Muscles of Mastication

1. MUSCLES OF MASTICATION PRESENTED BY: Dr. Anshul Sahu MDS 1ST Year

2. CONTENTS: Introduction Definitions Development Important facts about mastication

Features of Masticatory muscle Classification Primary muscles Accessory muscles Mandibular
movements and role played by muscles Masticatory muscle disorders Conclusion Reference

3. 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 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. Rhythmic opposition and separation of jaws with the involvement of teeth, lips ,cheeks
and tongue for chewing of food in order to prepare it for swallowing and digestion. 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.

4. 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 the mouth
& their role in the equilibrium created within the mouth. They also play a role in the configuration of
face. 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” Influence of these muscles in
prosthetic dentistry, defines the borders & peripheral extensions. A good knowledge of masticatory
system and functional efficiency is basic requirement for good prosthodontist.

5. DEFINITIONS: GPT 8 MUSCLE: An organ that by contraction produces movements of an animal; a

tissue composed of contractile cells or fibers that effect movement of an organ or part of the body.
MASTICATION Is defined as the process of chewing food in preparation for swallowing and digestion.

6. DEVELOPMENT: The muscular system develops from intra embryonic mesoderm from embryonic
cells called myoblast. Muscles of mastication are derived from first brachial arch that is mandibular arch.
5th- 6th week Primitive cells form and differentiate Get oriented to site of origin and insertion 7th
week Mandibular arch mass enlarges Cell migrate to areas of formation of 4 major muscles of
mastication Cell differentiation occurs before formation of facial arch. 10th week Muscle mass well
organized Nerve masses get incorporated

7. IMPORTANT FACTS ABOUT MASTICATION: There are about 15 chews in a series from the time of
food entry until swallowing Average jaw opening during chewing is between 16-20mm Average
lateral displacement on chewing is between 3 and 5mm Duration of masticatory cycle varies between
0.6 and 1 sec Men chew faster and have a shorter occlusal phase than women, it also depends on the
type of food Masticatory forces: The aver maximum sustainable biting force is 756N{170 pounds}.
Molar region: Biting force range 400-890N Premolar region: Biting force range 222-445N Canine
region: Biting force range 133-334N Incisor region: Biting force range 89-111N

8. FEATURES OF MASTICATORY MUSCLE: Have shorter contraction times than most other body
muscles Incorporate more of muscle spindles to monitor their activity Do not have Golgi tendon
organs to monitor tension Do not get fatigued easily Psychological stress increases the activity of jaw
closing muscles Occlusal interferences cause a hypertonic synchronous muscle activity Closing
movement also determined by the height of the teeth

9. CLASSIFICATION: PRIMARY MUSCLES Masseter Temporalis Lateral Pterygoid Medial

Pterygoid ACCESSORY MUSCLES Digastric Stylohyoid Mylohyoid Geniohyoid

10. FUNCTIONALLY CLASSIFIED AS JAW ELEVATORS Masseter Temporalis Medial pterygoid Upper
head of lateral pterygoid JAW DEPRESSORS Lower head of lateral pterygoid Anterior digastric
Geniohyoid Mylohyoid

11. PRIMARY MUSCLES OF MASTICATION

12. MASSETER MUSCLE

13. Greek word “maseter”- a chewer It is one of the most powerful muscles involved in the power
stroke closure of the mandible This is a quadrilateral muscle, partly tendinous, partly fleshy which
covers the lateral part of ramus of mandible. It consists of 3 layers which blend anteriorly. Multiple
arrangement of fibers: Superficial Middle Deep Deep Superficial

14. ORIGIN: SUPERFICIAL LAYER (LARGEST) Maxillary process of zygomatic bone Anterior 2/3rd of
inferior border of zygomatic arch MIDDLE LAYER: Medial aspect of anterior 2/3rd of zygomatic arch
Lower border of posterior third of zygomatic arch DEEP LAYER: Deep surface of zygomatic arch

