Neuroanatomy and

Physiology of the
Masticatory System

MAJ Joseph Lowe

October 15, 2010

 Purpose

 To provide a basic knowledge of the

functioning components of the masticatory
system
 To understand the general means of
sensation
 Outline
① Musculature
② Neurological Structures
③ Functions of the Neuromuscular System
④ Function of the Masticatory System
Mastication
Swallowing
Speech
 Muscles

Motor Unit- basic component

A number of muscle fibers that are
innervated by one motor neuron.
Motor end plate- junction of each
neuron with the muscle fiber
 Muscles con’t…

Activated neurons stimulate the motor

end plate due to the release of
acetylcholine which in initiates
depolarization. This causes shortening
(contraction) of the muscle fibers.
 Muscle Fiber/Motor Neuron Ratio:

Lower: more precise the movement

Example: ciliary muscles, lateral
pterygoid
Higher: less precise, more bulk movement
Example: large muscles such as rectus
femoris or the masseter
 Antagonistic
Arrangement of  Always another
Muscles muscle that
counteracts the
action of another
muscle.
 Establishes a
balance in any
particular muscle
system.
 Muscle Function- can only contract

 3 Types of Function

1. Isotonic contraction
2. Isometric contraction
3. Controlled relaxation
 Isotonic Contraction

 Shortening of a muscle under a constant

load
 Example- contraction of the masseter as
the mandible moves through a bolus of
food.
 Isometric Contraction

 Contraction of a muscle without shortening

 The muscle is used to hold or stabilize
 Example- contraction of the masseter
when statically holding something
between the teeth, such as a pencil
 Controlled Relaxation

 Occurs when stimulation of the muscle is

ceased.
 The fibers of the motor unit relax and return to
their normal length.
 Example: relaxation of the masseter just
prior to the mouth opening to accept a
bolus of food during mastication.
 Eccentic Contraction
 Can be damaging
 Happens when a muscle is lengthened, or
stretched, at the same time it is contracting.
 Example- a sudden force is applied to muscle
group as it is contracted.
 Often seen in whiplash types of incidents
when an outside force causes the sudden
stretch of a contracted muscle group.
 Neurological Structures

Neuron- basic structural unit of the

nervous system
Nerve Fiber- many neurons grouped
together
Parts of the a) Nerve cell body- mass
of protoplasm which
Neuron contains the nucleus.

b) Dendrites- branched
extensions (usually
several) of the cell body,
conduct impulses
TOWARD the cell body.

c) Axon- thin, long

process that conducts
impulse away from the
cell body to another
neuron or tissue.
 2 locations of nerve cell bodies:

1. Within the Central Nervous System (CNS),

they are found in the gray substance of the
spinal cord.
2. Outside the CNS, they are located in
ganglia.
 Neurons are named different terms
depending on their location and function.
 Types of neurons:
 Afferent
 Efferent
 Interneurons
 Sensory (receptor)
 Motor
  Afferent neurons-
conduct the impulse
toward the CNS-
sensory.
Neuron types…  Efferent neurons-
conduct the impulse
away from the CNS
towards the periphery-
motor.
 Interneurons
(internuncial)- conduct
impulses completely
within the CNS- sensory
and motor pathways;
function as connectors
 Sensory Neurons- receive and transmit
from receptor organs
 second and third order sensory neurons are the
interneurons and lie within the CNS.
 Motor Neurons- convey impulses that
produce muscular or secretory effects.
 Synapse

 Synapse is the area at which one neuron

transmits the impulse to another neuron.

 Note- all afferent synapses are within the

gray substance of the CNS. There are no
peripheral connections between sensory
fibers.
Interpretation of sensory information…

Needs to be transferred to higher

centers in the CNS for analysis, either
the brainstem or the cortex.
Exception to this rule-

Reflex pathways that have a connection between

a sensory afferent and an efferent neuron leading
back to the same organ.
 Can be monosynaptic or polysynaptic.
 Response is independent of will- no cortex or
brain stem influence.
 Protective function.
 Higher centers of the CNS:

 Function- to process sensory data then

form an appropriate response.
 2 Main CNS centers:
1. Brainstem
2. Cortex
General brainstem components relating
to masticatory processes:

Spinal Tract Nucleus

Reticular Formation
Thalamus
Hypothalamus
Limbic Structures
 Spinal Tract Nucleus

 Receives input from sensory afferents

within the oral structures.

