As we know that the muscles play an important role in stability and support of a prosthesis,hence we should be well learned about their peripheries and actions.
This presentation specifically deals with the maxillary and mandibular Major connectors used in a cast partial denture. it also mentions the uses, advantages and disadvantages of each,
This presentation specifically deals with the maxillary and mandibular Major connectors used in a cast partial denture. it also mentions the uses, advantages and disadvantages of each,
A number of theories have been put forward for impressions. each having its own advantage and disadvantage.
Different spacers guide and aid in in making the desired impression with adequate pressure in the desired region of the arch in maxilla and mandible. different materials are used for spacers depending on the need.
this presentation has all the techniques in impression making in the fabrication of an RPD.
The presentation is available on request. Mail me at apurvathampi@gmail.com
A number of theories have been put forward for impressions. each having its own advantage and disadvantage.
Different spacers guide and aid in in making the desired impression with adequate pressure in the desired region of the arch in maxilla and mandible. different materials are used for spacers depending on the need.
this presentation has all the techniques in impression making in the fabrication of an RPD.
The presentation is available on request. Mail me at apurvathampi@gmail.com
MUSCLES OF FACIAL EXPRESSIONS & PROSTHODONTIC PERSPECTIVE.pptxDr. Aayush Shah
The seminar titled "Muscles of Facial Expression and Their Prosthodontic Perspective" explores the complex interplay between facial muscles and prosthodontics, offering a thorough understanding of their critical function in both oral function and aesthetics. In this talk, the facial muscles' anatomy and physiology will be examined, with an emphasis on how important they are to prosthodontic procedures and treatment outcomes.
Muscles of mastication are the group of muscles that help in movement of the mandible as during chewing and speech. We need to study these muscles as they control the opening & closing the mouth & their role in the equilibrium created within the mouth. They also play a role in the configuration of face.
Rehabilitation of endodontically treated teeth : Post & CoreNaveed AnJum
These days we often come across mutilated or badly broken teeth in our practice. However various factors are involved for a better prognosis of such a teeth. This presentation mainly focuses on post and core treatment of such a teeth.
Impact of dental implant surface modifications on Osseo-integrationNaveed AnJum
implant macro design as well as the surface topography plays an important role in higher survival rates of implants, especially in poor bone quality or density. Various modifications in surface topography have been enumerated here.
The biological fixation determines the longevity of dental implant treatment. It ensures the long term survival of dental implant. Better the osseointegration,higher will be the survival rate
By definition, a veneer is a small sheath-like cover that conceals a particular entity. In dentistry, a veneer is a small piece of porcelain or composite material that fits over a tooth’s enamel, covering teeth abnormalities for a beautiful smile.
Here we discuss various types of veneers, their uses , preparation types as well as the recent advances in a phased manner.
Failures in Removable Partial Denture ProsthodonticsNaveed AnJum
This presentation gives the clinician a perspective towards various failures in removable partial prosthodontics. The presentation has been made by referring various books and articles related to prosthodontics.
The socket shield technique at molar sitesNaveed AnJum
The socket-shield technique for avoiding postextraction tissue alteration was first described in 2010. The technique was developed for hopeless teeth in anterior esthetic sites but has not yet been described for molar sites. Managing postextractive ridge changes in the posterior region by prevention or regeneration remains a challenge. The socket shield aims to offset these ridge changes wherever possible, preserving the patient’s residual tissues at immediate implants.
A STEP IN CASTING OF CAST PARTIAL DENTURE, a precious duplication process and proper wax up of refractory cast results in accurate fitting of the framework of the prosthesis.
AN INTRODUCTION TO REMOVABLE PARTIAL PROSTHODONTICS INCLUDING ITS CLASSIFICATION, MATERIALS USED, AND THE INSIGHTS OF THE TREATMENT.
THE PRESENTATION IS MADE BY GOING THROUGH VARIOUS ARTICLES BASED ON REMOVABLE PARTIAL DENTURE.
AND ADVANCEMENTS IN THE FIELD OF CAST PARTIAL DENTURE.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
3. Myology – study of
muscles.
Muscle is a soft tissue
made up of a large
number of fibres
bound together by
connective tissue into
bundles,or fascicles.
These bundles are
surrounded by
connective tissue
sheaths and
grouped together
into still larger
bundles.
