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GROUP 5 ASSIGNMENT,[object Object]
OBASANYA Adedotun Augustine-DEN/2007/051 (CHAIRMAN),[object Object],OGUNLOLA OmowumiAbosede-DEN/2007/057 (SECRETARY),[object Object],DADA Babatunde- DEN/2007/036,[object Object],OKUNOLA Ibukunoluwa Esther- DEN/2007/063,[object Object],IWEGBU Samuel Enere -DEN/2007/046,[object Object]
JAW MOVEMENTS AND POSITIONS,[object Object]
Introduction ,[object Object],MANDIBLE It is the largest and strongest bone of the face. It develops from the first pharyngeal arch. It has a horse - shoe body which lodges the teeth, and a pair of rami which projects upwards from the posterior ends of the body and provide attachments to muscles,[object Object],To study mandibular movement one should have knowledge about anatomy of temporomandibular joint, function and neurophysiology of masticatory system and mechanism of mandibular movement. ,[object Object]
Temporomandibularjoint,[object Object],The temporomandibular joint, or TMJ, connects the lower jaw called the mandible, to the temporal bone at the side of the head. There are two temporomandibularjoints, one on each side of the jaw.,[object Object],Since TMJ are flexible, the jaw can move smoothly up and down and side to side, allowing us to talk, chew and yawn.,[object Object],Muscles attached to, and surrounding the joint, control its position and movement,[object Object]
Temporomandibular joint,[object Object],When opening the mouth, the rounded ends of the lower jaw joint, called condyle, glide along the joint socket of the temporal bone The condyle slide back to their original position when we close our mouth,[object Object]
Articular disc divides the joint cavity into upper and lower cavities,[object Object],Mandibular notch,[object Object]
Temporomandibular joint,[object Object],Movements,[object Object],Protrusion or protraction, Retraction, Depression, Elevation,[object Object],Muscles involved are known as muscles of mastication. Muscles of mastication are –temporalis, masseter, lateral pterygoid (L Pt), Medial pterygoid( M Pt),[object Object]
Temporomandibular joint,[object Object],Protraction is brought about by lateral pterygoid assisted by medial pterygoid,[object Object]
Retraction by posterior fibers of temporalis,[object Object],•Elevation-temporalis , masseter and medial pterygoid,[object Object]
Lateral chewing movements-alternately protruding and retracting the mandible on each side with a certain amount of rotation,[object Object]
Determination of mandibular movements,[object Object],Factors that  determine  mandibular movements are:,[object Object],1.	Condylar guidance,[object Object],2.	Incisal guidance,[object Object],3.	Neuromuscular factors ,[object Object]
Condylar guidance(posterior determinant),[object Object],It can be defined as the mandibular guidance generated by the condyle and articular disc traversing the contour of the glenoid fossa.,[object Object],The condyle  moves along the glenoid fossa during mandibular movements . Hence, the surface of the glenoid fossa determines the path of movement of the condyle.,[object Object],The slope of the glenoid fossa is a S-bend, hence the condyle moves along a S-shaped path.,[object Object]
Incisal Guidance(anterior determinant),[object Object],It is defined as the influence of the contacting surfaces of the mandibular and the maxillary teeth during mandibular movements.,[object Object],During protrusion, the incisal edge of the lower anteriors slide along the slope of the lingual surface of the upper anterior teeth before reaching edge-to-edge  contact.,[object Object],The incisal guidance is absent in a completely edentulous patient. It is reproduced in the complete denture by arbitrarily setting the anteriors using a standard incisal guide value and modifying to suit the patient during aesthetic anterior try-in.,[object Object]
Neuromuscular factors ,[object Object],The muscles of mastication are the most important determinants of mandibular movements.,[object Object],Many neurological disorder like parkinsonism produce muscle dysfunction ,[object Object],Each muscle has a specific action on the mandible,[object Object],The movement of the mandible in any direction is predominantly controlled by one particular muscle and is coordinated by the remaining.,[object Object],When there is hypertrophy or dysfunction of one group of muscles, the movement of the mandible is un-coordinated and asymmetrical.,[object Object]
MECHANISM OF MANDIBULAR MOVEMENT,[object Object]
Mandibular movement occurs as a complex series of interrelated three dimensional rotation and transitional activities. It is determined by combined and simultaneous activities of both temporomandibular joints. Although the TMJ is cannot function entirely independent of each other, they also rarely function with identical concurrent movement.,[object Object]
Types of mandibular movement,[object Object],A.	Based on the dimension involve in the movement.,[object Object],Rotation,[object Object],Translation ,[object Object],B.      Based on the type of movement,[object Object],Hinge ,[object Object],Protrusion,[object Object],Retrusion,[object Object],Lateral movement,[object Object],C.         Based on the extent of movement,[object Object],Border movement,[object Object],Intra-border movement,[object Object]
CLASSIFICATION,[object Object],Mandibular movement occur as a complex series of interrelated 3-D ROTATIONAL and TRANSLATION activities.,[object Object]
1) Rotational movement,[object Object],[object Object]
In the masticatory system, rotation occurs when the mouth opens and closes around a fixed point or axis within the condyles.
