Introduction to Prosthodontics

Dr G S Aswal
 Learning outcomes

• Define prosthodontics terminologies (GPT)

• Use the terms appropriately
• Differentiate between dentulous and edentulous
• Identify and classify parts & surfaces of a complete
denture
• Enumerate qualities of a denture and the objectives
of complete dentures
• Classify impressions, casts and trays
 Prosthesis
• Artificial replacement of a missing part of
human body
Prosthodontics (Prosthetic dentistry)
• Dental specialty pertaining to
diagnosis, treatment planning,
rehabilitation and maintenance of
oral function, comfort, appearance
and health of patients with clinical
conditions associated with missing or
deficient teeth and/or maxillofacial
tissues using biocompatible
substitutes
Dentulous (dentate) Edentulous
Condition in which Without teeth, lacking
natural teeth are teeth
present in the mouth
Complete Denture : Removable dental
prosthesis that replaces entire dentition and
associated structures of the maxilla or
mandible

Parts of complete denture

• Denture base
• Artificial teeth
Parts of denture base
a)Flanges: labial, buccal, lingual
b)Border areas
c)Palatal plate (maxillary)

Surfaces of complete denture

a)Fitting surface
b)Polished surface
c)Occlusal surface
 Qualities of dental prosthesis

Retention : Resist the forces of dislodgment along

path of placement and away from tissues

Stability : Resist displacement by functional forces in

horizontal or rotational directions

Support: Area of foundation on which a dental

prosthesis rests. Resist vertically directed force.
 Objectives of complete denture therapy

Mastication, Speech, Aesthetics

1- Restoration masticatory efficiency

2- Restoration of facial contour and appearance
3- Correction of speech defects
4- Preservation of the remaining tissues
5- Patient satisfaction and comfort
Impression: Negative likeness or copy in reverse of
surface of an object; an imprint of teeth and adjacent
structures is called as dental impression

Complete denture impression: negative likeness of the entire edentulous

areas (denture bearing area) and associated oral structures
• Primary/ diagnostic impression
• Final impression
• Virtual impression

Dental Cast: A positive life size reproduction of a part or

parts of the oral cavity
• Diagnostic cast
• Master cast
• Refractory cast
• Mounting cast
• Virtual cast
Parts of cast
• Anatomical area
• Artistic area (Land area +base)
Dimension specifications of a cast
• Base : 11-13mm from the deepest part of the sulcus.
• Land area : 2-3mm thickness.

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Tray: A receptacle into which
suitable impression material is
placed to make a negative
likeness. A device used to carry,
confine and control impression
material while making an
impression

Types of tray
• Based on availability - Stock
trays or Custom (special) tray
• Based on material -Metal
trays, Plastic trays or Resin
trays (Self cure/ Heat cure)
• Based on use -Edentulous
trays or dentulous trays
• Based on design -Perforated
trays or Non perforated trays
Rim lock trays
Record base (permanent): Part
of denture that sits on
foundation tissues and to
which teeth are attached
Record base (temporary):
Acrylic or shellac base template
on which teeth arrangement
and wax up is done. It is
eventually replaced by a
permanent denture base

Occlusion rims: Occluding

surfaces fabricated on interim
or final denture bases for
purpose of making
maxillomandibular relation
records and arranging teeth.
Also called as record rim.
• Record base along with the
occlusion rims is called as record
block
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 Fox plane

Facebow Articulator
 References

• Glossary of prosthodontic terms 8

Basic requirements of impression making

• Knowledge of the oral anatomy

• Knowledge of reliable technique
• Understanding of impression materials
• Skill
• Patient management

(Cognitive, Psychomotor, Affective)

Anatomical landmarks
 Learning objectives

• Identify and mark all anatomical

landmarks
• Describe the clinical significance
of each landmark
 Grouping of landmarks
According to clinical significance
Landmarks of
edentulous jaws

Supporting
Limiting structures Relief areas
structures
 Supporting areas

1)Primary stress bearing area – forces are perpendicular,

dense bone and mucosa
2)Secondary stress bearing areas – forces greater than right
angles to occlusal forces or are // to them
3)Non stress bearing or relief areas
Extra-oral landmarks
• Naso-Labial Fold
• Philtrum
• Angle of the mouth
• Modiolus
• Vermillion Border
• Wet Line
• Mento-Labial Sulcus
 Maxillary

Supporting Structures Limiting Structures

 Residual Alveolar Ridge  Labial frenum

 Rugae (secondary)  Labial vestibule
 Mid Palatine Raphe  Buccal frenum
 Hard Palatal Vault  Buccal vestibule
 Maxillary Tuberosity  Hamular notch
 Fovea palatinae
 Posterior palatal seal area
Maxillary arch
Labial frenum
• Fold of mucous membrane at
the median line
• Moves with muscles of lip
• Adequate relief for muscle
activity
• Proper denture seal
• Excessive relief weakens
denture base

Labial notch
 Labial vestibule

• Record adequate
depth/width
• Overextension causes
instability/soreness
• Proper contouring gives
optimal esthetics

•Labial flange
Buccal frenum
 Single or double folds of
mucous membrane
 Broad and fan shaped
 Moves with muscles of cheek
during speech and mastication
 Adequate relief for muscle
activity-more clearence

Buccal notch
Buccal vestibule
• Buccal frenum to
hamular notch
• Record adequate
depth/width
• Improper extension
causes instability/
soreness

Buccal flange
 Maxillary tuberosity

• Distal end of denture must

have Coverage-stability/
retention
• Gross enlargement (fibrous or
bony –surgical correction

Area of tuberosity
Hamular notch
•Distal to maxillary
tuberosity
•Aids in locating
posterior palatal seal.
•Overextension
causes soreness.