The whole muscle is
enveloped by a
connective tissue
sheath,the
epimysium.
Muscles can be
voluntary(skeletal)
or involuntary
(smooth or cardiac)
4. INTRODUCTION:
Musculature is involved directly in several important phases of
complete dentures.
They exert a direct influence upon the peripheral
extensions,shape and thickness of denture bases,position of
teeth both horizontally and vertically and facial appearances.
In addition they are active during mastication,speech and
deglutition.
The muscles that are intimately involved with
prosthodontics are skeletal muscles.
5. In the majority of skeletal muscles ,the origins and insertions are
in bone.
However,many skeletal muscles involved in complete denture
construction have a bony origin but insert into an aponeurosis,a
raphe,or another muscle.
Following group of muscles are studied in relation to complete
dentures:
Muscles of mastication and its accessory
muscles.
Muscles of facial expression.
Muscles of soft palate.
Muscles of tongue.
7. Process of grinding and chewing food into
smaller pieces in the oral cavity ,turning it
into a food bolus
MASSETER
TEMPORALIS
MEDIAL PTERYGOID
LATERAL PTERYGOID
They enable the lower jaw to
make closing,opening,
protrusive,retrusive movements
along with side to side
movements.
INNERVATED BY :
MANDIBULAR
BRANCH OF
TRIGEMINAL
NERVE
DEVELOPMENT:
1ST BRANCHIAL
ARCH
8. QUADRILATERAL
3 layers-Superficial,Middle and
Deep.
• Superficial layer- Largest.
Origin- anterior 2/3rd of lower border of
zygomatic arch.
Insertion- lower part of lateral surface of ramus.
• Middle layer
Origin- anterior 2/3rd of deep surface and posterior
1/3rd of lower border of zygomatic arch.
Insertion- middle part of ramus.
• Deep layer
Origin-deep surface of zygomatic arch
Insertion- upper part of ramus and coronoid process
MASSETER:
9. ACTION- Elevates the mandible to close the mouth
INNERVATION-Masseteric nerve, branch of anterior
division of mandibular nerve.
10. CLINICAL IMPLICATIONS:
ON DENTURE BORDER:
In this area ,the buccal flange
must converge medially to avoid
displacment due to contraction of
masseter muscle,because the
muscle fibres in that area are
vertical and oblique.
An active masseter muscle will create concavity in the outline of
distobuccal border.
A less active masseter may result in convex border.
11. MASSETERIC NOTCH:
Instruct the patient to open mouth wide and then
close against the resting force of your finger.
Instructing the patient to close against
the finger on tray handle causes masseter
muscle to contract and push against the
medially situated buccinator muscle.
12. PALPATION:
• The patient is asked to clench their teeth and using both hands,the
practioner palpates the masseter muscles on both sides
extraorally,making sure that the patient continues to clench during
the procedure.
• Palpating the origin of the masseter bilaterally along the zygomatic
arch and continue to palpate down the body of mandible where the
masseter is attached.
13. FAN SHAPED
• ORIGIN- temporal fossa and temporal fascia
• INSERTION- coronoid process and anterior border of
ramus.
• INNERVATION- Deep temporal branch, branch of
anterior division of mandibular nerve
TEMPORALIS:
14. ACTION- Elevates the mandible
Helps in protruding
Helps in side to side grinding movements.
CLINICAL IMPLICATIONS:
15. PALPATION:
• Pateint is asked to clench the teeth.
• The anterior region above the zygomatic arch and anterior to
TMJ.
• The middle region above TMJ and superior to zygomatic arch.
• The posterior region above and behind the ear.
16. Quadrilateral
Small superficial and large deep head
ORIGIN:
• Superficial head-maxillary tuberosity.
• Deep head-medial surface of lateral pterygoid plate.
INSERTION-Medial surface of angle and ramus of
mandible, as high as the mandibular foramen.
.
MEDIAL PTERYGOID:
17. ACTION- Elevates the mandible
Helps protruding the mandible.
Right medial pterygoid and left lateral pterygoid helps
turn chin to the left side.
INNERVATION- Nerve to medial pterygoid ,branch of main trunk
of mandibular nerve
18. CLINICAL IMPLICATIONS:
Most commonly involved muscle in
MYOFACIAL PAIN DYSFUNCTION
SYNDROME.
