Mandibular movements

CONTENTS
Introduction
Methods of studying mandibular movements
 Factors Affecting Mandibular Movements
The opposing tooth contact and anterior guidance.
Neuromuscular system.
Mandibular positioning
Methods of studying mandibular movements
Clinical implication
Conclusion
Introduction
Mandibular movements occur around the TMJ which is capable of making movements
Complex mandibular movements are afforded by the masseter, temporalis, medial pterygoid,
lateral pterygoid muscles, and temporomandibular joints
Factors Affecting Mandibular Movements
Anatomy and physiology of TMJs
Opposing tooth contact and anterior guidance
Neuromuscular role
The action of muscles/ligaments
What is Tempromandibular joints
TMJ is the joint connecting your lower jaw and your skull
It is the articulation between the mandible and cranium
The movement of this joints lets you open and close your mouth and chew from side to side
Condylar path/ guidance and anterior guidance is known as End Controlling Factors
Condylar path is known as posterior determinant as this influence posterior part of mandible
and it consider as fixed factors
 Anterior Guidance is anterior determinant as influences anterior part of mandible which
consider variable factor and can be influence by dental conditions
Articulating part of TMJ includes convex head of mandibular condyle and the convexoconcave
part of the temporal bone i.e. mandibular fossa and articular tubercle.
An intrarticular disc made of fibrous tissue divides joint cavity into upper and lower
compartments.
Articular Disc
Ligaments of TMJ
1. Fibrous capsule
2. Lateral temporomandibular ligament
3. And two accessory ligaments i.e sphenomandibular and the stylomandibular ligaments.
Accessory ligaments

Stylomandibular ligaments limits excessive protrusive movements of mandible.

Muscular involvement in jaw motion
There are four main muscles of mastications:- Masseter, temporalis, medial and lateral
pterygoids.
All these except the lateral pterygoids acts as ELEVATORS
Masseter
Functions :-
◦ Elevates the mandible to close the mouth
◦ Occlude the teeth in mastication
◦ It has small effect in side to side movement,protraction
and retraction
Temporalis
It is a significant positioning muscle of the mandible
Functions : Anterior fibres: Elevates mandible
Posterior part: Retracts mandible
Medial pterygoid
Functions :
 Elevates mandible and closes the jaws
 Unilateral contraction – protrudes side of the jaw
Lateral pterygoid
Functions :
Protrude the mandible and depress the chin.
Acting alone and alternately, they produce side to side movements of mandible
The suprahyoid muscles
These depress the mandible , if the hyoid bone remains fixed.
Thus help when the mouth is opened wide or against resistance.
Movements
Opening and closing
Lateral pterygoid is the main muscle responsible for opening.
Opening of mouth is limited by the superior lamina of the articular disc
Protrusion and retraction
Protrusion is brought about by simultaneous contraction of the lateral and medial pterygoid on
both sides while retraction is mainly due to contraction of the posterior horizontal fibres of
temporalis muscle
Chewing
Chewnig or side to side movements occurs due to alternate contraction of muscles of both sides.
Certain Basics : Jaw Motion
 Condylar Path
This is the path travel by the condyle in the TMJs during various
mandibular movements
It is influenced by –
1. Inclination of glenoid fossa
2. Tone of muscles responsible for mandibular movements and their
nerve controls
3. Attached ligaments
4. Teeth (when present)
5. Shape and movements of the articular disc
The movements can be categorized as follows –
 Basic movements
Excursion movements
Border movements
Functional movements
Parafunctional movements
1.Basic movements -
◦ Two types 1) Rotation
◦ 2) Translation
◦ All mandibular motions is either rotation or translation
Rotational (Hinge movement) -
The Action / process of rotating on or as if on an axis/centre.
Movements is similar to door hinge and the condylar rotates without any bodily movements
It occurs in the lower compartment of TMJ
3 axis – 1. horizontal
2. frontal or vertical
3. sagittal
Axis -
It is a around which a body may rotate/around which a structure would turn if it could resolve

