TONGUE AND

ITS PROSTHODONTIC
IMPLICATIONS

Presented by:
Dr.Mrinmayee T Thakur I MDS
CONTENTS
• INTRODUCTION

• DEVELOPMENT

• ANATOMY

• CLASSIFICATION

• DEVELOPMENTAL DISTURBANCES

• PROSTHODONTIC IMPLICATIONS

• CONCLUSION

• REFERENCE
 INTRODUCTION
• The tongue is a muscular organ situated in the floor of mouth
• It is associated with functions like
1. Speech
2. Mastication
3. Deglutition
4. Taste
• Its is considered as a chief articulator of consonants and
modifies its position and shape for pronunciation
 DEVELOPMENT OF TONGUE
• The tongue appears in embryo of approximately 4 weeks
ANATOMY
Tongue has
1. A root
2. A tip
3. A body
• The BODY has 1. a curved upper surface or Dorsum
2. An inferior surface
• The Dorsum is divided into 1.ORAL PART

2. PARYENGEAL PART

• FORAMEN CAECUM
FRENULUM LINGUAE : on either side there is prominence
produced by DEEP LINGUAL VEINS

More laterally to these deep lingual veins is a fold called PLICA

FIMBRIATA

It is directed forward and medially

towards the tip of the tongue
 PAPILLAE OF TONGUE
They are 4 varieties
• Filiform Papillae
• Fungiform Papillae
• Foliate Papillae
• Circumvallate Papillae
 SUPERIOR
LONGITUDINAL

INFERIOR
LONGITUDINAL
INTRINSIC MUSCLES
MUSCLES OF TONGUE

TRANSERVUS

VERTICALIS

GENIOGLOSSUS

HYOGLOSSUS

EXTRINSIC MUSCLES

STYLOGLOSSUS

PALATPGLOSSUS
INTRINSIC MUSCLES
The Intrinsic Muscles of the tongue originate and
insert
within the substance of the tongue and they
alter the size and shape
of the tongue by
• Lengthening and shortening it
• Curling and uncurling its apex and edges
• Flattening and rounding its surface
Actions of muscles

SUPERIOR LONGITUDINAL Shorten the tongue makes its

dorsum concave
Your text here
INFERIOR LONGITUDINAL Shortens the tongue and makes
its dorsum convex

TRANSERVUS Makes the tongue narrow and

elongated

VERTICALIS Makes tongue broad and

flattened
EXTRINSIC MUSCLES
Genioglossus Hyoglossus
STYLOGLOSSUS PALATOGLOSSUS
BLOOD SUPPLY
• From the lingual artery, a branch of the external carotid artery.
• Also from the tonsillar branch of the facial artery and the ascending pharyngeal artery.
• The tongue is drained by dorsal lingual and deep lingual veins
 LYMPHATIC DRAINAGE
Part of tongue Drainage nodes
Tip of the tongue submental nodes

Right and left of the submandibular lymph node

remaining 2/3rd part

posterior part upper cervical nodes and

jugulodigastric nodes

Few might drain into deep cervical nodes

The whole lymph finally drains into jugulo-
omohyoid nodes
 NERVE SUPPLY
All Intrinsic muscles and 3 Extrinsic muscles except Palatoglossus
are supplied by hypoglossal nerve

Palatoglossus which is supplied by cranial root of accessory nerve

General sensation of ant 2/3rd of tongue is by lingual branch of

mandibular nerve

And taste sensation by chorda tympani except circumvallate

papilla

General sensation and taste sensation of posterior 1/3rd of tongue

and circumvallate papillae is supplied by glossopharyngeal nerve

Posteriormost part of tongue is supplied by vagus nerve through

internal laryngeal branch
CLASSIFICATION
• Tongue Form (HOUSE 1958)
Class 1 Normal in size, development and function. Sufficient teeth
are present to maintain the normal form and function of the
tongue

Class 2 Natural teeth have been absent for a sufficient period to

permit a change in the form and functional action of the
tongue

Class 3 Tongue is excessively large. All the teeth may have been
absent for an extended period of time, allowing an abnormal
development of the size of the tongue.

• Rehabilitation of Glossectomy Cases with Tongue Prosthesis: A Literature Review Journal of Clinical
and Diagnostic Research. 2016 Feb, Vol-10(2): ZE01-ZE04
• Tongue position (wright)
Class I: Tongue lies on the floor of the mouth
with
the tip forwards and slightly below the
incisal edges of the mandibular anterior
teeth
Class II: Tongue is flattened and broadened but
the tip is in normal position.