 In TMJ, rotation occurs as the movement within the superior surface of the condyle and the inferior surface of articular disc.
Rotational movement of mandible can occur In 3 ways(plane):  horizontal , vertical/ frontal andsaggital. ,[object Object]
Mandibular movement in horizontal axis is an opening and closing motion.,[object Object],Know as hinge movement (example of mandibular activity In which a pure rotational movement occurs ) ,[object Object],a) Horizontal  ,[object Object]
b) Frontal ,[object Object]
c) Saggital ,[object Object], Occurs when one condyle moves inferiorly while the other remains In the terminal hinge position.,[object Object],    because the ligaments and musculature of TMJ prevent an inferior displacement of the opposite condyle movements.  ,[object Object]
2) TRANSLATION MOVEMENT,[object Object],Define as: movement in “which each point of moving object has simultaneously  the same direction and velocity” ,[object Object],In the masticatory system it occurs when the mandible moves forward as in protrusion.,[object Object],Teeth, condyles and rami all move In the same direction and same degree.,[object Object],occurs within the: ,[object Object],[object Object],[object Object]
Protrusive movement ,[object Object],It occurs while incising and grasping food. This movement occurs after the condyle rotates for more than 13⁰ in the temporomandibular joint.,[object Object],When the mandible slides forward and the mandibular and maxillary anterior teeth are in edge to edge relation, the protrusive movement is said to be complete.,[object Object]
Retrusive movement ,[object Object],It occurs when the mandible is forcefully moved behind its centric relation. It is usually not a common movement and the patient cannot voluntarily produce it.,[object Object]
Lateral movements,[object Object],They are of two types,[object Object],Lateral rotation or laterotrusion,[object Object],Bennett movement ,[object Object],Lateral rotation:-,[object Object],This is said to occur when the mandible moves away from the mid-sagittal plane either on the left or the right. It should be noted that when the mandible moves laterally, the condyles on both sides do not share the same path of movement.,[object Object]
Simply put Lateral movement of mandible occurs when one condyle rotates within TM fossa and the other condyle translates forward and inward. The translating condyle is called the non-working condyle and the rotating condyle is called the working condyle. ,[object Object],The direction of lateral movements is determined by external – pterygoid muscle on the non-working side and by deep capsular ligaments of the condyle on working side. ,[object Object],The right condyle is allowed only a small rotatory movement because its lateral pole is limit by TM ligament and cannot move backwards for more than 1mm.,[object Object]
Bennett in 1908 studied the working condylar path and called it ‘Bennett movement’ now referred to as laterotrusion. Bennett movement is a bodily side shift of mandible that occurs during lateral movement.,[object Object],During lateral movement working condyle rotates and moves slightly outward. This movement is between 2-4 mm.,[object Object],If the TM ligament of rotating condyle is very tight, there is no bodily side ship of the mandible and there fore no Bennett movement occurs.,[object Object],Bennett movement ,[object Object]
BENNETT ANGLE,[object Object],It is defined as the saggital plane and the path of the advancing condyle during lateral mandibular movements as viewed in the horizontal plane.,[object Object],This is the angle formed between the path of the non-working condyle and the saggital plane,[object Object],It therefore moves forwards and medially in an arc around the opposite condyle while moving over the temporal bone,[object Object]
OVERBITE AND OVERJET,[object Object],The majority of patients with natural dentitions have upper anterior teeth which overlap their opposite number in the lower jaw both ,[object Object],horizontally (‘overjet’) normal is 2mm,[object Object],and vertically (‘overbite’), normal is 2mm ,[object Object]
Base on the extent of movement,[object Object],Border movement,[object Object],The maximum amount of movement in any plane or direction is termed the border movement.,[object Object],Within the confines of the border movements there is an extremely wide range of movement called intra-border movement. Most mandibular movement occurs as intra-border movements.,[object Object],Function at the border limits is usually demonstrated during Para-functional activities such as bruxism or wide opening yawning.,[object Object]
Base on the extent of movement,[object Object],The border positions are limited by nerves muscles and ligaments.,[object Object],Border movement demonstrates the movement from centric occlusion backward to centric relation and forward to protrusive border movement. The lowermost point in the point of maximum opening from where the mandible can be taken to all border movements.,[object Object],Border movements are recorded and measured because they are repeatedly reproducible.,[object Object]
