MASTICATION

Contents
1) Introduction
2) Definition
3) Importance of mastication
4) Masticatory apparatus
5) Muscles of mastication
Masseter
Temporalis
Medial pterygoid
Lateral pterygoid
6) T.M..
!) Tongue
") #eural masticatory receptors
$) Ma%or functions of masticatory system
1&) 'arafunctional mo(ements
)ru*ism
+lenc,ing
#ail -iting
'encil c,e.ing etc
11) +linical implications
T.M.. referred pain
/rofacial pain
Muscles trismus
0ig, points in restorations
12) 1eferences
13) +onclusion
INTRODUCTION:
2eeding or ingestion is t,e process of transferring food into t,e gut
for digestion. In many animals t,e mout, is merely t,e anterior opening of
t,e gut. 3,ere food is eit,er s.allo.ed as .,ole4 or in large c,un5s .it,
little or no mec,anical processing.
0o.e(er in terrestrial mammals t,e situation is generally different.
During mammalian e(olution4 c,anges occurred in t,e morp,ology of s5ull4
teet,4 %a.s4 and associated orofacial structures t,at permitted an addition
stage of mec,anical processing of food in t,e mout,4 prior to s.allo.ing.
T,is process of mec,anical -rea5do.n of food in t,e mout, is mastication
or c,e.ing.
Mastication can t,erefore -e regarded as an interruption in t,e
process of transporting food t,roug, oral ca(ity en route to t,e gut.
DEFINITION:
L.M. Harrison : defined mastication as a process of c,e.ing food.
IMPORTANCE OF MASTICATION:
1) Increases t,e surface area of food so t,at digesti(e en6ymes can act
on a greater area.
2) In case of most fruits and ra. (egeta-les .,ere t,e surface coating of
t,e food is made up of indigesti-le cellulose or ,emi cellulose4
mastication causes e*posure of inner digesti(e material.
3) It ,elps in t,e flo. of sali(a.
4) It ,elps in su-se7uent deglutition.
8rinding of food to a (ery find particulate consistency pre(ents
e*coriation of t,e 8.I.T. and increases t,e ease .it, .,ic, food is emptied
from t,e stomac, into t,e small intestine and t,en into all segments of t,e
gut.
MASTICATORY APPARATUS:
T,ese in(ol(e t,e organs and structures primarily functioning is
mastication (i6.
1) Teet,
2) Muscles of mastication
3) T.M..
4) Tongue
5) 9ccessory organs of mastication
Teeth:
Teet, are inargua-ly t,e principle organ of mastication and are
generally adopted for t,e functional re7uirement of t,e diet. Mammalian
dentition is ,eterodont i.e. t,e teet, in different parts of t,e mout, differ in
anatomical form and function.
T,e anterior teet, ,a(e s,arp edges for grasping4 incising or tearing
food .,ile posterior teet, are speciali6ed for cutting fles, of grinding
fi-rous plant materials.
T,e ,uman dentition is made up of 32 teet,. :ac, toot, can -e
di(ided into t.o -asic parts.
1) Cron an! the Root:
T,e root is attac,ed to t,e al(eolar -one -y means of speciali6ed
connecti(e tissue fi-ers called 'DL.
PERIODONTAL LI"AMENT:
T,e 'DL attac,es t,e toot, firmly to its -ony soc5et and also ,elps to
dissipate t,e forces supplied to t,e -one during mastication and acts as a
natural s,oc5 a-sor-er.
T,e 32 teet, are distri-uted e7ually in t,e al(eolar -one of t,e
ma*illary and mandi-ular arc,es of .,ic, 16 teet, are aligned in al(eolar
process of ma*illa and 16 in al(eolar process of mandi-le.
T,e ma*illary arc, is slig,tly larger t,an mandi-ular arc, and toot,
si6es are also greater t,an mandi-ular teet,.
T,e permanent teet, can -e grouped into 4 classification as follo.s
;according to morp,ology of cro.ns) <
1) Incisors
2) +anines
3) 'remolars
4) Molars
In#isors: teet, located in t,e anterior most region are incisors and are
s,o(el s,aped .it, an incisal edge. 4 ma*illary incisors are larger t,an
mandi-ular incisors.
Main function is used for incising or tearing food during mastication.
Canines: Distal to incisors are canines located at t,e corners of t,e arc,es
and are generally t,e longest teet, .it, a single cusp and root.
T.o ma*illary and 2 mandi-ular canines are present. In ,umans4
canines usually function and incisors and are used for ripping or tearing of
food.
Pre$o%ars: 4 ma*illary and 4 mandi-ular premolars are present.
& =ince t,ey ,a(e 2 cusps t,ey are called -icuspids.
& T,e presence of t,ese t.o cusps greatly increases t,e -iting
surfaces of t,ese teet,.
T,eir main function is to -egin t,e effecti(e -rea5do.n of food
su-stances into smaller particles.
Mo%ars: T,e last class of teet, are t,e molars. T,ere are 6 ma*illary and 6
mandi-ular molars.
& T,e cro.n of eac, molar ,as 4>5 cusps.
& T,is pro(ides for large4 -road surface upon .,ic, -rea5ing
and grinding of food can occur.
T,us eac, toot, is ,ig,ly speciali6ed according to its function. T,e
e*act interarc, and intrarc, relations,ips of t,e teet, are e*tremely
important and greatly influence t,e ,ealt, and function of t,e masticatory
system.
MUSCLES OF MASTICATION :
Muscles t,at po.er t,e %a. mo(ement during mastication are 5no.n
as muscles of mastication.
/t,er muscles li5e tongue4 muscles in lips and c,ee5s also aid in
mastication.
Muscles of mastication can -e classified and anatomically into 2
categories<
1) T,ose -et.een t,e cranium and mandi-le (i6 Masseter4 Temporalis and
'terygoids.
2) T,ose -et.een mandi-le and ,yoid -one (i6. 9nterior Digastric4
8enio,yoid and Mylo,yoid.
2unctionally masticatory muscles can -e classified as4
i) a. ele(ators< Masseter4 temporalis and medial pterygoid.
ii) a. depressors< 9nterior Digastric4 8enio,yoid4 Mylo,yoid and
Lateral pterygoid.
T,e muscles Masseter4 Temporalis4 Medial and Lateral pterygoid are
considered t,e principal muscles of mastication.
