PHYSIOLOGY OF
STOMATOGNATHIC
SYSTEM
INDIAN DENTAL ACADEMY
Leader in continuing dental education
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INTRODUCTION OF
PHYSIOLOGY OF STOMATOGNATHIC SYSTEM
STOMA
GNATHIA

- MOUTH
- JAWS

THE STRUCTURES OF THE MOUTH AND JAWS,
C...
CONTENTS

OSTEOLOGY
FUNCTIONAL OSTEOLOGY
MYOLOGY
MUSCLES OF FACE , TONGUE,
MASTICATION
TEMPOROMANDIBULAR JOINT
ANATOMY OF ...
BONE
INTRODUCTION
WHAT IS BONE
FUNCTIONS
CLASSIFICATION OF BONE
BONE MORPHOLOGY

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MICROSCOPIC STRUCTURE
PHASES OF BONE
BONE MINERAL
MECHANICAL PROPERTIES OF BONE

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INTRODUCTION OF BONE

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WHAT IS BONE ?

SPECIALISED FORM OF CONNECTIVE TISSUE

EXTRACELLULAR MATRIX –
COLLAGEN , PROTEINS,
PROTEOGLYCANS , MINERAL...
FUNCTIONS OF BONE
PROTECTION
SITE OF MUSCLE ORIGIN AND INSERTION
RIGIDITY
HAEMOPOIESIS
LABILE MINERAL POOL

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BONE MORPHOLOGY
CATEGORISATION:
TUBULAR

--

FEMUR

CUBOIDAL

--

CARPUS

FLAT

--

FRONTAL BONE

IRREGULAR --

VERTEBRAE
...
ACCORDING TO DEVELOPMENTAL ORIGIN

ENDOCHONDRAL BONE

INTRAMEMBRANOUS BONE

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ENDOCHONDRAL BONE FORMATION


BONE FORMATION IS PRECEDED BY FORMATION
OF CARTILAGENOUS MODEL – REPLACED BY BONE



MESEN...
INTRAMEMBRANOUS BONE


BONE LAID DOWN DIRECTLY IN FIBROUS MEMBRANE



MESENCHYMAL CELLS – BUNDLES OF COLLAGEN FIBRES


...
CLASSIFICATION OF BONE TISSUE


WOVEN BONE



LAMELLAR BONE



COMPOSITE BONE



BUNDLE BONE

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WOVEN BONE


WEAK, DISORGANIZED, POORLY MINERALIZED



SERVES WOUND HEALING BY :





RAPIDLY FILLING OSSEOUS DEFECTS...


NOT FOUND IN ADULT SKELETON



FUNCTIONAL LIMITATIONS :
IMP. ASPECTS OF ORTHODONTIC RETENTION
HEALING PERIOD FOLL. ORT...
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LAMELLAR BONE


STRONG,HIGHLY ORGANISED, WELL MINERALIZED



99% ADULT SKELETON



STRENGTH OF BONE DIRECTLY RELATED TO...
COMPOSITE BONE


LAMELLAR BONE WITH IN WOVEN BONE LATTICE



PRODUCES STRONG BONE



PRIMARY OSTEONS



SECONDARY OSTE...
BUNDLE BONE


FUNCTIONAL ADAPTATION



ATTACHMENTS OF TENDONS , LIGAMENTS



SHARPEY’S FIBRES

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MICROSCOPIC STRUCTURE
CANCELLOUS BONE (SPONGY BONE) ---TRABECULAE ----OSTEOCYTES ---LACUNAE

CORTICAL BONE ( COMPACT BONE)...
HAVERSIAN
SYSTEM
CENTRAL VASCULAR
CANAL
8 -10 CONCENTRIC
LAMELLAE
CEMENT LINES
VOLKMAN’S CANAL
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PHASES OF BONE
OSSEOUS MATRIX

----

CELLULAR COMPONENTS

ORGANIC,INORGANIC
COMPONENTS

----

OSTEOBLASTS,OSTEOCYTES,OSTEO...
BONE MINERAL

RESEMBLES PRECIPITATED HYDROXYAPATITES.
DISTINCTIVE FEATURES OF BONE APATITE :
SMALL CRYSTAL SIZE
LACK OF CH...
MECHANICAL PROPERTIES OF
BONE
TENSILE STRENGTH:
DEPENDS ON ORIENTATION AND NUMBER OF
COMPONENT COLLAGEN FIBRES.
SUPERIOR W...
COMPRESSIVE PROPERTIES
DEPENDS ON ARRANGEMENT OF COMPONENT COLLAGEN
FIBRES
CIRCUMFERENTIAL COLLAGENOUS FIBRES

-------

SU...
FUNCTIONAL OSTEOLOGY

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TRAJECTORIAL THEORY OF BONE
FORMATION
MEYER (1867) , CULMANN
TRAJECTORIAL THEORY OF BONE
FORMATION
BENNINGHOFF -(STRESS TR...


VANDERKLAU
(FUNCTIONAL CRANIAL COMPONENT)



MELVIN MOSS
(FUNCTIONAL MATRIX HYPOTHESIS)

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MECHANISMS OF BONE GROWTH

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BONE DEPOSITION AND RESORPTION
BONE DEPOSITION
BONE RESORPTION
BONE REMODELING
BONE REMODELING

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MODELING AND REMODELING
SKELETAL ADAPTATION :


ALTERATION IN MASS



GEOMETRIC DISTRIBUTION



MATRIX ORGANISATION


...
BONE MODELING
INDEPENDENT SITES , CHANGE THE
FORM OF BONE

BONE REMODELING
SPECIFIC, REPLACES PREVIOUSLY
EXISTING BONE

ww...
INTERNAL REMODELING VIA AXIALLY ORIENTED
CUTTING /FILLING CONES

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MODELING CHANGES

-- CEPHALOMETRIC TRACINGS

REMODELING CHANGES -- MICROSCOPIC LEVEL
TRUE REMODELING

--

NOT IMAGED ON CL...
ORTHODONTIC BONE MODELING

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

REGIONAL ACCELERATORY PHENOMENON



CLINICAL IMPORTANCE :


ORTHOPEDICALLY POSITION MAXILLA

 RAPID

ORTHODONTIC ALI...
CONTROLLED BY :
METABOLIC AND MECHANICAL SIGNALS


MODELING : CONTROLLED BY :
 FUNCTIONAL

APPLIED LOADS

 HORMONES
 M...


REMODELING :
METABOLIC DISORDERS
( PARATHYROID HORMONES AND ESTROGENS )

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BOIMECHANICS


GRAVITY



MECHANICAL LOADING

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 FROST’S

MECHANOSTAT THEORY

 MARTIN

AND BURR

 DISUSE

ATROPHY -- < 200 µE

200 - 2500µE
 HYPERTROPHIC INCREASE -- ...
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 CLINICAL

REFERENCE

 BIOMECHANICAL

LOADS

RESPONSES TO APPLIED

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IMP. OBJECTIVES OF ORTHODONTIC TREATMENT


AVOIDING OCCLUSAL PREMATURITIES



GUARDING EXCESSIVE TOOTH MOBILITY



OPTI...
DISTRACTION OSTEOGENESIS


BONES CAN BE INDUCED TO GROW AT
SURGICALLY – CREATED SITES.



A PROCESS OF NEW BONE FORMATIO...
ALIZAROV
(1950)

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GROWTH OF MAXILLA :
AT SUTURES
 DIRECT REMODELING
 TRANSLATED DOWNWARDS AND FORWARDS


GROWTH OF MANDIBLE :
 ENDOCHOND...
Steps involved :


Corticotomy/Osteotomy



Latency period



Distraction phase



Consolidation phase

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TENSION STRESS EFFECT

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CURRENT SCOPE :


Correction of Maxillo-Mandibular deformities
Maxillary lengthening
Mandibular lengthening
Maxillary and...


Alveolar ridge augmentation



Transport disc and Transformation
osteogenesis.



Dental Distraction.

