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ANATOMICAL LANDMARKS

OF PROSTHETIC INTEREST

:Objectives
At the end of the lecture the student should be
:able to
I- Define anatomical landmarks.
II-Differentiate between bony landmarks
and soft tissues landmarks.
III- Identify extra-oral anatomical landmarks
and their relation to complete denture
construction.

These are anatomical guides that


help in denture construction

:-These are either


I- Bony landmarks
II- Soft tissue landmarks

Soft tissues
landmarks
Easily identified

changing their
relation according to
their mobility

Bony
landmarks

POINTS OF
COMPARISON

Some are difficult to


palpate, while others are
easily palpated

Palpation
and
identification

Fixed in place

Position

The measurement can be


duplicated with more
accuracy than
measurements between
.soft tissue landmarks

Measurement

Extra Oral Landmarks of


Prosthetic
Importance

(in the face)

Extra-oral Landmarks
1- Vermillion Border.
2- Philtrum of the lip.
3- Nasolabial sulcus.
4- Mentolabial sulcus.
5- Modiolus.
6- Ala-tragus line.
7- Inter-pupillary line.
8- The angle of the mouth and
the outer canthus of the eye.

1- Vermillion Border
It is the transitional
epithelium between
the mucous
membrane of the lip
and skin

The amount of vermillion


border shown on the lips
depends on
1-The bulk of the orbicularis oris muscle.
2- The amount of the labial alveolar bone.
. 3-The alignment of the anterior teeth

After loss of Teeth

The amount of vermillion


border shown on the
upper lip is reduced
Alveolar bone resorbed
The orbicularis oris muscle
loses its support

The condition can be


corrected by
thickening of the labial
flange of the denture
and proper positioning
.of the anterior teeth

Philtrum of the Lip -2


It is a diamond
shaped
depression at
the center of the
upper lip and
base of the nose

After loss of teeth and


labial alveolar bone, the
.philtrum becomes flattened

This condition can be improved by


construction of proper denture with an
appropriate arch-form and tooth
. alignment

Nasolabial Sulcus -3
It is a
depression
that extends
laterally and
downwards
from the ala
. of the nose

The sulcus becomes more


prominent with aging due
to loss of teeth and loss of
. vertical dimension
The condition can be
modified by proper degree
of jaw separation and
.tooth positioning

Plumpers (thick
denture flanges)
sometimes improve the
condition but it may
interfere with
.muscular activity

Mentolabial Sulcus- 4
This is a
depression
that runs
horizontally
between the
lower lip and
the chin

Its curvature indicates


the character of the maxillomandibular relationship and
the degree of over-closure.

Angle Class I
(Normal Ridge
Relationship )
The sulcus shows a
gentle curvature
with obtuse angle

Angle Class II
Retruded Mandibular
Relation

The sulcus forms


an acute angle

Angle class III


Protruded mandibular
relationship

The sulcus
forms an angle of
.almost 180

Quiz

Fig A

Fig B

Fig C

Modiolus -5

It is located at the meeting of


buccinator and other facial
muscles distal to the angle of
.the mouth

With the loss of teeth the


modiolus drops. The
appearance can be improved
by proper positioning of the
maxillary teeth.

Ala Tragus Line -6


(Campers line)
The imaginary line
extending from
the superior
border of the
tragus of the ear
to the inferior
border of the ala
of the nose

This imaginary line is used


as a guide to establish the
antro-posterior occlusal
.plane of the artificial teeth

The Supra-Orbital Ridge and Eye Pupil -7


(Inter-pupillary line)

The imaginary line joining


the pupils of the eye
called inter- pupillary
line
It is used as a guide to
establish the anterior
occlusal plane of the
.artificial teeth

The Angle of the Mouth and the


Outer Canthus of the Eye

-8

The Angle of the Mouth and the

-8

Outer Canthus of the Eye


The distance from the outer canthus of the eye to the
angle of the mouth was used by Willis to determine
the vertical dimension of the edentulous patient at
rest by making the distance from the base of the
. nose to the lower edge of the mandible equal to it

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A 65 -YEAR OLD -MAN PRESENTED TO A DENTAL CLINIC ASKING

FOR RESTORATION OF LOST MAXILLARY AND MANDIBULAR


TEETH.
For this case
.A- Identify the extra-oral anatomical landmarks
.B- Select a type of prosthetic appliance
.C- List the clinical and laboratory procedures for this prosthetic treatment

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Thank You