Prosthodontics & Occlusion · patient case question
Which structure does NOT limit or interfere with the BUCCAL FLANGE of a maxillary complete denture?
Patient case: New Dentures That Never Felt Right
Patient: 71-year-old female
Chief Complaint: “These dentures make my face look collapsed and I whistle when I talk.”
Background: Maxillary complete denture and mandibular RPD made three years ago elsewhere. Chronic dry mouth.
Medications: Amitriptyline, oxybutynin, atenolol
Vital Signs: BP 134/78 mmHg · HR 68 bpm · RR 16 · T 98.4°F
Findings: Reduced lower facial height with deep nasolabial folds and angular cheilitis. The maxillary denture drops on wide opening. The posterior border ends short of the vibrating line. Mucosa is dry and tacky; the mirror sticks to the buccal mucosa.
Show answer and explanation
Correct answer: A. The infraorbital rim
- A. CORRECT — this is the exception. The INFRAORBITAL RIM is part of the orbital margin, high on the facial skeleton and nowhere near the denture-bearing area or the depth of the buccal vestibule. It has no relationship to the flange.
- B. The CORONOID PROCESS DOES interfere. It moves forward and medially as the mouth opens, encroaching on the distobuccal flange in the tuberosity region. This is exactly why a patient reports the denture dislodging on wide opening or on lateral movement.
- C. The zygomatic process of the maxilla DOES limit the flange. It descends into the vestibule above the first molar region and must be relieved, or the denture rocks and the tissue over it ulcerates.
- D. The buccal frenum DOES interfere. It is a fold of mucosa that must be notched into the flange, and it moves with the orbicularis oris and buccinator — its position is recorded during border moulding.
Note: Border moulding for the maxillary denture: pull the cheek out, down and inward and ask the patient to open wide and move the mandible side to side — the last movement records the coronoid limit specifically.
Practice Prosthodontics & Occlusion questions Prosthodontics & Occlusion study notes