Anatomic Landmarks and Physiological Areas of Relevance in the Management of Edentulous Maxillary and Mandibular Foundations in Prosthodontic Treatment

Introduction A knowledge of oral anatomy helps the operator provide enough landmarks to act as positive guides to the limits of impressions.

Maxillary Arch
Anatomical Landmarks: 1. Incisive papilla 2. Palatal rughae 3. Median raphe 4. amular notch

!. Ma"illary tu#erosity $. %ovea palatinae Physical Areas of Relevance: 1. &uccal sulcus 2. 'a#ial sulcus 3. 'a#ial frenum 4. &uccal frenum !. Posterior palatal seal area

Anatomic Landmarks:
1. Incisive Papilla : It is a pad of fi#rous connective tissue overlying the orifice of the nasopalatine canal. Significance: a. (ta#le landmark and gives its relation to incisive foramen through which the neurovascular #undle emerge and lie on the surface of #one. #. It is a #iometric guide giving information on positional relation to central incisors which are a#out )*1+ mm anterior to incisive papilla. c. &iometric guide which gives us information a#out location of ma"illary canines ,A perpendicular drawn posterior to the centre of incisive papilla to sagittal plane passes through canines-. Clinical Consideration : .uring final impression procedure/ care should #e taken not to compress the papilla. ence the incisive papilla should #e relieved with a spacer. Reason 0 a. 1ompression of #lood vessels o#literation of the lumen deprive nutrition to tissues #reakdown of tissues. #. Pressure on nerve causes parasthesia in the region of upper lip. 2. Palatal Rughae 0 2hey are raised areas of dense connective tissue radiating from the median suture in the anterior 133rd of the palate.

Significance : a. (aid to #e concerned with phonetics. #. Increase the surface area of the foundation and thus supplement the values of retention. c. It is the denture sta#ili4ing area in the ma"illary foundation. 3. Median Raphe : It is the area e"tending from the incisive papilla to the distal end of the hard palate. Significance : a. Area of sutural 5oint and covered with firmly adherent mucous mem#rane to the underlying #one with little su#mucosal tissue. #. 2his sututal 5oint is formed #y the median fusion of two ma"illary processes and two hori4ontal plates of palatine #one. c. %unction of sutural 5oint is growth and sometimes there will #e overgrowth of the #one at the sutural 5oint resulting in torus palatinus. d. 2he particular raphe #y virtue of its location and palate with deeper vault reflects the association of Pascal6s law of physics which states that pressure on a confined li7uid will #e transmitted undiminished and e7ually throughout the li7uid in all directions. Clinical Considerations : .uring final impression procedure this raphe is relieved in order to create an e7uili#rium #etween the resilient and non resilient tissues. 4. Hamular notch : 3

 It is a narrow cleft of loose connective tissue which is appro"imately 2mm in e"tent anteroposteriorly. 'ocated #y using 2*#urnisher. Significance : a. 1onstitutes the lateral #oundary of posterior palatine seal area in ma"illary foundation. #. 2he pterygomandi#ular raphe attaches to hamulus. Clinical Consideration : a. .enture should not e"tend #eyond the hamular notch/ failure of which will result in 0 i. 8estricted pterygomandi#ular raphe movement.

ii. 9hen mouth is wide open the denture dislodges. iii. Pterygomandi#ular raphe may #e sandwiched #elow the denture. !. Maxillary u!erosity : It is the distal most part of the residual alveolar ridge and presents the hard tissue landmarks. Significance : 2he last posterior tooth should not #e placed on the tu#erosity.

Clinical Significance : :ften there is lateral and vertical growth of tu#erosity and the area assumes importance when ma"illary antrum e"tends laterally with undercuts at the tu#erosity region. It is important to prevent oro*antral fistula so it is important to have radiograph #efore resection of the tu#erosity. It can #e used for the retention of the denture. 2u#erosity should #e resected on one side only i.e. if patient is right side chewer we should retain that sided tu#erosity. ". #ovea Palatinae: 2hey are the remnants of ducts of coalescence. ;sually two in num#er on either side of the midline. 2hey indicate the vicinity of posterior palatine seal area. It has no clinical significance. Physiologic areas of relevance $. %a!ial #renum: It appears as a fold of mucous mem#rane e"tending from the mucous lining of the lip to or towards the crest of residual ridge on the la#ial surface. It may #e single 3 multiple.

