Complete Denture Impression

Whats our job? Complete Denture Impression

Create a 3-Dimensional representation of the patients tissues that the denture will be sitting on!

Complete Denture Impression

Complete Denture Impression

Whats our job?

All tissues in the mouth ? Hard - Soft
Residual ridges - palate - any boney areas ? Cheeks - mucosa - tongue - lips ?

Whats our job?

All tissues in the mouth ? Movable
Soft palate - frenum - vestibules Stretched - at rest - somewhere in between ?

Complete Denture Impression

Complete Denture Impression

Whats our job?

The denture sits on the oral tissue. When the denture contacts an opposing prosthesis - or natural teeth - what happens to the tissue under the denture?

Whats our job?

What type of tissue would be capable of taking the force? Soft - Hard? Big surface area - or small? Who cares - well tell the patient to just eat water!
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Complete Denture Impression

Complete Denture Impression

Force directed to a large bearing area is more equally distributed and much less per sq. mm. than the same force directed against a smaller area. The amount of biting force an edentulous ridge will tolerate is directly proportional to the amount of surface area covered F F

Complete Denture Impression

Complete Denture Impression

Consequently, if we hope to assist a patient to achieve maximum biting force and preserve the supporting structure over a longer period of time,

Are all the tissues the same ?

NO !
Macroscopically (palate, mandibular ridge) Microscopically (submucosa)

The maximum amount of denture bearing area must be covered.

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Complete Denture Impression

Complete Denture Impression

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Complete Denture Impression

Complete Denture Impression

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Complete Denture Impression

Complete Denture Impression

Buccal Shelf

Retromylohyoid Space - Lateral Throat Form

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Complete Denture Impression

Complete Denture Impression

Are these tissues all equal in their capability to support a denture under pressure?

NO !
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Complete Denture Impression

Complete Denture Impression

Primary stress bearing area (1) Primary stress bearing area, (2) Relief area (3) Peripheral seal area
Best to resist vertical forces of occlusion Base of cortical bone Protected by firmly attached epithelial type tissue Sufficient thickness to form a cushion against the forces of occlusion.

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Complete Denture Impression

Complete Denture Impression

Relief area
Pressure causes discomfort to the patient Pressure causes instability of the denture base

Peripheral seal area

Soft tissue border areas, which the periphery of the denture must contact in order for the factors of retention to be effective. The peripheral seal area is divided into two parts:

(1) Resistant peripheral area (2) Nonresistant peripheral area

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Complete Denture Impression

Stress Bearing

Complete Denture Impression

Relief Areas

Ridge Crest Lateral Hard Palate

Papilla Zygomatica Suture

Ridge Crest Buccal Shelf Retromolar Pads

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Mylohyoid Ridge Mental Foramen

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Complete Denture Impression

Resistant Peripheral Areas

Complete Denture Impression

Resistant Peripheral Areas

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Complete Denture Impression

Resistant Peripheral Areas

Complete Denture Impression

Resistant Peripheral Areas

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Complete Denture Impression

Resistant Peripheral Areas

Complete Denture Impression

Resistant Peripheral Areas Hamular Process of the Medial Pterygoid Plate

Lip
Mucosa Alveolar Bone Tuberosity Hamular Notch

Pterygomandibular Raphe
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Complete Denture Impression

Resistant Peripheral Areas

Complete Denture Impression

Non-Resistant Peripheral Areas

It is imperative that all maxillary denture bases terminate in this notch.

Bases short of the hamular notch will end on the thin - nonflexible - tissue of the tuberosity and will consequently lack retention.
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Complete Denture Impression

Non-Resistant Peripheral Areas

Complete Denture Impression

Non-Resistant Peripheral Areas

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Complete Denture Impression

Non-Resistant Peripheral Areas

Complete Denture Impression

Alveolar Process

Hard Palate Posterior Limit of Hard Palate Soft Palate

Lip Labial Vestibule Mucosa Vibrating Line

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Complete Denture Impression

Non-Resistant Peripheral Areas

Complete Denture Impression

Non-Resistant Peripheral Areas

Classifications of Throat Form CLASS I 6 - 8 mm of soft palate extends beyond the hard palate before dropping downward or registering movement when the patient speaks CLASS II 3 - 4 mm CLASS III 0 mm
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Complete Denture Impression

Non-Resistant Peripheral Areas

Complete Denture Impression

Peripheral Areas

CLASS III

Resistant Peripheral Areas 1.Labial frenum 2.Lingual frenum 3.Buccal frenum 4.Distobuccal arch 5.Pterygomandibular raphe 6.Retromylohyoid curtain 7.Alveolo-lingual fold Nonresistant border areas