Class III Tongue is retracted and depressed into

the floor of the mouth
with the tip curled upwards,
downwards or assimilated into the body
of the tongue

Class I position has the best prognosis.

Class II and class III are unfavourable

• Rehabilitation of Glossectomy Cases with Tongue Prosthesis: A Literature Review Journal of Clinical and Diagnostic Research. 2016 Feb, Vol-10(2): ZE01-ZE04
DEVELOPMENTAL ANOMALIES
• Macro-glossia

• Micro-glossia

• Ankylo-glossia

• Bifid tongue
• Fissured tongue
• Lingual thyroid nodule
• Median rhomboid glossitis
• Benign migratory glossitis
• Hairy tongue
MACROGLOSSIA
(Tongue hypertrophy, prolapsus of the tongue,
enlarged tongue)
Inherited or congenital disorders associated
• Down syndrome,
• Beckwith-wiedemann syndrome,
• Amyloidosis,
• Congenital hypothyroidism
MICROGLOSSIA
Due to the failure of lingual swellings of the first arch to
develop the tongue
Lack of muscular stimulus between the alveolar arches, these
do not develop transversely and the mandible does not grow in
an anterior direction, resulting in dentoskeletal malocclusion
Ankyloglossia or Tongue-tie
• the lingual frenulum attaches to the bottom of tongue and restricts free
movement of the tongue
• Tongue-tie may also cause speech defects in articulation of the sounds: l, r, t, d, n,
th, sh, and z.
• Normal range of free tongue is greater than 16 mm.
• The ankyloglossia can be classified into 4 classes based on kotlow's assessment as
follows
class I mild ankyloglossia 12 to 16 mm
class II moderate 8 to 11 mm
ankyloglossia
class III severe ankyloglossia 3 to 7 mm

class IV complete less than 3 mm

ankyloglossia

• Ankyloglossia and its management J Indian Soc Periodontol. 2011 Jul-Sep; 15(3):
270–272
 BIFID TONGUE
A completely cleft or bifid tongue is a rare
condition
A partially cleft tongue is considerably
more common
it is manifested simply as a deep groove in
the midline of the dorsal surface
FISSURED TONGUE
(Scrotal tongue, lingua plicata)

Fissured tongue is a condition frequently seen

it is characterized by grooves noted along the
dorsal and lateral aspect.
Fissured tongue is seen in
• Melkersson-Rosenthal syndrome
• Down syndrome
LINGUAL THYROID NODULE
• The lingual thyroid is an
anomalous condition in which
follicles of thyroid tissue are
found in the substance of the
tongue
Median rhomboid glossitis.
• It is present in the posterior midline of the
dorsum of the tongue
• The long axis of the lesion is in
anteroposterior direction
• The lesions is associated with candidiasis.
• some cases may also demonstrate a
kissing lesion.
• Lesions are typically less than 2 cm in
greatest dimension and most demonstrate
a smooth, flat surface
Benign Migratory Glossitis
(Geographic tongue)

• Benign migratory glossitis is a psoriasiform

mucositis of the dorsum of the tongue
• Its dominant characteristics is a constantly
changing pattern of serpiginous white lines
surrounding areas of smooth, depapillated
mucosa
Hairy Tongue
(Lingua nigra, lingua villosa, lingua villosa
nigra, black hairy tongue)
• it is a condition of defective desquamation of the
filiform papillae
• The basic defect in hairy tongue is the hypertrophy
of filiform papillae on the dorsal surface of the
tongue, usually due to a lack of mechanical
stimulation and debridement.
• Normal filiform papillae are 1 mm in length,
whereas filiform papillae in hairy tongue are more
than 15 mm in length
 Acquired tongue disturbances
• Atrophic glossitis
• Scarlet fever
• Syphilis

