Dynamic Nature Of Lower Denture Space
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“ DY NAMIC
NATURE OF LOWER DENTURE S PAC E ”
Authors :- N Brill, Dr Odont ,Dr G. Tryde ,Dr R Cantor (Royal Dental college , cophenhagen, Denmark) JPD :-
{volume 15, number 3, may june 1965}
Pr esen ted By : San ke t Chak rav erty 1s t y ear
INTRODUCTION
In this particular journal Dr N Brill and colleagues have discussed the challenge faced by dentists in making a good retentive lower denture.
Many a times these lower dentures are subjected to conditions like resorbed ridges and muscle activity that hampers the stability of the denture.
Here we will discuss mainly the anatomical foundations on the basis of which the lower dentures will be fabricated.
DENTURE SPACE
They are formed when phenomenon like proptosis lingualis happen in which there is enlargement of the tongue that oblitrates the space meant for teeth in an edentulous patient. Thus, creating charecteristic spaces called denture space in the oral cavity.
EFFECTS OF PATIENT BECOMING EDENTULOUS.
Lips and cheeks are not supported by the teeth and bone , as a result they will tend to “fall” into the oral cavity.
PROPTOSIS LINGUALIS :- the tongue will expand into the space formerly occupied by the teeth , due to the growth of tongue.
EFFECTS OF PATIENT BECOMING EDENTULOUS.
Therefore , characteristic spaces develop in the oral cavity of the edentuolus patient called “DENTURE SPACE”
Thus , dynamics present in relation to the tissues surrounding will determine the form of the denture.
DENTURE SPACE
RESORPTION
Dr Bloch described the form of jaws from the base of the skull to the base of the mandible as “ A split cone with the base turned downward and the conical surfaces turned buccaly and laterally.”
RESORPTION
Therefore ,
↓ Height Of The Jaws
↓ Horizontal Dimension Of ↑ Horizontal Dimension Of The Upper Jaw The Lower Jaw
RESORPTION
More oftenly , the attachment of mentallis and mylohyoid muscles are located only 2 to 3 mm from the crest of the mandibular residual reidge ↓ can easily dislodge a denture
It also makes the surface of the soft tissues attached to the underlying bone reduced ↓ well deifned vestibular and lingual sulci are eliminated.
CLASSIFICATION OF THE MUSCULATURE OF THE LOWER DENTURE SPACES MUSCULATURE OF THE LOWER DENTAL SPACE DISLOCATING MUSCLES
FIXING MUSCLES
VESTIBULAR
VESTIBULAR •BUCCINATOR •ORBICULARIS ORIS
•MASSETER •MENTALIS •INCISIVUS LABII INFERIORIS
LINGUAL
•INTERNAL PTERYGO •PALATOGLOSSUS •STYLOGLOSUS •MYLOHYOIDEUS
LINGUAL •GENIOGLOSSUS •LINGUAL LONGITUDINAL •LINGUAL VERTICAL •LINGUAL TRANSVERSE
CLASSIFICATION OF DENTURE SURFACES SURFACES OF THE DENTURE
THE PRESSURE RECEIVING THE PRESSURE TRANSMITTING SURFACE SURFACE FOR EXAMPLE :- THE OCCLUSAL TABLE
FOR EXAMPLE :-THE BASAL SEAT
THE SECONDARY SUPPORTING SURFACE FOR EXAMPLE :-THE POLISHED SURFACES OF THE DENTURE AND THE LINGUAL AND THE BUCCAL SURFACES OF TEETH.
VESTIBULAR DISLOCATING MUSCLES
VESTIBULAR DISLOCATING MUSCLES MASSETER MUSCLE
The “ Posterior extension of the inferior buccal part ” of the denture space is determined by the action of the masseter muscle.
Impression made of this region while the masseter muscle is relaxed ↓
MASSETER MUSCLE
VESTIBULAR DISLOCATING MUSCLES MENTALIS MUSCLE
It originates from the frontal surface of the mandible between the “ Alveolar Jugum of the lateral incisor and the canine eminence.”
It extends inferiorly , anteriorly and medialy from its origin to fuse in the midline with corresponding muscle fibers from the opposite side.
Muscle inserts into the skin of the chin with the greater part of the fibers
MENTALIS MUSCLE
MENTALIS MUSCLE
“ Sicher and Tandler ” drew attention to the fact that
“ The origin of mentalis muscle is located closer to the crest of the residual ridge than the mucosal reflection in the alveolabial sulcus .”
