Periodontal & Peri-implant Surgical Anatomy

INTRODUCTION

Anatomy of the periodontium and the surrounding hard and soft structures

Determine the scope and possibilities of

periodontal and implant surgical procedures

MANDIBLE

Horseshoe-shape boneConnected to skull with TMJLandmarks mandibular canal-IAN mental foramen

MANDIBLE Contd…

Mental nerve devide in to three br.Paresthesia

MANDIBLE Contd…

.

A, Anterior view

B, Occlusal view

MANDIBLE Contd…

Panoramic radiograph

MANDIBLE Contd…

Lingual view of the mandible

MANDIBLE Contd…

Occlusal view external oblique ridge. Arrows show the attachment of the

buccinator muscle.

MANDIBLE Contd…

occlusal view of the ramus and molars

retromolar triangle area distal to the third molar (arrows)

MANDIBLE Contd…

Lingual view A, the inferior alveolar nerve

B, the lingual nerve

C, the attachment of the mylohyoid muscle inferiorly.

MAXILLA

• Paired bone-Mx sinus&Nasal cavity

• Four processs

i)alveolar

ii)palatine

iii)zygomatic

iv)frontal

MAXILLA

Occlusal view incisive canal / anterior palatine foramen (red arrow) greater palatine foramen (blue arrows).

MAXILLA Contd…

Occlusolateral view of the palate nerves (red) and vessels (blue) Incisive canal&papilla greater palatine foramen

MAXILLA Contd…

Histologic frontal section

• vessels &nerve

• adipose & glandular tissue

MAXILLA Contd…

Maxillary sinus. A, Frontal view. B, Lateral view.

MAXILLA Contd…Blood supply and innervation of the

maxillary sinus. A, Arterial blood supply. B, Innervation of the maxillary sinus.

EXOSTOSES

Mandible Lingual to canine & premolars above mylohyoid muscle

Maxilla Midline of hardplate

EXOSTOSES Contd…

Buccal exostosis in the maxillary arch Large midline palatal torus

MUSCLES

1, Nasalis;2,Levator anguli oris 3,Buccinator4,Depressor anguli oris5,Depressor labii inferioris 6,Mentalis.

ANATOMIC SPACES

Canine fossa Buccal space Mental/Mentalis space Masticator space Sublingual space Submandibular space

ANATOMIC SPACES Contd..

Posterior view of the mandible

A.attachment of the mylohyoid muscles B. geniohyoid musclesC. sublingual glandD. submandibular gland, which extends below and also to some extent above the

mylohyoid muscle E.sublingual nerveF. inferior alveolar nerve

MCQ-1

• Which of the following is responsible for paresthesia of the lip during placement of implant in lower jaw

(a)Trauma to the lingual nerve

(b)Trauma to the inferior alveolar nerve

(c)Trauma to the mental nerve

(d)Trauma to the palatine nerve

MCQ-2

• The following are the landmarks of surgical importance of Mandible Except

(a)Mandibular foramen

(b)Mental foramen

(c)Incisive foramen

(d)Mylohyoid ridge

MCQ-3

• Which of the following space infection leads to swelling of the upper lip,obliterating the nasolabial fold and of the upper and lower eyelids

(a)Buccal space

(b)Canine fossa

(c)Mental space

(d)Masticator space

MCQ-4

• Ludwig’s angina is a severe form of infection that results in hardening of the floor of the mouth and may lead to asphyxiation from edema of the neck and glottis.It is related with-

(a)Mentalis space

(b)Sub lingual space

(c)Submandibular space

(d)Submental space

MCQ-5

• Which of the following tooth is very close to the maxillary antrum

(a)Third molar

(b)Second molar

(c)Premolar

(d)Canine