• Amyloidosis

• Sarcoidosis

• Candidiasis
Atrophic glossitis
Atrophic glossitis also known as bald tongue
characterized by a smooth glossy tongue that is often
tender/painful
Caused by atrophy of the papillae (depapillation)
• Usually related to
1. Iron-deficiency anemia,
2. Pernicious anemia,
3. B vitamin complex deficiencies
4. Folic acid deficiency
• Scarlet fever
The tongue exhibits a white coating and the fungiform
papillae are edematous and hyperemic, projecting above the
surface as small red knobs.‘Strawberry tongue’.
The coating of the tongue is soon lost
Beginning at the tip and lateral margins, and tongue
becomes red, glistening and smooth except for the swollen,
hyperemic papillae.
The tongue in this phase has been termed as the ‘rasberry
tongue’.
• the Tongue in the Tertiary Stage of Syphilis
There are two types

Superficial sclerosing glossitis and

Deep parenchymatous glossitis

Superficial sclerosing glossitis

Widespread gummatous infiltration of the sub-epithelial tissues of the tongue which gradually
involutes and contracts.

The dorsum and sides of the tongue show dark-red areas which are smooth and shiny from atrophy of
the papillae.

As the condition progresses, the mucosa becomes winkled and divided into numerous plaques or
lobules.

When widely affected the tongue has been termed the ' cobblestone tongue,’

The surface of the plaques may show leucoplakic

• Deep Parenchymatous glossitis

In the early stage the tongue is enlarged, bright red and tender,

later, with ensuing fibrosis, it pales and shrinks

The contraction is iregular and the tongue may be distorted by large film nodules

Sometimes the nodules are situated deep in the substance of the tongue and unite
to form a firm, smooth, painless tumour which. in time, projects on the surface of
the tongue usually on the dorsum
Amyloidosis
• Amyloid involvement of the tongue is almost always secondary to
systemic amyloidosis
• Clinically : amyloidosis of tongue typically presents as
1. macroglossia
2. tongue protrusion beyond the alveolar ridge,
3. speech impairment
4. dysphagia .
On the lateral borders, they present as yellow or raised nodules
• Histopathologically: a special staining with Congo red was
performed, which showed apple green bifringence on polarized light
microscopy

• Amyloidosis of the Tongue-Report of A Rare Case J Clin Diagn Res. 2013 Dec; 7(12): 3094–3095

• Localized amyloidosis of the tongue: a review Am J Otolaryngol. 2004 May-Jun;25(3):186-9.

Sarcoidosis
• Sarcoidosis is a multi-system granulomatous disorder of unknown
aetiology
• the tongue is an uncommon site

• SARCOIDOSIS OF THE TONGUE- British Journal of Oral and Maxillofacial Surgery (1985) 23, 24LV-246 0 1985

• Oral involvement in sarcoidosis:QJM: An International Journal of Medicine, Volume 105, Issue 8, August 2012,
Candidiasis
• Oral candidiasis is a common fungal disease
• It is the most oppurtunistic infection
can be broadly classified as
1. Pseudomembranous candidiasis
2. Erythematous candidiasis
3. Hyperplastic candidiasis

Oral candidiasis.Millsop JW et al. Clin Dermatol. (2016)

Millsop Jillian W., Fazel Nasim, Oral Candidiosis, Clinics in Dermatology (2016
Predisposing factors
1. Immunosuppressive medications,
2. Tissue or organ transplants ,
3. Prolonged use of antibiotics, corticosteroids
4. Immunodeficiency like AIDS
5. Radiation therapy
6. Old age, infancy, and pregnancy
7. Xerostomia.
• Pseudomembranous candidiasis is the classic
presentation ,commonly known as “thrush

• Atrophiccandidiasis presents as erythematous

patches also referred to as antibiotic sore mouth,

• Chronic atrophic candidiasis: Denture stomatitis

Tongue Thrusting
• Tongue thrust is a forward placement of the tongue between the
anterior teeth and against the lower lip during swallowing, speaking
or at rest.
• It is an infantile swallowing pattern.
• It may be associated with macroglossia.
It causes

1. Proclination of anteior teeth

2. Anterior open bite

3. Bimaxillary protrusion

4. Posterior open bite in case of lateral tongue thrust

5. Posterior cross bite

• Complications of tongue thrust
Early loading of implant
• the force of tongue it is horizontal and can increase stress at the peri mucosal site
of the implant.
• most critical for stage surgical approaches and immediate restoration of implants