Trismus following inferior alveolar
nerve block is mainly due to
involvement of medial pterygoid
muscle.
19. PALPATION:
• Functional manipulation is done when the muscles becomes fatigued
and symptomatic.
• The muscle contracts as the teeth are coming in contact.
20. Short and conical
Has upper and lower head
• Upper head:
Origin - infratemporal fossa and crest of greater wing of
sphenoid
Insertion-pterygoid fovea on the anterior surface of neck of
mandible
• Lower head:
Origin-lateral surface of lateral
pterygoid plate
Insertion- articular disc in TMJ
LATERAL PTERYGOID:
21. ACTION- Depresses the mandible to open the mouth
Helps protrude the mandible (along with medialpterygoid)
Left lateral pterygoid and right medial pterygoid turn the
chin to the left side.
It is the only muscle that helps in abduction of the jaw.
INNERVATION-branch from anterior division of mandibular nerve
22. CLINICAL IMPLICATIONS:
Most commonly involved muscle is
MYOFACIAL PAIN DYSFUNCTION
SYNDROME
UNILATERAL FAILURE OF LP :
deviation of mandible towards the
affected side on opening.
BILATERAL FAILURE OF LP: Limited
opening,loss of protrusion.
23. PALPATION
SUPERIOR HEAD : equal pressure on lateral
poles of condyle as patient opens and
closes his mouth.
INFERIOR HEAD: placing the forefinger
,over the buccal area of the maxillary third
molar region and slide in medial direction
behind the maxillary tuberosity.
25. DIGASTRIC
ORIGIN INSERTION
ANTERIOR BELLY DIGASTRIC
FOSSA
TENDON
ATTACHED
TO THE BODY
POSTERIOR
BELLY
MASTOID
NOTCH
GRETER
CORNUA OF
HYOID BONE
ACTION
• Depresses mandible while
opening mouth
• Elevates hyoid bone while
swallowing
26. MYLOHYOID
ORIGIN INSERTION
MYLOHYOID LINE OF
MANDIBLE
POSTERIOR FIBRES TO THE
HYOID BONE.
MIDDLE & ANTERIOR FIBRES
DECUSSATE TO FORM
FIBROUS BANDS
ACTION
• Depresses mandible
while opening mouth
• Elevates hyoid bone
and floor of mouth
during deglutition
29. MUSCLES OF FACIAL EXPRESSION
The muscles in this region convey the
emotional state of an individual by controlling
expressions of the face.
These muscles move the skin , create lines and
folds and cause movement of facial features.
Also called mimetic muscles.
32. • Forms the occipito-frontalis muscle along
with the occipitalis muscle
ORIGIN- Galea aponeurotica
INSERTION-into the orbicularis oculi muscle and skin of forehead
INNERVATION- facial nerve
BLOOD SUPPLY-supratrochlear and supraorbital arteries
ACTION-lift the eyebrows(surprise)
Also acts when a view is too distant or dim
FRONTALIS
33. Only muscle capable in closing eyes
3 parts- orbital ,palpebral ,lacrimal
Orbital part-around the orbital margin
Origin - medial part of medial palpebral ligament
Insertion -forms concentric rings and blends with frontalis
Action – closes eyes tightly
Palpebral part-in eyelids
Origin-lateral part of medial palpebral ligament
Insertion-lateral palpebral raphae
Action-closes eyes gently- sleep or blinking
ORBICULARIS OCULI
34. Lacrimal part-lateral and deep to lacrimal sac
Origin- lacrimal fascia and lacrimal bone
Insertion- upper and lower eyelids
Action – dilates the lacrimal sac
Antagonist muscle- levator palpebrae superioris
INNERVATION- temporal and zygomatic branch of facial nerve
BLOOD SUPPLY-opthalmic, angular and zygomatico-orbital
arteries
35. • Originate from maxilla and mandible in midline
forms an ellipse around the mouth
• 2parts-extrinsic and intrinsic
Intrinsic part-
Origin- The superior incisivus and inferior incisivus
Insertion- Angle of the mouth
Extrinsic part-
Origin-Formed by converging muscles (buccinator and
elevator and depressors of lips)
Insertion – Lips and angle of the mouth
ORBICULARIS ORIS
36. ACTION- Kissing muscle
Closes and puckers lips
Purses the mouth
INNERVATION- Buccal branch of facial nerve
BLOOD SUPPLY- Superior and inferior labial artery
37. PROSTHODONTIC CONSIDERATIONS:
Because of horizontal
direction of fibres of
orbicularis oris,it has
indirect effect on
impression and denture
base.