 Carried by the 5th cranial nerve

(trigeminal)
 In contrast, sensory input from other
areas of the body enters the CNS (spinal
cord) by way of spinal nerves.
 Spinal Tract Nucleus con’t…

 The trigeminal spinal tract nucleus is the

masticatory equivalent of the dorsal horn
of the spinal cord.
 It is through the dorsal horn that sensory
afferents enter the CNS from areas outside the
oral structures.
 Spinal Tract Nucleus con’t…

 Impulses from the trigeminal nerve

synapse with 2nd order neurons in the spinal
tract nucleus within the pons.
 It has more sensory functions but has some
motor outputs, too.
 Reticular Formation

 Transmit impulses through interneurons to

higher centers.
 Monitors impulses (enhancing/inhibiting)
before sending up to the brain.
 Influences sensory input.
 Thalamus

 Central location within the brain.

 Receives nearly all sensory information
from the body before moving to higher
centers.
 Directs these impulses to the proper CNS
areas for appropriate interpretation and
response.
 Hypothalamus

 Small structure located in the base of the

brain.
 Functions:
 Primarily autonomic regulation of
internal body functions such as body
temperature, hunger and thirst.
 Stress can stimulate the hypothalamus
causing increased nociceptive impulses
influencing the brain.
 Limbic System

 Ill defined structures that form the inner

border of the cortex.
 Functions to control emotional and
behavioral activities.
 Anger, rage, docility, depression, anxiety
fear and paranoia.
 Thought to be a pleasure- pain center.
Limbic system stimulation of the
hypothalamus can modify the internal
body functions that are controlled by
the hypothalamus.
It plays a major role in pain problems.
 Cortex
 Outer region of the cerebrum
 Mostly made up of gray matter neural
tissue.
 Responsible for thinking and learning,
requires help from deeper structures of the
brain.
 It is where memories are stored and motor
skills are acquired.
 Average of 6mm thickness.
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Different regions of the cortex have specific functions, many of which have
been mapped out.
 Sensory Receptors

 Neurological structures/organs that provide

information to the CNS through afferent
neurons.
 Relays various information concerning the
status of tissue depending on the type of
sensory stimulation.
 Types of receptors in the masticatory
system…

1. Nociceptors- detect discomfort or pain

2. Proprioceptors- provide information
regarding the position and movement of
the mandible and oral structures.
 4 Types of Masticatory Sensory
Receptors…

1. Muscle Spindles
2. Golgi tendon organs
3. Pacinian corpuscles
4. Nociceptors
 Muscle Spindles

 Skeletal muscles consist of two types of

muscle fibers
1. Extrafusal Fibers- make up the bulk of
the muscle and are contractile.
2. Intrafusal Fibers- make up much less of
the muscle mass and are minutely
contractile.
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Muscle Spindles…
Muscle Spindle- each is composed of intrafusal fibers
bound by a connective tissue sheath.
*Primarily monitor tension within the skeletal
muscles.
*Interspersed and aligned parallel to the extrafusal
fibers within the muscle.
Muscle Spindles…  When the muscle is
elongated the spindle
is stretched,
therefore stimulating
the afferent activity
to the CNS.
 In contracted muscle,
the spindle becomes
slack, therefore
sensory inervation is
not stimulated.
 Muscle Spindle con’t…

 Receive motor efferent stimulus via

gamma efferents from the CNS.
 Cause contraction of the spindles.
2 Ways of Muscle Spindle Stimulation…

