MANDIBULAR MOVEMENTS

And JAW RELATIONSHIPS

Mandibular movements

Factors affecting mandibular movement

1-Temporomandibular joint (TMJ)

The disc divides the joint into two compartments; upper and lower. The lower compartment between the condyle head and the disc and the upper compartment between the disc and the Glenoid fossa.

Rotation and translation

Rotation and translation

Rotation occurs in lower compartment of the TMJ.  Translation occurs in upper compartme3nt of the TMJ. compartme3 All mandibular movements are combination of rotation and translation except posterior (when the condyles in most retruded position) opening and closing for about 20 mm. In this position the condyle do pure rotation.
 

2-Contact of opposing teeth

An example for the effect of the tooth  contact on mandibular movement is the incisal path. The incisal path is the path taken by  the incisal edges of the lower incisors on the palatal surface of the upper incisors until the teeth touch edge to edge. The incisal path angle is the angle  between the incisal path and the horizontal plane.

3-The muscles of mastication

The temporalis, masseter and medial pterygoids

The temporalis, masseter and medial pterygoids are elevators. Contraction of deep fibers of masseter muscle produces a backwards pull on the mandible, aided by the distal fibers of temporalis

The lateral pterygoid muscle

Some lateral pterygoid  fibers are inserted into the anterior part of the meniscus through the capsule pulling the condyles forward and downward (protrusion if the muscles in the two sides act). Action of the lateral pterygoid muscle in one side pulls the mandible to the other side.

4-The TMJ ligaments:. They provide  limits or borders of the mandibular movements. Movements on the boundaries of the  movement space are called border movements. Movements within the boundaries of movement space can be designated as intra-border movements.  5- The neuromuscular regulation of the above factors.

Basic mandibular movements

Opening and closing

Habitual opening starts from the intercuspal position to the maximum opening position. The closing movement is in reverse; from maximum opening to intercuspal position. Translation (forward and downward) and rotation of the condyle occur during this movement.


2-Forward (protrusive) movement orward

The condyle moves with the disk forward and  downward. The path of the condyle during this movement is termed the horizontal (sagittal) condylar path. It make an angle with horizontal called horizontal condylar path angle.
1= horizontal condylar path 2= horizontal plane. 3= horizontal condylar path angle.

Christensens phenomenon
During protrusion separation of posterior teeth occurs due to the downward and forward movement of the condyle . This called Christensens phenomena.


3-Backward (retrusive) movement



The retrusive movement of the mandible is similar to the protrusive one but in a reverse

4- Lateral movement
The side to which the  mandible moves is called working side. The condyle do rotation with slight translation (Bennett movement). The other side is called  non working or balancing; the condyle moves downward forward and medially.

The lateral condylar  path is the path along which the balancing condyle head moves medially during lateral movement. The lateral condylar  path angle it is the angle between the lateral condylar path and the sagittal plane

Lateral movement of the mandible. 1, the lateral condylar path angle in the balancing side (Bennett angle). 2, is the Bennett movement in the working side.

Bennett movement
Bodily shift of the mandible occurs during lateral movement called Bennett movement.


Jaw relationships


It is any relation of the mandible to the maxilla. It is classified into vertical, horizontal and orientation relations

I- Vertical relations
It represents the amount of jaw separation and  classified into: 1-Vertical dimension of occlusion; the vertical  measurement of the face when the teeth are in occlusion. 2-Vertical dimension of rest; the vertical  measurement of the face when mandible at rest position.

Free- way space

The rest position is obtained when the  patients head is upright and the elevator and depressor muscles are in equilibrium. At rest the teeth are not in contact, the gap in between is called the interocclusal distance or the freeway space

Measurement of vertical dimension

The vertical dimension of rest is measured between two points one on patients nose and other on chin. Then 2-4 mm are subtracted to be the vertical  dimension of occlusion.


II-Horizontal relations:

They are anteroposterior and side-toside-toside relations of the mandible to maxilla. maxilla. They include: include:




Centric occlusion:

It is the relation of opposing occlusal surfaces, which provides the maximum planned contact and /or intercuspation. intercuspation.

Centric relation.
It is the relation of the mandible to the maxilla when the condyles are in the uppermost and rearmost position in the glenoid fossa. In complete denture construction , it should be recorded and transferred to the articulator for setting up of teeth.