Main muscle of lip.
Its tone depends on
the support it gets
from buccal flange
and position of the
teeth.
Frenum contains fibres
of orbicularis oris and
mentalis muscle,hence
the denture should be
carefully fitted around it
to maintain a seal
without causing
soreness.
38. FROWNING MUSCLE
Small pyramidal shaped muscle
Located in the medial end of the eyebrows
ORIGIN-medial end of supercilliary arch
INSERTION-skin of medial half of eyebrow
ACTION -draws eyebrows medially downwards,producing
vertical wrinkles
INNERVATION-temporal branch of facial nerve
BLOOD SUPPLY- opthalmic artery
CORRUGATOR SUPERCILLI
39. ORIGIN- from nasal bone and upper part of nasal
cartilage
INSERTION- skin between eyebrows
ACTION - Helps in frowning, bring the fibres along the
medial angle of eyebrows.
Contributes to expression of anger.
INNERVATION-Temporal, lower zygomatic and buccal
branch of facial nerve
BLOOD SUPPLY- Facial artery
PROCERUS
40. ORIGIN- Anterior part of zygomatic bone
INSERTION- Skin at the corner of the mouth(modiolus)
ACTION- draws angle of mouth upward and laterally.
Responsible for smiling.
INNERVATION-Buccal and zygomatic branch of facial
nerve.
BLOOD SUPPLY –Facial artery
ZYGOMATICUS MAJOR
41. ZYGOMATICUS MINOR
ORIGIN- Malar bone
INSERTION- Upper lip medial to corner of mouth
ACTION- Draws the lip upward, backward and outward
(sad facial expressions)
INNERVATION- Buccal branch of facial nerve
BLOOD SUPPLY- Facial artery
42. LEVATOR LABII SUPERIORIS
Quadratus labii superioris.
ORIGIN- Medial half of infraorbital margin of maxilla.
INSERTION-Skin of lateral half of upper lip.
ACTION-Elevates the upper lip retracts or evert the
lower lip(pouting or sadness).
INNERVATION- Zygomatic branch of facial nerve.
BLOOD SUPPLY- Facial artery.
43. Also called caninus.
ORIGIN- Canine fossa immediately below infraorbital foramen
INSERTION- Skin at the corner of the mouth forming modiolus.
ACTION- Elevates corners of mouth during expressions such as smile
INNERVATION-Buccal branch
of facial nerve
BLOOD SUPPLY- Facial artery
LEVATOR ANGULI ORIS
It attaches beneath
the frenum and
affects the position
of frenum.
44. Associated with frowning.
ORIGIN- oblique line of mandible in relation to
canine and premolars
INSERTION- skin at the corner of the mouth,
blending with orbicularis oris muscle
ACTION- draws corner of the mouth down and
laterally
INNERVATION- mandibular branch of facial nerve
BLOOD SUPPLY- facial artery
DEPRESSOR ANGULI ORIS
45. Quadratus labii inferioris
ORIGIN-Oblique line of mandible
INSERTION-Skin of lower lip
ACTION- Depresses the lower lip draws the lip downward
and laterally
INNERVATION- Mandibular branch of facial nerve
BLOOD SUPPLY- Facial artery
DEPRESSOR LABII INFERIORIS
46. BUCCINATOR
Primary muscle of cheek
3 fibres-upper ,middle and lower
Upper fibres
Origin- maxilla , opposite to molar teeth
Insertion- upper lip
Middle fibres
Origin-Pterygomandibular raphae.
Insertion-Decussate before passing onto the lips.
Lower fibres
Origin-mandible opposite to molar teeth
Insertion-lower lip
Lower fibres.
