Muscles of mastication

Presented by:
Dr. Nahid Zafar
1st year
postgraduate trainee
( department of
prosthodontics
crown and bridges
&implantology)
Content
• Introduction
• Definition
• Development of muscles
• Classifications
• palpation
• Mandibular movements and role played by muscles
• Prosthodontic consideration
• Masticatory muscles disorder (clinical consideration)
• Conclusion
• The muscles of mastication move the mandible during mastication
and speech.
• They are the – masseter
temporalis
lateral pterygoid
medial pterygoid
• They develop from the mesoderm of first brachial arch and are
supplied by the mandibular nerve which is the nerve of that arch.
What is muscles??

An organ that by contraction produces movements of an animal.

or
A tissue composed of contractile cells or fibres that effect movement of
an organ or part of the body.
Mastication – mastication is the mechanical process which breaks
up larger food particles into smaller pieces.
• Mastication is defined as the process of chewing food in preparation
for swallowing and digestion. (GPT8)
Development of muscles

• The muscular system develops from intra embryonic mesoderm,

except some smooth muscles tissue- pupil, sweat gland and
mammary gland (differentiate from ectoderm)
• Muscle tissues develop from embryonic cells called myoblast.
• Muscular component of Branchial arch form many striated muscles in
the head and neck region.
• Muscles of mastication are derived from first arch which is also called
as MANDIBULAR ARCH.
Development continued…
Intraembryonic mesoderm

Pharyngeal arch musculature---- facial

expression muscles, muscles of
mastication ,pharynx and larynx
 Primary muscles Accessory muscles

Masseter Buccinators
Temporalis Suprahyoid muscles
Medial pterygoid Infrahyoid muscles
Lateral pterygoid
• Quardilateral
• Most powerful muscle for the
closure of the mandible
• Covers lateral surface of ramus of
mandible.
• And has three layers- Superficial
Middle
Deep
Masseter

superficial
origin Insertion

Origin and insertion of the masseter muscle

 ORIGIN INSERTION
• From anterior 2/3 of • Into lower part of lateral surface of
superficial lower border of ramus of mandible.
zygomatic arch and
adjoining zygomatic
process of maxilla

• From anterior 2/3 of • Into middle part of ramus.

Middle deep surface and
posterior 1/3 of lower
border of zygomatic arch.

• From deep surface of • into upper part of ramus and coronoid

Deep zygomatic arch. process of the mandible.
• Massetric nerve ,a branch of
anterior division of mandibular
nerve.

• Vascular supply: It is
supplied by a branch from
second part of maxillary artery .
• It is a powerful elevator of the mandible &
is very active during forceful clenched
(centric) occlusion.
•Deep head exerts primarily a vertical force
on the mandible.
• Superficial head exerts vertical &
anteriorly directed force.
•It also helps in ipsilateral excursion .This is
made possible by the fact that the origin of
Masseter is slightly lateral to its insertion,
therefore a contraction of Masseter on one
side can move the mandible to that side.
Temporalis

• It is a fan shaped muscle that fills

the temporal fossa.
• It is a powerful elevator of the
mandible.
• It overlies the lateral surface of
the mandible.
• The periphery of muscles is
attached to the inferior temporal
line, origin from the temporal fossa
except the zygomatic bone & from
the overlying temporal fascia.

• Coronoid process of mandible and

anterior margin of ramus of
mandible almost to last molar
tooth.
• Deep temporal nerves from the
anterior trunk of the mandibular
nerve.

• By deep temporal arteries

(which travel with nerve.), and
the middle temporal artery
( which penetrates the temporal
fascia).
• Elevates the mandible
• POSTERIOR FIBRES: Retract
the protruded mandible.
• Helps in side to side grinding
movements.
• it is short, thick ,triangular
muscle.
• Has two heads upper and lower.
• Upper head (small): From • Pterygoid fovea on the anterior
infratemporal surface and crest surface of neck of the mandible.
of greater wing of sphenoid
bone.
• Anterior margin of articular disc
and capsule of TMJ. Insertion is
• Lower head (larger): From lateral posterolateral and at a slightly
surface of lateral pterygoid. higher level than origin.
Nerve supply :A branch from anterior division of mandibular
nerve.
Blood supply: Pterygoid branch of
2nd part of maxillary artery

a) Depress mandible to open

mouth, with suprahyoid muscles.
b) Lateral and medial pterygoid
protrude mandible.
c) Left lateral pterygoid and right
medial pterygoid turn the chin to
left side as part of grinding
movements.
Medial pterygoid
• Thick quadrilateral
• Has a small superficial and a
large deep head.

Medial pterygoid
a) Superficial head ( small slip): from
tuberosity of maxilla and adjoining
bone
b) Deep head ( quite large):
from medial surface of lateral pterygoid
plate and adjoining process of palatine
bone.