Single Plane Border Movement,[object Object],Sagittal plane border and functional movement,[object Object],Horizontal plane border and functional movement,[object Object],Frontal (vertical) border and functional movement,[object Object]
Sagittal Plane Border Movement,[object Object]
Sagittal Plane Border Movement,[object Object],Posterior open border,[object Object],Anterior open border,[object Object],Superior contact border,[object Object],Functional movements,[object Object]
Sagittal Plane Border Movement,[object Object],Posterior open border movement,[object Object]
Sagittal Plane Border Movement,[object Object],Anterior open border movement,[object Object]
Sagittal Plane Border Movement,[object Object],Superior contact border movement,[object Object]
Sagittal Plane Border Movement,[object Object],Superior contact border movement(cont.),[object Object]
Sagittal Plane Border Movement,[object Object],Superior contact border movement (cont.),[object Object]
Sagittal Plane Border Movement,[object Object],Superior contact border movement (cont.),[object Object]
Sagittal Plane Border Movement,[object Object],Functional movements,[object Object]
Horizontal Plane Border Movement,[object Object],Left lateral border,[object Object],Continued left lateral border ,[object Object],	with protrusion,[object Object],Right lateral border,[object Object],Continued right lateral border ,[object Object],	with protrusion,[object Object],Functional movements,[object Object]
Horizontal Plane Border Movement,[object Object],Left lateral border,[object Object]
Horizontal Plane Border Movement,[object Object],Continued left lateral border with protrusion,[object Object]
Horizontal Plane Border Movement,[object Object],Right lateral border,[object Object]
Horizontal Plane Border Movement,[object Object],Continued right lateral border with protrusion,[object Object]
Horizontal Plane Border Movement,[object Object],Functional movements,[object Object]
Envelope of motion,[object Object],The “Full Envelope” of Hinge and TranslatoryMovements as viewed in the mid-saggital reference plane appears as a special “envelope-like figure” known as: POSSELTS ENVELOPE,[object Object]
Intra-border movement,[object Object],Functional movements,[object Object],[object Object]
Swallowing
Yawning
speechPara-functional movement,[object Object],[object Object]
Bruxism
Others,[object Object]
Mastication ,[object Object],Mastication is defined as the act of chewing. This act is made up of rhythmic and well controlled separation and closure of maxillary and mandibular teeth. Each opening and closing of mandible represents a chewing stroke. The chewing movement in the frontal view has tear shaped pattern.,[object Object],It can be divided into opening phase and closing phase.,[object Object],Closing phase is further divided into crushing phase and grinding phase. While chewing, adults open their mouth to a comfortable distance and move the mandible in a forward direction until the edges of maxillary and mandibular teeth meet. The food bolus is then transported to the centre and mandible goes to its original position. ,[object Object],Children below 10 years begin their chewing stroke with lateral movement but after 10 years of age the chewing pattern varies and the stroke is more vertical. ,[object Object]
Deglutition ,[object Object],Deglutition or swallowing is an innate function. It is starting point of peristaltic transport of food to stomach. This activity may be divided into-oral, pharyngeal and esophageal phases of which first is voluntary and other two one reflex.,[object Object],In order that deglutition may be initiated, the air passage through mouth must be closed. The anterior seal is normally accomplished by the lips, but the edge and apex of the tongue may substitute in some cases.,[object Object],During deglutition mandible is generally stabilized against maxilla by contraction of masseter and temporalis muscle. This results in contact of the upper and lower teeth.,[object Object]
Respiration The role of mouth in respiration is secondary to that of nasal cavity. If there is nasal obstruction, mouth becomes a primary respiratory passage. The mouth remains open, mandible depresses and the air passes through the mouth instead of the nose.,[object Object]
Speech ,[object Object],The teeth, tongue, lips, floor of mouth and soft palate form the resonance chamber that effects pronunciation. ,[object Object],During speech the teeth are generally not in contact although the anterior teeth may come very close together. During speech the various mandibular movements take place.,[object Object]