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TISSUE CHANGES FOLLOWING DO
HISTOLOGIC CHANGES :




During latency phase – formation of a
fibrous bridge.
During distra...
FACTORS AFFECTING DO
Biologic :
 AGE
 SITE

OF SURGERY

 LATENCY
 RATE

PERIOD

AND RHYTHM

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BIOMECHANICAL FACTORS :


Planning the distraction vector



Device fixity



Need for ‘ Bone moulding’

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Mandibular Distraction
INDICATIONS:
Hemifacial Microsomia
Treacher Collin Syndrome etc.
TMJ ankylosis and condylar fractur...
BIOMECHANICAL EFFECTS OF DISTRACTON
VECTOR

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THE SKULL
INTRODUCTION

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SKULL

CALVARIA
(BRAIN BOX)

FACIAL SKELETON

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

BONES OF THE SKULL

:

22 BONES

CALVARIA OR BRAIN CASE:
PAIRED

8 bones

UNPAIRED

PARIETAL
TEMPORAL

FRONTAL
OCCIPITA...
FACIAL SKELETON : 14 bones
PAIRED

UNPAIRED

MAXILLA
ZYGOMATIC
NASAL
LACRIMAL
PALATINE
INFERIOR NASAL CONCHA

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MANDIBLE
LARGEST,STRONGEST BONE
FIRST PHARYNGEAL ARCH
HORSE SHOE SHAPED BODY
PAIR OF RAMI

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BODY OF MANDIBLE
SURFACES:
OUTER SURFACE
INNER SURFACE

BORDERS:
UPPER BORDER
LOWER BORDER

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OSSIFICATION
Greater part ossifies in membrane
Parts ossifying in cartilage –
incisive, coronoid, condyloid, upper half
of...
AGE CHANGES IN THE MANDIBLE
IN INFANTS AND CHILDREN:
Two halves fuse -- first year of life
At birth – mental foramen opens...
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IN ADULTS
Mental foramen opens mid-way
Angle reduces – 110 or 120 degrees

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IN OLD AGE

Alveolar bone resorbed.
Mental foramen and mandibular canal – close to
alveolar border.
Angle again – obtuse– ...
MAXILLA
-- second largest bone of the face, first being
mandible
FEATURES:
BODY.
FOUR PROCESSES:
Frontal, zygomatic,
alveo...
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BODY:
pyramidal in shape , base directed medially,
apex laterally.
four surfaces
encloses maxillary sinus.

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OSSIFICATION
OSSIFIES IN MEMBRANE
FROM THREE CENTRES :
ONE FOR MAXILLA PROPER
TWO FOR OS INCISIVUM OR PREMAXILLA

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MAXILLA PROPER
CENTRE:
ABOVE CANINE FOSSA,
6TH WEEK OF INTRAUTERINE LIFE

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PREMAXILLA
MAIN CENTRE:
ABOVE INCISIVE FOSSA
7TH WEEK OF INTRAUTERINE LIFE
SECOND CENTRE (PARASEPTAL / PREVOMERINE):
VENTR...
AGE CHANGES
AT BIRTH:
TRANSVERSE AND AP DIAMETER MORE THAN
VERTICAL.
FRONTAL PROCESSES WELL MARKED.
BODY LITTLE MORE THAN ...
ADULT:
VERTICAL DIAMETER GREATEST

OLD:
REVERTS TO INFANTILE CONDITION
HEIGHT REDUCED

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 Sutures

of maxilla

– Frontomaxillary suture
– Lacrimomaxillary
– Zygomaticomaxillary
– Ethmoidomaxillary
– Palatomaxil...
MYOLOGY
STUDY OF MUSCLES,MUSCULAR SYSTEM
AND THEIR FUNCTIONS AND DISORDERS.

MUSCLE:
Physical properties: kinetic activity...
Elasticity:
a) length.
b) cross- section.
c) force exerted.
d) constant coefficient.
RATIO IN UNIAXIAL CASE :

FΔ = AEL

w...
Hooke’s law :
Muscle returns to exact original shape after being
stretched.
The linear elastic range is dependent upon the...
CONTRACTILITY:
The ability of a muscle to shorten it’s length under
innervational impulse

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SHERRINGTON : ALL OR NONE LAW
The intensity of contraction of any fibre is
independent of the strength of the exciting
sti...
ISOMETRIC CONTRACTION :
Occurs when a muscle is simply resisting an
external force without any actual shortening.
ISOTONIC...
PRINCIPLES OF MUSCLE
PHYSIOLOGY
Visualisation by Electromyogram.
EINTHOVEN (1918).
(Action current)
ADVANTAGE :
Relatively...
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

Muscle Tonus:
is a state of slight constant tension .
Serves to obviate the muscle.
Basis of reflex posture.
Maintenanc...


Stretch or Myotactic reflexes:
The reflex contraction of a healthy muscle which
results from a pull on its tendon.
(Ach...
THE FACE
MUSCLES OF THE FACE

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

FACIAL MUSCLES
SUBCUTANEOUS MUSCLES

EMBRYOLOGICALLY:
Mesoderm of second branchial arch
supplied by facial nerve

MORPH...


TOPOGRAPHICALLY:
SIX HEADS;

MUSCLES OF THE SCALP
MUSCLES OF AURICLE
MUSCLES OF EYELIDS
MUSCLES OF THE NOSE
MUSCLES ARO...
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ORBICULARIS ORIS
Composed of eight segments, each
segment resembles a fan wth its stem at
the modiolus.
Each fan is open i...


Extrinsic part :
– middle strata from buccinator and superficial
from lips and inserts into lips and angle of
mouth.

A...
BUCCINATOR
Thin , quadrilateral muscle between maxilla
and mandible.

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ORIGIN AND INSERTION :
Upper fibres – opposite maxillary molars –
insert in upper lip.
Middle fibres – pterygomandibular r...


Lower fibres -- opposite mandibular molars
– insert in lower lip.
ACTIONS :

Compresses the cheeks against teeth,
passs...
THE BUCCINATOR MECHANISM


FACTORS

IN ENVIRONMENTAL BALANCE :

MUSCULATURE :
A RESTING MUSCLE IS STILL PERFORMING A FUNC...








STABILITY DEPENDS ON :
GENETIC
EPIGENETIC
ENVIONMENTAL
MORPHOLOGIC
PHYSIOLOGIC FACTORS

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 Winders:
During mastication and deglutition, tongue
may exert two or three times much force on
the dentition as lips
and...


Lear and Moorrees:
Substantiate the imbalance of buccolingual
forces,
Limitations –
measuring equipment
hydraulic natur...
 Proffit:

Labial pressures are easier to measure than
lingual pressures.

Fry (1960)
Data for lingual pressure must be r...
BUCCINATOR MECHANISM

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TONGUE


Muscular organ situated in the floor of the mouth.

Associated with functions of taste, speech,
Mastication and ...


Has two parts :
Oral part - lies in the mouth.
Pharyngeal part -- lies in the pharynx.



These parts are separated by...
ROOT ;
attached to mandible and soft palate above
hyoid bone below.
BODY –

upper surface – curved k/a dorsum.

Dorsum : d...
PAPILLAE OF TONGUE :

CIRCUMVALLATE PAPILLAE
FUNGIFORM PAPILLAE
FILIFORM / CONICAL PAPILLAE
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MUSCLES OF TONGUE
INTRINSIC MUSCLES
SUPERIOR LONGITUDINAL
INFERIOR LONGITUDINAL
TRANSVERSE
VERTICAL

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EXTRINSIC MUSCLES :
GENIOGLOSSUS
HYOGLOSSUS
STYLOGLOSSUS
PALATOGLOSSUS

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ARTERIAL SUPPLY :
LINGUAL ARTERY – EXTERNAL CAROTID ARTERY
ROOT OF TONGUE – TONSILLAR AND ASCENDING
PHARYNGEAL ARTERIES.

...
LYMPHATIC DRAINAGE :
TIP OF TONGUE – bilaterally into submental nodes.
RIGHT AND LEFT HALVES – submandibular nodes.
POSTER...
NERVE SUPPLY :
MOTOR NERVE :
HYPOGLOSSAL NERVE -- ALL INTRINSIC AND

EXTRINSIC MUSCLES EXCEPT

PALATOGLOSSUS

PALATOGLOSSU...
DEVELOPMENT OF TONGUE
EPITHELIUM :
ANTERIOR TWO-THIRDS –
two lingual swellings , one tuberculum impar.
arise from first br...
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MUSCLES :
OCCIPITAL MYOTOMES – hypoglossal nerve
CONNECTIVE TISSUE :
local mesenchyme.

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MUSCLES OF MASTICATION
MASSETER
TEMPORALIS
LATERAL PTERYGOID
MEDIAL PTERYGOID

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MASSETER

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TEMPORALIS

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LATERAL PTERYGOID

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MEDIAL PTERYGOID

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

MUSCLES PRODUCING MOVEMENTS
DEPRESSION :

LATERAL PTERYGOID,DIGASTRIC,
GENIOHYOID, MYLOHYOID
– ELEVATION:
MASSETER, TEM...
TEMPOROMANDIBULAR JOINT
IS A SYNOVIAL JOINT OF CONDYLAR VARIETY.

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ARTICULAR SURFACES:
UPPER ARTICULAR SURFACE :
ARTICULAR EMINENCE
ANTERIOR PART OF MANDIBULAR FOSSA
LOWER ARTICULAR SURFACE...
LIGAMENTS:
FIBROUS CAPSULE
LATERAL LIGAMENT
SPHENOMANDIBULAR LIGAMENT
STYLOMANDIBULAR LIGAMENT

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

FIBROUS CAPSULE



ATTACHED ABOVE :

Articular tubercle
Circumference of mandibular fossa
Squamotympanic fissure
BELOW...