It may #e narrow 3 #road. It contains no muscle fi#res of significance. Attachment is of three types 1lose to crest of the ridge. Average. .istal to crest of the ridge.

Clinical Consideration : a. (ufficient relief should #e given during final impression procedure and in completed prosthesis #ecause overriding of function of frenum will cause pain and dislodgement of denture. #. .uring impression procedure the lip should #e stretched hori4ontal outwards for the proper recording of frenum. c. If frenum is attached close to the crest frenectomy is done/ failure of which will lead to the denture #order #eing placed on the #one tissue which will cause decreased #order seal. 2. %a!ial &esti!ule : It e"tends on #oth sides of the midline from la#ial frenum anteriorly to the #uccal frenum posteriorly. It is #ounded laterally #y the la#ial mucosa medially #y ma"illary residual alveolar ridge. 8eflection of the mucous mem#rane superiorly reflects the height. 2he area of mucous mem#rane reflection has no muscle.

Clinical Consideration : %or effective #order contact #etween denture and tissue/ vesti#ule should #e completely filled with impression material. '. (uccal #renum: %old or folds of mucous mem#rane e"tending from mucous mem#rane reflection area to or towards the slope or crest of residual alveolar ridge. Significance : 'evator angulioris ,caninus muscle- lies #eneath it and hence influenced #y other muscles of facial e"pression. Clinical Consideration: a. .uring final impression procedure and in final prosthesis sufficient relief should #e given for the movement of frenum #ecause overriding of function of frenum will cause pain and dislodgement of denture. #. .uring impression procedure the cheek should #e reflected laterally and posteriorly. c. If frenum is attached close to the crest of alveolar ridge/ frenectomy is called for 4. (uccal vesti!ule :

(oundries : It is #ounded anteriorly #y the #uccal frenum/ laterally #y the #uccal mucosa and medially #y residual alveolar ridge. Significance : In the area of #uccal flange of denture #ase where it rounds the disto#uccal area of alveolar tu#ercle/ sometimes a small muscle attachment is seen.

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Clinical Consideration : a. .uring impression procedure the vesti#ule should #e completely filled with impression material for proper #order contact #etween denture and tissues. #. 9hen the vesti#ular space that is distal and lateral to the alveolar tu#ercles is properly filled with denture flange the sta#ility and retention of the ma"illary denture is greatly enhanced. c. 2he #uccal flange #orders depend upon movement of ramus of mandi#le at the distal end of #uccal vesti#ule and hence the patient should move the mandi#le laterally and protrusively to make sure the mandi#le does not interfere with these functions. d. 2o effectively record the ma"illary #uccal sulcus the mouth should #e half way closed #ecause wide opening of the mouth narrows the space and does not allow proper contouring of sulcus #ecause the coronoid process of mandi#le comes closer to the sulcus. ). Posterior Palatal Seal *rea : 2his landmark presents a three dimensional seal area which supplements values of retention of ma"illary denture. palpated #y function. Anterior unit consists of as much resilient area as 2*#urnisher #ecause of histologic contents. Posterior limit is revealed #y the line of minimal

'ateral limit is revealed #y hamular notch area. (upperoinferior limit is revealed #y the thickness of low fusing impression compound.

Significance : a. It improves retention #y more than 1+ times. #. Instills confidence in a patient to wear and retain ma"illary denture. c. elps in wardng of gagging refle".

d. 8educes learning period of wearing denture. e. 2he percentage linear shrinkage does not change its dimension.

Mandibular arch
Anatomic Landmarks 1. 2. 8etromolar pad. =enial tu#ercle.

Physical areas of relevance 1. 'a#ial frenum 2. 'a#ial vesti#ule 3. &uccal frenum 4. &uccal vesti#ule. !. Massetric notch area.

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$. 8etromyloid area. <. 'ingual frenum. ). &uccal shelf area. Anatomic Landmarks $. Retromolar pad : It is the pear shaped #ody at the distal end of the residual alveolar ridge. Also called as retromolar triangle. Significance : a. 8epresents distal limit of mandi#ular denture. #. It has muscular and tendinous elements. * * * * * * %ew fi#res of temporalis. %ew fi#res of massater. %ew fi#res of #uccinator. %i#res of superior constrictor muscles of pharyn". 2endinous mandi#ular raphe. &ecause of muscular tendinous elements the area should not #e su#5ected to pressure. Clinical Consideration :

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a.

elps in maintaining the occlusal plane. * .ivide retromolar pad into anterior 233rd and posterior 133rd. * Posterior height of occlusal rim should not cross anterior 233rd.