Tooth movement.
• A tongue-thrust habit may lead to tooth movement or mobility, which is of
consequence when implants are present.
• If the remaining teeth exhibit increased mobility, the implant prosthesis may be
subject to increased occlusal loads
• Inadequate tongue room.
• A potential complication for a patient with a lateral tongue thrust is the
complaint of inadequate room for the tongue after the mandibular implants are
restored.
• the maxillary denture often loses valve seal and drops posteriorly
because only anterior teeth contact.
• so, the patient extends the lateral aspect of the tongue into the
edentulous region to prevent the maxillary denture from
dislodgement
• the tongue often accommodates to the available space, and its size may
increase with the loss of teeth.
• As a result, a patient not wearing a mandibular denture often has a larger-
than-normal tongue.
• The placement of implants and prosthetic teeth in such a patient results in an
increase in lateral force, which may be continuous.
• The patient then complains of inadequate room for the tongue and may bite it
during function
• the patient eventually adapts to the new intraoral condition

Carl E. Misch, in Dental Implant Prosthetics (Second Edition), 2015

Management
 The replacement of the teeth in the neutral zone for complete denture

 It will also help in eliminating the detrimental forces.

PROSTHODONTIC IMPLICATION
• In complete denture
1. Border moulding
2. Neutral zone
3. Retention and stability of denture
4. Phonetics
• Tongue prosthesis
 Border Moulding
It is also termed as ‘peripheral tracing
Tongue position and the degree of freedom provided for tongue movements
during border molding procedures also play an important role in positioning
of the denture borders
• METHODS:
1. Active method
2. Passive method
• Proper border moulding is essential for this retention.
• Sublingual crescent area/Anterior lingual sulcus
The patient is ask to protrude the tongue.
And then to retract his tongue.

• the border of the mandibular denture influenced by the genioglossus muscle in

the anterior lingual sulcus.
Middle region of alveolingual
sulcus

The border of the mandibular denture extends below

the mylohyoid ridge and turns medially

Parallel to the mylohyoid muscle fibers to avoid the

undercut underneath the mylohyoid ridge

And rest over the soft tissues below the tongue

Thus the tongue rests over the flange.

• Posterior region of alveolingual sulcus
• Ask the patient to protrude the tongue and then close the lower jaw.
• Protruding the tongue activates the superior constrictor muscle which molds the
disto lingual border of the denture
• When the patient closes his jaw, the medial pterygoid contracts against the
superior constrictor of pharynx which is immediately anterior to it which in turn
forms the postero lateral aspect of the retro mylohyoid

• Anatomy of the Lingual Vestibule and its Influence on Denture Borders Anat Physiol 3: 122
• The borders should be uniform and round to minimize trauma

• The shape of the final lingual borders should be such that the
patient should be able to wipe the tip of the tongue to the
vermilion border of the upper lip without noticeable displacement
of the tray.

• The final borders of the denture should be in harmony with the

anatomy of the floor of the mouth in rest and in function
Teeth setting

• The teeth must be placed in a position near to that occupied by natural teeth

• The potential space between the lips and cheeks on one side and the tongue on
the other area or position where the forces between the tongue and cheeks or
lips are equal.

• Teeth are to be arranged such that the forces exerted by the tongue, cheek and
lips are neutralized and the teeth along with the polished surfaces of the
denture remain in a ‘zone of equilibrium’.
Try-In

• At the time of try-in, the tongue acts as a guide

in evaluating the height of occlusal plane.

• The dorsal surface of the tongue is nearly level

with the occlusal surface of the posterior teeth.
 RESPIRATION

Phonetics
PHONATION
MECHANISM OF SOUND PRODUCTION by Kanter and West

RESONANCE

ARTICULATION

NEUROLOGICAL
INTEGRATION

AUDITION
Classification of consonants based on the
parts of mouth involved in the formation
Bilabial sounds Eg. P,b,m,w
Labiodental sounds Eg f,v
Linguodental sounds Eg th
Linguoalveolar sounds Eg t,d,s,z
Linguopalatal sounds Eg. Sh,ch,j,r,y
Linguovelar sounds Eg k,g,h,
• A palatogram is a static record of tongue and palatal contours
of the maxillary complete denture during sound articulation
which can be diagnostically used as a simple test for phonetics
evaluation

• It can also be used as a guide for the assessment of phonetic

alterations after placement of a maxillary prosthesis

• Another indication for use of the palatogram technique is in

the cvaluation of maxillary denture placcment in the sensory-
or muscularly impaired patient.