Origin-mandible opposite to molar teeth
Insertion-lower lip
47. • Pterygomandibular raphae separate buccinator and
superior constrictor muscle
• ACTION-Whistling action
Aids in mastication
Aids in neonates to suckle
• INNERVATION-Buccal branch of facial nerve
• BLOOD SUPPLY-Buccal artery
48. PROSTHODONTIC CONSIDERATIONS :
The buccinator muscle provides support and mobility for
the soft tissues of the cheek.
A major function of this muscle is to keep the cheeks
taunt.If this were not so,when the jaws close,the cheeks
would collapse and be caught between the teeth.
Another very important function is its participation in
deglutition.
It is important to know that the
proper external or polished surface
is obtained by functional influence
of buccinator to provide stability
to the denture bases.
The polished surface
occupies a position
of equilibrium
among these group
of muscles and is
referred as
NEUTRAL ZONE.
49. Overlaps sternocleidomastoid.
ORIGIN- Upper part of pectoral and
deltoid fascia
INSERTION-
Anterior fibres-Base of mandible
Poterior fibres-Skin of lower face and lip
ACTION-Depresses mandible
Pulls the angle of the mouth downwards
Draws the skin of neck superiorly during clenching
INNERVATON- Cervical branch
BLOOD SUPPLY- Suprascapular and Submental arteries
PLATYSMA
50. Chiasma of facial muscles.
Location- lateral and slightly superior to angle of
mouth (10-12mm lateral to the angle of the mouth)
Comprises of-
Orbicularis oris
Buccinator
Levator anguli oris
Depressor anguli oris
Zygomaticus major
Levator labii superioris
Risorius
Platysma
MODIOLUS
51. PROSTHODONTIC CONSIDERATIONS:
Activity of modiolus muscle is a guide for
occlusal plane determination.
Muscles radiate from the modiolus like an
array of fans.
The modiolus is lateral to lower premolars
so it will displace a lower denture if those
teeth are set too far buccally.
With teeth loss, the modiolus
displaced and give appearance of
sunken cheeks.
52. MENTALIS
Pouting muscle
Paired central muscle of the lower lip
ORIGIN-Incisive fossa of mandible
INSERTION-Skin of the chin
ACTION- raises central portion of lips
In conjunction with orbicularis oris, it allows the lips
to pout.
Mentalis contraction causes wrinkles in the chin ; eg-
doubt
INNERVATION-Mandibular branch of
facial nerve
53. The mentalis muscle
attachment to the
alveolar ridge can
dictate the level of
extension of the
labial flange of the
mandibular denture
below the crest of the
ridge.
PROSTHODONTIC CONSIDERATIONS:
The contraction of
this muscle is capable
of dislodging a
mandibular
denture,particularly
when the ridge in the
anterior region is the
same height as the
formix of the
vestibule.
54. RISORIUS
ORIGIN- fascia of parotid gland
INSERTION-Skin at the corner of the mouth ;modiolus
ACTION-Retracts angle of mouth to produce a smirk
INNERVATION- Buccal branch
BLOOD SUPPLY- Facial artery
55. FACIAL NERVE
Motor nerve supply
Emerges from the parotid gland and gives 5 branches-
1.Temporal-frontalis,auricularis,orbicularis oculi
2.Zygomatic-orbicularis oculi
3.Buccal- cheek and upper lip
4.Marginal mandibular – lower lip
5.Cervical -platysma
56. Damage to the facial nerve results in paralysis of the
muscles of facial expression on one side of the face
Infranuclear lesions- Bell’s palsy
Whole of the face on the same side -gets paralysed
Supranuclear lesions-Lower part of the opposite side of
the face is affected
CLINICAL SIGNIFICANCE
57.
58. MUSCLES OF SOFT PALATE
• The soft palate(velum) is a mobile muscular flap.
• It hangs down from the posterior border of the hard
palate into the pharyngeal cavity like a curtain .
• It separates the nasopharynx from oropharynx.
• The oral surface of soft palate is thicker and lined by
non keratinized stratified squamous epithelium.
59.
60. The soft palate consists of five pairs of muscles,i.e:
EXTRINSIC MUSCLES:
• Tensor palati( tensor veli palatini)
• Levator palati (levator veli palatini)
• Palatoglossus
• Palatopharyngeus
INTRINSIC MUSCLE:
• Musculus uvulae
INNERVATION:
MOTOR SUPPLY- All muscles of soft palate except tensor
Veli palatini are supplied by cranial root of accessory
nerve,whereas tensor veli palatini is supplied by nerve to
medial pterygoid,a branch of mandibular nerve.