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elps in arranging mandi#ular posterior teeth. * .raw a line from highest point in canine region to the ape" of the retromolar triangle e"tending it to the land of the cast. * 2he central fossa of all posterior teeth should lie on this crestal line.

c. Reason: i.

2eeth should not #e placed on the retromolar pad.

&one is situated in a inclined plane and hence forces are inclined anteriorly.

ii. iii. +. ,enial tu!ercle: the ridge. Significance :

.islodgement of denture. (oreness of tissue.

;sually seen #elow the crest of

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 relieved.

In severely resor#ed ridge it is seen a#ove the residual alveolar ridge and hence it should #e

Mucosa covering the genial tu#ercle is thin and tightly adherent to the underlying #one.

Clinical Consideration : It should #e relieved with wa" spacer/ failure of which will lead to ulceration.

Physiologic Areas of Relevance

$. %a!ial frenum : It is a fold of mucous mem#rane e"tending from mucous lining of mucous mem#rane of lips to or toward the crest of the residual alveolar ridge on the la#ial surface. Clinical Consideration : a. .uring final impression procedure the lip has to #e reflected anteriorly and hori4ontally. #. .uring final impression procedure and in final prosthesis provision should #e made in the form of notch to prevent overriding of function which may result in laceration. 2. %a!ial vesti!ule: It is #ounded anteriorly #y la#ial frenum/ posteriorly #y #uccal frenum/ laterally #y la#ial mucosa and medially #y residual alveolar ridge.

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Clinical Consideration : %or effective #order contact #etween denture and tissue/ the vesti#ule should #e completely filled with impression material during impression procedure.

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(uccal frenum : It is a fold of mucous mem#rane e"tending from mucous mem#rane of #uccal mucosa to or towards the crest of the residual ridge on the #uccal surface. It may #e single 3 multiple.

Significance : It is underlined #y depressor anguli oris. Clinical Consideration : .uring final impression procedure and final prosthesis sufficient relief should #e given to prevent overriding of function of frenum which may result in laceration. 4. (uccal &esti!ule: It is #ounded anteriorly #y the #uccal frenum/ posteriorly #y mucosa. Significance : a. #. It is an area of esthetic consideration. 2he #uccal flange covers a#out ! mm or role of fi#res of #uccinator in this area #ut since it runs in a hori4ontal manner in the anteroposterior direction/ it is not a dislodging factor. Clinical Consideration : a. 2his space constitutes an area to #e completely filled #y impression material during impression procedure. the

massetric notch area/ medially #y residual alveolar ridge and laterally #y #uccal

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#. It is necessary to limit the lateral content of #uccal flange in the region where the masseter muscle is in function ,anterior fi#res- may push against the distal part of #uccinator muscle/ failure of which may cause soreness of tissue when heavy pressure is applied. !. &uccal shelf area0 Area of compact #one which is #ounded laterally #y e"ternal o#li7ue ridge and medially #y crest of mandi#ular ridge. Significance : a. It presents an area of compact #one which #y virtue of its deposition is hori4ontal and therefore is #est suited to receive masticatory stresses in the vertical direction. #. foundation. Reason : i. c. It is hori4ontal and made up of cortical #one. 2he soft tissue and muscle attachment do not restrict coverage and e"tension of mandi#ular #ase. d. parallely. Clinical Consideration 0 It is advisa#le to e"tend the impression #eyond the e"ternal o#li7ue ridge failures may #e due to0 a. Inade7uate selection of impression tray. 2he dense closely placed tra#eculla are arranged It is the primary stress #earing area in the mandi#ular

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#. Involuantary effort on part of the operator. $. Massetric notch area: It is immediately lateral to retromolar pad and continuous anteriorly to #uccal vesti#ular sulcus. Significance : It is due to the contraction of masseter that a depression is formed at the disto#uccal corner of retromolar pad. Clinical Consideration: a. 9hen mouth is opened widely the #orders cut into the tissue so it should #e recorded. #. .uring impression procedure in the area of massetric notch downward pressure is applied and the patient is asked to close the mouth against the pressure. c. :vere"tension of denture causes * .islodgement of denture * 'aceration <. %ingual frenum : Muco#uccal fold that 5oins the alveolar mucosa to the tongue. Significance : It overlies the genioglossus muscle which takes origin from the superior genial spine on the mandi#le. Clinical Consideration : a. (ufficient relief should #e given in the final impression and the final denture to prevent overriding of function of frenum.