MASSETER:
It is a 7uadrilateral muscle consisting of 3 layers .,ic, -lend
anteriorly.
i) T,e superficial layer
ii) Middle layer
iii) Deep layer
M's#%e Ori(in Insertion
i) =uperficial layer It arises -y a t,ic5
aponeurosis from t,e
ma*illary process of
6ygomatic -one from
anterior 2?3
rd
of t,e
inferior -order of
6ygomatic arc,.
Its fi-ers pass do.n.ards
and -ac5.ards to insert
into t,e angle and lo.er
posterior ,alf of lateral
surface of mandi-ular
ramus.
ii) Middle layer 9rises from t,e medial
aspect of anterior 2?3
rd
of
6ygomatic arc, and from
t,e lo.er -order of post
1?3
rd
of 6ygomatic arc,
Inserts into t,e central
part of ramus of mandi-le
iii) Deep layer 9rises from deep surface
of 6ygomatic arc,
It inserts into t,e upper
part of t,e mandi-ular
ramus and into t,e
coronoid process.
Re%ations:
S')er*i#ia%: =5in4 'latysma4 1isorius4 @ygomaticus ma%or and 'arotid
gland.
Dee): Temporalis and ramus of mandi-le
Posterior: Margin is o(erlapped -y parotid gland.
Ner+e s'))%,: 9nterior -ranc, of mandi-ular ner(e.
A#tions: :le(ates t,e mandi-le to occlude t,e teet, in mastication.
TEMPORALIS :
Ori(in Insertion
9rises from .,ole of temporal fossa
;e*cept t,e part formed -y t,e
6ygomatic -one) and from deep
surface of temporal fascia.
Its fi-res con(erge and descend into
a tendon .,ic, passes t,roug, t,e
gap -et.een 6ygomatic arc, and side
of s5ull4 and attac,es to medial
surface4 ape*4 anterior and posterior
-orders of coronoid process and
anterior -order of mandi-ular ramus
of mandi-le almost to t,e last molar
toot,.
Re%ations:
S')er*i#ia%:
=5in4 9uriculars anterior and superior4 temporal fascial4 superficial
temporal (essels4 9uriculotemporal ner(es4 temporal -ranc,es of facial
ner(e4 6ygomatic temporal ner(e4 epicranial aponeurosis4 6ygomatic arc,
and Masseter.
Dee):
9re femoral fossa4 lateral4 lateral pterygoid4 t,e superficial ,ead of
medial pterygoid4 a small part of -uccinator4 t,e ma*illary artery4 deep
temporal ner(es and -uccal ner(e and (essels.
Ner+e s'))%,: Temporalis is supplied -y t,e Deep temporal -ranc,es of
anterior trun5 of t,e mandi-ular ner(e
A#tions:
1) :le(ation< temporalis ele(ates t,e mandi-le and also closes t,e mout,
and appro*imates t,e teet,.
2) 'osterior fi-res retract t,e protruded mandi-le.
3) 9lso contri-utes to side>to>side gliding mo(ements.
LATERAL PTERY"OID:
It is a s,ort4 t,ic5 muscle .it, t.o parts or ,eads.
> Apper ,ead
> Lo.er ,ead
M's#%e Ori(in Insertion
Apper ,ead It arises from t,e infratemporal
surface and infratemporal crest of
greater .ing of sp,enoid -one.
'terygoid fo(ea
Lo.er ,ead It arises from t,e lateral surface of
lateral pterygoid plate
9nterior margin of
articulating disc and
capsule of TM.
Re%ations :
S')er*i#ia%: are ramus of mandi-le4 t,e ma*illary artery4 tendon of
temporalis4 and Masseter.
Dee): are part of medial pterygoid4 t,e sp,enomandi-ular ligament4 middle
meningeal artery and mandi-ular ner(e.
Ner+e s'))%,: supplied -y -ranc, from anterior trun5 of mandi-ular ner(e.
A#tions:
U))er hea!: :le(ates t,e mandi-le and medial mo(ement from laterally
displaced position ;9ids mainly in c,e.ing).
Loer hea!: Depresses t,e mandi-le4 protrusion of mandi-le and side>side
mo(ements.
Me!ia% )ter,(oi!:
T,is is a 7uadrilateral muscle. It ,as a small superficial ,ead and a
large deep ,ead and forms t,e ma%or part of t,e muscle.
M's#%e Ori(in Insertion
=mall ,ead 2rom t,e tu-erosity of
t,e ma*illa and
ad%oining -one.
T,e fi-ers run do.n.ards and
-ac5.ards and laterally insert into
t,e roug,ened area on medial
surface of t,e angle and ad%oining
part of ramus of mandi-le -elo.
and -e,ind t,e mandi-ular foramen
and Mylo,yoid groo(e.
Deep ,ead 2rom t,e medial surface
of lateral pterygoid plate
and ad%oining part of
palatine -one.
Ner+e s'))%,:
#er(e to medial pterygoid i.e. a -ranc, of t,e main trun5 of
mandi-ular ner(e.
A#tions:
1) :le(ates t,e mandi-le
2) 0elps to protrude t,e mandi-le
3) =ide>to>side mo(ements i.e. c,e.ing mo(ements
Te$)oro$an!i-'%ar .oint:
1) T,e area .,ere craniomandi-ular articulation occurs is called t,e
T.M..
2) It pro(ides for ,inging mo(ement in one plane4 ,ence can -e
considered a ginglymoid %oint. 9t t,e same time it also pro(ides for
gliding mo(ements4 .,ic, classifies it as an art,roidal %oint. T,us it is
tec,nically considered as a ginglymoart,roidal %oint.
3) T,e T.M.. is formed -y t,e mandi-ular condyle fitting into t,e
mandi-ular fossa of t,e temporal -one. separating t,ese t.o -ones
from direct articulation is t,e articular disc. 2unctionally4 t,e articular
disc ser(es as a nonossified -one t,at permits t,e comple*
mo(ements of t,e %oint.
T,e T.M.. can -e discussed under t,e follo.ing ,eadings.
1) 9rticular surface
2) 9rticular disc
3) Ligaments
Arti#'%ar s'r*a#e :
1) T,e upper articular surface is formed -y t,e follo.ing parts of t,e
temporal -one.
i) 9rticular eminence
ii) 9nterior part of t,e mandi-ular fossa.
