Lec 8 3 (hard)
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Questions and Answers

What is the primary reason for using relief wax in the fabrication of a customized tray?

  • To enhance the aesthetic appearance of the tray
  • To increase the stability of the impression material
  • To reduce pressure on sensitive areas of the oral cavity (correct)
  • To improve the adhesion of the impression tray to the oral cavity
  • Which anatomical structures are considered support areas during the impression process?

  • Tongue and floor of the mouth
  • Gingival tissue and soft palate
  • Mucosa and muscle attachment
  • Teeth and bone (correct)
  • What is the role of relief holes in a customized impression tray?

  • To further reduce pressure applied to specific areas (correct)
  • To increase the weight of the tray for better handling
  • To decrease the flow of impression material during setting
  • To provide additional anatomical landmarks for reference
  • How is a primary cast utilized in the fabrication of a customized impression tray?

    <p>It acts as the first duplicate from which wax relief is applied (B)</p> Signup and view all the answers

    Which factor most influences the choice of materials for dental impressions in relation to patient comfort?

    <p>The ability of materials to compress and rebound (C)</p> Signup and view all the answers

    Which type of mucosa is primarily found in the vestibule and cheeks of the edentulous oral cavity?

    <p>Non keratinized unattached mucosa (C)</p> Signup and view all the answers

    What type of bone is typically found along the crest of residual ridges?

    <p>Medullary bone (C)</p> Signup and view all the answers

    Why is thick cortical bone considered an excellent supporting structure in the oral cavity?

    <p>It resists resorption and withstands occlusal forces. (C)</p> Signup and view all the answers

    Which factor contributes to the resistance of trauma or ulceration during denture use?

    <p>Thick keratinized attached mucosa (B)</p> Signup and view all the answers

    Which anatomical landmark is associated with the posterior aspect of the maxilla and is relevant in denture design?

    <p>Tuberosity (B)</p> Signup and view all the answers

    Which structure is primarily responsible for providing resistance to masticatory forces?

    <p>Pterygoid hamulus (B)</p> Signup and view all the answers

    Which area is considered a relief area that requires relief from pressure of the denture base during function?

    <p>Crest of residual ridges (D)</p> Signup and view all the answers

    Among the listed structures, which one is classified as a limiting structure?

    <p>Hamular notch (C)</p> Signup and view all the answers

    Which characteristic is NOT required for a supporting structure?

    <p>Tissue should be non-attached (A)</p> Signup and view all the answers

    What is located in the posterior palatal seal area?

    <p>Primary support (C)</p> Signup and view all the answers

    What are the primary characteristics of supporting areas in complete dentures?

    <p>Areas that absorb occlusal forces (B)</p> Signup and view all the answers

    Which part of the complete denture is responsible for contacting the supporting area of the mouth?

    <p>Denture base (D)</p> Signup and view all the answers

    What is the primary role of the occlusal surface in a complete denture?

    <p>To create balance during mastication (B)</p> Signup and view all the answers

    What happens to the forces generated during mastication in complete dentures?

    <p>They act compressively on underlying tissues (A)</p> Signup and view all the answers

    Which of the following best describes relief areas in a denture?

    <p>Areas designed to reduce pressure on specific tissues (C)</p> Signup and view all the answers

    What is a potential long-term consequence of the forces transmitted to supporting tissues by a complete denture?

    <p>Bone resorption in the underlying structures (C)</p> Signup and view all the answers

    Which aspect of the denture bearing area primarily influences aesthetics?

    <p>Denture flange (A)</p> Signup and view all the answers

    What is the definition of a denture bearing area?

    <p>Surfaces that contact the denture base (C)</p> Signup and view all the answers

    Which anatomical landmark provides resistance to masticatory forces?

    <p>Cortical bone (B)</p> Signup and view all the answers

    What type of mucosa is required for the areas that provide resistance?

    <p>Keratinized, attached mucosa (B)</p> Signup and view all the answers

    Which structure is considered a limiting structure in the classification of anatomical landmarks?

    <p>Labial vestibule (C)</p> Signup and view all the answers

    Identify an area that requires relief from pressure during denture base function.

    <p>Incisive papilla (B), Mid palatine raphe (D)</p> Signup and view all the answers

    Which muscle is directly associated with the junction of the hard and soft palate?

    <p>Superior pharyngeal constrictor (D)</p> Signup and view all the answers

    What does the posterior peripheral seal area define in dental anatomy?

    <p>The boundary of the denture base (B)</p> Signup and view all the answers

    Which anatomical term is used for a connection that involves no muscle between structures?

    <p>Raphal (C)</p> Signup and view all the answers

    Which area is NOT classified as a relief area?

    <p>Labial vestible (B)</p> Signup and view all the answers

    Which of the following structures satisfies all three criteria for supporting structures in prosthetic applications?

    <p>Buccal shelf (B)</p> Signup and view all the answers

    What is the primary purpose of alveoloplasty in pre-prosthetic surgeries?