Roughened area on the medial surface of

angle and adjoining ramus of mandible,
below and behind the mandibular foramen
and mylohyoid groove.
• a. Elevates mandible
• b. Helps protrude mandible
• c. Right medial pterygoid with
right lateral pterygoid turns the
chin to left side as part of the
grinding movements.
• BUCCINATOR
• SUPRAHYOID MUSCLES:
a) DIGASTRIC
a) MYLOHYOID
b) GENIOHYOID
c) STYLOHYOID
• INFRAHYOID MUSCLES:
a) STERNOHYOID
b) OMOHYOID
c) THYROHYOID
 The buccinator muscle plays a role in stabilizing the
denture by gripping the polished surface of the denture.
Buccinator Also, the longitudinal fibers hold the bolus of food
between the teeth during mastication.

• It is in the space between mandible and maxilla,

deep to the other facial muscles in the area.
• Forms the muscular component of the cheeks.
Origin :
• Arises from the posterior part of the maxilla and
mandible opposite the molar teeth and the
pterygomandibular raphe.
Insertion:
• Upper fibers: Straight to the upper lip
• Middle fibers: Decussate before passing to the
lips.
• Lower fibers: Straight to the lower lip
NERVE SUPPLY: Buccal branch of facial nerve

BLOOD SUPPLY:
It is supplied by branches of facial
artery and also the buccal branch of the
maxillary artery

FUNCTION:
• contraction of the buccinator
presses the cheek against the
teeth.this keeps the cheek taut and
aids in mastication by preventing
the food from accumulating
between the cheeks and teeth.
• The muscles also assist the forceful
expulsion of air from the cheeks.
palpation
• palpation will reveal tension or
tenderness which can be related
to hyperactivity of the muscle as
a result of overworking it in an
uncoordinated manner.
• The masseter muscles are
palpated extraorally by placing
the fingers over the lateral
surfaces of the rami of the
mandible.
The finger are placed over the
patient’s temples to feel the
temporalis muscles.

The index finger is used to touch

the medial pterygoid muscle on the
inner surface of the ramus.
Mandibular movements and role played by
muscles
• Chewing and grinding motion occurs
when the movements at the
temporomandibular joints on one side
are co-ordinated with a reciprocal set of
movement at the joint on the other side.

Movements of mandible includes-

depression
elevation
protrusion
retraction
ROLE OF MUSCLES IN VARIOUS MANDIBULAR
MOVEMENTS

• Temporalis muscles (anterior fibres)

• Masseter muscles
• Medial pterygoid muscle

• Right & left Inferior heads of Lateral pterygoids

• Right & left Suprahyoid and Infrahyoid muscles
• Anterior belly of Digastric & Mylohyoid .
PROTRUSION:
• Inferior heads of Lateral pterygoid
• Medial pterygoids
• Superior heads of Masseter

RETRUSION:
• Right & left Posterior fibres of Temporalis
• Right & left Deep heads of Masseter

RIGTH LATERAL EXCURSION: Right Masseter, Right Temporalis, Left Medial

pterygoid & Left Lateral pterygoid

LEFT LATERAL EXCURTION: Left Masseter , Left Temporalis, Right Medial

pterygoid & Right lateral pterygoid.
Significance of
MuScleS of
MaStication in
proSthodonticS
• The action of the masseter muscles pushes the
buccinators muscles towards the retromolar
pad. The impression will be reflected
superiorly and medially forming a groove
called the masseter groove.
• If the distobuccal flange of the mandibular
denture base is not contoured to allow freedom
for this action ,the denture will be displaced.
Significance of temporalis in prosthodontics

• It acts 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
SIGNIFICANCE of lateral pterygoid IN
PROSTHODONTICS
• 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.
The shaping of impression material along the border areas of an
impression tray by functional or manual manipulation of soft tissues
adjacent to the borders to duplicate the contour and size of the
vestibule.(GPT8)

• The functional movements are made during the border moulding

procedure by holding the modiolus with thumb and index finger.

• It helps in establishing the height of occlusal plane of maxillary occlusal rim.

Corners of the mouth are marked on the occlusal rims to provide the
dentist & technician with anterior landmarks for the height of first
premolars.
neutral Zone
• It is a potential denture space
where the forces of the tongue
musculature pressing outward are
neutralized by forces of the
muscles of the cheeks and lips
pressing inward.
PROSTHETIC SIGNIFICANCE:
• Neutral zone should be recorded
clinically & teeth arrangement
should be done in the neutral zone.
This contributes to the stability of
the denture.
ROLE OF MASTICATORY MUSCLES IN VARIOUS
PROSTHETIC PROCEDURES

• BORDER MOULDING: While checking for the tray extensions in the

mandible contraction of Buccinator & Masseter almost completely
obliterates the sulcus. So cut back the periphery of the tray so that it
is about 2mm short of the position occupied by buccal sulcus in
function.