Mentallis muscle contracts → Bottom of the sulcus is lifted →Depth and space of the oral vestibule is decreased considerably.
VESTIBULAR DISLOCATING MUSCLES
INCISIVE LABII INFERIORIS MUSCLE
Originates from the “ Lower Canine Jugum” runs laterally to the origin of the mentallis muscle.
Fibers of the muscle become fused with fibers of the orbicularis oris.
During contraction of the muscle → raises the bottom of the sulcus →
LINGUAL DISLOCATING MUSCLES INTERNAL PTERYGOID MUSCLE
It originates in the pterygoid fossa and the fiber bundles take a nearly parallel course posteriorly , inferiorly and laterally.
It then inserts on the medial surface of the mandible in much the same way as the masster muscle does on the lateral side.
It determines the extension of the lower posterior lingual part of the denture space.
LINGUAL DISLOCATING MUSCLES PALATOGLOSSUS MUSCLE
It descends from the soft palate in the arch to the lateral margin of the tongue.
Fibers from the right and left palatoglossus muscles meet each other at the midline of the tongue to create a sphincteric function when closing the posterior portion of the oral cavity.
During deglutition, it reduces the lumen of isthmus faucium → mucousa covering the lower part of the muscle is lifted superiorly , anteriorly and medially.
LINGUAL DISLOCATING MUSCLES PALATOGLOSSUS AND STYLOGLOSSUS MUSCLE When the muscle
contracts
↓ Terminating part of Alveolingual sulcus lifted alongwith the mucousa.
LINGUAL DISLOCATING MUSCLES MYLOHYOID MUSCLE forms the floor of the mouth.
It
This bilateral muscle originates from the mylohyoid line
They insert in the fibrous mylohyoid raphe.it forms a berth-like structure in which the tongue rests.
When both mylohyoid muscle contracts the floor of the mouth is lifted and the tongue is pressed against the palate
↓
MYLOHYOID MUSCLE
PTERYGOMANDIBULAR RAPHE
The tendinious pterygomandibular
raphe extends inferiorly from the pterygoid hamulus which inserts into the trigonum retromolar and in the retromolar pad above the trigonum.
The plica pterygomandibularis (fold of mucous membrane)is stretched, when the mouth is opened that can make the raphe stretched and can lift the posterior part of the retromolar pad.
TENDON OF GENIOGLOSSUS MUSCLE
They are derived from the genial spines. The are short and powewrful tendons. When the tip of tongue is lifted, the tendinous origins of the genioglossus muscles as well as the lingual frenum will get passively stretched and get lifted ↓ It presses the borders of the lower denture with a dislocating effect.
VESTIBULAR FIXING MUSCLES BUCCINATOR
This muscle has a “HORSE-SHOE SHAPED” origin. The maxillary part originates from the molar region at the base of the alveolar process. ↓ It runs posteriorly and inferiorly past to the maxiallary tuberosity to get inserted into the pterygomandibular
BUCCINATOR
After the raphe inserts into the retromolar pad, the buccinator muscle runs to the external oblique line and terminates in the region of the first or second molar. Nearly all the fibers of the buccinator muscle extends horizontally from their origin toward the mediolus(located laterally to the angle of the mouth). Fibers that originate from the pterygomandibular raphe decussate in the mediolus,maxillary part decussate into the upper lip and mandibular part
ACTION OF BUCCINATOR MUSCLE.
STRACK also called it as accessory muscle of mastication.
The buccinator muscle assists in positioning the food between the teeth and returning food that has escaped into the vestibulesulcus to the occlusal table, when the chewing and swallowing are done.
ORBICULARIS ORIS MUSCLE
It acts as the anterior sphincter of the oral cavity and forms the greater part of the bulk of the lips. It is attached to the maxillae by the incisive labii superior muscle and to the mandible by the incisive labii inferior muscle. It contains muscle fibers that pass with out bony projection from the upper lip to the lower
ORBICULARIS ORIS MUSCLE
This muscle is active, when the lips are pressed against teeth and alveolar process.
They are rhythmically active during chewing and swallowing.
LINGUAL FIXING MUSCLES
The muscles actively present here are lingual vertical ,lingual longitudinal, lingual transverse and the genioglosssus muscles. Out of which the lingual vertical, lingual longitudinal ,lingual transverse are considered an entity of the intrinsic muscles of the tongue and they run in three planes and at right angles to
Lingual vertical, Lingual longitudinal ,Lingual transverse muscles.
Lingual Longitudinal Muscle
The longitudinal muscle has a superficial layer and a deep layer .
