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INCISION

If we want to incise an apple, first, we have to open and then protrude the mandible. So, the condylar heads will slide forward and downwards onto articular eminence. Then, we depress the mandible in a protruded position. So, when we open our mouth wide, we are able to see the condyle is at the most forward position .So, if we want to incise the apple, we must close our mouth in order to bite it thoroughly. So, here we have hinge movement to elevate the body of mandible to edge-edge incisal position, and this situation is different from the situation of opening and closing our mouth like what weve discussed last week. In normal situation of opening / closing our mandible without incision, our condyle will slide backwards and it will rotate.

Muscles that are important for the protrusion of mandible is the lateral pterygoid and for the final elevation of mandible are the medial pterygoid and the masseter muscle . The maximum separation between maxilla and mandibular incisors respectively is 3 cm, and this is important to examine people with serious Temporomandibular Joint (TMJ) problems. To check whether youre okay, try to put 3 fingers inside your mouth vertically, if you could insert 3 fingers inside your mouth without any difficulties then you have a normal mouth opening and this varies from one person to another. In females the maximum separation of incisors usually is less than 3cm. Dentists usually make mistakes during this examination by putting their own fingers and not the patients. EXAMPLE :Imagine that you are a very big male and examining a tiny female, of course your 3 fingers wont fit in the girls mouth and you will come to a conclusion that the patient has a limited mouth opening. The correct way of doing this test is to make sure the patient use her/his own fingers to perform the test.

If we open beyond the maximum separation of incisors, this will lead to dislocation of the condyle. Normally the head of the condyle is located at the glenoid fossa and the articular eminence. Sometimes if we want to open wide or to exceed the maximum opening, In some people who lacks or they do not have a tense ligament,

dislocation of condyle in some people who dont have ligament , they are unlucky , because when they open their mouth to the maximum , the condyle moves forward . posterior to these location , we have the articular eminence , the condyle is not going back to its position . this is called temporary tmj dislocation . this people is feel severe pain because all the muscles are tense now . this people can't close the mouth , because the condyle can't move back to its normal location . there are 2 circumstances . the 1st is when the patient is yawning , sometime patient can't control the movement of mandible . you've may end up with dislocational of condyle . and some time , if you're dentist and treating a patient , and you told the patient to open his mouth . the patient have to open his mouth to its maximum position because you have to do surgery on his posterior teeth , this will end up with dislocation of the condyle . the condyle moving beyond the articular eminence . how can we set this mandible to its normal position . hold the mandible on the 3rd molar region , downward and backward . and usually , male dentists do this relocation of the condyle . what happen if you happen if you hold the mandible and move it backward , you can fracture the condyle . because the mandible can't move backward , because it will make contact with articular eminence . the eminence will be the obstacle . if you're a powerful man , you shouldn't push the mandible backward . you should move the mandible downward and then backward . unwise , it will breaks the condyle . incising resistant food sometimes we find something hard on apple's surface . when we find the resistance on food , the mandible begins to retrude ,but , the mandible stops until the resistance is felt . the mandible moves lateral and medial , (side to side oscillating retrusive slide , some lateral movement in protusion) until the food separates . mandible drops slightly to release the particle , and finally the lips guide it toward cheek teeth .

incising moderately resistant & soft food when we eat moderately resistant food like a burger , we will find that , our mandible start to slide back to intercuspaltation position . the food will separates in scissor-blade movement . but when we eat soft food , such as a piece of cake , this will be sheared by insicors . this will not cut all the way through . its just like separated , and the food become thin and parts . the food become thinner and thinner , until it becomes to parts . if you eat a cake , you dont want to go all the way through , but you just go for some distance , and you will cut the cake without go through all the way . incising & head movement this process is more apparent in carnivores . the incisors of the carnivores grip the food , and been fractured by downward jerk of the head . food transport muscles - toungue , lips , & cheek muscles - pass food back & forth between teeth extrinsic muscle of the tongue - genioglossus - hyoglossus - chondroglossus - styloglossus - palatoglossus intrinsic tongue muscle - superior longitudinal [shorten the tongue & elevates its edges] - inferior longitudinal [ shorten the tongue & depress its edges] - tranverse [elongate & narrow the tongue] - vertical [broaden & flatten the tongue]

facial muscles involved in food transport - buccinator ~pushes food back between occkusal surfaces ~opposes outward pressre of the tongue ~aids in transverse movement of food during mastication ~storage of food during mastication - less important in humans - perioral muscles ~same function as buccinator during mastication but anteriorly mastication is a complex process . by moving the body of the mandible in a verticle plane and in a horizontal plane . by moving the tongue , lips , & cheeks to control position and form of food . food reduced in size by teeth and movement of tongue . the food will mixed with saliva and eventually it will become softened mass (bolus) . the precision of the oral prevent bitting tongue , lips , or cheeks . MASTICATION

