Fovea Palatine

# Fovea palatine situated in hard palate are significant as: 

A. Termination of maxillary denture

B. Opening of minor salivary gland ducts 

C. Indicates closure of mid palatine raphe 

D. Opening of greater palatine canal

The correct answer is B. Opening of minor salivary gland ducts. 

Palatine fovea

These are the orifices of common collecting ducts of minor palatine salivary glands.

The fovea palatini are two depressions that lie bilateral to the midline of the palate, at the approximate junction between the

soft and hard palate.

They denote the sites of opening of ducts of small mucous glands of the palate. They are often useful in the identification of the

vibrating line because they generally occur with in 2 mm of the vibrating line.

The hamular process, or hamulus, is a bony projection of the medial plate of the pterygoid bone and is located distal to the

maxillary tuberosity. Lying between the maxillary-tuberosity and the hamulus is a groove called the hamular notch This notch

is a key clinical landmark in maxilla) denture construction because the maximum posterior extent of the denture is the vibrating line that runs bilaterally through the hamular notches.

The hamulus can be palpated clinically and it can be a possible site of irritation in denture wearing patients, touches this process. The tendon of the tensor villi palatine muscle runs across the hamulus to reach the soft palate. Under the

tendon is a small bursa (membrane between the moving tendon and the hamulus. Inflammation and pain can result from the denture mechanical irritation by unstable dentures.

Gillies Temporal approach

# In Gillies Temporal approach for reduction of zygomatic arch fracture, Rowes elevator is placed between:  

A. Superficial facia and temporal fascia  

B. Temporal bone and temporalis muscle  

C. Temporal fascia and Temporalis muscle

D. Skin and superficial fascia

The correct answer is C. Temporal Fascia and Temporal muscle. 

In Gillies temporal fascia for reduction of zygomatic arch fracture, elevator is placed between temporal fascia and Temporalis muscle.

The temporal fascia is attached to the zygomatic arch and the temporal muscle passes downward medial to the fascia to be

attached to the coronoid process.Between these two structures a natural anatomical space exists into which an instrument can be inserted and it can be utilized to elevate the displaced zygoma on its arch into position.

Technique: The hair is shaved from the temporal region of the scalp. The external auditory meatus is plugged with cotton to

prevent any fluid or blood getting inside.

An incision about 2 to 2.5 cm in length is made, inclined forward at an angle of 45 degrees to the zygomatic arch, well in the

temporal region. Care is taken to avoid injury to the superficial temporal vessels. The temporal fascia is exposed which can be identified as white glistening structure. The incision is taken into the fascia and the fibres of temporalis muscles will be seen. Long Bristow's periosteal elevator is passed below the fascia and above the muscle.

Once this correct plane is identified and instrument is inserted through it downward and forward, the tip of

the instrument is adjusted medially to the displaced fragment.

A thick gauze pad is kept on the lateral aspect of the skull to protect it from the pressure of elevator while reduction is going on.

The operator has to grasp the handle of the elevator with both hands and assistant has to stabilize the head of the patient. (During elevation procedure care should be taken that pressure is not exerted on the lateral surface of the skull to end up with depressed fracture of the skull).

The tip of the elevator is manipulated upward, forward and outward. The snap sound will be heard as soon as reduction procedure is complete. Wound is

closed in layers after withdrawing the elevator.

Care is taken that after surgery at least for 5 to 7 days, no pressure is exerted on the area till the bone consolidates. Patient is instructed to sleep in supine position or not to sleep on the operated side. 

Posterior Palatal Seal

# Excess height of the posterior palatal seal of a complete maxillary denture will usually result in which of the following?
A. Increased retention
B. A tingling or tickling sensation
C. Unseating of the denture
D. Gagging

The correct answer is C. Unseating of the denture.

Over contouring or excessive beading of the posterior palatal seal causes too much pressure to be exerted on the palatal tissues resulting in the unseating of upper dentures. 

The posterior palatal seal is typically placed approximately on the vibrating line between the hard and soft palate and provides a physiologically acceptable tissue pressure within the compressible portion of the soft palate to attain retention and peripheral seal. 

Over extending the coverage of seal will cause gaggling and painful swallowing for the part of the patient. 

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Vertical Dimension of Occlusion (VDO)

# A denture that is fabricated with excessive Vertical Dimension of Occlusion (VDO) may result in:
A. Inefficient mastication
B. Perioral rhytides (wrinkles)
C. Trauma to supporting soft tissue
D. Sagging oral commissures

The correct answer is C. Trauma to supporting soft tissue. 

Perioral rhytides, sagging oral commisures and deep labiomental groove is an indication that the vertical dimension of occlusion is insufficient. 

Excessive vertical dimension of occlusion (VDO) causes pain in the soft tissue under the denture because excessive force is created during occlusion. 

Excessive VDO manifests as a "full mouth" as well as a difficulty pronouncing words. 

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