Rotational movements
Horizontal
(transverse Frontal axis Sagittal axis
horizontal)axis

During mouth opening and Durind lateral

protrusion and is also a movements
posterior border movements
Horizontal axis of rotation
Mandibular movements around the horizontal axis is an opening and closing motions
It is referred to as hinge movements and the horizontal axis around which it occurs is referred to
as the hinge axis
Hinge movements is probably the only example os mandibular activity in which a “pure”
rotational movements occurs.
In all other movements rotation around an axis is accompanied by translation of the axis
Terminal hinge axis -
When the condyles are in their superior position in the articular fossae and the mouth is purely
rotated open, the axis around which movement occurs is called the terminal hinge axis.
Rotational movement around the terminal hinge rarely occurs during normal function.
Frontal/vertical axis of rotation -
Mandibular movement around the frontal axis occurs when one condyle moves anteriorly out of
the terminal hinge position with the vertical axis of the opposite condyle remaining in the
terminal hinge position.
Sagittal axis of rotation -
Mandibular movements around the sagittal axis occurs when one condyle moves inferiorly while
the other remains in terminal hinge positions.
3 reference planes of skull -
Horizontal or transverse – divides face into upper and lower parts. Shows roation around
frontal axis
Saggital plane – divides face into right and left parts. Sg\hows roation in transverse horizontal
axis
Frontal or coronal plane – divides face into anterior and posterior parts. Shows rotation in
sagittal axis
Translation -
This refers to bodily movement of the condyle , also known as sliding/gliding motions
If opening of the mandible beyond 20-25 mm then translation of the mandible occurs
It occurs during all the excursive mandibular movements
When the jaw is opened widely, it exceeds the maximum range of jaw opening
with rotational movements and a secondary gliding movements occurs. This
movements is called translation
Translation occurs within the upper compartment of the TMJ
Centric relation
Centric relation jaw position in which the head of the condyle is situated as far anterior and
superior as it possibly can within the mandibular fossa/glenoid fossa
This position is independent to tooth contact
It is restricted to purely rotary movements about the transverse horizontal axis
Maximal intercuspal position
The complete intercuspation of the opposing teeth independent of condylar position
It is sometime referred to as the best fit of the teeth regardless of the condylar position
It is also known as maximal intercuspation
2.Excursive movements
It occurs when mandible moves away from maximum intercuspation
Excursive movements are a combination of rotation and translation
The excursive movements are – 1]opening and closing
 2]protrusion and retrusion
 3]lateral excursion

In completely edentulous situation , it can be assumed as any movements of the condyle from the
CR position as it coincides with MIP
Movements

Depression of mandible Opens mouth

Elevation of mandible Closes mouth

Protrusion Protraction of chin

Retrusion Retraction of chin

Lateral/side to side Chewing/Grinding

movements
3.Border movements
Border movements are mandibular movement at the limits dictated by anatomic structures, as
viewed in a given plane
These are extreme positions of the mandible in any direction limited by nerves , muscles and
ligaments and are closely associate with occlusal patterns
Mandibular border movements are the nonfunctional movements of the mandible
These positions can be recorded in 3 anatomic planes . They are –
 Border movements in sagittal plane
 Border movements in horizonal plane
 Border movements in frontal plane
 Border movements in sagittal plane
This traces the movements as the mandible moves from centric occlusion maximum
protrusion maximual mouth opening closing while returing to centric occlusion.
 Border movements in horizontal plane
This traces the movements from centric relation right and left extreme lateral movements
maximal protrusion centric relation
Border movements in frontal plane -
This traces the movements from centric relation right and left extreme lateral movements
Maximal mouth opening back
Envelope of motion
This is the 3 dimensional space circumscribed of all border movements discussed.
It was first described by POSSELT.
The 3 dimensional space inside which the movements of a given point of the mandible can take
place is called envelope of motion
Bennett shift
 Bennett movement is defined as “condylar movement on the working side in the horizontal
plane”
 Condyle