Centric occluding relation:

It is a term sometime used to describe the condition in which the jaws are in centric relation and the teeth are in centric occlusion. occlusion.




Eccentric relations:

They are any relations of the mandible to the maxilla other than centric. centric. They are the protrusive, right and left lateral relations. relations.

Protrusive contact

Working side

Balancing side

III- Orientation relations (craniomaxillary orientation)



The relationship between the maxilla and the condyles or the cranium is recorded by the face bow and transferred unchanged to the articulator. articulator.

FACE-BOW


The face-bow is a caliper-like device that is used facecaliperto record the relationship of the maxilla to the temporomandibular joints or the opening axis of the jaws and to orient the casts in this same relationship to the opening axis of the articulator

Types of face-bow

1-The kinematic face-bow (mandibular, hinge axis locator ):

It is used to locate the  kinematic (true or terminal) transverse hinge axis. The transverse hinge axis is  an imaginary line, which the mandible rotates during posterior (maximum retrusion) opening and closing for about 20 mm

2-The maxillary face-bow

It is used to record the position of the upper jaw in relation to the hinge axis and transferring the relation to an articulator The maxillary face-bow is oriented to the facekinematic or arbitrary hinge axis.

The arbitrary hinge axis

is positioned on a line extending from the outer canthus of the eye to the middle of the tragus of the ear and approximately 13 mm. in front of the external auditory meatus.

The ear face-bows

are designed to utilize an arbitrary axis by fitting into the external auditory meatus.

References
1-Allen AA, Heath JR, Mc Cord: Complete Prosthodontics; Problems, Diagnosis and Management. Mosby-  Prosthodontics; MosbyWolf, London, 1995. 1995. 2- Beresin, V.E. and Schiesser, F. J.: The neutral zone in complete and partial dentures. 2nd ed. St. Louis, The Beresin, Schiesser, C.V. Mosby Company: 1978. 1978. 3- Coleman, R. D. and kaiser, W. B.: The Scientific Bases of Dentistry. Philadelphia, W. B. Sounders; 1966. kaiser, 1966.  4- Craig, R.G.: Restorative Dental Materials. 8th ed. St. Louis, C. V. Mosby Company.  Craig, Company. 5-Fenn, H.R.B.; Liddelow, K.P. and Gemson, A.B.: Clinical Dental Prosthetics. 2 ed. London, Staples; 1974.  Fenn, Liddelow, Gemson, 1974. 6- Geering AH,Kundert M , Kelesy C: Complete denture and overdenture Prosthetics. Theme medical  publication Inc. New York, 1993. 1993. 7-Grant AR, Heath JR, Mc Cord JF: Complete Prosthodontics; Problems, Diagnosis and Management. Prosthodontics;  MosbyMosby-Wolf, London, 1996. 1996. 8- Heartwell, C.M. and Rhan, A.G.: Syllabus of Complete Dentures. 3rd ed. Philadelphia, Lea and Heartwell, Rhan, Febiger; 1986. Febiger; 1986. 9- Sharry, J.J.: Complete denture prosthodontics. 3rd ed. NewYork, McGraw-Hill; 1974.  Sharry, prosthodontics. NewYork, McGraw1974. 10- Sowter, 10- Sowter, J.B.: Dental laboratory technology: prosthodontic techniques. Chapel Hill, University of North  Carolina; 1968. 1968. 11-Watt, D.M. and Mac Gregor, A.R.: Designing complete dentures. Philadelphia, W.B. Sounders; 1976. 11-Watt, Gregor, 1976. 1212- Winkler, S.: Essential of complete Denture Prosthodontics. 2nd ed. PSG Publishing Company; 1988.  Prosthodontics. 1988. 13- Zarb, 13- Zarb, G.A.; Bolender, C.L.; HicKey, J.C. and carlesson, G.E.: Boucher's Prothodontic Treatment for Bolender, HicKey, carlesson,  th. Ed. St-Louis, The C.V.Mosby Company; 1990. Edentulous Patients. 7 St1990.

N, B. All pictures in these slides are copied from the above references and from the internet.

Importance of the face-bow

1-Introduce errors in the occlusion of the finished denture. denture.  2-A change in OVD on articulator is possible. possible.  3-Support maxillary cast while mounting. mounting.