• Evaluation of speech patterns and food bolus management in

the orally disabled or geriatric patient may include palatal
contour asse

• Palatogram: A Guide to Customised, Functional Palatal Contour Journal of Clinical and Diagnostic Research.
2017 Jul, Vol-11(7): ZD06-ZD09

• Palatogram Assessment of Maxillary Comp H ete Dentures Journal ofPosthodonticr, Vol7, No 2 (June),
1998:pp 84-90
• Various other recording medium can be used are:

• Gothic arch tracing ink

• Pressure indicating media

• Powders-gypsum products, alginate

• Occlude aerosol

• Impression waxes

 Palatogram revisited:Contemp Clin Dent. 2014 Jan-Mar; 5(1): 138–141.

These photographs reveal
progressively increasing contact
with the palate when comparing
the undercontoured denture base
with the normal and overcontoured
palates for all sounds tested.

This is indicated both by increased

wetting of the marking material by
the tongue and the removal of the
marking material in certain areas
caused by greater contact
pressures.
Effect of tongue on retention and stability of denture
• The marked movements of the tongue such protrusion, withdrawal, rowing the tongue and display
of a range of continuous movements influences the retention and stability of the denture

• After the loss of teeth, tongue expands into the space created by loss of teeth, known as Proptosis
Lingualis.
• The enlarged tongue creates problem during impression making, contributes to mandibular
denture instability, is crowded by denture base resulting in difficulty in swallowing.
• The crowded tongue always presses on the front part of palate causing soreness and tenderness.
• It also causes excessive pressure on the mandibular denture which pushes it forward and outward
everytime the mouth is opened.

Tongue: The most disturbing element in mandibular denture ADR, Vol 2, Issue 1, 2012
• The most common complaint of complete denture patients concerns the loose mandibular
denture

• Patients should be educated to the three basic things associated with the mandibular
denture.

1. Although the area of the mandibular denture basal seats is less than the area of
maxillary denture, both are subjected to the same occlusal loads and thrusts.

2. Mandibular denture is surrounded lingually as well as buccally by muscles, all of

which have a potential for denture base dislodgment.

3. Third and most important factor the mandibular denture depends on proper tongue
position to maintain adequate peripheral seal and stability

INFLUENCE OF TONGUE IN COMPLETE DENTURE RETENTION AND STABILITY Vol. - III Issue 3 jul
– Sep 2011
Tongue prosthesis
Tongue is the major articulator during the production of sounds
the coordination of the muscle and nerve is impaired
The areas of surgical resection that affects function of the tongue
include
1. Removal of the anterior tip of the tongue,
2. Lateral glossectomy
3. Total glossectomy
Tongue (glossal) defects can be classified as
• Partial (i.e., < 50% of tongue removed)
• Total.

• Total glossectomy create

1. A large oral cavity,
2. Loss of speech
3. Compromised mastication
4. Pooling of saliva and liquid
Resected tongue can also be
restored by
• Free flap
1. Fibular flap
2. Lateral thigh flap
3. Scapular flap
• Myocutaneous flap

Maxillofacial RehabiIitatlon Prosthodontic and SurgicalConslderations

John Beumer III
 Completely edentulous with total glossectomy

 Completely edentulous with total glossectomy and hemi-

mandibulectomy.

 Partially edentulous with partial glossectomy involving anterior part

of the tongue.

 Dentulous patient with segmental resection of mandible and resection

of lateral part of the tongue.
 • Types of tongue prosthesis based upon the function
A. Single piece tongue
1. Tongue prosthesis for swallowing.
2. Tongue prosthesis for speech.
B. Two piece tongue
C. Prosthesis Attached to Maxillary Denture-Palatal Augmentation Prosthesis

Rehabilitation of Glossectomy Cases with Tongue Prosthesis: A Literature Review Journal of Clinical and
Diagnostic Research. 2016 Feb, Vol-10(2): ZE01-ZE04
 • The Palatal Augmentation Prosthesis (PAP) : As a palatal prosthesis that allows
reshaping of the hard palate to improve tongue/palate contact during speech and
swallowing because of impaired tongue mobility as a result of surgery, trauma, or
neurologic/motor deficits

• It is indicated when the tongue resection and reconstruction results in limited bulk
and restricted movement of the reconstructed tongue.