Para-functional Movements,[object Object],Para-functional movements of the mandible are activities that serve no useful function and are potentially harmful to the dentition and its contagious structures. They can result in tooth mobility, migration, excessive wear or fracture, PDL widening. TMJ pain, muscle pain, restricted mandibular movements.Bruxism Normal person masticate with chewing strokes that are well rounded, within definite borders, and less repeated.In bruxism the strokes are much shorter and slower and have an irregular but repeatable pathway appear to relate to the altered functional movement of the condyle which the disorder is centered.Bruxism may be due to habit, general stress, pain, exertion, anger, occlusal interference.,[object Object]
Clenching,[object Object],In vertical affort (clenching in centric occlusion), most of the elevator muscles are activated maximally. ,[object Object],In some subjects the medial pterygoid muscle activity is low.,[object Object],The variation between subjects related to occlusal contacts and musculoskeletal morphology. ,[object Object],The inferior head of the lateral pterygoid produces little activity or only 25 percent of maximum activity compared to the superior head. ,[object Object]
Clenching,[object Object],Muscle activity decreases when,[object Object],less posterior teeth ,[object Object],only the incisors in contact,[object Object],The digastric muscle,[object Object],slightly active during vertical effort with intercuspal clenching ,[object Object],more active during vertical incisive clenching. ,[object Object]
Jaw positions,[object Object],Physiologic rest position ,[object Object],The position assumed by mandible when the head is in an upright position, the muscles are in equilibrium in tonic contraction and condyles are in a unstrained neutral position is the physiologic rest position of mandible.,[object Object],The mandibular resting position is one of the earliest postural positions to be developed. The jaws are not clamped together but, they are separated by rather constant distance, even before there are any teeth in the mouth. Even though the muscles are not in active function, a limited number of fibers are apparently still contracting to maintain the relaxed position of the mandible and posture of the head.,[object Object]
Jaw positions,[object Object],The postural position can be altered by conditions in the masticatory system as well as by systemic factors. Factors influencing the postural rest position are 1) Body and head posture.2) Sleep 3) Psychic factors influencing muscle tonus.4) Age 5) Proprioception from dentition and muscles6) Occlusal changes, such as attrition.7) Pain8) Muscle disease and muscle spasms.9) Temporomandibular joint disease.,[object Object]
Free-way space ,[object Object],This is referred  to the space between the at rest.free -way space exist only at rest.,[object Object],During occlusion,the teeth come in contact with one another and the space is lost.,[object Object],Denture js fabricated in vertical dimension at occlusion so that the free-way space js formed,[object Object]
Rest Vertical Dimension(RVD),[object Object],It is defined as the length of the face when the  mandibule is at rest,[object Object],This is the position of the mandibule in relation to the maxilla when the maxillofacial musculature are in a state of tonic equilibrum.,[object Object],This position is influenced by the muscles of mastication,muscles involved in speech, deglutition and breathing.,[object Object]
Rest vertical dimension acts as reference point during recording the occlusal vertical dimension(ovd),[object Object],Vd at rest=VD at occlusion+free-way space,[object Object],Moving the head backwards tends to increase RVD, while tilting it forward has the opposite effect,[object Object]
Factors to consider when recording RVD,[object Object],1. 	The position of the mandible is influenced by gravity and the posture of the head. Hence while recording the patient should be asked to sit upright with his/her head upright and eyes looking front.,[object Object],2.	when recording all muscles affecting this record should be relaxed.,[object Object],3.	presence of any neuromuscular disease in the patient can influence at rest position.,[object Object]
Method used to measure RVD,[object Object],1.	Facial measurements after 		swallowing and relaxing,[object Object],2.	tactile sense ,[object Object],3.	measurement of anatomical 	landmarks,[object Object],4.	speech,[object Object],5.	facial expression,[object Object]
Occlusal vertical dimension(OVD),[object Object],OVD is the length of the face when the teeth are in contact and the mandible is in centric relation,[object Object],When the teeth are fully intercuspidated, the position is known as intercuspal position(IP),[object Object],The free-way space is at zero and the RVD is equal to the OVD.,[object Object]
Method of recording OVD,[object Object],Mechanical,[object Object],[object Object]
Pre-extraction record

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Group 5 assignment 7