There are 4 phases of mastication 1. Jaw opening phase Increasing separation of occlusal teeth 2. Rapid jaw closing phase Occlusal surfaces are brought together 3. Slow jaw closing phase Food particles are crushed 4. Tooth contact phase (power phase) Cut pieces of food

*THE DOCTOR SKIP THE NEXT SLIDES BECAUSE WE ALREADY COVERED IT IN H & N ANATOMY*

Control of Mastication

VOLUNTARY

INVOLUNTARY

1. The control of mastication involves 2 steps. The 1st one is INVOLUNTARY and then by VOLUNTARY. We already know that we can masticate voluntarily. But sometimes when we are eating and we are doing something else, our jaw is still working. That is when the involuntary action is in working. 2. But, the involuntary control can be easily overridden by voluntary control (voluntary is more dominant) 3. Mastication is INVOLUNTARILY initiated by stimulating the anterior sensorimotor cortex. In experiment it is proved that we can initiate mastication by stimulating the area of anterior sensorimotor cortex. Central Rhythm Generator 1. Control the automatic rhythmic activity. Each movement of jaw is equal 2. It is operated from the brain. Controlled by neurons which worked by stimulating elevator muscles, & simultaneously inhibiting active depressor muscles 3. Sensory inputs from intraoral muscle & joint receptors send signal to alter or change the rhythmic activity of the jaw

When we chew, receptor from periodontal ligament, muscle and joint will send receptor to the brain about the content of mastication. They detect the hardness of the object that we chewed. Cerebellum will react by whether increase or decrease the energy to chew.

Is it hard? Yes. Is it hard? No.

Muscles increase the power Muscles lower the power

Also when we masticate the softer food is chewed faster than the harder foods. For hard food type, in the beginning the rhythm of chewing is slower. Then after a few cut to the food the chewing activity will become more and faster. (Cycle of chewing smaller)

Control of Mastication Cycle is longer at beginning of ingestion. When you start eating, the first cycle are longer .Why? Because the food is not cut. But once the food is cut into fine pieces you will find the cycle of mastication become smaller and smaller. Different type of food fragment in different ways.

Food bolus is judges by oral receptors to be ready for swallowing. And this is important, we have receptor inside our mouth telling the brain that it is enough for mastication and now please swallowing. So that is why some people they tend to swallow food before complete mastication. So the best people are those who give sufficient time for mastication. Amount of chewing before swallowing: 1.Characteristic of the individual-(that is why people vary between one to another regarding the time that spent in chewing before swallowing) 2.Influenced by nature of food Usually the number of stroke before swallowing: Men>woman = men want more cycle than woman, this mean woman swallow faster/earlier. Woman, they do not spend long time for swallowing. So, the number stroke before swallowing is less than men. Each one cycle of mastication is call stroke. It involve depression and elongation. And some lateral movement. So, men have more stroke than woman. Women > children.=So if you have little brother or a kid for example, you will find that they swallow faster. Not markedly influenced by state of dentition.=Some people think that person with missing teeth need more stroke than normal person to be efficient.THIS IS NOT TRUE.They found that it is not influenced by the state of dentition. People with missing teeth and people with complete teeth will need the same amount of stroke for mastication. Influenced by efficiency of food comminution: Food comminution=food cutting Bite force. The maximum bite force for typical European food is 80 N :because their food are very soft. 64 N for denture wearers. Force is measured by a gnathodynamometer.

The maximum atypical force(it is not the force we are eating but the maximum force we can exert with our teeth 440 N-at the molar 150 N at canine region. Male 520N >Female 340N.( Male stronger than female) Western diet need less force because they usually soft. Force can be increase by training. Eskemo woman chew sealskin to use in clothing Force can reach 1450 & 1700 N Limit of force Stimulation of pain receptor in PDL: When you bite to the maximum,what actually prevent you from continuing or from exerting more force? We have receptors at the PDL.These are pain receptor.When you reach the maximum biting they told the brain that we it is enough and that is why we do not continue otherwise we can cause problems to our teeth.

Functions of chewing. No large particles damaging the esophageal or gastric mucosa.We chew because we do not want these particles to go to the easophagus or stomach without being cut.