MasticatoryAnatomy

TheMusclesofMastication

A.TemporalisMuscle

Origin:temporalfossa&
temporalfascia
Insertion:coronoidprocess
&anterioroframus

A.TemporalisMuscle

Function:Elevationand
positioningofthe
mandible

B.MasseterMuscle

Origin:zygomaticarch
Insertion:lateralsurface
oframus,coronoid
process&angleof
mandible

B.MasseterMuscle

Function:powerwith
verticalelevationof
themandible;deep
portionstabilizesthe
condyleinprotrusive
closure

C.MedialPterygoidMuscle
Origin:medialsurfaceof
lateralpterygoidplate,
pyramidalprocessof
palatinebone&Mx
tuberosity
Insertion:medialsurface
oframus&angleof
mandible

C.MedialPterygoidMuscle
Function:elevationof
themandible,
protrusionofthe
mandibleandlateral
movementofthe
mandiblewith
unilateralactivation

PterygomassetericSling

D.InferiorLateralPterygoidMuscle

Origin:lateralsurfaceof
lateralpterygoidplate
Insertion:pterygoid
foveaofcondyle

D.InferiorLateralPterygoidMuscle

Function:protrusion,
lateralmovementand
contributestoopening

E.SuperiorLateralPterygoidMuscle

Origin:infratemporal
surfacegreaterwingof
thesphenoidbone
Insertion:pterygoid
foveaofthecondyle
andvariabletothedisc

E.SuperiorLateralPterygoidMuscle

Function:activewiththe
musclesofclosure,
especiallyaiding
stabilizationofthe
condyleduringthe
powerstroke

TemporomandibularJoint
Anatomy

CraniomandibularJoint:a
diarthrodialorsynoviallinedjoint

Acompoundjoint:>2components

TemporalBone
MandibularCondyle
ArticularDisc

A.TemporalBone

Cranialcomponent
Mandibularfossa
Articulareminence
Articularsurfacefrom
superiorfossatothe
anterioraspectofthe
eminence,thickest
bone.

B.MandibularComponent:Condyle

Condylardimensions:
AP810mm
ML1520mm
Articularsurface:
anteriorsuperioraspect

B.MandibularCondyle

Variationsidetosidein
sizeandshapeiscommon.
Responsetoloading
Lateralpoleanteriorto
medialpole.

C.ArticularTissue
Origin:modified
periosteumof
intramembranousbone,
NOTendochondralorigin.
Aconsequenceof2
embryonictissuemasses
growingtowardseach
other,NOTasingletissue
massclefttoformajoint
articulation.

C.ArticularTissue
Function:1)
loaddistribution
2)synoviallubrication
Character:NOT
hyalinecartilage,but
fibrousinnature
1)avascular
2)NOTinnervated
3)resistanttoshear,
tensionforces
4)increased
remodelingpotential

D.ArticularDisc
Composition:
avascularconnective
tissue,collagenous
Shape:biconcavein
crosssectionwith
posteriorband,
intermediatezoneand
anteriorband
Position:posterior
bandedgeat12:00

D.ArticularDisc

E.TMJointCapsule
Function:
1)limitextremeROM
2)synoviallining
3)confinessynovial
fluid
4)jointproprioception

F.MandibularLigaments
Restrictandlimit
jointrangeofmotion

A.Temporomandibular
Ligament
Lateralthickeningof
theTMjtcapsule
Limits:retrusionand
inferiorcondylar
distraction

B.CollateralLigaments
Medialandlateral
Limit:medialand
lateralmovementof
thediscrelativetothe
condyle

C.AccessoryLigaments
Sphenomandibular
Ligament:
nonfunctionalvestige
orremnantof
Meckelscartilage
Stylomandibular
Ligament:limits
extremejaw
protrusion

TMJointStability
NOTligaments
Musclespulling
acrossjoints
ArticularDisc
Geometry

TMJointAnatomy:sagittal
LateralPterygoidM
Superiorheadinsertion
condyle&sometimesdisc
Inferiorheadinsertion
condyle
Retrodiscaltissues
1)Superiorelastic
2)Inferiorcheck
ligament
3)LooseC.T.venous
compartmentand
innervated
Synovialtissues

TMJointRetrodiscalTissue

TMJointInnervation:V3

TMJointFunctionalAnatomy
ReadpagesinOkeson,pp.2226!

CentricRelation(Okeson,2003)
Jawpositionwiththe
condylesintheirmost
superoanterior
postionsinthe
articularfossae,
restingagainstthe
posteriorslopesofthe
articulareminences,
withthearticulardiscs
properlyinterposed.

BiologyofCentricRelation
MuscloskeletalStability:
astablepositioninwhich
toloadthejoint,mmpull
acrossjtsseatingcondyle
ClinicalEvidence:
patientsdowellwithIP
coincidentalwithjaw
positioninCR(clinical
experience)

BiologyofCentricRelation
Clinicallyrepeatable:a
referencepositionfor
restorativedental
procedures
butNOTimmutable!
(CelenzaFV,JPD1973)
(~1yr?)