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#. .uring impression procedure touch the tip of the tongue to the incisive papilla region. ). Retromylohyoid space: 'ocated posterior to mylohyoid ridge and #ounded posteriorly #y the fi#res of superior constrictor of pharyn". Significance : a. 2he distolingual portion of the flange is influenced #y the glossopalatine and superior constrictor muscles which on stretching constitute the retromyolohyoid curtain. #. 1onstitutes the most important #racing potential in the mandi#ular foundation. Clinical Consideration : ?ven in poorest of poor conditions this has to #e recorded very critically for security of mandi#ular denture. -. Su!lingual Crescent area : 2he anterior portion of the lingual flange is commonly called the su#lingual crescent area. It is part of floor of the mouth covering the su#lingual gland. Significance : 2his has speciali4ed innervation. Clinical Consideration : :vere"tension of denture in this area causes #urning sensation.

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Conclusion
@(uccessful accomplishment of complete denture treatment constitutes a 5oint responsi#ility of #oth the operator and the patient #y way of correctly participating in the treatment proceduresA. It is imperative that apart from the knowledge of all the a#ove factors of anatomical and physiological relevance in treatment procedures/ e"ecution of the factors/ digital de"terity and communication skills of the operator are of paramount importance. 2hus/ the diagnostic and clinical acumen of the operator constitute important considerations in the application of a#ove knowledge. efinition of Im!ression An impression is a negative registration of denture #earing/ denture sta#ili4ing/ denture #racing and peripheral limiting areas o#tained in one of the plastic 3 semiplastic materials and which is registered at the moment of crystalli4ation of impression material. "y!es of im!ression !rocedures : $. impressions. &inding pressure was used/ so #orders were #eyond the functional limit or physiologic limit of tolerance. pathologic changes. 2ransient retention was o#tained resulting in Pressure group Initiated #y =reen &rothers. 1alled as =reen &rothers all compound

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.on pressure group / minimal pressure techni0ue Advocated #y arry '. Page. 2echni7ue was called as mucostatus. It advocated that0 a. Adhesion and cohesion were the only forces used for retention of denture. #. Advocate use of co#alt*chrome #ypassing gold as denture #ase material. c. Advocated limit of height of !mm only of #uccal flange. Controlled pressure / selective pressure Modified mucostatic pressure is in use. Principle of selective pressure techni7ue is

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e7uali4ation #etween resilient and non resilient tissues. Princi!les of im!ressions regarding gross anatomy: 1. Impression should cover ma"imum amount of tissues within the confines of the anatomy of the foundations. 2. Impressions must record the intimate details of surface of soft tissues. 3. Impressions should #e made with a understanding of the underlying gross structures such as the shape of the #one and

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attachment and direction of action of muscles and other limiting structures. Princi!les regarding histologic structures of su!!orting areas: 1. 2issues #oth #ony and soft respond to pressure. 2. (oft tissues closely attached to #one are #etter a#le to support pressure than those with loose attachment. 3. 2hicker su#mucosal tissues may #e displaced more than thin su#mucosal tissues. Princi!les and ob#ectives of im!ression Ma1ing: 1. 8etention. 2. (ta#ility. 3. (upport. 4. ?sthetics. !. Preservation of tissues. 1. Retention : It is that 7uality to #e incorporated in the treatment when the complete dentures would resist dislodgement forces which move the dentures away and act at right angles to the supporting tissues. It is the 7uality that resists the force of gravity/ adhesiveness of foods/ and the forces associated with the opening of 5aws. $actors that contribute to values % &uality of retention in com!lete dentures:

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a. Physical factors. #. Mechanical factors. c. Physiologic factors. d. Psychologic factors. e. (urgical factors. a. i. ii. iii. iv. v. Physical factors Adhesion 1ohesion (urface tension 1apillary attraction Atmospheric pressure

i. *dhesion 0 It is the physical molecular attraction of unlike surfaces in close contact. It acts when saliva wects and sticks to the #asal surface of dentures and at the same time to the mucous mem#rane of the #asal seat. ?ffectiveness of adhesion depends upon close adaptation of denture #ase to the supporting tissues and fluidity of saliva. ii. Cohesion : It is the molecular attraction #etween two similar surfaces in close contact.