LATERAL/TEMPOROMANDIBULAR
LIGAMENT :

Reinforces and strengthens lateral part .
 Fibres directed downwards and backwar...
SPHENOMANDIBULAR LIGAMENT


Accessory ligament.



Lies on deep plane away
fromfibrous capsule.



ATTACHED SUPERIORLY ...
STYLOMANDIBULAR LIGAMENT


ACCESSORY LIGAMENT.

ATTACHED ABOVE :
Lateral surface of styloid process


BELOW :
Angle and ...


ARTICULAR DISC

OVAL FIBROUS PLATE
DIVIDES JOINT INTO:
UPPER COMPARTMENT
PERMITS GLIDING
MOVEMENTS
LOWER COMPARTMENT
RO...
ARTERIAL

SUPPLY

SUPERFICIAL TEMPORAL ARTERY
MAXILLARY ARTERY
NERVE

SUPPLY

AURICULOTEMPORAL NERVE
MASSETERIC NERVE

w...


MOVEMENTS OF TMJ
BETWEEN UPPER ARTICULAR SURFACE
AND ARTICULAR DISC
(MENISCOTEMPORAL COMPARTMENT)
BETWEEN DISC AND HEAD...


PROTRACTION OF MANDIBLE
– Articular disc glides forwards over upper
articular surface, head of mandible moving
with it....
SLIGHT OPENING OF THE MANDIBLE



Head of the mandible moves on the undersurface
of the disc like a hinge.

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WIDE OPENING OF MANDIBLE


Hinge like movement is followed by gliding of the
disc and head of the mandible as in protract...
CHEWING MOVEMENTS


Involve side to side movements of mandible.





Head of right side glides forward along the disc a...


MUSCLES PRODUCING MOVEMENTS
DEPRESSION :

LATERAL PTERYGOID , DIGASTRIC
GENIOHYOID,MYLOHYOID

ELEVATION: MASSETER, TEMP...
FUNCTIONAL MOVEMENTS
The mandible is the only movable bone
in the head and face and can only
be moved in certain direction...
OPENING MOVEMENT OF THE MANDIBLE
Condyle brought downward and forward as chin
drops downward and backward.
Gravity and pri...
Hyoid bone moves downward and backwards.
Temporal , masseter and medial pterygoid muscles
show relaxation – opening moveme...
CLOSING MOVEMENT OF THE MANDIBLE
More power is elicited on mandibular closure.
Hyoid bone moves upward and forward .
Contr...
PROTUSION OF THE MANDIBLE
Brought about when medial and lateral pterygoid
muscles contract in unison, in conjunction with
...
RETRUDING ACTION OF MANDIBLE
By contraction of posterior fibres of temporalis
muscles with some assistance from geniohyoid...
WORKING BITE
To establish a working bite , the mandible must be
moved to the right or left.
This lateral movement is initi...
As the teeth are brought closure to an end to end
relationship, masseter contracts on left side,
assisting in ipsilateral ...
BENNETT MOVEMENT
In the lateral shift of the mandible, the articular disk
moves toward the side of the working bite.
The c...
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Primary contraction in the middle and posterior fibres
of temporalis muscle and in the posterior fibres of
masseter and so...
POSITIONS OF THE MANDIBLE

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Posselt recorded graphically various positions and
movement area in sagittal plane

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POSTURAL RESTING POSITION
In infants ,muscles associated with suckling or
intake of food are well developed from the
begin...
Mandibular resting position is one of the earliest
positions to be developed.
Mandible is suspended from
cranial base by
c...
Posselt observes that “ Postural position can be
altered by conditions in masticatory system as well
as by systemic factor...
CENTRIC RELATION
Refers to the position of
the mandibular condyle
in the articular fossa.

Defined as:
unstrained ,neutral...
Can be the same as postural resting position, initial
occlusal contact and centric occlusion.
Centric occlusion requires c...
INITIAL CONTACT
In normal occlusion :
It maintains centric relation position as far as
articular fossae are concerned.
mov...
Initial contact in the ideal
individual is usually
synonymous
with centric occlusion.

In malocclusion or premature contac...
CENTRIC OCCLUSION

Implies a state of balance .
must be harmonious
with centric relation

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Premature contacts , loss of teeth ,overeruption of
teeth , overextension of artificial restorations ,
Malpositions of ind...
MOST RETRUDED POSTION
(TERMINAL HINGE POSITION)
To establish mandibular
and maxillary
casts in their proper
positions on t...
starting point in occlusal analysis and
rehabilitation.

Many dentists believe that by forcing the
mandible into its most ...
MOST PROTRUDED POSITION

More variable from individual
to individual.

Condyle drawn anterior to
lowest point of articular...
HABITUAL RESTING POSITION
May not be the same as postural resting position.
Pathologic conditions that interfere in establ...
HABITUAL OCCLUSAL RELATION
In normal occlusion, centric occlusion and habitual
occlusion should be the same.
Occlusal rela...
FUNCTIONS OF
STOMATOGNATIC SYSTEM

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MASTICATION:
Mastication in infants

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MASTICATION IN ADULTS
FLETCHER – masticatory stroke in adult using
six phases ; outlined by MURPHY.
PHASES:
PREPARATORY PH...
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DEGLUTITION

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FLETCHER --

divided deglutitional cycle into :

Preparatory swallow.
Oral phase of swallowing.
Pharyngeal phase of swallo...
PREPARATORY SWALLOW :

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ORAL PHASE :

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PHARYNGEAL PHASE :

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ESOPHAGEAL PHASE :

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TONGUE THRUST
Condition in which tongue makes contact with any teeth
anterior to the molars during swallowing.

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Factors :
Genetic .
Learned behaviour (habit).
Maturational.
Mechanical restrictions.
Neurological disturbance.
Psychogeni...
OTHER TITLES FOR TONGUE THRUSTING :
PERVERTED OR DEVIATE SWALLOW.
REVERSE SWALLOW.
RETAINED INFANTILE SWALLOW.
TOOTH APART...
CLASSIFICATION OF TONGUE THRUSTING
BY JAMES S. BRANER AND HOLT :
TYPE I : Non – deforming tongue thrust.
TYPE II : Deformi...
TYPE III : Deforming lateral tongue thrust.
subgroup 1 : Posterior openbite.
subgroup 2 : Posterior crossbite.
subgroup 3 ...
Also classified as :
SIMPLE TONGUE THRUST

COMPLEX TONGUE THRUST

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RESPIRATION

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Mouth breathing
classified as :
Obstructive .
Habitual .
Anatomic .

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Clinical features :
Adenoid faces.

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Management :
Removal of nasal and pharyngeal
obstruction.
Interception of habit.
Rapid maxillary expansion.

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SPEECH
defined as ordered utterance of a language.

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Vowels : a e I o u
Consonants :p,g,m,b,s,t,r,z.
Bilabial sounds :
b, p, m.
Labiodental sounds :
f , v.

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Linguodental sounds :
th.
Linguoalveolar sounds :
t,d,s,z,v,l.
sibilants : s ,z ,ch ,sh.
Linguopalatal and linguovelar sou...
LINGUOALVEOLAR SOUNDS

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LINGUOALVEOLAR SOUNDS

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Classification of consonants :
Plosive or stop plosives :
/p/,/b/,t/,/d/,/k/,/g/.
Fricatives :
Affricatives :
Glides :
Nas...
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Speech mechanisms acts on breath stream in no. of
ways :
Controlling the air mechanism.
Air direction.
Air flow.
Air relea...
REFERENCES


T.M GRABER- ORTHODONTICS:PRINCIPLES AND PRACTICE
III Ed.



BONE BIODYNAMICS IN ORTHODONTIC AND ORTHOPAEDIC...


WILLIAM.F.GANONG-REVIEW OF MEDICAL
PHYSIOLOGY 20TH Ed.