Lip

Vibrating Line

For the Class III throat form where the movement of the soft palate starts immediately at the posterior border of the hard palate, problems may be encountered in establishing a good seal. 39

8.Labial vestibule 9.Buccal vestibule

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Complete Denture Impression

4.Distobuccal arch 5.Pterygomandibular raphe 6.Retromylohyoid curtain 7.Alveolo-lingual fold

Complete Denture Impression

4.Distobuccal arch 5.Pterygomandibular raphe 6.Retromylohyoid curtain 7.Alveolo-lingual fold

Posterior Limit of the Lower Denture The pterygomandibular raphe forms the attachment of the superior constrictor to the buccinator muscle. It runs from the posterior border of the hamular notch downward to the apex of the retromolar pad. The raphe stretches when the mouth is opened, pulling the distal edge of the pad upward. Dentures should not extend beyond this line of movement.
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The distobuccal arch is under the control of the masseter muscle which has its origin at the zygomatic arch. It is attached to the lateral border of the mandibular ramus. Dentures, which are overextended in this area, interfere with the contraction of the masseter muscle, which pushes forward against the buccinator muscle creating discomfort when the patient closes. The distobuccal arch ange, if properly shaped, will usually run at a 45-degree angle from the mesiobuccal arch to the apex of the 41 retromolar pad.

Complete Denture Impression

4.Distobuccal arch 5.Pterygomandibular raphe 6.Retromylohyoid curtain 7.Alveolo-lingual fold

Complete Denture Impression

4.Distobuccal arch 5.Pterygomandibular raphe 6.Retromylohyoid curtain 7.Alveolo-lingual fold

Distolingual Extension of the Lower Denture The retromylohyoid curtain lies lingual and inferior to the retromolar pad. It is formed by the mucous membrane of the lingual lateral border of the mandible and is attached to the posterior sides of the tongue. Its size, shape, and position vary with tongue movements. The curtain moves upward and backward as the tongue moves upward and backward in swallowing. It moves upward and forward during protrusive and lateral movements of the tongue. The amount of upward and forward movement of the curtain during these protrusive and lateral movements is referred to as the lateral throat form of the mandibular denture. If this movement is slight and the angle formed by the posterior part of the curtain to the retromolar pad is approximately 90 degrees, it is a Class I throat form. Extreme forward movement of the curtain resulting in an angle of 45 degrees or less in Class III throat 43 form and in between the two is Class II throat from

The amount of posterior lingual extension of the base is controlled by the movement of this curtain. Overextension of the denture flange results in the patient complaining of a sore throat or unseating of the denture. Underextension handicaps the tongue in controlling the lower denture and allows ingress of food under the denture. This tissue offers very little resistance to pressure so the operator must be careful not to create a false undercut by displacing it when making the impression. 44

Complete Denture Impression

Complete Denture Impression

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Complete Denture Impression

Complete Denture Impression

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Complete Denture Impression

4.Distobuccal arch 5.Pterygomandibular raphe 6.Retromylohyoid curtain 7.Alveolo-lingual fold

Lingual Extension of the Denture The alveololingual fold is formed by the mucous membrane's attachment to the lingual side of the mandible laterally and its attachment to the lateral borders of the tongue lingually. Because of this attachment, the fold is elevated when the tongue is protruded or when the tongue is moved laterally. Supporting the mucous membrane and forming the floor of the mouth is the mylohyoid muscle posteriorly and the sublingual gland anteriorly.

The mylohyoid muscle originates at the mylohyoid ridge. Its fibers pass downward and inward and are inserted posteriorly to the hyoid bone and anteriorly, with its neighbor, form the opposite side at the median raphe.

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Complete Denture Impression

Mylohyoid

Complete Denture Impression

Buccinator Mandible 3rd Molar Region The mylohyoid muscle, along with the mucous membrane can be easily displaced by pressure. Overextended bases in this lingual area will cause the denture to either lift out of position or result in a denture injury. For this reason it is necessary that an accurate non!pressure impression be obtained of the functional range of the fold.

1st Molar Region

Premolar Region

Canine Region
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Complete Denture Impression

Whats our job?

Below the sublingual gland are the mylohyoid muscles, and when this muscle raise upon swallowing it forces the gland and the floor of the mouth upward. Therefore, this is a resistant border area, and extension of the base is limited to the functional position of these tissues.

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