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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 bone Connected to skull with TMJ Landmarks 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,Buccinator 4,Depressor anguli oris 5,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 muscles C. sublingual gland D. submandibular gland, which extends below and also to some extent above the mylohyoid muscle E.sublingual nerve F. 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