MUSCLES

OF
MASTICATION
Presented by: Dr.HUMERA TABASSUM
FIRST YEAR MDS
DEPARTMENT OF ORTHODONTICS
 CONTENTS
• INTRODUCTION
• EMBRYOLOGY
• CLASSIFICATION OF MUSCLES OF MASTICATION
– PRINCIPAL MUSCLES
– ACCESSORY MUSCLES
• EXAMINATION OF MUSCLES OF MASTICATION
• ORTHODONTIC IMPLICTIONS
• CLINICAL CONSIDERATION
• ARTICLES-ROLE OF MUSCLES OF MASTICATION IN
ORTHODONTICS
• CONCLUSION
• REFERENCE
 INTRODUCTION
• To propel the skeleton, man has 639 muscles, composed of 6 billion
muscle fibers.Each fiber has 1000 fibrils, which means there are
6000 billion fibrils are at work at one time or another.

• Food is the main source of energy ,this energy is derived through the
complicated process of digestion. 1st step of digestion is
mastication.

• Teeth, jaws, muscles of the jaws, tongue and the salivary glands aid
in mastication.

• Main purpose of mastication is to reduce the size of food particles to

a size that is convenient for swallowing (bolus formation) with the
help of saliva. Breaking down food into smaller pieces also increases
its surface area so that digestive enzymes can continue to break it
down more efficiently.
• .
Chewing reflex:
• Presence of bolus causes inhibition of elevator muscles of jaw ,causing
lower jaw to drop.

• The drop in turn initiates a stretch reflex of the jaw muscles leading to
rebound contraction.

• This automatically raises the jaw to cause closure of the teeth compressing
the bolus against the linings of mouth.
•
• This inhibits jaw muscles once again allowing the jaw to drop and rebound
another time ; this is repeated again and again.
• DEFINITION OF MUSCLE :
• A band or bundle of fibrous tissue in a
human or animal body that has the ability to
contract, producing movement in or maintaining
the position of parts of the body..

• The term muscle is derived from the Latin word

musculus.
• Meaning "little mouse" perhaps because of the
shape.

• When a muscle contracts, the muscle movement

under the skin resembles movement of the mice
scurrying around.
• Muscles of mastication are the group of muscles that help in movement of the
mandible as during chewing and speech.

• We need to study these muscles as they control the opening & closing of the
mouth & their role in the equilibrium created within the mouth.

• Four pairs of the muscles in the mandible make chewing movement possible.
These muscles along with accessory ones together are termed as “MUSCLES OF
MASTICATION”..

• A good knowledge of masticatory system and functional efficiency is a basic

requirement and influence of these muscles in orthodontics has vital role.
Action of muscles during masticatory movements:

Opening / Depressor jaw muscles

Mylohyoid muscle
Digastric muscle
Inferior lateral pterygoid muscle

Closing / elevator jaw muscles

Medial pterygoid
Superficial masseter
Temporalis
 EMBRYOLOGY
• MUSCLES OF MASTICATION DEVELOPS FROM THE
FIRST BRANCHIAL ARCH THAT IS THE
MANDIBULAR ARCH.

• Muscles of mastication at first develop in

relation to meckel’s cartilage but are
independent of the insertions and are
attached only to the forming mandible.

• Mandibular division of trigeminal nerve

supplies the muscles of mastication.

• Second part of maxillary artery forms the

arterial supply.
Development
CLASSIFICATION OF MUSCLES OF MASTICATION

▪ MUSCLES OF MASTICATION ARE

CLASSIFIED AS:
– PRINCIPAL MUSCLES
➢ MASSETER
➢ TEMPORALIS
➢ LATERAL PTERYGOID
➢ MEDIAL PTERYGOID
– ACCESSORY MUSCLES
➢ DIGASTRIC
➢ BUCCINATOR
➢ MYLOHYOID
➢ GENIOHYOID
 DEFINITIONS OF KEY WORDS

• ORIGIN-The end of the muscle that is attached to the least moveable structure.

• INSERTIONS-The end of the muscle that is attached to the more moveable

structure.
The insertion moves towards the origin- in most cases.
ACTION– The work that is accomplished when muscles fibers contract.

SYNERGISTS - Muscles with similar actions which work together.

ANTAGONISTS-Muscles which have opposite action.

