THE HUMAN TEMPOROMANDDWLAR JUINT: KINEMATI[CS AND

ACTIONS OF THE MASTICATORY MUSCLES

JOHAN ULRICH, M.D.

temporomandibular joints during mouth opening, pro-

T HE MOBILITY OF THE
trusion, and lateral movement, and the ranges of functional movements dur-
ing speech, singing, and mastication were investigated.
Further, the resultant actions of the different muscles which move the man-
dible were examined on cadavers and compared with movements performed by
corresponding muscles in living persons.

MATERIAL AND METHODS

The photographic method used in this investigation was similar to that em-
ployed by Lute’ and Marey.2
For recording purposes, an apparatus was fixed to the lower teeth by means
of a splint which did not interfere with the occlusion of the teeth. An extension
from the splint carried a number of reflective silver balls to either the right or left
side of the subject. Three of the balls were located in front of the incisors, a fourth
at the mandibular angle, a fifth outside the mandibular foramen, and one or two
at the condyle. The balls were placed in the same sagittal plane as that of either
the left or right temporomandibular joint.
An exposure was made of the head when the teeth were in the occlusal
(intercuspal) position. Tracings ot the path of the moving jaw were obtained
by exposing the photographic plate while the balls were brightly lighted. The
skin covering the joint, the mandibular angle, and the zygomatic arch were marked
on the subjects with a white color before they were photographed.
A total of 13 subjects with natural teeth were examined. However, not all
of these were used in all of the experiments.
Lateral profile photographs were made during normal opening movements
and also during an attempted retrusion of the mandible. Similar records were
made during a mandibular protrusion with the teeth in contact, followed by an
opening movement.
Corresponding points on each of the recorded movement paths were marked
(see Figs. 1, 3, and 4). This was done by using a transparent celluloid plate con-
taining holes that marked the positions of all of the balls at the starting position.
Condensed and translated by Dr. Ulf Posse& Royal Dental School, Malmii, Sweden, from a
thesis for a Doctorate in Medicine entitled, “Undersijgelser over Kjtlbeleddet ho8 &Wmesket
med stirligt Hensyn til de mekaniske Forhold,” Copenhagen, 1896, 102 pages. Pub&&d with
permissIon granted by surviving relatives of Dr. Ulrich.
398
 ULRICH J. Pros. Den.
400 May-June, 1959

All subsequent positions in the recorded curves could be located by pricking

through the holes with a fine needle. In this way, a total of from 10 to 12 positions
were marked on each curve.
Exposures were made also during lateral movements of the jaw. In this study,
the subject was recumbent, and the silver balls were located differently to facilitate
their being photographed by a camera that was placed in the direction of the long
axis of the body. The balls were placed at the level of the occlusal plane but lateral
to the condyles.

Fig. l.-Tracings of a habitual opening movement made from a photographic plate (see
Figs. 3 and 4). The curve -.-.-.-. connects the instantaneous axes for the opening movement
as calculated mathematically for this particular subject.

In the photographs “from above,” by means of a celluloid plate, points cor-

responding to the exact positions of the condyles were pricked into the photograph
(see Fig. 6).

RESULTS

Movement of Maximal Opening.-The condyles moved forward with a fairly

even velocity, except during the last part of the movement at which time they moved
more slowly or not at all. The condyles generally moved anterior to the lowest
part of the articular eminence.
The total opening angle for three subjects gave a mean value of 25 degrees
(range 21 to 29 degrees). The mean total shift of the condyle was 14 mm. (range
9to21 mm.).
Volume 9
Number 3 HUMAN TEMPOROMANDIBULAR JOINT 401

Instantaneous Axes of the Opening Movement.-The marked points were

connected with straight lines for one subject. Then, a mathematical calculation
was made of the positions of the kinematic axis for each successive shift of position.
This method was used as a check on the instantaneous axes as constructed gee-
metrically. Geometric constructions are inexact because of the very short arcs.
The results of the mathematical calculations and the geometrical constructions
correspond reasonably well. The main conclusion obtained from these calculations
and constructions was that since the condyles start their forward movement immcs-
diately upon jaw opening, only a changing axis can be responsible for the opening
movement (Fig. 1).
The paths of an opening and closing movement in the same individual did nc:t
coincide. The closing path was generally in front of the opening path when the
teeth were not brought together. However, the paths deviated least when the
movements were executed in rapid succession and the teeth were brought tar-
gether each time (Fig. 2). In the latter instance, naturally the consciousness that
the teeth are going to be brought together in the normal intercuspation will regn-
late the movement path.