15. INSERTION: SUPERFICIAL LAYER (LARGEST) Angle of mandible Lower posterior half of lateral
surface of mandibular ramus MIDDLE LAYER: Middle part of the ramus of mandible DEEP LAYER:
Upper part of mandibular ramus Coronoid process

16. NERVE SUPPLY: Supplied by masseteric nerve a branch of anterior division of mandibular nerve
BLOOD SUPPLY: Supplied by masseteric artery branch of maxillary artery Venous drainage through
masseteric vein

17. FUNCTION: Elevates the mandible to close the mouth and to occlude the teeth in mastication. Its
activity in the resting position is minimal. It has a small effect in side-to-side movement, protraction
and retraction.

18. PALPATION: The patient is asked to clench their teeth and, using both hands, the practitioner
palpates the masseter muscles on both sides extra orally, making sure that the patient continues to
clench during the procedure. Palpate the origin of the masseter bilaterally along the zygomatic arch
and continue to palpate down the body of the mandible where the masseter is attached. Anterior
Superior Position Posterior Inferior Position

19. CLINICAL IMPORTANCE OF MASSETER: On Denture Border An active masseter muscle will create a
concavity in the outline of the distobuccal border and a less active muscle may result in a convex border.
In this area the buccal flange must converge medially to avoid displacement due to contraction of the
masseter muscle because the muscle fibers in that area are vertical and oblique

20. EFFECT OF MASSETER MUSCLE ON THE DISTOBUCCAL BORDER: A. Moderate activity will create a
straight line B. An active muscle will create a concavity. C. An inactive muscle will create a convexity.

21. TEMPORALIS MUSCLE

22. Extensive fan-shaped muscle that covers the temporal region. It is powerful masticatory muscle
that can easily be seen & felt during closure of mandible. Bulk and length of the fibers are larger than
that of medial pterygoid and masseter. It is the largest masticatory muscle but not considered to be
the most powerful muscle.

23. ORIGIN: Origin is from inferior temporal line, floor of the temporal fossa and from the overlying
temporal fascia Divided into 3 areas: Anterior temporal Middle temporal Posterior temporal
Anterior Middle Posterior

24. INSERTION: Margins & deep surface of the coronoid process Anterior border of ramus of
mandible NERVE SUPPLY: Deep temporal branches from anterior division of mandibular nerve BLOOD
SUPPLY: Superficial temporal artery branch of maxillary artery superficial temporal vein & middle
temporal vein

25. FUNCTION: Anterior fibers elevate the mandible Posterior fibers retract the mandible Crushing
of food between the molars Posterior fibers draw the mandible backwards after it has been protruded
It is also a contribute side to side grinding movement

26. PALPATION: The muscle is divided into three functional areas and therefore each area is
independently palpated. To locate the muscle, have the patient clench. The anterior region is
palpated above the zygomatic arch and anterior to the TMJ. The middle region is palpated directly
above the TMJ and superior to the zygomatic arch. The posterior region is palpated above and behind
the ear. Anterior Middle Posterior

27. CLINICAL IMPORTANCE OF TEMPORALIS MUSCLE: Sudden contraction of temporalis muscle will
result in coronoid fracture, which is rare. The patient is instructed to close and move his mandible
from side to side and then immediately asked to open wide. The side to side motion records the
activity of the coronoid process in a closed position whereas opening causes the coronoid to sweep past
the denture periphery.

