STOMATOGNATHIC

SYSTEM
 INTRODUCTION

RESPIRATION

SWALLOWING OR DEGLUTITION

– INFANTILE SWALLOW

– MATURE SWALLOW
CONTENTS
– STAGES OF SWALLOWING
- BUCCINATOR MECHANISM AND CLINICAL
SIGNIFICANCE
- MASTICATION

- MURPHY’S SIX STROKES OF MASTICATION

- SPEECH
- TRAJECTORIAL THEORY OF BONE FORMATION
 Learning Objectives :

1. Describe the importance of Buccinator mechanism

2. Distinguish the normal functions of stomatognathic system

(mastication, deglutition, respiration and speech) from
abnormal

3. Analyse the influence of all these factors on malocclusion

Introduction:

• STOMA – MOUTH
• GNATHIA – JAWS

• STOMATOGNATHC SYSTEM
INCLUDES :
• The important physiologic orofacial functions include respiration,
swallowing, mastication, and speech (orofacial reflexes )

TIME OF DEVELOPMENT OF DIFFERENT REFLEXES DURING INTRAUTERINE LIFE

RESPIRATION

• Physiologic respiration is the process by which multicellular living

organisms capture and excrete the gaseous fuel and waste of
cellular respiration.

• Neonates are obligate nasal breathers and if the nasal airway is

blocked, their survival becomes difficult. Later, breathing through
the mouth becomes possible for the child.
 SWALLOWING OR DEGLUTITION
INFANTILE SWALLOW
Suckling is associated with the type of
infantile swallowing mechanism.
It is also called as VISCERAL SWALLOW.
1. Jaws are apart with the
tongue interposed between
the gum pads.
2. Mandible is stabilized by
the contraction of muscles of
facial expression and by the
interposed tongue.
3. Swallowing is guided and
controlled by the sensory
interchange between the lips
and tongue.
MATURE SWALLOW
Subsequent to the eruption of teeth and shift
to semisolid and solid food, the infantile
swallow disappears
As the incisors erupt completely, tongue occupy
the space between the remaining edentulous
areas of the upper and lower gum pads
The lips close, the tip of the tongue lies behind
the incisors during the swallowing act.
By 18 months of age, the mature swallowing
pattern is usually observed in a child.
Tongue is no longer placed between the gum pads
or incisors.
Diminishing of anterior mandibular thrust, the muscles
of mastication take control of the position of mandible,
the tip of tongue is retracted and placed behind the
incisive foramen
INFANTILE SWALLOW MATURE SWALLOW
 Stages of Swallowing

1.
3. 4.
ORAL 2.
PHARYNGEAL ESOPHAGEAL
PREPARATION ORAL STAGE
STAGE STAGE
STAGE
 Preparation Stage

Purpose:
1. Solid food reduced mechanically by mastication is mixed with
saliva to produce a pulverized consistency appropriate for
swallowing. (BOLUS)
2. Produces the pleasurable sensation of eating.

Neuromuscular actions:
1. Lip closure to hold food in the mouth anteriorly.
2. Tension in the labial and buccal musculature to close the anterior
and lateral sulci. Rotary motion of the jaw for chewing.
3. Lateral rolling motion of the tongue to position food on the teeth
during mastication.
4. Bulging forward of the soft palate to seal the oral cavity
posteriorly and widen the nasal airway.
 Oral stage
Purpose:
Move food from the front of the oral cavity to the anterior faucial
arches, where the reflexive swallow is initiated.

Neuromuscular actions:

1. Tongue makes vertical contact anteriorly with alveolar ridge

2. Vertical tongue-to-palate contact progresses posteriorly, propelling
the bolus ahead of it toward the pharynx.

As in oral preparative stage, tongue motion is most important.

Requires fine muscular control of tongue to elevate and move in a
smooth anterior to posterior direction. This stage lasts less than one
second in duration. Innervation is primarily from the vagus in the brain
stem, but involves cranial nerves IX through XI.
 Pharyngeal stage

Purpose:
1. Transport food from the faucial arches to the esophagus.
2. Protect the airway by preventing aspiration.

Neuromuscular actions:
1. Velopharyngeal closure, to prevent entry of food or liquid into
the nasal cavity
2. Pharyngeal peristalsis
3. Airway protection to prevent aspiration through elevation and
closure of larynx:
4. Opening of the cricopharyngeal region allows bolus passage into
the esophagus
 Esophageal stage

Purpose:
To transport the food bolus from the UES to the stomach

Neuromuscular actions:
• Extends from level of cricoid cartilage (C6) to the cardia of the
stomach with average length of 25 cm in males and 23 cm in
females.

Esophageal stage lasts 8 to 20 seconds

 BUCCINATOR MECHANISM:
Buccinator mechanism refers to a phenomenon in which a continuous band of muscles encircles the
dentition and is firmly anchored at the pharyngeal tubercle of the occipital bone

A. Starts with the decussating fibers of

the orbicularis oris joining the right
and left fibers of the lip

B. It then runs laterally and posteriorly

around the corner of the mouth,
joining other fibers of the buccinator
muscle which gets inserted into the
pterygomandibular raphe.

C. Here, it mingles with the fibers of

superior constrictor muscle and runs
posteriorly and medially to get fixed
to the pharyngeal tubercle.
 THE TONGUE ACTS OPPOSITE TO THE
BUCCINATOR MECHANISM EXERTING AN
OUTWARD FORCE

CLINICAL SIGNIFICANCE OF
BUCCINATOR MECHANISM
 Any imbalance in buccinator mechanism leads to
malocclusion.

 In pernicious oral habits like thumb sucking and

tongue thrusting, the equilibrium between
buccinator mechanism and tongue is lost.

 This causes various changes in dentition like

constricted maxillary arch, increased proclination
and open bite.
MASTICATION :
DEFINITION:
The reduction of food in size, changing in
consistency, mixing it with saliva and forming into a
bolus suitable for swallowing.

Mastication is the action of breaking down of food,

preparatory to deglutition. The object of chewing is to
crush, triturate and mix food with saliva, so that food
can be transported by deglutition down the digestive
canali
Muscles involved:

The most important muscles for this purpose are

• Temporalis (anterior and posterior),

• The masseter (superficial and deep),
• The medial pterygoid, the lateral pterygoid
(superior and inferior),
• The digastric muscles.
 Murphy’s Six Strokes of Mastication
Six phases: (1) Preparatory phase; (2) Contact with food bolus; (3) Crushing
phase; (4) Tooth contact; (5) Grinding phase; and (6) Centric occlusion
SPEECH
 Trajectorial theory of Bone formation/ Julius
Wolff’s law
• 1867- Georg Hermann von Meyer proposed the Trajectorial
theory of bone formation

The lines of orientation of bony trabeculae follow

the pathways of maximum pressure and tension
1. The trabeculae are thicker in areas of maximum stress.
2. The alignment of trabeculae in spongy bone followed trabeuclar
lines in mechanical structure.
3. The trabeculae are actually lines of maximum stress within the
bone.
4. Most of trajectories crossed at right angles, an excellent
arrrangement to resist manifold stresses on bone.
Wolff’s law of transformation of bone

• 1870- Julius Wolff gave the reason for the trabecular pattern.

‘A change on the direction and magnitude of force

could produce a marked change in the internal
architecture and external form of bone.’
• Increase in function  Increase in density of bone
• Lack of function  Decrease in trabecular pattern
Trajectories of Maxilla
Trajectories of Mandible
References:

Essentials of Orthodontics – Fifth edition- Sridhar Premkumar