GRANT’S ANATOMY- ATLAS



GRAY’S ANATOMY



SALZMANN-ORTHO...
Thank you
For more details please visit
www.indiandentalacademy.com

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Physiology of stomatognathic system /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

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Physiology of stomatognathic system /certified fixed orthodontic courses by Indian dental academy

  1. 1. PHYSIOLOGY OF STOMATOGNATHIC SYSTEM INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. INTRODUCTION OF PHYSIOLOGY OF STOMATOGNATHIC SYSTEM STOMA GNATHIA - MOUTH - JAWS THE STRUCTURES OF THE MOUTH AND JAWS, CONSIDERED COLLECTIVELY AS THEY SUBSERVE THE FUNCTIONS OF MASTICATION, DEGLUTITION, RESPIRATION AND SPEECH IS CALLED AS STOMATOGNATHIC SYSTEM ( DORLAND MEDICAL DICTIONARY ) www.indiandentalacademy.com
  3. 3. CONTENTS OSTEOLOGY FUNCTIONAL OSTEOLOGY MYOLOGY MUSCLES OF FACE , TONGUE, MASTICATION TEMPOROMANDIBULAR JOINT ANATOMY OF TMJ MOVEMENTS OF MANDIBLE FUNCTIONS OF STOMATOGNATHIC www.indiandentalacademy.com SYSTEM
  4. 4. BONE INTRODUCTION WHAT IS BONE FUNCTIONS CLASSIFICATION OF BONE BONE MORPHOLOGY www.indiandentalacademy.com
  5. 5. MICROSCOPIC STRUCTURE PHASES OF BONE BONE MINERAL MECHANICAL PROPERTIES OF BONE www.indiandentalacademy.com
  6. 6. INTRODUCTION OF BONE www.indiandentalacademy.com
  7. 7. WHAT IS BONE ? SPECIALISED FORM OF CONNECTIVE TISSUE EXTRACELLULAR MATRIX – COLLAGEN , PROTEINS, PROTEOGLYCANS , MINERAL www.indiandentalacademy.com
  8. 8. FUNCTIONS OF BONE PROTECTION SITE OF MUSCLE ORIGIN AND INSERTION RIGIDITY HAEMOPOIESIS LABILE MINERAL POOL www.indiandentalacademy.com
  9. 9. BONE MORPHOLOGY CATEGORISATION: TUBULAR -- FEMUR CUBOIDAL -- CARPUS FLAT -- FRONTAL BONE IRREGULAR -- VERTEBRAE www.indiandentalacademy.com
  10. 10. ACCORDING TO DEVELOPMENTAL ORIGIN ENDOCHONDRAL BONE INTRAMEMBRANOUS BONE www.indiandentalacademy.com
  11. 11. ENDOCHONDRAL BONE FORMATION  BONE FORMATION IS PRECEDED BY FORMATION OF CARTILAGENOUS MODEL – REPLACED BY BONE  MESENCHYMAL CELLS - CONDENSED – CHONDROBLASTS -- HYALINE CARTILAGE (PERICHONDRIUM, VASCULAR AND OSTEOGENIC CELLS) – INTERCELLULAR – CALCIFIED BY ENZYME ALKALINE PHOSPHATASE SECRETED BY CARTILAGE CELLS – EMPTY SPACES ---PRIMARY AREOLAE ---SECONDARY AREOLAE – OSTEOGENIC CELLS – OSTEOBLASTS – OSTEOID – CALCIFIED - LAMELLA OF BONE www.indiandentalacademy.com
  12. 12. INTRAMEMBRANOUS BONE  BONE LAID DOWN DIRECTLY IN FIBROUS MEMBRANE  MESENCHYMAL CELLS – BUNDLES OF COLLAGEN FIBRES  ALSO ENLARGE – BASOPHILIC CYTOPLASM – OSTEOBLASTS – GELATINOUS MATRIX(OSTEOID) –BONE LAMELLAE – OSTEOBLASTS MOVE AWAY – OSTEOID – CALCIFIED – BONE  OSTEOBLASTS TRAPPED BETWEEN TWO LAMELLAE k/a OSTEOCYTES. www.indiandentalacademy.com
  13. 13. CLASSIFICATION OF BONE TISSUE  WOVEN BONE  LAMELLAR BONE  COMPOSITE BONE  BUNDLE BONE www.indiandentalacademy.com
  14. 14. WOVEN BONE  WEAK, DISORGANIZED, POORLY MINERALIZED  SERVES WOUND HEALING BY :    RAPIDLY FILLING OSSEOUS DEFECTS INITIAL CONTINUITY FOR FRACTURES AND OSTEOTOMY SEGMENTS STRENGTHENING BONE WEAKENED BY SURGERY OR TRAUMA  FIRST FORMED BONE TO ORTHODONTIC LOADING www.indiandentalacademy.com
  15. 15.  NOT FOUND IN ADULT SKELETON  FUNCTIONAL LIMITATIONS : IMP. ASPECTS OF ORTHODONTIC RETENTION HEALING PERIOD FOLL. ORTHOGNATHC SURGERY www.indiandentalacademy.com
  16. 16. www.indiandentalacademy.com
  17. 17. LAMELLAR BONE  STRONG,HIGHLY ORGANISED, WELL MINERALIZED  99% ADULT SKELETON  STRENGTH OF BONE DIRECTLY RELATED TO MINERAL COMPONENT WOVEN BONE < NEW LAMELLAR BONE < MATURE LAMELLAR BONE www.indiandentalacademy.com
  18. 18. COMPOSITE BONE  LAMELLAR BONE WITH IN WOVEN BONE LATTICE  PRODUCES STRONG BONE  PRIMARY OSTEONS  SECONDARY OSTEONS www.indiandentalacademy.com
  19. 19. BUNDLE BONE  FUNCTIONAL ADAPTATION  ATTACHMENTS OF TENDONS , LIGAMENTS  SHARPEY’S FIBRES www.indiandentalacademy.com
  20. 20. MICROSCOPIC STRUCTURE CANCELLOUS BONE (SPONGY BONE) ---TRABECULAE ----OSTEOCYTES ---LACUNAE CORTICAL BONE ( COMPACT BONE) – BASIC STRUCTURE – HAVERSIAN SYSTEM www.indiandentalacademy.com
  21. 21. HAVERSIAN SYSTEM CENTRAL VASCULAR CANAL 8 -10 CONCENTRIC LAMELLAE CEMENT LINES VOLKMAN’S CANAL www.indiandentalacademy.com
  22. 22. www.indiandentalacademy.com
  23. 23. PHASES OF BONE OSSEOUS MATRIX ---- CELLULAR COMPONENTS ORGANIC,INORGANIC COMPONENTS ---- OSTEOBLASTS,OSTEOCYTES,OSTEOCLASTS www.indiandentalacademy.com
  24. 24. BONE MINERAL RESEMBLES PRECIPITATED HYDROXYAPATITES. DISTINCTIVE FEATURES OF BONE APATITE : SMALL CRYSTAL SIZE LACK OF CHEMICAL PERFECTION INTERNAL CHEMICAL DISORDER www.indiandentalacademy.com
  25. 25. MECHANICAL PROPERTIES OF BONE TENSILE STRENGTH: DEPENDS ON ORIENTATION AND NUMBER OF COMPONENT COLLAGEN FIBRES. SUPERIOR WHEN COLLAGEN FIBRES ARE PARALLEL TO LONG AXIS OF TENSION. HAVERSIAN SYSTEMS WITH HIGH LEVEL OF CALCIFICATION ARE STIFFER. www.indiandentalacademy.com
  26. 26. COMPRESSIVE PROPERTIES DEPENDS ON ARRANGEMENT OF COMPONENT COLLAGEN FIBRES CIRCUMFERENTIAL COLLAGENOUS FIBRES ------- SUPERIOR COMPRESSIVE STRENGTH, INFERIOR TENSILE PROPERTIES LONGITUDINAL COLLAGEN FIBRES -------- SUPERIOR TENSILE , INFERIOR COMPRESSIVE PROPERTIES www.indiandentalacademy.com
  27. 27. FUNCTIONAL OSTEOLOGY www.indiandentalacademy.com
  28. 28. TRAJECTORIAL THEORY OF BONE FORMATION MEYER (1867) , CULMANN TRAJECTORIAL THEORY OF BONE FORMATION BENNINGHOFF -(STRESS TRAJECTORIES) JULIUS WOLF (1870) (LAW OF ORTHOGONALITY) ROUX (LAW OF TRANSFORMATION OF BONE) www.indiandentalacademy.com
  29. 29.  VANDERKLAU (FUNCTIONAL CRANIAL COMPONENT)  MELVIN MOSS (FUNCTIONAL MATRIX HYPOTHESIS) www.indiandentalacademy.com
  30. 30. MECHANISMS OF BONE GROWTH www.indiandentalacademy.com
  31. 31. BONE DEPOSITION AND RESORPTION BONE DEPOSITION BONE RESORPTION BONE REMODELING BONE REMODELING www.indiandentalacademy.com
  32. 32. MODELING AND REMODELING SKELETAL ADAPTATION :  ALTERATION IN MASS  GEOMETRIC DISTRIBUTION  MATRIX ORGANISATION  COLLAGEN ORIENTATION OF LAMELLAE www.indiandentalacademy.com
  33. 33. BONE MODELING INDEPENDENT SITES , CHANGE THE FORM OF BONE BONE REMODELING SPECIFIC, REPLACES PREVIOUSLY EXISTING BONE www.indiandentalacademy.com
  34. 34. INTERNAL REMODELING VIA AXIALLY ORIENTED CUTTING /FILLING CONES www.indiandentalacademy.com
  35. 35. MODELING CHANGES -- CEPHALOMETRIC TRACINGS REMODELING CHANGES -- MICROSCOPIC LEVEL TRUE REMODELING -- NOT IMAGED ON CLINICAL RADIOGRAPHS CONSTANT REMODELING –- COUPLING FACTORS ( INTERNAL TURNOVER) www.indiandentalacademy.com
  36. 36. ORTHODONTIC BONE MODELING www.indiandentalacademy.com
  37. 37.  REGIONAL ACCELERATORY PHENOMENON  CLINICAL IMPORTANCE :  ORTHOPEDICALLY POSITION MAXILLA  RAPID ORTHODONTIC ALIGNMENT OF TEETH FOLL. ORTHOGNATHIC SURGERY www.indiandentalacademy.com
  38. 38. CONTROLLED BY : METABOLIC AND MECHANICAL SIGNALS  MODELING : CONTROLLED BY :  FUNCTIONAL APPLIED LOADS  HORMONES  METABOLIC AGENTS  PARACRINE AND AUTOCRINE MECHANISMS ( LOCAL GROWTH FACTORS , PROSTAGLANDINS ) www.indiandentalacademy.com
  39. 39.  REMODELING : METABOLIC DISORDERS ( PARATHYROID HORMONES AND ESTROGENS ) www.indiandentalacademy.com
