Adhesives in maxillofacial prosthesis /orthodontics courses in india

ADHESIVES
IN
MAXILLOFACIAL PROSTHESIS
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com
www.indiandentalacademy.comn

CONTENTS
•TERMINOLOGIES
•CLASSIFICATION
•CONCLUSION
•BIBLIOGRAPHY

TERMINOLOGIES:TERMINOLOGIES:

Maxillofacial prosthetic adhesive::
A material used to adhere
external prosthesis to skin and associated
structures around the periphery of an
external anatomic defect.(GPT-8)

Adhesion:
1) The property of remaining in close
proximity, as that resulting from the
physical attraction of molecules to a
molecular attraction existing between the
surfaces of bodies in contact.(GPT-8)
2) The stable joining of parts to each
other, which may occur abnormally.
(GPT-8)

Sensory RootSensory Root::
• from the cells of the semi lunar
ganglion
• which lies in the apex of the petrous
part of the temporal bone.
• On entering the pons, divide into
upper and lower roots.
• This lower root is sometimes named
the spinal root of the nerve.

BRANCHES OF TRIGEMINAL NERVEBRANCHES OF TRIGEMINAL NERVE
• In Latin, tress means three,geminus
means twins i.e.; three born together.
•Trigeminal nerve has three main
branches
Ophthalmic
Maxillary
Mandibular

The Ophthalmic Nerve:The Ophthalmic Nerve:
• It is first division of the trigeminal.
• It is a sensory nerve.
• It is the smallest of the three divisions
of the trigeminal.
• It supplies branches to the cornea,
ciliary body, iris,lacrimal gland
,conjunctiva, mucous membrane of the
nasal cavity, skin of the eyelids,
eyebrow, forehead, and nose.

OriginOrigin::
•upper part of the semilunar ganglion.
•a short, flattened band, about 2.5 cm.
long.
•passes below the oculomotor and
trochlear nerves.
•enters the orbit.

Branches:Branches:
• just before entering the orbit,
through the superior orbital fissure,
it divides into three branches
Lacrimal
Frontal
Nasociliary

TheThe Lacrimal NerveLacrimal Nerve
•It is the smallest of the three branches
•It passes forward in a separate tube of
dura mater, and enters the orbit through
the narrowest part of the superior orbital
fissure
•In the orbit it runs along the upper
border of the Rectus lateralis
•It enters the lacrimal gland and gives
several filaments, which supply the
gland and the conjunctiva.
•Finally it pierces the orbital septum,
and ends in the skin of the upper eyelidwww.indiandentalacademy.comn

TheThe Frontal NerveFrontal Nerve::
•It is the largest branch of the
ophthalmic
•It enters the orbit through the superior
orbital fissure
•Midway between the apex and base of
the orbit it divides into two branches,
Supratrochlear
Supraorbital

TheThe supratrochlear nervesupratrochlear nerve::
• The smallest branch of frontal nerve.
• It escapes from the orbit through the
supraorbital foramen.
• It supplies the skin of the lower part of
the forehead close to the middle line and
sends filaments to the conjunctiva and
skin of the upper eyelid.

TheThe supraorbital nervesupraorbital nerve::
• Passes through the supraorbital
foramen.
• It then ascends upon the forehead, and
ends in two branches, a medial and
lateral.
• supply the scalp till the lamdoid
suture.

TheThe Nasociliary NerveNasociliary Nerve::
• It is intermediate in size
• It enters the orbit
• It passes through the anterior
ethmoidal foramen
• Entering the cavity of the cranium,
traverses a shallow groove on the lateral
margin of the front part of the cribriform
plate of the ethmoid bone, and runs
down, through a slit at the side of the
crista galli, into the nasal cavity
• It supplies internal nasal branches
and external nasal branch.www.indiandentalacademy.comn

BranchesBranches::
The nasociliary nerve gives off the
following branches, viz.:
long root of the ciliary ganglion.
long ciliary nerves.
ethmoidal nerves.

The Maxillary NerveThe Maxillary Nerve::
•It is second division of the
trigeminal
•is a sensory nerve
•It is intermediate, both in position
and size, between the ophthalmic and
mandibular

OriginOrigin::
•It begins at the middle of the semilunar
ganglion
•As a flattened plexiform band
•It leaves the skull through the foramen
rotundum
•Where it becomes more cylindrical in
form, and firmer in texture

CourseCourse::
• It then crosses the pterygopalatine
fossa
• enters the orbit through the inferior
orbital fissure
• it traverses the infraorbital groove and
floor of the orbit
• appears upon the face at the
infraorbital foramenwww.indiandentalacademy.comn

BranchesBranches::
Cranium- Middle meningeal
Pterygopalatine Fossa- Zygomatic.
Sphenopalatine.
Posterior superior alveolar.
Infraorbital Canal- Anterior superior alveolar.
Middle superior alveolar.
Face- Inferior palpebral.
External nasal.
Superior labial.