1. Generalized stretching of the entire muscle

(extrafusal fibers).
2. Contraction of the intrafusal fibers via
gamma efferents.
A total shutdown of spindle activity
would occur without gamma efferent
output. This efferent activity assists in
maintaining muscle contraction.
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Golgi Tendon Organs

Located in the muscle tendon between the muscle fiber and
bone attachment.
Function to monitor tension.
Receptors are stimulated by tension to the tendon to both
stretching and contraction of the muscle.
Inhibitory effect on efferent motor neurons that protects the
muscle from overcontraction/overstretching.
  Oval organs made
Pacinian up of layers of
connective tissue,
Corpuscles
primarily located in
the joints.
 Perception of
movement and firm
pressure
 Stimulated when
applied pressure
deforms the organs.
 Nociceptors
 Most are stimulated by injury and convey this
information to the CNS via afferents.
 Several types respond to different stimuli:
noxious mechanical, thermal, tactile, and
injury.
 Mechanoreceptors- low thresholds; detect light
touch, pressure and facial hair movements.
 Primary Function of Nociceptors…

 Monitor the condition, position and

movement of the tissues in the masticatory
system.
 Alert the CNS to conditions that are
potentially harmful or have already caused
damage to the tissues.
2 types of masticatory reflex pathways

1. Myotatic
2. Nociceptive
 Myotatic Relfex

 Only monosynaptic jaw reflex

 Stimulated when the muscle fibers of the
masseter are suddenly stretched causing an
afferent response from the spindles.
 Myotatic reflex con’t…

 This response is transmitted to the afferents

cell body located within the brainstem
(trigeminal mesencephalic nucleus).
 A synapse occurs between the afferent and
a motor efferent which sends the stimulus
back towards the masseter.
  This reflex can be
Myotatic relfex
demonstrated by
con’t…
tapping downward
on the chin when
the jaw is relaxed.
 The efferent then
stimulates the
masseter’s
extrafusal fibers
causing it to
contract.
 Muscle Tonus

 Partial contraction of a muscle.

 Myotatic reflex prevents the jaw from
dropping by counteracting the forces of
gravity.
 Muscle tonus con’t…

 Stretching of the muscle spindles

stimulates afferents and therefore causes
the elevator muscles to partially contract.
 This relieves the stretch of the muscle
spindle and establishes a rest position of
the mandible.
 CNS influence

 Higher center can influence the response of

the myotatic reflex.
 The CNS can activate intrafusal muscle fibers
which can lower the response threshold of the
muscle.
 CNS influence con’t…

 Gamma efferent signals from the CNS cause the

intrafusal fibers to contract.
 This lessens the overall muscle stretch required
for the muscle spindles to produce afferent
activity.
 Decrease in gamma efferent activity from the
CNS decreases the myotatic reflex.
 Nociceptive Reflex

 Polysynaptic reflex to noxious stimuli.

 Considered protective.
 Masticatory example:
 Sudden suppression of the elevator
muscles and activation of the opening
muscles when a hard object is contacted
suddenly during a chewing stroke.
  Occurs through antagonistic
inhibition
Nociceptic reflex
con’t…  In the previous example,
sensory afferents within the
PDL respond to the hard
object.
 Impulses are sent to the
trigeminal motor nucleus, two
things occur:
1. Efferents cause the jaw
opening muscles to
contract;
2. Inhibitory interneurons
cause the jaw elevating
muscles to relax.
 Influence from higher centers

 Cortex
 Brainstem
 Central Pattern Generator (CPG)
 Cortex
 Determines most actions to CNS stimulation
 Appropriate response is influenced by the
thalamus, CPG, limbic structures, reticular
formation and the hypothalamus before
acting
 Main area of thought and conscious decision
making
 Brain Stem