DEGLUTITION-The act of swallowing.
PHONATION-The act of speech.
 PRINCIPAL MUSCLES OF MASTICATION

• THE CHARACTERISTIC FEATURES OF THE PRINCIPAL MUSCLES OF

MASTICAION ARE:

➢ ALL ARE LOCATED IN OR AROUND THE INFRATEMPORAL FOSSA

➢ ALL ARE INSERTED INTO THE RAMUS OF THE MANDIBLE
➢ ALL ARE INNERVATED BY THE MANDIBULAR DIVISION OF THE TRIGEMINAL NERVE
➢ ALL ARE CONCERNED WITH MOVEMENTS OF MANDIBLE ON THE TEMPORO-
MANDIBULAR JOINT
➢ ALL DEVELOP FROM THE MESODERM OF THE FIRST PHARYNGEAL ARCH.
ARTERIAL SUPPLY
NERVE SUPPLY
ACCESSORY MUSCLES OF MASTICATION
• DIGASTRIC MUSCLE

– It is a strap like muscle consisting

of posterior and anterior bellies
united by an intermediate tendon

• ORIGIN:
Anterior belly arises from the
digastric fossa on the lower border
of the mandible close to the
symphysis menti.
Posterior belly arises from mastoid
notch of the temporal bone.
• Insertion:
• Digastric muscle inserts on the hyoid
bone, which is a horseshoe-shaped bone
located in the middle front of the neck
just above the larynx/voice box. The
digastric muscle inserts on the hyoid
bone by the tendon that connects the
anterior and posterior bellies of this
muscle.
NERVE SUPPLY :

• The anterior belly of the digastric muscle is

innervated by the mylohyoid branch of the
trigeminal nerve, i.e, cranial nerve V.

• The posterior belly of the digastric muscle is

innervated by the facial nerve, i.e,
cranial nerve VII.
ACTIONS:
Helps to depress the mandible when the
mouth is opened widely against resistance
Pulls the hyoid bone upwards during
deglutition.
 Buccinator muscle

• The buccinator (also buccinator

muscle, latin: musculus buccinator)
is a facial muscle that participates in
forming the anterior part of the
cheek and the lateral wall of the oral
vestibule.
• The buccinator is a thin
quadrilateral muscle occupying the
interval between the maxilla and
mandible. it is covered by the
buccopharyngeal fascia.
• Buccinator muscle is also known as
Bugler’s muscle/Trumpeter’s muscle.
• Origin:
• The fibers of the buccinator arise from the
alveolar processes of the maxilla and
mandible at the region of the 1st and 2nd
molar teeth, and from the
pterygomandibular raphe.

• Insertion:
• The buccinator inserts into the angle of
the mouth radiating into the fibers of the
orbicularis oris muscle.
• Action:
• Upon contraction the buccinator pulls the angle of the
mouth laterally, presses the cheeks to the teeth, thus
decreasing the oral vestibule.

• Contractions of the buccinator muscle produce facial

expressions presenting satisfaction, as well as laughing and
crying.

• Flattens the cheek against the gum and teeth and thus
prevents accumulation of food in the vestibule of the mouth
during mastication
• It is responsible for blowing the cheek and expelling the air
between the lips from inflated vestibule as in blowing the
trumpet(hence the name trumpeters muscle
 MYLOHYOID
• It is a flat triangular muscle lying deep to the
anterior belly if digastric.

• Origin:
From the mylohyoid line of the mandible.

• Insertion:
The fibres run downward and medially.

Posterior fibres- Inserted into the body of the

hyoid bone.

Middle and anterior fibres- Inserted into the

median fibrous raphae extending from symphysis
Menti to the hyoid bone.
ACTIONS:
The mylohyoid muscle elevates the floor
of the mouth and helps the tongue during
the first stage of deglutition
It also helps in depression of the mandible
against resistance
It fixes or elevates the hyoid bone

Nerve supply:
It is supplied by the mylohoid nerve branch
of the inferior alveolar nerve
frommandibular nerve.
GENIOHYOID
Geniohyoid muscles

• It is a narrow muscle that lies alongside the

midline deep to the mylohyoid
• Origin: From the inferior genial tubercle of the
mandible.

• Insertion: The fibres run backwards and

downwards to be inserted into the anterior
surface of the body of the hyoid bone.

• Nerve supply: c1 fibres through the hypoglossal

nerve.
• Actions: shortens the floor of the mouth by
elevating the hyoid bone.
ACTIONS
EXAMINATION OF MUSCLES OF
MASTICATION
• TEMPORALIS:
The muscle is palpated
simultaneously with the finger-
tips aligned in a row from the
hairline just above the supra-
orbital ridge to above the ear.
• MASSTETER:
• Palpated bilaterally in the area overlying the
anterior border of the mandibular ramus.