Area of hamular notch

Vibrating line
• Junction of movable
and immovable part of
soft palate.
• 2mm ant to fovea
palatinae
• Aids to establish PPS

• Post palatal seal

area
• From hamular notch to
hamular notch
• Anterior to vibrating
line
• Aids in retention
Fovea Palatinae

• Bilateral indentations
near the midline of palate
• Formed by coalescence of
several mucous gland
ducts
• Posterior to junction of
hard and soft palate
• Aids in determining
vibrating line
Hard palate

• Support for the

maxillary denture
• Primary stress bearing
area- horizontal portion
of hard palate lateral to
midline
• Secondary stress
bearing area –rugae
 Alveloar ridge

• Residual bone with

mucous membrane
• Primary stress bearing
area

Alveolar groove
 Incisive papilla
• Elevation of soft tissue over
the incisive foramen or
nasopalatine canal
• Location : on or labial to
ridge.
• Impingement –burning
sensation, parasthesia and
pain
•Incisive fossa • Relief necessary
Rugae

• Irregular shaped rolls of

soft tissue
• Secondary stress bearing
area
• Should not be distorted in
the impression
Median palatine raphae
• Extends from incisive papilla
to distal end of hard palate
along the midline
• Thin mucosal covering and
non-resilient
• Relieve adequately to avoid
trauma from denture base

Median palatine groove

 Mandibular landmarks

Supporting structures Limiting structures

• Slopes of Alveolar Ridge • Buccal and Labial Borders
• Labial Frenum
• Retro molar pad
• Labial Vestibule
• Buccal Shelf Area • Buccal Frenum
• Torus Mandibularis • Buccal Vestibule
• Massetric Notch Area
• Retromolar Pad

Lingual border Anatomy

• Lateral Throat Form
• Retro-mylohyoid Region
• Lingual crescent area
• Lingual Frenum
Mandibular arch

Labial frenum
• Shorter and wider than
the maxillary frenum
• Adequate relief for
muscle activity (mentalis)
• Proper fit around it
maintains seal without
soreness

Labial notch.
 Labial vestibule
• Labial-buccal frenum
• Overextension causes
instability/sorenes
• Muscles attachment
close to the crest of the
ridge- limits the denture
flange extension
• Record adequate depth
and width
• Proper contouring gives
optimal esthetics

Labial flange
Buccal frenum

• Adequate relief for

muscle activity
• Proper denture seal

Buccal notch.
Buccal vestibule

• Buccal frenum-retromolar
pad
• Record adequate depth
and width
• Impression is widest in
this area

Buccal flange
Buccal shelf

• Extends from buccal frenum

to retromolar pad.
• Between external oblique
ridge and crest of alveolar
ridge
• Primary stress bearing
area(cortical bone)- lies at
right angles to vertical
occlusal forces
External oblique ridge

• A bony ridge runs antero-

posteriorly outside the
buccal shelf
• Denture border 1-2 mm
beyond this ridge
• Shows as Groove in
impression
Alveolar ridge

• Residual bone with

mucous membrane
• Crest to be relieved
• Buccal and lingual
slopes are secondary
stress bearing areas
 Retromolar pad
• Triangular soft pad of
tissue
• Posterior end of lower
edentulous ridge
• Limiting landmark of distal
extension of complete
denture upto ant 2/3 rd of
retro molar pad
• Determines height and
width of the occlusal table

Retromolar fossa
 Alveolo-Lingual sulcus
• Anterior region- lingual
frenum to mylohyoid ridge
• Sublingual crescent area
• Border of Impression to
make contact with the
mucosa of the floor of the
mouth when tongue
touches the upper incisor
• Overextension causes
Premylohyoid soreness and instability
eminence Lingual flange
Middle region
• From pre-mylohyoid
fossa to the distal end of
the mylohyoid ridge.
• Lingual flange extends
below the level of the
mylohyoid ridge- tongue
rests on the top of
flange and aids in
stabilizing the lower
denture
Posterior region
• The flange passes into
the retromylohyoid
fossa
• Proper recording gives
typical S –form of the
lingual flange
• Lateral throat form
Mylohyoid ridge

• Attachment for the

mylohyoid muscle
• Sharp or irregular
covered by the mucous
membrane
• Trauma from denture
base –relief necessary
 Genial tubercle
• Area of muscle attachment (Genioglossus and Geniohyoid)
• Lies away from the crest of the ridge
• Prominent in Resorbed ridges
• Adequate relief to be provided
Lingual frenum

• Fold of mucous
membrane
• Base of tongue to
supragenial tubercle
• Registered in function

Lingual notch
 References
• Zarb, Bolender, Prosthodontic treatment for edentulous patient,
12th edition, Mosby St. Louis, Pp 209-251

• Sheldon Winkler, Essentials of complete Denture prosthodontics,

second edition,1996, AITBS Publishers ,India, Pp 88-105

• Deepak Nallaswamy, Textbook of Prosthodontics, 1st

edition,2006, Jaypee Publications, NewDelhi , Pp 45-90

• John J. Sharry, Complete denture Prosthodontics, third

edition,Mc Graw Hill company, pp 123-144.