• FREEWAY SPACE: When the mandible is at rest it is supported by the

elevator group of muscles fibers which are not fully relaxed but are in
a state of partial contraction or tonus which is sufficient to balance
the tonus of the depressor muscles & gravity.
• Myofacial pain
• Myositis
• Hypermobility/ hypo mobility of
the muscle
• Trismus
• Bruxism
• Myospasm / muscle cramp
• Myofascial pain can be defined
as "pain associated with inflammation
or irritation of muscle or of the fascia
surrounding the muscle".

• Most commonly reported type of

masticatory muscle disorder.
• It is characterized by a dull regional
ache that increases during function.
• Palpation reveals tenderness of these
muscles.
• It is primary inflammation of muscle resulting from infection / trauma.
• It is characterized by constant acute pain in one or more of the
masticatory muscles usually accompanied by swelling, redness of
overlying skin & increase in temperature over the affected area.
• It results in jaw dysfunction & limited range of movement.
Hypermobility/ hypo mobility of the
muscle
• Disorder comes under hypermobility of syndrome is ‘’

Ehlers Danlos syndrome (EDS) is a group of hereditary connective tissue

disorders that manifests clinically with skin hyperelasticity, hypermobility
of joints, atrophic scarring, and fragility of blood vessels.
• Which sometimes results into hypermobility of the TMJ

• Instability of mandible during masticatory function as well as

maximal opening, which leads to protective muscle contraction which
involves Masster, Temporalis and the two pterygoids.
Trismus
• from the Greek word (“gnashing,” as in teeth),
refers to the restriction of the range of motion of
the jaws. Commonly referred to as “lockjaw,”
trismus typically stems from a sustained, tetanic
spasm of the muscles of mastication
Etiology :
• 1)Trauma to muscles or blood vessels in
infratemporal fossa associated with dental
injections of local anesthetics.
• 2)Haemorrhage
• 3) Pericoronitis
• 4) Odontogenic infections with spread involving
masticatory muscles,TMJ, bone or fascial spaces.
• 5)Parotitis
• 6)Otitis
• 7)Tetanus
Bruxism
• Bruxism is the parafunctional grinding of teeth;
an oral habit consisting of involuntary rhythmic or
spasmodic nonfunctional gnashing, grinding, or
clenching of teeth, in other than chewing
movements of the mandible, which may lead to
occlusal trauma; nocturnal bruxism, occlusal
neurosis, tooth grinding.(GPT9)

• Stressful events,
• Non stress related or hereditary
myospasm/ muscle cramps

• Acute condition resulting from a

sudden, involuntary & continuous
tonic contraction of muscle.
• It is characterized by localized
acute pain& severely limited range
of motion of the mandible.
• These characteristics coupled with
their sudden onset at rest allow the
clinician to differentiate myospasm
from other masticatory muscle
disorders.
Treatment Component description
Self-management Explanation regarding diagnosis, treatment, prognosis, and patient’s and doctor’s roles in therapy
Information, skills training, and adherence monitoring for patient to be competent with self-exercise,
thermal modalities, self-massage, diet and nutrition, bilateral chewing, yawn control, and
parafunctional behavior control

Physiotherapy Education regarding biomechanics of jaw, neck, and head posture and integrated movement patterns
Passive modalities (heat and cold therapy, ultrasound, laser, and TENS) for pain
Passive stretching and range of motion exercises
Posture therapy sufficient to regain a neutral zone
General exercise and conditioning program

Intraoral appliances Cover all the teeth on the arch the appliance is seated on
Adjust to achieve simultaneous contact against opposing teeth
Adjust to a stable comfortable mandibular posture
Does not alter mandibular position
Use during sleep and rely on behavioral methods for waking hours

Pharmacotherapy NSAIDs, acetaminophen, muscle relaxants, antianxiety agents, tricyclic antidepressants

Relaxation techniques Relaxation therapy

& Hypnosis
behavioural therapy Biofeedback
concluSion
• The masticatory muscles includes the vital part of the vital part of 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 prosthodontists.
• 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 proper management and periodical self examination of the muscles may
provide a greater chance of catching disease process at an early stage which
may be useful for its better prognosis.
Refrences
• Human anatomy- B D Chaurasiya (4thed)
• Grey’s anatomy – 38th edition
• M. K. Anand _ human anatomy 3rd ed
• Complete denture prosthodontics- john j sharry
• Burkett’s oral medicine diagnosis and treatment 13th ed
• Textbook of complete denture by Charles M Heartwell
• Inderbir singh (human embryology- 11ed)
Thank you !