Beruflich Dokumente
Kultur Dokumente
FACIAL
EXPRESSIONS
Presented by:
Harsha vardhan k.v
Department of
prosthodontics
SVSIDS
CONTENTS
INTRODUCTION
EMBRYOLOGY
CLASSIFICATION
REFERENCES
INTRODUCTION
Face is Window of the soul. Facial expressions are a form of nonverbal
communication. Facial expression results from one or more motions or positions of the
muscles of the face. These movements convey the emotional state of the individual to
observers.
The importance of facial musculature in dentistry is emphasized, to create a desire
to learn more, and point out what information is known or felt to be of direct consequence
to the art and science of complete denture prosthodontics.
The action of muscles as prime movers of the mandible and hence as the power for
repeated occlusion of the teeth. They are active during mastication, deglutition and speech.
Has a direct or indirect influence on the peripheral extensions, shape and thickness of
denture bases, the position of the teeth both horizontally and vertically and facial
appearance.
The import of the raised eye brow, a contemplative frown or any contagious smile
is often far more a key to the individual than the spoken words which may accompany
these expressions. The fleeting and varied facial movements is responsible for personality
and are characteristics of an individual.
The modifications or loss of such characteristics has a tremendous psychologic
impact on a patient.Preservation of these important functions is necessarily the
responsibility of the dentist charged with prosthodontic treatment of the patient.
To know about various expression we should first know the anatomy of muscles of
facial expression.
The muscles of facial expression are located in the subcutaneous tissue, originating from
bone or fascia, and inserting onto the skin.
By contracting, the muscles pull on the skin and exert their effects. They are the only group
of muscles that insert into skin.
They migrate from the arch, taking their nerve supply with them.
EMBRIOLOGY
These muscles have a common embryonic origin the 2nd pharyngeal arch.
The cartilage of the second or hyoid arch (Reicherts cartilage) gives rise to the stapes,
styloid process of the temporal bone, stylohyoid ligament, and ventrally, the lesser horn
and upper part of the body of the hyoid bone.
Muscles of the hyoid arch are the stapedius, stylohyoid, posterior belly of the digastric,
auricular, and muscles of facial expression.
CLASSIFICATION
The facial muscles can broadly be split into three groups; orbital, nasal and oral.
ORBITAL GROUP
1. ORBICULARIS OCULII
2. CORRUGATOR SUPERCILLI
3. LEVATOR PALPEBRE SUPERIORIS
NASAL GROUP
1. PROCERUS
2. COMPRESSOR NARIS
3. DILATOR NARIS
4. DEPRESSOR SEPTI
ORAL GROUP
1. ORBICULARIS ORIS
2. LEVATOR LABII SUPERIORIS
3. ZYGOMATICUS MAJOR
4. LEVATOR ANGULI ORIS
5. ZYGOMATICUS MINOR
6. DEPRESSOR ANGULI ORIS
7. DEPRESSOR LABII INFERIORIS
8. MENTALIS
9. RISORIUS
10. BUCCINATOR
This muscle, closes the lids when blinking and allows you to squint or wink your eye, is
one of the muscle that affect the functions of the lids.
The muscle has fibers that form two semicircles, one above and one below the eye.
These fibers arise on the nasal part of the frontal bone, on the frontal process of the maxilla
in front of the lacrimal goove, and on the borders of the medial canthal tendon.
Action
Orbital part - Provides voluntary eyelid closure, such as a response to bright light.
Lacrimal Part - When the eyelid closes, the lacrimal portion pulls the inside corners of
the lid toward the nose and turns them inward slightly. This action positions tiny holes,
called puncta, in the most favorable position to collect tears.
BLOOD SUPPLY
Maxillary artery
Opthalmic artery
Facial artery
NERVE SUPPLY
CLINICAL SIGNIFICANCE
As it is the only muscle capable of closing the eyelid, disruption of the function of this
muscle produces exposure of the eyeball, requiring lubricants and possibly, surgery.
These are very superficial muscles whose attachments are not to bone but to underlying
fascia.
Most people cannot use these muscles, but if they can, they are able to wiggle their ears
The buccinator is the muscle of the cheek which aids in chewing by holding the cheek close to the
teeth.
It arises from the outer surfaces of the maxilla, the mandible, and the superior constrictor
pharyngis muscle, and is joined to that muscle by the pterygomandibular raphe.
It inserts into the orbicularis oris and the modiolus, beneath the risorius muscle.
ACTION
Flattens cheek against gums and teeth which prevents food accumulation
Whistling muscle
BLOOD SUPPLY
Facial artery
NERVE SUPPLY
PROSTHODONTIC SIGNIFICANCE
1. In lower jaw it becomes part of denture bearing area in buccal shelf region.
2. Its action is parallel to plane of occlusion.
3. Activation of masseter pushes the buccinator medially in distobuccal region, which
accommodates masseteric notch in the denture border. If not recorded properly can cause
dislodging of denture.
4. In upper jaw- its position of origin in the upper jaw determines the vertical height of distobuccal
flange of the maxillary denture.
5.
If the Distobuccal flange of the denture base is not contoured to allow freedom for this action,
the denture will be displaced.