    <p>Reduce sharp bony extensions of the alveolar ridge (B)</p> Signup and view all the answers

    Which procedure is typically used to increase the depth of the sulcus around the denture?

    <p>Vestibular extension/Sulcus deepening (B)</p> Signup and view all the answers

    What is the intended outcome of debulking flabby tissues during pre-prosthetic surgery?

    <p>To enhance mucosal support (C)</p> Signup and view all the answers

    In which scenario would ridge augmentation be a crucial procedure?

    <p>To increase the height of the alveolar ridge (B)</p> Signup and view all the answers

    Which treatment is performed to create vertical space in the posterior ridge without prosthetic teeth?

    <p>Tuberosity reduction (B)</p> Signup and view all the answers

    What is the significance of the pterygo-mandibular raphe in terms of denture support?

    <p>It contributes to the stability of the denture base. (A)</p> Signup and view all the answers

    Which statement accurately describes secondary supporting structures in denture fabrication?

    <p>They meet at least two support criteria. (C)</p> Signup and view all the answers

    Flashcards

    Denture Bearing Area

    All surfaces contacted by the denture base.

    Supporting Area (Denture)

    Area in the mouth used to support a denture against functional forces during chewing.

    Relief Area (Denture)

    Areas of the mouth that need to be relieved from the denture base to prevent discomfort or irritation.

    Complete Denture

    Full mouth dentures without natural teeth.

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    Denture Base

    Part of the denture that contacts the supporting areas in the mouth.

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    Occlusal Forces (Dentures)

    Forces perpendicular to the chewing surface generated during chewing.

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    Bone Resorption

    Loss of bone tissue due to pressure.

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    Ischemia

    Reduced blood flow to tissues.

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    Dental Impression

    A procedure to record the shape and structure of the oral cavity using special materials and trays.

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    Selective Pressure Impression

    A technique for taking dental impressions that applies pressure only where needed, avoiding damage to soft tissue.

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    Relief Wax

    Wax used in custom impression trays to reduce pressure on soft tissues during an impression.

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    Support Areas (denture)

    Areas of the oral cavity that can withstand pressure during an impression or denture fabrication, including teeth and hard palate.

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    Keratinized Attached Mucosa

    A type of oral mucosa, present on the roof of the mouth and the gum ridge, that is tough and resistant to wear and tear.

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    Non-Keratinized Unattached Mucosa

    A type of oral mucosa, found in the cheeks, lips, and floor of the mouth, that is soft and delicate.

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    Cortical Bone

    The hard outer layer of bone, present in most areas of the mouth except the ridge of the gums.

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    Medullary Bone

    The soft, inner layer of bone, present along the ridge of the gums, that is more prone to resorption.

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    Favourable Supporting Areas

    Areas in the mouth that can withstand the forces of chewing and provide stable support for dentures.

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    Keratinized Mucosa

    Tough, protective tissue lining the mouth that helps dentures stay in place.

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    Supporting Structures

    Areas of the mouth that provide resistance to chewing forces, helping hold dentures in place.

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    Limiting Structures

    Edges of the denture base that are determined by tissues like frenums (muscle attachments) or the vestibule (space between teeth and cheeks).

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    Relief Areas

    Areas in the mouth that need to be left free of denture pressure to prevent discomfort or irritation.

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    Incisive Papilla

    A small, raised bump of tissue behind the front teeth, which needs to be relieved on the denture to avoid pressure.

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    Mid Palatine Raphe

    A ridge of tissue in the roof of the mouth that extends from the front to the back, needing denture relief.

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    Canine Eminence

    A bony bump above the canine tooth, providing support for dentures.

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    What are the three characteristics of a supporting structure?

    1. Cortical bone: Strong, dense bone that provides resistance to forces.
    2. Keratinized, attached mucosa: Tough, resistant tissue that helps hold the denture in place.
    3. Perpendicular to occlusal forces: Able to withstand chewing forces directly.
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    What is the function of a limiting structure?

    Limiting structures act as boundaries, determining the limits of denture base extension. They prevent the denture from covering areas that are sensitive or prone to irritation.

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    What is the purpose of a relief area?

    Relief areas are areas in the mouth that are exempt from direct denture base pressure during rest and function. This prevents discomfort, irritation, and potential damage to sensitive tissues.

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    Buccal Vestibule

    The space between the cheek and the teeth/denture

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    Hamular Notch

    A small, crescent-shaped indentation on the posterior border of the palate, which limits denture base extension.

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    Pterygo-mandibular Raphe

    A fibrous band that extends from the pterygoid hamulus to the retromolar pad, dividing the buccal and lingual vestibules.

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    Genial Tubercles

    Two small bony projections on the lingual surface of the mandible, just below the lower incisors.

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    Buccal Shelf

    A bony shelf located in the lateral part of the alveolar ridge, supporting the denture base.

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    Lingual Frenum

    A fold of tissue that attaches the tongue to the floor of the mouth.

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    Lingual Vestibule

    The space between the tongue and the inner surface of the teeth.

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    Mylohyoid Ridges

    Two prominent bony ridges on the lingual surface of the mandible, extending from the symphysis to the molar area.

