ANATOMY OF MANDIBLE

CONTENTS

INTRODUCTION
DEVELOPMENT OF MANDIBLE
GROWTH OF MANDIBLE
ANATOMY OF MANDIBLE
AGE CHANGES OF MANDIBLE
APPLIED ASPECTS
CONCLUSION
REFERENCES
INTRODUCTION

The mandible or lower jaw, is the largest & strongest bone of the

face.
The word Mandible is derived from Greek word

mandere to masticate or chew.

The Latin word mandibula lower jaw.

It is horse-shoe shaped & the only movable

bone of skull.
Lower facial skeleton.
DEVELOPMENT OF MANDIBLE

Prenatal
growth Postnatal
growth
Prenatal Growth of mandible

About the 4th week of IU life, the developing brain & pericardium

form two prominent bulges which are separated by the primitive oral
cavity or stomodeum.
The floor of stomodeum is formed by the bucco-pharyngeal

membrane, which separates it from forgut.

Pharyngeal arches are laid in approximation

with stomodeum.
 In humans, six pairs of pharyngeal arches form on either side of the

pharyngeal forgut.
The 5th arch disappears after its formation

1st arch is known as mandibular arch,

2nd arch as hyoid arch.

 Each arch has

1. Outer covering of ectoderm

2. An inner covering of endoderm

3. Core of mesoderm.
Arches are separated from each other by

1.Pharyngeal cleft or groove externally

2.Pharyngeal pouches internally

 Each arch contains

1. A cartilaginous supporting element

2. An arch artery

3. An arch-associated cranial nerve

4. A muscular component

branchiomere
 The development of face begins in the 4th to 8th week of intra-uterine

life.
The face is derived from

An unpaired frontonasal process

A pair of Maxillary process

A pair of Mandibular process

 Mandibular arch gives of a bud from dorsal

end called maxillary process

It grows ventro-medially called mandibular

process.
Mandibular processes of both sides grow

towards each other & fuse in midline.

MECKELS CARTILAGE:

Meckels cartilage is derived from

1st branchial arch around 41st 45th

day of IU life.

It extends from the cartilagenous otic

capsule to the midline.

Provides a framework around which

the growth of the mandible occurs.

 Meckels cartilage lacks the enzyme alkaline phosphatase found in

the ossifying cartilages, thus precluding its early ossification.

A major portion of the Meckels cartilage disappears. It persists until

as long as the 24th week IU life

 Remaining part develops:

1. Mental ossicles.

2. Incus & Malleus.

3. Spine of sphenoid bone.

4. Anterior ligament of malleus.

5. Spheno mandibular

ligament.
 Mandible is the second bone to ossify in the body.

It is partly membranous & partly cartilaginous in ossification.

Incisive part below

symphysis menti
Coronoid
Cartilage Condyloid process
Ramus above
mandibular foramen

Whole of body
Membrane except lower incisive
part
Lower half of ramus
upto mandibular
foramen
 The 1st structure to develop in the primordium of the lower jaw is the

mandibular division of the trigeminal nerve.

6th week of IU life a single ossification centre for each half of

mandible in the region of the bifurcation of inferior alveolar nerve.

Meckels cartilage

Inferior alveolar nerve

Initial site of osteogenesis

Mental branch
 Ossification spreads below & around the inferior alveolar nerve.

The Meckels cartilage is surrounded by bone and ossification then

stops at the lingula

The bony plate extends towards the midline where it comes to lie in

close relationship with the bone forming on the opposite side.

However, two plates of bone remain separated at the Mandibular

symphysis by fibrous tissue.

Bony union takes place at around 18 months after birth.
 Endochondral bone formation seen in 3 areas.

They appear between the 10th and 14th week of IU life.

Mental
region
Coronoi
d
process
Condyla
r
process
Condylar process:
5th week of IU life- mesenchymal condensation at the ventral aspect

mandible.
10th week - develops into a cone shaped cartilage.

14th week- begins ossifying.

4th month - fuses with the Ramus of the developing mandible.

It persists as Growth cartilage & Articular cartilage

Coronoid process:
10-14th week of IU life Secondary accessory cartilage appear in

the region of coronoid process.

It grows as a response to Temporalis muscle.

This accessory cartilage fuses with the ramus and disappears by

birth.
Mental region:
On either side of the symphysis, one or two cartilages appear which

ossify to form the mental ossicles at 7th month of IU life.

These get incorporated into the intramembranous bone when the

symphysis ossify completely ( 1st year of post natal life.)

Postnatal Growth Of Mandible

Overall pattern of growth of the mandible can be represented in two

ways,
1) If the cranium is the reference area ,the chin moves
downward and forward.
2) According to the data from the vital staining experiments,
the posterior surface the ramus, the condyle and coronoid
process are principal sites of growth.
Growth is quite general during the first year of life with all surfaces
showing bone apposition.
Mandibular growth becomes more selective.
 The mandible can be divided into several sub-units like

Chin
Alveolar process
Body
Lingual tuberosity
Ramus
Angular process
Coronoid process
Condylar process
Chin:
1-2 years chin prominence is seen
The mental protuberance forms by bone deposition
The change in the contour occurs by following two mechanism.
1) The area just above the chin and
the base of the alveolar process,
is a resorptive area.
2) There is forward translation of
chin as mandible grows forward.
Alveolar process:
This develops in response to the developing tooth buds.
Body: (corpus)
The length of the body increases as the ramus moves posteriorly
Lingual tuberosity:
It forms the boundary between

the ramus & body

A combination of the resorption

and deposition accentuates its

prominence.
Ramus:
The ramus is seen to move posteriorly due to deposition at its

posterior border and resorption on its anterior border

Angle:
The combined deposition and resorption causes flaring of the angle

of the mandible.
Coronoid process :
Enlows enlarging V principle.