The strong superior longitudinal fibers form a broad band beneath the mucous membrane from the apex of the tongue to to its base extending the full width of the tongue.
Action
This muscle helps in the shortening of the tongue with simultaneous contraction of the lingual vertical muscle whose fibers run from the inferior surface of the tongue to the mucuous membrane.
The margins of the tongue will be pressed laterally with
Lingual Transverse Muscle
It arises from the median fibrous septum in the tongue.
It extends into the mucous membrane of the sides of the tongue.
Genioglossus Muscle
It is a fan shaped projection into the tongue.
It inserts into the mucous membrane of the dorsum of the tongue from the apex of the base.
Action
The movements of the tongue esp the contraction is in conjunction with the lingual vertical and the genioglossus muscle that helps in the drawing of the tongue anteriorly towards the floor of the muscle.
Hence, it increases the pressure which the tip of the tongue can exert on the floor of the oral
Genioglossus Muscle
ACTIVE MUSCULAR FIXATION
The tongue can be brought in contact with the various structures of the oral cavity due to its mobility in the absence of the limiting joints.
The forces of the tongue are directed against a lower denture which can dislocate the lower denture easily and cant be counteracted by equal forces exerted by the musculature of the cheeks and the lower lip.
ACTIVE MUSCULAR FIXATION
Here, BRODIE spoke about the “Antagonistic” muscle groups.
It can be used to stabilize the dentures.
PASSIVE MUSCULAR FIXATION
It is possible to fix a lower denture even if all the muscle of the cheeks, lower lip, and tongue are quite passive.
In this instance, the denture is fixed by the mass and weight of these structures and through the pressure exerted by the muscle tonus.
PASSIVE MUSCULAR FIXATION
The resting muscles can be made to fix a denture by 2 condtions:-
By the inclination of the polished surfaces of the dentures.
By the polished surfaces of the denture between the cheeks and the lower lip on the one side and the tongue on the other side.
Inclination of polished surfaces
The buccal flanges of the lower denture must slope inferiorly and laterally.it shld extedn below the fold of buccinator muscle very definitely in the molar region. The lingual flanges also must extend inferiorly and medially below the anterior and lateral parts of the tongue, and as far as posteriorly by the range of
Inclination of polished surfaces
Postion of the polished surfaces.
NATURE OF LOWER DENTURE S PAC E ”
Authors :- N Brill, Dr Odont ,Dr G. Tryde ,Dr R Cantor (Royal Dental college , cophenhagen, Denmark) JPD :-
{volume 15, number 3, may june 1965}
Pr esen ted By : San ke t Chak rav erty 1s t y ear
INTRODUCTION
In this particular journal Dr N Brill and colleagues have discussed the challenge faced by dentists in making a good retentive lower denture.
Many a times these lower dentures are subjected to conditions like resorbed ridges and muscle activity that hampers the stability of the denture.
Here we will discuss mainly the anatomical foundations on the basis of which the lower dentures will be fabricated.
DENTURE SPACE
They are formed when phenomenon like proptosis lingualis happen in which there is enlargement of the tongue that oblitrates the space meant for teeth in an edentulous patient. Thus, creating charecteristic spaces called denture space in the oral cavity.
EFFECTS OF PATIENT BECOMING EDENTULOUS.
Lips and cheeks are not supported by the teeth and bone , as a result they will tend to “fall” into the oral cavity.
PROPTOSIS LINGUALIS :- the tongue will expand into the space formerly occupied by the teeth , due to the growth of tongue.
EFFECTS OF PATIENT BECOMING EDENTULOUS.
Therefore , characteristic spaces develop in the oral cavity of the edentuolus patient called “DENTURE SPACE”
Thus , dynamics present in relation to the tissues surrounding will determine the form of the denture.
DENTURE SPACE
RESORPTION
Dr Bloch described the form of jaws from the base of the skull to the base of the mandible as “ A split cone with the base turned downward and the conical surfaces turned buccaly and laterally.”
RESORPTION
Therefore ,
↓ Height Of The Jaws
↓ Horizontal Dimension Of ↑ Horizontal Dimension Of The Upper Jaw The Lower Jaw
RESORPTION
More oftenly , the attachment of mentallis and mylohyoid muscles are located only 2 to 3 mm from the crest of the mandibular residual reidge ↓ can easily dislodge a denture
It also makes the surface of the soft tissues attached to the underlying bone reduced ↓ well deifned vestibular and lingual sulci are eliminated.