  40. 40. BOIMECHANICS  GRAVITY  MECHANICAL LOADING www.indiandentalacademy.com
  41. 41.  FROST’S MECHANOSTAT THEORY  MARTIN AND BURR  DISUSE ATROPHY -- < 200 µE 200 - 2500µE  HYPERTROPHIC INCREASE -- 2500 - 4000 µE  PATHOLOGIC OVERLOAD -- > 4000µE  PHYSIOLOGICAL PHYSIOLOGICAL LOADING -- www.indiandentalacademy.com
  42. 42. www.indiandentalacademy.com
  43. 43.  CLINICAL REFERENCE  BIOMECHANICAL LOADS RESPONSES TO APPLIED www.indiandentalacademy.com
  44. 44. IMP. OBJECTIVES OF ORTHODONTIC TREATMENT  AVOIDING OCCLUSAL PREMATURITIES  GUARDING EXCESSIVE TOOTH MOBILITY  OPTIMAL DISTRIBUTION OF OCCLUSAL LOADS www.indiandentalacademy.com
  45. 45. DISTRACTION OSTEOGENESIS  BONES CAN BE INDUCED TO GROW AT SURGICALLY – CREATED SITES.  A PROCESS OF NEW BONE FORMATION BETWEEN SURFACES OF BONE SEGMENTS SEPARATED BY INCREMENTAL TRACTION (COPE -- 1999) www.indiandentalacademy.com
  46. 46. ALIZAROV (1950) www.indiandentalacademy.com
  47. 47. GROWTH OF MAXILLA : AT SUTURES  DIRECT REMODELING  TRANSLATED DOWNWARDS AND FORWARDS  GROWTH OF MANDIBLE :  ENDOCHONDRAL PROLIFERATION AT THE CONDYLE  APPOSTION AND RESORPTION OF BONE www.indiandentalacademy.com
  48. 48. Steps involved :  Corticotomy/Osteotomy  Latency period  Distraction phase  Consolidation phase www.indiandentalacademy.com
  49. 49. www.indiandentalacademy.com
  50. 50. TENSION STRESS EFFECT www.indiandentalacademy.com
  51. 51. www.indiandentalacademy.com
  52. 52. CURRENT SCOPE :  Correction of Maxillo-Mandibular deformities Maxillary lengthening Mandibular lengthening Maxillary and Mandibular widening Lengthening of the Hard palate Distraction in other cranio-facial areas www.indiandentalacademy.com
  53. 53.  Alveolar ridge augmentation  Transport disc and Transformation osteogenesis.  Dental Distraction. www.indiandentalacademy.com
  54. 54. TISSUE CHANGES FOLLOWING DO HISTOLOGIC CHANGES :   During latency phase – formation of a fibrous bridge. During distraction phase – distinct zones seen www.indiandentalacademy.com
  55. 55. FACTORS AFFECTING DO Biologic :  AGE  SITE OF SURGERY  LATENCY  RATE PERIOD AND RHYTHM www.indiandentalacademy.com
  56. 56. BIOMECHANICAL FACTORS :  Planning the distraction vector  Device fixity  Need for ‘ Bone moulding’ www.indiandentalacademy.com
  57. 57. Mandibular Distraction INDICATIONS: Hemifacial Microsomia Treacher Collin Syndrome etc. TMJ ankylosis and condylar fractures Transverse deficiency of the mandible www.indiandentalacademy.com
  58. 58. BIOMECHANICAL EFFECTS OF DISTRACTON VECTOR www.indiandentalacademy.com
  59. 59. THE SKULL INTRODUCTION www.indiandentalacademy.com
  60. 60. www.indiandentalacademy.com
  61. 61. SKULL CALVARIA (BRAIN BOX) FACIAL SKELETON www.indiandentalacademy.com
  62. 62.  BONES OF THE SKULL : 22 BONES CALVARIA OR BRAIN CASE: PAIRED 8 bones UNPAIRED PARIETAL TEMPORAL FRONTAL OCCIPITAL SPHENOID ETHMOID www.indiandentalacademy.com
  63. 63. FACIAL SKELETON : 14 bones PAIRED UNPAIRED MAXILLA ZYGOMATIC NASAL LACRIMAL PALATINE INFERIOR NASAL CONCHA www.indiandentalacademy.com MANDIBLE VOMER
  64. 64. MANDIBLE LARGEST,STRONGEST BONE FIRST PHARYNGEAL ARCH HORSE SHOE SHAPED BODY PAIR OF RAMI www.indiandentalacademy.com
  65. 65. BODY OF MANDIBLE SURFACES: OUTER SURFACE INNER SURFACE BORDERS: UPPER BORDER LOWER BORDER www.indiandentalacademy.com
  66. 66. OSSIFICATION Greater part ossifies in membrane Parts ossifying in cartilage – incisive, coronoid, condyloid, upper half of ramus. Each half ossifies from only one centre – 6th week of intra uterine life -- in mesenchymal sheath of meckel’s cartilage – mental foramen. Symphysis menti www.indiandentalacademy.com
  67. 67. AGE CHANGES IN THE MANDIBLE IN INFANTS AND CHILDREN: Two halves fuse -- first year of life At birth – mental foramen opens below the sockets Angle is obtuse -- 140 degrees or more www.indiandentalacademy.com
  68. 68. www.indiandentalacademy.com
  69. 69. IN ADULTS Mental foramen opens mid-way Angle reduces – 110 or 120 degrees www.indiandentalacademy.com
  70. 70. IN OLD AGE Alveolar bone resorbed. Mental foramen and mandibular canal – close to alveolar border. Angle again – obtuse– 140 degrees. www.indiandentalacademy.com
  71. 71. MAXILLA -- second largest bone of the face, first being mandible FEATURES: BODY. FOUR PROCESSES: Frontal, zygomatic, alveolar, palatine. www.indiandentalacademy.com
  72. 72. www.indiandentalacademy.com
  73. 73. BODY: pyramidal in shape , base directed medially, apex laterally. four surfaces encloses maxillary sinus. www.indiandentalacademy.com
  74. 74. OSSIFICATION OSSIFIES IN MEMBRANE FROM THREE CENTRES : ONE FOR MAXILLA PROPER TWO FOR OS INCISIVUM OR PREMAXILLA www.indiandentalacademy.com
  75. 75. MAXILLA PROPER CENTRE: ABOVE CANINE FOSSA, 6TH WEEK OF INTRAUTERINE LIFE www.indiandentalacademy.com
  76. 76. PREMAXILLA MAIN CENTRE: ABOVE INCISIVE FOSSA 7TH WEEK OF INTRAUTERINE LIFE SECOND CENTRE (PARASEPTAL / PREVOMERINE): VENTRAL MARGIN OF NASAL SEPTUM 10TH WEEK FUSES WITH PALATAL PROCESS www.indiandentalacademy.com
  77. 77. AGE CHANGES AT BIRTH: TRANSVERSE AND AP DIAMETER MORE THAN VERTICAL. FRONTAL PROCESSES WELL MARKED. BODY LITTLE MORE THAN ALVEOLAR PROCESSES TOOTH SOCKETS REACHING FLOOR OF ORBIT MAXILLARY SINUS MERE FURROW ON LATERAL WALL OF NOSE. www.indiandentalacademy.com
  78. 78. ADULT: VERTICAL DIAMETER GREATEST OLD: REVERTS TO INFANTILE CONDITION HEIGHT REDUCED www.indiandentalacademy.com
  79. 79.  Sutures of maxilla – Frontomaxillary suture – Lacrimomaxillary – Zygomaticomaxillary – Ethmoidomaxillary – Palatomaxillary – Nasomaxillary – Sphenomaxillary – Intermaxillary www.indiandentalacademy.com
  80. 80. MYOLOGY STUDY OF MUSCLES,MUSCULAR SYSTEM AND THEIR FUNCTIONS AND DISORDERS. MUSCLE: Physical properties: kinetic activity 1: Elasticity. 2: Contractility. www.indiandentalacademy.com
  81. 81. Elasticity: a) length. b) cross- section. c) force exerted. d) constant coefficient. RATIO IN UNIAXIAL CASE : FΔ = AEL www.indiandentalacademy.com
  82. 82. Hooke’s law : Muscle returns to exact original shape after being stretched. The linear elastic range is dependent upon the nature of material involved. Valid and linear only at initial stage. www.indiandentalacademy.com
  83. 83. CONTRACTILITY: The ability of a muscle to shorten it’s length under innervational impulse www.indiandentalacademy.com
  84. 84. SHERRINGTON : ALL OR NONE LAW The intensity of contraction of any fibre is independent of the strength of the exciting stimulus, provided the stimulus is adequate. The strength of muscle contraction depends on : The frequency of stimuli. No. of fibres involved. Applies only when muscle is in physiologic reacting state www.indiandentalacademy.com
  85. 85. ISOMETRIC CONTRACTION : Occurs when a muscle is simply resisting an external force without any actual shortening. ISOTONIC CONTRACTION : there is actual shortening. Eg.flexing the biceps. www.indiandentalacademy.com
  86. 86. PRINCIPLES OF MUSCLE PHYSIOLOGY Visualisation by Electromyogram. EINTHOVEN (1918). (Action current) ADVANTAGE : Relatively accurate picture of muscle activity under diverse functional conditions. www.indiandentalacademy.com