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 It occurs in the layer of saliva #etween the denture #ase and the mucosa. Adhesion and cohesion can #e achieved #y 0 I. tray 2hich 0ualifies. a. It covers denture #earing/ sta#ili4ing/ #racing and #order limiting structures ade7uately. #. It confirms to the outline form of the ridge and conforms to the shape of the vault of the palate. c. 'eaves an even space of < to ) mm #etween the tray and tissues. I. thermoplastic impression compound a. ;se of thermoplastically controlled water#ath. #. ;niform softening and kneading of compound. c. ;niform loading of the tray. II. custom impression tray iii. surfaces. Interfacial surface tension It is the resistance to Correctness in the fa!rication of Manipulation of shellae !ased Correct selection of stoc1 metal

separation possessed #y the film of li7uid #etween two well adapted

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It is found in the thin film of saliva #etween the denture #ase and the mucosa of #asal seat.

iv.

1apillary attraction It is the force that causes the surface of li7uid to #ecome elevated or depressed when it is in contact with a solid. 9hen the adaptation of denture #ase to mucosa on which it rests is sufficiently close/ the space filled with a thin film of saliva acts like a capillary tu#e and helps retain the denture

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v.

Atmospheric pressure It is an emergency retentive force if other retentive forces are #eing overpowered/ atmospheric pressure may #e a#le to keep denture in position. It is mainly governed #y 0 a. &order molding of the impression and placement of #order tissues within physiologic limits of tolerance of tissues and #y e"ecuting functional simulation of the tissues for making an allowance for tissue function. #. &y e"ecuting a posterior palatine seal. It augments the values of retention #y more than 1+ times. It is a three dimensional seal.

#. Mechanical factors i. ;ndercuts

ii. (uction discs iii. Magnets i. 3ndercuts : Ma"illary tu#erosity act as mechanical lock. It there is overgrowth of ma"illary tu#erosity/ the side on which the patient chews should #e retained and the opposite side should #e resected.

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ii.

Suction discs : 9hen acryli4ing denture a stainless steel ring around which is the ru##er washer is incorporated in the palatal region which creates a negative pressure.

4isadvantage : I. &ecause of constant contact there will #e irritation which results in inflammation and proliferation of soft tissue into the cham#er. iii. Magnets : It is used in poorly resor#ed cases where retention and sta#ility is difficult to achieve. Magnets placed in opposing dentures with like poles opposing each other. 2hus force of repulsion helps in retention. d. Physiological factors i. (aliva ii. Beuromuscular control iii. Caw si4e and relationship i. Saliva : Affects the effectiveness of physical forces. 2he higher the viscosity owing to the mucoid content/ the lower the flow and greater is the fi"ation. ence mucous saliva provides #etter cohesion than serous saliva.

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'euromuscular control: Patients a#ility to control the denture with lips/ cheeks and tongue depends on neuro muscular control. 2he interplay of forces #etween the tongue and the cheek in placing holding food on the occlusal surface of teeth suggests that the teeth should ideally #e placed at a neutral point in relation to these forces. 2he general cross sectional shape of the polished surface of a denture through the residual ridge area should #e triangular which permits forces to #e directed against these surfaces for #est retention. A ma"illary denture #uccal surface which inclined inward from the #order to the teeth would tend to direct lateral forces from contracting #uccinator muscle so that the force would have its greatest superior component and thus tend to seat the denture. 2he alveolar palatal surfaces of the upper denture should #e concave permitting the greatest superior component of tongue force. 2he #uccal surface of lower denture should #e concave to face up and out permitting the cheek to cradle in against the flange and give the desired inferior component of forces. 2he lingual flange of lower denture should #e concave and face in and up. &ecause of shape of mandi#le and #ecause of functional movements of mucosal reflection of alveolingual sulcus/ this flange cannot appro"imate the #ody of the mandi#le #elow the attachment of mylohyoid. Its greatest e"tension can #e achieved #y turning at lingually

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under the lateral surface of the tongue which directs the tongue to direct forces inferiorly against the flange. 2he modiolus acts as a mova#le attachment to aid the or#icularis oris and #uccinator in their functions associated with mastication/ speech and deglutition. 2his action tends to draw the modiolus medially and hence e"erts forces against the teeth or denture flanges in premolar area. a denture that is wide in premolar area will therefore tend to #e displaced from its tissue seat. ii. 5a2 si6e and relationship: 8etention is directly proportional to the area of coverage. ence it implies that when there is atrophy of mandi#le there is going to #e lot of space which gives rise to many leverages which may topple the denture. d. Psychologic factors 0 (uccess of denture depends upon the patients reactions and mental attitudes and clinical assumptions of the clinician. 1lassification given #y ,M.M. mind $. Philosophical mind ouse- in 1>3< according to patients

1*a- 2hose of a well #alanced mental type who had come previously for e"traction in wearing denturesD such patients are dependent upon dentist for proper diagnosis/ prognosis and education. 1*#- 2hose who have worn satisfactory dentures/ are in good health and of the well #alanced type who may #e in need of further service.