SENSORY SUPPLY- Lesser palatine nerves and glossophary
ngeal nerve.
61.
62. PALATINE APONEUROSIS
It is a sheet of fibrous tissue that
provides stability and flexibility to
the soft palate and serves as an
anchoring point for a number of
its muscles.
Along its attachment to the hard palate,the palatine
aponeurosis continues with the periosteum and
submucosal connective tissue on the oral and nasal
surfaces on the hard palate.
63. TENSOR VELI PALATINI( tensor palati)
Thin,triangular muscle.
ORIGIN:
Lateral side of auditory tube.
Part of the base of skull.
INSERTION:
It descends,converges to form a delicate tendon,which winds
round the pterygoid hamulus,passes through buccinator and
flattens to form palatine aponeurosis.
ACTIONS:
Tightens the soft palate.
Opens the suditory tube.
64. LEVATOR VELI PALATINI
Cylindrical muscle.
ORIGIN:
Inferior aspect of auditory tube.
Inferior surface of petrous
temporal bone.
INSERTION:
Into the upper surface of palatine aponeurosis.
ACTIONS:
Elevates soft palate and closes pharyngeal isthmus.
Opens auditory tube.
65. PALATOGLOSSUS
ORIGIN: Oral surface of palatine aponeurosis.
INSERTION: Descends into palatoglossal arch,to the side of the
tongue at the junction of its oral and pharyngeal parts.
ACTIONS: Pulls up the root of the tongue.
66. PALATOPHARYNGEUS
It consists of two fasciculi that are separated by levator veli
palatini.
ORIGIN :
Anterior fasciculi: from posterior border of hard palate.
Posterior fasciculi : from palatine aponeurosis.
INSERTION:
Posterior border of the lamina of the thyroid cartilage.
Wall of the pharynx .
ACTIONS : Pulls up the wall
of pharynx and shortens it
during swallowing.
67. PASSAVANT’S RIDGE :
Fibres of palatopharyngeus Membrane of pharynx
Form a sphincter in
Superior constrictor
Constitute
Passavant’s
muscle
Contraction
of the muscle
raises a ridge
PASSAVANT’S
RIDGE
Soft palate when elevated comes in
Contact with PASSAVANT’S RIDGE
Closure of
Pharyngeal
Isthmus.
68. MUSCULUS UVULAE
Longitudinal strip,placed on each side of median plane.
ORIGIN : Posterior nasal apine.
Palatine aponeurosis.
INSERTION: Mucous membrane of uvula.
ACTIONS: Pulls up the uvula.
69. PROSTHDONTIC CONSIDERATIONS:
CLASSIFICATION OF SOFT PALATE: BY HOUSE
• Large and normal in form.
• Shows a movable band of tissue 5mm-12mm
distal to a line drawn across the distal edges of
tuberosities.
CLASS 2
• Medium sized and normal in form.
• Shows a resilient band of 3-5mm distal to a line
drawn across the palate distal to tuberosities.
CLASS 3
CLASS 1
• Usually accompanies a small maxilla.
• The curtain of soft tissue turns abruptly 3-5mm
anterior to a line drawn across the palate distal
to tuberosities.
70. POSTERIOR PALATAL SEAL:
The soft tissues along the junction of
the hard and soft palates on which
pressure within the physiologic limits
of the tissues can be applied by a
denture to aid in the retention of the
denture.- GPT 8
• It is the most posterior most limiting structure in
maxillary denture.
• Resist the horizontal and lateral torquing of the
maxillary denture and provide the rete tion.
• Maintains contact of the denture with soft palate
during functional movements.
71. PTERYGOMAXILLARY SEAL :
• Extends through pterygomaxillary notch continuing 3-
4mm anterolaterally approximating the mucogingival
junction.
• Occupies the entire width of hamular notch.
72. VIBRATING LINE : The imaginary line across the posterior part of the
Palate marking the division between movable and immovable tissues
Of soft palate.
ANTERIOR VIBRATING LINE:
• CUPID BOW SHAPED
APPEARANCE.
• ALWAYS ON SOFT PALATAL
TISSUES.