Rehabilitation of Glossectomy Cases with Tongue Prosthesis: A Literature Review Journal of Clinical and
Diagnostic Research. 2016 Feb, Vol-10(2): ZE01-ZE04
1. Modifying a stock maxillary impression tray.
2. The palatal section of the maxillary tray is built up
3. The tentative contours of the prosthesis are developed in wax and evaluated
intraorally prior to processing
4. Wax up for the tongue prosthesis was done on the auto-polymerized acrylic resin
record bases, which was done like the shape of a tongue that conforms to oral
cavity dimensions with rounded edges
5. Ensuring freedom in lateral and protrusive movements, and to check for adequate
palatal contact of the tongue prosthesis during speech and deglutition
6. After processing, the denture base is reevaluated with pressure-indicating paste
Materials Used for Tongue Prosthesis
• Acrylic Resin

1. Polymethylmethacrylate (PMMA) resin was the material of choice in the past.

2. Easy to work
3. Hygienic, durable and easily matches to skin colour.
4. Intrinsic and extrinsic colouration can be done.
5. Strength of this is material is high compared to silicone.
6. Alterations can be easily done
7. Compatible with most adhesive systems,
8. Heat PMMA preferred over the auto polymerizing PMMA (presence of free
toxic tertiary amines).
9. It last for up to two years.

Rehabilitation of Glossectomy Cases with Tongue Prosthesis: A Literature Review Journal of

Clinical and Diagnostic Research. 2016 Feb, Vol-10(2): ZE01-ZE04
• Silicone
1. Single component
2. Eliminating mixing errors
3. Can be polymerized simultaneously with acrylic
4. Stands the influences of oral environment
without deterioration,
5. Non-irritant
6. Odourless and tasteless
CONCLUSION
• Knowledge of anatomy, physiology and functions of tongue is im[ortant to
understand the morphological and functional changes in the tongue with
aging or with complete and partial edentulism.

• This knowledge will help us to reach optimal prosthetic success, as tongue

plays significant role in affecting stability and retention of prosthesis.

• So we can conclude that a proper diagnose of tongue is must before

proceeding and planning any type of dental procedures.
references
1. Rehabilitation of glossectomy cases with tongue prosthesis: a literature review journal of clinical and diagnostic research. 2016 feb, vol-10(2):
ze01-ze04

2. Maxillofacial rehabiitatlon prosthodontic and surgical conslderations john beumer iii

3. Influence of tongue in complete denture retention and stability vol. - Iii issue 3 jul – sep 2011

4. Tongue: the most disturbing element in mandibular denture ADR, vol 2, issue 1, 2012

5. Palatogram revisited :contemp clin dent. 2014 jan-mar; 5(1): 138–141

6. Palatogram: A guide to customised, functional palatal contour journal of clinical and diagnostic research. 2017 jul, vol-11(7): ZD06-ZD09

7. Palatogram assessment of maxillary complete dentures journal of posthodonticr, vol7, no 2 (june), 1998:pp 84-90

8. Carl E. Misch, in dental implant prosthetics (second edition), 2015

9. Oral candidiasis.Millsop JW et al. Clin dermatol. (2016)

10. Millsop jillian W., Fazel nasim, oral candidiosis, clinics in dermatology (2016)

11. SARCOIDOSIS OF THE TONGUE- British Journal of Oral and Maxillofacial Surgery (1985) 23, 24LV-246 0 1985

12. Oral involvement in sarcoidosis:QJM: An International Journal of Medicine, Volume 105, Issue 8, August 2012,

13. Amyloidosis of the Tongue-Report of A Rare Case J Clin Diagn Res. 2013 Dec; 7(12): 3094–3095

14. Localized amyloidosis of the tongue: a review Am J Otolaryngol. 2004 May-Jun;25(3):186-9.

15. Anatomy of the Lingual Vestibule and its Influence on Denture Borders Anat Physiol 3: 122
• Next seminar

DR.KIRAN
 The tongue frequentlyresponds to
the loss of posterior teeth and
alveolarbone by changing size to
bring its lateral bordersinto contact
with the buccal mucosa.

The insertionof a new denture

introduces a new environment
forthe tongue, and the intrinsic
tongue musculaturereorganizes the
shape of the tongue to conform to
the altered space available.

A degree of retraining tongue

activity also takes place.
Furthermore, the posterior residual
ridges are exposed to new
sensations from the overlying
prosthesis.

Pressures transferred through the

denture base replace tactile stimuli
from the tongue and frictional
contact with food.
• Macroglossia

• Microglossia

• Retruded tongue position

• ankyloglossia