PRE-CLINICAL
REMOVABLE
PROSTHODONTICS
INTRODUCTION
AND
ANATOMICAL LANDMARKS
Dr. Tushar Bhagat
7508tvb@gmail.com
Ref: Hasabulla Principal of complete denture.
Course Description
Course Code
DSP 331
Course Name
Preclinical Removable
Prosthodontics
Level
Second Year (1st & 2nd Semester)
Prerequisite
none
No. Of Credits
6 credits
Credit Distribution
1 lecture + 1 practical
Course Description
References:
1. Hassaballa, M.H. and Talic, Y.F. Principles
of Complete Denture Prosthodontics. 1st
Edition. King Saud University-Academic
Publishing and Press 2004.
2. Textbook of Complete Dentures. Rahn AO,
Heartwell CM, 5th edition, 1992.
3. Dental Laboratory Procedures, Vol. 1
(Complete Dentures), Rudd and Morrow, 2nd
Edition, 1986, The C.V. Mosby Co., St.
Loius.
Outcomes of this course
Complete removable denture philosophies.
Use of Articulators
Occlusal contacts and teeth arrangement
Laboratory procedure for removable prosthodontics
Practical Sessions
How to Perform labortary steps for removable
prosthesis procedures.
How to arrange artificial teeth for complete denture
How to do surveying for RPD designing.
RPD designing
Methods of Assessment
Continuous Assessment: 60%
1st Mid-term theory exam = 10%
2nd Mid-term theory exam = 10%
3rd Mid-term theory exam = 10%
1st Practical Assessment Examination = 05%
2nd Practical Assessment Examination = 05%
3rd Practical Assessment Examination = 10%
Final Examination: 40%
5th Practical Assessment Examination = 10%
4th Mid-term theory examination
= 10%
Quizzes
= 10%
Logbook evaluation
= 05%
Attendance
= 05%
60%
40%
DEFINITIONS
Prosthesis : an appliance which replace
lost or congenitally missing tissues.
Prosthetics : is an art and science of
designing and fitting artificial substitute to
replace lost or missing tissue.
DEFINITIONS
Dentulous ??
Edentulous??
OBJECTIVES OF
COMPLETE DENTURE
1) To provide adequate masticatory function.
2) To restore natural appearance
3) To restore normal speech
Anatomical landmark
According to the clinical significance
Landmarks
of edentulous jaws
Limiting structures
Supporting
structures
Relief areas
Limiting structures in
maxilla
Labial frenum-Fibrous band
covered by mucous membrane.
A labial notch is be narrow but
deep enough in CD to avoid
interference.
Labial vestibule (sulcus)-
bounded on one side by the
teeth, gingiva and residual
alveolar ridge and on the outer
side by lips.
Buccal frenum-Attachment of
following muscles;levator anguli
oris,orbicularis oris,buccinator.
Buccal vestibule (sulcus)-Extends from
buccal frenum anteriorly to the hamular
notch posteriorly.The size of the
vestibule is dependant uponcontraction of buccinator muscle
position of the mandible
masseter action
amount of bone loss