2) T,e inferior articular surface is formed -y t,e ,ead of t,e mandi-le.
3) T,e articular surfaces are co(ered .it, fi-rocartilage.
4) T,e %oint ca(ity is di(ided into upper and lo.er parts -y an
intrarticular discs.
Arti#'%ar !is#:
1) T,e articular disc is an o(al fi-rous plate t,at di(ides t,e %oint into an
upper and a lo.er compartment.
2) T,e upper compartment permits gliding mo(ements4 and t,e lo.er4
rotatory as .ell as gliding mo(ements.
3) T,e disc ,as a conca(o con(e* superior surface and a conca(e
inferior surface.
4) T,e perip,ery of t,e disc is attac,ed to t,e fi-rous capsule.
Li(a$ents: t,ese are
i) 2i-rous capsule
ii) T,e lateral ligament
iii) T,e sp,enomandi-ular ligament
i() =tylomandi-ular ligament
i) Fi-ro's #a)s'%e: is attac,ed a-o(e to t,e articular tu-ercle4 t,e
circumference of t,e mandi-ular fossa and t,e s7uamotympanic fissure
and -elo. to t,e nec5 of t,e mandi-le. T,e capsule is loose a-o(e t,e
intra>articular disc4 and tig,t -elo. it. T,e syno(ial mem-rane lines t,e
fi-rous capsule and t,e nec5 of t,e mandi-le.
ii) The %atera% /te$)oro$an!i-'%ar) %i(a$ent: it reinforces and
strengt,ens t,e lateral part of t,e capsular ligament. Its fi-res are
directed do.n.ards and -ac5.ards. It is attac,ed a-o(e to t,e auricular
tu-ercle4 and -elo. to t,e posterolateral aspect of t,e nec5 of t,e
mandi-le.
iii) The s)heno$an!i-'%ar %i(a$ent: it is an accessory ligament4 .,ic,
lies on a deep plane a.ay from t,e fi-rous capsule. It is attac,ed
superiorly to t,e spine of t,e sp,enoid4 and inferiorly to t,e lingula of t,e
mandi-ular foramen. It is a ruminant of t,e dorsal part of Mec5elBs
cartilage.
T,e ligament is related laterally to<
> T,e Lateral pterygoid
> T,e 9uriculotemporal ner(e
> Ma*illary artery
> Inferior al(eolar ner(e and (essels
Medially t,ere are
> Medial pterygoid
> T,e c,orda tympani ner(e and
> T,e .all of t,e p,aryn*
#ear its lo.er end it is pierced -y t,e Mylo,yoid ner(e and (essels.
i() The St,%o$an!i-'%ar %i(a$ent: is anot,er accessory ligament of t,e
%oint. It represents a t,ic5ened part of t,e deep cer(ical fascia .,ic,
separates t,e parotid and su- mandi-ular sali(ary glands. It is attac,ed
a-o(e to t,e lateral surface of t,e styloid process4 and -elo. to t,e angle
and posterior -order of t,e ramus of t,e mandi-le.
Re%ations o* T.M.0.:
Latera% : =,in of fascial4 parotid gland and temporal -ranc,es of t,e facial
ner(e.
Me!ia%: T,e tympanic plate separates t,e %oint from t,e internal carotid
artery. =pine of sp,enoid4 .it, t,e upper end of t,e sp,enomandi-ular
ligament attac,ed to it. T,e 9uriculotemporal and c,orda tympani ner(es4
Middle meningeal artery.
Anterior: lateral pterygoid4 massetric ner(e to (essels.
Posterior: t,e parotid gland separates t,e %oint from t,e e*ternal auditory
meatus. =uperficial temporal (essels and 9uriculotemporal ner(e.
S')erior: Middle cranial fossa
Middle meningeal (essels
In*erior: Ma*illary artery and (ein
1%oo! s'))%,: )ranc,es from superficial temporal and ma*illary arteries
Ner+e s'))%,:
> 9uriculotemporal ner(e
> Massetric ner(e
1io$e#hani#s o* T.M.0.:
T,e T.M. is a compound %oint. Its structure and function can -e
di(ided into 2 distinct systems.
1) /ne %oint system is t,e tissues t,at surround t,e inferior syno(ial ca(ity
;i.e. t,e condyle and t,e articular disc).
=ince t,e disc is tig,tly -ound to t,e condyle -y t,e lateral and
medial discal ligaments4 t,e only p,ysiologic mo(ement t,at can occur
-et.een t,ese surfaces is rotation of t,e disc on t,e articular surface of t,e
condyle.
T,e disc and its attac,ment to t,e condyle are called t,e condyle disc
comple*. T,is %oint system is responsi-le for rotational mo(ement in t,e
T.M..
2) T,e second system is made up of t,e condyle discomple* functioning
against t,e surface of t,e mandi-ular fossa.
=ince t,e disc is not tig,tly attac,ed to t,e articular fossa free>sliding
mo(ement is possi-le -et.een t,ese surfaces in t,e superior ca(ity. T,is
mo(ement occurs .,en t,e mandi-le is mo(ed for.ard ;referred to as
translation).
Translation occurs in t,e superior %oint ca(ity -et.een t,e superior
surface of t,e articular disc and t,e mandi-ular fossa. T,us t,e articular disc
as a nonossified -one contri-uting to -ot, %oint systems.
#ormal functional mo(ement of t,e condyle and disc during t,e full
range of opening and closing. T,e disc is rotated posteriorly on t,e condyle
as t,e condyle is translated out of t,e fossa. T,e closing mo(ement is t,e
e*act opposite of opening.
Ton('e:
1) T,e tongue is a ,ig,ly muscular organ of deglutition4 taste and
speec,. It plays se(eral 5ey roles in food ingestion and su-se7uent
intraoral processing.
2) It is partly oral and partly p,aryngeal in position4 and it is
attac,ed -y its muscles to t,e ,yoid -one4 mandi-le4 styloid
processes4 soft palate and t,e p,aryngeal .all.
3) It ,as a root4 an ape*4 a cur(ed dorsum and an inferior surface.
Mo(ement of t,e tongue in(ol(es mainly an antero>posteriorly
directed cyclic pattern .,ic, is lin5ed .it, (ertical mo(ements of t,e %a.s.