Fig. 2.-Projections on the median plane made from one or two pairs of opening and
closing movements. If the closure was stopped immediately before the teeth made contact,
the closing curve was in front of the opening path (Abl, AbIll, AbIV, AbV). These curves,
however, coincided near the maximal opening. When the movements were rapid and the
teeth were brought together each time, the opening and closing paths deviated considerably
less, especially in the neighborhood of occlusal contact (Abbl, Abbll).

Protrusion With the Teeth in Contact and Subsequent Maximum Opek~/.---.

Because of the vertical overlap of the anterior teeth, the curve developed during
protrusion of the mandible with the teeth in contact had first a downward and
then an upward direction (Fig. 3). It was clearly shown that the condyles moved
further forward when the mandible was moved from the maximum protruded
contact position to maximum opening. In other words, the condyles did not move
fully,forward during protrusive gliding. The same maximum opening position was
reached after a usual opening as well as when opening followed maximum pro-
trusive glide.
Possibility of a Tern&ml Hinge Opening.-Three of the subjects were asked
to hold the mandible back while opening maximally. Two of the individuals could
not suppress the forward movements of the condyles, but the third individual did
carry out an opening movement to almost half of its extent without any significant
402 ULRICH J. Pros. Den.
May-June, 1959

Fig. 3.-A photographic plate exposure made during a protrusive movement with the
tee1
th in contact and a subsequent opening movement of the mandible.

Fig. 4,An exposure made during an attempted hinge opening movement.

 HUMAN TEMPOROMANDIBULAR JOINT 403

forward glide of the condyles (Fig. 4). The condyles did not remain stationary but
moved downward and backward on a convex curve. The movement area in the
median plane is seen in Fig. 5.

LATERAL MOVEMENTS

The first part of the curves, developed when lateral excursions of the man-
dible were made, indicated a small bodily shift* of the mandible directly laterally
(varying in extent from 1.5 to 3 mm.). In other words, the Bennett shift seemed
to prevail at the start of the movement. After a similar shift (medially i, the

Fig. L-The movement area on the median sagittai plane for different points fixed to the
mandible. The paths DI and AaII were recorded from the same subject. The path CI was
traced by another subject who was not able to perform a terminal hinge as well as one of
the other two subjects investigated.

balancing condyle moved forward and somewhat medially, while the working
condyle moved a little farther laterally and backward. Therefore, the axis of the
left or right lateral movement was not located in the working condyle but was
located posteriorly and medially to the working condyle. The axes were not
stationary at any moment.
The fact that the working condyle often moved backward corresponds to
the observation which can be made on oneself and others that a small shift of the
mandible is possible posterior of the usual closed position. The movements from
the occlusal position maximally to the right are shown in Fig. 6.
*Translator’s note: This movement was later known as the Bennett movement, following
a publication by Bennett (1908).
 J. Pros. Den.
404 ULRICII May-June, 1959

A series of registrations of the lateral movement when the individual attempted

to protrude the mandible at the same time showed that the balancing condyle moved
farther forward during this type of lateral movement than it did during the un-
complicated protruded movement. This might be paralleled with the previous
finding that during maximum opening the condyles made larger excursions than
they did during protrusion.

Fig. 6.-A lateral movement to the right as projected on the horizontal plane.

MASTICATORY MOVEMENTS

Further tests were made to investigate mandibular movements performed dur-

ing the chewing of grain. However, no conclusions could be drawn because of
the short length (only about 1 degree lateral shift) and irregularity of the curves.
Probably tooth facets had a definite influence on these movements.
Volume 9 HUMAN TEMPOROMANDIBULAR JOINT
Number 3 4O.T

EXPERIMENTS WITH MUSCLES WHICH MOVE THE MANDIBLE

The muscles and soft tissues were dissected on a wet specimen, but the tem-
poromandibular joint was left untouched. The muscle insertions were marked
during the dissection, and strong strings were fixed to these locations. The strings
were carried through the muscles and their origins to positions where they could
be pulled conveniently. The hyoid bone was fixed in its natural position, and
strings were led through it to simulate the action of the digastric muscle. Strings
were substituted for the following muscles : masseter, posterior fibers of the
temporal, internal and external pterygoids, digastric, geniohyoid, and the pas-
terior fibers of the mylohyoid. In the same manner as for the living subjects,
photographic exposures were made when a pull was exerted on one or more of
the strings. It was learned from the experiments that every single natural move-
ment required the cooperation of several muscles. Most of the movements effected
by the strings were not identical with those seen in vivo. This showed the i~u-
portance of the synergetic coordination of various muscles.