Hamular notch-It is depression
situated between the maxillary
tuberosity and the hamulus of the
pterygoid plate .It is a soft area of
loose connective tissue.
The posterior extent of the denture in this
region should end in the hamular notch
·Posterior palatal seal area[post dam]Soft tissue at or along the junction of
the soft and hard palate on which the
pressure within the physiological limits
of the tissue can be applied by a
denture to aid in the retention of the
denture
Made of two regions·→
1.Pterygomaxillary seal-The
part of the posterior
palatal seal that extends
across the hamular
notch.It extends 3-4 mm
anterolaterally to end in
the mucogingival junction
on the posterior part of the
maxillary ridge.
2.Posterior palatal seal-This
is a part of the posterior
palatal seal area that
extends between the two
maxillary tuberosity
Vibrating line(area)-An imaginary
line drawn across the palate when
the patient says ‘ah’ extending from
one hamular notch to the other
hamular notch; lying usually 2mm in
front of fovea palatinae.
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
Limiting structures in mandible
Labial frenum-Fibrous band
extending from the labial aspect of
the residual alveolar ridge to the
lip.
It is an active frenum containing
a band of the fibrous connective
tissue the that helps in attachment
of the orbicularis oris muscle
It is quite sensitive too and
hence denture should have an
appropriate labial notch.
Labial vestibule-Runs from the labial
frenum to the buccal frenum on each
side.
Mentalis muscle is quite active in this
region
 Buccal frenum
 Buccal vestibule- Extends posteriorly
from the buccal frenum to outside back
corner of the retromolar pad
Impression is widest in this region.
.
*Area maximisation can be safely done
here as because the fibres of the
buccinator runs parallel to the border
and hence displacing action due to
buccinator during its contraction is
slight
Lingual frenum-This area is
shallow and hence should be
recorded in function because at
rest the height of the
attachment is deceptive ;in fact
in function it goes quite close to
the crest of the ridge even
though at rest it might be lower.
Alveolingual sulcus-The space
between the ridge and the
tongue extending from the
lingual frenum to the
retromylohyoid curtain. A part
of it is available for the lingual
flange of the denture.
It can be divided into three partsa.Anterior part or the pre mylohyoid region :
Extends between the lingual frenum and pre
mylohyoid fossa.It is the shallowest
portion(least height) of the lingual flange.
b.Middle region or the mylohyoid region:Extends
from the premylohyoid fossa to the the distal
end of the mylohyoid region. The denture
border here should extend beyond and not
below the mylohyoid ridge in this area if proper
lingual seal is to be achieved.
c.Posterior portion or Retromylohyoid fossa regionExtends from the end of the mylohyoid ridge
end to the retromylohyoid curtain.
Provides for a valuable undercut area so
important retention in case of a mandibular
denture.
Retromylohyoid pad -
Pear shaped triangular soft pad
of tissue at the distal end of the
lower ridge is referred to as the
retro molar pad.
Supporting structures
Masticatory forces produce quite a pressure on the
underlying structures and not everyplace beneath the
denture can take such stress hence we need to know the
areas which can bear the stresses well.
These can be divided into-
1.Primary stress bearing area
2.Secondary stress bearing area
Primary stress bearing
area
These are the areas that are most
capable to take the masticatory
load providing a proper support
to the denture.
Some desired properties for
primary stress bearing area
are-
1.Tightly adherent sufficient fibrous
connective tissue with an
overlying keratinized mucosa
2.Presence of cortical bone cover
3.Should be at right angles to the
vertical occlusal forces.
4.No underlying structures should
be present that will get harmed
due to stress.
Stress bearing areas in the maxilla
Primary
 Posterolateral slope of the
hard palate formed from the
horizontal process of the
palatine bone
Posterolateral part of the
residual alveolar ridge
 Secondary
The palatal rugae areamucosal folds located in the
anterior region of the palatal
mucosa
Maxillary tuberosity.
Stress bearing areas in the mandible
Primary-
Buccal shelf area-area
between the buccal frenum and
the anterior border of the
masseter
Bounded medially
by:crest of the ridge and by the
retromolar pad
* The total width of the bony
foundation of this region
becomes greater as the
alveolar resorption continues

Secondary
residual alveolar ridge
[the underlying bone is
cancellous]
Relief area
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.
Relief areas in the maxilla
Incisive papilla-Midline
structure situated beneath the
central incisors. It is an exit
point of nasopalatine nerves
and vessels
It should be relieved failure
of which would result in
necrosis of the distributing
areas and paresthesia of
anterior palate.

Mid palatine raphae-Median
suture area covered by thin
submucosa
Relief is to be provided as it is
supposed to be the most
sensitive part of the palate to
pressure
Few areas like the
cuspid eminence ,
fovea palatinae and
torus palatinus may
be relieved according
to condition required
Relief areas in the
mandible
Mylohyoid ridge-Running along the lingual surface
of the mandible anteriorly the ridge lies close to the
inferior border of the mandible while posteriorly it
lies close to the ridge.
The thin mucosa over the mylohyoid ridge may be
traumatized and hence should be relieved.
Also the extension of the lingual flange is to be
beyond the palpable position of the mylohyoid ridge
but not in the undercut
Mental foramen-Lies on
the external surface of the
mandible in between the
1st and the second
premolar region.
It should be relieved
specially in case it lies
close to the residual
alveolar ridge due to ridge
resorption to prevent
parasthesia
Few places such as
genial tubercle,torus
mandibularis may be
required to be relieved
according to the
condition.
Other importance
Many of the above
landmarks help us in
determining the
original position of the
teeth and thus helping
us to set the teeth as
they were within “the
neutral zone” ;
important for stability
of the denture.
Conclusion
Thus, we see that a
sound knowledge of the
anatomical landmarks of
the edentulous jaw is a
prerequisite if one has to
achieve the objective one
has in mind; fabrication of
a complete denture that
has maximum retention,
stability and support with
preservation of underlying
structures with minimum
post insertion problems.