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TheMusclesofMastication
A.TemporalisMuscle
Origin:temporalfossa&
temporalfascia
Insertion:coronoidprocess
&anterioroframus
A.TemporalisMuscle
Function:Elevationand
positioningofthe
mandible
B.MasseterMuscle
Origin:zygomaticarch
Insertion:lateralsurface
oframus,coronoid
process&angleof
mandible
B.MasseterMuscle
Function:powerwith
verticalelevationof
themandible;deep
portionstabilizesthe
condyleinprotrusive
closure
C.MedialPterygoidMuscle
Origin:medialsurfaceof
lateralpterygoidplate,
pyramidalprocessof
palatinebone&Mx
tuberosity
Insertion:medialsurface
oframus&angleof
mandible
C.MedialPterygoidMuscle
Function:elevationof
themandible,
protrusionofthe
mandibleandlateral
movementofthe
mandiblewith
unilateralactivation
PterygomassetericSling
D.InferiorLateralPterygoidMuscle
Origin:lateralsurfaceof
lateralpterygoidplate
Insertion:pterygoid
foveaofcondyle
D.InferiorLateralPterygoidMuscle
Function:protrusion,
lateralmovementand
contributestoopening
E.SuperiorLateralPterygoidMuscle
Origin:infratemporal
surfacegreaterwingof
thesphenoidbone
Insertion:pterygoid
foveaofthecondyle
andvariabletothedisc
E.SuperiorLateralPterygoidMuscle
Function:activewiththe
musclesofclosure,
especiallyaiding
stabilizationofthe
condyleduringthe
powerstroke
TemporomandibularJoint
Anatomy
CraniomandibularJoint:a
diarthrodialorsynoviallinedjoint
Acompoundjoint:>2components
TemporalBone
MandibularCondyle
ArticularDisc
A.TemporalBone
Cranialcomponent
Mandibularfossa
Articulareminence
Articularsurfacefrom
superiorfossatothe
anterioraspectofthe
eminence,thickest
bone.
B.MandibularComponent:Condyle
Condylardimensions:
AP810mm
ML1520mm
Articularsurface:
anteriorsuperioraspect
B.MandibularCondyle
Variationsidetosidein
sizeandshapeiscommon.
Responsetoloading
Lateralpoleanteriorto
medialpole.
C.ArticularTissue
Origin:modified
periosteumof
intramembranousbone,
NOTendochondralorigin.
Aconsequenceof2
embryonictissuemasses
growingtowardseach
other,NOTasingletissue
massclefttoformajoint
articulation.
C.ArticularTissue
Function:1)
loaddistribution
2)synoviallubrication
Character:NOT
hyalinecartilage,but
fibrousinnature
1)avascular
2)NOTinnervated
3)resistanttoshear,
tensionforces
4)increased
remodelingpotential
D.ArticularDisc
Composition:
avascularconnective
tissue,collagenous
Shape:biconcavein
crosssectionwith
posteriorband,
intermediatezoneand
anteriorband
Position:posterior
bandedgeat12:00
D.ArticularDisc
E.TMJointCapsule
Function:
1)limitextremeROM
2)synoviallining
3)confinessynovial
fluid
4)jointproprioception
F.MandibularLigaments
Restrictandlimit
jointrangeofmotion
A.Temporomandibular
Ligament
Lateralthickeningof
theTMjtcapsule
Limits:retrusionand
inferiorcondylar
distraction
B.CollateralLigaments
Medialandlateral
Limit:medialand
lateralmovementof
thediscrelativetothe
condyle
C.AccessoryLigaments
Sphenomandibular
Ligament:
nonfunctionalvestige
orremnantof
Meckelscartilage
Stylomandibular
Ligament:limits
extremejaw
protrusion
TMJointStability
NOTligaments
Musclespulling
acrossjoints
ArticularDisc
Geometry
TMJointAnatomy:sagittal
LateralPterygoidM
Superiorheadinsertion
condyle&sometimesdisc
Inferiorheadinsertion
condyle
Retrodiscaltissues
1)Superiorelastic
2)Inferiorcheck
ligament
3)LooseC.T.venous
compartmentand
innervated
Synovialtissues
TMJointRetrodiscalTissue
TMJointInnervation:V3
TMJointFunctionalAnatomy
ReadpagesinOkeson,pp.2226!
CentricRelation(Okeson,2003)
Jawpositionwiththe
condylesintheirmost
superoanterior
postionsinthe
articularfossae,
restingagainstthe
posteriorslopesofthe
articulareminences,
withthearticulardiscs
properlyinterposed.
BiologyofCentricRelation
MuscloskeletalStability:
astablepositioninwhich
toloadthejoint,mmpull
acrossjtsseatingcondyle
ClinicalEvidence:
patientsdowellwithIP
coincidentalwithjaw
positioninCR(clinical
experience)
BiologyofCentricRelation
Clinicallyrepeatable:a
referencepositionfor
restorativedental
procedures
butNOTimmutable!
(CelenzaFV,JPD1973)
(~1yr?)