Mastication Physio
Mastication Physio
Mastication Physio
Depressors (Only when the hyoid Muscles of the lips & cheeks
bone is fixed by infrahyoid muscles
Tongue muscles
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Muscles of mastication
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Depressors
suprahyoid infrahyoid
Digastric – Sternohyoid
main
depressor
Mylohyoid Thyrohyoid
Stylohyoid
Omohyoid
Geniohyoid
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• Perioral muscles
• Same functions as buccinator during mastication but
anteriorly
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Rest position
• Teeth are held slightly separate
• Mandible is held by the sling of medial pterygoid &
Masseter
• TMJ is not loaded
• Freeway space *average (2-3mm) = interdental space =
speech space
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• Transport
• To & between premolar & Molar teeth
• Mastication
• Fragmentation of food by approximation (occlusion)
• Moving mandible against maxilla
• Deglutition (swallowing)
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Incision
• Consists of
• Protrusive movement
• Condylar heads sliding forwards &
downwards onto articular eminence
• Depression in protruded position
• Hinge movement to elevate the
body to edge-edge incisal position
• Acting muscles
• Protrusion – Lateral pterygoid
• Final elevation – Medial perygoid
& Masseter
• Maximum separation 3 cm
• Beyond that - dislocation
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Mastication
• Primary role of mastication is to break down
foodstuffs for subsequent digestion by means of
the masticatory forces generated between teeth
•
• Movement of the body of the mandible
• In a vertical plane
• In a horizontal plane
• Movement of the tongue, lips & cheeks
• To control position and form of food
• Food reduced in size by
• Teeth
• Tongue against palate
• Food mixed with saliva – softened mass (bolus)
• Precision – rarity of biting tongue, lips or cheeks
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Mastication
3-Inferior head of
Latral pterygoid
• Degree of separation
• depends on size & consistency of food
• Varies in one person
• Lower incisors move 10 – 15 mm downwards
Control of mastication
• Voluntary initiation
• Involuntary periods also occur
• Reflex activity (ex. bite hard object)
• Can be overridden by voluntary control
Control of mastication
• Central rhythm generator : the area controlling the
mastication in brainstem
Control of mastication
• Incision / food taken into the mouth »»
• Rhythmic pattern of mastication »»
• Receptors in PDL, muscles, joints
• Pressure & touch receptors in tongue & palate
• Monitor hardness of food & degree of comminution
»»
• Feedback to
• Motor neurons
• Rhythm generator
• Cerebellum
• Adjust the activity of the muscles »»
• Soft food is chewed faster than hard food
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Control of mastication
• Cycle is longer at beginning of ingestion
• Food become smaller so chewing cycle become shorter
• Different types of food fragment in different ways
• Food bolus is judges by oral receptors to be ready for
swallowing
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Control of mastication
• Amount of chewing before swallowing
• Characteristic of the individual
• Influenced by nature of food
• Number of strokes before swallowing
• Men > women
• Women > children
• Not markedly influenced by state of dentition
• Influenced by efficiency of food comminution
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Bite force
• Force measured by a gnathodynamometer
Functions of chewing
• No large particles damaging the esophageal or gastric
mucosa
• Reduce amount of digestion in stomach
• Maintenance of oral mucosal health
• Psychological value
• Fulfilling emotional needs (gum & tobacco chewing
• Satisfaction or calming effect
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Masticatory reflexes
Modification of central rhythm •
Unloading
reflex
Jaw jerk reflex 35
Unloading reflex
• Control of mastication – a protective mechanism
• Sudden reduction in the resistance of a food particle »»
(peanut)
• Sudden inactivation of massetric muscle spindles »»
• Massetric activity is decreased »»
• Immediate stop in closure
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Swallowing
◦ A complex of true reflex actions.
◦ Unlike mastication which is sensormotor behavior learned
after birth , swallowing is an innate
Complex :
Dual function of pharynx:
◦ Part of digestive system.
◦ Route for air passage to the lungs.
Infants vs Adults
( Pharynx, Larynx Anatomy)
Suckling
◦ Is another example of a complex orofacial
sensorimotor behavior
◦ Very primitive reflex.
◦ Demonstrated as early as 20 weeks in utero.
◦ Fully developed just before birth.
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Suckling
◦ Baby pulls & sucks the nipple (areola is held in the
mouth).
◦ Nipple is pulled as back as possible hard & soft palates.
◦ Tooth pads are not approximated.
◦ Tongue is protruded & in contact with lower lip.
Suckling
◦ Lower jaw is lowered and raised alternatively:
◦ Jaw lowered body of tongue moves downwards & forwards
◦ Negative pressure – facilitates passage of milk from nipple.
◦ Airway is maintained
Bottle Feeding
Few seconds
Bolus formation passed back in the
mouth
Lasts 1 second Voluntary
Reflex
Within a second
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Oral Phase
◦ Two phases:
Bolus Formation
Pharyngeal Phase
The larynx is displaced upward and forward as the epiglottis
tilts backward
Esophageal Phase
Respiration is reestablished
*Matsuo et al 2009, Anatomy and Physiology of Feeding and Swallowing – Normal and
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Frequency of Swallowing
◦ ~600 / 24 hrs.
◦ ¼ during food ingestion (~150).
◦ ¾ for saliva (~450) accumulation of 5ml volume
of saliva triggers swallowing reflex.
◦ During sleep ~6 / hr.
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Protective Reflexes 57
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Gagging(Retching)
Irritation or noxious stimulation of the posterior part of the oral
cavity
Gagging or retching
Gagging (Retching)
Thank you•