TheThe Middle Meningeal NerveMiddle Meningeal Nerve::
•Is given off from the maxillary nerve
directly after its origin from the semilunar
ganglion
•supplies the dura mater

TheThe Zygomatic NerveZygomatic Nerve::
Arises in the pterygopalatine fossa, enters
the orbit by the inferior orbital fissure
It divides into two branches,
zygomaticotemporal
zygomaticofacial.

•passes along the inferolateral angle of the
orbit.
• It pierces the temporal fascia about 2cm
above the zygomatic arch, to supply the
skin of the temple.
• It communicates with facial and
auriculotemporal nerve.
The zygomaticotemporal branch:

The zygomaticofacial branch:
•This nerve also traverses the inferolateral
angle of the orbit and emerging on the
face through a foramen in the zygomatic
bone, perforating orbicularis occuli
muscle.
•It supplies the skin on the prominence of
the cheek.

The Sphenopalatine BranchesThe Sphenopalatine Branches::
•Two in number, descend to the
sphenopalatine ganglion.
•They also serve as important functional
communication between the ganglion and
maxillary nerve.
•The branches of distribution of
pterygopalatine nerves are divided into
three groups
• orbital, nasal and palatine

TheThe Posterior Superior AlveolarPosterior Superior Alveolar
BranchesBranches::
• Arise from the trunk of the nerve just
before it enters the infraorbital groove.
• They descend on the tuberosity of the
maxilla.
• Give off branches to the lining membrane
of the maxillary sinus and three twigs to
each molar tooth.

TheThe Anterior Superior AlveolarAnterior Superior Alveolar
BranchBranch::
•Is given off from the nerve just before its
exit from the infraorbital foramen.
•supply the incisor and canine teeth

TheThe Middle Superior AlveolarMiddle Superior Alveolar
BranchBranch::
• It is given off from the nerve in the
posterior part of the infraorbital canal.
• supply the two premolar teeth.

TheThe External Nasal BranchesExternal Nasal Branches::
•Supply the skin of the side of the nose
and the septum.

TheThe Superior Labial BranchesSuperior Labial Branches::
•The largest and most numerous.
•They are distributed to the skin of the
upper lip, the mucous membrane of the
mouth, and labial glands.

The Mandibular NerveThe Mandibular Nerve::
•It is the largest of the three divisions
•is made up of two roots
a large, sensory root
a small, motor root
•motor root:unites with the sensory
root, just after its exit through the
foramen ovale.

•Immediately beneath the base of the skull,
the nerve gives off from its medial side a
recurrent branch nervus spinosus and the
nerve to the Pterygoideus internus.
•It then divides into two trunks
The anterior division
The posterior division

TheThe Nervus SpinosusNervus Spinosus
•It enters the skull through the foramen
spinosum.
•It supplies the dura mater

The Internal Pterygoid Nerve:The Internal Pterygoid Nerve:
•The nerve to the Pterygoideus internus
is a slender branch, which enters the
deep surface of the muscle

The anterior division:The anterior division:
•branches are the
Masseteric
Deep temporal
Buccinator and
External pterygoid.

The posterior division:The posterior division:
branches are the
Auriculotemporal
Lingual and
Inferior alveolar nerves.

TheThe Auriculotemporal NerveAuriculotemporal Nerve::
•Orign: by two roots between which the
middle meningeal artery ascends.
•It runs backward beneath the
Pterygoideus externus to the medial side of
the neck of the mandible.
•It then turns upward with the superficial
temporal artery.
•It ascends over the zygomatic arch, and
divides into superficial temporal branches.www.indiandentalacademy.comn

BranchesBranches
branches of distribution are:
• Anterior auricular
• External acoustic meatus
• Articular branches
• Parotid branches
• Superficial temporal

TheThe Lingual NerveLingual Nerve::
•It supplies the mucous membrane of the
anterior two-thirds of the tongue.
•It lies medial to and in front of the inferior
alveolar nerve.
•The lingual nerve along with chorda
tympani crosses obliquely to the side of
the tongue.
•It finally runs across the duct of the
submaxillary gland, and along the tongue
to its tip, lying immediately beneath the
mucous membrane.

BranchesBranches
supply the
sublingual gland
mucous membrane of
The mouth
The gums
Anterior 2/3’rdof the tongue

TheThe Inferior Alveolar Nerve:Inferior Alveolar Nerve:
•It is the largest branch of the mandibular
nerve
•It then passes into mandibular foramen
•It then passes forward as far as the mental
foramen
•It divides into two terminal branches
incisive
mental

BranchesBranches
· Mylohyoid
· Dental
· Incisive and
· Mental.