Tongue retraction occurs mainly .,en t,e teet, are apart4 .,ile tongue is
protruded .,en t,e teet, are closer toget,er in t,e occlusal p,ase and early
opening p,ase of c,e.ing cycle. Tongue may also act as an organ of
mastication. =oft foods may -e s7uas,ed ? mus,ed -y t,e tongue against t,e
,ard palate.
It is di(ided -y t,e A>s,aped sulcus terminalis into an anterior4 oral or
presulcal part facing up.ards and a posterior4 p,aryngeal or post sulcal part
facing posteriorly. T,e anterior part forms a-out t.o>t,irds of t,e tongueBs
lengt,.
Ora% /Pres'%#a%) )art : is located in t,e floor of t,e oral ca(ity4 t,is ,as an
ape* touc,ing t,e incisor teet,4 a margin in contact .it, t,e gums and teet,
and a superior surface ;dorsum) related to t,e ,ard and soft palates. Its
general sensory ner(e is t,e lingual -ranc, of t,e mandi-ular4 t,e c,orda
tympani -ranc, of facial ner(e.
Phar,n(ea% /)osts'%#a% 2 )art) forms t,e -ase of t,e tongueC it lies
posterior to t,e palatoglossal arc,es .it,in t,e orop,aryn*4 forming its
anterior .all. De(oid of papillae4 it is no ele(ations due to lymp,oid
nodules em-edded in t,e su-mucosa collecti(ely termed t,e lingual tonsil.
M's#%es o* ton('e:
9 middle fi-rous septum di(ides t,e tongue into rig,t and left ,al(es.
:ac, ,alf contains 4 intrinsic and 4 e*trinsic muscles.
Intrinsi# $'s#%es E3trinsi# $'s#%es
1) =uperior longitudinal
2) Inferior longitudinal
3) Trans(erse and
4) Dertical
1) 8enioglossus
2) 0yoglossus
3) =tyloglossus
4) 'alatoglossus

1%oo! s'))%,:
Lingual artery4 a -ranc, of e*ternal carotid artery.
T,e root is supplied -y t,e tonsillar and ascending p,aryngeal
arteries.
Ner+e s'))%,: T,e Lingual ner(e is t,e ner(e of general sensation and
+,orda tympani is t,e ner(e for taste in t,e ant 2?3
rd
e*cept for (allate
papilla.
> T,e 8lossop,aryngeal ner(e is t,e ner(e for -ot, general sensation and
taste for posterior 1?3
rd
of t,e tongue including circum(allate papilla.
> T,e posterior most part of t,e tongue is supplied -y t,e Dagus ner(e
t,roug, t,e Internal laryngeal -ranc,.

A##essor, or(ans o* $asti#ation:
1) T,ese play essentially supporti(e role.
2) Lips can aid in t,e ingestion of food and pro(ide an anterior o(al seal
to pre(ent spillage of food from mout,.
3) Tongue and c,ee5 com-ine to direct t,e -olus on t,e occlusal surface
of posterior teet,.
4) =ali(ary glands pro(ide t,e intra oral lu-rication for t,ese acti(ities.
Ne'ra% $asti#ator, re#e)tors:
1) T,e (arious coordinated masticatory acti(ities of t,e mandi-le are
reflected -y t,e appro*imate muscle function.
2) :ac, muscle is inner(ated -y ;alp,a) >efferent motor neurons t,at
supply t,e e*trafusal muscle film.
3) 3,ere as >efferent supply t,e intrafusal fi-res of t,e muscle spindle.
4) :ac, muscle comprises fi-res t,at e*,i-it rapid t.itc, contraction or
slo. t.itc, contraction. T,ere are also muscle fi-res .it,
intermediate properties.
5) +ontraction of indi(idual muscle fi-res is a function of muscle unit.
Muscle unit comprises a single ;alp,a) motor neurons4 its ;alp,a)
E efferent ner(e fi-re and num-er of muscle fi-res.
1) M's#%e s)in!%e:
1) T,ey comprise stretc, sensiti(e4 slo.ly adopting speciali6ed intrafusal
muscle fi-re t,at are 2) contained .it, in a capsule laying parallel to t,e
e*trafusal muscle fi-res. =pindle generally ,as a dou-le afferent
inner(ation.
i) Large E group Ia myelinated afferent fi-res terminate in t,e
central region of eac, intrafusal fi-re called as primary or annual
spiral ending.
ii) =maller group II myelinated afferent fi-re ending on eit,er
side of t,e central region as spray or secondary endings.
T,ere is a concept t,at t,e muscle spindle may -e in(ol(ed in
correcting small errors -et.een t,e intended and actual mandi-ular
mo(ements and maintaining a constant posture against t,e effect of
gra(ity.
4) "o%(i ten!on or(ans:
T,ese are t,e receptors primarily located at muscle tendon %unctions
or TM capsule. T,ey are inner(ated -y I- myelinated afferent fi-res. T,ere
is no e(idence of suc, units .it,in t,e masticatory muscles.
5) Perio!onta% $e#hanore#e)tors: T,e periodontal ligament
mec,anoreceptors respond to forces applied to t,e teet,. T,ese
mec,anoreceptors ,a(e a .ide range of properties.
i) =ome are e*cited -y %ust often microns of toot,
displacement.
ii) =ome are less sensiti(e and respond only to muc, larger
forces.
iii) =ome e*,i-it directional sensiti(ity4 .it, ner(e fi-res
responding ma*imally to forces in one particular direction.
i() =ome are slo.ly adopting and produce continuous
disc,arge .,en constant stimulus is applied.
() =ome adopt more rapidly4 producing only a fe. impulses
immediately .,en stimulated.
(i) =ome are (ery rapidly adopting units and do not respond
unless a (ery rapid stimulus is applied.
(ii) =ome are (ery slo.ly adopting units and pro(ide a constant
disc,arge t,at can -e increased ? decreased -y applying forces in
specific direction.
Most single fi-res respond to mec,anical stimulation of %ust one
teet,4 -ut some also respond to stimulation of upto 3 ad%acent teet,. +ell
-odies of t,ese fi-res are located in trigeminal ganglion4 .it, some ot,ers in
t,e trigeminal mesencep,alic nucleus.
6) M'#o's $e$-rane re#e)tors:
T,ere are some cells in t,e mesencep,alic nucleus4 main sensory and
spinal trigeminal nuclei t,at respond to pressure in t,e palate4 particularly in
t,e region %ust distal to central incisors.