  87. 87. www.indiandentalacademy.com
  88. 88. www.indiandentalacademy.com
  89. 89. www.indiandentalacademy.com
  90. 90.  Muscle Tonus: is a state of slight constant tension . Serves to obviate the muscle. Basis of reflex posture. Maintenance of various positions.  Resting Length: Permits maintenance of postural relations and dynamic equilibrium -- contraction of minimal no. of fibres. www.indiandentalacademy.com
  91. 91.  Stretch or Myotactic reflexes: The reflex contraction of a healthy muscle which results from a pull on its tendon. (Achilles Tendon Reflex)  Reciprocal Innervation and Inhibition: Given by Sherrington. Brought about by excitation of its antagonist. www.indiandentalacademy.com
  92. 92. THE FACE MUSCLES OF THE FACE www.indiandentalacademy.com
  93. 93.  FACIAL MUSCLES SUBCUTANEOUS MUSCLES EMBRYOLOGICALLY: Mesoderm of second branchial arch supplied by facial nerve MORPHOLOGICALLY: remnants of panniculus carnosus www.indiandentalacademy.com
  94. 94.  TOPOGRAPHICALLY: SIX HEADS; MUSCLES OF THE SCALP MUSCLES OF AURICLE MUSCLES OF EYELIDS MUSCLES OF THE NOSE MUSCLES AROUND MOUTH MUSCLES OF THE NECK www.indiandentalacademy.com
  95. 95. www.indiandentalacademy.com
  96. 96. www.indiandentalacademy.com
  97. 97. www.indiandentalacademy.com
  98. 98. ORBICULARIS ORIS Composed of eight segments, each segment resembles a fan wth its stem at the modiolus. Each fan is open in peripheral segments and closed in marginal segments. ORIGIN AND INSERTION : Intrinsic part : superior incisivus from maxilla and inferior from mandible –inserting into the angle of mouth. www.indiandentalacademy.com
  99. 99.  Extrinsic part : – middle strata from buccinator and superficial from lips and inserts into lips and angle of mouth. ACTIONS : Closing the mouth. whistling. www.indiandentalacademy.com
  100. 100. BUCCINATOR Thin , quadrilateral muscle between maxilla and mandible. www.indiandentalacademy.com
  101. 101. ORIGIN AND INSERTION : Upper fibres – opposite maxillary molars – insert in upper lip. Middle fibres – pterygomandibular raphe – decussate. www.indiandentalacademy.com
  102. 102.  Lower fibres -- opposite mandibular molars – insert in lower lip. ACTIONS : Compresses the cheeks against teeth, passsing food inbetween them in mastication. Expelling air when the cheeks are distended. www.indiandentalacademy.com
  103. 103. THE BUCCINATOR MECHANISM  FACTORS IN ENVIRONMENTAL BALANCE : MUSCULATURE : A RESTING MUSCLE IS STILL PERFORMING A FUNCTION – ENVIRONMENTAL FACTORS : CONTACT RELATIONSHIP AND RESISTANCE OFFERED BY : Buttressing effect of contiguous teeth. Occlusal interdigitation Bone building resorption balance Actual size and shape of roots of teeth Total amount of periodontal fibres www.indiandentalacademy.com
  104. 104.       STABILITY DEPENDS ON : GENETIC EPIGENETIC ENVIONMENTAL MORPHOLOGIC PHYSIOLOGIC FACTORS www.indiandentalacademy.com
  105. 105.  Winders: During mastication and deglutition, tongue may exert two or three times much force on the dentition as lips and cheeks at any one time. www.indiandentalacademy.com
  106. 106.  Lear and Moorrees: Substantiate the imbalance of buccolingual forces, Limitations – measuring equipment hydraulic nature of response size of sample geometry of dental arch www.indiandentalacademy.com
  107. 107.  Proffit: Labial pressures are easier to measure than lingual pressures. Fry (1960) Data for lingual pressure must be recorded with some suspicion. www.indiandentalacademy.com
  108. 108. BUCCINATOR MECHANISM www.indiandentalacademy.com
  109. 109. www.indiandentalacademy.com
  110. 110. TONGUE  Muscular organ situated in the floor of the mouth. Associated with functions of taste, speech, Mastication and deglutition.  www.indiandentalacademy.com
  111. 111.  Has two parts : Oral part - lies in the mouth. Pharyngeal part -- lies in the pharynx.  These parts are separated by V –shaped sulcus k/a sulcus terminalis.  External features: ROOT . TIP. BODY. www.indiandentalacademy.com
  112. 112. ROOT ; attached to mandible and soft palate above hyoid bone below. BODY – upper surface – curved k/a dorsum. Dorsum : divided into : oral part pharyngeal part Inferior surface – confined to oral part. www.indiandentalacademy.com
  113. 113. PAPILLAE OF TONGUE : CIRCUMVALLATE PAPILLAE FUNGIFORM PAPILLAE FILIFORM / CONICAL PAPILLAE www.indiandentalacademy.com
  114. 114. MUSCLES OF TONGUE INTRINSIC MUSCLES SUPERIOR LONGITUDINAL INFERIOR LONGITUDINAL TRANSVERSE VERTICAL www.indiandentalacademy.com
  115. 115. EXTRINSIC MUSCLES : GENIOGLOSSUS HYOGLOSSUS STYLOGLOSSUS PALATOGLOSSUS www.indiandentalacademy.com
  116. 116. www.indiandentalacademy.com
  117. 117. ARTERIAL SUPPLY : LINGUAL ARTERY – EXTERNAL CAROTID ARTERY ROOT OF TONGUE – TONSILLAR AND ASCENDING PHARYNGEAL ARTERIES. VENOUS DRAIN : DEEP LINGUAL VEIN www.indiandentalacademy.com
  118. 118. LYMPHATIC DRAINAGE : TIP OF TONGUE – bilaterally into submental nodes. RIGHT AND LEFT HALVES – submandibular nodes. POSTERIOR ONE- THIRD – jugulo-omohyoid nodes. www.indiandentalacademy.com
  119. 119. NERVE SUPPLY : MOTOR NERVE : HYPOGLOSSAL NERVE -- ALL INTRINSIC AND EXTRINSIC MUSCLES EXCEPT PALATOGLOSSUS PALATOGLOSSUS – CRANIAL ROOT OF ACCESSORY PHARNGEAL PLEXUS NERVE THROUGH SENSORY NERVE : LINGUAL NERVE – CHORDA TYMPANI – NERVE OF GENERAL SENSATION NERVE OF TASTE www.indiandentalacademy.com
  120. 120. DEVELOPMENT OF TONGUE EPITHELIUM : ANTERIOR TWO-THIRDS – two lingual swellings , one tuberculum impar. arise from first branchial arch. supplied by lingual nerve. POSTERIOR ONE –THIRD – cranial part of hypobranchial eminence. arise from third arch. supplied by glossopharyngeal nerve. www.indiandentalacademy.com
  121. 121. www.indiandentalacademy.com
  122. 122. MUSCLES : OCCIPITAL MYOTOMES – hypoglossal nerve CONNECTIVE TISSUE : local mesenchyme. www.indiandentalacademy.com
  123. 123. MUSCLES OF MASTICATION MASSETER TEMPORALIS LATERAL PTERYGOID MEDIAL PTERYGOID www.indiandentalacademy.com
  124. 124. MASSETER www.indiandentalacademy.com
  125. 125. TEMPORALIS www.indiandentalacademy.com
  126. 126. LATERAL PTERYGOID www.indiandentalacademy.com
  127. 127. MEDIAL PTERYGOID www.indiandentalacademy.com
  128. 128. www.indiandentalacademy.com
  129. 129.  MUSCLES PRODUCING MOVEMENTS DEPRESSION : LATERAL PTERYGOID,DIGASTRIC, GENIOHYOID, MYLOHYOID – ELEVATION: MASSETER, TEMPORALIS, MEDIAL PTERYGOID – PROTUSION : LATERAL ,MEDIAL PTERYGOID – RETRACTION : POSTERIOR FIBRES OF TEMPORALIS – LATERAL OR SIDE MOVEMENTS : LEFT LATERAL PTERYGOID AND RIGHT MEDIAL PTERYGOID www.indiandentalacademy.com
  130. 130. TEMPOROMANDIBULAR JOINT IS A SYNOVIAL JOINT OF CONDYLAR VARIETY. www.indiandentalacademy.com
  131. 131. ARTICULAR SURFACES: UPPER ARTICULAR SURFACE : ARTICULAR EMINENCE ANTERIOR PART OF MANDIBULAR FOSSA LOWER ARTICULAR SURFACE : HEAD OF MANDIBLE www.indiandentalacademy.com
  132. 132. LIGAMENTS: FIBROUS CAPSULE LATERAL LIGAMENT SPHENOMANDIBULAR LIGAMENT STYLOMANDIBULAR LIGAMENT www.indiandentalacademy.com