• TO PERFORM VALSALVA
MANEUVER
• ALSO LOCATED BY ASKING THE
PATIENT TO SAY ‘AH’ WITH
SHORT VIGOROUS BURSTS.
POSTERIOR VIBRATING LINE:
• MARKS THE DEMARCATION
BETWEEN MOVABLE &
IMMOVABLE PART OF SOFT
PALATE
• MARKS THE MOST DISTAL
EXTENSION OF DENTURE BASE.
• IMAGINARY LINE AT JUNCTION
OF TENSOR VELI PALATINI
MUSCLE AND MUSCLES OF SOFT
PALATE.
73. TONGUE
“Tongue is barely three inches long but it can kill a person six feet tall”
• Tongue is a muscular organ situated in
the floor of the mouth.
• Associated with the functions of
taste,speech,mastication and deglutition.
• Oral part – lies in the mouth.
• Pharyngeal part – lies in the pharynx.
• These parts are separated by a V shaped
sulcus: Sulcus terminalis
74. DEVELOPMENT OF TONGUE
Appears at the end of 4th week.
Connective tissue develops from
local mesenchyme.
ANTERIOR 2/3RD :
• From two lingual swellings
and one tuberculum
impar,which arise from 1st
branchial arch
• Supplied by lingual nerve
and chorda tympani
POSTERIOR 1/3rd :
• From the cranial large part
of the hypobranchial
eminence,from the third
arch.
• Supplied by
glossopharyngeal nerve.
POSTERIOR MOST:
• From the fourth arch.
• Supplied by superior laryngeal
nerve.
75.
76. EXTERNAL FEATURES OF TONGUE:
A ROOT : Attached to the mandible and soft palate above,and
to the hyoid bone below.
It is related to geniohyoid and mylohyoid muscle.
• A TIP OR APEX: Forms the anterior free end.
At rest lies behind the upper incisor teeth.
• A BODY : a curved upper surface or dorsum.
an inferior surface.
• The dorsum is
divided into oral
and pharyngeal
parts.
• The inferior surface
is confined to the
oral part only.
78. PAPILLAE OF THE TONGUE: Gives the anterior 2/3rd of the tongue its
characteristics rough appearnce.
FILIFORM PAPILLAE:
• Smallest and most numerous.
• Located along the entire dorsum
of the tongue.
• Give rise to velvety appearance of
the tongue.
FOLIATE PAPILLAE:
• Small folds of mucosa
located just infront of
palatoglossal arch along
the lateral surface of the
tongue.
CIRCUMVALLATE PAPILLAE:
• Large is size 1-2mm in diameter
and 8-12 in number .
• Arranged in form of V with apex
pointing backwards .
• Each is cylindrical projection
surrounded by circular sulcus.
FUNGIFORM PAPILLAE:
• Numerous near tip and
margins of tongue.
• Smaller than vallate
papillae.
• Visible as discret pink or
bright red pin heads.
79. WRIGHT’S CLASSIFICATION OF TONGUE POSITION:
CLASS I: The tongue lies in the floor of
the mouth with the tip forward and
slightly below the incisal edges of the
mandibular anterior teeth.
CLASS II : The tongue is flattened and
broadened but the tip is in normal
position.
CLASS III : The tongue is retracted and
depressed into the floor of the mouth
,with the tip curled upward,downward
or assimilated into the body of the
tongue.
CLASS I position is ideal,because
in such a case the floor of the
mouth is at an adequate height
,hence the lingual flange of the
denture contacts it and
maintains the peripheral seal of
the denture.
80. ARTERIAL SUPPLY OF TONGUE : Tongue is supplied by the lingual
artery which is branch of external carotid artery.
Root of the tongue is also supplied by tonsillar artery which is a
branch of facial artery.
81. A middle fibrous septum divides tongue into right and left
halves.
Each halves contains Four intrinsic and Four extrinsic
muscles.
INTRINSIC MUSCLES : SUPERIOR LONGITUDINAL
INFERIOR LONGITUDINAL
TRANVERSE
VERTICAL
EXTRINSIC MUSCLES: STYLOGLOSSUS
HYOGLOSSUS
GENIOGLOSSUS
PALATOGLOSSUS
MUSCLES OF TONGUE
82. INTRINSIC MUSCLES:
• Occupy upper part of the tongue.