7) 0oint re#e)tors:
2ree ner(e fi-res composite t,e predominant receptors in TM
capsule. T,e lateral aspect of %oint capsule and lateral ligament also contains
1uffin4 'acinian and 8olgi receptors and are supplied -y a -ranc, of
9uriculotemporal ner(e.
Contro% o* $asti#ation:
T,oug, mastication is a F(oluntaryB process4 little conscious effort is
in(ol(ed4 actually c,e.ing occurs anatomically in muc, t,e some .ay as
.al5ing or -reat,ing. 9 num-er of t,eories ,a(e -een put for.ard to
e*plain ,o. mastication is controlled. Most of t,ese t,eories include a
contri-ution from refle* actions.
0a re*%e3es:
1efle* can -e defined as an automatic ? in(oluntary acti(ity -roug,t
a-out -y relati(ely simple circuits .it,out consciousness -eing necessary
in(ol(ed.
a. refle*es effort t,e (ertical relations,ip -et.een upper and lo.er
%a. as .ell as ,ori6ontal relations,ip .,ic, in(ol(e lateral and
anteroposterior mo(ement of mandi-le .it, respect to t,e ma*illa.
T,us %a. refle*es can -e discussed under 2 ,eadings (i6.
> Dertical %a. refle*es and
> 0ori6ontal %a. refle*es
8erti#a% .a re*%e3es:
Dertical %a. refle*es can -e considered under 2 -road categories.
1) T,ose e(o5ed -y stimulation of receptors .it, in t,e muscles
t,emsel(es.
i) a. %er5 refle*
ii) a. unloading refle*
2) T,ose .,ic, are responses to stimuli of e*ternal origin ;eg. food)
i) a. opening refle*
ii) 1efle*es .,ic, in(ol(e acti(ation of t,e %a. ele(ator muscles.
i) 0a .er9 re*%e3 :
a. %er5 is t,e simplest of t,e %a. refle*es in t,at if t,e only one
mediated -y a monosynaptic pat,.ay. It is analogous to t,e 5nee %er5 and is
a stretc, refle* .,ere-y stretc,ing t,e %a. ele(ator muscles usually -y
applying a do.n.ard tap on t,e c,in>produces a refle* contraction of t,ese
muscles.
T,e significance of t,is refle* lies not in it ,appening as suc, during
normal function -ut in t,at it demonstrates t,e e*istence of feed-ac5
-et.een t,e %a. ele(ator muscles and t,eir o.n motor neurons. T,is
feed-ac5 mec,anism ,elps in t,e fine control of %a. mo(ements during
normal functions to ta5e account of (arying e*ternal circumstance. :.g.
c,ange in t,e consistency of food as it is -ro5en up during mastication.
T,e refle* arc for t,e %a. %er5 is 5no.n to start .it,in t,e %a.
ele(ator muscles at t,e muscle spindle primary ending .,ic, (ia t,eir
primary afferent ner(e ma5e direct monosynaptic connections .it, t,e
motor neurons in t,e trigeminal motor nucleus.
ii) 0a 'n%oa!in( re*%e3 :
T,is refle* in(ol(es some %a. opening -ut most -e distinguis,ed
from t,ose refle*es 5no.n as %a. opening refle*. =ince its trigger is (ery
different.
a. unloading refle* is e(o5ed .,en a ,ard o-%ect .,ic, is -eing -it
-rea5s suddenly t,us FunloadingB t,e %a. ele(ator muscle toget,er .it, an
acti(ation of %a. depressor muscles. T,e result is t,at t,e opposing teet, do
not come strongly into contact .it, one anot,er after -rea5ing troug, t,e
,ard o-%ect and t,at is t,is .ay4 potential damage to t,e masticatory
apparatus is a(oided.
T,is refle* is ,ea(ily dependent on receptors in t,e %a. and muscles.
3,en one is -iting on an o-%ect .,ic, one 5no.s or suspects to -e
-rittle4 one sends not only po.erful e*citatory signals to t,e %a. ele(ator
motor neurons -ut also4 as a precaution4 .ea5er e*citatory signals to t,e %a.
depressor motor neurons.
a. ele(ator motor neurons recei(e positi(e feed-ac5 from t,eir o.n
muscle spindle (ia %a. %er5 pat,.ay.
=ignals from %a. ele(ator muscle spindles produce an in,i-itory
effect on t,e antagonist4 %a. depressor motor neurons E t,is is 5no.n to
occur in spinal cord.
T,us .,ile -iting on t,e o-%ect t,ere .ill -e 2 e*citatory dri(es to
%a. ele(ator motor neurons .,ile t,e depressor motor neurons .ill -e
recei(ing a mi*ture of e*citatory and in,i-itory dri(es.
3,en t,e o-%ect -rea5s4 t,e sudden s,ortening of ele(ator muscles
.ill result in decrease in spindle acti(ity and ,ence in o(erall e*citatory
dri(e to t,e %a. ele(ator motor neurons and t,e in,i-itory dri(e to t,e %a.
depressor motor neurons. In turn t,is causes t,e decreased acti(ity in t,e
%a. ele(ator muscles and increased acti(ity in t,e depressor.
iii) 0a o)enin( re*%e3 :
T,e term %a. opening refle* can -e misleading since t,ere are se(eral
refle*es .,ic, can in one or ot,er .ay4 cause %a. opening E including %a.
unloading refle*.
=implest of t,ere is t,e disynaptic refle* acti(ation of motor neurons
to t,e 9nterior Digastric muscle in response to t,e mec,anical or no*ious
stimulation in or around t,e mout,.
T,e 1
st
synapse is -elie(ed to -e in t,e trigeminal sensory nuclear
comple* mast pro-a-ly in nucleus oralis or nucleus interpolasis and 2
nd
synapse located in t,e trigeminal motor nucleus.
Hori:onta% .a re*%e3es:
T,ese refle*es in(ol(e lateral4 protrusi(e and passi(ely retrusi(e
mo(ements of t,e %a. in response to stimulation of intraoral
mec,anoreceptors. T,ese refle*es are for less .ell understood t,an t,e
(ertical once mainly -ecause t,ey are more difficult to in(estigate.
