Muscle of Mastication And its

role in Prosthodontics
Ramya Srinivasan
Junior Resident-1
 Muscle

• Muscle (14c) - an organ that by contraction produces movements of an

animal; a tissue composed of contractile cells or fibers that effect
movement of an organ or part of the body.

• Mastication(1649): the process of chewing food for swallowing and

digestion

- GPT 9
Primary Muscles of Mastication

• Masseter
• Medial Pterygoid
• Temporalis
• Lateral Pterygoid
 Functional Classification

Jaw Elevators Jaw Depressors

• Masseter • Lateral Pterygoid

• Temporalis • Anterior Diagastric
• Medial Pterygoid • Geniohyoid
• Mylohyoid
Border Moulding
 Masseter

• The masseter - quadrilateral muscle

Two heads - Superficial & Deep
Superficial head
Origin: Temporal process of Zygomatic bone &
Anterior 2/3rd of the inferior border of
the zygomatic arch
Insertion: Angle of the mandible & inferior half -
lateral surface - ramus of the mandible.
Deep Head:

Origin: Posterior 1/3rd of the lower border and from the medial surface of the
zygomatic arch.

Insertion: upper half of the ramus as high as the coronoid process of the
mandible.
• Blood supply :Masseteric artery

• Nerve supply :Massetric nerve.

• Function : Elevation of the mandible

Lateral movements of the mandible

Retraction of the mandible

 Palpation

Palpate the origin of the masseter bilaterally along the zygomatic arch
and continue to palpate down the body of the mandible where the
masseter is attached
 Clinical Importance

• Active masseter muscle will create a concavity in the outline

of the distobuccal border

• Less active muscle may result in a convex border

• In this area the buccal flange must converge medially to

avoid displacement due to contraction of the masseter
muscle because the muscle fibers in that area are vertical
and oblique
Activation of Massetric Notch and Distal area

• Instruct to open wide and then to close against the resting force of
the fingers

• Opening wide - activates the muscles of pterygomandibular raphae

which thereby defines the most distal extension.

• Closing against the fingers on the tray handle - causes masseter

muscle to contract and push against the medially situated
buccinators muscle
 Medial Pterygoid

Origin : Lateral pterygoid plate,maxillary tuberosity.

Insertion : Medial angle of the Mandible

Arterial supply: Pterygoid branch of Maxillary artery.

Nerve Supply : Mandibular nerve through the medial pterygoid.

Functions: Elevates the mandible

Helps in side to side movement.

Palpation of medial pterygoid:

Gently palpate them on the medial

aspect of the jaw, simultaneously from both inside
and outside the mouth
 Clinical Importance

• Influence the denture border in the region of the retro-mylohyoid curtain.

• Lingual flange should not be overextended as the lingual nerve is
closely related to the lingual flange and even the submandibular
duct can be blocked.
Centric Relation
 Temporalis

Large Fan Shaped

Origin: Temporal fossa and the deep part of temporal

fascia

Insertion: Coronoid process of the mandible,

retromolar fossa posterior to the most distal mandibular
molar
• Blood Supply: Deep Temporal, branch of maxillary artery

• Nerve Supply: Deep Temporal, branch of mandibular nerve.

• Functions: Elevation of the mandible

Retraction of the mandible

Crushing of food between the molars.

Side to side grinding movement

 Palpation

To locate the muscle ,have the patient clench.

 Clinical Importance of Temporalis
Muscle

• Sudden contraction of temporalis muscle will result in coronoid

fracture

• The patient is instructed to close and move his mandible from side
to side and then immediately asked to open wide.

• The side to side motion records the activity of the coronoid process
in a closed position whereas opening causes the coronoid to sweep
past the denture periphery
• As its most posterior fibers pass very close to the condyle the posterior
temporalis functions as a stabilizer of TMJ.

• It suspends the mandible in centric relation. Anterior group of fibers

which are aligned vertically hold the mandible in superior most position.

