Evaluation of Supporting Soft Tissue
: Assessment of the quality of tissue of the primary . denture-bearing area overlying the alveolar ridge is of , utmost importance. The amount of keratinized tissue firmly attached to the underlying bone in the denture-bearing area’ should be distinguished from poorly keratinized or freely movable tissue. Palpation discloses hypermobile fibrous tissue inadequate for a stable denture base (Fig. 13-5). The vestibular areas should be free of inflammatory changes, such as scarred or ulcerated areas caused by denture pressure or hyperplastic tissue resulting from an ill-fitting denture. Tissue at the depth of the vestibule should be supple and without irregularities, for maximal peripheral seal of the denture. Assessment of vestibular depth should include manual manipulation of the adja- .
cent muscle attachments. By tenslngthe soft tissue adjacent to the area of the alveolar ridge, the dentist can note muscle or soft tissue attachments (incluing frena) that . approximate the crest of the alveolar ridge and are often responsible for the loss of peripheral seal of the denture during speech and mastication.The lingual aspect of the mandible should be inspected
with a mouth mirror in the linguovestibular area to determine the level of attachment of the’ mylohyoid muscle in relation to the crest of the mandibular ridge and the attachment of the genioglossus muscle in the anterior mandible. The linguovestibular depth shouldbe evaluated with the tongue in several positions, because movement of the tongue accompanied by elevation of the mylohyoid and genioglossus muscles is a common cause
of movement .and displacement of the lower denture.