T,ere is a possi-ility t,at t,ose refle*es are triggered -y ,ori6ontal
loading of t,e teet, and t,at conse7uently t,ey mig,t play a role in
ad%usting t,e final closure of t,e %a.s from t,e moment of 1
st
toot, contact
until t,e intercuspal position is reac,ed.
Masti#ator, $an!i-'%ar $o+e$ents:
T,e range of masticatory mandi-ular mo(ements .ere first descri-ed
-y Alric, and )ernet at t,e turn of 2&
t,
century. T,ey s,o.ed t,at t,ere .as
no fi*ed a*is of mandi-ular rotation.
Mandi-ular mo(ements occurs as a comple* series of interrelated
t,ree dimensional mo(ements.
T,ey can -e -ro5en do.n into 2 -asic components.
T.o types of mo(ements occur in t,e TM.
1) 1otational< .,en t,e -ody is turning a-out a*is.
2) Translational< .,en all t,e points .it,in a -ody ,a(e identical
motion.
:(ery possi-le 3 dimensional mo(ement can -e descri-ed in terms of
t,ese 2 components.
It is easier to understand mandi-ular mo(ement .,en t,e components
are descri-ed as pro%ections in 3 perpendicular planes.
1) =agittal
2) 0ori6ontal and
3) 2rontal ;(ertical) planes
Re*eren#e )%anes:
Sa(itta% )%ane:
In t,e =agittal plane4 t,e mandi-le is capa-le of a purely rotational
mo(ement as .ell as translation.
1otation occurs around t,e terminal ,inge a*is4 .,ic, is an imaginary
,ori6ontal line t,roug, t,e rotational centers of t,e left and rig,t condylar
processes. T,e rotational mo(ement is limited to a-out 12mm of incisor
separation -efore t,e T.M. ligaments and structures anterior to t,e mastoid
process force t,e mandi-le to translate t,e initial rotation or ,inging motion
is -et.een t,e condyle and t,e articular disc.
During translation4 t,e lateral pterygoid muscle contracts and mo(es
t,e condyle dis5 assem-ly for.ard along t,e posterior incline of t,e
tu-ercle. +ondylar mo(ement is similar during protrusi(e mandi-ular
mo(ement.
Hori:onta% )%ane:
In t,eir plane4 t,e mandi-le is capa-le of rotation around se(eral
(ertical a*es e.g. lateral mo(ement consists of rotation around on a*is
situated in t,e .or5ing ;laterotrusi(e) +ondylar process4 .it, relati(ely
little concurrent translation.
T,is slig,t lateral translation is 5no.n as )ennett mo(ement4
mandi-ular side s,ift4 or laterotrusion. T,is is fre7uently present. T,is may
-e slig,tly for.ard called lateroprotrusion or slig,tly -ac5.ard called
lateroretrusion.
T,e or-iting ;or non.or5ing) condyle tra(els for.ard and medially as
limited -y t,e medial aspect of t,e mandi-ular fossa and t,e
temporomandi-ular ligament. 2inally4 t,e mandi-le can ma5e a straig,t
protrusi(e mo(ement.
Fronta% )%ane:
3,en a lateral mo(ement occurs in t,e frontal plane4 t,e
mediotrusi(e ;non>.or5ing) condyle mo(es do.n and medially4 .,ile t,e
laterotrusi(e ;or .or5ing) condyle rotates around t,e =agittal a*is
perpendicular to t,is plane.
Due to t,e anatomy of t,e medial .all of t,e mandi-ular fossa on t,e
mediotrusi(e side4 transtrusion may -e o-ser(ed.
Due to t,e anatomy of t,e mandi-ular fossa on t,e laterotrusi(e side4
t,is may -e lateral and up.ard or lateral and do.n.ard ;laterotrusion) and
laterodetrusion. 9 straig,t protrusi(e mo(ement occur in t,e frontal plane4
.it, -ot, condylar processes mo(ing do.n.ard as t,ey slide along t,e
tu-ercular eminences.
1or!er $o+e$ents:
Mandi-ular mo(ements are limited -y t,e T.M. and ligaments4 t,e
neuromuscular system and t,e teet,.
'osselt first .,o descri-ed t,e e*tremes of t,e mandi-ular
mo(ements4 .,ic, ,e called as t,e -order mo(ements.
'osselt used a 3>dimensional representation of t,e e*treme
mo(ements t,e mandi-le is capa-le of 9ll possi-le mandi-ular mo(ements
occur .it, its -oundaries.
=tarting at t,e intercuspal positions in t,e protrusi(e pat,.ay4 t,e
lo.er incisors are initially guided -y t,e lingual conca(ity of t,e ma*illary
anterior teet,. T,is leads to gradual loss of posterior toot, contact as t,e
incisors reac, t,e edge>to>edge position. T,is is represented in t,e 'osseltBs
diagram -y t,e initial do.n.ard slope. 9s t,e mandi-le mo(es furt,er
protrusi(ely4 t,e incisors slide o(er a ,ori6ontal tra%ectory representing t,e
edge>to>edge position ;t,e flat portion in t,e diagram)4 after .,ic, t,e lo.er
incisors mo(e up.ard until ne. posterior toot, contact occurs. 2urt,er
protrusi(e mo(ement of t,e mandi-le typically ta5es place .it,out
significant toot, contact.
T,e -order fart,est to t,e rig,t of 'osseltBs solid represents t,e most
protruded opening and closing stro5e. T,e ma*imal open position of t,e
mandi-le is represented -y t,e lo.est point in t,e diagram.
T,e left -order of t,e diagram represents t,e most retruded closing
stro5e. T,is mo(ement occurs in 2 p,ases.
T,e lo.er portion consists of a com-ined rotation and translation4
until t,e condylar processes return to t,e fossae.
T,e record portion of t,e most retruded closing stro5e is represented
-y t,e top portion of t,e -order t,at is fart,est to t,e left in 'osseltBs
diagram. It is strictly rotational.
Posterior an! anterior !etri$ents:
T,e c,aracteristics of mandi-ular mo(ement are esta-lis,ed
posteriorly -y t,e morp,ology of t,e T.M.Bs and anteriorly -y t,e
relations,ip of t,e anterior teet,.
T,e posterior determinants are s,ape of t,e articular eminences4
anatomy of t,e medial .alls of t,e mandi-ular fossae configuration of t,e
mandi-ular condylar processes.
Impact of s5eletal (aria-les on occlusal form of restorations.