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    Alveoloplasty

    A surgical procedure to reshape the alveolar ridge, removing bony irregularities or sharp edges to improve denture fit and stability.

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    Study Notes

    Prosthodontics Lecture 8 & 9 - Denture Bearing Areas

    • Topic: Denture bearing areas of maxilla and mandible
    • Lecturer: Dr. Vinothkumar Sengottaiyan (@Dr_VK)
    • Institution: Oman Dental College

    Learning Outcomes

    • Differentiate denture bearing areas (supporting, relief, limiting) of maxillary and mandibular arches
    • Plan and condition denture bearing areas for complete dentures
    • Understand preprosthetic surgeries for denture construction
    • Identify situations needing specialist referral

    Support - Definition

    • General: Foundation area for a dental prosthesis, resisting occlusal/functional forces
    • Complete dentures: Area of mouth available for support
    • Other: Areas in the mouth for absorbing mastication forces

    Parts of Complete Denture

    • Denture base/foundation: Part of the denture contacting supporting areas (impression surface, intaglio surface, support areas, relief areas, and peripheral seal/border areas)
    • Denture flange: Surface outside denture base, called cameo/art surface, aesthetically developed by the dentist (doesn't affect function).
    • Occlusal surface: Formed by artificial teeth, creating balance during mastication

    Denture Bearing Area

    • Refers to surfaces contacted by the denture base.
    • The denture base (fitting surface) contacts oral tissues.
    • Denture bases are typically made of hard materials like acrylic, and don't change shape during function.
    • All occlusal forces are transferred to denture bearing areas by the denture base

    Forces in Complete Dentures

    • Forces perpendicular to the occlusal plane during mastication are transmitted to underlying supporting tissues as compressive forces.
    • These forces cause bone resorption in bone and ischemia (reduced blood flow) in tissues.
    • Bone resorption and ischemia can result in long-term problems.
    • However, in some instances, short-term pain, ulceration, and irritation could occur.

    What Happens When We Make an Impression

    • A dental impression records the anatomy of the oral cavity using impression trays and appropriate materials.
    • Pressing the material against oral structures is compression.
    • The denture base applies similar force during impression making.
    • Some structures (teeth, bone) can withstand pressure longer; others (mucosa, muscle attachments) can't.

    How to Manage Compression in Denture Bases

    • Fabricate a customized tray contacting only pressure-resistant areas.
    • Use a first duplicate (primary cast) from the preliminary impression.
    • Place wax sheets (relief wax) in areas needing reduced pressure during impression making.
    • Create a special tray with acrylic, removing the wax after the final impression.
    • Relief holes can further reduce pressure inside the tray.

    Anatomical Landmarks

    • Visible/palpable structures within the oral cavity (edentulous patient).

    • Important for understanding how to classify structures.

    • Support classification helps create custom trays for selective pressure during impression making.

    • Support areas: Primary and secondary

    • Relief areas:

    • Border/peripheral seal areas:

    Tissues of Edentulous Oral Cavity

    • Mucosa:
      • Keratinized attached mucosa: Present on residual ridge and palate
      • Non-keratinized unattached mucosa: Vestibule, cheeks, floor of mouth, soft palate, uvula, and tonsillar pillars
    • Submucosa: Fibrous, anterior palate, tuberosities, residual ridges
    • Fatty/glandular: Posterior palate, some floor of mouth areas
    • Muscular: Along vestibule, cheeks, floor of mouth
    • Bone:
      • Cortical bone: Most areas except crest of residual ridges
      • Medullary bone: Crest of residual ridges

    Favourable Characteristics of Supporting Areas

    • Thick cortical bone: Avascular, resists resorption (excellent support)
    • Thick keratinized attached mucosa: Resists trauma/ulceration from denture movements.
    • Direction relative to occlusal plane: Maximum support/resistance when parallel or perpendicular to occlusal forces.

    Maxillary Anatomical Landmarks

    • (List of specific landmarks - see the text)

    Mandibular Anatomical Landmarks

    • (Refer to the text, list mandibular Landmarks)

    Preprosthetic Surgeries

    • Alveoloplasty (invasive): Reduces sharp bony extensions of alveolar ridge.
    • Vestibular extension/Sulcus deepening: Increases sulcus depth, usually achieved with skin or mucosal grafting.
    • Tuberosity reduction: Creates vertical space in posterior ridge.
    • Debulking of flabby tissues: Achieves firm mucosal support.
    • Ridge augmentation: Increases height of the alveolar ridge for improved denture stability and possibly, implants instead of removable dentures.

    Textbook for Reference

    • Zarb, G.A., 2012, Prosthodontic Treatment for Edentulous Patients: South Asia Reprint-E-book, Elsevier Health Sciences.

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    Description

    Dive into the intricacies of denture bearing areas in maxillary and mandibular arches with this quiz. Learn to differentiate between supporting, relief, and limiting areas, and explore the planning and conditioning of these areas for complete dentures. Understand the essentials of preprosthetic surgeries and the situations requiring specialist referrals.

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