• The area of palpation is directly above the

attachment of the body of the mandible
• MEDIAL PTERYGOID:
Palpated near its insertion
by placement of the index
finger laterally and
posteriorly into the floor
of the mouth towards the
angle of the mandible.
• LATERAL PTERYGOID:
The index finger is positioned distal and
posterior to the maxillary tuberosity and
posterior pressure is exerted to compress
tissue against the muscle to detect
tenderness
 ORTHODONTIC IMPLICATION

• Functional matrix theory of melvin moss explained the

mechanism by which the soft tissue envelope could
direct/divert the skeletal growth.

• According to moss theory, as growth of jaws depends

on the activity of muscles,Jaws muscles,can excessive
muscle activity can restrict growth.
• Functional matrix theory(Moss 1960) proffit moss says if neither bone
nor cartilage were determinant for growth of craniofacial skeleton,the
control would lie in the adjacent soft tissues.He theorizes that growth
of the face occurs as a response to functional needs & is mediated by
the soft tissues in which it is embedded. He theorizes that growth of
the maxilla & mandible occurs due to enlargement of nasal & oral
cavities.
• Sassouni(1969) outlined the concept that the vertical alignment of
jaw-closing muscles has a direct skeletal growth toward a shallow
mandibular plane angle, an acute gonial angle, and deep bite,
whereas obliquely aligned jaw-closing muscles permit a steep
mandibular plane, an obtuse gonial angle, and open bite.
• FMT (Grabber & Petrovic) regional & local factors play a role in cranio
facial morphogenesis. It says that the growth of bone & cartilage seems
to be a compensatory response to FM growth.The functional matrix
include muscles, nerves, glands, teeth,blood vessels etc. The growth of
functional matrix is primary; the growth of skeletal unit is secondary.

• He classified the skeletal facial types into

– Short face syndrome

– Long face syndrome.

 SHORT FACE SYNDROME

Characterized by: 2 subgroups include:

Sfs1:
– Reduced lower facial height • Long ramus
– Reduced eruption of posterior • Sharply reduced sn:mp angle
teeth • Slightly reduced posterior
maxillary height
– Increased posterior facial
height
Sfs2:
– Flat mandibualar plane angle • Short ramus
• Slightly reduced sn:mp angle
• Sharply reduced posterior
maxillary height
 LONG FACE SYNDROME

• CHARACTERIZED BY:

– Excessive eruption of posterior teeth

– Normal or excessive eruption of anterior teeth
– Short posterior facial height
– Steep mandibular plane angle

• DIAGNOSTIC CRITERIA:

– Go-gn to sn line angle(mandibular plane angle)- 37˚ or greater

– Posterior(s to go) to anterior facial height(n-me) ratio(jaraback’s ratio)- 0.65 or less
 BUCCINATOR MECHANISM
• Buccinator mechanism: Continuous band of
muscles that encircle the dentition and is
firmly anchored at the pharyngeal tubercle
of the occipital bone.

• The balance between the muscles is

responsible for the ntegrity of the dental
arches and the relation of teeth to the
arches.
• In pernicious oral habits like thumb sucking, tongue thrusting, the
equilibrium between buccinator mechanism and tongue is lost.

• This causes:
– Constricted maxillary arch
– Increased proclination
– Open bite.
 Clinical consideration
• TRISMUS- The muscles of mastication,when
damaged,causes limitations in mouth opening.
Trauma to muscle can occur to faulty mandibular
nerve block.

• Mayofacial pain dysfunction sydrome - Pain

disorder,in which unilateral pain is referred from
the trigger points in myofacial structures,to the
muscles of head and neck.
• OROFACIAL PAIN
The muscles of mastication can be
subjected to myofacial
pain,myospasm,local
myalgia,myofibrotic contracture and
myositis. Myospasm greatly limits the
mandibular movements and can
change occlusion suddenly due to rapid
onset.
• MYASTHENIA GRAVIS - Acquired autoimmune disorder
characterized by difficulty in mastication and deglutition,
drooping of jaw, speech is often slow, disturbances in
taste sensation.