CLASSIFICATION OF THE MUSCULATURE OF THE LOWER DENTURE SPACES MUSCULATURE OF THE LOWER DENTAL SPACE DISLOCATING MUSCLES
FIXING MUSCLES
VESTIBULAR
VESTIBULAR •BUCCINATOR •ORBICULARIS ORIS
•MASSETER •MENTALIS •INCISIVUS LABII INFERIORIS
LINGUAL
•INTERNAL PTERYGO •PALATOGLOSSUS •STYLOGLOSUS •MYLOHYOIDEUS
LINGUAL •GENIOGLOSSUS •LINGUAL LONGITUDINAL •LINGUAL VERTICAL •LINGUAL TRANSVERSE
CLASSIFICATION OF DENTURE SURFACES SURFACES OF THE DENTURE
THE PRESSURE RECEIVING THE PRESSURE TRANSMITTING SURFACE SURFACE FOR EXAMPLE :- THE OCCLUSAL TABLE
FOR EXAMPLE :-THE BASAL SEAT
THE SECONDARY SUPPORTING SURFACE FOR EXAMPLE :-THE POLISHED SURFACES OF THE DENTURE AND THE LINGUAL AND THE BUCCAL SURFACES OF TEETH.
VESTIBULAR DISLOCATING MUSCLES
VESTIBULAR DISLOCATING MUSCLES MASSETER MUSCLE
The “ Posterior extension of the inferior buccal part ” of the denture space is determined by the action of the masseter muscle.
Impression made of this region while the masseter muscle is relaxed ↓
MASSETER MUSCLE
VESTIBULAR DISLOCATING MUSCLES MENTALIS MUSCLE
It originates from the frontal surface of the mandible between the “ Alveolar Jugum of the lateral incisor and the canine eminence.”
It extends inferiorly , anteriorly and medialy from its origin to fuse in the midline with corresponding muscle fibers from the opposite side.
Muscle inserts into the skin of the chin with the greater part of the fibers
MENTALIS MUSCLE
MENTALIS MUSCLE
“ Sicher and Tandler ” drew attention to the fact that
“ The origin of mentalis muscle is located closer to the crest of the residual ridge than the mucosal reflection in the alveolabial sulcus .”
Mentallis muscle contracts → Bottom of the sulcus is lifted →Depth and space of the oral vestibule is decreased considerably.
VESTIBULAR DISLOCATING MUSCLES
INCISIVE LABII INFERIORIS MUSCLE
Originates from the “ Lower Canine Jugum” runs laterally to the origin of the mentallis muscle.
Fibers of the muscle become fused with fibers of the orbicularis oris.
During contraction of the muscle → raises the bottom of the sulcus →
LINGUAL DISLOCATING MUSCLES INTERNAL PTERYGOID MUSCLE
It originates in the pterygoid fossa and the fiber bundles take a nearly parallel course posteriorly , inferiorly and laterally.
It then inserts on the medial surface of the mandible in much the same way as the masster muscle does on the lateral side.
It determines the extension of the lower posterior lingual part of the denture space.
LINGUAL DISLOCATING MUSCLES PALATOGLOSSUS MUSCLE
It descends from the soft palate in the arch to the lateral margin of the tongue.
Fibers from the right and left palatoglossus muscles meet each other at the midline of the tongue to create a sphincteric function when closing the posterior portion of the oral cavity.
During deglutition, it reduces the lumen of isthmus faucium → mucousa covering the lower part of the muscle is lifted superiorly , anteriorly and medially.
LINGUAL DISLOCATING MUSCLES PALATOGLOSSUS AND STYLOGLOSSUS MUSCLE When the muscle
contracts
↓ Terminating part of Alveolingual sulcus lifted alongwith the mucousa.
LINGUAL DISLOCATING MUSCLES MYLOHYOID MUSCLE forms the floor of the mouth.
It
This bilateral muscle originates from the mylohyoid line
They insert in the fibrous mylohyoid raphe.it forms a berth-like structure in which the tongue rests.
When both mylohyoid muscle contracts the floor of the mouth is lifted and the tongue is pressed against the palate
↓
MYLOHYOID MUSCLE
PTERYGOMANDIBULAR RAPHE
The tendinious pterygomandibular
raphe extends inferiorly from the pterygoid hamulus which inserts into the trigonum retromolar and in the retromolar pad above the trigonum.
The plica pterygomandibularis (fold of mucous membrane)is stretched, when the mouth is opened that can make the raphe stretched and can lift the posterior part of the retromolar pad.