Non Working Working

Forward, Downwards Rotate On Its Axis &

And Medially Laterally

Laterotrusion
Bennett movement

Mediotrusion
During lateral movement the mandible shift 1 to 4 mm towards the working side. This Is
Bennett Movement
It has also been termed previously as “BENNETT SHIFT or MANDIBULAR SIDE SHIFT”
Bennett Angle
The angle formed between the sagittal plane and the condylar path on the balancing side during
lateral mandibular movements is known as “BENNETT ANGLE OR LATERAL ANGLE”
4.Functional movements
 Chewing,swallowing,speaking,yawning and associated movements constitute the functional
movements of the mandible.
 These take place within the border movements.
 The envelope of motion recorded during chewing appears as a characteristic “tear drop” and
can be viewed in all 3 planes.
The movements are variable within the borders and are influenced by
–
 Consistency, bulk and type of food
 Size, number and form of teeth
 Excess or lack of saliva
 Musculature and force of chewing
5.Parafunctional Movements
These are sustained movements of the mandible tat occur other than normal, manifested by long
periods of increased muscle activity.
They are almost impossible for patients to control.
2 most common parafunctional activities – Bruxism
 Clenching
Parafunctional movements of mandible are activities that serve no function and are potentially
harmful to the dentition and its associated structures.
They can cause restricted mandibular movements.
These have to be diagnosed and appropriate remedial measures need to be initiated , as they
might affect jaw relation records and prognosis of the prosthesis.
 Functional activities Parafunctinal activities
Chewing Bruxism
Swallowing Clenching
speech Habits(pipe smoking, pencil biting,
safety pin opening)
respiration
Yawning
Facial expression
Opposing tooth contact
In complete denture wearers, a balance occlusion is essential to prevent mandibular deflection
and displacement of dentures.
During mandibular movements, the inclined planes of teeth should not disrupt the influence of
condylar guidance posteriorly and incisal guidance anteriorly.
Deflective contacts produce variations in mandibular movements but patients tend to avoid third
by chewing on both sides at the same time during mastication.
Neuromuscular system
This is another important factor in regulating mandibular movements.
The muscles responsible show increased activity and may be associated with movement, fixation
or stabilization of mandible such that there is a smooth and coordinated movements from one
position to another.
The muscles performs their specific function because they receive impulses from central nervous
system.
The impulses may arise at the conscious or subconscious levels and result in voluntary or
involuntary muscular activity respectively.
Mastication is a programmed event residing in a hewing centre located wtin the brain stem,
probably in reticular formation of pons
The cerebellum ensures a coordinated response from muscles during mandibular movements, by
acting as a feedback control mechanism..
Loss of proprioceptors, located principally in periodontal ligaments, eliminates
an important source of control in positioning edentulous patients
Muscles Mandibular movements
Masseter Closing and retrusion

Temporalis Elevation and retrusion

Medial pterygoid Closing and lateral movements

Lateral pterygoid Opening, protrusion and lateral movements

Suprahyoid group of muscle Depress the mandible assisted by infrahyoid

group of muscles
Significance of mandibular movements
In recording jaw relation
For designing, adjustment and selection of articulator
For creating a tooth form of dental restorations
For understanding basic principles of occlusion
For diagnosing and treatment of TMJ disturbances
For preserving the periodontal health
Conclusion

Knowledge of jaw movements is essential for successful treatment of patients. It is imperative to

learn as much possible about jaw movemnts, in order to reproduce those aspects of its motion,
considered necessary for proper functioning of the occlusion, either natural or artificial.
References
Complete denture prosthodontics – 3rd edition, by john j sharry
Prosthodontic treatment of edentulous patients – by zarb and bolender,12th edition.
An evalution of mandibular border movements: their character and significance – haary c
lundeen
THANK YOU