28. LATERAL PTERYGOID MUSCLE

29. Also called as external pterygoid muscle. It is the muscle of mastication that occupy primarily a
horizontal position. It is a thick, short, conical and triangular muscle with two heads: Superior head
Inferior head Inferior head Superior headInfratemporal creast

30. ORIGIN: Superior head: Infratemporal surface & infratemporal crest of the greater wing of the
sphenoid bone. Inferior head: Lateral surface of the lateral pterygoid plate. INSERTION: Fibers run
backwards and laterally and converge into the pterygoid fovea on anterior surface of neck of mandible
Into anterior margin of articular disc and capsule of TMJ Superior Inferior

31. NERVE SUPPLY: Mandibular nerve via lateral pterygoid nerve from anterior trunk BLOOD SUPPLY:
Maxillary artery Ascending palatine artery FUNCTION: Acting together, these muscles protrude the
mandible and depress the chin. Acting alone & alternately, they produce side –to –side movements of
mandible

32. PALPATION: Placing the forefinger, or the little finger, over the buccal area of the maxillary third
molar region and exerting pressure in a posterior, superior, and medial direction behind the maxillary
tuberosity.
33. CLINICAL IMPORTANCE OF LATERAL PTERYGOID MUSCLE: Most commonly involved muscle in
MPDS Unilateral failure of lateral pterygoid muscle to contract results in deviation of the mandible
toward the affected side on opening Bilateral failure results in limited opening, loss of protrusion and
loss of full lateral deviation In patients with nonworking side interferences, the lateral pterygoid
muscle on the opposite of the interference is sometimes painful

34. MEDIAL PTERYGOID MUSCLE

35. It is also called as the internal pterygoid muscle. It is almost a mirror-like image of the masseter
muscle. It is rhomboidal and runs practically in the same direction on the inner surface of the mandible
It consist of two heads which differ in origin: Superficial Deep

36. ORIGIN: Superficial head from maxillary tuberosity Deep head from medial surface of lateral
pterygoid plate and part of palatine bone INSERTION: Fibers run backwards, downwards and Laterally
into the roughened area of medial surface of the angle mandible Origin Insertion

37. NERVE SUPPLY: Branch of the main trunk of mandibular nerve BLOOD SUPPLY: Pterygoid branch
of 2nd part of maxillary artery FUNCTION: It helps to elevate the mandible and closes the jaws .
Acting together, they help to protrude the mandible. Acting alone, it protrudes the side of the jaw.
Acting alternately, they produce a grinding motion

38. PALPATION: It can be palpated by placing the finger on the lateral aspect of the pharyngeal wall of
the throat, this palpation is difficult and sometimes uncomfortable for the patient. Functional
manipulation is done when the muscle becomes fatigued and symptomatic. The muscle contracts as
the teeth are coming in contact. Also stretches when the mouth is open wide.

39. CLINICAL IMPORTANCE OF MEDIAL PTERYGOID MUSCLE: Most commonly involved in MPDS
Trismus following inferior alveolar nerve block is mostly due to involvement of medial pterygoid muscle
The medial pterygoid muscle is not usually involved in gnathic dysfunctions but when they are
hypertonic, the patient is usually conscious of a feeling of fullness in the throat and an occasionally pain
on swallowing

40. ACCESSORY MUSCLES OF MASTICATION

41. DIGASTRIC MUSCLE Formed by 2 belly like masses of muscle tissue joined by an intermediate
tendon. ORIGIN: Anterior belly from diagastric fossa of mandible, lateral to mental symphysis.
Posterior belly from mastoid notch of temporal bone. INSERTION: Both meet at the intermediate
tendon and held by the fibrous pulley to the hyoid bone.

42. NERVE SUPPLY: Anterior belly by nerve to Mylohyoid Posterior belly by –facial nerve FUNCTION:
Depression of jaw, both sides contract simultaneously Provide antagonism to elevation of mandible
Elevation of hyoid during swallowing

43. MYLOHYOID MUSCLE Flat, triangular muscle lying deep to the anterior belly of digastric It forms
the floor of the mouth. Flat triangular ORIGIN: Mylohyoid line of mandible. INSERTION: Middle and
anterior fibers into median raphae. Posterior fibers body of hyoid bone.