Posterior !eter$inants 8ariants I$)a#tion restoration
Inclination of articular
eminence
=teeper 'osterior cusps may -e taller.
2latter 'osterior cusps must -e s,orter
Medial .all of glenoid
fossa
9llo.s more lateral
translation.
'osterior cusps must -e s,orter.
9llo.s minimal
lateral translation.
'osterior cusps may -e taller.
Intercondylar distance 8reater =maller angle -et.een laterotrusi(e
and mediotrusi(e mo(ement.
Lesser Increased angle -et.een laterotrusi(e
and mediotrusi(e mo(ement.
The anterior !eter$inants: are t,e (ertical and ,ori6ontal o(erlaps and t,e
ma*illary lingual conca(ities of t,e anterior teet,.
T,ese can -e altered -y restorati(e and ort,odontic treatment.
9 greater (ertical o(erlap causes t,e direction of mandi-ular opening
to -e more (ertical during t,e early p,ase of protrusi(e mo(ement and
creates a more (ertical pat,.ay at t,e end of t,e c,e.ing stro5e.
Increased ,ori6ontal o(erlap allo.s a more ,ori6ontal %a. mo(ement.
En+e%o)e o* $otion:
)y com-ining mandi-ular mo(ements in t,e t,ree planes ;i.e. sagittal4
,ori6ontal4 frontal) or 3>dimensional en(elope of motion can -e produced4
t,at represents t,e ma*imum range of mo(ement of t,e mandi-le.
T,e superior surface of t,e en(elope is determined -y toot, contacts4
.,ereas t,e ot,er -orders are primarily determined -y ligaments and %oint
anatomy t,at restrict or limit mo(ement.
Three !i$ensiona% $o+e$ents:
To demonstrate t,e comple*ity of mandi-ular mo(ement4 a
seemingly simple rig,t lateral e*cursion .ill -e used.
9s t,e musculature -egins to contract and mo(e t,e mandi-le to t,e
rig,t4 t,e left condyle is propelled out of its centric relation position.
9s t,e left condyle is or-iting anteriorly around t,e frontal a*is of t,e
rig,t condyle4 it encounters t,e posterior slope of t,e articular eminence4
.,ic, causes an inferior mo(ement of t,e condyle around t,e sagittal a*is
.it, resultant tilting of t,e frontal a*is.
9dditionally4 contact of t,e anterior teet, produces a slig,tly greater
inferior mo(ement in t,e anterior part of t,e mandi-le t,an in t,e posterior
part4 .,ic, results in an opening mo(ement around t,e ,ori6ontal a*is.
)ecause t,e left condyle is mo(ing anteriorly and inferiorly4 t,e ,ori6ontal
a*is is s,ifting anteriorly and inferiorly.
T,is e*ample illustrates t,at during a simple lateral mo(ement4
motion occurs around eac, a*is ;i.e. sagittal4 ,ori6ontal4 (ertical) and
simultaneously eac, a*is tilter to accommodate to t,e mo(ement occurring
around t,e ot,er a*es. 9ll t,is ,appens .it,in t,e en(elope o&f motion and
is intricately controlled -y t,e neuromuscular system to a(oid in%ury to any
of t,e oral structures.
MA0OR FUNCTIONS OF MASTICATORY SYSTEM:
F'n#tiona% $o+e$ents:
T,e t,ree ma%or functions of t,e masticatory systems are
1) Mastication
2) =.allo.ing
3) =peec,
Most functional mo(ements of t,e mandi-le ta5e place inside t,e
p,ysiologic limits esta-lis,ed -y t,e teet,4 t,e T.M.Bs and t,e muscles and
t,e ligaments of mastication. 0ence t,ese mo(ements are rarely coincident
.it, -order mo(ements.
Masti#ation:
Mastication is defined as t,e act of c,e.ing foods.
It represents t,e initial stage of digestion4 .,en t,e load is -ro5en
do.n into small particle si6es for case of s.allo.ing.
It is a comple* function t,at uses t,e muscles4 teet, and periodontal
supporti(e structures4 as .ell as t,e lips4 c,ee5s4 tongue4 palate and sali(ary
glands.
Chein( stro9e:
Mastication is made up of r,yt,mic and .ell controlled separation
and closure of t,e ma*illary and mandi-ular teet,. T,is acti(ity is under t,e
control of t,e +entral 'attern 8enerator ;+.'.8) located in t,e -rain stem.
T,e complete c,e.ing stro5e ,as -een descri-ed as a tear s,aped
mo(ement pattern. It can -e di(ided into an opening mo(ement and a
closing mo(ement.
T,ey closing mo(ement ,as -een furt,er su-di(ided into t,e crus,ing
p,ase and t,e grinding p,ase.
During mastication similar c,e.ing stro5es are repeated o(er and
o(er as t,e food is -ro5en do.n.
Tooth #onta#ts !'rin( $asti#ation:
1) 3,en food is initially introduced into t,e mout,4 fe. contacts occur.
9s t,e -olus is -ro5en do.n4 t,e fre7uency of toot, contact increases.
2) In t,e final stages of mastication4 %ust -efore s.allo.ing4 contacts
occur during e(ery stro5e.
3) T.o types of contacts ,a(e -een identified <
i) 8liding contact4 .,ic, occurs as t,e cuspal inclines pass -y
eac, ot,er during t,e opening and grinding p,ases of mastication.
ii) =ingle contact4 .,ic, occurs in t,e ma*imum intercuspal
position.
4) T,e mean percentage of gliding contacts t,at occur during c,e.ing
,as -een found to t,e 6&G during t,e grinding p,ase and 56G during
t,e opening p,ase.
5) T,e o(erage lengt, of time for toot, contact during mastication is 1$4
msec.
6) It ,as -een demonstrated t,at t,e occlusal condition can influence t,e
entire c,e.ing stro5e.
!) During mastication t,e 7uality and 7uantity of toot, contacts
constantly relay sensory information lac5 to t,e +#= regarding t,e
c,aracter of t,e c,e.ing stro5e.
") T,is feed -ac5 mec,anism allo.s for alteration in t,e c,e.ing stro5e
according to t,e particular food -eing c,e.ed.
$) 8enerally4 ta5e cusps and deep fossae promote predominantly (ertical
c,e.ing stro5e4 .,ereas flattened or .arn teet, encourage a -roader
c,e.ing stro5e.