6. Its action pulls the corner of the mouth laterally and posteriorly.
This muscle is used when you to close your mouth and to pout.
It has some similarities with the orbicularis oculi muscle, discussed above, in that its fibers
encircle the mouth just as the fibers of the oculi muscle encircle the eye, and both are sphincter
muscles.
Most of these fibers go around the mouth, but unlike the fibers of the oculi muscle, they are in
four sections with some of the fibers attaching to the underside of the skin.
ACTION
1. Puckering of lip
2. Closes mouth
3. Pursing of lips
BLOOD SUPPLY
1. Superior labial artery
2. Inferior labial artery
3. Infraorbital artery
4. Mental artery
5. Transverse facial artery
NERVE SUPPLY
1. Buccal
2. Marginal mandibular branch of facial nerve
PROSTHODONTIC SIGNIFICANCE
1. Upper lip is supported by maxillary anterior teeth and not the denture border.
2. When teeth are in occlusion, the superior border of the lower lip is supported by incisal
third of the maxillary anterior teeth. If not so lower lip would get caught between the
anterior teeth during occlusal contacting.
3. When muscles are relaxed, lips become flaccid. This can happen with the jaws open and
is important in impression making.
4. Angle of mouth are easily irritated when an impression tray is inserted.
5. On wide opening the Orbicularis oris muscle along with the muscle of lower lip becomes
stretched and the sulcus will be narrow.
6. If the flange is thick, this would displace the mandibular denture and hence impressions
will be narrow in the anterior region.
It originates on the maxilla just below the Infraorbital foramen and inserts into the modiolus.
The depressor anguli oris muscle of the lower lip aids in drawing the lower lip downward.
MODIOLUS
1. orbicularis oris,
2. buccinator,
3. levator anguli oris,
4. depressor anguli oris,
5. zygomaticus major,
6. risorius,
7.
platysma,
PROSTHODONTIC SIGNIFICANCE
The importance of this hub /nave region where all the radial muscles converge is recognized by
us.
Lightoller describes it as a thick mass just distal to the corner of mouth with a total vertical depth
of 3.5-4.5 mm from the exterior to the mucous membrane.
It is flattened cone shape and extreme mobile. It can be fixed instantly and moved voluntarily.
Dentures should be constructed not only to accommodate it but also to allow for its flexibility and
for its radial muscle components.
PLATYSMA
ORIGIN
INSERTION
Posterior fibers to the skin of the lower face and lips and may be continuous with the risorius
ACTION
BLOOD SUPPLY
Branches of the Submental artery and Suprascapular artery
NERVE SUPPLY
Cervical branch of the facial nerve
Zygomaticus major.m
IMPORTANCE OF SMILE
Smile is produced by the elevation of the lips assisted by retractors and the true laughter
occurs when the Orbicularis oris is completely and involuntarily inhibited.
A prosthodontic significance of a smile is the recognition that if one part of this complex
is out of position will affect other components which make up the smile.
The lips are drawn against the teeth by the elevation of the maxillary lip and the
retraction of the corner of mouth.
So the placement of teeth become extremity important in forming the backdrop for the
smile.
If the teeth are placed too far labially, the orbicularis oris is stretched and this effect tends
to exert a dislodging effect on the maxillary denture.
If there is a lack of maxillary lip support and teeth are set on the crest of the ridge, there
is a downward cast to the smile which is similar to the expression of grief and this is one
of the pitiful prosthodontic error.
SURPRISE
FROWNING
ANGER
SADNESS
Angle of the mouth drawn downwards and laterally - Depressor angulii oris.M
GRINNING
DOUBT
WHISTLING
Pressing the cheek against gum with pursing of mouth with small opening
Buccinator.M
MUSCLE DISORDERS
HEMIFACIAL SPASM
Begins in the periorbital muscles but soon spreads to the entire half face.
FACIAL HEMIATROPY
ParryRomberg syndrome (also known as progressive hemi facial atrophy)
Is a rare neurocutaneous syndrome
Slowly progressive wasting of subcutaneous fat skin ,cartilage, bone and muscle
MYSTHENIA GRAVIS
Most frequently involved muscle are that of mastication and facial muscle
Difficulty in mastication and deglutition and drooping of jaw . Speech is slow and
slurred
Diplopia and ptosis along with drooping of eyelid lead to sorrowful appearance
BELLS PALSY
Abrupt isolated unilateral peripheral facial nerve paralysis without detectable cause
Inflammation of facial nerve with resultant edema cause nerve compression while it
passes through temporal bone
Ear
- retroauricular and subauricular nodes
All drain into cervical lymph nodes around the jugular vein.
CONCLUSION
We should
1. Consider the role which the facial muscles play in expression
2. Analyze these muscles in terms of the expressions of various emotions
3. Evaluate their prosthodontic significance
REFERENCES
Anatomy of facial expression and its prosthodontic significance J.P.D 1962 12-6,1020
42
Lightoller G.S : Facial muscles: the modiolus and muscles surrounding the rima oris with
some remarks about the paniculus adiposus J.anat 60:1-85, 1925-26