• TETANUS(LOCK JAW) - Pain and stiffness in the jaws and

neck muscles with muscle rigidity producing trismus and
dysphagia

• BRUXISM - Occur as a brief rhythmic strong contractions

of the jaw muscles during eccentric lateral jaw
movements, or in maximum intercuspation.
REVIEW OF ARTICLES
 MASTICATORY MUSCLE FUNCTION AND CRANIOFACIAL
GROWTH
• Masticatory muscle function and its influence on craniofacial
growth have been investigated in animal experiments and clinical
studies.

• These investigations commonly show that the elevator muscles of

the mandible influence transverse and vertical facial dimensions.
Increased loading of the jaws associated with masticatory muscle
function increases sutural growth and stimulates bone apposition,
resulting in greater transverse growth of the maxilla and broader
bone bases for the dental arches.
• Further more,an increase in masticatory muscle function is often associated
with an anterior growth-rotation pattern an well-developed angular, coronoid,
and condylar processes in the mandible.

• Thus, individuals with strong masticatory muscles usually have a

hypodivergent facial type, although not all individuals with hypodivergent
facial form have strong masticatory muscles.
• The literature supports the hypothesis that a certain level of masticatory muscle
strength may be sufficient for normal vertical craniofacial growth,though it is
not a prerequisite.

• Thus, it may be concluded that the masticatory muscles are able to influence
craniofacial growth of man provided that the tension they apply to the facial
bone structures is above a certain threshold, reaching what Frost calls “the mild
overload window.”
Role of muscle in retension and stabilty:Arch width changes in extraction
and nonextraction treatment in class I patients .
Angle. Orthod. Vol.75.6.948-952

• Alfred coleman (1865) was the first person who

claimed that muscular pressure is responsible for
relapse .

• According to MOYERS abnormal 7th nerve action

affects the facial muscles, especially the mentalis
muscle, in incisor correction.
• Stedman- initiated mentalis muscle hypertension, as factors
in bringing about undesirable post treatment changes or
relapse.

• Strang- mandibular inter canine and inter molar arch widths

are accurate indicators of the individual's muscle balance and
dictate the limiStedman- initiated mentalis muscle hypertension, as factors
in bringing about undesirable post treatment changes or
relapse.
• The results of many studies of the relationship between the mandibular muscles and
craniofacial morphology would seem to confirm the ever-present but elusive
relationship between form and function.

• Bite forces between conditions like brachyfacial and dolichofacial subjects in this
study seem to be related to the strength or mechanical advantage of mandibular
muscles.

• The effects of the mandibular muscles associated with different types of tooth
movements should be considered during orthodontic treatment planning.
• The choice of treatment mechanics, the timing of treatment, and any
extraction decision might be quite different for different underlying
vertical patterns, even for the management for similar occlusions.

• From a review of literature, it is reasonable to suggest at either

extreme of the vertical facial spectrum are likely to pose the greatest
challenges to the orthodontist during treatment.
 Conclusion

• The masticatory muscles include a vital part of the orofacial structure and are
important both functionally and structurally .It can be influenced by a variety
of factors many of which are controlled by the practicing orthodontist.
• The masticatory muscles include a vital part of the oro-facial structure and are
important both functionally and structurally it is crucial responsibility of a
clinician to recognize each patient’s muscular environment and be aware of
the problems related with excessive or deficient use of muscle and their
bearing to the dentition.
• The proper management and periodical self -examination of the muscles may
provide a greater chance of catching the disease process at an early stage
which may be useful for its better prognosis.
 REFERENCES
• Hideki Tabe, Influence of Functional Appliances
on Masticatory Muscle Activity. The Angle
Orthodontist: July 2005, Vol. 75, No. 4, pp. 616-
624.

• Arch width changes in extraction and

nonextraction treatment in class I patients
.Angle. Orthod. Vol.75.6.948-952.

• Ekta gupta,Measurement of Perioral Pressures at

Rest and its Correlation with Dental Parameters in
Orthodontic Patients with Different Occlusions,
Jun, Vol-13(6): ZCJournal of Clinical and
Diagnostic Research. 2019 13-ZC18
• Anthea Rowlerson Fiber-type differences in masseter muscle associated
with different facial morphologies, Am J Orthod Dentofacial
Orthop:2004.03.025.

• Pepicelli A, Am J Orthod Dentofacial Orthop. 2005 Dec;128(6):774-80.

• Gray’s,anatomy for students, second edition.
• B .D Chaurasia,9thedition.
• Graber T.M,orthodontics practice and principle,third edition.
• Sridhar premkumar,text book of craniofacial growth ,2011 edition.
• Huston,Text book of orthodontics,2nd edition.