44. NERVE SUPPLY: Nerve to Mylohyoid FUNCTION: Helps in depression of mandible, elevation of
hyoid bone It elevates the floor of mouth to help in deglutition.
45. CLINICAL IMPORTANCE OF MYLOHYOID MUSCLE: ON DENTURE BORDERS: Mylohyoid area Instruct
the patient to place the tip of his tongue into the upper and lower vestibules on the right and left side.
The area to be molded is reheated and the patient and is instructed to swallow two or three times in
rapid succession. The tongue movements raise the level of the floor of the mouth through contraction
of the mylohyoid muscle.

46. GENIOHYOID MUSCLE Short and narrow muscle lies above Mylohyoid ORIGIN: Inferior mental
spine (genial tubercle) INSERTION: Fibers run backwards, downwards to be inserted into the anterior
surface of the body of hyoid bone.

47. NERVE SUPPLY: 1st Cranial nerve, the fibers pass through hypoglossal nerve. FUNCTION: Carry
hyoid bone and the tongue upward during deglutition.

48. CLINICAL IMPORTANCE OF GENIOHYOID MUSCLE: For mandibular impressions: On recording labial
flange and labial frenum The lip is massaged from side to side to mold the compound to desired
functional extension. In order to activate the mentalis muscle the patient is asked to pout or lick his
lower lip. For maxillary impressions in labial flange and labial frenum area: Manually mold the
compound by externally moving the lip side to side, simultaneously applying finger pressure to control
the width of the border Lift the patients upper lip and vertically place the frenum into the softened
compound and mold with your fingers using a side to side external motion

49. STYLOHYOID MUSCLE Small muscle that lies along the upper border of the posterior belly of digastric
muscle. ORIGIN: From the lateral & inferior surface of the styloid process of temporal bone.
INSERTION: Is inserted into the body of the hyoid bone, at its junction with the greater cornu. NERVE
SUPPLY: Branch from facial nerve FUNCTION: Pulls hyoid bone upwards and backwards

50. BUCCINATOR MUSCLE It is an accessory muscle of mastication, occupying the gap between mandible
and maxilla forming important part of the cheek. Also known as muscle of cheek. ORIGIN: Upper
fibers: From maxilla opposite molar teeth Middle fibers: From pterygomandibular raphe Lower
fibers: From mandible opposite molar INSERTION: Upper fibers: Straight to the upper lip Middle
fibers: Decussate before passing to the lips Lower fibers: Straight to the lower lip

51. NERVE SUPPLY: Buccal branch of facial nerve FUNCTION: Flatten cheek against gums and teeth,
prevent accumulation of food in the vestibule of mouth and to bring the food on to the occlusal table
during mastication.

52. CLINICAL IMPORTANCE OF BUCCINATOR MUSCLE: ON DENTURE BORDER For buccal flange area in
mandibular impressions: The area is moulded by massaging the cheek in an anterior- posterior
direction using moderate manual pressure against the compound. This moves the fibers of the
buccinators muscle and the tissues of the cheek in the direction of functional action of the buccinators
muscle. In maxillary impressions: The cheek is manually molded in anterior-posterior direction using
slight finger pressure against the compound or the patient is instructed to control the amount of
movement by sucking action.

53. MANDIBULAR MOVEMENTS AND ROLE PLAYED BY MUSCLES: 1. ELEVATION: Prime Movers: (a)
Masseter (b) Medial Pterygoid (c) Temporalis Antagonist: (a) Superior Lateral Pterygoid 2.
DEPRESSION: Prime movers: (a) Inferior lateral pterygoid (b) Digastric Antagonist: (a) Elevator group
muscles
54. 3. PROTRUSION: Prime Movers: (a) Inferior Lateral Pterygoid (b) Masseter (c) Medial Pterygoid
Antagonist: (a) Digastric (b) Posterior Temporal 4. RETRUSION: Prime movers: (a) Posterior & Middle
Temporal (b) Digastric Antagonist: (a) Inferior Lateral Pterygoid 5. LATERAL: Prime movers: (a)
Working side of temporal muscle Antagonist: (a) Non working side of Pterygoid muscle