3,en t,e posterior teet, contact in undesira-le lateral mo(ement4 t,e
malocclusion produces on irregular and less repeata-le c,e.ing stro5e.
1) #ormal persons .it, good occlusion masticate .it, c,e.ing stro5es
t,at are .ell rounded4 .it, definite -orders and less repeated.
2) T,e c,e.ing stro5es of persons .it, TM pain s,o. a repeat pattern.
T,e stro5es are muc, s,orter and slo.er and ,a(e an irregular
pat,.ay.
T,e mout, t,an opens slig,tly4 t,e tongue pus,es t,e food onto t,e
occlusal ta-le4 and after mo(ing side.ays4 t,e mandi-le classes into t,e
food until t,e guiding teet, contact. T,is cycle is completed as t,e mandi-le
returns to its starting position.
T,is pattern repeats itself until t,e food -olus ,as -een reduced to
particles t,at are small enoug, to -e s.allo.ed4 at .,ic, point t,e process
can start o(er.
T,e directed of t,e mandi-ular pat, of closure is influenced -y t,e
inclination of t,e occlusal plane .it, t,e teet, apart and -y t,e occlusal
guidance as t,e %a. approac,es.
Inter#'s)a% )osition:
T,e c,e.ing pattern o-ser(ed in c,ildren differs from t,at found in
adults. Antil a-out age 1&4 c,ildren -egin t,e c,e.ing stro5e .it, a lateral
mo(ement. 9fter age 1&4 t,ey start to c,e. increasingly t,e adults4 .it, a
more (ertical stro5e.
=peec, occurs .,en a (olume of air is forced from t,e longs -y t,e
diap,ragm t,roug, t,e laryn* and oral ca(ity. +ontrolled contraction and
rela*ation of t,e (ocal cards ;.e -onds of t,e laryn*) create a sound .it,
t,e desired pitc,. /nce pitc, is produced t,e precise from assumed -y t,e
mout, determines t,e resonance e*act articulation of t,e sound. =peec,
occurs during e*piration.
S)ea9in(: T,e teet,4 tongue4 lips4 floor of t,e mout, and soft palate form
t,e resonance c,am-er t,at affects pronunciation.
During speec, t,e teet, are generally not in contact4 alt,oug, t,e
anterior teet, may come (ery close toget,er during F+B F+0B4 F=B and F@B
sounds4 forming t,e spea5ing space.
3,en pronouncing F2B t,e inner (ermilion -order of t,e lo.er lip
traps air against t,e incisal edges of t,e ma*illary incisors.
Para*'n#tiona% Mo+e$ents:
T,ese can -e descri-ed as sustained acti(ities t,at occur -eyond t,e
normal functions of mastication4 s.allo.ing and speec,.
T,e (arious parafunctional acti(ities are<
1) )ru*ism.
2) +lenc,ing.
3) #ail -iting.
4) 'encil c,e.ing etc.
'arafunction is manifested -y long periods of increased muscle
contraction and ,yperacti(ity.
:*cessi(e occlusal pressure and prolonged toot, contact occur4 .,ic,
is inconsistent .it, t,e normal c,e.ing cycle. /(er a protracted period t,is
can result in e*cessi(e .ear4 .idening of '.D.L and mo-ility4 migration or
fracture of teet,. Muscle dysfunction suc, as myospasms4 myositis4 myalgia
and referred pain ;-orderers) may also occur.
1r'3is$: =ustained grinding4 ru--ing toget,er4 or gnas,ing of teet, .it,
greater t,an normal c,e.ing farce is 5no.n as )ru*ism.
T,is acti(ity may -e diurnal4 nocturnal or toot,.
T,e etiology of -ru*ism is often unclear. =ome t,eories relate
-ru*ism to malocclusion4 neuromuscular distur-ances4 responses to
emotional distress4 or a com-ination of t,ese factors.
C%en#hin(: Is defined as forceful clamping toget,er of t,e %a.s in static
relations,ip.
T,e pressure t,us created can -e maintained o(er a considera-le time
.it, s,ort periods of rela*ation in -et.een.
T,e etiology can -e associated .it, stress4 anger4 p,ysical e*ertion4
or intense concentration on a gi(en tas54 rat,er t,an on occlusal disorder.
E**e#ts:
9-fractions i.e. cer(ical defects at t,e +: may result from sustained
clenc,ing. 9lso t,e increased load may result in damage to t,e
periodontium4 temporomandi-ular %oints and muscles of mastication.
T,e ele(ator muscles may -ecome o(er de(eloped. 9 progression of
muscle splinting4 myospasms4 and myositis may occur.
1itin( *or#e: /For#es o* $asti#ation)
T,e ma*imum -iting force t,at can -e applied to t,e teet, (aries from
indi(idual to indi(idual. 8enerally males can -ite .it, more force t,an
females can.
In females ma*imum -iting load ranges from !$>$$ pounds ;35." E
44.$ 5g).
9 maleBs -iting load (aries from 11">142 pounds ;53.6 E 64.4 5g).
T,e greatest ma*imum -iting force reported is $!5 pounds ;443 5g).
T,e -iting force also (aries from toot, >toot,. T,e ma*imum amount
of force applied to a molar is usually se(eral times t,at .,ic, can -e applied
to t,e on incisor.
T,e range of ma*imum force applied to t,e 1
st
molar is $1>1$"
pounds ;41.3 E "$." 5g). T,e ma*imum force applied to control incisors is
2$ E 5B pounds ;13.2 E 23.1 5g).
T,e ma*imum -iting force appears to increase .it, age up to
adolescence.
T,e factors influencing -iting force are<
1) 'articular toot,.
2) Dietary consistency.
3) Degree of c,ronic periodontal disease.
4) a. separation.
5) #atural ? artificial teet,.
6) )iting practice and parafunctional o(eruse.
!) +raniofacial morp,ology.



+onclusion
1eferences<
8rayBs 9natomy> 3"
t,
:dition
Te*t-oo5 of Medical ',ysiology4 $
t,
:dition< 8uyton and 0all
:ssentials /f /ral ',ysiology< )radley
=cientific )asis /f :ating< 1.3.9 Linden
0uman 9natomy Dol 3< ).D +,aurasia
Medical p,ysiology 5
t,
:dition< =u%it H.+,aud,uri