  133. 133.  FIBROUS CAPSULE  ATTACHED ABOVE : Articular tubercle Circumference of mandibular fossa Squamotympanic fissure BELOW ; Neck of condyle. www.indiandentalacademy.com
  134. 134.  LATERAL/TEMPOROMANDIBULAR LIGAMENT : Reinforces and strengthens lateral part .  Fibres directed downwards and backwards.  Attached above : articular tubercle Below : posterolateral aspect of neck of condyle www.indiandentalacademy.com
  135. 135. SPHENOMANDIBULAR LIGAMENT  Accessory ligament.  Lies on deep plane away fromfibrous capsule.  ATTACHED SUPERIORLY : Spine of sphenoid.    INFERIORLY ; Lingula of mandibular foramen. www.indiandentalacademy.com
  136. 136. STYLOMANDIBULAR LIGAMENT  ACCESSORY LIGAMENT. ATTACHED ABOVE : Lateral surface of styloid process  BELOW : Angle and posterior border of ramus of mandible.  www.indiandentalacademy.com
  137. 137.  ARTICULAR DISC OVAL FIBROUS PLATE DIVIDES JOINT INTO: UPPER COMPARTMENT PERMITS GLIDING MOVEMENTS LOWER COMPARTMENT ROTATORY AND GLIDING MOVEMENTS www.indiandentalacademy.com
  138. 138. ARTERIAL SUPPLY SUPERFICIAL TEMPORAL ARTERY MAXILLARY ARTERY NERVE SUPPLY AURICULOTEMPORAL NERVE MASSETERIC NERVE www.indiandentalacademy.com
  139. 139.  MOVEMENTS OF TMJ BETWEEN UPPER ARTICULAR SURFACE AND ARTICULAR DISC (MENISCOTEMPORAL COMPARTMENT) BETWEEN DISC AND HEAD OF MANDIBLE www.indiandentalacademy.com
  140. 140.  PROTRACTION OF MANDIBLE – Articular disc glides forwards over upper articular surface, head of mandible moving with it. – Reversal of this movement is c/a retraction. www.indiandentalacademy.com
  141. 141. SLIGHT OPENING OF THE MANDIBLE  Head of the mandible moves on the undersurface of the disc like a hinge. www.indiandentalacademy.com
  142. 142. WIDE OPENING OF MANDIBLE  Hinge like movement is followed by gliding of the disc and head of the mandible as in protraction.  At the end of this movement, head comes to lie under articular tubercle. www.indiandentalacademy.com
  143. 143. CHEWING MOVEMENTS  Involve side to side movements of mandible.   Head of right side glides forward along the disc as in protraction, Head of the left side rotates on vertical axis.  As a result chin moves forwards and to left side www.indiandentalacademy.com
  144. 144.  MUSCLES PRODUCING MOVEMENTS DEPRESSION : LATERAL PTERYGOID , DIGASTRIC GENIOHYOID,MYLOHYOID ELEVATION: MASSETER, TEMPORALIS,MEDIAL PTERYGOID PROTUSION : LATERAL ,MEDIAL PTERYGOID RETRACTION : POSTERIOR FIBRES OOF TEMPORALIS LATERAL OR SIDE MOVEMENTS ; LEFT LATERAL PTERYGOID AND RIGHT MEDIAL PTERRYGOID www.indiandentalacademy.com
  145. 145. FUNCTIONAL MOVEMENTS The mandible is the only movable bone in the head and face and can only be moved in certain directions because of limitations of morphology And structure of temporomandibular articulation. www.indiandentalacademy.com
  146. 146. OPENING MOVEMENT OF THE MANDIBLE Condyle brought downward and forward as chin drops downward and backward. Gravity and primary contraction of lateral pterygoid muscles. Stabilizing and adjusting activity seen in suprahyoid ,infrahyoid groups ,in the geniohyoid , mylohyoid, and digastric muscles. Stylohyoid muscle changes in length. www.indiandentalacademy.com
  147. 147. Hyoid bone moves downward and backwards. Temporal , masseter and medial pterygoid muscles show relaxation – opening movement smooth. (paralysis of these makes opening movement jerky and uncontrolled). Articular disc brought forward by lateral pterygoid muscle and capsular ligaments as condyle rotates against inferior surface of the disk. www.indiandentalacademy.com
  148. 148. CLOSING MOVEMENT OF THE MANDIBLE More power is elicited on mandibular closure. Hyoid bone moves upward and forward . Controlled relaxation of lateral pterygoid muscles helps in smooth closure of mandible. www.indiandentalacademy.com
  149. 149. PROTUSION OF THE MANDIBLE Brought about when medial and lateral pterygoid muscles contract in unison, in conjunction with controlled stabilizing relaxation of opening muscles. www.indiandentalacademy.com
  150. 150. RETRUDING ACTION OF MANDIBLE By contraction of posterior fibres of temporalis muscles with some assistance from geniohyoid , digastric and mylohyoid muscles. Hyoid bone moves posteriorly. Electromyographic research indicates that deep fibres of masster muscle assist in retrusion of the mandible. www.indiandentalacademy.com
  151. 151. WORKING BITE To establish a working bite , the mandible must be moved to the right or left. This lateral movement is initiated by the contraction of lateral pterygoid muscles on one side and relaxation on the opposite side. www.indiandentalacademy.com
  152. 152. As the teeth are brought closure to an end to end relationship, masseter contracts on left side, assisting in ipsilateral activity. As the teeth are brought together , strong activity is elicited in both masseter and temporalis muscles on both sides. www.indiandentalacademy.com
  153. 153. BENNETT MOVEMENT In the lateral shift of the mandible, the articular disk moves toward the side of the working bite. The condyle moves slightly laterally and rotates on the working side. www.indiandentalacademy.com
  154. 154. www.indiandentalacademy.com
  155. 155. www.indiandentalacademy.com
  156. 156. Primary contraction in the middle and posterior fibres of temporalis muscle and in the posterior fibres of masseter and some increased activity in hyoid group. BALANCING SIDE : Condyle and disc moves downward and forward on the articular eminence Muscle activity consists largely of lateral pterygoid contraction and controlled relaxation of masseter , temporalis and suprahyoid group. www.indiandentalacademy.com
  157. 157. POSITIONS OF THE MANDIBLE www.indiandentalacademy.com
  158. 158. Posselt recorded graphically various positions and movement area in sagittal plane www.indiandentalacademy.com
  159. 159. POSTURAL RESTING POSITION In infants ,muscles associated with suckling or intake of food are well developed from the beginning. When child is not engaged in taking food,mandible assumes position of rest whether the teeth are present or not. www.indiandentalacademy.com
  160. 160. Mandibular resting position is one of the earliest positions to be developed. Mandible is suspended from cranial base by cradling musculature. www.indiandentalacademy.com
  161. 161. Posselt observes that “ Postural position can be altered by conditions in masticatory system as well as by systemic factors.” Factors influencing postural position : Body and head position. Sleep Psychic factors influencing muscle tonus Age Proprioception from the dentition and muscles. Occlusal changes. Pain. Psychic factors. Temporomandibular joint disease. www.indiandentalacademy.com
  162. 162. CENTRIC RELATION Refers to the position of the mandibular condyle in the articular fossa. Defined as: unstrained ,neutral position of the mandible in which the antero- superior surfaces of the mandibular condyles are in contact with the concavities of articular discs as they approximate the postero- inferior third of their respective articular eminentia. www.indiandentalacademy.com