GanglionGanglion
•Associated with the three divisions of the
trigeminal nerve are four small ganglia.
•The ciliary ganglion is connected with
the ophthalmic nerve
•sphenopalatine ganglion with the
maxillary nerve
•the otic and submaxillary ganglia with
the mandibular nervewww.indiandentalacademy.comn

Testing of trigeminal nerve:Testing of trigeminal nerve:
•Trigeminal nerve is tested for both motor
and sensory functions
•Motor branch supplies the muscles of
mastication.

Motor:Motor:
•Another useful test of motor power is to
carry out voluntary displacement of the
jaw against the imposed resistance of the
examiners hand
•Like, place the thumb on the lower molar
table with fingers externally about the
body and ramus.
•The patient is asked to move the jaw
Forward
Sideways
Upward
• His head is steadied by the other handwww.indiandentalacademy.comn

Sensory:Sensory:
•Maxillary:
•These tests are conducted with the
patients eye closed.
•Test tube filled with warm and cold fluid
are pressed alternatively against the
cheek.
•Differences in response on the opposite
sides of the face indicate increased or
decreased sensitivity to temperature.
•Differences in response to pinpricks on
the opposite sides of the face indicate
increased or decreased sensitivity to pain.www.indiandentalacademy.comn

•A variety of instruments are available
as aids in sensory evaluation.
•Graded von Frey hairs.
•Two point esthesiometers
•Calibrated thermal devices
•Disc of sand paper
•Stereognostic forms
•Taste testing.

Prosthodontic viewProsthodontic view

MasseterMasseter
•At the time of preliminary impression is
made, while the compound on the borders
of the impression tray in this region is still
soft, considerable downward force should
be exerted on the lower jaw by dentist.
•Now the patient is attempting to counteract
this downward pressure which will cause
the masseter muscle to contract.
•This forces the softened compound away
from impingement in this region.

•Thus the denture border can also be
contoured to accommodate this action. If
this is not done the muscle interaction
will displace the mandibular denture and
force it in an anterior direction

Temporalis muscleTemporalis muscle
 The action of this muscle is
sometimes used as a test to determine
whether the patient is closing in centric
relation.

The Facial NerveThe Facial Nerve
(N. Facialis; Seventh Nerve)(N. Facialis; Seventh Nerve)

Type:Type:
The facial nerve mixed
motor and
sensory root

Origin:Origin:
motor root arises from a nucleus in
lower pons.
The sensory root arises from the
genicular ganglion, in the facial canal.

coursecourse
•Entering the brain at the lower border of
the pons.
•sensory root pass into the substance of
the medulla oblongata and end in the upper
part of the terminal nucleus.
•From the superficial attachments to the
brain, the two roots of the facial nerve pass
lateralward and forward to the internal
acoustic meatus.

•In the meatus the motor root lies in a
groove on the upper and anterior surface
of the acoustic nerve, the sensory root
being placed between them.
•At the bottom of the meatus, the facial
nerve enters the facial canal, termination
at the stylomastoid foramen
•On emerging from the stylomastoid
foramen, the facial nerve runs forward in
the substance of the parotid gland, and
divides behind the ramus of the mandible
into branches

Branches of Communication:Branches of Communication:
•In the internal acoustic meatus- With the acoustic nerve
•At the genicular ganglion- With the sphenopalatine ganglion by the
greater petrosal nerve.
- With the otic ganglion by a branch which joins the lesser petrosal.
-With the sympathetic on the middle meningeal artery.
•In the facial canal- With the auricular branch of the vagus.
•At its exit from the stylomastoid foramen- With the
glossopharyngeal,
With the vagus,
With the great auricular,
With the auriculotemporal.www.indiandentalacademy.comn

• Behind the ear- With the lesser occipital.
• On the face- With the trigeminal.
• In the neck- With the cutaneous cervical.

Branches of Distribution:Branches of Distribution:
•The branches of distribution of the facial nerve may be thus arranged
•With the facial canal- Nerve to the Stapedius muscle.
Chorda tympani.
•At its exit from the stylomastoid foramen- Posterior auricular.
Digastric.
Stylohyoid.
•On the face-
Temporal
Zygomatic.
Buccal.
Mandibular.
Cervicalwww.indiandentalacademy.comn

Testing of facial nerve:Testing of facial nerve:
Affections of chorda tympani may be
associated with failure of salivary flow to
increase following application of lemon
juice or citric acid to the affected side of
mouth.

• Ask the patient to ‘mimic’ the muscles of
facial expression. like
 wrinkle the forehead
 Frown
 Close the eyelids tightly
 Wink
 Open the mouth
 Retract the mouth
 Blow out the cheeks
 Pucker the lips
 Screw up the nose
 Whistle
 Speakwww.indiandentalacademy.comn

Thank you
For more details please visit
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Adhesives in maxillofacial prosthesis /orthodontics courses in india

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