• Temporal headaches are common in TMD’s

 Lateral Pterygoid
• Origin:

• Upper head – Infratemporal surface

Crest of Greater wing of Sphenoid bone

• Lower head – Lateral Pterygoid Plate

• Insertion :

Pterygoid fovea on anterior surface of neck of

mandible

Anterior margin of articular disc & capsule of TMJ

• Nerve Supply: Pterygoid branch of Trigeminal nerve.

• Arterial supply: Pterygoid branch of Maxillary artery.

• Functions:

Depresses the mandible

Protrudes it forward for opening of the jaw

Side to Side Movements

PALPATION OF THE LATERAL PTERYGOID
 Clinical Importance of Lateral
Pterygoid Muscle

Most commonly involved muscle in MPDS

• Unilateral failure - Deviation of the mandible toward the

affected side on opening
• Bilateral failure -
Limited opening, loss of protrusion and loss
of full lateral deviation
Muscle on the opposite of the interference
• Non-working side interferences -
is painful
• During closure of the mouth the backward gliding of the articular
disc & condyle is controlled by slow elongation of lateral pterygoid
while Masseter & Temporalis restore the jaw to the occlusal
position. Thus it acts as a stabilizer of TMJ .

• • It holds the condyles in centric relation position

Disharmony Between the occlusion and the TMJ

• If the condyles must be displaced from centric relation to achieve max

intercuspation ,the lateral pterygoid must contract.

• This causes muscle incoordination with potential for occlusal disease,

muscle pain, or disorders of TMJ
Tooth interferences to the centric relation in
the arc of closure

Activates lateral pterygoid

Hyperactivity of the closing muscles

 Placement of a simple flat interocclusal
device on the anterior teeth

Separates the posterior teeth

Allow the TMJ to completely seat up into CR

Lateral pterygoid releases contraction

Co-ordinated muscle function

 OCCLUSAL SPLINT THERAPY

Occlusal splints - muscle relaxation

Platform for the teeth –

Equal distribution of tooth contacts,

Immediate posterior tooth disocclusion in all movements (with anterior

guidance)

Reduced stress on the joint.

Neuromuscular harmony that follows provides for optimal function and comfort.
NTI (Nociceptive Trigeminal Inhibition) Tension
Suppression System

Direct stimulation of the periodontal ligament of the lower incisors -

feedback loop - limits the contraction intensity of the closing muscles.
 Stabilization splint

Temporary and Removable ideal occlusion.

Reduces abnormal muscle activity and produces neuromuscular balance.

 Anterior Bite Plane

• It disengage the posterior teeth and thus eliminate their influence in

the function or dysfunction of the masticatory system
 Muscle Reconditioning Splint

It is used for its effect on the muscular reconditioning and also to

reinforce the personal responsibility of the patient.

In all cases of persistent TMD and the presence of acute

musculoskeletal pain, despite a preliminary treatment
Situational Usage of Splints

J.-P. Ré.,et.,al ,The occlusal Splint Therapy, J. Stomat. Occ. Med. (2009) 2: 1–5
 Features of Masticatory muscle

• Have shorter contraction times

• Incorporate more of muscle spindles - monitor their activity

• Do not have golgi tendon organs - monitor tension

• Elevators predominantly fibrous which fast twitching

 Features of Masticatory muscle

• Do not get fatigued easily

• Psychological stress increases the activity of jaw closing muscles

• Occlusal interferences - hypertonic muscle activity

• Closing movement - by the height of the teeth

 CONCLUSION

• The masticatory system is extremely complex, primarily made of

bones, muscles, ligaments and teeth.

• Precise movement of mandible by the musculature is required to

move the teeth effectively across each other during function.

• The knowledge of the anatomy physiology and mechanisms of

these muscles are basic to understand the movements.
 References

• Human anatomy A K Dutta -3rd Edition

• Grays Anaatomy
• Burkits oral medicine diagnosis & treatment 10 th edition
• Textbook of Complete dentures by Charles M Heartwell
• J.-P. Ré.,et.,al ,The occlusal Splint Therapy, J. Stomat. Occ. Med.(2009) 2: 1–5