It prevents the air entry between
the denture base & soft palate
The posterior palatal seal is divided
into:
• PTERYGOMAXILLARY SEAL
Extends across the hamular
notch & extends 3-4 mm anterolaterally
to end in the mucogingival junction on
posterior part of maxillary ridge
•POST PALATAL SEAL
Extends between the maxillary
tuberosities.
VIBRATING LINES
Vibrating line(area)-An imaginary
line drawn across thepalate that
marks the beginning of the
movement of soft palate when the
patient says ‘ah’ extending from
one hamular notch to the other
hamular notch;lying usually 2mm
in front of fovea palatinae.
The distal end of the denture should
extend at least to the vibrating line.
Functions of the posterior palatal
seal:
•Aids in retention
•Prevents food accumulation
•Compensation for polymerization
shrinkage
•Reduces the tendency for gag
reflex due to downward movement
of the denture during incising
SUPPORTING STRUCTURES
• Load bearing areas
•Show minimal ridge resorption under constant load.
•Denture should be designed such that most of the loadis
concentrated on these areas.
•Two types of stress bearing areas:
primary stress bearing areas
secondary stress bearing areas
SUPPORTING AREAS IN THE MAXILLA
PRIMARY STRESS BEARING AREAS
1. Hard palate
The horizontal portion of the
palate lateral to the midline
is the primary stress bearing
area.
Trabecular pattern in the
bone is perpendicular to the
direction of the force thus
withstanding any amount of
force.
2. Residual ridge
Portion of the alveolar ridge
& its soft tissue covering
which remains following
the removal of teeth.
-GPT
Mainly the posteriolateral
portion of the residual ridge
is the primary stress bearing
area.
SECONDARY STRESS BEARING AREAS
1. Rugae
Mucosal folds located in
the anterior region of the
palatal mucosa.
2. Maxillary tuberosity
Bulbous extension of the
residual ridge in second &
third molar region.
They are secondary stress
bearing because they are
least likely to resorb.
RELIEF AREAS
These are the areas which either
resorb under constant load or have
fragile structures within or are
covered by thin mucosa which can
be easily traumatized
& hence should be relieved.
They are:
• incisive papilla
•Mid palantine raphe
•Fovea palatina
•Torus palatinus
RELIEF AREAS
1. Incisive papilla
Position
midline structure
situated behind the
central incisors.
Why a relief area ?
Exit point of the
nasopalatine nerves &
vessels. Hence the area
should be relieved to
prevent necrosis of the
distributive areas &
parasthesia of the
anterior palate.
Mid palatine raphe
Position
median suture area
covered by thin
submocosa.
Why a relief area ?
the submucosa in the
mid palatine suture is
very thin. Hence relief
should be provided in the
denture covering the suture.
Fovea palatina
•Formed by the coalescence of
ducts of several mucous
glands.
•Guide to locate posterior
border of the denture.
•Patients with thick ropy saliva
they should be left uncovered
to prevent the displacement of
the denture.
TORUS PALATINUS
Hard bony enlargement in midline
of roof of the mouth in 20% of
people.
Covered by thin mucous
membrane.
Relief should confirm accurately
to the shape of the torus because
the denture is robbed of the
support area.