TENDON OF GENIOGLOSSUS MUSCLE
They are derived from the genial spines. The are short and powewrful tendons. When the tip of tongue is lifted, the tendinous origins of the genioglossus muscles as well as the lingual frenum will get passively stretched and get lifted ↓ It presses the borders of the lower denture with a dislocating effect.
VESTIBULAR FIXING MUSCLES BUCCINATOR
This muscle has a “HORSE-SHOE SHAPED” origin. The maxillary part originates from the molar region at the base of the alveolar process. ↓ It runs posteriorly and inferiorly past to the maxiallary tuberosity to get inserted into the pterygomandibular
BUCCINATOR
After the raphe inserts into the retromolar pad, the buccinator muscle runs to the external oblique line and terminates in the region of the first or second molar. Nearly all the fibers of the buccinator muscle extends horizontally from their origin toward the mediolus(located laterally to the angle of the mouth). Fibers that originate from the pterygomandibular raphe decussate in the mediolus,maxillary part decussate into the upper lip and mandibular part
ACTION OF BUCCINATOR MUSCLE.
STRACK also called it as accessory muscle of mastication.
The buccinator muscle assists in positioning the food between the teeth and returning food that has escaped into the vestibulesulcus to the occlusal table, when the chewing and swallowing are done.
ORBICULARIS ORIS MUSCLE
It acts as the anterior sphincter of the oral cavity and forms the greater part of the bulk of the lips. It is attached to the maxillae by the incisive labii superior muscle and to the mandible by the incisive labii inferior muscle. It contains muscle fibers that pass with out bony projection from the upper lip to the lower
ORBICULARIS ORIS MUSCLE
This muscle is active, when the lips are pressed against teeth and alveolar process.
They are rhythmically active during chewing and swallowing.
LINGUAL FIXING MUSCLES
The muscles actively present here are lingual vertical ,lingual longitudinal, lingual transverse and the genioglosssus muscles. Out of which the lingual vertical, lingual longitudinal ,lingual transverse are considered an entity of the intrinsic muscles of the tongue and they run in three planes and at right angles to
Lingual vertical, Lingual longitudinal ,Lingual transverse muscles.
Lingual Longitudinal Muscle
The longitudinal muscle has a superficial layer and a deep layer .
The strong superior longitudinal fibers form a broad band beneath the mucous membrane from the apex of the tongue to to its base extending the full width of the tongue.
Action
This muscle helps in the shortening of the tongue with simultaneous contraction of the lingual vertical muscle whose fibers run from the inferior surface of the tongue to the mucuous membrane.
The margins of the tongue will be pressed laterally with
Lingual Transverse Muscle
It arises from the median fibrous septum in the tongue.
It extends into the mucous membrane of the sides of the tongue.
Genioglossus Muscle
It is a fan shaped projection into the tongue.
It inserts into the mucous membrane of the dorsum of the tongue from the apex of the base.
Action
The movements of the tongue esp the contraction is in conjunction with the lingual vertical and the genioglossus muscle that helps in the drawing of the tongue anteriorly towards the floor of the muscle.
Hence, it increases the pressure which the tip of the tongue can exert on the floor of the oral
Genioglossus Muscle
ACTIVE MUSCULAR FIXATION
The tongue can be brought in contact with the various structures of the oral cavity due to its mobility in the absence of the limiting joints.
The forces of the tongue are directed against a lower denture which can dislocate the lower denture easily and cant be counteracted by equal forces exerted by the musculature of the cheeks and the lower lip.
ACTIVE MUSCULAR FIXATION
Here, BRODIE spoke about the “Antagonistic” muscle groups.
It can be used to stabilize the dentures.
PASSIVE MUSCULAR FIXATION
It is possible to fix a lower denture even if all the muscle of the cheeks, lower lip, and tongue are quite passive.
In this instance, the denture is fixed by the mass and weight of these structures and through the pressure exerted by the muscle tonus.
PASSIVE MUSCULAR FIXATION
The resting muscles can be made to fix a denture by 2 condtions:-
By the inclination of the polished surfaces of the dentures.
By the polished surfaces of the denture between the cheeks and the lower lip on the one side and the tongue on the other side.
Inclination of polished surfaces
The buccal flanges of the lower denture must slope inferiorly and laterally.it shld extedn below the fold of buccinator muscle very definitely in the molar region. The lingual flanges also must extend inferiorly and medially below the anterior and lateral parts of the tongue, and as far as posteriorly by the range of
Inclination of polished surfaces
Postion of the polished surfaces.
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