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&. 7xacting mind 1*a- 2hose who/ while suffering ill health are seriously concerned a#out the appearance and efficiency of artificial dentures and therefore ar reluctant to accept the advice of their physician and dentist and are unwilling to su#mit to the removal of their natural teeth. 1*#- 2hose wearing dentures unsatisfactory in appearance and usefulness and who dou#t to such an e"tent the a#ility of the dentist to render a service that will #e satisfactory/ that they often insist upon a written guarantee or e"pect the dentist to make repeated attempts without an additional fee. C. Hysterical mind 1*a- 2hose I #ad health with long neglected pathological mouth conditions who dread dental service and su#mit to removal of teeth as a last resort and are positive in their own minds that they can never wear dentures. 1*#- 2hose who have attempted to wear dentures have failed and are thoroughly discouraged. 4. Indifferent mind 1. 2hose who are unconcerned regarding their appearance and feel very little or no necessity for mastication. 2hey are therefore non pursuing and will inconvenience themselves very little to #ecome accustomed to the use of dentures. 7. Surgical factors : a. #renectomy : 2he relief of la#ial3 lingual frenum is indicated where it may cause mo#ili4ation of the denture and prevent utili4ation of ade7uate area for retention. 2)

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Ridge extension techni0ues: 2his is done where there is e"tensive atrophy of the ridge. 8idge e"tension techni7ues often provide initial results that are gratifying #ut within several months the ridges are almost as #ad as they were at first. c. Resection of the tu!erosity In #ilaterally enlarged tu#erosity the tu#erosity on the side the patient chews is retained while on the opposite side it is resected.

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Sta!ility : Euality of the denture that has to #e incorporated in the denture that resists the dislodging forces which act in general towards the supporting tissues.

%actors which create insta#ility are of greater magnitude than that for retention. Sta!ility depends upon: a. Euality of final impression. #. Caw relation record. c. Proper placement of teeth d. 1ontouring of polished surface of complete denture. a. Impression should cover as large an area of denture foundation within anatomical confines of foundation. ;tili4ing the #racing area in retromylohyoid fossa in the mandi#le lateral to tu#erosity in the ma"illa. 2>

&uccal shelf area should #e utili4ed in the mandi#ular foundation.

In ma"illa when palate is flat minimal pressure impression techni7ue should #e used.

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5a2 relation record (ta#ili4ed #ase is a prere7uisite. In cases of shellae it has to #e overlaid with tinfoil and 4inco"ide eugenol paste. =old record #ases covers greater area #ecause of #etter flow resulting in increased cohesion and adhesion. Caw relation has to #e critically recorded.

c.

eeth arrangement 2eeth should #e placed in the natural 4one. 2eeth have to #e narrowed in the #uccoocclusal ta#le.

d.

Contouring of polished surface Ma"illary denture #uccal surface should #e inclined inward from #order to the teeth. 2he palatal surface of ma"illary denture should #e concave. 2he lingual flange of mandi#ular denture should #e concave.

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 2he #uccal surface of lower denture should #e concave to face up afford satisfactory and comforta#le retention of the dentures when there is no closing force on them. '. Support : (upport is the resistance of a denture to the vertical components of mastication and to occlusal or other forces applied in a direction toward the #asal seat. 4. 7sthetics : 2he cosmetic effect produced #y a dental prosthesis which affects the desira#le #eauty/ attractiveness/ character and dignity of an individual. &order thickness should #e varied with the needs of each patient in accordance with the e"tent of residual ridge. ). Preservation of tissues: Preservation of the remaining residual ridges is one o#5ective. It is physiologically accepted that with the loss of stimulation of the natural teeth the alveolar ridge will atrophy or resor#. Pressure in the impression techni7ue is reflected as pressure in the denture #ase and results in soft tissue damage and #one resorption.

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