• Attached to the submucous fibrous layer and to the median
fibrous septum.
• Alter the shape of the tongue.
SUPERIOR LONGITUDINAL-
• Lies beneath the mucous membrane.
• Shortens the tongue ,makes its dorsum concave.
INFERIOR LONGITUDINAL-
• Lying close to the inferior surface of the
tongue.
• Between genioglossus and hyoglossus.
• Shortens the tongue,makes its
dorsum convex.
83.
84. TRANSVERSE-
• Extends from median septum to the margins.
• Makes the tongue narrow and elongated.
VERTICAL-
• Found at the borders of the anterior part of tongue.
• Makes the tongue broad and flattened.
85. EXTRINSIC MUSCLES:
GENIOGLOSSUS- LIFE SAVING MUSCLE
Fan shaped muscle.
Forms the bulk of tongue.
• ORIGIN : Upper genial tubercle of mandible.
• INSERTION:Upper fibres –tip of the tongue
Middle fibres – dorsum
Lower fibres – the hyoid bone
• ACTIONS :
Retracts the tongue.
Depresses the tongue.
Pulls the posterior part of tongue
forwards and protude the tongue
forwards.
86. HYOGLOSSUS-
• ORIGIN : Greater cornu ,front of lateral part of body of hyoid
bone.
• INSERTION : Side and inferior aspect of tongue.
• ACTION : Depresses the tongue.
Retracts the protruded tongue.
87. STYLOGLOSSUS:
• ORIGIN : Tip and part of anterior surface of styloid process.
• INSERTION : Into the side of tongue.
• ACTION : Pulls tongue upwards and backwards during
swallowing.
88. PALATOGLOSSUS-
• ORIGIN : Oral surface of palatine aponeurosis.
• INSERTION : Side of tongue(junction of oral and
pharyngeal parts )
• ACTION : Pulls up the root of tongue, approximates
palatoglossal arches, closes oropharyngeal isthmus.
90. EFFECT OF TONGUE IN COMPLETE DENTURE
Role of tongue in impression making in alveolingual sulcus:
ANTERIOR PART:
• Mainly influenced by Genioglossus muscle,lingual
frenum and to a lesser extent by sublingual gland.
• The lingual border of the impression in this region
should extend down to make contact with the floor
of the mouth,when the tip of the tongue touches
the upper lip.
MIDDLE PART:
• When the middle of the lingual flange is made to slope towards
the tongue,it can extend below the level of mylohyoid ridge.
• In this way the tongue rests on the top of the flange and aids in
stabilizing the lower denture on residual ridge.
91. POSTERIOR PART:
• Flange can turn laterally towards the ramus to fill the fossa and
complete the typical s shaped lingual flange.
Role of tongue size:
SMALL :
Facilitate impression
making but jeopardize
the lingual seal.
LARGE:
Problem in impression making
Denture stability
Tongue biting.
In edentulous patients,without replacement the
tongue often remains hypertropied.
92. Role of tongue space:
• Artifical teeth must be arranged in
NEUTRAL ZONE,where, inward pressure
of cheeks and lips=outward pressure of
tongue
• If tongue is cramped by denture
lateral pressure exerted instability in denture
when tongue moves.
93. ANOMALIES OF TONGUE:
FISSURED TONGUE MACROGLOSSIA BENIGN MIGRATORY
GLOSSITIS
TONGUE TIE CLEFT TONGUE
LINGUAL VARICES
HAIRY TONGUE
LINGUAL VARICES
94. CONCLUSION
Knowledge of anatomy,physology and functions of
the muscles is an essence to understand the complex
morphological and functional changes in the muscle
with aging or with complete and partial edentulism.
The knowledge will help us to reach optimal
prosthetic success,as muscles plays significant and
perhaps didacting role in affecting stability and
retention of prosthesis.
95. REFERENCES
1. BD Chaurasia’s HUMAN ANATOMY for Dental students;2nd edition.
2. Syllabus of complete denture: Charles M.Heartwell ;4th edition.
3. Essentials of complete Denture: Sheldon winkler ;3rd edition.
4. Anatomy of facial expression and its prosthodontic significance
Alexander L,MartoneD.D.S.;jpd vol 12,issue 6 nov-dec 1962