  163. 163. Can be the same as postural resting position, initial occlusal contact and centric occlusion. Centric occlusion requires contact of teeth in addition to unstrained position whereas centric relation does not require occlusal contact. www.indiandentalacademy.com
  164. 164. INITIAL CONTACT In normal occlusion : It maintains centric relation position as far as articular fossae are concerned. movement in TMJ is almost completely rotation of condyle. the point of initial contact produces no change in function of TMJ. www.indiandentalacademy.com
  165. 165. Initial contact in the ideal individual is usually synonymous with centric occlusion. In malocclusion or premature contact, initial contact is no longer the same as centric occlusion. www.indiandentalacademy.com
  166. 166. CENTRIC OCCLUSION Implies a state of balance . must be harmonious with centric relation www.indiandentalacademy.com
  167. 167. Premature contacts , loss of teeth ,overeruption of teeth , overextension of artificial restorations , Malpositions of individual teeth -- mitigate against centric occlusion. www.indiandentalacademy.com
  168. 168. MOST RETRUDED POSTION (TERMINAL HINGE POSITION) To establish mandibular and maxillary casts in their proper positions on the articulator. www.indiandentalacademy.com
  169. 169. starting point in occlusal analysis and rehabilitation. Many dentists believe that by forcing the mandible into its most posterior position , it is easier to eliminate occlusal prematurities that exists. www.indiandentalacademy.com
  170. 170. MOST PROTRUDED POSITION More variable from individual to individual. Condyle drawn anterior to lowest point of articular eminence. www.indiandentalacademy.com
  171. 171. HABITUAL RESTING POSITION May not be the same as postural resting position. Pathologic conditions that interfere in establishment of normal postural position of the mandible are : Abnormal atmospheric pressure. Paralysis induced by poliomyelitis Enlarged adenoids Pain TMJ pathology Trauma Mouth breathing www.indiandentalacademy.com
  172. 172. HABITUAL OCCLUSAL RELATION In normal occlusion, centric occlusion and habitual occlusion should be the same. Occlusal relationship is much more susceptible : Environmental assaults Functional aberrations improper restoration of carious teeth Tooth loss Malposition of individual teeth Premature contacts. www.indiandentalacademy.com
  173. 173. FUNCTIONS OF STOMATOGNATIC SYSTEM www.indiandentalacademy.com
  174. 174. MASTICATION: Mastication in infants www.indiandentalacademy.com
  175. 175. www.indiandentalacademy.com
  176. 176. MASTICATION IN ADULTS FLETCHER – masticatory stroke in adult using six phases ; outlined by MURPHY. PHASES: PREPARATORY PHASE FOOD CONTACT CRUSHING PHASE TOOTH CONTACT GRINDING PHASE CENTRIC OCCLUSION www.indiandentalacademy.com
  177. 177. www.indiandentalacademy.com
  178. 178. DEGLUTITION www.indiandentalacademy.com
  179. 179. www.indiandentalacademy.com
  180. 180. FLETCHER -- divided deglutitional cycle into : Preparatory swallow. Oral phase of swallowing. Pharyngeal phase of swallowing. Esophageal phase of swallowing. www.indiandentalacademy.com
  181. 181. PREPARATORY SWALLOW : www.indiandentalacademy.com
  182. 182. ORAL PHASE : www.indiandentalacademy.com
  183. 183. PHARYNGEAL PHASE : www.indiandentalacademy.com
  184. 184. ESOPHAGEAL PHASE : www.indiandentalacademy.com
  185. 185. www.indiandentalacademy.com
  186. 186. TONGUE THRUST Condition in which tongue makes contact with any teeth anterior to the molars during swallowing. www.indiandentalacademy.com
  187. 187. www.indiandentalacademy.com
  188. 188. Factors : Genetic . Learned behaviour (habit). Maturational. Mechanical restrictions. Neurological disturbance. Psychogenic factors. www.indiandentalacademy.com
  189. 189. OTHER TITLES FOR TONGUE THRUSTING : PERVERTED OR DEVIATE SWALLOW. REVERSE SWALLOW. RETAINED INFANTILE SWALLOW. TOOTH APART SWALLOW. www.indiandentalacademy.com
  190. 190. CLASSIFICATION OF TONGUE THRUSTING BY JAMES S. BRANER AND HOLT : TYPE I : Non – deforming tongue thrust. TYPE II : Deforming anterior tongue thrust. subgroup subgroup subgroup 1: 2: 3: Anterior openbite. Anterior proclination. Posterior crossbite. www.indiandentalacademy.com
  191. 191. TYPE III : Deforming lateral tongue thrust. subgroup 1 : Posterior openbite. subgroup 2 : Posterior crossbite. subgroup 3 : Deep overbite. TYPE IV : Deforming anterior and lateral tongue thrust. subgroup subgroup subgroup 1: 2: 3: Anterior and posterior open bite. Proclination of anterior teeth. Posterior cross bite. www.indiandentalacademy.com
  192. 192. Also classified as : SIMPLE TONGUE THRUST COMPLEX TONGUE THRUST www.indiandentalacademy.com
  193. 193. RESPIRATION www.indiandentalacademy.com
  194. 194. Mouth breathing classified as : Obstructive . Habitual . Anatomic . www.indiandentalacademy.com
  195. 195. www.indiandentalacademy.com
  196. 196. www.indiandentalacademy.com
  197. 197. www.indiandentalacademy.com
  198. 198. Clinical features : Adenoid faces. www.indiandentalacademy.com
  199. 199. Management : Removal of nasal and pharyngeal obstruction. Interception of habit. Rapid maxillary expansion. www.indiandentalacademy.com
  200. 200. SPEECH defined as ordered utterance of a language. www.indiandentalacademy.com
  201. 201. www.indiandentalacademy.com
  202. 202. Vowels : a e I o u Consonants :p,g,m,b,s,t,r,z. Bilabial sounds : b, p, m. Labiodental sounds : f , v. www.indiandentalacademy.com
  203. 203. Linguodental sounds : th. Linguoalveolar sounds : t,d,s,z,v,l. sibilants : s ,z ,ch ,sh. Linguopalatal and linguovelar sounds : year, she, vision, onion. k ,g , ng. www.indiandentalacademy.com
  204. 204. LINGUOALVEOLAR SOUNDS www.indiandentalacademy.com
  205. 205. LINGUOALVEOLAR SOUNDS www.indiandentalacademy.com
  206. 206. Classification of consonants : Plosive or stop plosives : /p/,/b/,t/,/d/,/k/,/g/. Fricatives : Affricatives : Glides : Nasals : /f/,/v/,/th/,/s/,/z/,/sh/. /ch/,/dz/ /l/,/w/,/r/,/j/. /n/,/m/,/ng/. www.indiandentalacademy.com
  207. 207. www.indiandentalacademy.com
  208. 208. Speech mechanisms acts on breath stream in no. of ways : Controlling the air mechanism. Air direction. Air flow. Air release. Air pressure. General air path and Lingual airpath. www.indiandentalacademy.com
  209. 209. REFERENCES  T.M GRABER- ORTHODONTICS:PRINCIPLES AND PRACTICE III Ed.  BONE BIODYNAMICS IN ORTHODONTIC AND ORTHOPAEDIC TREATMENTVOL 27 CRANIOFACIAL GROWTH SERIES  PROFFIT- CONTEMPORARY ORTHODONTICS III Ed.  STRANG- TEXTBOOK OF ORTHODONTIA  MICHAEL.H.ROSS, EDWARD.J.REITH-HISTOLOGY, A TEXT AND ATLAS www.indiandentalacademy.com
  210. 210.  WILLIAM.F.GANONG-REVIEW OF MEDICAL PHYSIOLOGY 20TH Ed.  GRANT’S ANATOMY- ATLAS  GRAY’S ANATOMY  SALZMANN-ORTHODONTICS IN DAILY PRACTICE  HOUSTON,STEPHAN,TULLEY-TEXTBOOK OF ORTHODONTICS  ANGLE ORTHODONTIST(1994)-WOLFF’S LAW www.indiandentalacademy.com
  211. 211. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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