DISCUSSION

Ferrein3 described in detail many of the movements of the jaw and the
temporomandibular joint. Many later authors merely repeated his views. ‘I%
curves of Marey’s2 figures have not been analyzed in detail.
Many of the previous investigations have not elucidated individual differences.
This is true of Henke’s* theory. He saw the movements of the condyles during
opening and closing movements as a combination of a rotation around a frontal
axis through the center of the curvatures of both articular eminences and a condyle
hinge axis rotation. Therefore, during forward movement, the meniscus and the
condyles moved as a unit.
Two phases of movement, such as a translation and rotation, could be com-
bined into one, but any segregation of these movement phases or any convenient
combination of them was arbitrary. It could only be of use for demonstrating or
describing the movement.
The movement paths during protrusion of the mandible with the teeth in
contact did not show any resemblance to the occlusal curvature as indicated by
Spee.” It was concluded that in protrusion with a vertical overlap the axis of the
movement could not be in the region of the orbitae such as suggested by Spee.>
Further, the theory would only be true in rare instances when the cusps were
completely worn down. Finally, protrusion to such an extent was not used in
mastication.

SUMMARY

The shape of the joint surfaces do not govern movements, but these are tle-
termined rather by the synergistic action of muscles.
The results can be summarized in the following points* :

*Translator’s note: An almost literal translation is used here.

 J. Pros. Den.
406 ULRICH May-Ju~~e, 1959

1. Large variations were found in the patterns of opening and closing, as

well as forward and lateral movements because of the laxity of the joint tissues.
2. The instantaneous axis shifted very much during the whole of the opening
movement. No single axis could be shown.
3. The angle of opening and the amount of translation of the condyles were
calculated. In maximum opening the condyles, as a rule, glided forward some-
what further than to the top of the eminentiae. The condyles could be held back
actively so that no or only a small amount of translation was effected during the
first part of the habitual (natural) opening.
4. The total range of movement of the jaw was seldom utilized during such
functions as speech and singing. The opening angles used during speech were
generally only from 1.5 to 4.5 degrees. While singing, opening degrees of 4.3 to
8.6 were used as compared to 20 to 30 degrees of total opening. Ten degrees
corresponds to 7 to 8 mm. of total condyle translation. Usually, during function,
only 2 to 3 mm. of horizontal translation was used.
5. The movement area in the median plane for an anterior point of the man-
dible did not correspond fully with those described by Henke4 and others.
6. Sagittal translations of the condyles were the largest during lateral
movements.
7. The axes for lateral movements were posterior to the condyles.
8. A bodily side shift of the mandible of 2 to 3 mm. was possible.
9. The total angle of rotation (from one extreme lateral position to the
other) was calculated to be 30 degrees on the average.
10. Freer lateral movements of the mandible could be performed when it was
protruded than could be from its posterior position.
11. Masticatory movements were combinations of opening, forward, and
lateral movements.
12. The digastric, geniohyoid, genioglossus, and mylohyoid muscles could
cause a lowering of the mandible (opening movement), but not a movement of
natural character.
13. The combined effect of the external pterygoid muscles and the afore-
mentioned other muscles resulted in an opening movement pattern resembling that
obtained in living individuals. The same was true for lateral movements. Many
muscles must work together to produce a natural movement.
14. Contraction of the external pterygoid muscles precludes the necessity for
extreme shortening of the digastric muscles.

REFERENCES

1. Lute, C. E.: The Movements of the Lower Jaw, Boston Med. Surg. J. 121:8-11, 1889.
2. Marey, M. : Les Mouvements Articulaires &dies par la Photographie. Mouvements du
Maxillaire Infkrieure, Compt. rend. Acad. SC., 118:1020-10.24, 1894.
3. Ferrein, M.: Sur les Mouvemens de la Machoire InfCrieure. Histoire de 1’Academie
Royale des Sciences, Paris, 1748, pp. 427-448.
4. Henke, W.: Handbuch der Anatomie und Mechanik der Gelenke, Leipzig u. Heidelberg,
C. F. Winter’sche Buchandlung, 1863.
5. Spee, F. G.: Die Verschiebungsbahn des Unterkiefers am Schldel, Arch. Anat., Anat. Abst.
285-294, 1890.