 Maintain subconscious body functions and

homeostasis
 Respiration
 Heart rate
 Blood pressure
 Digestion
 Central Patter Generator
(CPG)
 Controls rhythmic muscle activities
 Breathing, walking and chewing
 The CPG allows the process of mastication to
be fine tuned through constant input from the
lips, tongue, teeth and PDL’s to determine an
appropriate chewing stroke.
 This learned pattern is called a muscle
engram.
 Higher Center Influences
 Increased emotional stress- fear, anxiety,
frustration, anger
 Excites gamma efferent system stimulating the
muscle spindles
 This lowers the threshold of muscles making them
more sensitive to reflex actions and external stimuli
 Often increases irrelevant muscle activity- biting
fingernails, clenching or bruxing.
 Primary Functions of the
Masticatory System

 Mastication
 Swallowing
 Speech
 Secondary- respiration and facial
expression
 Mastication

 Rhythmic and controlled separation and closure

of the maxillary and mandibular teeth
 Can be voluntary or involuntary
 Tear-shaped chewing stroke
Opening Phase

Closing Phase

*Crushing

*Grinding

Less lateral movement

as food is broken down.
  Tracing the mandibular
incisors, they move
anterior during opening
Mastication and posterior during
closing.
con’t…
 More lateral movement
initially, then becomes
less as food is broken
down.
 Lateral movement
increases with harder
food, decreases with
softer food.
 The lips, tongue and
cheek work in positioning
the bolus for breakdown
by the teeth.
 Swallowing
 Coordinated movement of the bolus from the oral
cavity into the esophagus, then to the stomach.
 Decision to swallow depends on:
 Fineness of the food
 Intensity of the bolus
 Lubrication of the bolus

 During swallowing:
 Lips are closed
 Teeth brought into MIP stabilizing the mandible
 Types of Swallow

 Somatic- when teeth are present to stabilize the

mandible.
 Visceral- infantile, the mandible is braced by the
tongue placed between the dental arches
 Occurs until posterior teeth erupt
Swallowing  First Stage
 Voluntary, bolus is
formed.
 Bolus position on to
the dorsum of the
tongue and pressed
against the hard
palate.
 Lips sealed, teeth
brought together
 Bolus sent to the
pharynx by the
contraction of the
tongue.
Swallowing  Second Stage
 Peristaltic wave from
the pharyngeal
constrictors carries the
bolus down the
esophagus
 Nasal cavity is sealed
by the rise of the soft
palate touching the
posterior pharyngeal
wall
 The epiglottis covers
the trachea and keeps
the bolus in the
esophagus
  Third Stage
Swallowing  Bolus travels the
length of the
esophagus and
enters the stomach
 Takes
approximately 6 –
7 seconds
 First and second
stage each take
approximately 1
second
 Articulation

 Occurs when a volume of air is forced out of the

lungs
 Contractions and relaxation of the vocal cords
make the pitch
 Precise form assumed by the mouth determines
the resonance and exact articulation of the sound
Relationship of the lips and tongue to
the palate and teeth produce sounds
formed by various letters.
 Sounds…
 M, B and P- the lips come together and touch
 S- incisal edges of the maxillary and mandibular
teeth closely approximate but do not touch. Air
passed between the teeth creates the “s” sound.
 D- tip of the tongue touches the palate directly
behind the incisors
 Th- the tongue touches the maxillary incisors
 F, V- lower lip touches the incisal edges of the
maxillary teeth
 K, G- posterior portion of the tongue rises to touch
the soft palate.
 Conclusion

 The masticatory system is a complex array

of structures which are coordinated at
many levels; the components of which
function together in several processes.
 References
 Okeson JP, Management of Temporomandibular
Disorders and Occlusion, 5th ed, Mosby 2003
 McNeill C, Science and Practice of Occlusion,
Quintessence 1997
 Neuroanatomy and Physiology of Occlusion, MAJ
Richard Ritter, 2004
 Kawamura Y, Neurophysiological Background of
Occlusion, Periodontics, Jul/Aug 1967
 Tortora, Anagnostakos, Principles of Anatomy and
Physiology, 4th ed, Biological Sciences Textbooks, 1983
 Mohl ND, A Textbook of Occlusion, Quintessence, 1988
Me and Christi with our nephew, Micah,
saying goodbye the day we moved to
Georgia…