55. MASTICATORY MUSCLE DISORDERS: SOME OF THE COMMON MASTICATORY MUSCLE DISORDERS
INVOLVE: Trismus Bruxism Tetanus Congenital hyperplasia/ hypoplasia Hypermobility/ hypo
mobility of the muscle Muscle pains MPDS Myositis ossificans etc. Temporal tendonitis

56. TRISMUS Due to prolonged tetanic spasm of the jaw muscles by which normal opening of the
mouth is restricted. Restricted jaw movements regardless of the etiology. CAUSES: Intracapsular:
Arthritis Condylar fracture Pericapsular: Irradiation Dislocation Infection & inflammation Muscular: TMJ
dysfunction syndrome Tetanus Other: Oral sub mucous fibrosis Systemic sclerosis Fractures

57. PROBLEMS: Eating issues Oral hygiene issues Swallowing issues Joint immobilization
TREATMENT: Removal of the cause Heat therapy Warm saline rinses NSAIDs Passive muscle
stretching exercises

58. BRUXISM Bruxism is the clenching or grinding of the teeth when the individual is not chewing or
swallowing It can occur as a brief rhythmic strong contractions of the jaw muscles during eccentric
lateral jaw movements, or in maximum intercuspation, which is called clenching. CAUSES: Associated
with stressful events Non stress related or hereditary Bruxism may lead to: Tooth wear Fracture of the
teeth or restoration Muscle hypertrophy

59. Increased muscle tension is directly related to stress activity during the day. TREATMENT:
Coronoplasty Maxillary stabilization appliance

60. TETANUS (LOCK JAW) Tetanus is a disease of the nervous system characterized by intense activity
of motor neuron and resulting in severe muscle spasm Caused by exotoxins of gram positive bacillus,
clostridium tetani. CLINICAL FEATURES: Pain and stiffness in the jaws and neck muscles ,with muscle
rigidity producing trismus and dysphagia Rigidity of facial muscles Sometimes whole body becomes
affected. TREATMENT: All patients should receive antimicrobial drugs Active and passive
immunization. Surgical wound care Anticonvulsant if indicated

61. MYOFACIAL PAIN DYSFUNCTION SYNDROME (MPDS) Muscular disorders (myofacial pain disorders)
are the most common cause of TMJ pain associated with masticatory muscles. Common etiologies
include: 1. Many patient with “high stress level” 2. Poor habits including gum chewing, bruxism, hard
candy chewing 3. Poor dentition TREATMENT: Its treatment includes 4 phases of therapy which
includes muscle exercises and drugs involving NSAIDs and muscle relaxants. A bite appliance is also
worn by the patient in the furthur stages to ‘splint’ the muscle movement.

62. CONGENITAL HYPOPLASIA/ HYPERPLASIA It occurs very rarely, and is more common in masseter
and orbicularis oris. Its oral symptoms include enlargement or decreased size of the affected muscle,
which may show an asymmetric facial pattern and stiffness in the temporo-mandibular joint. It may or
may not be associated with hypermobility/ hypo mobility of the muscles.

63. MUSCLE HYPERMOBILITY/ HYPOMOBILITY This disorder involves extreme or diminished activity of
the masticatory muscles. Its etiology includes various factors such as: Decreased/ increased
threshold potential of neural activity. Parkinsonism Facial paralysis Nerve decompression
Secondary involvement of systemic diseases.

64. 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 prosthodontist During functional impression making Accurate
recording of various clinical parameters like vertical dimension, centric relation Morphology of
artificial tooth Maintenance of arch form 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.

65. REFERENCES: Human anatomy by B.D. Chaurasia, 3rd ed. Human anatomy by dental students
by M.K. Anand, 1st ed. Burkits oral medicine diagnosis & treatment 10th edition Textbook of
complete dentures by Charles M heartwell Complete denture prosthodontics by John J Sharry.

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