Birth: Coronoid process is at higher

level than condyloid process.

Childhood: Coronoid & condyloid

processes are at same level.

Adult: Condyloid process is at

higher level.
Condyle:
Condylar growth rate increases at puberty and reaches its peak by

12-14 years.
The growth ceases at around 20 years

Role of condyle:

o Primary displacement

o Carry away phenomenon

ANATOMY OF MANDIBLE

Mandible

Body Two Rami

Surfaces Borders Surfaces Borders Processes

Lateral/ Medial/ Condyloid Coronoid

External/ Internal/ External Internal
Outer Inner

Superior/ Inferior/ Anterior Posterior Superior Inferior

Alveolar Base
Body: Outer surface

Symphysis Menti

Mental Protuberance

Mental Foramen

Oblique Line

Incisive Fossa / Mental Fossa

Body: Inner surface

Mylohyoid line
Submandibular fossa
Sublingual fossa
Superior genial tubercles
Inferior genial tubercles
Mylohyoid groove
Attachment of
pterygomandibular raphe
lingual nerve
Body: Superior & Inferior border

The upper border, the alveolar part, contains 16 alveoli for roots of
the teeth.

The lower border, the base, extends posterolaterally from the

symphysis into that of ramus behind the third molar.
Ramus: External/ lateral surface
Upper & posterior smooth area

Major rough area

Ramus: Medial/ Internal surface
Mandibular foramen

Lingula

Rough area below & behind

mylohyoid groove
Structures related above &

behind mandibular foramen

Ramus: Borders
Anterior Posterior

Superior Inferior
Ramus: Coronoid process
A flat, triangular projection

from the anterosuperior part

of the ramus
Lateral to pterygoid plate

Medial to zygomatic process

Anteriorly continuous with ramus

Posterior border bounds the

mandibular notch/incisure
Ramus: Condylar process
Strong upward projection from postero-superior part of ramus

It consists:

1. Upper part- Head

2. Lower part- Neck

Head
Neck
Salivary glands
Ligaments attached to mandible

Stylomandibular ligament

Sphenomandibular ligament

Temporomandibular ligament

Pterygomandibular raphe /

ligament
Nerve supply of mandible
The trigeminal nerve- V cranial nerve
Opthalmic (smallest)
Maxillary
Mandibular (largest)

MANDIBULAR NERVE
Main trunk
Anterior trunk
Posterior trunk
 Posterior division of the mandibular nerve

Auriculotemporal Lingual Inferior alveolar nerve

nerve

Mylohyoid Mental Incisive

nerve nerve nerve
Vascular supply of mandible
Maxillary artery

It is divided into 3 parts by the lateral pterygoid.

Mandibular

Pterygoid

Pterygopalatine
 INFERIOR ALVEOLAR ARTERY

Lingual Mylohyoid Branch Mental

branch branch supplying branch
mandible and
teeth
Venous drainage
Lymphatic drainage of the mandible
AGE CHANGES OF MANDIBLE

At Birth In Childhood

Geriatric Mandible Adult Mandible

APPLIED ASPECTS:
Dislocation

55
 Reduction

Downward pressure followed by posterior and upward movement

Fracture
Surgical consideration:
Mandibular canal Partially or completely edentulous cases
placement of implants difficult.
Injury to the mental nerve paraesthesia to the skin of the chin, the
lower lip and the labial mucosa
Injury to the lingual nerve during flap reflection, releasing incisions,
anesthestic injections
External oblique ridge
Resective surgery difficult because of the amount of bone to be

removed.
Apical positioning of the flap is difficult in these areas.

A high buccinator attachment results in a shallow vestibule, making

grafting procedures difficult.

Mandibular tori
The mucosa over the tori region is usually thin and hence is subject

to tearing.
Source of autogenous bone for grafting procedures.
Mylohyoid ridge
A prominent ridge may broad bony ledge resulting in limited

surgical access and also makes flap reflection difficult.

Coronoid process
A prominent coronoid process may be in close proximity to the
maxillary tuberosity resulting in limited surgical access
Genial tubercle
In cases of severe horizontal bone loss they may pose a problem
during implant placement and flap reflection
Alveolar process
Prominent teeth results in marginal tissue recession, bony dehiscence
or fenestration
CONCLUSION:

The selection of an appropriate surgical technique that can

best satisfy the treatment goals & objectives is directly influenced by
through knowledge of anatomic relations between bone, soft tissues
& teeth. The study of anatomy of mandible & surrounding structures
is essential
REFERENCES:
Grays anatomy, 38th edition.

Human anatomy, B.D Chaurasia, 4th edition.

Essentials of human anatomy, A.K Datta, 2nd edition

Fundamentals of human anatomy, N Chakraborty.

Human embryology, William Larsen

Contemporary orthodontics ,Proffit ,4th edition.

Text book of orthodontics ,S.I Bhalaji ,3rd edition.

Discuss the development, ossification & age changes of the mandible
(20 marks)
Discuss in detail Trigeminal nerve (20 marks)
Describe in brief the functional anatomy of TMJ (20 marks)
Discuss the related structures of maxilla & mandible to determine
the periodontal surgical procedure (20 marks)
Describe muscles of mastication with their development, nerve
supply & action (20 marks)
Submandibular salivary gland (5 marks)
Inferior alveolar nerve (5 marks)
Describe branches of mandibular nerve & structures supplied by
them (5 marks)